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12 SOUTHWICK ST - BUILDING INSPECTION POE) I noropd� ? 2 3�S CpSWA RL The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 730 CMR SALEM Revise),Lfrrr_, 01! Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Tivo-Family Dwelling This Section For Official Use Only !BuildingPe itNum er. Dat Applied; ' iilding Official( riot Ngme) Signatu -Date 3 SECTION 1:SITE INFIbRXIATION 1.1 Property Address• 1.2 Assessors Map& Parcel Numbers I.I a Is this an accepted street?yes n'P o Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq 11) 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 a 40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private❑ Zone: _ Outside Flood Z e? Municipal On site disposal system ❑ Che f y ck ies SECTION 2: P"'OFGI:.TV-_WNERSHIP'. 2.1 Owner of Record: ihme(Print) City,State,ZIP No.mid Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction ❑ 1 Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition Pf Demolition 5V Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brie escriptio of Propose Vork'': iPzA rt42 n v - J W S SECTION 4: ESTIb1A{'ED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials) I. Building $ j Z two 1. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee- 2. Electrical $ ❑Total Project Cost"(Item 6),x multiplier x 3. Plumbing S 2. Other Fees: $ 4. Mechanical (HVAC) S List: _ - 5. Mechanical (Fire Suppression) S Total All Fees: $ X Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ D D O 0 Paid in Full ❑Outstanding Balance Due; SECTION 5: CONSTRUCTION SERVICES. , 5.1 Construction Supervisor License(CSL) Er,&&4 tz)Z,1�0 License Number Expiration Date Namc of CSL Holder t��0o S.W List CSL Type(see below) No.and Street "type Description /ML �� 'j39/� U Unrestricted(Buildings tip to 35,000 cu. It.) R Restricted 1&2 Family Dwelling Cityrrown,State,ZIP M Nfasonry �fJQ/ Sor�s /Vo0 5r /A) 20wf/Z- 414 RC Window Cover Sin WS W window and Sidin /a!S�hooG S7' SF Solid Fuel Burning Appliances �tY R!/P/`l?7� LDw"GC I Insulation Tele hone r14& Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address City/Town, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 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 ...........X No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property,hereby authorize t9 act on my behalf, in all matters relative to we c uthorized by this it g permit application. Print O vner's Name(Electronic Signature) Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below, 1 hereby,attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. �/ -D 2 Q///I 11r'nt OwfterKor Audi zed A11 is N� ne(E o is Signatu Date 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 not have access to the arbitration </ program or guaranty fund under N.G.L.c. I42A.Other important information on the HIC Program can be found at www.mass.eov'oca Information on the Construction Supervisor License can be found at www.nrtss_�,ov:/dns 2. When substantial work is planned,provide the information below: Total floor area(sq. 11.) (including garage, finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" r �0 CITY-OE S.iL.ENt; NL-1SS.ICHL"SETTS BL•¢D .NG DEPARTSI&%4T �/_ , F_ 120 WAsHINGTON STREET,3w FLOOR �J�LCYnb T EL (978) 745-9595 u��rM PAX(978) 740-9846 /� KIN tSERt>rY DRISCOLI T MAYOR HONW ST.PTERRB DIRECTOR OP PUBLIC PROPERTY/BUILDING COSL%IISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A a licant Information Please Print Le ibl Van1C(BlainessOrsani:atiorulndividual): 6 Address: l3 / Cityistatcizip Phone#: / / b /�� ✓ J XAre nu an employer%Check t e appropriate box: Type of project(required): II am a employer with 4. El am a general contractor and 1 6. ❑New construction // unployees(full and/or part-time).* have hired the subcontractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet 1 7' Wemadeling ship and have no employees These subcontractors have V. Demolition working.for me in any capacity. workers'comp:insurance. 9, ❑ Building addition (No workers'comp.insurance 5-0 we are a corporation and its required.) officers have exercised their !0.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 1 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' 13.0 Othe-. comp,insurance required.). ;Any applla:un that chcoka Isox el most also fill out the seciloo below showing their workers'compensation polity innumadom 'I hvneownevs who submit this affidavit indicating they am doing all work and thm hire oatiide eontmeterf must submit a now aMdavit indicting suck =Canuxtora that chc<k This box most anuhcdan additional shoat showing the mmna of thbsub.Nntractont and their workers'comp.policy infamanon. I um an employer that Is providing workers'c'ompensadon hisurance for my employees: Below is the policy and Job site injonnuriam insurance Company Name: - policy 4 or Self-ins.Lie. N: ,J \�, Expiration Datta- q Job Site Address:12 t-P74ll�Jd� Cityistatr/Zip L1. Attaeb 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 tine up to S1,500.00 and/or one-year imprisonment,as wall as civil penalties in the form of STOP WORK ORDER and a line Of up to SM.00 a day against the violator. ITe advised that a copy of this statement may be forwurdcd to the Office of Investigutitnts ul'tlte DIA for insurance covcrago verification /do hereby certify under the paters and penaides of peryury that the h1fornrallon provided above is true and correct. Sismuure;� ��_.. Data• Uf.ricial use only. Du not write in this areeq to be completed by city ur town oyyiciaL citynrTuwn: ___ Prrmit/Llcense;: ___ Issuing Aulhority(circle one): 1. Board of Ilealth 2. Ruildln4 Departmeul 3.Citylrown Clerk 4. Electrical inspector 5. Plumbing Inspector 6.Oilier_— Contact Person: _ Phone B: [ CITY OF SM.E I, TNUY SSACHUSETTS • BU .DING DEPARTMENT 130 WASHINGTON STREET, 3' FLOOR TEL (978) 745-9595 Fax(978) 740-9846 K1N[BFui FY DRISCOI L MAYORDR THOM.us ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BULDING CON]MRSSIONER Construction Debris Disposal Affidavit (required for all demolition 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 be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. f The debris wilt be transported by: CA rq's (name of hauler) The debris will be disposed of in : (name of facility) (address of facility) I 'signature of r n appl ant date 9cbnsal(Jce ne! re unf 11 rtnel lna ecllana p y v - - . � � case prriciel. ) 1 cr Canada f l I N � � energyslarnrcan- ( ��` O P rAWn:9D.0 P {) C i+ CUJ c ggE�� W a C US./[.U. ... W lL' energystacgOv 'D =Qualaied/A�ngslbla Sih/erLine� — an Andersen Company CPO" SIL- 8501 Db eH00353-00001 tbn 1'leal Fan ou gA 9 Vinyl in Yl Dual Glazed i ENERGY PERFORMANCE RATINGS U-Factor 0 . 34 1 . 93 a 93 sal", Heat Gain Caeefficieni (U.S./I•P) (Mefric/SI) 0 . 28 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 53 MenuM�� Ce N hat th RC lapin a1 s mta applit eNRC Product" Iroduots2e. 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I _.._. as.... — -- /6 PROPOSED SECOND FLOOR PLAN w: a yEX15TMG SECOND FLOOR PLAN 8 PROPOSED ROOF FRMING PLAN 00 oo Cry2IDGE BEAM OPTIONS 5) r- � PROPOSED FRONT ELEVATION og=_ e.......,. .�-o 0� 3 T XISTING ROOF FRMING PLAN _ �* — o0 (�PROPSED REAR DORMER (DE XIS TING FRONT ELEVATION Al Uv. - -o Outlook - shortsaleman@live.com Page 1 of 1 I New Reply( Delete Archive Junkl Sweep Move to Categories William normal Search eman P RE: 12 SOUTHWIK FLOOR PLAN W h^ rr„�, •'^° A Folders To see messages related to this one,group messages by conversation. Make your in %FRTWize _ �ddB-it with-a color ai the d Inbox John Crowell((jcrowell@deerhillarchitects.com) Addmmnracss B/¢/t3 Options icon. To:'William limmodl' Alreadyfrie Junk 10 K Facebook'+ Oose Drafts 17 - , 1 attachment(285.7 KB) oudao Sent _. Deleted Southwick PUNS 9- Agents 15 01 Beatrice Biz 2 Ciambelli Biz 13 Clients View Dame Closed Flips a Contracting and hand... Download as zip Contractor Contacts 2 William, Di Dick Emery Deals 6 Attached are the proposed plan.Please let me know if there is anything you would like changed or added.you can have these printed form the PDF's at Staples,etc.,or I can print you out some copies that you can pickup or I can put in the Fighting 19 mail. Financing Contacts 12 Flipping Boston Deals Hickox biz Note that generally when you open an existing cavity(between studs or rafters)the code requires you to fill them with insulation,but not necessarily meet code.But typically new portions of the construction need to meet code. If that is the Important Contacts 29 case,and they make you get an R-38 insulation in the new dormers,you would need to use deeper rafters or fur them Investments 29 down.Different building inspectors interpret this indifferent ways. Land and New Constr... Leads 7 Marketing 3 Best regards, Me Di and Amy flips ... Meegan Biz 30 John E.Crowell Megi Deals Pecora Biz Deer Hill Architects LLC Personal sT jcrowell@deerhillarchi[ec[s.com Tibbetts Biz t Tools < 978-532-8660 Training and Informa... www.deerhillarchitects.com Traniello Biz 7 Vitali Biz 3 New folder From:William gonna[mailto:shortsaleman@Iive.mmj Sant:Monday,August 12,2013 9:57 AM To:<Jcrowellgsdeerhillarchitec[s.com> QUICK Views Subject:Re:12 SOlITHWIK FLOOR PLAN Documents a Flagged 1 If you could draw up both options that would be preferred. Photos a Shipping updates Sentfrom my i Phone New category On Aug 12,2013,at 9:22 AM,"John Crowell"<'CrowellLaldeerhillarchitects.cii wrote: i William, If you want to span form one end of the house to the other with a new ridge beam the beam itself is going - to be 18"tall,limiting your overall head height if you can put a post on each side of the stair(and bring ..—._._._._.— - u Contentfmm LO Y D 2013 Microsoft Terms Pri®*131abazlorrs TeRnOeh( mmOStallimmlopers English(United States) Learn more Tom off https://bayl65.mail.live.com/default.aspx?id=64855 8/27/2013 BONNE-1 OP ID: PP CERTIFICATE OF LIABILITY INSURANCE osr ,l THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS . CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,! EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED - REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER Phone:781-9354MO NAME: - DeSanctis Insurance Agcy,Inc. Fax:781-933-5645 PHONE INC.No): 100 Unicorn Park Drive A/C No EXt Woburn,MA 01601 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Carrier Will Send Certificate INSURED William Bonnell INSURER B: 170 Hollis St INSURER C: Pepperell,MA INSURERD INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 MAYBE 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. r OF INSURANCE L B POLICY NUMBER MM%DDY EFF PPOM/pp�Y LIMITS Y EACH OCCURRENCEL GENERAL LIABILITY PREMISES Ea acanmce $ -MADE OCCUR MED EXP(Any aria rson) $ PERSONAL&ADV INJURYGENERAL AGGREGATEE LIMITJECT APPLIES PER: PRODUCTS-COMP/OP AGG SPRO- LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea aceldam 4DED O BODILY INJURY(Per person) $ ED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NOWOWMED PROPERTY DAMAGE $ (Par. dent) UTOS AUTOS $ LALIAB OCCUR EACH OCCURRENCE $ LIAB CLAIMSIliAOE AGGREGATE is RETENTION$ $ WORKERS COMPENSATION X WC TATU LAM[[ O R ft AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECl/TIVE YIN TBA 08123113 OB/23N4 E.L.EACH ACCIDENT $ 100,00 OFFICERNEMBER EXCLUDED? N/A (Mandatory in NH) E.I.DISEASE-EA EMPLOYE $ 100,00 If yas,descdba DESCRIPTIO under OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 N OF DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule.If more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION EVIDE-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EVIDENCE OF INSURANCE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRE A 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD OP U.DF!P G!BTTJ- ON FOU FN CNPZFS; DPNCP!JE/ TUBWT!PC3FNC!vPZFS XJMWBNI CPODFNM 111: 96297 Joej wj evbm 281! 1 PMW T! TU CFCCFSFW ! NB! 12574 DPVFSBHF!HSPVQ 2148: 35 Dpwf sbhf I voef s! ui j t 1 bt t j honf ou! U f ! Xbj wf s! pg! Pvs! Si hi ul up! bggrrj f t ! up! Nbt t bdi vt f uut ! Sf dpwf s! gspn! Pui f st ! 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PR OPOSED ROOF FRMING PLAN W Mnn C5ARIDGE BEAM OPTIONS L'lin--r-o nPROPOSED FRONT ELEVATION ...�.� Ll.n -o' op ig /1EXISTING ROOF FRMING PLAN -- o os ��n -o — — - xao Nx ® ao 00 ,n ..-o v /1PROPSED REAR DORMER 0 1STING FRONT ELEVATION Al LJ . .-o IIIIIIIIIIIIII ...._ Al CHAPTER 1 ADMINISTRATION 1 PART 1—SCOPE AND APPLICATION ing building and addition comply with this code as a single building. Exception:The following need not comply provided the SECTION 101 energy use of the building is not increased: SCOPE AND GENERAL REQUIREMENTS 1. Storm windows installed over existing fenestra- 101.1 Title. This code shall be known as the International tion. Energy Conservation Code of(NAME OF 1IIRISDlC170N], and 2. Glass only replacements in an existing sash and shall be cited as such.It is referred to herein as"this code' frame. 