43 UNION ST - BUILDING INSPECTION �5(0 l �Cgsg
The Commonwealth of Massachusetts P 't rat.i•4I ' "'t ?{l: '
Board of Building Regulations and Standards CITY OF�I,EIv�
Massachusetts State Building Code, 780 CMR Nib DEC ` �j JJ l
ev ed a11
( Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Wicial Use Only
( Building Permit Number: ate Applied: if - .
-" & ) i9JI& _
-® Building Official(Print Name) Signature - Date
SECTION 1:SITE INFORMATION
1.1 Property Address, 1.2 Assessors Map&Parcel Numbers
1.1 a 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)
1.5 Building Setbacks(ft)
Fr at Side Yards Rear Yard
Required -d Reqrre Provide equir 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 Record: �(_�.�(�
Name(Print) �aI - "'�1 r C State,ZIP
No.and Streetelephon Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Spe
Brief Description of Proposed Work 2:
SECTION 4:ESTIMATED CONSTRIJCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 44 1. Building Permit Fee:$ "Indicate how fee is determined:
2. Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List: .
5.Mechanical (Fire $
Suppression) Total All Fees:$
Check No. - Check Amount: Cash Amount:
6.Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due:
Rmtic �r c�t�D s', co�t� IN S-rR_ Gll;P— • W4,-,
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor Licte�nse(CSL) �
��'�196 1 W..5 Licenser Exp1r no ate
Name of CSL Holder vr�' t y 1 J
List CSL Type(see below)
i�:7
No.andSheet Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Fatuity Dwelling
City/T�te,LIP M Masonry
RC Roofing Covering
WS Window and Siding
JD I a SF Solid Fuel Burning Appliances
I Insulation
Tele hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) �
Hegtstratiaon N/3umber P lion Date
HIC Cor p� Na re egi4rant Name
No n4t5trect
� ' Email address
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 co feted and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance 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 `l°l �o
to act on my behalf,in all matters relative to work authorized by this building perinit application.
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
contaigeo in this pplication is true and accurate to the best of my knowledge and understanding.
Print a 's or Aiitborized 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(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. 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 haWbaths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
CITY OF SiUENI, N'L-1SSACHUSETTS
BuILDLNG DEPARTJtENT
130 WASHLNGTON STREET, 3r FLOOR
TEL (978) 745-9595
FAX(978) 740-9846
1QJIBERLSY DRISCOLL
MAYOR T Hows ST.PMM
DIRECTOR OF PUBLIC PROPERTY/BU DING COMMSIO,iER
Construction 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:
(name of hauler
The debris will be disposed of in :
1 cil y)�f
(adcriess of cility)
sI a permit apphcant
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ay
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Pleaje Print Legib!"
A P I)1dCA I t In-formatloo
-�j nolle
L—A're Y31 IdmplWj-r' Cbeck the ap'/proprat%e b0l:
Type If proijet -quir-dj:
xffrctDr and I
-7 Loy'r '��—l� �=,� ,,,A Ind,�)r par.-dmc.).' ha/shred -he un-FoultrutOrs
tzaptoy'cs '�- :h, jttached ihae�.
7 1 im A 3OLd 0 Ocl� LOT at Partner- UIted Oct
-r , a -rat,z nab-CCI!L3ct3rS hXf- Demolition
;hip and bx-m no!111-007e--s -MP[oittas any nav, woelfff Budding iddiricc
Cos me in Iny capaciu,
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Jab Site Address:
page (3howin,the policy uAmber and aspiration date).
_A.ttleh .3 copy oj the work-,r3' compenIation pl)(W7 ddelftrabou I C'l. 0 rhe unposIt-ion of criumal penalties of I
�,-on a5A of - t52 car t d t Ld
'1n.- Ov'rj,�! Is L.quircd mda S� and 1r Wilt-, .D , , Ilea in the total of I ST,,jp Wo-�-K 0?,Dt
dn,-u? to 51,300.00 Inj'or oce-ytor impriSOEMI-IlEi is w,!L as civil penal dodto the,Office Of
Be ad.,Ased.,.hm a copy of this =t-ment may be for'VAT
he violator
Of UP to$25 .Qo
[UivestigabotI3 of the DU for basurmce coverage verification.
I do her yepal d p al es of petJ th the information provided above is true and corrict.
Si
phoue
Offlejal use only. Do not write in this area, to be completed by ct'Y or town Officidt
Perimit"License 4
City or Town: --------------
L-Suind Authority(circle one): Town Clerk 4. Electrical laillectOr 3.plumbing Inspector
I )""tor
1. Board of Health Z. Building Department 3.City'
6. other Phone
Contact Person:
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Abi Contacts
Wednesday,December 07,2016
Comments Lead: 9726749 GO Advanced Search 1:09 PM
' Info%ltptlates V. - Homeowner Informabon 'y Tx _ Job lnformahon '_-' -=¢`
- ... — .v _ ._-..- -- - - - -
Homeowner Mrs. Barbara Mateau Sale Amount $7,571.00 Balance Due: $7,571.00
Commissions - - - - - - - - - -- -
Homeowner2 Mr.Tom Graves Product Advanced Protection System (8%)
Documents •Job Site Address 43 union st Status _ Sale/Order Received-PSG _
Job Issues SALEM,MA 01970 Branch T Boston North
Measure# 79709014
Material PO County ESSEX - _: - - Sales :.Z4_s
Order Detail -Billing Address 43 union st Commission �$0.00 Rate
- - - •-
SALEM, MA 01970 Consultant Name Term Date Solit Como Plan
Permits _ •JEREMY FRALEY 100.00%Straight Commission
PO Primary Phone (617)538-0362
Work Phone Ext. B-Back: No Cross Ref# 1-9260666842 Siebel Ord... 229155
Result Combo Cell Phone • � `. - 'Key Dates " ` '' ,
Services
Work Phone 2 Sale Date 11/27/2016 FUP Date '
- - -
Cell Phone 2 Credit Date 11/27/2016 FPD-Customer
Show Mao Email _ _ _ RTP Date 11/29/20_16 Post Install Date
TouchPoints Cross Street Start Date FPD-Home Depot
�
__ Marketing. Inspection
_
Update Job - - ,
Referral Store 2623 DANVERS EAST � �- �. ,;. �- _�„ Job Intlicators
Work Orders Base Store 2686 SALEM,9 v - Job On Credit Hold. /) �``
_Lea_d Source 0205 SC Working Store Partial Job. K ..
Lead Paint:No Test-LSW P Not Req •IF�)`V"
User ' .;_ _ Date =Time sStatus c„, sT :- _Corr:: A_ppt.Date :Appt.Time Consultantl
Ricardo Medina 12/5/2016 4:43 PM Order Received-PSG No 11/27/2016 3:30 PM JEREMY FRALEY
Ricardo Medina 12/5/2016 4:43 PM Measure Complete No 11/27/2016 3:30 PM JEREMY FRALEY
Cythina Raglin 11/29/2016 11:40 AM Released to Production No 11/27/2016 3:30 PM JEREMY FRALEY
Cythina Raglin 11/29/2016 11.38 AM Order Entry No 11/27/2016 3.30 PM JEREMY FRALEY
JEREMY FRALEY 11/28/2016 12:27 AM Credit Pending No 11/27/2016 3:30 PM JEREMY FRALEY
JEREMY FRALEY 11/28/2016 12,27 AM Sale Pending No 11/27/2016 3:30 PM JEREMY FRALEY
Dayend Dayend 11/26/2016 9:02 PM Sent to the Field No 11/27/2016 3:30 PM JEREMY FRALEY
DEVARUS HARRI 11/26/2016 10,55 AM Confirmed-Customer No 11/27/2016 3:30 PM JEREMY FRALEY
DEVARUS HARRI 11/26/2016 10:55 AM Pre-Book No 11/27/2016 3:30 PM JEREMY FRALEY
JEREMY FRALEY 11/26/2016 10:50 AM Lead Entered No
Close Print
�( ��'
HOME IMPROVEMENT CONTRACT Sold,Famished and Installed by:
PLEASE READ THIS CONTRACT THD At-Home Services.Inc.
d/b/a The Home Depot At-Home Services
908 Boston Turnpike Unit 1,Shrewsbury,MA 1545
Toll Free 87790337WFax 8009863610
Branch Name: Boston North Date:11/27/2016 ME Lie#C 02439 RI Cont.Lie# 16427
CT Lic#HIC.0565522 MA Home Improvement
Branch No: 33 Contractor Reg.# 126893 Federal ID#
75-2699460
Installation Address: 43 union st Salem Ma 01970
City State Zip
Purchaser(s): Work Phone: Home Phone: Cell Phone:
Barbara matteau 9726749 (617)538-0362 617 349-8781
Tom raves 617 538-0362
Home Address:
(If different from Installation Address) - City State Zip
E-mail Address (to receive project communications and Home Depot updates):Bmatteatiftmail.com
Marketing emails will not be sent from The Home Depot.
Project Information: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to
buy,and THD At-Home Services, hic. ("The Home Depot')agrees to furnish,deliver and arrange for the installation("Installatl
on")of all materials described on the below and on the referenced Spec Sheet(s),all of which are incorporated into this Contract
by this reference,along with any applicable State Supplement and Payment Summary (where applicable)attached hereto and any
Change Orders(collectively,"Contract'):
Job#:(internal Reference) Products: Spec Sheet(s): Project Amount
Roofing $7,571.00
Minimum 25% Deposit of Contract Amount Total Contract Amount $7,571.00
due upon execution of this contract
Customer agrees that,immediately upon completion of the work for each Product,Customer will execute a Completion
Certificate(one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each
Customer under this Contract agrees to be jointly and severally obligated and liable hereunder.
The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included
herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations
due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,
pricing errors or because work required to complete the job was not included in the Contract.
Pavment Summarv-
The Payment Summary# ,included as part of this Contract,sets forth the total Contract
amount and payments required for the deposits and final payments by Product(as applicable).
as1171i4SA Page 1 of 7
HOME IMPROVEMENT CONTRACT
PLEASE READ THIS CONTRACT
ROOFING SPECIFICATION SHEET
DESCRIPTION OF WORK
Customer Name: Barbara ma@eau9726749 Date: 11/27/2016
Branch Name: Boston North Job#:
Sales Consultant: Jeremy Fraley
LINE# I -„ - .. . ._ �r -
APS, Royal Sovereign 25 yr,Weathered Gray Material Removal
Decking Replacement=Partial, Decking Replacement
Material=Plank, 100, Linear Feet of Decking to be
Installed,Additional Leak Barrier to be Installed= No,
Synthetic Underlayment Upcharge=No
Number of Squares(excluding Low Slope)=7.33, Number
of Flat Roof Squares=0 Flashing
Misc Drip Edge=Yes, Linear Ft of Drip Edge to be Installed=
Rigid Ridge Vent=Yes, Linear Ft Ridge Vent to be 120, Color of Drip Edge to be Installed=Galvanized
Installed=38, Rigid Ridge Vent-Color= Black, 3"Circle -
Vent= No, Replace Fascia=PVC Trim Board, Fascia-1x
Material-Linear Feet=40, Cut-up Roof=No, Disposal
Fee=Up to 10 Squares,Additional Labor Hours=20,
Misc Labor Hours Notes=steep/scaffolding
Pricing Includes:
Fascia
Misc Labor
Drip Edge-in 10R Sgmts
Decking Replacement Material
Shingle Removal and Application
Disposal Fee
SPECIAL CONSIDERATIONS `E
PRE-EXISTING CONDITIONS
ADDITIONAL CHARGES:
If rotted or damaged wood is discovered AFTER removing the existing roofing,or could not be identified at the time of sale,there will
be an additional charge of$ 88 per sheet of 4x8 sheathing and/or$ 10 per linear ft.of dimensional lumber for decking.
06117114SA Page 5 of 7
y -
HOME IMPROVEMENT CONTRACT
PLEASE READ THIS CONTRACT
NOTICE TO CUSTOMER
You are entitled to a completely filled-in copy of the Contract at the time of sign.Do not sign a Completion Certificate(note:
there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that
Product is complete.
In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,
expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus
any other amounts set forth in this Agreement or allowed under applicable law.THE HOME DEPOT MAY WITHHOLD
AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE,
WITHOUT LINHTING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVER OF SUCH AMOUNTS.
Acceptance and Authorization: Customer agrees and understands that this Contract is the entire agreement between Customer
and The Home Depot with regard to the products and installation services and supersedes all prior discussions and agreements,
either oral or written,relating to said products and installation.This Contract cannot be assigned or amended except by a writing
signed by Customer and The Home Depot.
Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and has received
a copy of this Agreement.
You are entitled to a paper copy of this Agreement if you choose. If you consent to an emailed copy,your consent applies
only to this Agreement.By contacting sales office (g77)903_376S ,you may update your email address,withdraw your
consent,or obtain a paper copy of the Agreement at no charge. By signing below,you confirm the following:
• You consent to receive only an emailed copy of this Agreement
• You have access to a computer that can receive and open emails and PDF(Adobe Reader Version 10.1.4 or
later)formatted documents.
• Your email address is correctly listed on the Home Improvement Contract
Submitted by: Accepted by:
Sales Consultant Jeremy Fraley Customer
License Name. Signature:
(877)903-3769 Customer Tom graves 9726749 (Nov 27, 2416,
Telephone No. Signature:
Sales Consultant -
License No. (as applicable)
CANCELLATION:CUSTOMER MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION B1
DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY
AFTER SIGNING THIS AGREEMENT.THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM
'TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE.
06117114-SA Page 7 of 7
r _
Y jo St-Al ' 1A
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• 4 t ter A
11769
CITY OF SALEM, MASSACHUSETTS
BUILDING DEPARTMENT
120 WASHINGTON STREET,3RD FLOOR
TEL. (978)745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR THOMAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
February 14, 2017 Py
Mr. Mike Bedard
Permit Coordinator
THD—At-Home Services, Inc.
908 Boston Turnpike, Unit 1
Shrewsbury, Ma 01545
Dear Mike:
Mr.St. Pierre received your letter regarding the cancellation of B-16-1427,43 Union St.,Salem, Ma.
We have noted that you cancelled the re-roofing job at that address. However,we cannot reimburse
any associated fees to any application if it is granted. Please see the attached sheet: Salem Code#4
that specifies this.
Hope this helps with this cancelled permit.
Sincerely,
Marcia Kirkpatrick
Clerk in Building Dept.
Attachment#1
o
February 8, 2017
Salem Building Department
Salem City Hall
93 Washington Street
Salem, MA 01970
The homeowner at 43 Union Street, has cancelled the re-roofing job with Home
Depot. It was building permit#B-16-1427, and we had paid $56.00.
Would you please cancel this permit, and make refund check payable to:
Permit Services, LLC
303 Narragansett Avenue
Barrington, RI 02806
If you have any questions, please call me at 508-962-6942, or email me at
Mike' W—Bedard @ homedepot.com.
Thank you,
Mike Bedard
Permit Coordinator
THD At-Home Services,Inc.
908 Boston Turnpike• Unit 1 •Shrewsbury, MA 01545
Phone:774-275-2139•Fax: 508-845-6076•Toll Free:800-657-5182
Commonwealth of Massachusetts q7� i
City of Salem
120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641
Return card to Building Division for Certificate of Occupancy
Permit :No.
$5 B-16.1427 PERMIT TO BUILD
FEE PAID: $56.00
DATE ISSUED: 12/19/2016
This certifies that MATTEAU 13ARBARA GRAVES THOMAS
has permission to erect, alter, or demolish a building , —43,UNION STREE Map/Lot: 350310-0
as follows: Roofing STRIP & REROOF ^ ..
Contractor Name: EVANGELOS LIAPIS/ HD
DBA: THE HOME DEPOT
Contractor License No: CS-64795
12/19/2016
Building Official Date
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official
may grant one or more extensions not to exceed six months each upon written request, -�
All work authorized by this permit shall conform to the approved application and the approved co4atruct16n documents for which this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location cieariy visible from access street or road and shall be maintained open_for public inspection for the entire duration of the
work until the completion of the same.
1
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
' r
HIC#: 126893 "Persons contracting with unregistered contractors do not hove access to 9re guaranty fund"(as set forth in MGL c.142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.