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20 RAYMOND AVE - BUILDING INSPECTION B6j"-of Bieildlrtg.Kegulutions and Massachusetts tstatd-',Bu ldmg Cade 780 CMR 7 t edtdon z 75A FyyE AIt _pW!c. .4., !d-n— JMo—. A ronstruct. e- ia rzRenovate ...... C1 cud l t' n f", F- X., uii Al Signature kq� 7, . .... f L, putt 4 wi Property ................. j, Axlwii siio -1-7i 'I -g! SECTIONZe .............. ... ..... ..... o N"m -M �77 it OOUP Detnohtion MCI F, Description... ........... ............ amt, J fitatcd Co OflkwM n ON—NI'll Q Total Project Cosh(Item 6)tc..... ..... 3PlumbtPBi $ r �`OtherFees 3 ' �° g t� g,� Ek. 7 t =tt 7 Z i; 'A ro Cosh ._ject,r, O -0-11-41--'�'�,�,-,� a Q Outstanding Bniwrce P A, F, "'.AR'R.' ;;'Wow A gw� Q SECT.1(3N:S.ttCONSTRUCTIONzSER-VICES- ' ' ;W� rr 5 M Oi SO#ervbqr(CSWNfit. qp "g-w�ym-, y'll- t. TAT U �, lywwwtljhgQ,�� - R __ I�11 A P; gy IV MMJiS 5 g 7� -v' Q&A Xtttt :qqyywm H.-W I F �g Ono" OR, Z Mir It dfifrgi 610*Mv ............ ".. .. E I -_11359 Co WR M WFIr 0z" — - � k COMPENSATION INSURNMEAMDAV17(MGiW' ICMW3SW(Q)� .. - Y'it rat Workers'Coiupensution Insurance affidavit mus`t"�completed undts�ubmlRed wuh this eppl(canun. Failure n pri�vtde" " ................. RRMW.1 of the- hereby- f touetwrmy behalf in all matters MUM, Sk- workauthorized byMIS-Dullatnglpf. ............... .................... l..; ZL E ....... UTHORIM' LA-b" that theslntements and information on the fore mg'apph�t(on are true Dad accurate to tbb best of my'kh' JW -bid' No AM QJQQ AM Em(S under the us -411 .............. PMM -'d 'his/her-' -will not hove OWthe7ilC- MW0- 1 'Wor 4ST plunged provide W orffm owbiftW: en's., MMUMMlloth i'pj (M.t* rl i A 4_wl th. A I ffich Atticsy d ee- -OK Ore l- � t ,Type of gaoling system........ ...... i� � 3-' "I,otnl Project Square Foo[age--tnay 6esubsbtutedafor;�I'otul Protect Costa ` � ' _ 4`�y r A ,A � . �� L �+t}�} �� i�� I e � /! ' r t i CITY OF S.0 ENL 4 iNv'LkSSACHUSETTS BUILDING DEPAEL ENT 130 W♦SHINGTON STREET,3'n FLOOR of TEL (978) 745-9595 FAX(978) 740-9846 Kl\ffiFRi RY DRISCOII MAYOR THOnus ST.PIERRH DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AP1111k2rit information I Please Print Le ibl Name(Businc aOrganiration/individual): v V Address: '' 11 � City/State/Zip: N Phone#: w 3- 3q`tJ (�- q Are yo n employer?Cheek the appropriate box: Type or project(required): 1.El I am a employer with 9 4. 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).' have hired the subcontractors 2_❑ 1 am a sole proprietor or partner- listed on the attached sheet t 7. 0 Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity, workers' comp. insurance. 