47 WARREN ST - BUILDING INSPECTION The Coin mon Wei lth of Massachusetts
T gourd of Budding Regulations and Standards
rc a MUNK iP
1 MstsstchusettsStateButidmgCode ?$tiClytR 7rdtdan Uyt
Building'Permit ApPhc thou Tti'Constrltct; Repair i2enouate Of taemoltsh u RcitrOd IRnuiir i
(?ne orTtia hirutilvDKeltorg
This Set.tion Ftkr 4f�tcial Use ORl
Autldin gPermitNumber Date Applied
y�' Signuturr .. g', ,=
BuddingCuinmissionerlingpe.. rel'Butdutgs a DWd ,
'- SECTION.1.SRT.E,INFORINATIQN'
k$ Proper <Addr F°Z Assessors Mop&Parcel Nunibars
t..ta Iff lhi5 gR:nll2 fed Y[Teet) es', ._ now �hiap Number Pua�l Num4 q
t 3'Zoning lnf iination 14 Property Dtmeastons
Zoning District: Proposed Use Lai Areo tsq',Ri Frpniage tlt;
15 BaHHdHngSetbacks"ift) r: •`.'-. .
:From Yardear
Rcyuired'a - Eovided Required FRivuted Required"„ 'Pruvuled
1.6 Waker y (M O;L a 40 §54) !7 Ftond Zone Infot7tiallon 1 8;.Sewage Dis sal System
Zane fAtksliie Rood Zv{ie7 �,}�'�
`; .. Check if es❑,.,,_. ,. .. n site d€spasal systrm ❑
PuMia ,, ,Pnvnte Municipnt . _6,. _
SECTION'2r PROPERTY fl1V1VF.RSliIP1
2'1 flwner'iaPRecar
- .t At3dr�ess Por Service '
Signnnise fielephun ,
SECTION,3 DESCRIP TIOIY,OF PROPQSED WQRK=(cheek u het;'upplyj_,
1Yew20iestiuchon❑ 'Ezishng8uildingG Owner4cecup�cdxC7 ltgpmrs{sj`, Altern_tion(s) 4 Addition:C7
Deeaoldion ❑ Accessory 8idg❑, Number of Lltits' Other Q'9pectYy
BeiefDeseriptorrofPraposedWnr E
SECTION 4 ES'TtMA'TED CONSTRUCTION
Rein Estimated Costs
iC tibor aiidMaterials) Qflicisl Use Only
l::Budd[ng S " t Budding PermttFee $ '- Indicate hRw fee'is determined
q Standiud City/Tnwrt Apphcution Fee
2:Electncal ' $
❑Total Prujtxt Cost(Item b�x multtpttei--: x,
3'Piumbiag . S, , ° Omer Fees $
s
4.l4fechanterti,'(HVAC) ' $ t.lst
S,�Mochanrcal '(Frye S
3u' cession) �'z TataIAli'Fees 3
Checir No Che+k Amaint CJSh Amriunt
5.Total Project Cost $ �'.-.`: Q-Pmd, iifull „, �,!❑OulStandmg'13tlura.e Due,`
s
SECTION5 C0NSTRUCTtONSERl±lC6S=
S 1 Licensed Consiruc.... perviaar'(GSL) _ � �.. T l� /
f.3tense Namber a Exptrattan Dati
a IastCSLType{seehvEowt
_: U Uitnstriciedtu .ta350isUCa:FtS
i Marc
Restricted lA:Fumii Dw2iiin -
rr u M M tsori" Qnl41.