101.2 Scope.This code applies to residential and commercial 3. Existing ceiling, wall or floor—cavities buildings. during construction provided that these cavities 101.3Intent This code shall regulate the design and construe- are filled with insulation. tion of buildings for the effective use of energy.This code is 4. Construction where the existing roof,wall or floor intended to provide flexibility to permit the use of innovative cavity is not exposed. approaches and techniques to achieve the effective use of energy.This code is not intended to abridge safety,health or 5. Reroofing for roofs where neither the sheathing environmental requirements contained in other applicable nor the insulation is exposed.Roofs without insu- codes or ordinances. lation in the cavity and where the sheathing or insulation is exposed during reroofing shall be 101.4 Applicability.Where,in any specific case,different sec- insulated either above or below the sheathing. lions of this code specify different materials,methods of con- struction or other requirements, the most restrictive shall 6. Replacement of existing doors that separate condi- govem. Where there is a conflict between a general require- tioned space from the exterior shall not require the ment and a specific requirement,the specific requirement shall installation of a vestibule or revolving door, pro- govern. vided,however,that an existing vestibule that sep- arates a conditioned space from the exterior shall 101A.1 Existing buildings. Except as specified in this not be removed, chapter,this code shall not be used to require the removal, alteration or abandonment of,nor prevent the continued use 7. Alterations that replace less than 50 percent of the and maintenance of,an existing building or building system luminaires in a space, provided that such alter- lawfully in existence at the time of adoption of this code. ations do not increase the installed interior lighting 101 power. listed i Historic buildings.Any building f Historic that is g Alterations that replace only the bulb and ballast listed a the State to National Register of Historic Places; within the existingluminaires in a space provided designated as a historic property under local or state desig- p p nation law or survey; certified as a contributing resource that the alteration does not increase the installed with a National Register listed or locally designated historic interior lighting power. district;or with an opinion or certification that the property 101A.4 Change in occupancy or use.Spaces undergoing a is eligible to be listed on the National or State Registers of change in occupancy that would result in an increase in Historic Places either individually or as a contributing demand for either fossil fuel or electrical energy shall com- building to a historic district by the State Historic Preserva- ply with this code.Where the use in a space changes from tion Officer or the Keeper of the National Register of His- one use in Table 505.5.2 to another use in Table 505.5.2,the toric Places,are exempt from this code. installed lighting wattage shall comply with Section 505.5. 101A.3 Additions, alterations, renovations or repairs. 101A5 Change in space conditioning. Any noncondi- Additions,alterations,renovations or repairs to an existing tioned space that is altered to become conditioned space building,building system or portion thereof shall conform shall be required to be brought into full compliance with this to the provisions of this code as they relate to new construc- code. tion without requiting the unaltered portion(s)of the exist- ing building or building system to comply with this code. 101A.6 Mixed occupancy.Where a building includes both Additions,alterations,renovations or repairs shall not cre- residential and commercial occupancies, each occupancy ate an unsafe or hazardous condition or overload existing shall be separately considered and meet the applicable pro- building systems. An addition shall be deemed to comply visions of Chapter 4 for residential and Chapter 5 for com- with this code if the addition alone complies or if the exist- mercial. 2009 INTERNATIONAL ENERGY CONSERVATION CODE® L