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64 SUMMER ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts lrfbPEC"NNA ED ° Board of Building Regulations and Standards CITY 0 SER110ES Massachusetts State Building Code,780 CMR ''ae Building Permit Application To Construct, Repair,Renovate Or Demolish a RNt dSEP 2fy A ": 01 , One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Dat A'_pppllii,`e,,d,': Building Official(Print Name) Signature o Dat SECTION 1: SITE INFORMATION 1.1 Proy Address: 1.2 Assessors Map& Parcel Numbers Co:-1pert �VmME�S� r� Lla 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 ft) Frontage(ft) 1 1.5 Building Setbacks(ft) Front Yazd Side Yards Rear Yard Required Provided Required Provided ' Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Name(Print) City,State,ZIP CDA Summer- s' 00,9-74q -0302 A9 No.and Street Telephone Email Ad ess SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) W- Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': —VeAAr �,sov .c 4vo r re +, wl zx� PT clot Hte a4penn,eJer r LYums eve -aam SA Xlrs SECTION 4: ESTIMATED CONSTRUC ION COSTS Item Estimated Costs: Official Use Only Labor and Materials I.Building $ DO 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) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$ / 0- Check No. Check Amount: Cash Amount: 6.Total Project Cost: $f ❑Paid in Full ❑Outstanding Balance Due: y AA;( 1W I - SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 10p�s2 / a7 /(o d'QS�-m �m.�w�y NA;11��Va1x xLicense Number Expiration Date Name of CSL Holder 9) List CSL Type(see below) S �'otr oh\\� � No.and Street Type Description nI� U Unrestricted(Buildings up to 35,000 cu.ft. 1l toy�p\Pone�� -V 1, 0 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Mason ry RC Roofing Covering WS Window and Siding n ( ^ SF Solid Fuel Burning Appliances KV ) �kI//eSl_r,,inpr I Insulation 'telephone Enlail address F I D Demolition 5.2 Registered Home Improvement Contractor(HIC) /S3 �2Z 1 �\ o Q .. ' , ��v�slty e'l� Lt Q� ® ,�� , 30 HIC Registration Number Expiration Date H1\l�emorS RegistrantNeale No \S.I& P \Ow Dteb Wf•to mail address e&a 7$21-1o51.277gZ City/Town,State,ZIP Tele hone 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 ..........G%� No...........❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize 0 " )NA V-Vti C to act on my behalf,in all matters relative to work authorized by this building permit application. -Da mernie- jaizzto 9-Q),a--19 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below,I 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. Print Owner's or Authorized Agent's Name(Electronic Signature) 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 M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos 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.U.F.Nl, T%L-kSS.A cHLSE= BI;II.D ,PIG DEPART.\MSIT • 130 WASH ,NGTON STREET,3� FLOOR TEL (978) 745-9595 FAX(978) 740-9946 KI1tBERLHY DRISCOLL MAYOR THomm ST.PIERRB DIRECTOR OF PLBLIC PROPERTY/Bunni IG CONMSSIONER Construction ct on 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. The debris will be transported by: Int y\Y\k (name of hauler) The debris will be disposed of in : (name of facility) nth (acVxss of facility) signature of permit applicant dale dcbriutT.doc The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 u,p Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Presto Painting and Construction Address:8 Yorkshire road City/State/Zip: Marblehead, Ma Phone #: 781-631-2742 Are you an employer? Check the appropriate box: Type of project(required): I.0 I am a employer with 8 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L[J Plumbing repairs or additions myself. o workers' com right of exemption per MGL y �` p• 12.RM Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they we doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Travelers Insurance Policy#or Self-ins. Lic. #:56875379 Expiration Date:3-15-15 Job Site Address: 63 Summer Street City/State/Zip:Salem, Ma 01970 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 certify under h and penalties o e ' that the information provided above is true and correct 9-22-14 Signature: Date' V Phone#: 7816312742 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#: • '•^e••���^ of auA cvis o: uocvD API I-ALuL d/UUZ YB:K Server CERTIFICATE OF LIABILITY INSURANCE DATErMAvoomrYI T IFICATE 13 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(SI,AUTHORIZED REPRESENTATIVE IMPORTANT:If the ceHlficato holder Is an ADDITIONAL INSURED,the WIDOW must be endorsed. If SUBROGATION IS WAIVED,subject to the arms and conditions of the pal",certain Pollcles may require and endorsement. A statement on this cert(Roate does not confer rights to the cerlifleale holder In fieu of such endorsemen s. PRODUCER CONTACT NAME: EASTERN'INS CROUP LLC PHONE PAX 233 WE51•CENTRAL STRiwf (AIC:N0.Exj; (A)C.No): NATICK,MA 01760 E-MAIL ADDRESS: 22MLW INSURE R(S)AFFORDING COVERAGE NAICa INSURED INSURER A: 7kA4pyISRSINT)EMNM MNtPANYQTANfMR7A PRESTO PAINTING S CONSI'RUCT3ON NC. INSURER B: INSURER C: S YORKSHIRE ROAD INSURERD: � •�- MARBLEHEAD,MA 01945 INSURER E: INSURER F: COVERAGES CERTFICATE NUMBER: REVISION NUMBER: THS Y THAT OR NAHyC I;ACT HAVE BEEN THE INSURED NAMES mow FOR THE POLICY PERAWN TEA NOTYATHITANOND ANYADWB THEE FRO erl COCRUIEDNonrDN EANY CSUJECT OR OTHER DDCLWENT W RESPECT Tomm Tins CERTmATE MAY aE ISSUED OR MAY PERTAIN.THE NSMPAHCE AFFORDED BY THE POLICIES DESCRWEDNEttED!D lAIaUECT TO ALL PAN CLAIMS. THE TEAMS,"CLUSIQNS AND CONDITIONS OF SUCH POLICIES.LW MS SHOYM MAY KAYE SEEN REDUCED BY BYSR AOD SUB POLICYEFFOATE POLCTEXPOATE LTR TYPE OF INSURANCE L R POLICY NUMBER fLa1'DOXYYY) (MMw'YYYY) LEAKS GENERAL LIABILITY AOHOCCURRENr-E S Cm"AMERCIAL GENERAL L 1A31_RY CLAIPASrAADS MOCCUR, ARAC.ETORENTED I$ REMISES f,Es mmuai.m) ED EXP(Afty ms pomml Is GERL AGGREGATE LIMIT APPLIES PER ER.SCNAL R AOV W'JRY ['S 71 POuCY ElPRa ECT❑:OC ENEPAL AGGREGATE Is RODUCTS-COMPIDPAGG 'S AUTOMOBILE LIABILITY ANY.AUTO 'O)dBINED SINGLE $ LIMIT(Ea acmdem) !EDUEAL)TOS 30011Y KIJRY S SCHEDULE AUTOS (Pat amm) { MIRED AUTOS 30DiLY MuUPY ¢§ NCNd:WNED AUTOS fPer swiderv.) PROP EPTY DA MAGE "$ (PW axidem) V FEACH DCCURP.ENCE GGGEGATEUCTIBLE ENTION S Is A WORKERS COMPENSA71ON Ate) WC STATUTORY GTX H� EMPLOYER'SUABILITY YM il8-i3R7c3iDad D:Uti2D16 U3'Ii�2D15 x U)An3 F O ? ;VMFTROWPARTNER'EkECIJfI'JF a WA E L.EACH ACCIDENT FF'OER'MFMP,EP E%CLUDEOT IM-wooty n NH) E.L.DISEASE-EA EMPLOYEE § 50G,000 It�ft 6acalbe.'. OCSCR."ON OF OPERATIONS Wm E.L.DISEASE POLICY LMIT I S 50D 00O DESCRIPTION OF OPERATCNSILOCAITONSA•ENICLESIRESTRICTIOKWSPECIAL ITEMS THIS REPLACM ANY PRTOR CEHTIFICATTi I$SI)FDTY.)THIi LTRIMCATEROLDBR.APTFA TQ WORKERS Cr1MPMvIFRAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT VE A ACORD 25(2D10f05) The ACORD name and logo are registered marks of ACORD i' -2010 IDORD CORPORATION.All rig--All ACOI o® CERTIFICATE OF LIABILITY INSURANCE °"'�`M�°12/2 014°14 `� 6/ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Select Dept eXt 66807 Eastern Insurance Group LLC ift-�E.T;Iectwork@easterninsurance.com (508)651-7700 FAX No;(T81)586-8244 233 West Central Street EMAIL selectwork@easterninsurance.com ADDRES : INSURER$ AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERAXain Street America Assurance 29939 INSURED INSURERB Safety Indemnity Insurance Co 33618 PRESTO PAINTING & CONSTRUCTION CO. INSURER C:National Grange Mutual 14788 8 YORKSHIRE RD INSURER D: INSURER E MARBLEHEAD MA 01945-1028 INSURER F: COVERAGES CERTIFICATE NUMBER CL13122425453 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 MAY BE 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. INSR LTR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/VYYY) (MMIDD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY TRERTEu— PREMISES Ea occurrence $ 500,000 A CLAIMS-MADE ®OCCUR 4PO89800 11/15/2013 1/15/2014 MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 2,000,000 K POLICY 71 PFQT RO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea.trident 11000.000 EIx ANY AUTO BODILY INJURY(Per person) $ ALL OS R SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS X NON-OWNED 203010 /5/2014 /5/2015 PROPERTY DAMAGE $ AUTOS Per accident Undennsured motorist BI split $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 C EXCESS LIAB CIAIMSMADE AGGREGATE $ 2,000,000 OED I X I RE FU089800 11/15/2013 11/15/2014 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERTUABILITY Y/NYLIM ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more apace is required) Painting, Carpentry CERTIFICATE HOLDER CANCELLATION (97 8)740-9846 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salem ACCORDANCE WITH THE POLICY PROVISIONS. Inspectional Services 120 Washington Street AUTHORIZED REPRESENTATIVE Salem, MA 01970 John Koegel/CMH2 ACORD 25(2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. INSn25 rmannsl m Th.AC%nin nnmc and Innn nrn roniefnrui m.,k.of Annon ,. ���.� Vhe��UH/LOp(RKY)��o�Pl��✓`rC�PM��i' Office of Consumer AffMrs&Business Regulation k„j+OME IMPROVEMENT CONTRACTOR egistradon: 153422 Type: expiration:. 1 O 113 0/2 201 4 Pnvate Corporatir PRESTO PAINTING AND CONSTRUCTION COMPANY IOANNIS MAKRIS ' 8 YORKSHIRE ROAD MARBLEHEAD,MA 01945 - Undersecretary Massachusetts-Department of Public Safety Board Of Building Regulations and Standards Construction Supen Sur Specialh. License: 4 CSSL- -`` tII " IOANMS MAfM t. 8 Yorkshire Road_ L& Marblehead MA b19410P !"i-4——61r6Cgc, 'r w 0 Commissioner Expiration ofmnolo PRESTO 6CARPENTRV . PAINTING ROOFING 586 Rear Hale Street (PO BOX 140) 111C#153421 Prides Crossing,Ma 01965-0140 CSSL#100452 (978)356-5419—(866)PRESTO-7 www.PrestoCPR.com PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: Domenic Pizzo 64 Summer Street 64 Summer Street Salem Salem, Ma DATE OF PROPOSAL: (978)744-0302 (978)317-5423cell July 15, 2014 Having visited and examined the site of the proposed project and being familiar with the conditions relating to the construction, including the availability of the materials and labor, Presto Painting Company hereby proposes to furnish all materials, labor, equipment and supervision required and to complete the work in accordance with this contract document. CARPENTRY: 1. At the front side—support the 2nd floor porch. Jack up the 2"d floor porch & roof to be level. 2. Tear down the I'floor front porch& dispose. 3. Dig up four new footings, four feet deep with 10-inch diameter, sonic tube and re-bar. 4. Frame,to build a new I"floor porch at the same dimensions- Frame with 2x10 Pressure treated wood, double framed around perimeter and with beams every 16-inches, support with galvanized joist hangers. Build stairs with four(4)2x12 double stringers. 5. Attach porch to house- install ice&water shield, lead flashing and secure porch to house with log screws. 6. Apply ice& water shield on frame prior to installing new floor. 7. Install new floor boards. 8. Install new railing. COST with 514x6AZEKfloor& Panorama railing: $14,110.00 f"/ —`OPTIONS: "� 1. Install six(6) new round composite structural columns. 2. Save one old column and install on 2"d floor. COST. $3,000.00 Certainteed Panorama PVC Composite Railing system. Features: Convenient universal rails for top& bottom rails topped with decorative cap. Concealed external rail to post and a patent pending bracket for seamless appearance on flat, stair, column & 45° applications. Classic style with architectural details. Corrosion-resistant stainless steel hardware. OTHER COMMENTS. EPA<Environmental Protection Agency> certified for Renovator, Repair& Paint(RRP). OSHA<Occupational Safety& Health Administration>certified. Project will be performed under the state requirements & requirements of EPA. BBB(Better Business Bureau) accredited business with an A+ rating. Care will be taken during the progress of the work; greenery, walkways and all other surfaces needed will be covered with suitable drop cloths to prevent from any damage or harm occurring during the workday. Work area will receive a complete inspection at the end of each workday and will be swept and cleaned daily as found. All surfaces will be prepared and finished in a manner that meets professional standards. Presto may withdraw this proposal if not accepted within ninety (90)days. All materials are guaranteed to be as specified. Presto Painting&Construction will obtain any and all necessary construction related permits, if needed, any owner who secure their own construction permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. No work shall begin prior to acceptance of proposal. No verbal agreement is accepted INSURANCES: FULL PROPERTY AND LIABILITY INSURANCE IS THE RESPONSIBILITY OF PRESTO PAINTING& CONSTRUCTION INSURED UNDER NATIONAL GRANGE MUTUAL INSURANCE policy#MP089800 expiration 11/15/14 FULL WORKERS COMPENSATION COVERAGE INSURED UNDER TRAVELERS INSURANCE COMPANY policy#WC5B875379 expiration 03/15/15 (Insurance certificates are available upon request) PAYMENT SCHEDULE: Payments are to be made as follows: One half upon beginning of work and balance including any extras in full when work are complete. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be ode as outlined above. i Authorized Signature i —" Presto Painti g&Construction Ioannis Makris Signature ,7 Domenic Pizzo r 64 summer street, Salem Date of Acceptance Z Ln r "HIGHEST QUALITY AND CLEANLINESS--YOUR PRODUCT OUR BUSINESS"