9, 0 Building addition (No workers'comp. insurance 5. We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3,0 1 am a homeowner doing all work right of exemption per MGL I LEI P mg repairs or additions myself[No workers'comp. C. 152,§1(4),and we have no 12. Roof repel' insurance required.)t employees. nc workers' 13. Other 1 on comp. insurance required.) •Any applicant that checks boa 81 most also rill out the sectica below showing their wotkes'compensation policy infutmarim t I fnmwrwnera who submit this affidavit indicating they are doing all work and thin hire outside contractors most submit a new affidavit indicating suck :Contmetots that check this box musk anached an additional abed showing the name of kite subcon actors and their worke t'comp.policy infamatim lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. T Insurance Company Name: J •L(�/� / Policy#or Self-ins.Lis N:j.��LUC'n-n,1�1ii�L/ I'�,'D — lP ' Expiration Date: Job Site Address: ,�y L t GG1 i'/`f d Yi1 W City/State/Zip: Attacb a copy of the workers'compensation policy declaration page(showing the policy number and explradon date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations orthe DIA for insurance coverage verification. !do here certify under the of and penoldes of perjury that the information provided above is true and correeL ' ;t Date: 513 U Phone �3 Official use only. Do not write in this area,to be completed by city or town oflxh f City or Town: Permit/Idcense# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.Cilyffown Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone#: CITY OF S.U.E. i, Axss.kCHUSETTS • BUMDING D EPA RLII&NT • 130 WASHNGTON STREET,3'0 FLOOR TEL (978) 745-9595 FAX(978) 740-9846 IOhtgFRT RY DRISCOLL MAYOR THOhtAS ST.PIERRS DIRECTOR OF PUBLIC PROPERTY/BUUMLNG COMUSSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions ofMGL c 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: (name of hauler) The debris will bnnell disposed of in : E UW (name of facility) (abdress of facility) I signal of permit applicant Ala I� date debriulydoe a DM CONSTRUCTION 85 FAETER RD. SOUTH HER NId''H'ON, Nit. 03827 603-394-9944 OFFICE 603-.394-8004 FAX 4/14/08 CLAY VENTRE 20 RAYMOND AVE. SALEM,MA- STI21P&RE ROOFF-MAIN HOUSE,CHEEKS & RABBIT RUN fflLX.LA55 SJ'ST M- FRONT& BACK PORCHES We hereby propose to fiunish all labor necessary for the completion of work at THE ABOVE ADDRESS. please see attached invoice:for job specifications. Ail work performed by us is guaranteed against workmanship for a period of two(2)years from acceptanc?date. Any defects becoming evident during period of guarantee, upe.n written notice of the dwelling owner,shall be promptly repaired at no additional cost to the dwelling owner. Includes 30 year material warranty form shingle distributor. All material is guaranteed to he as specified,and the above mentioned work to be performed in accordance Willi specifications submitted for above wort:and completed in a professional manner I&the sum of: $7,250.00- STRIP&RE-ROOF-ASPHALT SHINGLES $1,475,00-POLYGL.ASS SYSTEM -FRONT PORCHES $975.00-POLYGLASS SYSTEM-RACK PORCHES *INCLUDES LABOR,MATERIAL,& DEBRIS REMOVAL *SEE ATTACHED SHEET FOR JOB SPECIFICATIONS&PRICE BREAKDOWN Anv alteration or deviation from