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23 SYMONDS ST - BUILDING INSPECTION The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY Massachusetts State Building Code, 780 C'MR, 7'"edition OF SALEM II Revised Jamrury Building Permit Application To Construct, Repair, Renovate Or Demolish a 1. 2008 UOne-or Two-Family Dwelling Secti or Official Use Only Building Permit Number: Date Applied: Signature: 44 Building Cum ' sioner/inspect"" Bui list Date SECT N 1: ITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers a3 Sum �ho/� 21. ' Ma 1.1 a is this an accepted streeo t. yes_ no_ 0 Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq 11) Frontage(it) 1.5 Building Setbacks(R) Front Yard 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 ycsE3 SECTION 2: PROPERTY OWNERSHIP' ,2.1 O ner'of Record: Name(Print) ! Address for Service: c/les // 7n US l/. S / i 7C✓�' j7d -7�/� 3 y'f Signature Telephone SECTION 7: DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ I Repairs(s) ❑ Alieration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.O Number of Units_ Other ❑ Specify: Brief Description of Proposed Work': c La 1' 'n r :/� x Vic✓ AA /� // ;�(/ ' Ear /Y"'/'C/�`7E�4 -S'�i• /NT �% Cc., 'z' - c ( SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials I. Building S I. Building Permit Fee:S Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Cost(Item 6)x multiplier x ). Plumbing S 2. Other Fees: S / 4. Mechanical (HVAC) S List: o S. Mechanical (Fire S Su ression Total All Fees:S Check No._Check Amount: Cash Amount:_ 6.Total Project Cost: S 6"7 y3 • G ❑Paid in Full ❑Outstanding Balance Due: �� ��J01 � SECTIONS: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) fiRCResidential -.2©16uce / nc r Expiration Date Name ofC'SL•I IuiJe`r. % ; / r ' (see below) r-.lstriccted I&2Signature n-,Ply ���'� ential Roaring Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition S.2,�pp``egl,tered om Improvement Contractor(HIC) N��Scn B(cn-F.rap I IIC Company Name or UI Registrant Name Registration Number Address 4t4l� ��N %JOG Expiration Date Signalure Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 2SC(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..........13, No...........O SECTION 7s:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AG/,ENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,� �/',/�i: �/ �/ //�� �i—' 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. (��+— j -,20/U Sianature of Owner Date SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION I. // Iv2 e 77V, -,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. Print Name�/ _,t__, �/ / ./�-x,, --z-l�C-�"( J Signature of Owner or Authorized Agent Date (Signed under the pains and penalties ofperjury) 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 PJ 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 780 CMR Regulations I IO.R6 and I IO.RS,respectively. 2. When substantial work is planned,provide the information below: Total floors 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 7. -Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF Sa1I_E.`I, Nlakss.kcHuSEM KiLDvil;DEPAM.LENT 120 WASHINGTON STREAT. 3ie FLOOR TEL (978) 74S9595 FAx(978) 740-9846 KlmBERLEY DRMOLL THOMUST.PMAM 41AY011 D1REctnR OF PI rLIC pROPERTy/IULDLNG CONMOS.SIONER Workers' vit: guilders/ContractorWElectrielanslPlumben u CP omenaat)on InsuranceAf8dr s r (leant Intormatlon /� Plerse Print Ledh b VatnaltlmtnavrOrtarurarionlndavdrull' C/JCh X20C /7�c Addrew L9 Z ZOO, �rt✓F / "[elLe. CitylStatdZip: Phone 0- ,ire Yoe re employer!Check the appropriate boss Type of project(required): 1.[J 'am a crnployer.with 4. Q I am a pnaal contracem and 1 6, ❑Now construction anployees(full andtor pan-time).• have hired dw&,&Conant" am a sole proprietor rx partner-I listed an the attached shrol,: 7. 0 Remodeling I.❑ +hip and have no employees Tltae sub-contractors tars haw a. ❑Demolition working for me in any capacity. workers'comp.insumnee. 9. (]Building addition INo workm'cornµ inaursnce S. ❑ We are a corporadce and its 10.0 Electrical repairs or additions require d.1 odkers have a aacised their 3,0 1 am a ho w ancener doing all work right of examprion per MOL I I.❑Plumbing repairs car additioro mysele[No workers'comp. c. I32.41(4).and we hew no 12.0 Roof repair insurance required.)t cmpkeyeaa LNe workers, 11.0 Oaten camµ insurance required.] -any appacara the cltarta Oda et mart alw 00 uw tM rcrim aglow akowing rhak eotka'eorepwtan4oa polity ittrwaaeloa 't j nom ec who subode drlo aeldwil in/lodnp ihwy are doing all work ace than him ouaide caerncon mae sulark a now artldwie indkriq and =(',.urawn due ctrn4 Baia aces morn ansha/an sldirww.l Jre Jwrine car irae art6n aaawrnewe car iMr worhwe'coop.policy inNnaalaa /uw or rwPl^yes rharr b/rorldGrE arerRers'romPetrsrtba/nar►etaes jw my emplrryeer Bohm b than pe P rrd w sib injorarwloe. In..uranceCOmpany-ame: �J6 /?G//f � cr _TC Policy Out Seif•ina. Lie.N.' G ys/'�/r7>�SS Expiration Date .1 5 —,2 Jab SireAddresa: � 3 1 G,011 City/state/Zip: _Nle,', /,Z`'S1 G/ .knack a copy of the workers'compowatton policy doeberallon pap(showing the policy ormber deal sieplradon delo). Failure to secure coverep as required under Scctlos ISA of MOL a 132 can lad to the imposition of criminal penalties ore fine up to SI,500.00 and/or one-year imprisonment,as well as civil penalties in the form of d STOP WORK ORDER and a five or up to S230.00 a day a1{aima the violator. lie advisad that a copy of this statement maybe furwardcd to the Office of hrv.,osarions ol'tha n1A for insurance covcrop v%milieation. 1,10 hereby cndfy under the Paine and penalties o/Perjury thou Air injerwedw yrovi/a--a77f above is true and a und e `�c/i- lcn 1120 � Dole: O/J/cir/we mr/.V6 Ciat I City Or fuwa: PermiNl.lernsee__ Lsuina.%uthunty icircle one): 1. Ituard a llralrb i. Ruddlna Department 3.City/town clerk A. Electrical Invpeclor S. Plumbing Incpeetor 6.other L,mtacl Person: _ . _ ... Phones: ,S CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT M 10 �'.,it ll.\L:�>.v)1'NUT O SAJ I M, l'F1 978.74.5•9595 I'.\X:978•N49916 Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the Slate Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40,S 54; Building Permit If _ is issued with the condition that the debris resulting from this work shall he disposed of in a properly licensed waste disposal facility as derived by MGL c 111. S 150A. The debris will be transported by: I[lame 01 hauler) The debris will be disposed of in Inane o army) (aJ Tres. of facility) signature of Ixnnn applicant date -�"— Mar, 12. :010 12:47PM No, 5194 F 2 Aulson Roofmg, Inc. 2/o/ C;-C�- 49 Damon Drive Mathucn,.Msaswhtoft 01844 (978)97S-4S00 ha: WM 6954753 ,Uff B '] EAR g1MILE ONLY Pro anal (97V 831.1012 NASCAP r(9�78 V104010 Nae� JM IYIar fi.wa+Mnew 93 Main street Wool Swan f:+p tlwa Zq f'.cF *A far. P!ebody,MA 01960 23 Pyrnorlds Street,Salem,MA Pre A,-,dypropossr 10fMI11111 JIMW mid eukrMls M 1011011119 new Afth•roof CO n s"e4halmes specijkwfi to by MelMawMr: * t his atlmue Covers the following shingle roof areas:AA a Remove the aaisting(3)layem of shingles sad tblt down to the wood cloak * 7 he building will be tai;;W during the removal process. * Respect for and replace any loose or totted wood. P.rry wood dell replacement would be an additional$540.per linear W or$3.00 per square tool, We would match the existing disking as Cioae as pouible. * (vr prappW is based on removal of three Myers of shingles. if there is additional ityerof shingles ft would be An additional cost to the contract Tindall jce and water shield 3 net along the odgo.of .roof * tavernmeliderofreofwa911Slbfeltpaper 9 he shingles will be instilled by using roolhittlails. 01 a' 'r x7 he.sbhaglas that will be used are CertalnTeed landmark Woodseapt;30 Tear algae nalasent • Your choice of Color: * Utsall:new vent plpe flashing up to 4 inches. Arty larger will be property scaled. F.euse and-seal the existing sidtwaii and chimney flashing, — --�-1 alleavesmrdrrkes. _.._... .._..._._..._._ ------_-.... • 1 o install anew.cfinef aleq ridge vent to be covered whh asphalt ahiniles vrould be an adrlitkntal $475.00 to fbntrscL !% • Clean and remove all'adsidejbb-telated debris; • F rovide.standard 30.you shingle manufectunces guarsatee. ' Frovidd standerd.Aulson Roofing,Inc,2 year workmanship guaramc:. * c'snpalinacessary worltew Compensation NW Nab111ty In9urance • 0**a or permit'will be an additional on"to The etisho6r. -- CNepAOlasaerreynlrrtttra.at.rehitrerrroArrcwepr�w.awaporwsa.sorrrp.giredoa/bref....y.•$6,70160 ,�hossand:9evelt Sliandsed!'finely Five Dollars and so Cents. Terns and Cbedidoase 'I. I'ayman4-'Pgyment.ternw are as follows: Deposit of 1/3; 1/3 when halfdony balance upon Completion 2. A li teoniae dueand'payablrshall*dons interest Aom the date such psymeat may be due at a rate equal to 1,•12S6pamomh. Aulson Roofing, Inc. 5­3 " 49 Danton Drive Methuen,Massachusetts 01844 (978)975-4500 Fax: (978)685-0753 Proposal Proposal submitted to: Phone: pare: MJCftP M531 d_�4 7k,35_ Street Job Name Contact Person 7Y Mlql.%✓ J cSWv4rJ Qv State,Zip Code Job Location rv4 a3 s Mows We hereby propose to furnish labor and materials to install new shingle roof to manufactures specifications by the following: * This estimate covers the following shingle roof areas: Remove the existing a layer of shingles and felt down to the wood deck. * The building will be tarped during the removal process. * Protect all shrubbery as required. Inspect for and replace any loose or rotted wood. Any wood deck replacement would be an additional $5.00 per linear foot or$3.00 per square foot. We would match the existing decking as close as possible. Our proposal is based on removal of� () layer(s)of shingles. If there is an additional layer of shingles this would be an additional cost to the contract. * Install ice and water shield 3 feet along the edge of roof. Install ice and water shield 3 feet along the edge of roof and in valleys. * Cover remainder of roof with 151b felt paper. * All valleys to be weaved. * The shingles will be installed by using roofing nails. * The shingles that will be used are CenainTeed Landmark Woodscape; 30 year algae resistent * The shingles that will be used are G.A.F. Royal Sovereign;25 year shingles. The shingles that will be used are G.A.F. Timberline; 30 year shingles. * Your choice of color: Install new vent pipe flashing up to 4 inches. Any larger will be properly sealed. * Reuse and seal the existing sidewall and chimney flashing. * Reuse and seal the existing skylight flashing. * Re-lead the chimeny with 8"and 10" lead flashing. * Install 8 inch white, bmame, mill finished aluminum drip edge along all eaves and rakes. * To install a new concealed ridge vent to be covered with asphalt shingles. w 6J k k 8 Z PVV eon a676 rpil loci * Clean and remove all outside job-related debris. * Provide standard 25 year shingle manufacturer's guarantee. - Provide standard 30 year shingle manufacturer's guarantee. Provide standard Aulson Roofing, Inc. 2 year workmanship guarante 75 Cary all necessary workers'compensation and liability insurance Any fees or permits will be an additional cost to the customer. * Contract Option: 03/05/2010 14:11 9789750987 AULSON pPAGE 01 'I3 Aulson Roofing, Inc l U Z 49 Danton Drive Methuen,MA 01844 (978)975-4500 Fax: (978)975-0101 Customer Estimate Request Date: 3I5 J/d Time: v7:Q [`Pm Lead Taken By: Customer Name: ffASCA(� mo.1'u �o��h Short �ommux..;+ Contact:' Home Phone: Cell Phone/Pager: Work Phone:( Q7r) 6 Fax Number: G 00d '5wa l<_ Mailing Address: City: Zip Code: ✓✓ .: Work Location: 013 Srm e>7(dg City: So-lem m A Zip.Code:. Estimate For: New Roof/Re-roof [ ] Repair [ ] Inspection [ ] Insurance [ ] Real Estate Appraisal ( 1 Other (S 50.00 charge for insurance and real estate appraisals) Existing Roof: Shingle [ ] Rubber/Flat [ ] Slate [ ].Metal [ ] Other Does Anyone Have to-Be Home? [ ] Yes ( ] No Reference: [ ] Yellow Pages [ ] Publication [ ] Direct Mailing ( J Other Product Line: [ ] Royal Sovereign [ ] Timberline/Slate f ]Marquis ( ) Other Estimate Date: Time: 30_ q(14, Notes: (f /y s�0 ,d-IUkA.e.. 3 L/A E;W9 voxz,0 3� 166 I�S1� xi3s ay3 � �Svo i3o 1-960 6 Sys a 5� � B and of u�g�ai�ons an �ards One Ashburton Place - Room 1301 Boston. Massiwhusetts 02108 Home Improvemenj2*actor Registration Rapiatraftr 111909 Type: Supplarnard Card Expiration: YJ=IT J AULSON ROOFING, INC. Bruce Tinkham 48 DANTON DRIVE METHUEN, MA 01a44 • - ' 4 r6 Update Address and rotorn enrd.Mark reason for e/ange. orscAr a awoanaooeuratrres7aensae - ❑ Addrm Renewal 0 Employment Lod Card A �l Hoard ofBWWm Mplaaoos and Standards Lkew or registration rend far tndfvtdul wa a* HOME IMP ENT CONTRACTOR before the eap[radm date. If found return to:9 Reyl.a n. 7719a8 Board of Building Regulation and Standarda OneAahburlan Place ear 1301 _ 11 cardBodao,Ms.moo AULSON ROOFIryae, n �t7 - Bruce Tirdthe�a t:, _ r 49 DAI4TON 0RNE• .'.`9 / METHUE14 MA 018N Adadn"trotor Not valid withost slamtura • Massachusetts- Department uI'Public Satetl 1 Board nP Building Regulations :uttl St:mditr•ds Construction Supervisor Specialty License Licepse: CS SL W977 Restricted to: RF,W3,IC x "` BRUCE TINKHAM >; 20 BALDWIN STREET i PEABODY, MA 01960 _ _ i3cJ� Expiration: &19I2p11 1 „uuni..i�,hrr Tra: W977 _ r iF AcoRn_ CERTIFICATE OF LIABILITY INSURANCE OP ID RS I DATE(MWDWVYri) AULSO-2 1 Si 03 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DeSanctis Insurance Agcy, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 36 Cummings Park ALTER THE COVERAGEAFFORDED BY THE POLICIES BELOW. Woburn MA 01801 Phone: 781-935-8480 Fax:781-933-5645 INSURERS AFFORDING COVERAGE NAIC it INSURED INSURER Star Su lus Lines Ins Co INSURERS T,. Caerw I..ura. C.q,.ey Atilson Roofing, Inc INSURER .ca Pr a AAuTslson Indus sal Services Inc op.rl:r A r-.u.L Nn. c, 49 Denton Drive INSURER D: Methuen HA 01844 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIRE►ENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR WY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF$WN POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAU)CLAMS. lTR RI TYPE OF INSURANCE POLICY NUMBER DATE Y DATE(MMIDDIM LIMITS GFKERAL IJABHITY EACH OCCURRENCE S1,000,000 A R COMMERCIAL GENERAL LABILITY SISLEIL72010009 10/31/09 10/31/10 PREMISES E.Omrmce $50 000 CLAIMS MADE ®OCCUR MED EXP(Any Oro perm) $5,000 R Lead 6 Asbestos W/ POLLUTION 6 MO PERSONuaADVINJURY $1,000 000 Abatement Liab. GENERAL AGGREGATE s2 000 O00 GEML AGGREGATE LIMIT APPLES PER: PRODUCTS-COMPIOP AGO s2,000 000 POLICY $ Pno- LOC JECT AUTOYOBRA UABSU Y COMBINED SINGLE LIMIT B ANY AUTO 09MMCYY1459 10/31/09 10/31/10 (Eearrideldl $1,000,000 ALL OWNED AUTOS BODILY INJURY f X SCHEDULED AUTOS (Per wIim) % HIRED AUTOS BODILY INJURY s $ NON-OWNED AUTOS (Per 8.dent) PROPERTY DAMAGE f (Ps acddmd) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT IS ANY AUTO OTHER THANEA ACC s AUTO ONLY: AGG f FJICESSAIMBRELLA LABLLT' EACH OCCURRENCE s3,000,000 !► R OCCUR ❑CLAIMS MADE SISLXRYT3010009 GL/CPWSL 10/31/09 10/31/10 AGGREGATE s3,000.000 GL/CPL s DEDUCTIBLE 6 EL s hX RETENTION $10 000 f WORKERSCOYPOISATgNAND R TORY LMRS ER EMxormrTORPAR LIABILITY C45817.155 10/31/09 10/31/10 E.L.EACH ACCIDENT s 1 000 000 ANYPROPRIETORIPARTNDED? CIITNE O,F'F��ICERAIDABEREXCLUOE07 MA, ME,NH E.L DISEASE-EA EMPLOYE $1 000 000 M'C" PROVISIONS Wow E.L.DISEASE- POLICY LIMIT $1 OOO OOO OTHER :SCRIPIION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS VIDENCE OF COVERAGE :RTIFICATE HOLDER CANCELLATION PEABO-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO YAR 30 GAYS WRITTEN City of Peabody NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL City Nall 24 Lowell Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR Peabody MA 01960 REPRESENTATIVE& AUTHORIZED REPRESENTA �ORD 25(2001/08) ©ACORD ORPORATION 1988 v