4 1-2 VISTA AVE - BUILDING INSPECTION (2) s �•� z l �
The Commonwealth of Massachusetts CITY OF
Board of Building Regulations and Standards SALEM
Massachusetts State Building Code, 730 CMR
ii ✓✓✓ Revised.61nr 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Fainily Divelling
This Section For Offici. Use Only
Building Permit Number: Da .Applied:
Building Official(Print Name). Signature - Date
SECTION C:SITE INFORMATION
1.1 Pruperty Address: 1.2 Assessors Nlap& Parcel Numbers
t-F�o�I llS� C�`NL�R�.tl i
I.I a Is this an accepted street?yes no blap Number Parcel Number
1.3 Zouing Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq tl) Frontage(It)
1.5 Building Setbacks(ft)
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: 1.3 Sewage Disposal System:
Zone: _ Outside Flood Zone?
Public❑ Private❑ Check if yes❑ Municipal❑ On site disposal system ❑
SECTION2: PROPERTY OWNERSHIP`
2.1 vnertof Record:
ONO(no
Q rmee�(Print) City,
p. `' City,State,ZIP p
` 17i lJ i� VA Q2V� ���- g /V/A
Nu. �:m11 Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied Cl Repairs(s) Alteration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work':
SECTION a: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
I Building S 1. Building Permit Fee:S Indicate how fee is determined:
Electrical $ ❑Standard City/Town Application Fee
2. ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: S
d. Mechanical (FIVAC) S List: -L%—�J-
5. Mechanical (Fire S
Su ressiun) 'rota(All Fees:S
Check No._Check Amount: Cash Amount:_
6. Total I'ruject Cost: S �e1Soo ,`s'f 0 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 999 f_/ 6/
�5 k- p,n � License Number E.epuuuon Uate
Name of CSL Holder
List CSL Type(see below)
LAaE �
No.and Street Type Description
b _`,, �t� U Unrestricted(Buildings u to 35,000 cu. ft.)
oa�oo �y \<\�l A C)V' kk)=C), R Restricted 1&2 Family Dwelling
Citylfot ,State,ZIP bt Nfrisonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
)-C) �/ I I Insulation
'fdc hone Email address D Demolition
3.2 Registered Home Improvement C tractor(11IC)
Improvement
U C� OlS
r HIC Registration Number Expiration Date
tIIC Cum,ppan Nume or HIC R� istrant Nan e
E a cS11'\L r)r i � QVI< [OiYt
o. and Stre t 9S� Email address
�� �r -6���> t531 9SS'' °
't /Town,State,ZIP 'fete hone
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 A THORIZATION,TOBECOMPLETEDWHEN:
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING.PERMIT
[,as Owner of the subject property,hereby authorize n--,
t9 a it my behalf,in all matters relative to work authorized by this building permit application.
o 13
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
contained inthis application is true and accurate to the best of my knowledge and understanding.
Prin Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I. .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 tM.G.L.c. I42A.Other important information on the HIC Program can be found at
tv.vw.ntass.gov'oca Information on the Construction Supervisor License can be found at wtvw.tuass.aov:'d ss
2. When substantial work is planned,provide the information below:
'total floor area(sq. ft.) (including garage, finished basementlattics,decks or porch)
Gross living area(sq. R.) Habitable room count
Number of fireplaces' Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
'fypeofcoolingsystem Enclosed Open
3. "total Project Square Footage"may be substituted for"Total Project Cost" �cf
i�i Vf CITY OF SM.EM, NWSACHUSETTS
' • 'a BUILDING DEP.�R'I MNT
120 WASHINGTON STREET, 3" FLOOR
`�. TEL (978) 745-9595
F.ix(978) 740-9846
KIMHERL.EY DRISCOLL
NL1YOR THOSLAS ST.PIEM
DIRECTOR.OF PUBLIC PROPERTY/BUILDING CO\L�MSIONER
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 1 l 1.5
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:
"1
(name o� f hauler)
The debris will be disposed of in
(name of Facility)
(address of facility)
signatura of permit applicant
dat'e _
dcbn5ail Jx
CITY OF Same .s•M9 4L ssACHUSETIS
- j
BUILDLNG DEPARTMENT
p< 120 WASHINGTON STREET, 3a°FLOOR
TEL (978) 745-9595
F.kX(978) 740-9846
KIJIBERLEY DRISCOIJL
T
MAYOR H064AS ST.PIE.'tR&
DIRECTOR OF PUBLIC PROPERTY/BUILDING CO',LslISSIONER
Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers
A r tlicant information A Please Print Legibly
MamC (BusintssOrganizatioMndivicluai): 'F' S
Address: Cp 4 Q \�SZ S
City/State/Zip: t,�Lj_11�C Cllci(d� Phone #: �9� 53`l-9S57 /
A,reA1ou on employer"Check the appropriate box: Type of project(required):
I\\ \ am a employer with 4. 0 1 am a general contractor and I b.e have hired the sub-contractors ❑New construction
employees(full and/or part-time).
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.t 7. Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers'comp.insurance. 9. 0 Building addition
[No workers'comp. insurance 5. 0 We are a corporation and its
required.] officers have exercised their 10.0 Electrical repairs of additions
3.0 1 am a homeowner doing all work right of exemption per MGL I I.0 Plumbing repairs or additions
myself. [No workers' comp. c. 152,§1(4),and we have no 12,kdD oof repairs
insurance required.] t employees. [No workers' I3.LJ Other
comp. insurance required.]
•Any applicant drat checks box#1 must aisu rill out the section blow showing their workers'compensation policy inii)rnation.
t 1 Lsmeowm"who submit this affidavit indicating they arc doing all work and then hirC oUtsidC cantmctors mast submit anew affidavit hciiu ing such.
