Loading...
133 WASHINGTON ST - BPA-10-442 RPR ROOF 1 The Commonwealth of Massachusetts Department of Public Safety •V-,.•� Ma.ssachu.rtl.tilate Building Code(780 C SIR)Set'enth Edition City of Salem Building Permit Application for any Building other than a 1- or 2-Family Dwelling (This Section For Official Use Onlv) Building Permit Number. Date Applied: Building Insp cur: SECTION 1: LOCATION (Please indicate Block# and Lot# for locations for whigh a reef is not available) ce9 Sf r V •l4tr 'OR \b. and Street Cih• /Torun Zip Code Name o(Building(if applicable) SECTION 2:PROPOSED WORK If New Cups uction check here❑or check all that apply in the two rows below Existing Building Repair Alteration ❑ Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ u ❑/ Is an Independent Structural Engineering Peel Review required? rr 1n� Yes ❑ N Bef scriptiun of Proposed W k:�&P0\W aS (O h O r RovF�' ( f1 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDMON,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Evaluation is enclosed (See 780 CMR 3402.0) ❑ Existing Use Group(s): Proposed Use Group(s): r Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area (sq. ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as a licable) A. Assembly A-] ❑ A-2r ❑ A-2nc❑ A-3 ❑ A-4❑ A-5❑ B: Business ❑ E-Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional I-1 ❑ 1-2 ❑ 1-3❑ 1-4 O M: Mercantile❑ I R: Residential R-113 R-2 ❑ R-3❑ R-4 ❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ 18 ❑ IIA ❑ IIB ❑ -Ft ❑ 1(IB ❑' IV ❑ VA ❑ VB ❑ SECTION 7:SITE INFORMATION (refer to 780 CMR 111.0 fordetails on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal ❑ A trench will not he Licensed Disposal Site O Pri ra to❑ or mdentifc Zone:_ or on site,%stem ❑ required ❑or trench or.pecity: permit isenclusrd ❑ Railroad right-of-way: Hazards to Air Navgi ation: \I..\ Ili*tnri.l' nnmi>�iun It.•c i,„ Prnrr..; \ol Appliceble❑ I.St niclurc tnthut airpnrt approach area' I. (heir iea iew cnmpleted.' u ( ,�n.cnt to Ruild endo'rd ❑ Yes❑ or.No❑ Yes ❑ \o ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY I ' iuon oI C t,dc: L',e(d,Rjptnl: k pe of Cun.trucliun: Occupant Lund per flmw 0.w, the budding containan Sprinkler S% tern": SpcCtal Stipulations: SECTION 9: PROPERTY OWNER AUTHORIZATION t +d AdU es.rl Prupe ttQ��ner Name(Print) No.and Street u T City/Town Zip Property lhv ner Contact Information: Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable, the property owner hereby authorizes Name - Street Address City/Town State Zip to act on the pro+erty u+c nee s behalf, in all matters relative to work authorized by this building permit application. _ SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) (if L•uiklin•is less than 35,ULN1 at). ft.of enclosed s wee and/or not under Construction Control then check here O and skip Section I01) 10.1 Registered Professional Responsible for Construction Control hg2 -VA [ 4VI-0 _ I YS 3 3 N1 r,(R gistran Tele, hu N e-mail address "� p/�,, Registratio Number L'O o" v1 LO h /u f Z 2 3 20 Street Address City/To n State Zip Discipline intion Date 10.2 