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American Properties Team, Inc. /\
TO: Harvey Calichman—21) Russell Drive
FROM: Jill Fama, Property Manager
RE: Deck Repairs/ Replacement
P
DATE: January 30, 2006
Please be advised, the Rnird of Tnistees for PickM.M Park dries not object to the
replacement of your deck. Please be advised;you may not cliange the dimensions of the
existing deck. A licensed contractor must replace the deck. A permit must be pulled
prior to this work commencing. A copy of the permit should be sent to me. Once the
work is complete and the Building Inspector has signed off on this work, a signed copy of
the building permit will be required as well.
Please be advised, the Association will reimburse you or pay your contractor directly to
install flashing between the deck and building. This is typically approximately $75.00.
I am including a copy of the original deck staining list; however, it may behoove you to
try to match the building color as they may have changed slightly since this last
publication.
Should you have any questions or concerns, please feel free to call me directly.
cc: Salem Building Dept.
500 WEST CUMMINGS PARK • SUITE 6050 • WOBURN • MA • 01801 • 781-935-4200 • FAX 781-935-4289
r
DECK COLORS AND PROCEDURES
NEW DECKS:
1. Pressure treated material should be allowed to dry per manufacturer's
recommendations. All other types of woods should be lightly sanded in order to
remove any potential mill glaze.
2. Apply one coat of oil based clear decking stain. As always, follow manufacture's
instructions.
EXISTING DECKS:
1. Scrape and/or sand any peeling or blistering paint. -
2. Wash with a solution of 3 parts water to 1 part bleach to remove any potential mold.
3. Allow to dry and apply one coat solid latex deck stain.
PRODUCTS:
1. California Products Corp. —Storm Stain clear deck finish and waterproofing sealer
#20040.
2. Cabot Stain Inc. —Clear decking stain #1400 series.
3. .Performance Coatings—Penofin Cedar/Marine, Marine oil finish exterior.
Locations of where to purchase the above listed products:
1. Walls of Decor, 5I5 Lowell Street, Peabody, MA
2. Waters and Brown, 281 Derby Street, Salem, MA
3. Norman's Paint & Wallpaper, Vnnin Square
4. 'Winer Bros. Paint, 85 Lafayette Street, Salem, MA
5. Moynihan Lumber, Beverly, MA
6. Town Paint and Supply, 317 Cabot Street, Salem, MA
If you install new pressure treated stairs to an existing deck that is already painted:
Apply clear stain from the companies above.
If you will be staining your existing deck, the following is a list of colors that were
applied by address:
Cabot Desert Sand Cabot Red Cedar Olympic Beechwood
Halsey Nimitz Fillmore
Spruance Marion Hart
Russell Fletcher Griswold
Arnold Dewey Stillwell
Pickman
if your street is listed under Cabot Desert Sand or Cabot Red Cedar, please stay with the
Cabot product. If your street is listed under Olympic Beechwood, a discontinued color,
retailers suggest matching the color with a California Paint Color.
The Commonwealth ofMassaehusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.massgov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers
Applicant Information Please PJrinnt�Letaibly
Name (Basi�ss(o` anizatiott/Inaiviauat):
Address: 2-
City/State/Zip: ��' �` ';44 Phone#:
Are you an employer?Check the appropriate boa-' Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the soli-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working;forme in any capacity. workers' comp insurance. 9. ❑ Building addition
[No workers'comp;insurance 5. ❑ We are a corporation and its'
required] " ;,
officers bave exercised their' ME] Electrical repairs or additions
3.El am a homeowner,doing all work right of exemptrtin'per M'GL' 11.0 Plumbing repairs or additions
myself. [No workets',comp. c. 152,§1(4�,and we haven , 12.❑ Roof repairs
insurance required:l t, employees. [No;workers' 13.0 Other
comp.insurance regwra,
-Any applicant that checks box pl tint also fill out the section below showing their,workoie'compensation policy infommtim
t Homeowners who submit this affidavit indicating they ere doing all work and then hire outside connectors nicer submit a now affidavit indicating such
tContrwtm that check this boti'nine attached on additional"sheet showing the name of the submm ctots and then workers'camp.policy information.
