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5 STILLWELL DR - BUILDING INSPECTION RFCFIVED T15 _ I1� _ $ LSq The Commonwealth of MassJOUPIRNAL SERVIC -7 1 Department of Public Safety 7 r➢I Massachusetts State Building Code(780 CI FR l J b A 3 b Building Permit Application for any Building other than a One-or wo- amity Dwelling (This Section For Official Use Only) Building Permit Number: Date Applid"H: Building Official: SECTION 1:LOCATION(Please indicate Block p and Lot#for locations for which a street addre s not available) No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ Alterati29L ition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans an construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineer: Pei{Review reyuired? Yes ❑ No ❑ Brief Description of Proposed Work:— /�- � 7r 1/ � �-T�71Y14 — SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): 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-2❑ Nightclub ❑ A�3 ❑ A4❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H4❑ H-5❑ I: Institutional I-1❑ I-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-111 R-2❑ 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 ❑ IIB ❑ ILIA ❑ HIS ❑ IV ❑ 1 VA Cl 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 will not be Licensed Disposal Site❑ Private❑ or indentify Zone: or on site system❑ required❑or trench or specify: permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Prucess: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Croup(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Ap4ress of Property�ner J / /W,h •�rhtrt N me(Print) —� No.and Street City/Town Zip Property Owner Contct Information: Title�a�,r M 44(I� Telephone No.(business) Telephone No. (cell) e-mail address If ap lica e,the roperty o er hereby authorizes Name Street Address City/Town State , Zip to act on the property owners behalf,in all matters relative to work authorized by this building permit application. . SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here I and ski Section 10.1 10.1 Re 'stered 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 General Co utractor - Co an Same Vas), CAS - 07�9d S� I�XrKe of Person kesponsible for C trucfty' � Licensa No. and Type if Applicable Street 2Address � Town St t Zip ��L1—n 1 /' ,LV 10#0 .mac-1 Telephone No.(business) Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT .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❑ No ❑ SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ /)Tj' Building Permit Fee=Total Construction Cost x_(Insert here 2.Electrical $ appropriate municipal factor)_$ 3.Plumbing S 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ ,�j� �— (contact municipality)and write check number here f SECTION 13.SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this 1 application tq�true and accur o the best of my knowledge and erstanding. / Pgse not and sign namN r) C 1�] _ _ I �ti� _Telephone No ate Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval• Name Date American Properties Team, Inc. Ask TO: Salem Building Inspector FROM: Jennifer Pappas, Property Manager RE: Roof Replacement & 5 Fillmore Road; 1 & 3 Spruance Way; 2, 3 & 5 Stillwell Drive DATE: April 10, 2014 Please be advised that the Board of Trustees for Pickman Park have approved a roof replacement project at the above referenced buildings. This work will be completed by Thor Roofing & Construction. Should you have any questions or require additional information, please feel free to call me directly at (781) 569-2675. 500 WEST CUMMINGS PARK•SUITE 6050- W0BURN -MA •01801.781-932-9229 -FAX 781-935-4289 ' SECTION 9: PROPERTY OWNER AUTHORIZATION Name and A Ppess of Property er NNme(Print) d No.and Street City/Town Zip P�opPrtyt ner C ct Information: Title /j/�.,e 4nq t{I— Telephone No.(business) Telephone No. (cell) e-mail address If ap lica I the roperty oYvner hereby authorizes , Name Street Address City/Town State Zip to act on the property owner's behalf in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) building is less than 35,000 cu.h.