'(.UNrg301a that check Ibis box most anach ai an additiu al sheet showing the mmne of the sub+xuaraetom and their workem'comp.policy information.
I ran an eiriployer that is providinAr workers'compensation insurance for my employees. Below is the policy and jab sire
information. _ p
Insurance Company Name:� /�1.._R--AS��o1 04
Policy#or Self-ins. Lic.//0:,, —I0 ) —� <���0 o`- Expiration Date: �a p
Job Site Address: c-h�L ��r .S 17( CA-9 . City/State/Zip: �POWIAA _ 4C C7\5gb
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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up m S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
investigutions of4te DIA For insurance coverage verification.
I do hereby certify under the pains mid penalties of perjury that tine information provided above is
irue and correc4
Data
Official use only, Do nor write in this area,to be completed by city or lawn official
Citynr'ftiwn:
Issuing Aulhurity(circle one):
1. Board of health 2,Building Department 3.C'ity(rown Clerk 4. Fieetrical Inspector 5. Plumbing Inspector
6,Other._..__,
Contact Person: ._..__ .. .._._._. Phone#:
1
r`
Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
C imtructiun Supeniatir Speci;Jh
License: CSSL-099962
SCE V EN M LAM9"
6 FELTON STREET ;
Peabody MA 01960U. ,;
_ Expiration
Comnnsswner 10/22/2015
to
v
Office of Consumer Affairs& 1;usiness 12el,ulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
- registration: 168689
_ Type: Office of Con mer su Affairs and business Regulation
_= piration: 3/20/2016 LLC 10 Park Plaza-Suite 5170
SML ROOFING& ROOF REPAIRS LLC. Roston,MA 02116
STEVEN LAMONDE
6 FELTON STREET
...6___
PEABODY, MA 07960
' �Undarser r"to ryat-y Not valid wit nu[signahtre
Proposal # 1152013
Page# 1 of 2
From: Steven Lamonde November 5, 2013
SML Roofing& Roof Repairs, LLC
6 Felton Street
Peabody, Ma. 01960
(978) 531-9557 Job Name: Serino
To: Mr. & Mrs. Thomas Serino
4 '% Vista Avenue Job Address: 4 'h Vista Ave.
Salem, Ma. 01970 Salem, Ma.
(978) 741-5208
1 hereby submit specifications and estimates for: Approximately 14 Squares of a strip & a
re-roof of shingles including the roofs cap.
Shingles
I will first begin stripping the 1 old existing layer of shingles from the main roofs
and the mansard, then I will de-nail the roofs as well as nailing off any loose boards. I will
replace any rotted roof boards up to 32' or any rotted sheets of plywood up to 8' (1 sheet)
for free and any additional board replacements after the specified amount will become an
extra charge on the final payment with prior notice. Board replacements after the
specified amount will cost $4.00 a foot to install plus the charge per each board. Then I will
apply an ice & water shield 3' up from the mansards bottom edges, and around the
windows in the mansard area and then the remaining opened areas of the mansard will
have 15 felt paper applied prior to shingling it in. Then main roofs will have ice & water
shield applied 100% prior to re-roofing them in. Then I will nail down F-8" Mill finish
drip-edge to all of the roofs perimeters and I will begin to re-roof with new 50 year GAF
Architect shingles by Timberline in the color of Shakewood by hand storm nailing. Then I
will replace the 1 existing 3" flange with a new 3" aluminum flange and I will use new
Karnack for a water tight seal. Then I will install approximately 35' of new CRV where
needed along with the roofs new 3-Tab cap to match where needed.
Unfinished attics: If there is attic space that is unfinished with personal belongings that
may be affected by the debris that can fall while stripping the roof you may want to remove
or cover them for your protection. If you do not have tarps or drop clothes we can supply
you with some if needed. SML Roofing is not responsible for any damages that can occur
to stored items that were not previously removed or covered prior to the start date.
Page#2 of 2
Prior to receiving written permission to do the Job we can't physically remove shingles/060
during an estimate to know how many layers are currently on the roof. This could
contribute to more water damage to the interior or it may cause new leaking. Therefore we
will use our professional judgment to price accordingly, if any additional layers are
encountered when stripping the roof you the Home Owner will be supplied with photos if,
you are not available to view the additional layers. We will add the additional charge per
square to the invoice.
All material and debris pertaining to this Job will be supplied by and removed by SML
Roofing& Roof Repairs, LLC. This Job comes with a 5 year guarantee to Mr. & Mrs.
Thomas Serino. These terms above to be voided in the event of new Ownership, and or if
any future work is to be done to or on the above areas mentioned in this proposal, unless
done by the said Contractor.
I hereby propose to furnish labor& materials-complete in accordance with the above
specifications for the sum of$6,500.00 Six Thousand, Five Hundred Dollars. With
payments to be made as follows, a deposit in the amount of per customer$3,250.00 for
the stock and the permit will be required in advance along with the signing of this proposal
in order for SML Roofing to start this Job. The remaining balance of$3,250.00 to be paid
in full upon the completion of this proposal with extras if any is requested by Tom.
If this proposal is to your satisfaction and you are accepting these specifications and
conditions along with the payments to be made as follows, please sign and date then return
Our signed copy with the deposit to schedule. Upon receiving the deposit I will pull the
permit to start ASAP. (November 6, of 2013,weather permitted).
�,X Accepted Signature:
X Date:A� 5 3
Contractors Authorization to do the work as specified, Steven Lamonde.
`Please return this copy with the deposit for our records.
Thank you in advance,
Steven Lamonde
SML/tdl