The URL can be used to link to this page

8C RUSSELL DR - BUILDING INSPECTION PUBLIC PROPERTY �Ud DEPARTMENT roR T Nn 120 WM MNcmN hrzF • u,�' Sss rnaatt;st�-ts 01970 '11L•97&74S-9S9S♦PAX'97&740.98" APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION DEMOLITION OR CHANGE Off'USE OR OCCUPANCY FOR ANY EXISTING STRUCTURE OR BUILDING 1.0 SITE INFORMATION " Locadon Name: � S e�( Df Building: Property Address: iz, ussd erty Prop Is kxWed in a; Conservation Area YM Historic District 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land ` Name: I Ar G C I Yl S Address: /� ec, K U jS e DoVyl Telephone: 7,/ Z 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Z Renovation t/ Number of Stories Renovated Change in Use New Demolition �/ Existing Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New Brief Description of Proposed Work: � C, his Pe4/- 1�q,z9 ,-Ah, word �.,rl e I What is the current use of the Building? Material of Building? Ld to qc — If dwelling,how many units?__.--- Will the Building Conform to Law? Asbestos? n� Architect's Name Address and Phone Mechanic's Name Address and Phone Construction Supervisors License# (��—HIC Registration# Estimated Cost of Project$=', Permit Fee Calculation Permit Fee$ Estimated Cost X$71$1000 Residential Estimated Cost X$11'$1000 Commercial An Additional$5.00 is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of perjury t OI N Ll �+ W H 93 r V 7 O 0 � Y ° 96qv- _ CrrY OF SALEM PUBLIC PROPERTY DEPARTMENT w,a>o,t..+r� �.�. t3o�sw.tictnrsts.ar.sttstt,tskua..watsatrn 1b:9lLU&ffilti0 PAZ MUM" Const medos Debris Dispasl AMdavit (mgttirad Loa an damoWm and mwadw wok) to atxotdsooe with the sittdt adidon of dw Sams HnildtnS Co"7W CUR sag ►111.5 Debr*and dw p wAdow of UCL a 4%3 A SUM MI ft. d is is=W with the oonam that the darts m=Wns doo this wont dull bs disposed of its s pwparllr Itamsad arssss dlapwsl atatUty>.dednad by Mt$.o l l t.31JOA. no dabs wiU be RtsnsporW by: I �1"'yafVE, (same oLbsslst) i The doWs wiU be disposed of in: Tr; y7s4,,-- (Dam.of fmwto A141 (addmdo of FUMY) si,wae.otparmie� der. 7 CITY OF SALEM DEPARTMENT OF PLANNING AND 'h COMMUNITY DEVELOPMENT 1^ � " 120 WASHINGTON STREET ♦ SALEM, MASSACHUSETTS 01970 TEL: 978-745-9595 ♦ FAX: 978-740-0404 KIM DRISCOLL, MAYOR LYNN GOONIN DUNCAN, AICP DIRECTOR HousING REHABILITATION LOAN PROGRAM WORK WRITE-UP PROPERTY INFORMATION: Homeowner Date: September 5 2006 (s): Nicolina Reisman 8C Russell Drive (978) 741-3238. Prepared by: Cliff Ageloff Case #: Housing & Construction Consultant 978-768-3131 1 . LICENSE: The contractor must meet all local and State licensing requirements. 2. INSURANCE: Contractor must show proof of adequate liability insurance and workmen's compensation coverage be provided. 3. PERMITS: The contractor must obtain all required building permits prior to starting work. Copies of the required permits must be submitted to the Housing Program. 4. CODE REQUIREMENTS: All workmanship must conform to the Program's guidelines, all applicable Massachusetts Building Code and local codes and must be of acceptable quality, as determined by the Housing Programs Inspector. 5. WORK AREAS: The owner must completely remove all furniture, stored items and other obstructions in the work areas identified herein. Items must be moved to a non-work area and covered by the owner or relocated to temporary storage as needed. Neither the Program nor the Contractor is responsible for owners' items improperly relocated during construction. Work can not proceed unless work areas can be freely accessed by the contractor(s) on a regular basis during the term of the contract. Failure to provide regular and unfettered access to work areas may be cause for contract termination. Contractors are responsible for verification of field conditions measurements and quantities. Submission of a bid is resumptive evidence that contractor has evaluated all site conditions which ertain to the wo rk herein. Permits and Permit Fees to be included in all bids. WORK SPECIFICATIONS for REPAIRS 1. Rear Deck Replacement - General Carpentry Remove existing deck and install new composite deck on pressure-treated frame. Deck approximately 8 x 10 1 . Remove and dispose rear egress deck and stairway. 2. Take note of all design and deck features to be replicated within the provisions of the MSBC for the new egress deck and stairs. 3. Replace all structural components of the deck with pressure-treated dimensional stock, Use existing footings. Provide frame for deck and stairs. 4. Use galvanized joist hangers and shear-rated 'strong-tie' fasteners or equal to construct frame. 5. Provide new ledger at intersection of deck and dwelling; lay ledger over new ice and water shield" at sheathing and flash with metal flashing to ensure water barrier at installation. 6. Provide and install all new railings, guardrails and balustrade. Provide graspable railing to meet requirements for handrails at stairways. Match adjacent unit details for railings and deck including 7. Extend all decking 1" from non-stair edge of landing. 