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1 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 General Co tractor Co an ame 4S075'g�S'- e of Person esponsible for C tructipp Lice a No. and Type if Applicable Street Address —I V zip �G - �aD —� ��Town 140 0 State- i /� Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT .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 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ !J 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 $ $ ,55� —_ Enclose check payable to > 6.Total Cast � (contact municipality)and write check number here f SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application t true and accuritteAD the best of my knowledge and erstanding.� �Ud o can) r�l ItJ P,leLase rint and sign name f/� _ _ _ �-,d Title Telephone No. ate 7� f �O�t r i'Y1�f�G /ft1-( �_[YSI.�l2 �Y•3,�I/, /�1� ,, Street Address Ci Town ty/ State Zip Municipal Inspector to fill out this section upon application approval: Name Date IrrFIVFn The Commonwealth of MassaOU09NAL SERVICES Department of Public Safety 1 Massachusetts State Building Code(780 CI epR b A 3` 3 b Building Permit Application for any Building other than a One-or wo-1 amily Dwelling (This Section For Official Use Only) Building Permit Number: Date Applictd: Building Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ Alterati ition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural E Work:erin P�f Review required?uved Yes ❑ No ❑ Brief Description of Proposed Work: �,//�� � 7 _ _ _` —� SECTION 3:COMPLETE THIS SECTTON IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): 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-i❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: Hi Hazard H-1❑ H-2❑ H-3 ❑ H 1❑ H-5❑ I: Institutional I-1❑ 1-2❑ I-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑ 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 ❑ IIB ❑ ILIA ❑ IIIB Cl 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 will not be Licensed Disposal Site❑ -( Private❑ or indentify Zone: or on site system❑ required❑or trench or specify: permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: (.fil"(r Off ice of Consumer Affairs and Business Regulatr 10 ParlcPlaza - Suite, 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registi atio TYp Expiratio WJN CONSTRUCTION CORP. _ WILLIAM MANGIASI 407 REAR MYSTIC AVE. UNIT 36A MEDFORD, MA 02155 -- -" Update Address and Address Rei SCA 1 C, 20M-D5111 - — — - � V rvnau,vutK.n/l�r¢C�2r'issoc/.�ac!(a License or registration valid for indivi; office of Consumer Affairs& Business Regulaliou before the expiration date. If found re ej� IM oOME PROVEM ENT CONTRACTOR Office of Consumer Affairs and Busim �` �egetration� 123356 Type: 10 Park Plaza-Suite 5170 xpiretion 2/4/2015 Private Corporation Boston,MA 02116 WJN CONSTRUCTION'CORF. - WILLIAM MANGIASI ._ 407 REAR MYSTIC AVE UNIT 36A MEDFORD• MA 02155 Undersecretary Not valid without signatytc 1 S Massachusetts - Denartment of Public Satety Board of Bu iding Regulations anc Standards . - Conscructino Supcn i+m L;cetise: CS-075985 ._ WILLIAM A MANGIASI 13 GIBSON CIRCLE MEDFORD MA 02155 n .a Jww... JJJ/.��f• ;. _ -vatic., �ammissiooer 07/17/201f OP ID: MS CERTIFICATE OF LIABILITY INSURANCE DA E(120/1/YYY) O 4 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 terns 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 978-9Y5-1300 ONTACT C Be rave&Hall Insur.Assoc.1nc PHONE 305 North Main St. 978-975-7596 PHONE No Eat: AX Andover,MA 01810 -MAF ac No: Lawrence J.Hall ADDRESS: CUSTOMER IDO.WJNCO-1 INSU0.ER5 AFFOROWG COVERAGE NAIcIf INSURED VVJN Construction Corp INSURERA:AFI)ella PfOfeCtlOn Ins.CO. Thor Construction 41360 407 Rear Mystic Ave #36A ' INSuRERa:COmmerce Insurance Co. 34754 Medford, MA 02155 INSURER C: INSURER 0: INSURER E: INEURER F: COVERAGES CERTIFICATENUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE"V. BOVE FOR THE POLICY PERIOD INDICATED. NO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER ITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEDSUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSRsm LTR TYPE OF INSURANCE POLICY NUMBER MMIDOIYYYY MMIOO/YYYYLIMITS GENERAL LIABILITY ENCE S 1,000,00 A X COMMERCIAL GENERAL LIABILITY 8500036963 05121/13 