Loading...
1 SHORE AVE - BUILDING INSPECTION V The Commonwealth of Massachuscits Town of Board of Building Regulations and Standards Massachusetts State Building Code. 780 CMR. 7"edition Building Dept Building Permit Application To Construct. Repair. Renovate Or Demolish a One- or maih Dsvelfing is Section For Official Use Only Building Permit Numbe : Date Applied: �• Z 21' Signature: Z 3• Budding Co is over/Inspector dinga Date TION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers / Shore Av2 1.la Is this an accepted street'!yes no Map Number - Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq R) Frontage(R) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40.154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private O Zone: _ Outside Flood Zone? Municipal❑ On site disposal system O Check if vesO SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record; n/`�S o t7 Lorralvt� X f (74ore— Ave- Tame y2. Name(Print) Address for Service: Cr-7�- 2 y-/- 30 r Signature Telephone SECTION J: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction O Existing Building❑ Owner-Occupied Repairs(s) ❑ 1 Alteration(s) ❑ Addition ]8; Demolition ❑ Accessory Bldg. O Number of Units_ Other O Specify: Brief Description of Proposed Works: ere c.✓ e-c- QNd Suvl/-Cop- if/f9 Fc,0f- S {- Cz4er�c� SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials I. Building S /3 S OCd 1. Building Permit Fee: f Indicate how fee is determined: 1. Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x t . Plumbing f 1. Other Fees: T 4. Mechanical (HVAC) S List: 5 .Mechanical (Fire 5 Suppression) Total All Fees: S C Check No. _Check Amount: Cash Amount:_ 6. Total Project Cost. f /3,5 OC' p Paid in Full O Outstanding Balance Due: �)Nac t t/ V oc l fic SECTIONS: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) Q�17 q 7 y /ur•� ®V"I�L.JV�i LicenseNulm_ber. Ea /nation ate N ul'CSL Hfllder Lost CSL Type(ace beluw) �M ;afrr ,ti 4 a r i �Ltida� AJ ss fr T' Description �� U Unrestricted luo to 35,000 Cu. Fr) R Restricted I&2 FamilyDwelling fsnature�ip� r1 S1 Masonry Only 62 3) a L.S �G d—' RCRcstdenual Roofin Covering Telephone WS ResidrntiaI Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition kthis gistered Home Improvement Contractor(HIC) 4 f" K�Ci, s-S //C- 1"! CDG f m . y Name or HIC Registrant Name Registration Number � LoaEa ration Date e Telephone ECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 2SC(6)) Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide davit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes.......... No...........13 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized,by this building permit application. Signature of Owner Date /� SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION I. {�QO'Ci CDS,f uyCi ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and behalf. JJ Print Narpa,r /� n Sign of Owner ororGAlutho izeed-_A'gent Date Si tied under the sins and nalties of perjury) NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will Ma have access to the arbitration program or guaranty fund under M.G.L. c. I42A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 790 CMR Regulations I IO.R6 and 1 IO.RS,respectively. Lliving substantial work is planned,provide the information below: rs area(Sq. Ft.) (including garage, finished basement/attics,decks or porch) g area(Sq. Ft.) Habitable room count f fireplaces Number of bedrooms f bathrooms Number of halfbaths ating system Number of decks/ porches olingsystern Enclosed Open 1. "Total Project Square Footage" may he.uhstiluted for 'Total Project Cost" CITY OF SALLM r � PUBLIC. PROPRERTY 4y Ir �F DEPARTMENT Construction Debris Disposal .affidavit octluircd 1br all demolition and renovation work) In accordance w I I i the sixth edition of the State Building Code, 780 CAIR section 1 1 1 5 Dcbi is, and the provisions of.NIGL c 40, S 