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18 ROPES ST - BPA-10-349 The Commonwealth of Massachusetts N, I Department of Public Safety NIAtIstchuselts State Building Code(780 CNIR)Seventh Edition City of Salem Building Permit Application for any Building other than a 1-or 2-Family Dwelling (This Section For Official Use Onlv): Building Permit Number: Date Applied: Building Inspector: SECTION 1: LOCATION (Please indicate Block N and Lot 8 for locations for which a street address is not available) 'FP,,R- Ufe,j CCo'1Ao TYLJs-1 XNo. and Street Cih /TownSAM Zip Code 0I 7r2 Ui) Name of Building(if applicable) SECTION 2: PROPOSED WORK If New Construction check here O or check all that apply in the two rows below Existing Buildin Repair Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: k lls✓1 Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ Now' Is an Independent Structural Engineering Peer Review required? Yes ❑ Now Brief Description of Proposed Work: i [/� (f e a) cE (gaAfLShie (A Sul " (tor �Tf 7� (I Ales 30 / n1 stir vht T cFa[f New tJnNA" 54u /-s SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Evaluation is enclosed(See 780 CMR 3402.0) O Existing Use Group(s): Proposed Use Group(s): f Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area(sq. ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2r ❑ A-2nc❑ A-3 ❑ A-4❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional 1-1 ❑ 1-2❑ 1-3❑ 1-4❑ M: Mercantile❑ R: Residential R-10 R- R-3❑ R-4❑ S: Storage S-1 ❑ S-2 ❑ U: Utility ❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ _ IB ❑ IIA ❑ IIBO IIIA ❑ IIIB ❑ 1 IV ❑ VA ❑ VB ❑ SECTION 7:SITE INFORMATION (refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check if outside Flood Zone ❑ Indicate municipal ❑ A trench nvill not be Licensed Disposal Site❑ required O or trench or specify Private❑ or indentifv Zune:_ or on site system ❑ permit is enclosed O Railroad right-of-way: Hazards to Air.Navigation: \I:\ I C,-rttnt-wn \ut \pplicabic ❑ I.titrurture cn ill Ill airport oppmadt area? I. their ree iew completed.' rt C nn>enl lu Budd endo.ed ❑ Yes❑ or.No❑ 1'es ❑ .No ❑ SECTION 8:CONTENT OF CERTIFICA"rE OF OCCUPANCY I[dnion of C Oaie: LIe Gnnip(s): fvpeof Constmdion: Occupant 1_0a11 per Ioor: Does the building contain an Sprinkler ticslem.': Special Stipulations: Gal t 7q6M Af&W41J PUAI n `� i()f bjo c� SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Properly Owner Name(Print) Nu.and Street City/Town zip P,r!�i}�erty Otvner Contact Information: /f�lilL� -Jilrrs2� 9nFr_�-Title Telephone Telephone No. (business) Telephone No. (cell) e-mail address If applicable, the property owner hereby authorizes :Name Street Address Citv/Town State Zip to act on the pro pert% knc ner's behalf, in all matters relative to work authorized by this building permit a >>licatiun. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) (If buildin•is less than 35,tXW cu. It.of enclosed s nice and/or not under Construction Control then check here O and skip Section 10.0 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10_..2/G,eneral Contractor ACM Co pany Name:/ ��1 o v;s .0� [JIZ�UPz_ 4wwsE —1—kn l2r rye Mesv4— /a 3 a 8"9 Name uvi e�a> R puny�ibl)r fucCunstructiun ��� License No. and Type if cable K-L+ o!tCoS SSttrree�et dress - City/To n St at tp Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes O No O SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item - Estimated Costs: (Labor and Materials) Total Construction Cost(from Item 6) _$ 1. Building $ / Building Permit Fee=Total Construction Cost x_(Insert here 2. Electrical $ appropriate municipal factor)_$ 3. Plumbing $ 4. Mechanical (HVAC) $ Note: Minimum fee=$ (contact municipality) 5. Mechanical (Other) $ Enclose check payable to 6. Total Cost $ wZ 00�J. rry (contact municipality)and write check number here SECCIO 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below, I hereby attest tinder the pains and penalties of perjury that all of the information containqthisapplication is true aand accurate to the best of my knowledge and understanding. Please printand sign name Title Telephone N CA,;, I Izr.