12 RICE ST - BUILDING INSPECTION --- I'he C'onununar;dth ut,biassaehuseus
/ y a Board of Building Regulations and Slandards Cl 11' OF
sI ;" "lIs.saelmtsctts Slap Building Cute, 7y0 C NIR SALI:\l
Building Permit Application 'ro C'onstrucL Repair, Renovate Or Demolish a
Orw-or Two-Pionill-Dmel(irrp
This Section For Olrcial Use Onl
Building Permit Number: Date Ap '
i
Building Otlieial(Print N une) Si ature [Mg
SECTION It SITE INFORAI I
I Property Addre 1.2 Assessors flap parcel Number
12 RIGS S 5'�1�( M44
I.la Is this an acce led street?yes �r no Map Number Purcel Number
1.3 Zoning Information: 1.4 Property Dimensions.-
Lun(ng Dirlrict I'ropuscd Bse Lot Arco(sq 11) Frontage(it)
1.5 Building Setbacks(R)
Front Yurd Side Yards Rear Yard
Required Pruvidcd Required Provided Required Provided
1.6 Water Supply:(M.G.I.e. 40.154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone?
Chock if es0 Municipal❑ On sit*disposal s)Slum ❑
SECTION2: PROPERTY OWNERSHIP'
Owners of Roe rd:
N;unc(Prim) (t).Sl4la.l.Ir /
l2 ICE ejtfe g72f NIPS 1o�7�f ,1`f�(CStl rg(a /'r eiivcI
No.and Strout r0cphone hlnail Address he�
SECTION l: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ E isti:sy Building❑ Owner•Occupied ❑ "111:1��i I Alteratlon(s) ❑ Addition e
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specily:
Brief Description of Proposed work-:
u d n}tw U EYM4 C✓ F Ed tWrlcylR P 2 f3rovn S�
A a n 10 r)o ZE S t E ul It Seri r2i S P2 u t
- - —
SECTION a: ESTBLATED CONSTRICTION COSTS
ltum Estimated Costs: pfilclul Use Only I Libor and.\laterials) y
I Building S r f�(yK I. Building Permit Fee: S Indicate how fee is determined:
2. lacctrical S ❑Standard Cify:Tuwn Application Fee
❑Tutal Project Cost I Item 6).v multiplier
1 1 1'lumhing S
_. Usher Fees; S.
a. \Ic:h.mic.d ill\ W) S Lit::
�,qy+ressiuni S roral .\II Fces: S a -'
�• Foul project Curt S 16&) `'/C10o ('heal No.
CC -- ❑P.tiJ m F'ull 0 Outstanding B.tl:mee Doc:
J �" c:A s`T I'17:`j7CrA;r L4;v c�uJ'TtiL -30CA
�oziio t,1 P_I`S' r �-•� .G( ea f`� 23
SFAA[ON 5! ('ONSfittici-IONSIl FA
S.I ('orwiluclitill Supen isor AA kill License(CSI-)
Npinitioll
......
PC
ti
No. mid.sil it Ilamstrioctlillkilldill-3 t to 34,000'll.
l4c,imted 1&-, 1.11110) 1)%%Cllill1
R( Hlalin Gus Grin
-
'A S lilil sidill
SF sulid Fuel 11limills %Flplijjlce3
I lillitilul
D Mill
l'cic bona
6,2 Registered lionit Improvamenl Contractor(1110
Njil I:Npiratioll Date
No. md Sad
Ci n State ZIP ro
e hung
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 192.1 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the issuance of the building permit.
Signed Affidavit Attached? yes.......... C! No...........
iq ;70 lilt,I'll MEN' flioRiZATION TO BE Caltill WHEN
3L%l r .OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize
to act on my bill in all matters relative to work authorized by this building permit application.
Print Owner's N,ne(EIcclrQ,lc tinulure) RATION
SECTION 7b:OWNER' OR ZED AGENT DECLARATION
By entering my Maine below, I hereby attest under the pains and penalties of Pedl that all of the information
his a I' l* , true and accurate to the best of my knowledge and understandin7.