I am an employer that is providing workers compensation insurance for my employes Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie. #: Expiration Date: 7
Job Site Address: s�- E)_il ,i/r P,- A City/StateMp: lti --
Attach a copy of the workere compensation policy declaration page(showing the policy number and expiration 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby cerdfy under the pains and/p'ena/Nes of perjury that the information provided above is true and correct
Simattve: dl��/Iiv��cZ; =_ Date: 12 Jc/z�7�
Phone#:
Offleial use only. Do not write in this area,to be completed by city or town ofj9cial,
City or Town PermWLicense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 3.Plumbing Inspector
6.Other
Contact Person: Phone#•
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employi,'ees-1.
pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of Eire, , t
express or implied,oral or written."
An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However-the
owner of a dwelling house having not more'ban three apartments
and who resides therein,or the occupant of the`
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to Your situation and,if
necessary,supply sub-contracto(s)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers' compensation insurance: If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be,sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy;please.call the Department at the number fisted below. Self-insured companies should enter their
self-insurance license`--heron the appropriate lime.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in die event the Office of Investigations has to contact you regarding the applicant
Please be sure to fill in the pemmittlicense number which will be used as a reference number. In addition,an applicant
that must submit multiple Permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on fie for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen'is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc•)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. #617-727-4900 ext 406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 5-26-05 www,mass.gov/dia
........... ......
2�1!
N 101
-17-03
......... ......... 07
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PARENTE INS AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
94 LYNN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIEA BELOW.
PEABODY MA 01960 COMPANIES AFFORDING COVERAGE
COMPANY
22TCN A THE TRAVELERS INDEMNITY COMPANY OF ILLINOIS
INSURED COMPANY
PANTAPAS, PAT DBA ADD A ROOM 8
22 COUNTY STREET COMPANY
PEABODY MA 01960 C
COMPANY
D
...........
THIS IS TO CERTIFY THAT 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 OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY POUCTLIFFECTIVE POIUCYEVIRATIOJ UNITS
LTF DATE,'20WMYV) I)
GENERALUABILITY GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP ASS. $
=__lCLAIMS MADEFI OCCUR. PERSONAL&ADV.INJURY $
OWNERS&CONTRACTOR'S PROT. EACH OCCURRENCE $
FIRE DAMAGE(Any one fire) $
MED.EXPENSE(Any one pemon) $
AUTOMOBILE LIABILITY
COMBINED SINGLE $
ANY AUTO UMrr
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per Penton)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (PerAwldanl
PROPERTY DAMAGE $
�ZtGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
p AGGREGATE 8
EXCESS LLUHUTY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM I
A WORKER'S COMPERrATION AND STATUTORY UNIFTS
EMPLOYER'S LIABILITY CUB-7707A77-7-03) 107-19-05 07-19-06 1
EACH ACCIDENT $
THE PROPRIETOR/ 100,000
PARTNERS/EXEcLrnVE INCL DISEASE-POUCYUMR $ 500,000
OFFICERS ARE: RX EXCL DISEASE-EACH EMPLOYEE $ 100.000
:7:
DESCRIPTION OF OPERALTIONSA.OrA!nomaim-CLESAMSYMCTIONSWECIAL ITEMS
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE.
...... 6 CAN 4
C
. ...................... ......
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
UMS EXPIRATION DATE THEREOF, THE ISSURIG COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NDT= SHALL IMPOSE no OBLIGATION OR
LIMMUTY OF ANY KIND UPON THE COURANT,ITS AGENTS OR REPRESENTATIVES.
/t7 /4- AUTHORIZED REPRESENTATIVE
......... ......�*'__,i
CITY OF SALEM, MASSACHUSETTS
• ♦ PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MASSACHUSETTS 01970
STANLZV J. U$Ov1CZ, JR. TELEPHONE: 978-743-9593 EXT. 380
MAYOR FAX: 978-740-9846
Salem Building Department
Debris Disposal Form
In accordance with the provisions of MGL c40 S 54, a condition of your
Building Permit is that the debris resulting from this work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL
Chapter III, S 150 A.
The debris will be disposed of in: /, q�
'/-7 (Location of Facility)
Ll� � __
Signature of Applicant
Date