8. Provide composite components for all railing system components; see adjacent unit deck details for general guidelines. 9. Provide Choice-Deck, Trex, or equal composite decking for all treads and decking and rail systems caps. All decking may be screwed or nailed to comply with manufacturer's requirements. 10.NOTE $ ALTERNATE PRICE: Price deck as above with untreated decking and rails, primed and painted to match existing. „ Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 132170 Type: Private Corporation Expiration: 11/29/2008 Tr# 132170 EAGLE ENVIROMENTAL CONTRACTORS MALL MCGUIRE P.O. BOX 2256 WESTFORD, MA 01886 Update Address and return card. Mark reason for change. ' � ❑ Address I_.I Renewal Employment Lost Card OPS-CA1 0 5OM-05/06-PO8490 ✓�ze "1Donxoxarzwe¢L!/[ a�..'l�aaeae•�zeme!!d .. p� ExBoard of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 132170 Board of Building Regulations and Standards piration,:;,_11)29/2008 Tr# 132170 One Ashburton Place Ran 1301 Boston,Ma.02108 Type:;,Private Corporation EAGLE ENVIROMENTAL CONTRACTORS INC. NIALL MCGUIRE 150 HAYDEN RD GROTON, MA 01450 - Adminishator Not valid without signature / BOARDLUI License CONS Cp REGUL¢T1OI < UCTION SUPERVISOF < 'NUMU61 1, TR B 081701 r�h��te OSl29J1955 p(re P,5/29J20b8 t Tr. no: Rstt+:ietl - 2276 MALL T MCG 00 >'s UIR = 150 HAYDEN RDA GROTpN MA 01450 C m�ton CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT KAIBERLEY DRLSCOLL MAYOR 120 WAsHmTON STREET*SAIEN.MASSACHUSEM 01970 TEL•979-745.9595 a FAX:978.740.9846 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyfilly Name (Busineesss/Organizaeon/Individual): Yp t Address: T , i71 60)e /_2 z S-� - q City/State/Zip: W—L2 / 7 a✓G1- MA Phone #: C77e?' 69 2 O D OZ Are you an employer?Check the appropriate box: Type of project(required): 1.11 t am a employer with ZiS 4. ❑ I am a general contractor and I 6. ❑New construction (full and/or part-time).• have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet t 7. MkemodeOng ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10. Electrical required.] officers have exercised their ❑ repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself.(No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees.(No workers' comp. insurance require 13.❑Other d.] 'Any applicant that therm box el must sim fill out the section below showing their workers'compenutim policy Wotmsdoa. I Homeowners who submit this affidavit indicating they am doing all wait and than hire outside contractors must submit a new affidavit iodieatiug aneh. =Contractors that chak this box must attached=additional sheet showing the name of the sub ommdan and their workers'comp.policy info teal' . I am an employer that Ls providing workers'compensation insurance for my employees. Below is the policy and Job sits information. Insurance Company Name: C N'INnerr'_ t 1/t. wi tya his. ( o Policy#or Self-ins..Lic.#- /W_L2 a 2-3 -7 Expiration Date 3 d I T Job Site Address:b K{il S I r City/State/Zip: Jod m V� A 6 ]77 w- Attach a copy-ofthe-wrorkenr t6inpsmatlon 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 S 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 certify under the pains and penalties o that the information provided above is true and correct Si t , Q Ph Z 00cial use only. Do not write in this area,to be completed by city or town oJJlciaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, 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 than three apartments and who resides therein,or the occupant of the tion or dwelling house of anther who punt t thereto shall no because of persons to do maintenance, uch employment bework deemed to be an employ or on the grounds or building appurtenant MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall the commonwealth the Issu roance r any r renewal of a license or permit to operate a business or to construct buildings in 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 bien presented to the connecting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to yotu situation and,if necessary.supply sub-contractor(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 lice=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 listed below. Self-insured companies should enter their self-insurance license number on the a hate line. City or Town Official 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 the event the Office of Investigations has to contact you regarding the applicant.Please be sure to fill in the permittlicense 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 file f��.future permits or licenses. A new affidavit must be filled out each R 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 Offlee of Invesdgadons 600 Washington street Boston,MA 02111 Tel. #617-7274900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia