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8 STORY ST - BPA-16-883 :�56 C �(nOlob3Fo Ins The Commonwealth of Massachusetts F O CITY Board of Building Regulations and Standards C ITY M Massachusetts State Building Code, 780 CMR SALEM Revised Mar 2011 n Building Permit Application To Construct,Repair,Renovate Or Demolish a One-or Two-Family Dwelling �O This Section For Official Use Only Building Permit Number: Date Applied-. _CJ Building Official(Print Name) Signunue Date 1 SECTION 1:SITE INFORMATION I1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 8 STORY STREET SALEM,MA 01970 93 0014 1.1 a Is this an accepted street?yes_ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: R2 ONE FAM Zoning District Proposed Use Lot Area(sq ft) Frontage(it) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Acquired Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if yes❑ Municipal❑ On site disposal system ❑ SECTION2: PROPERTY OWNERSHW 2.1 Owner'of Record: MAI IRFEN SI II I IVAN SALEM MA 01970 Name(Print) City,State,ZIP 8 STORY STREET 978-594-5041 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building Id Owner-Occupied Nf I Repairs(s) Vf I Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other Specify:Replacement Brief Description of Proposed Work": REPI ACE 3 WINDOWS - NOSTRI JCT11RA1 CHANGE SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials Official Use Only 1.Building $ 6,382.00 1, Building Permit Fee.$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2- Other Fees-, $ 4.Mechanical (HVAC) $ LisL 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 6,382.00 ❑Paid in Full ❑Outstanding Balance Due: ��� M�t'>-AE�Q IN sr:), s. SECTIONS: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 90125 10-0 6-16 Jamie Moirn License Number Expiration Date Name of CSL Holder U Lis[CSL Type(see below) 86 Gardiner St No.and Street Iype Description Lynn, MA 01905 U Unrestricted(Buildings u to 35,000 cu.ft. R Restricted 11a2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 508-351-2214 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 170810 12-2 3-17 Renewal by Andersen HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 30 Forbes Rd No.and Street 508-351-2214 Email address Northborough, MA 01532 City/Town, State,2IP 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 ..........9 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 Jamie Morin to act on my behalf,in all matters relative to work authorized by this building permit application. SEE CONTRACT Print Owner's Name(Electronic Signature) Date SECTION 7b: O R AUTHORIZED AGENT DECLARATION By entering my name below,I by attest der the pains and penalties of perjury that all of the information contained in this application i e and s ate to the best of my knowledge and understanding. r JAIME MORIN Print Owner's or Author' s Name(Electronic Signature) Date NOTES: 1. An Owner v4p4btains a building permit to do his/her own work,or an owner who hives an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.