General Contractor JROS CO Ib" KAP.AVOLAS m� M No.38495 A , Gump ny Name: J Lr 2 A q 4) , �to J Name ST of Person Res ansible fur Cu slructiun License No. and Type if A plc o`e Street Address City/Town State Zip ` 1g�J2 9/�� 2 V 3 3 4 vfo 35 Telephone No. (business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'CONWENSATION INSURANCE AFFIDAVIT(M.G.L.e.152.4 25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes O No O SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs: (Labor Total Construction Cost(from Item 6) _$ and Materials) 1. Building $ Building Permit Fee=Total Construction Cost x_(Insert here 2. Electrical $ appropriate municipal factor)=$ 3. Plumbing $ 4. Mechanical (HVAC) $ Note: Minimum fee=$ contact municipality) 5. Mechanical (Other) $ Enclose check payable to Z/, 6 6.Total Cost I $- �' B"-a (contact munici ality)and write check number here SECTION 13: SIGNATURE OF BUILDING PERMIT APPLICANT 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 m ifx.and Linderslandin�•j. er l error df fid,� 7 P��� g/ I'Ieas• ,(nt and sij`na mr 94 Ile �Tclephunr.V��. ©Date ;live( :Address Citvi Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date .Iole.oSlutmpV t ------ - - __ 09610 VW'A409V3d 1S HFINONVEJ YI S.ONAVW S01MAJNV ! 'ONI ANVdW00 S.SOUAVW uoltwodloa e19Ppd .edA.L 1 £6Z49Z oil lWraz :uopejtdia. EE991'6 :uogensl6811 yy�y�p��2rgle)0yel�p3p�Vy2�i1N�.Og 1N3W3A0tldWI MOHnmM no 0,/M �[np o pjU 8 \ Nails.- cilusclls - VCpOI lnacnl m 1 uou1 dt�i jS Board of Building Regulations and Standards �1 Construction Supervisor License License: CS 50721 Restricted to: 00 It JOHN L KARAVOLAS 29 ABINGTON AVE PEABODY, MA 01960 a Expiration: 9/25/2010 µ'('ommic ioncr Tr#: 4567 �o1e�lslvlmpV 0961,0 VW 'AOOaV3d F 1S NaNONVJ YI• i S.ONAVW S0IV k0NV I '0NI ANVdW00 S.SOUAVW uogao oq elpmd ;vdAl •r £4Z>9Z 1N1 I.W/£/Z mollmil4i, ££9841 :uogensl6aa MOJ.OVNINSS0,,01N3W3A021dW1 3WOH _` \ MassacinAwtil- uc'pai tlnCut Vi . uvu� .�{.u• Board of Building Regulations and Standards �.� Construction Supervisor License License: CS 50721 Restricted to: 00 s JOHN L KARAVOLAS 29 ABINGTON AVE N3 PEABODY, MA 01960 a cTL iy�j� Expiration: 9/25/2010 ri'('unnniscioner. Tr#: 4.567 ,\ CITY OF SALEM �, 1 PUBLIC PROPRERTY a; Y',,p/ DEPARTMENT 1'.G: N1ti '.KN Oil \I SRILrT •S.0 1'!1, I'FI:VV-.74 9595 • 1°.\Y:978-740-IOS46 Construction Debris Disposal Affidavit (required I'ur all demolition and renovation work) In accordwice with tlhe sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit N is issued with the condition that the debris resulting from this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c I11. S 150A. The debris will be transported by: h P}JF III'' I name of hauler) 'I'he debris will be disposed of in Q�IV`t1 e.- (mane,Aut nazi 1ty) y h P4 5 L I:Iddreis,It (al'I 11y) +igualur 'Immitapplicant i2�y�° V date CITY OF S.U.&M. NLksmicHusETTS BI:ILDLNG DEPART\1E.NT 120 W.ASHLNGTON STREET. Y°FLOOR TEL (978) 74S-9595 R+x(978) 740-99" KIM3EA EY DRISCOLL THOhW ST.PMRRS .�,(AYOIt Dtmcrot OF gel:9LIC pltoPEnTY/111L MDLNG CONonsstON Ell Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectrlclanslPlumbers knallcant Informatlan 'l Please Print LISM Naine(dusine orpoo,atiotiln,Lvidual): bgol V�0-S Address: Ig 6-l9 -ol-j.-R S'F city/state/zip: gee-bo `i �l� Phone Al. 97g" 5 3f 58 S S^ %re ou as employer!Cheek the appropriate boa: Type of project(required): I. I am a employer with a. 0 1 am a general contractor aad 1 employees(full and/or part-time).• have b hired the sucontracows1110.0 ❑New construction1.0I am a sole proprietor or partmer- listed on the attached sheet, . 0Remodeling ,hipand have no employees Theca sub•contraetors haw . 0 Demolition working ror me in any capacity, workers'comp.inwrsam . 0Building addition I No workers'compinsurance S. 0 We are a corporation andidrequiretL) officers have exercised theirElectrical repairs a additions 3.0 1 am a homeowner doing ail work right of exemption per MGL 11.0 P�ufibing repairs or additions myself.(No workers'camp. c 152, 41(4) aid we have no 12.=Roof mpsas insurance required.)t employees.LNo workers' comp insurance required.] 13.0 other -Any appanrr err draw boa n mtwr also(Ia out the r lu below rboWaa roar+ar►ws•canwnrri,w policy In6umurea 't Lwuuwnwa who submit this affidara indledng they an doing all work are then hits outride contraction tnM mi nta a now aMdavit indicating ruck :C.mttmew that chock this bar mud amarhae tot sir lkmwl INN Jawing ow t arras w*yaelllrasm,sna their wwhna'cones.policy infataits om. I ace as enrphyer that 6 providhtg workerx'com/raauba Insareaeejo►ray awpfeyarat gr1Vw 6,1MPW1d7 rwdia All, injormodom Insurance Company Name: /'1-onr) S co r Policy M or Sci6-ins. Lic. N: wC— ZO 2-0 p 22 0 49 O &0 t Expiration Dan: 2) 20 'Ol Job Site Adtkcss: City/State/Zip: ,%rtacb a copy of the workers'compensation policy deelaratlso pop(showing the policy somber and eaplradsn date)6 Failure to secure coverage 3s required under Section 25A of MGL a 152 can lead to the imposition of criminal penalties of a nine up to S 1.500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a(too of up to S250.00 a day against the violator. lie advi.wd that a copy of this statement may be rurwurded to the OITICe of o,vc,ugatioru„Pilfer MA ror insurance coverage veriticalion. I do hereby errtijy un th nolr/rr ojper/ury that tAi injormodoa providted ubow$a r run/cenrtS P`n A oQlrisl we only Do not write in this arary to 6e a'ornpletd by rify or town o/jla'/r! City or ruwn: _ Pcrmit/Llcrnre a__. _ luuing Aulhurily (circle une): I. Iluard u(Ilrallh 1. Rudding Mpartmcni 3. Cilyffown Clerk 1. elr.tric,l 1111pec100' 5. Plumbing Inspector 6. Other l.-nttact Penan: _ ._ _.. Phone e• ACORD CERTIFICATE OF LIABILITY INSURANCE °A�'R°A"r ' 02/09/21 09 RROauCFp M-us CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Richard P Hertolino Jr Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1200 Salem St #121 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lynnfield, Ha 01940 INSURERS AFFORDING COVERAGE NAIC# INe•mcn INSURER A: Penn America Mavros Construction Inc usuRERa: Pilgrim Insurance INsu/EBc:Arcadia Insurance Company 14 Cardnei 9r nINs!O Peabody Mass 01960 IREIAtERE 