54; Building Permit t$ is issued with the condition that the debris resulting front This work shall he disposed of in it pruperly licensed waste disposal facility as defined by MGL c I11. S 150A. The debris will be transported by: n/�lt�- c ^l Q I f-�< Qf— T Inamc Of hauler) I lie debris will be disposed of in f3�sf DI`sPa c- / P (name ut Ian ny) ,/� )0\J l�eLo� Nlf ,C93o77 I 1•idJr¢w ur l]nlnvt � lei LIId WIC pili nt .yyd;cani � a `' Phone 503-895-2092 Morgan Exteriors LLC Fax 603-895-1140 HOME IMPROVEMENT CONTRACT 130 ROCKINGHAM RD. LONDONDERRY, NH 03053 THIS AGREEMENT,made and entered into between,Morgan Exteriors 130 Rockingham Rd,Londonderry NH 03053 hereinafter referred to as Contractr AND o.tifatAe A, _ A1150 h STREET q _ CITY —'j-ale Y1n STATE ZIP Home#: _ Work#:Mr./Mrs. hereafterrelerred to as OWNER. CONTRACTIDIR beregy agrees that it will furnish all labor and materials necessary to insist the following described work at Premises located at the above address.CONT CTOR agrees to start described work on/or about 6 to 8 weeks after Issuance of building permit,and to complete described work in about ,– to working days.Time not being of the essence. If reQuiretl,building permit is the responsibility of the said Contractor. CONTRACTOR shat not be held liable or delays due to causes beyord central. CIRCLE APPROPRIATE ITEMS Special Instructions UV e a1z,614N Writ 3 SEASON DOUBLE PANE GLASS+SCREEN j C 4 SEASON S DOU ANE SLIDING WINDOWS COLOR HIT EARTHTONE a ROOMSIZE ROOF SIZE O U ' L] * �1� MOVES Y N DR RVENT SPIGOT ROOF STYLE CATHEDRA TUDI COLOR WHITE) U l PLYWOOD OVER EXISTING DECK Y/ N INSULATE AND CDX OVER AND UNDER DECK Y THERMO FLOOR SYSTEM INCLUDING FOOTINGS Y P.T.DECK Y SIZE IN ric not tcoAkee�performed-by MVRI "TE JRIOR LATTICE Y/fi) WHITE P/Tu Je�Y{ �V P1 tL'. �,IA�t(W~� STEPS Y/10NUMBER SKYLIGHTS Y/ NUMBER O BAY Y/ TRANSOM Y N TOP BOTTOM CUSTOM TRAPEZOIDS Y nN O A11 checks payable 10 MORGAN&WERIORS OPTI S: ��� m, TOTAL INVESTMENT$ _4bC Qt !x(1 n DEPOSIT$ Tf OO" —� M DUE AT PERMIT R ORDERS L+ nO0 DUEATSTARTS BALANCE due on completion b a You may cancel this agreement if it his been signed by a parry thereto at a place other than the address of the seller, which may be his main office or branch thereto,provided you notify the seller in wrifing at his main office or branch by ordinary mail posted,by Telegram sem,or by delivery, not later than midnight of the third business day following the signing of this agreetrtmL !f the Owner rclose,to permit Confroem,to proceed with the work herein,or In the exon of any breach by rhe Owner of this agreement;for any,reason whaboretr shell carie the owner to pay Contractor a sum of money equal to Nirty-dray and one-ehird percent of the prim agreed to be paid,as fired liquidated and ascertained damages,and net as a penalty, without further proof of/on or damage. Contractor shaft not be held liable in damages for delays in the performance of this contract due to causes beyond tt reasonable control Owaer warrant that he is the owner of the propetry an which the work it m be performed or that he is"henvise authorized on behalf or the matter as emer into this agreemeN. This Contract represent the More agreement behot"the Own" and Contractor and no reprrsentative or unrramy shall be binding upon ether pally,antras Included herein.An!Merest charge of 7.39%per month (IS%per year)will be added to any amount unpaid after 30 days from invoice data In the event of Ailauh in payment of alt order or any pan thereof and the account is referred to an attorney for collection,the purchaser agrees It,pay reasonable anorttry fees All mmerhd&guaronlred re be a,syeeAed.All wed to be compl"ed In a workmanlike manner according to standard pracdces Any as"anions or as,a deviation from above Jflmdana Inro/ving more cosy will be execmed onty open written order,and will become an caro charge over and abnee the esdmate. The contract"represent m aft our him am filly covered by Workmen It Compensation Insurance. r. Dole of Acceptance n Signatures – a slgnatur !owned (For Conotrewr)-7 I Signature Lin Date. 0 (u word CONSUMER INFORMATION FORM -"SUNROOMS" Ulf Massachusetts State Building Code (780 CMR, Appendix J, Section J1.1.2.3.1) The Massachusetts State Building Code(780 CMR) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, construe ting/instal ling a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom" of any size, configuration, orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a "sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a "sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO "SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation - Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls, and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency, Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J 1.1.2.3.1, requires that the actual property owner (not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the info ation in this document concerning sunroom comfort and energy conservation. 27� Signature of Actual B ilding Owner Date `f tr 9 Print Name Address of Permitted Project Owner Address (if different than project location) Owner's telephone number .. w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le¢ibly Name (Business/Organization/Individual): MO!-bgi-, EK1-e-r'-r0✓J //C- Address: /LAddress: 136 1,4M /-,I— City/State/Zip: Lce7dyemferr V IV# D 3 oS3 Phone #:(6 d3) Q c(S O °(J— Are you an employer? Check the appropriate box: Type of project(required): 1.X 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 sub-contractors 2.E3 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 for me in any capacity. workers' comp. insurance. 9. ❑ 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.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ 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' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box most attached an additional sheet showing the name of the sub-contractors and their workers'wrap.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: G G 4 r',_1 y✓/Su r 4n c e &G—OCA 0 Policy#or Self-ins.Lic.#: /4 0 G ct / S//( Expiration Date: 4 fys O 9 Job Site Address: / 5401-e- /4ye- City/State/Zip: S u(6vt /'2A D/7'?,0 Attach a copy of the workers' 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby{cert�under the pains andpenalties ofperjury that the information provided above is true and correct. Signature Date:rr�� ,,, (� Date• 4 fS/d / Phone#:C&O3 / � C/S — rJ-0 ( o�— Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#• ♦ 4 11/09/2008 12:28 FAX 803 898 8269 FOY INSURANCE SALEM AC CERTIFICATE OF LIABILITY INSURANCE jumwa PRpplgeR (603)898-63 FAX (603)898-8269 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Foy Insurance Group - Salem ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE i 130 Main St - Suite 103 HOLDER.THIS CERTIFICATE DOES NOTAMEND,EXTEND OR AL FO D6YT LI SEL . Salem,.NH 03079 Terri Truhn INSURERS AFFORDING COVERAGE NAIC0 PLEA NDrgan Exteriors LILC INSUR RA. Ceocerd General Mutual Ins Co 2 72 1305 Rockingham Road lNSORERS; GOard Insurance Group 18331 Londonderry, NH 03053 INRURER D: INSURER DI IN$u%!A E . GES THE POLICIES OF INSURANCE L STIED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD WDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OP 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,ERCLUBIONS AND CONDITIONS OF SUCH POLICIE8,AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAM. TMPBOPUNKIRANCE -.Pmxvma®FRR YRRS oeRrRAI•LIA�Y E6157155 06/O5 008 06 8/2009 enoHaccuaREJJDE A 2 Opp, P,A COMMWM L GENERALLMaIM f SDCLAMMADEEK OCCUR MEOLVWwe pemenl S 001AP6ffiDNALAADVIN,IURY f 2 000,001 ALGENERAGGREGATE S ¢ 000LAGGREGATE LRATAPPLIES PER PRODUCTO•COMPAWAGO S 4,000 OB LOCICOMSIN d NNOLEALL0IM�DAUTOS A8=CHEC;LMLwAVM=S lppleHPPRROOAapDTMr YtlaIsNrJNr U�7RY (pwp HIRED TOS NONOWEDAUTQ9 =lYA LIAmI1AUTO ONLY-.PAA�CCIDNT $ faS CTHRR THAN EAACC a AUTO ONLY., AGG i LWwCWRSCOA��AW A1NSlQJAEACH OCCURRENCE t UR FICLAIMS WIDEUCTIBLEENTgN AND N011C915111 9 S 008 o9/1S/z 9 x wesrARIINUTY RoE CLT 4H JI SCNAccNe1A a 1.000.