s RC: ReadeiihalERoatSn ;Canon s=
h+$.-. ResiilcntiaFlYitnlutw"undsidta ._
,,'., ' ..SF �„� .R�yidetivalSnlid.Foel Burnm.,�: hwn� hrstiulatnnt -
•
S1 egistered Noine Imprnve4le I CB tjgetat
�EY�'CA/�S?�2wG 17-t3 � ! Z
t ti1C puny N " r HIV.J ist t N Regtsttatitin Nu
T I 'fit
SECTfQN 6 ':WORKERS' OMPENSAT- 1 Ih$IfRA1YCE AFFJDAYIT(M G L c 152 § 25C(6))
Warkers',Compensation insurange ut�idavtt leiust be corppieted uait�"submitted Wuh this appticuuun Flare tonic tde'
this ufftlnvit w18 re3uit to the`deiilai of the issunnca of,he Eiudd(pg;perndt
Signed AtFtdavtC'Attrtcited? Yes O Nb ❑
SECTION7u OWN7sRAT3TAORI7.ATIONOHIiCOMPLETEDWHTsiAT
OWNER'S AGENTlO1i SON I R4CTOlt'APRI IES FDit'BIIIZ DINOTERMIT ,z
sy
as 6"in 4 of thei,su fit eot property herefiy
authorize' to act on my trehittf in ttlt mutters
aelati ve k authonud by tbi3 = tag perm[[apphsmbon
d
=St amre.oTOw e
14' :SECTION; OWNER"OR AU fNORI2ED AGENT DECLARATION,
`I ' � � _�? r =� � � . asG?uwaF,erAuiltor3zcd Agani,hereby declare - '�
that the statements and mfarmahon on the faiegatng apphaadon are true andkaccurate Eo the best of my knowledge and
fi
FT nc N
;Signatu of Owner or Aittharized ".m ,?, an , { '' bme
= St ediii r the wits uutd nW[ie6'of -
3
xNOTES,„ Z 1
t An Ouyner xhd atimins a btniding permdto do his�Iier own work pr an owner who hires on unregistered can tract
r.
(ntit registered in kh¢14ame Impravemeiit Cntttraetar��fl1C)Prttgram) will-�hove oeiress to the drbttrawttt
pmgrtiirt ar guaratity fund uirdertvt Q I c {142A Other tmpartartt tntRrmatloir nn the iiIC Prograrti ittd
Construcuon�Sup rvtsor Licensing(C9L)can be fnitnd in 780 CMR�Regui¢kons 130 RS&A I MRS re�pix tiyety
2 When substanuat work is planned provide the mfamation wc, =
Taral floc area{Sq Ft) �triciudtng garage fintahed basement/atncs decks ur parch!
':fSrass hvtng area tSq F't-!'` �- :_ �iiabrtabte room wont
_N'um(rerpfhreplaces x � ,x � B7umfserbfbjdrooms %:
+'Ntunberafbathrooms' � ^ � Numberafhulflbaths
•,Type of heisnng system = Number of decks!porches
' 1Type at coohag systeiii � � '. Enctased Y P' Qpen " ' N
t
'3 'Total,Fin,{ect Square Footage' tnny be,subsunt[ed fq "Tote!Protect Cost '
x
h.
r v 'i
3
r
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY)
03/24/2009
PRODUCER (978) 745-6964 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Rose Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
66 Loring Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 958
Salem MA 01970- INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A'Associated Employers Insu
BC Construction INSURER B:
501 Cabot St #2 INSURER C.
INSURER D.
Beverly MA 01915- 1 INSURER E'
COVERAGES
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.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) OATE(MMIODNY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE S
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES Ea occurrence)s
CLAIMS MADE E OCCUR / / / MED EXP(Any one Person) Is
PERSONAL S ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $
POLICY JECOT LOC
AUTOMOBILE LIABILITY / / / /
COMBINED SINGLE LIMIT
ANYAUTO (Ea acciderrt) s
ALL OWNED AUTOS BODILYINJURV
SCHEDULED AUTOS (Per person) $
HIRED AUTOS BODILY INJURY
NON-OWNEDAUTOS (Per amiEent) $
PROPERTY DAMAGE
(Per accident) S
GARAGELWBILITY AUTO ONLY-EA ACCIDENT $
ANYAUTO OTHER THAN EA ACC S
AUTOONLY:
AGG $
EXCESSIOMBRELLA LIABILITY / / EACH OCCURRENCE S
OCCUR CLAIMS MADE AGGREGATE e
B
DEDUCTIBLE S
RETENTION S a
A WORKERS COMPENSATION AND AWC7022799012007 12/11/2007 12/11/2008 1 TO WCSTATU- GTH-
EMPLOYERS'LIABILITY RY LIMITS ER
ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000
OFFICERNEMBER EXCLUDED? / / E.L.DISEASE-EA EMPLOYEE S 100,000
It yes,describe under
SPECIAL PROVISIONS Cebw E.L.DISEASE-POLICY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE