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50 VALLEY ST - BUILDING INSPECTION (3) No.ll? w Novoa wara In YK�N, � btolpavLsoma ,✓ MItIIaeo lMIMV AM%XATM PON Pa"vx Conglow a' Oook. shggd P0 (Grob whiolwrot wiv) pL how PL KAsiE lM LWf LW&V aOOrN,EMV TO AVOW OUAVS IN/110CMMW0 TO THE INBPEtrM OF BULD64s' Tha tndonipnad hot* appla for a PON 10 bm a000 ft I tha o toMowYp unre Nama Addwa a P1+oe. �n ��lleQ� S c� ig7g -74'k :2 6 Atoh Ca Ntotta A Addws a Phore . Nam tj Addn�a a Phone+ 1 I— — I _ rr��w.p•vo••a wrar� D,se99, , taw a ararat h I lion" twr eryl bnar4 "■Mrdrpoa+000to`." Iloono C S o73`lR 1 itaoetod oat .3 S R � qi tio�ta� N A a� � am us. d I, Of APPMorx — OP pomm CBSCMPMN OF WORK TO ME DONE ` . IZmo�- o1loc and 16 wNn slnecfl �ocm� a�n n� e s� e kd(DS Kama + s eo d a G2 w. MAIL PERWT APPLICAUM �TO FOR L,OCATXM PEF"T OPANTED " of a a Dwma s 3 34-0" 0 Existing 2nd floor layout m d " I Bedroom I Bedroom 2 Front - -------- , 't Porch „ Q O Q � N O loft area Hal1w loft area common area 12'-0" �— I exiettncl dormer\ N 6-O u 34-0° � 40.-0° I Tanigawa - 50 Vallsy Street N , I I . � � I t < 3 n� 6'-O" 341�u O 01 Proposed 2nd floor layout IV I I 1 I I I 1 I Bedroom I Bedroom 2 - -------- _ Front ^ -------- O - Porch m Q Q N O N h ^ Fi6llweu/ rrew room new room common area N 40'-0" a Tanlgawa - 50 valley Street • _ I AIL- _ _^..-•�: "� _,may,. aR s � Mar 01 06 11 : 14a P. 6 Mar 01 06 10: 45a P. 1 F I <—s17tlN 47 )c Sri+s�x� srclsr�wlCf wcvy I`�3ry 1 O __ _ -- vQ1► o U 9r+ Isix;-:7 � at ` of ro�Jd"S �nrh I I I M:p N i � I V 9Nl esixl o i NI G?b? IS'S j _��al� 91'►, Sr x� Otr4l -3 T} Ol — OY S y ey-P I fl, x C, N3N c+� i I i i 4DCITY OF SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RO FLOOR SALEM, MASSACHUSETTS 01970 STANLEY J. UIOYICZ, JR. TELEPHONE: 978-743-9593 EXT. 380 MAYOR FAX: 978-740-9846 Salem Building Department Debris Dispwal Form In accordance with the provisions of MGL c40 S 54, a condition of your Building Permit is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL Chapter III, S 150 A. The debris will be disposed of in: r � d (Location of Facility) � �� (Yhq Sign ture of Applicant .zlts 0 6 Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 wwrv.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aanlicant Information "" '`` Please Print Legibly Name (susiness/0.r' Zaaonnndividual): iJ"L03 ' it ' S�_)rvceS LLG Address: . O. 2o,( 2223 City/State/Zip: Qo64crn MA O[��' Phone#: 0 20 3 Are you an employer?Check the appropriate boa ' ?' Type of project(required): 1.❑ I am a to employer with *' ❑'I am a general contractor and I E emp y 6. ❑New construction employees (full and/or part-time).• have hired the snb-contractors 2. I am a sole proprietor or partner- listed on the attached sheet t ?• X Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity,.. workers' comp.insurance , 9; ❑ Building addition [No workers' comp.insurance .5, [1 We are a corporation and its' 10.❑ Electrical repairs or additions required.] t officers have<„ „ :_,., exerclsed then " 3.❑ I am a homeowner doing all work right of exemption per MGL- I LE] Plumbing repairs or additions myself. [No workers comp. c. 152,§1(4),and we have no t 12,❑ Roof repairs ' insurance required:]t; employees. [No workers,' yj` 13.❑ Other comp.insurance required.] 'Any applicant that checks box#1 must also fill outthe section below showing their workers' fom ootnpensation policy inmtion.' t Homeowners who submit this affidavit indicating they are doing all work and then Lire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the narrc of the sulicontiectms and their workers'comp:policy information. I am an employer that is providing workers'compensation insurance for my employees: Below is the policy and,job site information Insurance Company Name: Policy#or Self-ins.Lic. #: 1 1 Expiration Date: n Job Site Address: Do City/State/Zip: n l m tT O 1470 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 c. 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 up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains and penahies of perjury that the information provided above is true and correct Signature: Dater 2I /3�06 Phone#• `79-1 760 203 O Icial use only. Do not write in this area,to be completed by cky or town official. City or Town: Permit(IJeense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers.to provide workers compensation for their employees.' Pursuant to this statute, an employee is defined as"...every person in the s'etvice of another under any contract of hire; . express or implied,oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the` dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer" MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance: If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be'sure to sign and date the affidavit. The affidavit should be retuned to the city or town that the application for the permit of license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy;please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the perrnittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in I (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a.valid affidavit is on file,for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related,to any,business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents y Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia BOARD OF BUILDING REGULATIONS ::. License: CONSTRUCTION SUPERVISOR r Number: CS 073991 Birthdate: 0 410 7/1 9 6 2 i Expires: 0 4/0 712 0 0 6 Tr.no: 22927 ...... __ Restricted: 00 GERALD WHITE 54 EMERALD DR Ac � LYNN, MA 01904 n ting C mis Doer , ` ��d 0I d>LN)46)tfPCQI�� f.�v'�l[[JrONffLJF� License or registration valid for individul use mth Board of MPRO Building Regulators and ACTOR ds before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration: 129177 One Ashburton place Rm 1301 -�,�,a•: Expiration: 7/1912007 Boston,Ma.02108 Type: Individual Gerald White ''`• Gerald While -� 54 Emerald Drive Lynn,MA 01904 Administrator Not valid without signature T d d1E o1 So bZ xoD 02/14/2006 09:36 FAX 19TS5322217 B X MCCARTBY I , ®004/005 9 Clien WM N S ACQ-RLX CERTIFICATE OF LIABILITY INSURANCEou,aeTHIS PRODUCER ONLY AND CONFERS icATew NO�HTS UPON THE CERTIFICATE OF ON conifer Insurance Agency,Inc. HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTOND OR 10 Centennial Drive ALTER THE COVERAGEAFFORDED BY THE POLICIES BELOW. Peabody ,MA 01960 r 978532-5"S INSURERS AFFORDING COVERACE NAIC;t .IMIReA INBU+FRA PmBuilders S ecial'Ily Insurance Co. 33610 Neaps II Services LL.0 wsuaiPo S Irdemnity btSDrance Co. F.O.BOY 2823 uJBVIIER C: Woburn,MA 018" wBVREPD: !, ai91°ILR F. I - cOVERA6ES POLICY pgRiou THE POLICES OF INSURANCE LISTED aELOW HAVE BEEN M7 -U TO THE INSUREDWRNED�6PECCTO WHICH THIS CERTIFICATE MAY eE ISSUED OR ANY REOUIREMENT,TERM OR CONDMON OFANY CONTRACTOR OTHER OOGVE FO UaY MAY PERTAIN,THE mSURANCE AFFORDED IY THE POLICIES DESCRIBED HEREIN IS SUBJECT ToALL THE TFRId9,IXCLUSpNs AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 7Mi POMOY NYMaPI UMRs RAN°E N8500SO05 08112/05 OB/171D6 FACHOOCUP> " s10000D0TO REHMO sENERALLWBILT'DE a DOCYIR 55 000 -3.500 PeASOwLIADV RuuRY s1000 D00 -_ °eNERALAWAWATE DOD PRDDUDTa-fAMPpPA00 11 DOO OOO GENlADGREGATEIPIRAAAUEi PER Pplpy � lflC B ADIOIDBLEUPeIUIY 311663E 11118/05 11110(06 cauCi EDiINGLELMIT re.Imaona ` I AHYAU O ALLONNCOAUTOS (suatIrIICAI RY s250,00D r X SWEDULWAVIOS X IaRED AUTOO BDwLY.INJURY 5500,00 IPMago" X NOHovmEo anw AIIfO ONLr-rA ACCDENr S ' CAMOE UARWTY EAPCG L OTHER THAN AIIY AlRO AUrO°NLY: AG 5 ElIL WMBR63AWBIUW EALHOCCUiI@ICE f OCCUR l?NM8"M AGfAEGAYE s 1 .. 5 I 'OD-0UCnILE s REfENfION T TAMTR OTH• Emng''a COIAPIFURY RAND f11R0TLA5 WBINIY EL PACH ACCI M S ETp RpA ENE gDwcurrwe yDISFASE-FAEMRAYEE s Ir aMornawn Fl -POUCYUMn i LL vIIOYLSIONS W. OTTER i DESCAiIIDN OF oAEA,=NI I LOGAY"S I VEHICLES I ElICLYIONG ADDED BY FNDOREDAENTf9PECIIL PBW1810N6 V m: David TanlpMla,50 Valley St Salem,MA 01970 i CERTIFICATE HOLDER NCE TOM anLtID A11Y OF THE ABONE„E••aacn FOUlaw Be CA... SEFORETNE�IPIRAT�NIH i city Of Salem,City HSI DAre L1v+ ,TnBReLIwD bIIlIa9laRl Doe•wRYO Man �_ WYIMAATEN 120 Washington Street NOTIQE.TO TNECIRIIRGTe110L091 NAYFD TO IRE IFET,aef FAAVPEfD ODSO SHALL I Salem,MA 01970 IMPosENDosUOAnoR ANIDwox rxel .ns aOEHT°Da I i I r AVTHOPI=I RG` 8S ACOR025(2D01108)1 of 2 f150080 LEG ®ACO CORPORATION 198s I F z d d9S ,I 90 b [ 9dj Ii Nexus II Carpentry and Construction Design P.O.Box 2823 Wobum,MA 01888 781 760 2031 or 978 688 7929 Fax 978 9751263 Contract This is a contract proposal between Dave& Alyssa Tanigawa of 50 Valley Street, Salem, MA 01970-1951 (Hereafter referred to as the "Owner") and Nexus II Carpentry and Construction Design (hereafter referred to as "Nexus")to carry out work at the above address dated February 8,2006. GENERAL SCOPE OF WORK DESCRIPTION WE HEREBY SUBMIT SPECIFICATIONS AND CONTRACT FOR: work to create a shed dormer with center gable,new shingle roof over existing entry porch and new shingle roof to house. Scone of work: General ♦ Remove and trash existing shingle roof over existing entry porch ♦ Furnish and install new ice and water shield protection ♦ Furnish and install new Architectural grade roof shingle (Silver Lining/equivalent— Sovereign in color) ♦ Furnish and install primed pine fascias to front entry porch ♦ Investigate any "animal penetration" and report to "Owner" ♦ Furnish and install new white seamless gutter system to front and M of existing entry porch only ♦ Remove and trash existing roof shingles on house and existing dormer ♦ Furnish and install framing for shed style dormer along length of RH side of house with hip/valley design for interior cathedral ceiling(inset from front and rear of existing structure by approximately 6") ♦ Furnish and install gable framing over center dormer window only ♦ Furnish and install opening into rear of new dormer to create an access hole for air conditioner unit ♦ Furnish and install x tilt in, double hung, single large windows with white grills between glass and white vinyl finish inside and out. Windows to be approximately 4' x 4'. ®Furnish and install 1 x tilt in, double hung, single large window with white grills between the glass and white vinyl finish inside and out. This window to have an the to to match example provided by "owner" and detailed on J order--3 web site incl'ovu tb be`a roitifflalcl 41 W'ii)dwitfi a"flaters"arch ♦ Furnish and install sheathing with Tyvek paper on outside to new exterior framing for walls and roof t"condition). Landscaping "Nexus"will leave site in"broor or fencing. Removal of soils Final constNQilP,p cleaning( sanitation,p ace between bottom ork of any kind• Tempor� uired heig } and irrigation W or code-req -ale by under housa in order to obtain 18 inches( other maw Of joists and soil. Reni"O�f filled ground or rock or any t ` e _ ♦ Furnish and install new primed pine fascias along both sides of the existing house to cover rafter tails ♦ Furnish and install 30 year grade shingle roof with ice and water shield and ridge vent to existing roof and new dormer roof ♦ Furnish and install insulation to new walls and roof ♦ Remove and trash 2 interior bedroom walls adjoining new dormer ♦ Furnish and install framing to new dividing walls between existing bedrooms and new dormer p to 24 deeper into existing bedrooms— ur ocation to a sit bSct1ed(IuHng constructio ♦ Furnish and install CDX plywood floor where required ♦ Furnish and install 2 interior doors (to match existing design as closely as possible) for entry into 2 new rooms created ♦ Remove all associated trash from site Work not included in this contract The above quotation does not include the cost of any of the following and in some cases where stated allowances have been given to assist you in selection. The amounts quoted for the following are your costs for us to do these additional items at the same time as the main project—doing them at a later date may increase these item costs) ♦ Permit costs associated with proposed scope of work ♦ Unseen conditions not apparent at time of quotation ♦ Flooring to be by owner/others ♦ Plumbing to be by owner/others ♦ Electrics to be by owner/others ♦ Exterior siding to be by owner/others ♦ Sheetrock and plaster to be by owner/others ♦ Baseboard trim and casing trim to be by owner/others ♦ Painting and staining to be by owner/others ♦ Repair to landscape disturbed during construction ♦ Any potential necessary upgrades to electrical panel ♦ Any potential necessary upgrades to boiler or furnace PERMITS "Nexus"will accept responsibility to obtain the necessary building permits. "Plexus"will act as a GC and work in accordance with fair and reasonable practices, and cooperate fully and under the guidance of the"Owner"and authorized parties.Any costs of necessary permits will be added to overall contract price at second payment. Standard Exclusions: Unless specifically included in the"General Scope of Work" section above,this agreement does not include labor or materials for the following work(any Exclusions in this paragraph which have been lined out and initialed by the parties do not apply to this Agreement): Removal and disposal of any materials containing asbestos or any other hazardous material as defined by the EPA. Custom milling of any wood for use in project. Moving"Owner's"property around the site. Labor or materials required repairing or replacing any"Owner"-supplied materials. Repair of concealed underground utilities not located on prints or physically staked out by"Owner", which are damaged during construction. Surveying that maybe required to establish accurate property boundaries for setback purposes(fences and old stakes may not be located on actual property lines). Final construction cleaning("Nexus"will leave site in"broom swept"condition). Landscaping and irrigation work of any kind. Temporary sanitation,power,or fencing. Removal of soils under house in order to obtain 18 inches(or code-required height)of clear space between bottom of joists and soil. Removal of filled ground or rock or any other materials not removable by ordinary hand tools(unless heavy equipment is specified in scope of work section above),correction of existing out-of-plumb or out-of-level conditions in existing structure. Correction of concealed substandard framing. Removal and replacement of existing rot or insect infestation. Construction of a continuously level foundation around structure(if lot is sloped more than 6 inches from front to back or side to side, "Nexus" step the foundation in accordance with the slope of the lot). Exact matching of existing finishes. Repair of damage to roadways, sidewalks, or driveways that could occur when construction equipment and vehicles are being used in the normal course of construction. The"Owner"is to enter into contracts for all of the above-mentioned services and provide direct payment to"Nexus"for all of the services we are to provide. "Nexus"will be responsible for removing all components and all construction materials relevant to the "scope of work" in this contract. Trailer and Dumpster notices "Nexus"will make arrangements for removal of all site debris created as part of the above scope of work and will coordinate with the local building department to confirm all guidelines are followed. Throughout the duration of the scope of work"Nexus"will have park on site their own trailer vehicle which is utilized to store materials and tools required to complete the work noted. This trailer is the sole responsibility of"Nexus"and will be appropriately insured under the company insurance policy of"Nexus". Warranties All the components supplied by"Nexus"as part of the original order are covered under the warranty exercised by"Nexus"and supported by the vendors. All labor and materials purchased from other suppliers to achieve completion of contract are warranted(1)one year from completion of the construction. Expiration of this Agreement: This Agreement will expire 30 days after the date at the top of page one of this agreement if not accepted in writing by"Owner"and returned to"Nexus"along with the necessary deposits within that time frame. People Authorized to Sign Change Orders: The following peop a authorized to sign Change Orders: "Nexu ark G bed or Ged White " wn av Tanigawa o Alyssa Tanigawa Concealed Conditions: This Agreement is based solely on the observations"Nexus"was able to make with the structure in its current condition at the time this Agreement was bid. If additional Concealed Conditions are discovered once work has commenced which were not visible at the time this proposal was bid,"Nexus"will stop work and point out these unforeseen Concealed Conditions to"Owner"so that"Owner"and"Nexus"can execute a Change Order for any Additional Work. w Changes in the Work: During the course of the project, "Owner"may order changes in the work(both additions and deletions). "Nexus"will determine the cost of these changes and the cost of this additional work will be added to "Nexus"profit and overhead. Contract Cost and Payment Schedule: Total cost of work description and materials included in the Proposal(except materials/work stated)-$35,989.00(Thirty five thousand,nine hundred and eighty nine dollars and no cents) PAYMENT SCHEDULE First payment due upon signing this contract TOTAL $11, 997.00 a,c Second payment due upon completion of roof over new dormer ) O 13 TOTAL $11,996.00 Final payment due upon completion of scope of work TOTAL $11,996.00 Total due upon acceptance of this agreement $ 11,997.00 �� CV1;2- q ,O b I have read and understand,and I agree to,all the terms and conditions containe�in the proposal above. Date...e�h l 0.6...... "Nexus"Authorization.. .. ............................................... Date..a (./`"........... "Owner"Authorization.... ..... ........ .. e/ Date...Zll ff............. Owner"Authorization...... .. . . . /............... SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT