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13 VALIANT WAY - BUILDING INSPECTION S z- f )( (o��,f The Commonwealth of Massachusetts REC VICES hA� SE[� Board of Building Regulations and Sta SECllo CITY OF npI Massachusetts State Building Code, 780 CMR --��SALEM R�v ed Mar 2011 Building Permit Application To Construct,Repair,Renov �rD� o�ish as One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: 00 Building Official(Print Name) Signature Date _ SECTION 1:SITE INFORMATION t 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers Irr Lla Is this an accepted street?yes--L no Map Number Parcel Number l 1.3 Zoning Information: 1.4 Property Dimensions: ` Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(FQ 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 9f Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2./1'Owner'of Record: LlMAU'r 1�ayrwt 1�. nh�zrs. QJ1R olri23 Name(Print) City,State,ZIP 2b Lulsleu l2l. CNQ- "11"1 -4125 No.and Street t Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ Existing Building 6ir Owner-Occupied ❑ Repairs(s) d I Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': fALne-r. re trr::,cln.l 4milrhr-abm mrr,4A s SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ 2Z t.Lb, Aft L Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 35 Uj 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 241 10b. OD ❑Paid in Full ❑Outstanding Balance Due: mAl l.t� Cp � 1 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) �Fttivv F. t I\litK�lu License Number Expiration Date Name of CSL Holder l 11 kzhrnate fir. List CSL Type(see below) Li No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) a-LV\W rS. UP, bIGZ_?3 R Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding I-� II SF Solid Fuel Burning Appliances Gl8-�-14-333.3 CJftarsQ 11rLwi) Lh.CGr� I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 103L,l I 7 79 it.Bn14 n S F..t C V en a C?ALa/ HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 12 E-InL4en �T . hYtaN Ct �fGWIISL6 ,ccn. jJo.and Street Email address Lctr\U,Lrs . MN 01923 CM--714. 3333 City/Town,State,ZIP 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 .......... E( 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 Owner's Name(Electronic Signature) Date SECTION 7b:OWNERS 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. VrD a i hu rytwY UC VI-� ��lr � PnVvner's or Authorized gent' 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. ovg /oca Information on the Construction Supervisor License can be found at www.mass.eov/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"maybe substituted for"Total Project Cost" BR WV W KfTC EN & B44 TH CENTER 72 Holten Streets Danvers,MA 01923 Telephone(978) 774-3333 s Fax(978) 774-8709 Home Improvement License#103611 s Mass.Builders License#073375 CONTRACT This contract,dated below,for materials and/or labor to be supplied by Browns Kitchen&Bath Center (Hereinafter,referred to as the contractor),at the sole request and order of.- NAME:Art Barnett PHONE:978-7774125 DATE:Apr.10,2015 ADDRESS: 13 Valiant Way Salem,MA 01923 (Hereinafter referred to as the owner or buyer)to be supplied/performed at premises set forth above,subject to all of the terms and conditions set forth on both sides of the Agreement,as follows: Browns Kitchen&Bath Center is pleased to furnish you with a quotation on your Kitchen remodeling. For the purpose of this quote we have used Kemper cabinets. These will be supplied and installed according to our design and drawing. Flooring: The floor will be prepared for Owner Supplied Brown's installed tile Plastering: None Plumbing: We will disconnect and reconnect appliances We will supply and install an undermount stainless steel sink and Kohler Forte pull-out faucet(BN). We will connect owner supplied disposal, dishwasher and icemaker. All work to be connected to existingplumbing.Any modifications to accept draws or other items will be extra.If any upgrades are needed a quote will be provided Ventilation:None Heating:None Electrical.None Counters:For this quote Mid-priced Granite(Kashmir Cream)with 4"backsplash has been quoted. The wall between the upper and base cabinets will have owner supplied Browns installed tile. "All hardware(knobs and pulls)must be picked out at time of signing contract or within a week of signing. If there is a delay in ordering hardware and it is not at the job when cabinets are being installed there will be an additional charge for the carpenters to come back 'Counters are priced per our measurements, size changes will a$ect price Marble like the and large rile are an added cost for installation. Tile backsplashes are priced for installation of plain straight backsplash Intricate patterns are an additional cost for installation Nothing other than stated above is included in this quote.No paint or paper.All sales tax is Included All work is fully Insured Any debris created by Browns will be disposed of by Browns. Local Permit fees not included s Owner supplied material is the sole responsibility of the owner. Any defects or problems will be billed at an hourly rate. Door Style:Dewitt AGREED PRICE: $16,000.00 Wood:Oak Color:Briarwood 1/3 DEPOSIT: Counter BALANCE DUE: It is understood and agreed that this contract will be completed on or before the day of.2015. The owner represents and warrants that he is owner of aforesaid premises and that he/she has read this agreement set forth on both sides. IT iS EXPRESSLY AGREED THAT NO STATEMENT,ARRANGEMENT OR UNDERSTANDING,ORAL OR WRITTEN, EXRESSED OR IMPLIED NOT CONTAINED HEREIN WILL BE RECOGNIZED AND THIS CONTRACT CONSTITUTES THE ENTIRE AGREEMENT. It is further agreed that this contract is not subject to cancellation except by written consent of both parties. SALESPERSO?44Md ACCEPTED: ACCEPTED BY: X X (SUBJECT TO ALL CONDITIONS ON TBE REVERSE SIDE) The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Mass. 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �/� `.' y� ' 1 r' Q Please _Print lLegibly y Name(Business/OrgmizationMdividual): BF ML1r?IW.1 1 Um6na 4 kcg! J - D� tyTG1e116%`B Address: '72 Nolttn &. City/State/Zip: l74r1XY-S . MK NPIZ3 Phone#: 9-1'4- T14-B114 Areyou an employer?Check the appropriate box: Type of project(required): 1. 9 1 am an employer with 3a 4. 0 I am a general contractor and 1 6. G New construction employees(full and/or part time).* have hired the subcontractors �_ p Remodeling 2. 0 I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' [No workers'comp. insurance comp.insurance.$ 9. 0 Building addition ra required] 5.0 We are a corporation and its 10. 0 Electrical repairs or additions 3. 0 I am a homeowner doing all work officers have exercised their myself [No workers'comp. right of exemption pens MGL 11. Y Plumbing repairs or additions insurance required) t c. 152,§ 1(4),and we have no 12. 0 Roof repairs employees.[no workers' 13. 0 Other comp. insurance required.] -Any applicant that checks box to most also fill out the section below showing their workers'compensation policy information. fnomeowners who submit this affidavit indicating they are doing as work and then hire outside contractors must submit a new affidavit indicating such. tCoumclon that check this box must attach an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they most provide their workers'came,noll"number. lam an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. //�1 Insurance Company Name:tltsi=airti EmOipWs lnz,. Co. Policy#or Self-ins.Lic.#: WCC 501=1 2A1 2015 Expiration Date: bl 1 1201b Job Site Address: 13 \fLQ..lanA LbAU City/State/Zip: 31Lrv. . MR dlq-?D 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 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 $250.00 a day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: I/ Date: Print Namepn F I1)UYO�IU Phone# �llg 1l1} • 3)1N 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): l.Board of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact person: Phone M BROWN 72 Holten Street,Danvers,MA 01923 Telephone(978) 774-3333 " Fax(978) 774-8709 Home Improvement License#103611 * Mass.Builders License#073375 C_ C)N`TRAC ' This contract,dated below,for materials and/or labor to be supplies by Browns Kitchen&Bath Center (Hereinafter,referred to as the contractor),at the sole request and order of: NAME: Art Barnett PHONE:978-7774125 DATE:Apr.10,2015 ADDRESS: 13 Valiant Way Salem,MA 01970 (Hereinafter referred to as the owner or buyer)to be supplied/performed at premises set forth above,subject to all of the terms and conditions set forth on both sides of the Agreement,as follows: Brown's Kitchen and Bath Center is happy to furnish you with a quote on your Bathroom project. Hall Bath Carpentry:We will remove existing vanity and top We will supply and install a vanity size:24"x 21" -Wood:Oak—Color:Natural—Door: Danbury The vanity will have a Granite(Saphire Blue)top with a Kohler Caxton undermount sink(bisque) Flooring: The floor will be prepared for Owner supplied and Brown's installed tile. Plumbing: We will disconnect all fixtures needed. We will supply and install new Symmons shower trim:Model#S-4702(chrome) we will supply and install a Kohler 8"Revival lave faucet.(chrome—wing handles) We will supply and install a Highline Comfort height toilet w/elongated seat.(bisque) All work to be connected to existing plumbing.Any modifications to accept draws or other items will be extra.If any upgrades are needed a quote will be provided. Shower Door:To be quoted Heating:None Ventilation:None Electrical:None Master Bath Carpentry:We will remove existing vanity and counter We will supply and install a vanity size:48"x 21"-Wood:Oak—Color:Natural—Door:Danbury The vanity will have a Granite(Saphire Blue)top with a Kohler Caxton undermount sink(bisque) Floorin :The floor will be prepared for Owner supplied and Brown's installed tile Plumbing:We will disconnect all fixtures needed We will supply and install a Symmons new tub/shower trim:Model#S-4702(chrome) We will supply and install a Kohler 8"Revival lave faucet(chrome—wing handles) We will supply and install a Highline Comfort height toilet w/elongated seat(bisque) All work to be connected to existing plumbing.Any modifications to accept draws or other items will be extra.If any upgrades are needed a quote will be provided. Heating:None Ventilation:None Electrical:None *Tile quote is based on a straight installation.Intricate patterns or large tile are higher in price for install.Marble like the is a higher price for install. *At time ofjob all knobs,handles,TP holders,towel bars etc must be on site for installation.If not on site during Job installation a service fee will be charged to return to job and install these liema. Nothing other than stated above is included in this quote.No paint or paper.All sales tax is Included Ali work is fully insured Any debris created by Browns will be disposed of by Browns.Local mermit fees not included *Owner Supplied material is the sole responsibility of the owner.Any defects or problems will be billed at an hourly rate. Door Style AGREED PRICE: Half Bath: S3750.00 Master Bath:$4450.00 Handle/Pulls Floor 113 DEPOSIT: 'Counter BALANCE DUE: This quote is good for(30)Thirty Days from date above. The owner represents and warrants that he is owner of aforesaid premises and that he/she has read this agreement,set forth on both sides. IT IS EXPRESSLY AGREED THAT NO STATEMENT,ARRANGEMENT OR UNDERSTANDING,ORAL OR WRITTEN, EXRESSED OR IMPLIED NOT CONTAINED HEREIN WILL BE RECOGNIZED AND THIS CONTRACT CONSTITUTES THE ENTIRE AGREEMENT. It is further agreed that this contract is not subject to cancellation except by written consent of both parties. SALESPERSOMQQf�h,( /�� ACCEPTED: ACCEPTED BY: I- X X (SUBJECT TO ALL CONDITIONS ON THE REVERSE SIDE) 95„ 13" '- 69" 13" I ' 13" 70" 12" + 24 71" N iIi ill NA �fy ,. NJ00 - CO 00 t N 0 N N m U) W A A L A i I l% W 'I l� O O Z T a ip CO M Q [Y w W W O O O `MO �. NN/1", xC00 W c ° '• -- -� r' O _ - -- , W N N 4 N N N _=_------` r '. W W w W W w a _ _ OD All dimensions size designations Browns Kitchen Bath This is an original design and must Designed: 2/23/201 given are subject to verification on 15 Elm St. not be released or copied unless Printed: 2/23/2015 job site and adjustment to fit job Danvers, MA. 01923 applicable fee has been paid or job conditions. 978-774-3333 order placed. &(N.L rt+GhaM Rsrnett All Tl.o..A n.. d4 t N.. Colo BFMURPH OP ID:AA CERTIFICATE OF LIABILITY INSURANCE !0911D°'"YYY' osnvla 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 pollcy(ies)must be endorsed. If SUBROGATION IS WANED, 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 781-9141000 NAME: Cheri Rossetti TGA Cross Insurance,Inc. PHONE FAX 401 Edgewater Place,Suite 220 a o .781-9141079 No:781-246-2601 Wakefield,MA 01880 E-MAIL ss:crosset6 cross.com Chris Hawthorne INSURERIS AFFORDING COVERAGE NAICd INSURER A:Plymouth Rock INSURED BF Murphy Plumbing&Heating, INSURER a:NauUluslnsurancecompany 17370 Inc&Browns Kitchen&Bath Inc Associated Employee Ins.Co. 72 Holton Street INSURERC: Danvers,MA 01923 INSURER D: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBS TYPE OF INSURANCE POLICY NUMBER MMIUD EFF MWDDr EXP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 B X COMMERCIAL GENERAL LIABILITY NN466236 06101114 06101115 PREMISES Ea occurrence $ 300,000 GLAIMSWADE OCCUR NED EXP(Any am peman) S 5,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE UNIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,00 X POLICY PRO- LOC S JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ A ANY AUTO PRC000Uf003W 06101114 06101/16 BODILY INJURY(Par person) S ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident b X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,00 B EXCESS UAB I CLAIMS-MADE ANg15775 06101114 06101115 AGGREGATE $ 1,000,000 OED I X I RETENTIONS 10000 $ WORKERS COMPENSATION - X WC STATUS OTH- AND EMPLOYERS'LIABILITY TORV LIMITS ER t: ANY PROPRIETORIPARTNERIEXECUTNE YIN CC6010W201a114 NI OW01114 08/01/15 E.E.L.VI EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L DISEASE SEA EMPLOYE S 100,00 If yyes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S 600,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SALEM-7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salem THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN LY ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Dept 978-740-9846 AUTHORIZED REPRFSENTATNE 120 Washington Street Chris Hawthorne Salem,MA 01970 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD . 4 SCA1 Q 20M-05/1 • ':J�C�mi�tninnraea�/�r��=%��oJao['�u�n,//' � \ Office of Consumer Affairs&Business Regulation ;"'Expiration: _:,OME IMPROVEMENT CONTRACTOR h eglstrabon. 103611 Type: � �xpuabon :7I912016 Private Corporation BROWN'S KITCHEN 9 BATH CENTER BRIAN MURPHY _ - 72 HOLTEN ST. Danvers,MA 01923 Undersecretary uh OMMONWkXdk OF M1 SaAOHUSETFS w , :€ 11 kyj 61 Lei • • • • BOAR R PLUMBERS A�1D,.6ASF I TT1 RSY` w w ISSUES THE FOLLQWfNG LfCENSE 41. AS A MASTER PLUMBER z, BRIAN F MURPHY 11 KENMORE° DR pANVEItS MA 01923-112& 132'5a o %01/16 z15oo9 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supenisor - License: CS-073375 BRIAN F ML}RFH}� 11 KENMORE DR I Danvers MA 01923 Expiration " . . Commissioner 09/03/2016 I May 26 15 09:17a p.2 t e ca Norman Bogosian PO Box 4523 Property Manager Salem,MA 01970 Office(978)745-2225 Fax(978) 745-2251 E-Mail:NormBogosiau@Comcast.net May 25,2015 Judy Browns Kitchen &Bath Co. 72 Holten Street Danvers,MA 01923 RE: Remodeling kitchen of Rental Unit#13 Valiant Way Arthur & Katherine Barnett(Owners) Dear Judy It is my understanding that Arthur Barnett has engaged your services to remodel the kitchen of Unit#13 There is no objection for you to remodel the kitchen of 13 Valiant Way,Salem,MA,providing 1. Your kitchen remodeling meets or exceeds the existing building codes in Salem,MA 2. Your company provides a certificate of insurance that will be in effect during your proposed kitchen renovation to unit# 13 3. Your company works between the hours of 8 am and 5 pm,Mon through Friday 4.Your company cleans up all debris at the end of each day If you should have any questions please call the office at(978) 745-2225 or Email at No rmBogosian(a),Comcast.net Very truly yours, you B � Property Manager Village at Vinnin Square Condominium Trust cc: Trustees-Village at Vinnin Square Condominium Trust Bogosian and Company LLC(Property Management Co.) May 26 15 09:17a p,1 B.F.Murphy Plumbing &Heating,Inc. Browns Kitchen &Bath Center,Inc. 72 Holten Street 72 Holten Street Danvers,MA01923 Danvers,MA 01923 Showroom located at IS Elm Street (978) 774-3174 Fax(978) 774-8709 (978) 774-3333 To.L&' ! k�.m uEill� }, 9, `F ct�4 L tG'CZ�tltf � �cNt ltiy,J Fax# 1 I y � G - From: -r�r 4 nS �r�t !s.kr t3 � C �t�• Date: y I2fnIIS Job: S-�ficLlese c i h Pages including cover Z Ff Confirmation is required by fax Sign and Return l � 1 { ��� �...�AL.YS �iTn i./_�Y1 ill �✓'a'1�:fC:�l i}ij, 'TLi ): li:hS ' 'Jlri •a122.71� L 1 7 ,IILL�:.i 2. � �..t 1 ihLnL' u,. L