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65 TREMONT ST - BUILDING INSPECTION (2) a The Commonwealth of Massachusetts Board of Building Regulations and Standards Y Massachusetts State Building Code, 780 CMR £ Building Permit Application To Construct, Repair, Renovate Or Demolish a Rev. Sepl10l4 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number. DateApp ' Building Official(Print Name) Signature Date I n SECTION 1: SITE INFORMATION 1.1 Pro Wyy Address: , 1.2 Assessors Map& Parcel Numbers I L la Is this an accepted street?yes_ no Map Number Parcel Number _ 1.3 Zoning Information: 1.4 Property Dimensions: v, rn Zoning District Proposed Use Lot Area(sq ft) Frontage(t]) a n 1.5 Building Setbacks(ft) tV _orl Front Yard Side Yards Rear Yard ` r Required Provided Required Provided Required Pro ed u' m +*1 < 1.6 Water Supply; (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal Syste rn Public❑ Private❑ Zone: _ Outside Flood Zone?Check if yes❑ Municipal ❑ On site disposal system [!P SECTION 2; PROPERTY OWNERSHIP' S!e(P,,, wnert of Record: Namt) City,State,ZIP` - - aaa and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ Existing Buildin wner-Occupied Repairs(s) Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: BriefDescrip i n ofPro osed Work': Cjt,o� f p✓ !�` SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: O Labor and MaterialsOfficial Use Only 1.Building $ 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 (IIVAC) $ list: 5.Mechanical (Fire Suppression) $ Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $�� 13 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) M -0V (mac( _ (}e�, _- License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street , p �r .Type Description U Unrestricted(Buildings up to 35,000 cu. ft. R Restricted 1&2 Family Dwelling City/Town,State,ZIP P M Mason ry �� RC Roofin Covering [ WS Window and Siding � ® n ! SF Solid Fuel Burning Appliances A l V�' . (/1�� I I Insulation Tele hoe Email address D Demolition Q2 egt/stere Home Improvement Contractor(11 ) ,HIC Registration`Number Expiration Date C Comp ny N. re or HIC e istrapt�ay�e I V(/'/) Pp JLk- Email address City/Town, State,1ZIP 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 ........ 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 authorizer `�"' n � +^�` to act on my behalf, in all matters relative to work authorized by this building permit application. + 94�,Q�k &kj� `�,� Print Owner's Name(Electronic S' nature) 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: 1. 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(I-HQ 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. og v/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 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" 383 Rear Lowell Street,Suite 2G r , "kill Wakefield,MA 01880 �+ ems'" Tel: 617-571-9056 PETER RYA' 352 Main Street,Suite 3C and 0 Gloucester,MA 01930 tljk, Tel: 978-559-7333 ROOFING, Inc. www.PeterRyanAndSon Roo fing.com Submitted To: lob location: Steven Ashley 65 Tremont Street 65 Tremont Street Salem, MA 01970 Salem,MA 01970 Phenet 857-222-6372 Email: steven@stevenashley.com Proposal data: May 11,2015 We are pleased to hereby submit this proposal to famish materials and labor,completely In accordance with the below specifications: (Additional charges may apply for any change's not included below in proposal either by request ofowner,or if Peter Ryan and Son Roofingfrnds unforeseen circumstances that will affect the performance,quality or integrity of this job). In the event legal action is taken to enforce any provision of this agreement,the prevailing party shall be entitled to all its reasonable costs, including reasonable in-house or outside atiorney's fees. Not responsible for debris in attic. s0kelLail fjwa.11 Stria entire roof to bare wood andreshingle: $4,980.00 • Strip existing shingles down to bare wood -- • Check for rotted wood and replace as needed • Nail down any loose wood • Install ice&water shield to first 6-feet,and in all valleys and around any protrusions " • Install premium synthetic underlayment(in place ofstandard 301b.felt paper) BBB• • Install all new 8"white drip edge on perimeter and step flashing,where needed • Install manufacturer suggested starter course of shingles 1 ' i • Install IKO or GAF Lifetime/architectural shingles in color of your choice • Install ridge vent • Cap ridge vent properly with manufacturers suggested cap(GAF Timbertex(P or IKO Hip&Ridge 12) • Properly flash any protrusions and all new pipe flanges,ifany on roof Option:Re-lead and point chimney where needed: S500.00 clean up: • Will cover area with tarps to minimize debris and remove debris related to work • NOTE: Please cover any belongings in the attic,as they will get dusty,ifapplicable PAl"MENT�T��15 q Cost deIallS', Includesegstofxermit; PaymentSehodule 1RA*"n.6M&� Without Option: 1't payment due upon signing: $1,494.00 Total Cost[without Option]: 34.980.00 Total balance due upon completion: $3,486.00 Total Cost(with Option]: SIABO.00 With Option: I"Payment due upon signing: $1,644.00 Total balance due upon completion: $3,836.00 Kindly remit paymentto"PeterRyen". Thankyou! (� 1 Respectfully Submitted by: J Accepted by.4r Our craftsmanship is 100%guarantee for 10-y ars. All oth ntees are through the manufacturer.All wSrian ees will be null&void i is not paid in full. Peter Ryan and Son ,Inc.License 4178871 —Thank you for letting us serve you!!! w: Peter c Vie C'orr morametrlth nfUasTttc/msetts Relarnrtimetit a,jltrrlrtstrfrilAcclzdsrr'ts Qfj7ve ofltivesfigations I Cofigres�5'vwt, ,S'ttlte 100 ° Bostori, AIA 02114-20..17 - W01,11cel's, Compe'ltsstionI1181sviince Affidavit: aas/Pltirn e.v A. idiettnt I fotmatimi PIest.w. a Ita.l , r OMe (slls;nes;ro,galltLRtioJ11eltv;au !): Peter Ryan and Son Roofing, Inc. Ca Acicii'ess: 383[rear] Lowell Street,Sulte 20 City/Statt0p: Wakenold,MA 01880 Pll:olae #: 617.571-9056 Are your an employer? E:Iiecic.tine approprtzate box: T�1rr of project (required): 1.❑ I nm a employer with 4. © I run a general 4ontractor orixt I T Newv ject (requin enrxployats (fillet and/or part-tisne).'I: have hired Ilse sub-contvactol"s 6. '.❑ I out n sofie do^o1:1vietor or partilcr- listed oil the attached sheet,. 7. ❑RenlorJclina These sub-00111rapto15 have ship andhave no rmployee's 8. [] Deanohtu'+.n 'working for me in any capuity. employee's and have Workers' 9, uildin addition [No svoa:kc s' camp, itt.st aiwe comp.ilmlrarloe.t ❑ B g recitsiretl] 5, ❑ We are a corporation and its IO.❑ Electrical t'epans oradditions :;.❑ I am a li oneori'mer el'oing.all worko.fficcls have exercised their I IQ Plumbing repairs or ndditions myself, [No workers' comp. Might of cxemptionn pea::MCTL t Q. 1..5:2. §1 4 and we have no I2.7 Roofaepairs insurancet�entticect,] S ( )• 13.❑ Other employees, [No ,vorkers` G6m17. insilranoe 1'eC aired.] "Alxy ap(}p{cll}tl that C11C4k4 boa#.I tnllst allo till Ont'dte 3e.Ctl'911 be#nly BhotV,hdg'ihe.tF NortCftTY'CIAaPF1ISafIloa l?oltcy htfotlnliaPoll.. t htonleowllers who sabollt this affda'vit hidicaling Tiley Rrv,doing 111 Mrk lad their IlWP otl'ts;de centraCt-0t9 111MI!K*lTit a MTV IMdAVa hldiCTahlQ,9UC'h. l'l�Plit[aCtCl's thel Check Ihls tlox Illost&tGOCheia aid adldiilonal'sheel shCiR�ing Ihe:aanlY of lhesllb-Co11A1'aflots afld slate.wilethel'of not alone mUlles bAw employees, If the sub-colnmctors have employees,alley nlclsl provide their wol:kers comp.policy 1luntber. I oat an enTI;Igr'er that O prvr/ading wor kersl c ofnpetlsadati:itrsarvtrr€re fa+'my erri/idopees, Below !s the potte,p and,lob site htfurmallon, Insarattct CompanyNarne: N/A (I am not required to carryWX.as I have no emPloyees) Please seethe Sub-Contra otor's W,C,.affIdaVlt attao' Policy g OF Self ins.Lio. 9, RSA Expbation Date, Job Site Aiklltss. „ 1 � .- r'itylStnte+Zi.p- Attach it copYy of the xi=orkers, compens« dmi pollcy,declaration page.(s:hoaxxug the policy number lin(I 0-xpiltntlon dslfe),. Failure to seciw^ coverage as tequived tnidoi-5atxtion 25A of MCTL c. 152 can lead to the ullpositioll of criminal pena:llies of n firle lip to I1.500.00 naitbor One-year imprisoluslertt, 'm 4vel.l as Qi-61 peltalties ill .file foam of STOP WORK ORDER and a #.sue of tqa to$250,00 a.flay agc dnst the violator, Be advised that a dopy of this statemetkt may be forwarded to the Office of Investigations ot'the DIA for insat-ml,,c eox•emge veliflcntian. I do 71ereby r,tw f}retulm,the pa,ht�s crrt4pwwlries ofp�eiynrl that the Injormatiotryzr-ovidad archaic is (rri, and nna�erf. 617 5719056� _..., . Df,�citld I'm ort()I, Do not rl)vlte In Ods aura, to be comlikied hr rilp ar toim ciffrfad, City or Torw Pe:rknit/License it Issithig Aa'mority(circle one)i 1. Board of Health '2. ButI d41 g Department It, Cary/Town Clerk 4, Electrical Inspector 5.P1mni ing Inspector 6,Oth:er C;oltta.ct Perscrttt P1xo:ne lit. The C'om:naontpeNth of Massllclttr.setts Department gf1prdustrfalA•v.vWrrf-s Qfpce af.1tivestigattons 1 C.'ongre:ss.SfreeG Su to 100 Boston, MA 021144017 TOP al+,m(tss,gop/fNa Workers'(_:UlT pensi tion T:mwrim.ce Affidn'1rit; Bllil(TeS'S/( 011tl'}]Ct01`S/E.1PCt1'jt itjllS/P1111T11)el'S Autxlknutl0brinaticli, Pleais.e Pi-Int Leetfil) Name (Bus ress/Qrggrrizatiordhidi.vidtrgl);, Lenny Construction, Inc, Address: 71 Prospect Street City/State/Zil): Brockton, MA 02301 pliclle#: 508-232.1,194 Are you an employer? Check file nppropr.late box, Type of project(required): 1,V I nm g employer with '10 4. I and a.gi nernl conk notorr and I employees(hilt nndfor pgit dine). ' ltnve hired the sub-continoors 6, ❑New oonst(liction 2•❑ 1 sm a sole proprietor or.partner- Misted on the attached sheet. 7. ❑ Remodeling ship grad lim 110 erltployees These sub-contractors llnve 81 ❑ Demolition working for lue in any capacity, eq)loyees atui llar'e workers' 9. ❑Building addition [No work rs' comp. illstlrnuce comp insarnnoc.t required.] 5. ❑ We nine a colporatiou and its 10,❑.Electrical repairs or additions 3.❑ 1 gilt a honleomva r doing,all Work officers have exercised their 1 LO Plumbing repairs or ndditions myself. [No workers' comp. right of exemption per MOL 12.❑Roof repairs nsurgnce r¢iiniced.]t c, 152, §1(4),and We!lave no employees. [Nowodccr.s' 13,0 C)ther comp. insurance requh•ed] 'Fury apµlicauf thatchecks box 01 musWw fill otit the section betow sliming lUeir wo;1ew'compensation policy iafonnnlion. t lionleocvnen who submit this affidavit indicating they are doing all worl;wd then hire.outside contractors nurst wbniit e:aew atydavit indicating such. tContmctors that cireckthis box unrst attadled an gdditianat'sheet showing the uwie ofthe sub-couirictors and mite whether or not those entitios have employoes. If she w1b-connectors havee employees, they must provide their workers'comp.policy mmibm I nrrr arr errs/Flvyvr(barn it prvnt t�rrg rrvr/rerr'cvrrtp rlsatinrr Jrrsar'trnce fvr rrr,h crrrplvl+ers, Betow is IN,pollq and f ob si(v Inforrnatlon, Insurance Comp'srlyName: Insurer A; Northland Insurance, Insurer B: Arbelle Protection, Insurer C; Travelers A/R Policy 9 or Self-ins. Lic. 4 6S60UB-5B086�0J6699-2.1(5 Expiration Date: 03.01.2016 City'Stntclzip: Attach a copy of the workers' compeusntlon policy declaration page,(.showing the polio' u•tlurbe:r m1cf,explratio•li date), Failure to secure covesake as,recluired under Section 25A of MCiL c. 152 can lead to the imposition of critllinal penalties of a fine up to$1,500.00 anclJol:one-year imprlsomueilt, 'm well as civil penalties in the form of a STOP WQRK CfRDER mid a fine of up to$250.00 a day agahlst the violator. Be advised that a copy of this simcireirt may t :forkvarded to the Oftioe of Invent gatians of the DIA for iilsuraiioe cove(ttge verification, fP nn r 1 my5rrn tYmtNrebrfkrrnnrtonlnrtdFerlaGo r IrHaieaniaovrct o '.nra +rerl , t rer ra n r nrr 19I1 .#w._ 508 232.1194 _.__......._ _,_.___ .....,_......_•.,_,_..,,._.., ,.._..,-._.._,__.,,..m_,m.__ _.,_.._._,__•_ �.....,.._.,_A __..._..._..m_.___ Offiatal.(isei only, Do nor write In this area, to be completed bl+ Ofy yr town ofj7dal. C9ty or Toavn; Permit/License tr Issuhig Awliority(circle orie)t 1, Bom-d of Hvilth :2, Bnildinr Depm-tweut. 3, Caty/Town Clerk 4,Electile'd Iuspector 5, phillibl;u;g lnspector G, (!Hier Contact Person; Pholle 9; LICENSURE .. ... ... Peter Ryan and Son Roofing, Inc, N•NPCC b78871 Peter Ryaln, . ._. <rij(,'!r u,,,a rr R/ /"//r... /,I�/6 IICS+Itonr rcUlinnlimrvnlhl fnr lndhidnl loss .OM" (CnnauinerhlTulaRlhW ilea ltrN i6itln Ualnl.tlwoxplrplhm flute,(rfurnul5cturn 1pmE IMPROVEMENT CONTRAOTOR Typp (1(1len0 C,onenma An III I null lluNhmsS llegulminn t. ogWmItOM IR0071 [(1 hi PInvn.Salle Bl 70 "ax xplfollonV 0)20}2010. CarrpomEon Iloilnn,MA 07110 n. FETCH R'!AN 0 BON:ROUYIN50a INO PI TCR RYAN �" 100(REARI LOW t V OVI'IE9 1.+.• .«/i,_: 1 OJAHEFIElf1,IdA 0780V lndora5ominry Nnl Mid n 111 ISIµuuVn'n �SL4ae�se�k; N ,�( MpaenohueeRe•DaNnrtment 01 PubllO Sntety ; Bonrd of Banding Rogulat Oine and slondcrde Cnnxlruudon Supun11mil• /vI`\ S^ Z�S . 2bL lloenee,GS•1Oa��OB 1 CLINTON A GAIY3 It 229 Vo7T7ue SI noC Wukolteld MA OPoBO ..'I. ra R.uW Ca i.. � I nrN`° Ex.pfrntlon .°. Conunleelonp, 0710112018 L.. •,,,,,, ,,, ,,,,, L 11, AVMIDRMATION FROM CpTYtTtA ORS FOR SEC' OMIARTWTO pvu pmwr� COWANY• To wtram 4 may.00ncem, ViK tor)rdn'P�}ts foxti� com�ay �, Printed Pismet ,r � �VI, a Notary; ' Comm.