+ee. EL DISEASE.PAEMIWM a 1 000 0 SIONS helve . ,000.ATIMj LOOATMAI; xRLEae SxCLU81d/g AODBpBY91O IBR/BPBSAL PR(R�Iplm TF o�oert _ I CULDANYOFTHEAB M DVAF9BBDPda0P3gE•Awm. W FORM THE . P>aR1ATRJN OAT8711r#AR TNa m8YSl0 NSURFRYlIµmIOE0.Y0RM WL . 10. D"SaIRTI mI NOTCb 70 THECERTWGTg NOLDCR NAILIDT07MLEPT, gUrFALURE TO MAL MICH NOMCESHALL IRPOSB NOOSLMATIONCH LIMILITY OFANYgND 71.1a901UEKTIMAGIRMCRREPR SIRMATIM TATNE ACORD 28(2oo7/08) FAX: (603)625-6824 8V4CORD CORPORATION 4988 Massachusetts- Department of Public Safeq Board of Building Reindations and Standards Construction Supervisor License License: CS 92194 - Restricted to: 00 MARC W COUTURE 114 LANGFORD RD RAYMOND, NH 03077 --�- -yj� Expiration: 7/17/2011 ('unmlissioner Tr#: 17661 1 S ;x "'Q ` /WB arc la m4-- Wn6j ! One Ashburton Place "R =1301 Boston. Mass husetts (t} 1:Q$ Home Improvementractor Ristratron Registration 146964 — TYpe Ltd Liatility`Partne Expiration 6/2/261:1 Tr# 2646 { i OR MAN EXTERIORS LLC. _ W MARC COUTURE > — 130 ROCKINGHAM RD. �� r LONDONDERRY, NH 03053 tr#y '_ -e%• IR ifwAddress,and°return csld':Markreasowfor © eY# cess ❑ Renew-al Ej 6utployment E] I DPSCAI 0 40M-08/08-DBSLIF0RMCA108212008 - T� ��2>h,�rwealrh �.��r�ad,�� I Board of Building Regulado s and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. In found return *. Board of Building Regulations and Standards Registratlo„� 146964 One Ashburton Place Rm 1301 gy /2011 Tr# 264654 Boston,Mo.02108 ability Partne -C MORGAN EXTEOtlf i MARC COUTUREBk � �f�130 ROCKING -- — ------ ----- . LONDONDERRY,NH 03053 Administrator Not valid withou t signature r DRAFT Ift SNOW LOAD: 50 WIND LOAD: 100 awc i 6004 o PRINT APPROVAL I # 6004 07/14/zaps ti PIee•° indicLLe =vur aypr�„ MORGAN EXTERIORS / WILSON _ JD of th3a damgo �6 and rctUndn; to: THERMAL IND. INC. DREAMSPACE 300 WHITE / MARQUEE m mom' 3" 3-PLY ROOF SYSTEM 17 w i 2 12.000 3.502' .734 OVERHANG INCLUDING GUTTER TRAN30W PANEL TUWSO PPANEL SLE 500 SLE 500 98.000 36- 1 /2 36- 1 /2 88.4.20 HANGING HEIGHT X X FINISHED 55-3/4 WALLA M L55-3/4 HEIGHT WALL A 23.687 23.687 KICK PANEL KICK PANEL I— 84.000�I SIDE 1 (ILO) WALL MODULES WEIGHING 200 KUNDS o DRAWING: INSIDE LODKING OUT. OR MORE W[LL BE SHIPPED UNASSEMBLED 0 0 w L C r DRAFT 1 SNOW LOAD: 50 WIND LOAD: !DO DWG 0 6004 ? PRINT APPROVAL # 6004 07/14/zoos o Please lanleate T ki a,pm.el MORGAN EXTERIORS / WILSON � k recd nIM ta n6 bolo THERMAL IND. INC_ DREAMSPACE 300 WHITE / MARQUEE m 3" 3- PLY ROOF SYSTEM fine D.b �„ 6.901 6.901 6.901 TRANSOM TRANSOMrTRANSOM{ PANEL PANEL f PANEL SLE 500 SLE 500 SLE 500 88.420 38-3/8 /8 38-3/8 38-3/a 88.080 FINISHED X MODULE WALL 55-3/4 55- 3/4 55-3/4 HEIGHT HEIGHT A F M JF M A 23.687 23.687 23.687 KICK PANEL KICK PANEL KICK PANEL 132.000 SIDE 2 (1 LO) WALL MODULES WEIGHING 200 POUNDS o ORAWING: INSIDE LOOKING OUT. o ❑R MORE WILL BE SNIFFED UNASSEMELED � 0 0 w L I C r DRAFT fl SNOW LOAD: 50 WIND LOAD: 100 OWG P 80D4 P PRINT APPROVAL # 6004 07/14/2009 Plsee iieb m yoei ypt�>r MORGAN EXTERIORS / WILSON J05 of thisdvdeexm and scivamiad to: THERMAL IND. INC. DREAMSPACE 300 WHITE / MARQUEE m 3" 3-PLY ROOF SYSTEM w 12.000 121 OVERHANG .73413.50T INCLUDING GUTTER MAH30N PANG 7R,1V50V PANEL SLE 500 SLE 500 88.420 36-1 /2 36- 1 /2 98.000 FINISHED X X HANGING WALL HEIGHT HEIGHT 55-3/4 55-3/4 A F M A 23,687 23.6137 IS PANEL KICK PANEL L 84.000�I SIDE 3 (I LO) WALL MODULES WEIGHING 200 POUNDS o DRAWING: 114SIDE LOOKING OUT. ❑R MORE WILL BE SHIPPED UNASSEMBLED o 0 0 W I Shore Ave. or 70 9,9 s ll � I Shore Ave. door 7' I Shore Ave, Floor and Wall Cons, 11' i