06/21/14 acaRence s 300,00 CLAIMS-WOE OCCUR one porson) S 6,00 PERSONAL S ADV INJURY M52,000,00 ._-- GENERAL AGGREGATE GEN'LAGGREGATE LIMIT APPLIES PER. PRODUCTS-COMROP AGO POLICY PRO AVTOMOBILE LIABILITYCOMBINED SINGIE LIMIT ANY AUTO (Ea ecudent) ALL OWNED AUTCS BODILY INJURY IPerparson)B X SCHEDULED AUTOS BDRZHT 08/13/13 08/13/14BODILY INJURY(ParawidanU HIRED AUTOS PROPERTY DAMAGE (Par amidaM) s 100,000 NON-OWNED AUT05 S S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS 1-I19 - CLAIMSAIADE AGGREGATE 5 UEOUCTIeLE 5 RETENTION 5 WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY X WC 1TATLL O1RH- A ANY OFRCERIMEMBR EXCWDETQBY D]�CUrIVE YIN NIA 910389 01/01/14 01/01/15 E.L.EACH ACCIDENT S 500,00 (Mandolary In NH) It yes,tlascriho urIdar E.L.DISEASE-EA EMPLOYEE S 500100 DESCRIPTION OF OPERATIONS h 11 elc E.L.DISEASE-POLICY LIMIT S 500,00 I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD IUI,AddlUonal Romarks Sclmdula,if more spacc is roquiradl , �1 CERTIFICATE HOLDER CANCELLATION 0000000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE I ©1988-2009 ACORD CORPORATION. All rights reserved. ACDRD 25(2009/09) The ACORD name and logo are registered marks of ACORD I' The Commonwealth of Massachusetts Department of Public Safety s m Massachusetts State Building Code(780 CMR) Building Permit Application to Construct,Repair,Renovate or Demolish any Building other than a One-or Two-Family Dwelling Code and Other Requirements for Building Permits The Department of Public Safety has issued these building permit application forms so that municipalities across the state can move toward use of a single permit form and consistent permit application process. The MA State Building Code specifies the requirements of building permits and the applicant is advised to review and be familiar with these requirements in order to avoid some of the common permit application problems.Likewise the applicant should be aware that some municipalities require that the owner confirm, even prior to acceptance of the building permit application, that no outstanding property taxes,water fees, etc.exist. Filing Instructions 1.Please contact the city or town where the work will be done to ensure that the city or town will accept this application form and if any additional information is required, and obtain the correct mailing address. After doing so, print the application, fill in completely and then submit to the local city or town where the work will be done. 2.A11 applications shall be considered complete and will be reviewed if construction documents, specifications, fee, and other materials that may be required as indicated in the Building Permit Application are included with the application. 3.Please include a check for the Building Permit fee. The fee may be calculated using the information to be supplied in section 12 of the Building Permit Application. The check is to be made payable to the local city or town where the work will be done. Appendix 1 For the demolition of structures the building permit applicant shall attest that utility and other service connections are properly addressed to ensure for public safety. Please fill in the information below and submit this appendix with the building permit application. The building permit applicant attests under the pains and penalties of perjury that the following is true and accurate. Property Location (Please indicate Block#and Lot#for locations for which a street address is not available) No. and Street City/Town Zip Name of Building(if applicable) For the above described property the following action was taken: Water Shut Off? Yes ❑ No �/ Provider notified and Release obtained? Yes ❑ No ❑ Gas Shut Off? Yes ❑ No Provider notified and Release obtained? Yes ❑ No ❑ Electricity Shut Off? Yes ❑ Nov Provider notified and Release obtained? Yes ❑ No ❑ Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Appendix 2 Construction Documents are required for structures that must comply with 780 CMR 107.The checklist below is a compilation of the documents that may be required for this.The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(nnay require repeaters) 6 HVAC 7 Electrical 8 Plumbing include local connections 9 Gas(Natural,propane,Medical or other 10 Surveyed Site Plan(Utilities,Welland,etc. 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report 17 Architectural Access Review 521 CMR 18 Workers Compensation Insurance 19 Hazardous Material M fi ation Documentation 20 Other(Specify) 21 Other S 22 Other S `Areas of Design or Construction for which plans me not complete at the time of application submittal most be identified herein.Work so identified most not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction.Work started prior to approval may be subjected to triple the original permit fee. Registered Professional Contact Information Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Ton State Zip Discipline Expiration Date w Name(Registrant) Telephone No. e-mail address Registration Number Street Address Ci Town State ZipDiscipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Discipline Expiration Date Street Address City/Town State Zip i� MAR-25-2014 oe:16 FROM: � ' / T0:17315692657 P.1/3 407 Rzar MyStie¢lvenull Unit 36v evativad# Medford,MIl, 02155 791-396-5420 (Fug)781.396-5450 We Are: ®Licensed ®Insured Will tog'Grained ®Facto Certified Installers Proposal Submitted To: Piekman Park Condo Assoc Phone 11" Date:01/17/2012 R' W' Street: Job Name Same City,State,Zip Code Salem.Ms.01970 Job Location Same Proposal to furnish and install the following: New Roof /Strip Off.......Entire Building Complete Roof Preparations—Services provided to help you avoid hassles and to protect your home Home exterior to bo protected by tarps and plywood Shrubs,landscaping,trees to be protected from damage Entire existing roofing material to be removed to existing decking. Site to be cleaned everyday,debris removed at project completion Deteriorated existing decking replaced at a cost of:$3.50 Per Lineal,Ft. 9"Metal drip edge installed at caves 0 A"Metal drip edge installed at rake edges New lead step flashing will be installed around chimney base New plumbing vent flashing will be installed and dashed Shingle valleys witl be installed Contractor will pick up building permit 6' fee and Water shield installed at all caves to protect from ice dams(and meet codes in the north) -Provides the bust protection for your home 3' ice and Water shield installed in all valleys,around penetrations,and chimneys to protect critical areas -Protects the most vulnerable areas on the roof GAF Shingle-Mate reinforced underlayment installed over entire decking GAF Ridge Vent System will be installed -Ensures that your roof system will last,your utility bills will be lower,and your warranty will be valid Clean up and can away all debris. Quality Shingles: CAFTimberlin?Series Cl LIFETIME 2 Stillwell Dr.(4 units;A-D).......$14,600.00 Color-ShakewmA Other Shingle 3 Stillwell Dr_(4 uuils;A-D).......$14,600.00 OAF Nip and Ridge that matches shingle warranty will be installed 5 Stillwell Dr.(4 units;A-D).......$14,600.00 Warranty: 1 Sproance Way(4 units;A-D)......$14,600.00 Roof to carry manufacturers(lifetime)limited standard warranty 3 Spruance Way(4 units;A•D)......$14,600.00 and Thor's(2)year labor warranty. I Fillmorc Rd.(4 units;A-D)......$14,600.00 With payment to be made as follows' 1/3 Start of Work/1/3 Midway Thra/ 113 Cotttpletiaa O� Date of Acceptance: Contractor: Thor Construction Company � 1 Property Owner Signature: I - "� ,,T ,��� �" �'; .✓�"�uui C'ar�buu�fs�u`c L'airLpaiu� L.� 407 Roar Myatie eo # g9V¢na¢ Unit 36 �� l Allyt �` ,1 -- Kzdford, M,N. 02155 791-3%-5420 (rux)701-3H-5450 We Are: ELicensed ©insured [Wa tory Trained Wactog Certified Installers Proposal Submitted To: Pickman Park Condo Assoc. Phone#'s Date: 03/03/2013 H:W: Street: Job Name Same Cit;,State,Zip Code Salem,Ma. Job Location 5 Fillmore Street,Salem,Ma. Unit#5A,5B,5C,5D Proposal to furnish and install the following: New Roof /Strip Off.......Entire Front And A&B Back Complete Roof Preparations—Services provided to help you avoid hassles and to protect your home Home exterior to be protected by tarps and plywood Shrubs, landscaping,trees to be protected from damage Entire existing roofing material to be removed to