� iZ,7J o titreet :Address City/T (I tipt , 0 0 d wh O l 3 .Municipal Inspector to fill out this section upon application approval: G / 'ame )ate / 1 �3 z F /37 CITY OF S.U.E.`I, AxSSACHUSETTS BUILDLNG DEPARTIEINT 120 W.►SHLNGTON STREET. 3w FLOOR TEL (978) 745-9595 F.tx(978) 740.99" KI,(gE]tLEY DRISCOLL �LAYOR THObus ST.Mug DmECTOROF Pt.BLIC PROPERTY/BL'ILDLNG CMMUSSIONER Workers' Compensation Insurance Alfldavit: Builders/Contractors/Electricians/Plumbers Applicant Information n/ Please Print Legibly Nalne (susirts�a,Orsannradiomlndavtdual): 1 ""� 'T, r'` , r Address' (/,L( KeS It City/State/Zip: Phone#: -7 S-7 -7 7 1 ——7 LSF Are y to employer?Check the appropriate boa: Type of project(required): 1. Tam a employer with 4• ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or pan-time).• have hired the subcontractors 2.❑ 1 am a sole proprietor are partner- listed an the attached sired t 7. ❑ Remodeling ,hip and have no employees Then sub-contractors have S. ❑Demolition working for me in any capacity. worker'comp.insuraooe. 9. ❑Building addition [No workers' comp. insurance S. ❑ We are a corporation and its officers have exercised their 10.0 Electrical repair are additions required.] 3.❑ 1 am a homeowner doing;all work right of exemprion per MGL 11.Q Plumbing repairs or additions myself.(No workers'comp. C. 132.§1(41 and we have no 12.0 Roof repairs insurance required.] t employees. (No waiter' 13.❑Other, comp. insurance required.] -Any applicaat that checks hot al mdatt A"fin and the nation below showing their workers•compemudow policy ittfamdaloa 'I fi Incuwners who submit thin affidavit indicting they aer doing all work and them him ouwide eemtmwems most"limb a now antdsvir indicating suck {„mm "n that chock dus boa ratted aeaehod an additional And showing the IOme of the a la wm motto and Ack workrat'Camp,policy infxossuem. /una as eap/oyer that&preWalling wo Mora'rotapenrasloa Insurance for day smp/uyses, Brlow is(IN Policy andm list injormulion, ^/ Insurance Company Name:,�IL — � �r�`��`e-r lu ! Policy 4 or Self-ins. Lic.q: C y 5- / �� r� [�T— Expiration Date: 2Z—ZO%U Job Sire Address: J Ora e C City/StawiZip: Sri � ,%ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Scction 23A of MGL c. 132 can lead to the imposition of criminal penalties of■ nine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fins ,tf up to S230.00 a day against the violator. Ik advised that a copy of this statement maybe rorwarded to the Office of Invcaugatiuns of the DIA for insurance coverage verilicatiun. ' /da herr a n ' nadir the a an nakln of perjury that that informalloa Providrd above is true and correct, G,17 t r ' pate: Phone Ofcial wr only. Do nor wrife in this areas a bat cutrrpleted by city or town o/flriar! City are town: _ eermiul3cense I Issuing Aulhurily (circle une): -- - — I. Ituard of Health 2. Ruilding Department I Cityrrown Clerk J. Electrical Inspector 5. Plumbing Impactor 6. Other 1.smart rerson. _ ._. _.. Phones: CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT \I'+n-N 120 W%ill[M.;ON$INLET �.\IrM,S1.Ni.\t ill itI +:I'1 '1'r.1 478•N '),y$ 1:.\X:978-7449846 Construction Debris Disposal Affidavit (required lur all denwlition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit _ is issued with the condition that the debris resulting from this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be trans/ported by: Ila of haular) 'file debris will be disposed of in : ��liG,me ut au uy) ' //494'i-s Lc<t�,�cdal �, vyrH, laddrexs of laaluy) � IIafO 11elllllt all ! date i�. H.G.M. INDUSTRIES INCORPORATED Commercial-Residential Roofing P.O. Box 333 ROWLEY,MA 01969 TELEPHONE (781)771-7859 FAX (978)914-6712 . ............................................................................................................................................................ • Fairview Condo Trust Att: Mike Ruvisio August 26, 2009 • 18 Ropes St. • Salem ,MA 01970 ( 978) 621 - 5475 ( Fax # 508 - 490 - 9408) • ITEM : Roofing , Gutters with Downspouts and Soffits • PROJECT : Main Building ( Rear Porch Not included ) • 1. Roofing and Flashing ( REVISED PROPOSAL ) • Scope of work includes; • • Strip off all existing asphalt roofing shingles and dispose of properly and legally. • • Inspect existing roof deck boards for rot, replace as required ( Limited ) . • • Install new 36" Ice and water shield to all eve edges of roof areas and around chimney. • • Install new 15#felt paper( Roofers felt)to all remaining roof deck boards. • • Install new ( 8" ) aluminum drip edge to all Eve edges of roof areas. • • Install new 30 year Architectural roofing shingles to all roof areas . • • Install new aluminum flashing flanges to all pipes located on roof areas. • • Install new Lead to existing Brick chimney and seal to new roofing system. • • Remove existing front sky-lite curb and board in as required , Rear sky- lite to remain. • • Clean all debris pertaining to roofing work on a daily basis. • Total Cost for Roofing : $8, 500. 00 • 2. Aluminum Gutters with Downspouts ; • • Remove all existing wooden gutters and old metal Down spouts. • • Spot repair existing wood fascia and cover with pre- bent white aluminum coil stock. • • Install new Seamless ( white )Aluminum gutters with outside corners. • • Install new 2"x 3"Aluminum Downspouts at ( 4 ) existing locations. • Total Cost for Gutters : $ 1, 500. 00 • Total Cost for Coil cover$ 1, 000. 00 • 3. So)tted , ing ; • • ?Install I J-Trim and new 12"Vinyl soffitt panels to all soffitt areas on Main house Total Cost for Vinyl soffitt$ 1,000. 00 S Acce ce y • r - date 2-1-09 • Lou' L. V qu P.M. i stee • R ing C ntra or Property Personell act7R0® CERTIFICATE OF LIABILITY INSURANCE 10/1N3/200VDD/YY 10/19 PRODUCER (978)223-4037 FAX: (978)223-4038 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Nicholas -A. Consoles Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 153 Andover Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Unit 208 - Danvers MA 01923 - INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Northland Insurance Company HGM Industries Inc. f INSURER g:Safety Insurance Company 1 39454 P 0 Box 54 INSURERC:ACE Property & Casualty ' I INSURER D: GeorgetOP/n MA 01833 INSURER I COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OFSUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR'ADD'LT POLICY NUMBER POLICYEFFp CTIYiW DATE MM DD TIONIT LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 COMMERCIAL GE^: W _ DAMAGE — ER�A�L�LL�ARII-ITu. PRFMIg'cS(Ea ccc��.re„-�1 $ 51 000 A CLAIMS MADE I n l OCCUR IWSO40741 9/13/2009 9/13/2010 MED I(Any one person)_ $ 5,000 _ PERSONAL&ADV INJURY $ 11000,000 _ GENERAL AGGREGATE $ 2,000,000 GGEEN'L AGGREGATE LIMIT APPLIES PER: I�PRODUCTS-COMP/OP AGG �$ 2,000,000 LOT lC POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ALL OWNED AUTOS 62043.54 — �_ ANY AUTO (Ea accident) IrX SCHEDULED AUTOS 11/1/2008 11/1/2009 goDILV INJURY $ 250,000 B I- (Perperson) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS ! sill (Per accident)___ 500_000 I — PROPERTY DAMAGE $ 250,000 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC _$ AUTO ONLY'. AGG $ _EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE l$ rOCCUR 17 CLAIMS MADE AGGREGATE $ I $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION ., WC STATU- OTH- C AND EMPLOYERS'LIABILITY �__ ORY LIMITS ER ANY PROPRIFTORIPARTNFR/Fy,Fr11TIVF_ r� q11 - A,_H PI..QI^B:`v'T g _ 500;_nnn_ OFFICEWMEMBER EXCLUDF_Ot -- (Mandatory inNH) C45796863 9/22/2009 9/22/2010 E.L DISEASE-EAEMPLOYEF-I $$ 00,000 If yes,describe under � — SPECIAL PROVISIONS below E L DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town Of Marblehead DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Attn: Building Dept. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 188 Washington Street Marblehead, MA 01945 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE N Consoles/GAIL - ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200901) The ACORD name and logo are registered marks of ACORD