-S-�t pp'ca I
K/ ale
7
-tjoic Slglwl
NOTES:
owner whohires-it, ullrellistered cunlractot
building permit to do his.heramn work.arin W ef
I An Owner who obtains a
(tot registered in the Hullic 1111provellient Contractor tHIC) Program).will no have access to the arbitration
program or guur,1114 fund under.M.G.L.c. 141A, Othcr important information on the HIC Program can bte ftluild at
Information on the Construction Supervisor License can be round at—11% !;!'N 'It"
2. N bars substantialwork is p1jill 7LJ.pruN ide the Inlornintionding g bclobasement1 incluarngt. linishcbasement attics,decks or porch)
rota) dour area liq. 11 f 1abitablc room count . .. . . .
(;r,,jjli\ing area l54. t I Number of bedrooms
\III 1,tcr of llrcjllaces Nulliticr ill liall,h;1111i
\,,t,i,eroi hathl \,inticl lj,jrjlcS
I* pa al lic.1ting S)item .01'ell
I S.%009
1 ImA ilrojc,t \tjtjarc lggl,lLe riot be kcal llrojeO O)A
A fin,
85 Constitution Lane
K. Professional Profiles Inc. Danvers,5MA01923
(978) 774-0022
s , FAX: (978) 750-9838
Receipt for 12 Rice Street Temporary Handicap Ramp
From:
Lucy Silva
12 Rice Street
Salem,Ma 01970
Deposit Amount Paid $2000.00
Check Number 30057959 7/30/2012
Deposit considered acceptance of estimate and confirmation for job start.
Job scheduled for August 6, 2012
Douglas Dalke
TLC
Mass oC nstruction Supervisor lic# CS 095124 exp 05/20/2014
Ned Kittredge
From: Jack Silva iJacksilvag@comcast.net]
Sent: Friday, July 27, 2012 3:14 PM
To: Ned Kittredge
Subject: Re: Ramp Estimate
Ned,
I spoke with my parents today. They do want you to build the ramp for them.
I hope to deliver the deposit($2000.00) to your office on Monday afternoon(7/30).
Thanks again,
Jack SIlva
r "
On Jul 26, 2012, at 5:26 PM,Ned Kittredge wrote:
This is an estimate for Professional Profiles Inc to build a free standing, temporary,wheelchair accessible ramp for
Anthony Silva into the rear door at 12 Rice St.Salem MA.
This ramp will be made up of four sections that are bolted together. The sections consist of:
1. One 4' by 5' landing outside of the back door
2. One 4' by 15' ramp section (running from back door to corner of the house)
3. One 4' by 4' landing with a right turn
4. One 10'to 12' ramp section (running from corner landing to end of driveway)
Final length may vary due to final fitting to keep correct pitch
This estimate includes all materials, pressure treated lumber, permits, dump fees and all labor.
Estimate:$3500.00 to$4000.00
Upon acceptance of this estimate Professional Profiles will require a deposit of$2000.00. Balance to be paid upon
completion.
Once we have received the deposit we will submit our drawings to the Salem Building Dept for approval or completion
of the permit if required. Once we have approval we will need up to 5 days to schedule the project and the project
should take approximately 2 to 3 days to complete with good weather.
Should you have any further q uestions please do not hesitate to contact me directly.
Ned Kittredge
Vice President
Professional Profiles Inc
t
CITY OF S.IL&Nr, ttiLkSS.+CH[:SETTS
JL'LDLVC DEP.IATILPNr
I 20 7UHNGTON STIEXr, JwFZCCR
It?1. (97� 74J.939!
KIACHRI Y DUXOL.L FAX(973) 749344
MAYOlt fHo uu St Pttittts
0"UTC&OP Pl8L1C PROP!taTY/BCQACYC CO.%MISsIONEIt
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In seeefdanee with the sixth Oebris, edition of the State Building Code, 730 CUR section III.J
and the provisions of MGL c 40, S 54;
Building Permit Ai is issued with the condition that the debris resulting from
this work shall be disposed of in
11 I, S IJOA. a properly licroscd waste disposal facility as defined by NjGL c
The debris will be transported by:
�ro I St' 1) r6
(n4me ul haular�� ��
is mollyfAtq5Cr Stv+bV)
The debris wi II be disposed of in : ?f '33
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Massachusetts -Department of Public Safety'
Board of Building Regulations and Standards
Construction Supen'isor
License: CS-095124
DOUGypS E DES j c
P.O.BOX 38 € _ .�
Hampton NH 0343 mf
'Expiration
J.� 05120/2014
Commissioner
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