existing d^eking. Site to be cleaned everyday,debris removed at project completion Deteriorated existing decking replaced at a cost of: $3.50 Per Lineal.Ft. 8"Metal drip edge installed at eaves ❑ 8" Metal drip edge installed at rake edges New lead step flashing will be installed around chimney base New plumbing vent flashing will be installed and flashed Shingle valleys will be installed Contractor will pick up building permit 6' Ice and Water shield installed at all eaves to protect from ice dams(and meet codes in the north) -Provides the best protection for your home 3' Ice and Water shield installed in all valleys, around penetrations,and chimneys to protect critical areas -Protects the most vulnerable areas on the roof GAF Shingle-Mateo reinforced underlayment installed over entire decking GAF Ridge Vent System will be installed -Ensures that your roof system will last,your utility bills will be lower, and your warranty will be valid Clean up and cart away all debris. Quality Shingles: GAF Timberline Series El LIFETIME Color_ Other Shingle GAF Hip and Ridge that matches shingle warranty will be installed Warranty: Roof to carry manufacturers (lifetime) limited standard warranty and Thor's (2) year labor warranty. Total Contract Price: $10,950.00 With payment to be made asfollows: 5% Deposit/ 1/3 Start of Work/1/3 Midway Thru / 1/3 Completion PrDate of Acceptance: �I'� l/l /I Contractor: Thor Construction Company p .otv Owner Si gT a urea: � ltb �nU itional Terms Attached ► l3 - r � -�so � �5y°° 0.'ZI The Commonwealth of MaSSa&llSCtt9NAL SERVICES `y C/ Department of Public Safety Massachusetts State Building Code(780 CM PR Ib A 3: 3 b Building Permit Application for any Building other than a One-or wo- amily Dwelling (This Section For Official Use Only) Building Permit Number: Date AppliM: Building Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street addreA is not available) _a No.and Street City/Town, Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ Alterati ition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ 1 Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineerin P Review required? Yes ❑ No ❑ Brief Description of Proposed Work: r SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.h.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A 1❑ A-5❑ I B: Business ❑ E: Educational ❑ R Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H 4❑ H-5❑ 1: Institutional I-1❑ I-2❑ I-3❑ I4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑ 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 ❑ IIB ❑ IIIA ❑ 11111 ❑ rv ❑ 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 will not be Licensed Disposal Site❑ Private❑ or indentify Zone: or on site system❑ required❑or trench or specify: permit is enclosed❑ Railroad right-of-Way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed?, or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: III Does the building contain an Sprinkler System?: Special Stipulations: I SECTION 9: PROPERTY OWNER AUTHORIZATION Name and A er N me(Print) No.and Street City/Town Zip Pr_ operty Owner C M Information: Title Kg4fr Telephone,No.(business) Telephone No. (cell) e-mail address If ap lin e,the roperty owner hereby authorizes Name Street Address Ctty/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10,CONSTRUCTION CONTROL(Please fill out Appendix 2) (If ilding is less than 35,600 cu.ft.of enclosed space and/or not under Construction Control then check here❑and skip Section 10.1 10.1 Reyjstered 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 General Co tractor Co an ame N%rKe of Person kesponsible for C truce" Lice a No. and Type if Applicable 04 —Poe. /'YI e- Street Address �— ` � ity/Town Sr<jte` Z ip s�_f-�Q 'rtjf('rl � o�� ►��i ��lrYi-r<�16�/fY'1—(� Telephone No.(business Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT .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 $ ,�j� (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this i application i true and accur o the best of my knowledge andhemrstanding.,�Print ameG Telephone No. Date �{ J YhN e �yls Street Address fCity/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date