55 TREMONT ST - BUILDING INSPECTION (4) I
�) I� Hie Commonwealth of Massachusetts - - - -
✓ ?i Fill
Board of Building Regulations and Standards CI"I'YOF
Massachusetts State Building Code, 780 CMR tiALLkt.. Revived.liar?Ill1
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Fumilr Dwellhkq
This Section For Of6eN Use Only
Building Permit Number: D e Applied
Building 011icial(Print Name) Signature pale
SECTION I: SITE INFORMATION
1.1 Property address: 1.2 Assessors Map& Parcel Numbers
5-S Mzzoh,07 S%
I.la Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Imposed Ilse Lot Area(sq 11) Frontage(11)
1.5 Building Setbacks(R)
Front Yard Side Yards - Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.I.c. 40•§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone?Check if ycs❑ IMunicipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Rscord:
Zk�. ?. +byc/1� 01970
N;une(Print) Tay.State,ZIP
Nu.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction ❑ 1 Existing Building Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s)2OAddition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work':
t'fi xiC dL� kc.0"E f -R1T o,y /f Are.) Imo r-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials) y
1. Building S u' I. Building Permit Fee:S Indicate hoIdeternuned
'. Eleevicni g ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier
1. Plumbing S �. Other Fees: S
a„Mechanical III\':\CI S List:_-__
S \Ieetlallle:mi (Fire
Su m Iressionl S Totai :\it Fees:S_ ----- -.
_ C'hcckVo- Chak:\mount: Cash Amount:
b. Total Project Cult: S � ❑Paid in Full ❑Outstanding Balance Due:
41/7
SECTION 5: CONSTRUC'TiON SERVICES
5.1 Construction Supervisor License(CSL)
,Qv/,�fIi'l,(J% License Number ——-- ILvptralio I Unie
N:me of l'SI. I IulJer
List GSL 1)pc(see heloiv)
- � Type Description
No. .m Street
If Unrestricted(Buildings up to 35,000 cu. It.)
R Restricted M2 Family Dscellin
City/Colin,State.Zl ' M Nlasonry
RC Rooting Curcrin
- W'S Window and Siding
SF Solid Fuel Burning Appliances
��'"�fLS�4 /7ii/7D C/UZ /0 3C�CDOP/S' r I Insulation 9
'I'cle hone Ilmail address U I Demolition
5.2 Registered Home Improvement Contractor(HIC)
I IIC Registration Number Expiration Dale
I IIC Company Name or I IIC Itegistrunt Name
No. mid Street Email address
City/Town.State,ZIP "rele hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 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 .......... ❑ 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
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Uwner'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 p1t7ccurate to the best of my knowledge and understanding.
11rint Oa cr's or:\uthorized Agent's Name I lilcetnmic Signuure) Date
NOTES:
1. An Owner who obtains a building permit to do his,her own work,or an owner who hires an unregistered contractor
(nut registered in the Horne Improvement Contractor(HIC) Program),will No have access to the arbitration
program or guaranty fund under I.G.L.c. 142A.Other important information on the HIC Program can be found at
o ,i Information on the Construction Supervisor License can be found at 5\Nkk mass dp;
2. When substantial work is planned, provide the information below:
Total floor area(sq. ft.)_ (including garage, finished basemenCattics,decks or porch)
Gross liming area Isq. (t.) _ Habitable room count
Number of fireplaces__- Number of bedroonis
Number of bathrooms Number of half baths
I. pe of heating sy stem _ -- _ _--..- Number of decks, porches
F\Pe Uf c00Ii06 S\Steal - - -- — Fnclo Sed Olsen - - --
J. "Total Project Square Footage"niay be Substituted for"folal Project Cost"
CITY OF S.uy., f, NLASS.-kCHUSETTS
BULDLNG DEP.IRT\IJUNT
120 W."JiNGTON STIM, JiO Ft00R
M (978) 745-9595
P.ut(978) 74Q9&M
KID®ERLfiY DRL4COLL
,MAYOR THOar,►a ST-ftm
DIRECTOR OF PLBUC PROPERTY/BCIIDLYG COMMISSIONER
Construction Debris Disposal Afttdavit
(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
l 11, S 150A.
The
debris will be transported by:
00�C
(name of hauler)
The debris will be disposed of in
(name of facility)
r
C�kJ&,e-7/od
(address of racihty)
signature of permit applicant
datC
I.hn vl( Lc
AMERICAN HOME Il"ROVEMENT
105 ATLANTIC AVENUE
SALISBURY,MA.01952
Phone(978)465-2283
Email roadking-103@comcast.net
July 29,2011
Marc Bouchard
55 Tremont St:
Salem,Ms.01970
JOB PROPOSAL
We are pleased to quote the work you requested to be performed at your home as described below:
Roofing of main house:
Strip all layers of existing roof shingles and re-roof with 30 yr.I K O"Cambridge"Asphalt roof shingles,
re-nail roof boards as needed.
8"drip edge,6'of ice and water shield from eave edge up and 15 LB felt on all other surfaces.Cut back
roof sheathing at ridge to allow for air flow and install ridge vent with cap gles over.Replace vent pipe
fleshings /� V $7,320.00
Any rot or damage to roof sheathing or structure discovered under shingles will be repaired as an EXTRA
as described in Note:below.
Existing rubber roof not included
Grind out old flashing and install new chimney flashing,if needed can done as an extra. $450.00
Note:American Home Improvement is not responsible for any debris that may enter into attic
through cracks in existing roof boards.
Extra work if any can be done @cost plus 20%on materials.Labor as follows:Carpenter @$30.00/Hr.,
Master Builder/Carpenter@$55.00/Hr..
Above work to be performed in a professional workman-like manner.Contractor to furnish and
install the above complete in accordance with the attached specifications.
For the sum of$7,320.00
SEVEN THOUSAND FIVE HUNDRED_THIRTY-EIGHT DOLLARS__
PAYMENT TERMS:
Upon acceptance of proposal$2,500.00
When roofing cojmpllee'te/$4,820.00
Author'vxd nature Date
Customer's Signature Date
Note:This proposal may be withdrawn by contractor if not accepted within ten(10)days.