above specifications involving extra costs,will be executed only upon written request or verbally,and will become an extra charge to dre dwelling owner. Workers Compensation and Liability insurance to he supplied by din construction upon request. A 20%deposit is requircei from dwelling owner before job start date. Balance due upon job completion. *Please remove ail gardening and/or yard decorations from perimeter of dwelling. Please remove any valuable decorstions/bangings from walls inside home and any valu,abics in the attic Should be removed or covered. Dh4 Construction is not responsible for these items getting damaged during the work performed at the owners dwelling. Respectfully submitted: Dawn Melansou-Owner —�� — --- Note: this proposal may be withdrawn if not accepted within 30 days. Th�etro92tisalbpi ng_er1& ylatmd befitre tow or gserfot'ated. ACCEPTANCE OF PROPOSAL The above prices,specifications,&couditions are satisfactory and are hereby accepted. OM Construction is authorized to do the work as specified by code. Payment will be made as outlined above. Pl EASE MAKF,-CIIB CK PAPA&1�To DAWN MELANSON pp Signature _-- ._ 1 ©1 _. _ _.__�.----..__-------.._—_ ate__-- -Date -- Signature .� _ �_ UT?_--- DM CONSTRUCTION 85 EXE TER RD. SOO'I'lt &1A.MPTON, NM 03827 603-394-9944 OFFICE 603-394-8004 FAX 4!14l0S CLAY VENTRE 20 RAYMOND AVE. SALEM,MA. STRIP& RE-ROOF"-MAIN HOUSE,CHEEKS& RABBIT RUN PROTECT LANDSCAPE&DWELLING STRIP&REMOVE ALL ROOFING MATERIALS INSTALL 8" DRIP EDGE INSTALL 6' ICE& WATER SHIELD INSTALL 15 LB FELT INSTALL 30 YEAR ARCHITECTURAL SHINGLES INSTALL RLDGE VENT INSTALL CAP REPLACE VENT PIPE FLANGE IF NEEDED INCLUDES LABOR,MATERIAL,& DEBRIS REMOVAL PLEASE REMOVE ALL GARDENING ANDItilt YARD DECORATIONS FROM PERIMETER OF DWELLING PLEASE REMOVE ANY VALUABLE WALL HANGINGS FROM INSIDE WALLS TOTAL: $7,250.00 IDM CONSTRUCTION 85 EXETER R D. SOUTH HAMPTON, Nit. 03827 603•-394-9944 OFFICE: 603-394-8004 FAX 4/14/08 CLAY VENTICE 20RAYMOND AVE, SALEM,MA. POLYGLASS ROOF SVSTEM-FRONT& BACK PORCHES (PLAT ROOFS) STRIP& REMOVE ALL ROOFING MATERIALS RENAIL LOOSE ROOF DECKING -IF NEEDEiD I;4STALL POLYGI.ASS BASE SI IF.ET W NAILS ADHERE TOP POLYGLASS SHEET TO BASE SHEET W/BONDING ADHESIVE INSTAL[..LDC3E METAL,FLASHING INCLUDES LABOR,MATERIAL,& DEBRIS REMOVAL ALL APPLICATIONS TO BE PER rdANUF'AC:TUREICS SPECIFICATIONS TOTAL: S1,475.00-FRONTPORCHE:S S87100-BACK PORC_UE:S c. J 1pw� DM CONSTRUCTION 85 EXE.TF:R NA SOUTtli IIANIP EON, NH. 03827 4/14/08 CLAY VENTURE. 20 RAYMOND AVE SALEM, MA. A k ,1 S d)Ni SFiAICE`4D3iNC' S�'ST„ Nt - S7'RiP Ra.RESIDE.-MA1N HOUSE iaTRA - INSULATION BOARDS& SIDE.WALL WORK We hereby propose to furnish oll labor necessary for the completion of work AT THE ABOVE, ADDRESS. please see attached invoice for job specifications. All work performed by its is guaraanemi against workmanship for a period of two(_>)years from acceptance date. Any defects becoming evident during period of gurirantxe,upon written notice of homeowner,shall be promptly repaired at no additional cost to the home owner. Includes 30 year material warranty from shingle distributor. All material is guaranteed to be as specified,and the above mentioned work to be performed in accordance with specifications submitted for above work and completed in a professional manner for the sum of: $3,850.00-SIDNG SYSTEM - MAIN HOUSE EXTRA: r,50A0- INSULATION BOARDS $950.00-SIDEWALL WORK "SEE ATTACHED SliEE'f FOR JOB SPECIFICATIONS& PRICE BREAKDOWN Any alteration or deviation from above specifications involving extra costs, will be executed only upon written request or verbally,and will become an extra charge to the homeowner. Workers Compensation and Liability insurance to be supplied by DM Construction upon request. A deposit is required from homeowner before job start date. Balance due upon completion of job. `Please remove all gardening and/or yard decorations from perimeter of dwelling. Please remove any valuable decorations/hangings from walls inside home and say valuables In the attic should be removed or covered. DM Construction is not responsible for these items getting damaged during the work performed at the homeowners dwelling. Respectfully submitted: Dawn Mehtnsou-Owner Neste:this proposal may be withdrawn if not accepted within 30 days. Th nr ui�nsul must be slencd& +igLed before nv worts 1.-syer oral -------- - --------------------- ._-._ - ---_- - A.CCEP"TANCE OF PROPOSAL The above prices,specifications,&conditions are satisfactory and are hereby accepted. DM Construction is authorised to do the work as specified by code. payment will be made as outlined above. PLEASE NL&USHE K PAYABLE TO DAWN MELANS Signature_ - ------.---------___----Date Signature__ I Date:6Ll — OFFICE FAX 603-394-9944 603-394-8004 J DNII CONSTRUCTION 85 EXETER RD. SOUTH TIA.,YIPTON, NIL O3H27 arr aqua CLAY VENTURE 20 RAYMOND AVE SALEM,MA. IMPRESSION SHAKES SIDING SYSTEM - STRIP& RESIDE MAIN HOUSE STRIP&REMOVE ALL WOOD SHAKES SIDING MATERIALS RE-NAIL ANY LOOSE.BOARDS INSTALL TYVEK HOUSE WRAP INSTALL STARTER STRIPS INSTALL J CHANNEL UNDER SILL TRIM WHERE NFEDED INST,%ll GREEN rMPRESSION SliAKES SIDING INSTALL CORNIER PIECES INCLUDES LABOR,MATERIAL, & DEBRIS REMOVAL ALL APPLICATIONS TO HE PER MANUFACTURERS SPECIFICATIONS TOTAL: $3,850.00 OFFICE FAX 603-394-9944 603-394-8004 DM CONSTRUCTION 85R ` ETERIR -D. soU'TIR IRA.11rIPT4IN, SH. 03827 4/14108 CLAY VENTURF IM RAYMOND AVE SALEM, MA. IMPRESSION SIIAICF.S SIDING. SYSTEM__STRIP& RESIDE L TKAS INSTALL SHEETS OF 3i8"FAN STYLE DOW RIGID FOAM INSULATION BOARD OVER ENTIRE EXTERIOR WALL PRIOR T`O SIDIN''G (TO ASSIST IN TAKING OUT WALL LMPE'RF CTIONS& ADDS INSULATING VALUE) DOTAL: $750.00 INSTALL ICE&WATER SHIELD UP:IILILWALLS INSTALL.NEW STEP FLASHING BEND& INSTALL WHITE COIL.STOCK AL..ONG TOP OF FP.('IN'T& BACK PORCHES, ALONG 'TOP OF CHEEKS ON LEFT& RIGHT SIDE OF HOUSE, &ANY OYLIER NECESSARY AREAS TOTAL: $950.00 INCLUDES LABOR, MATERIAL,& DEBRIS REMOVAL ALL APPLICATIONS TO BE PER MANUFACTURERS SPECIFICATIONS TOTAL: $1,700.00 OFFICE. FAX 603-394-9944 603-394-8004 011,31/2006 11:16 FAS 19766333147 M.P.ROBERTS INSLBAIXE @001 AMQ- CERTIFICATE OF LIABILITY INSURANCE ! i%3ii oo8a FROOlA91 :XIS CERTBICATE 16 MWED AS A MATTER CP EIPORMATION M.P. ROBERTS INS AGCY I= a0T AND GONE —' ND WOMB 1DON ME CERTMAM 1d60 Oa4oa1 Street HOLDER. THIS CBRTIFI[A58 D096 NOT AMEXD. EMEND OR L ALTOR THE COYFJSW AFFORDED IW THE PON IPMS 6ELOW, North Andover, MA 01845 f" 7 (978)683-8073 WSNRm FFO ES ANC:XO COVERale MAC$ :swseo D.M. CONSTRVCTI04T _ B.O. LOX 1602 ire: I I 98ABROOR, MR 03874 ;W,ISBna C. a �-- --- ^�----'I CavesAAeS TMEiO_IC:ESD-1R51'RANGFUSTED LEUWIHAVT WEN IeGk�T-fHE INSIMJ R.WW ABOVE FOR'.lPCIrY Ml CO MCAi� lOiWMWr.WVAG ANT REOVIREWAT,TD OR CONCITivt OF eVT CORTF/wT OR C:RM f-R 70Cs::rENI WNe:R rRq ceRY:s;:ATE Info B!IBBytT3 CR MAY PERTA!!,THE MBVRANCE,4'Fq 0 67 THE r010M DESMMq UAW 15 fe LC`M ML ME MRNh alLM0,43 Mt-CONO.'YIORS r<tWCN NOtAybS.AG^wZuD?'S LUTSMA"AU "Vi KfiN R6OVCia BY 4fIJCIAR6 t°tn �M,NFJRaIc! —'•---.•.-- uY vJ.C,(-..TiitTfSJ � .MY � P.Td4�•NAMW � M'IEM.:IY1"ry! ^W�`1.S9M R ma t 1000 000 1 8 aawacfu.ameRuss+Bsm FRBBRx6 E.°wbstl s 50,000 aArseR iXIe:axl EXCLUDED A, I_ 1 3CY4175 - 01/26/08 01/26/09 •RFwFRnsauY,asnr s 1 000 000 IffnkFK fcsrlocs+E 's 2,000,000 , j ae3N.w�saria�.wn,er aNs: 1 Nseattsa>«Paares; s 1.000,000 Imo' PIRIWRv'�YltT 1�1'EMD BMNFtMFT �! °eLYLI AU RVM I ! ®xrwVw ; 1'— ummullAwsoa I ! i I��°41s :s RNFA:WIM iiWITNM/ I, � 1 I I „' i I �marlantAR,ae t 1 CiRIBi ItIB°lTY �XJYuOKv.4Y"G]FI/T t I fRIAIRC 1 ru.Kamw J'�' r I AMMr. nee s �azswrFxu tF-1 F,n vsiwcRw s j..-xcTrt L;auAAsuoe i � � I ssrecnTE t I I , I VYNe(fJ10MRCYf.F�rKNge 1 —� ��° A . I T— i:CAY/LIIMR � 4 i rmunve FRf.e,al.meesr .s 50c,0001 D W' "ffi°4w IWC 984-03-61 ' 01/26/Oe 101/26/09 1 Fl,=l .ueertAEe !! 300,0001 a�e.Nn. Bt asewE-.a+crws.l 600,000 I I i asplr,roNwualnscanou-cevva.nsa.�xw�.m®cTsaaowaueln:alea.l.mowelon i FAX: 503--394-8004 CMRt GATE XOLZM CANCELLATbM _ p^ eIIF1.w ANTw eO NFS,e ebFll'#lB RhGiWlel G,M21.lDBliGER1F 11PlIM� qs-�j TRIO CERTIFI CAT$ HAS BBBN ISSUBO e e,Rsaar.n.RuwB RBYRB ena s+mnwe m sn _n s vmex I� FOR INFORMATION PURPOSES ONLY. NSBtE ro+RE csEtrlx.TE RfAOER RusinmrsA lvr.sur=AssFs rA a>earwi ORIGnIAL CERTIFICATES OF R�!'m saan:Kr.a usttun a wR Arm VKp rRe NN.tR31.rta,Bvsl!sn INBURAMM MUST BE REQUESTED AND 1 R@,6FpT„l,e. •liRalY80 RAt6MA+M ISSIMM BY OUR OFFICR. ACORD?LWOS) 6ACORD CORPORAMN ISSO Boar o ull mg egulat3ons an tan Ts One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement'Contractor Registration Registration: 1569M _ Type: DBA ' - - . -. Expiration: 820t2009 Tro 251FISO DAUN MELANSON CONSTRUCTION DAUN MELANSON P.O. BOX 1602 SEABROOK, NH 03874 7 T Update Address aad return card Mark rewoo for choose. 7 address —1 Renewal F Empluyraeat L Log Card Oa W, a soM�ra--�uoo R - - r 1 ,,�" j � �,/'", � i ,, I