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.mass.gov/dns 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (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' CITY OF S UJ&N , INLISSACHUSETTS BURDLNG DEPAItntENT ' 120 WAsmNGTON STREEr,Ya Est ooR TEL(978)745-9595 PAX(978)740-9846 Kiat$RRi.EY DRISCOLL MAYOR THOU"ST. MISLE DmECTOi of PuKx PROPEm/sl:mmr.co,.mamoNER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code,780 CUR section 111.5 Debris,and the provisions of MGL c 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111,S 150A. The debris will be transported by: Renewal by Andersen (name of hauler) The debris will be disposed of in : Renewal by Andersen (name of facility) 30 Forbes Rd, Northborough, MA 01532 (address of facility) mt applicant date debrinfr w ?eWal Agreement Document and Payment Terms 4AMers rl aw byAmdenea u60'sstsa mmunnnn xullh an. kWJ Ramp:Buccal hr Prxtusert UC 43 Mcqstreet 120814! 5ikon.MA 01979 ffmmr 4a Ea+lrts.r'.+.avj9 Roghhomuph,Pi't«5o*m P'C70554-50at }taru?: 4335d-22CUPFar:lSkt;'sM 9F, -7+AA8!'E suBoslan0@erattrsnypx+r t+SenCeipxum '� 073'ts'7"M CniewirmLiis)Nanny- Maureen Sullivan ti�9 itraet L7art 07115MG C:m,wai r(s) Street ikd&ew-$ Stor115treet, Salem MA 01970 pe iemaNy�l'elejai'onate 1".nm�er_����.��5914-�0•�j', .Seeu ���[:NI-u��w*�,"0eti6ec-.�7���79�17t��i� 1'tvisary Eoku - r0MSUllrftC MkCast,net iulaa4p�ttia l_ Lirnycafsyhereby q,iardy and,-A%. sallyagmets w pwchwediepiroducis andtaracwi aof firamal.by Axutrsm LLC`;d1b:+a Remewal4g eAndasr-m onrlptas`to7rh(.°�wireat�rsr';1,in aeeoanlaute7ewitbdie rcrotie7 amd ht ihu Agreftsw3ii.Ductatncmr amyl Paymio--ot T+rrtts, hnrteca of Tum.imexl0r&r fi csipt,lm p* Jcr.Tn5.q3A C.ccradiCan_E+aESjIP>I�3 4ak I aan. Vaitwr.:fEtiJairg rn Ra+74ssr and as y anccr dat4urrtent airachrd to this Agac> meat Doarroent LIM terms ofwl96.sm Al armed,co b;*the F.rrics and incatpafiared 9ert ei lama¢ellisreace{mlleeively�.ehis'.kA eement:"1. Rt;mrfs)I"3•.agr ra sign a.crampletiao oamifiicotte after C"-,samtra M It"❑asnprlened all"Pik. under c6is.kg'MEMemc. '1 oLd Jowl,-rtrme�met: S6..382 By,"gpmg:ihns agrWrmsni.1-0 kmn<m*dg*that th6 NJaPM,Ewe.,MO tlhc AM,ogrnr 9�rrced mztst Le in.-Mub ea�t:rw1,h+�k7 I„ak'che& a edh caiA or�ekhe Ft7Mp�vir Icsti�ix�ed: 52,1'22 BAkaft DM: S4.2$5 FSeirnartsd Sdari- FP-Idttmeed Ccimspl LhMb: Auniunum Fitlmpmd: So $weeks 1OWeelcs LAlohod of Rayntent: Cme4it Cited vl sit edetle nstalpa2io u lxascoi on alar dwe of cbe signed cononcr and secoMad[j,on t'L"ta/e:: the duos 6which 1 . nrtF]ete the irrhmiml mraxu8ean¢nta-The instnllariet,chte t6.ii. 52127 E1oWn ,,graar pruticlirag as this time is only:2Acsdmmtc,We will communiczean oaflieial dace $2127 an start' aual time at a later date. Rain=J tatucaor*cud=ate cmau emmiezoon eat>ses•for S2128 on cmMpl¢tlon d&' Iluy.erfl1 agro cs and.undersr=&Joat dris Agmem cmt oonsriuures the ester ttttderssarerliugs 1,etwem,slat parties and that There are no wdnl. trmlcssrmndltr�t;:cltangii oftn6rlifryrittp;ampofelicmc-sasolthisAiytclnietrt: t+Iaalxamimimeraarde,+laammai7xmi.afhisisSri�rSatnrwillPry-Yalud �nA.at c the sigat�1,w attarv+aart� nr rof brorh r_hg 8� 3 wed Cr ntt7Fr 3r, B aes)6srst.} orry tkae Buy�r(s) 'fy lies rgn:l'tltts 3Apeenrenr,=d Ittnda the texrns Uf dais Itigrecrrte®r xnd'ha€rr€rived a cc mpkte$ na d and day tag y a9 ta�httss A rxcrm€nc,pnclnsiirt the ewe atmae a:e^•otFaQ,aFC�rme[latia,S,on rlw rEstr fist u*rinrten alsone aced. )rrar.mrrallpr infnrmo,i$of�rr�ca$ rt tm o:anaa this, tAl+.seca„ear.. I,OTICF TO CtWN FR-Da faun Sign Lhk contrwo if 66a1c Yon tee o ncitled r0 a.010•,nf dte cvtmrrtavt ad dot ru aErirost sigh. YOU,THE BUYER, iY°AY CANCU THIS' 1SsAMION AT TY'TLME NOT LATER THAN MIDNIGHT T OF 0711912416 OR THE THIRD HUSlXIM DAY AFrER`CHE.D.ATE OF THIS`Ti'R,p1NISAC Q it1N, WHICHEVER DATE IISS LATER-SEE THE i1iTrACH nNOTICEUPCANCELLATIONFOR,MFORAN EXPLANATION Of THIS RIGHT. :Lecd-sag RMMA hY An.dm LLC cammok&W � $r,'4c�rsrnaE S'�resawre of 5al�-e I��sWm 5i�umceer 4.it;raacWae Bruce speck Mav Peen Sullivan Pivit'N-atmeofs;&S Vitrnmsi ptitu Mahe print tN:t to 47+I5t16 pace 2 1 12 RL'newal Itemized Order Receipt NArdemen aw L14unppm Sullivan t1V.6Fd?rSErLLLC 35inryStreef sintim.Kf%01970 MA-5153Z CgTW94-5044 Ax _:57,351-2200 1 fat:154M Kr.—TZU I 997V,6979-6377 105 KN Window Gliding -Double, Gliding. 171, Passive lActrm, EJ Frame, LXTIE§tIQR Wh4e.INTERIOR V0111e, GIA44:5Mill All; High Performance Smart5an,Ghats, No Pattern. llianfwzre:White, Screerm Tru5cene vinth Erteflor Color Match,FL41 Screen, Grille Style, Na Grilles, Non 106 Ki4 Wj nclaw. C asernen I -Single. Casement, Right.,EJ frame, EXTERIOR White, INTERJOR white, Glass. Sash Aft High 5rriaftSUn 614N%, No Palter., Hr*Tdw*j*-.WNW. kwrk: IFUScenq vAth InIenor Color Match. 6w.111he Style: No Grilles, Mist Non 107 Kit Wind*w.Casement -Songle, Casement, Left. EJ Frame, EXTERIOR while, FNFEFJOR Whitte, Glass., 5.aish AN: HpQh Performance SmartSun Glass, tJG Pattern, Hardwarerr White, Screen.; TruScene Mth Interior Color Matit1h, Grill*Style-. No Grilles, Misr. Nun 9M001US!3 PATIOE00RklO SPECIALTY'0 MISCs 0 ToTAL UPDATED: W15116 /0=�, A"mmal�b Agimem it rontmiried m owr ourme"'rafeey fly Oil rV I F Paw 4 t Q ,� ?Yre CLtte�fuptrltmafrk�Mattt�taarer� offiw Of lowilbolorat so WaSNAMMA.1tiwa An tom AU i2111 �amave,�nvk7is 6Workm,Cotapen80flon iawiteance AM&—Ac a al�uatxactals/�iwarlcl [r}�bera I\iam�tt>ttsaeresrt"araa�..:aettoW4altaAuat:; RENEWAL BY ANDERSEN Address;_30 FORBES ROAD - - - City/S lip'.NORTHBORO,MA 01532 _ P�tOtae 508-351-2200 Aree 0euwby&'•'caeck the wAwopvinbbow 1�e�peq�etlre9WrydY i; tam a eeapkgs»23t 30 t. © 1 am■ I vetnctoratdI d El oana aims e�pkrjues(PuJasbbrpa:t-timny" iaavrtumldieNd►rampaarors 101 sea a SaeputiWIdor or pmtw- twat')rm dw 4"Chod t3tart.: ?'�'Pj limaadeling shipaedhatiaaa ws m�*j7j,-^ue�at.-wmlave 2 0-notolitim vmddog for meat any a*scity- woderrs'e®p.hourdo . jNo UG&Ms'wmr,avainetae 5. 0 %Ware a cagmmtam Mud its 9 ©Btuldntp addRlon tetpti W j offitxas taut cmNcWM thair 10.L0 t"I drkal tapaim to aQrvl m a.[,j 1am a>a rmr.aoiwg all-amlt t ow ofe�,za}rdioa per-ma 11: P1ttm4i"Pal 4raddtttans n sw..jNowwbets'twnv. 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C-3115UMP.- _`yOA60 Gate' 10-01-16 _ 1obSttsAtlal ew: R GTflRY TREET41ly,Sfaw40;_^ jALEM, MA 01970 Attach a coo aP ibeworlera'aampewd"pWkv tfa (shmbg tlw pa3q ataabs:aad trsptraftaa datey ltalltttr m oetvo cwretage as aquireti M�7 3aciivn:t 1 aPb1fL a:1 ty eevt l4rod w the imp("an ofcyyaeittac petml�s ofa fw up to 31„ V-00 attt(iar atao-yaer wpnwaa�m wt9l as cat ii�tgia:m the item of a S1 DP W mrw nd pmabtaio fs "up w""00 a day agaves the viold0dr 1?c ddrienl thaz a espy oititiv statmMam may ha fiativarded w the Olpiae a¢ lavemodEim of dw INA for ae�x am�vetifeatron tdd owpokowsolP•+�riatmtaleAgAr p�t�(afaGetxk wtrdtsrKcs IR>o�p. 508-351-2200 Fdo taaxattvierattrffedrtae M& b�*iN�rotra�iist —� � ` 1. ohic a otw1: --�� 1 BaiEdttgAerft3 4.F3seCfealpaear,sPimulbbK'�apeetor_, lebonep� t Maw-aehuoetb-Department of Pubpe Metely Board of BWIdIn6 Reputadow and SfaMterde ConsWrean Sapen*or � d'EtSt]�Ilt3m'tbf`r: �. t GYlStDae r '.�.ar .NLdc¢� n'a•a Expiration i tcrinhelorto„ 1gIOtlPgiC *7EMP Coma oer AWN&Basins[Reeolation IMPROVEWNT CONTRACTORstration: 471i m Type. IrallaI*..S L Supplement Card RENITWALBYANDdw**W�Lf:C' . , JAIME MORIN 90 PORBES RD NORTHBOROOOH,MA 01532 Undenmretary i t i I . - . Dundnmwi MMlldoo&hffplWm Son kbW trtibn kffl o. Y , e +aaewm urCa ♦ Renewal' AND44t02 . ...�' Waad/VlAyl Compon ' Pmdurd Types C✓saemellt I Edgar PEPFOFNMWOE RKnNG8 . .LLFab3r '8der.Heed Oeln Coellident 0.29 1.65 0.28: ' KDDMCXN L PERPOWJ"CE PKTIW= ' Vlslble Trenendltance •. 0e48 '- rxer+rys:+nwmarya�rs�►rn.a+er.r,wza t me.mr.rnvw.r.srrr. w MSOrw.M4YMlc•.pyYlYAaIY DP7DPSOS i ' toLLOhp19e7'dDD1 i r t � Ao natmmor.�IIvl m�+0sp�m.A:rei.hdhti�e.ietaame. 'Q .M1.o�.w^. ��Raa1NM,enWT�. _ oil APIDN-aS w®dm�N Eaare�s�+ a� FmduCT�yp�e�:suaa U-Fadw solar Flee!Qaln cadde t 1.65 ehirJ81 IwamaaaL FAMRSMU annaoe Vile Tta`emitlanae 0.49 ,ae \ aw�d �® • � x+�'n...wwrawu+uaxaac .OP pyile.cd6: ti teDae'J14Cd6-0{3