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. PoU4Y MOVER Poll(.Y EFFKINE FL9MlpN 11R M311P TYPE OF PSVAANC£ OA1E 150wOOMY1 °AlE1l9A9PW1 LB.i11S p GFNETWLItiminY PAC681265 02/15/2009 02/15/2010 EACI OcwIRERrF s1,000,000 X X .Cot9 CVLGENFlULUABIDtt PPBAIEEE(En axure,u)_ t 1,000,000 X X ..SANOE ❑OCCLTi wFD EJtP(Mywpdvn) E$,000 al-xsoNa.s Alrvlwuar s1,000,000 - - - _--- cENFaALA°cREGATE s2,000,000 GENLAUGREGATE wirt aPAUES PER PRooucTs-COMWOP AGG $1,000,000 wucv M 17Loc H [AUTO�RX LN�fiY PGCOOOOOI007651 02/10/2009 02/10/2010 51,000,000 BOOLY INIUtYi100,000 SCNnTIkFO AUf09MREa AUTOSD=LY RLURYt300,000 r NcNQ ,— s100,000 i tPtt a�am) OARAGEDAmDtt - PUEOONLY-El1 ACg0@? i________._ Arrr Avto oTRsanwn EA Acc s NITO ONLY: AGO t A 02/15/2009 02/15/2010 61CHOCGLHRft1('E I s o�Im �nAlms w>n� Iot.Grs m SS,000,000 s 'aEoucns� s rRkTENiION i t C RC 20 20 002068 00 02/27/2009 02/27/2010 1TORV LRnrs EH sePLovERs•L/Amurr EL.a ti AccToaTlr _ $100,000 aNv axoPR�oRmARTNIHsuTNE i ___.._ ___ - oeFleame®ER ExcwomT IEL asEnsE-FAOmLovaa___ s 500,000 u wi.aRxme unN soECU�PROlIONS l,m., IE.L -Poucv uuIT is 100,000. °INER I OESCANIMN K OPEINTIMI 1 IACATpIb/VFHILIF9/Qf1L5XMb RQ®6Y ENOORSe.¢')/T/:iE W L PROV 6if M6 Seperate Cart has been ordered for holder from Mass Workers Comp Rating Bureau 19 Elm St Peabody Mass CERTIFICATE HOMER CANCELLATION City of Peabody SRO" ANY OF THE ABOVE aexme Po1TClEt BE ^ �^ B6aRE THE fXPmaIION OMTE TRVMO. TRC ssu mvmm mu FimPAVOR m sue ogre vmrtro+ Building Dept — NOTICE TO TE fBIT(YAIE HmnEii NAitED TO TIE LST. RUF FAREOE TO W SO EMAtl Peabody Mass 01960 RIPOSE NO OBIYiAl16Y 00. HABRIIY OF ANY 1(WD UPON 11E IIbWER, TS PGEN15 OR 978-538-5987 ImmesExraTmms AtIIXOflPFD R@RFSk3RATNE Richard Hertolino ACORD 25(2001O8) 0 ACORD CORPORATION 1938 1 -d 8ILOIES8L6 bC ouljoq.Jag P.JeyOTb eZI =LO 60 90 -AdFJ Company Inc*,71� orporated November 30,2009 100 BIRNEY ST # 3 Proposal submitted Peabody,MA,01960 TALK REALTY TRUST Tel: 1-(866)-863-8300Toll free 133 Washington st Fax: 1-(978)-977-9185 Salem ma 01970 H.I.C.LIC 145533 mavros@comcast.net PROPOSAL Re roof back side Complete roof preparation: 8 inch metal drip edge installed at eaves rake edges. New metal step flushing will be installed where is necessary New plumbing vent flashing will be installed and flashed. We will change chimney flashing in the back of building We will install skylight caps . We will repair chimney flasmg over the big meeting room We will repair and paint dormet on art adamopulos office COMPLETE 5 PART WEATHER STOPPER Gaf leak barrier installed at all eaves to protect from ice dams and meet codes. Gaf leak barrier installed in all valleys, around penetrations,and chimney to protect critical area Install 3 tab shingles 7 nails per shingle Serves as second line of defense. Aprx 15 sq We hereby propose to finish labor and materials complete in accordance with the proposal For the stun: $ 6,000.00 n MAVROS COA-S TR UCTION INC g RESDENTIAL*CO'+3_� AFL*INDUSTRIAL*LICENSED*INSURED ACEF 1-gCE OF PROPOSAL P2 JM b! +ad been TALI:REAI1tTY TRUST I lere in after"Red the This agreement made the lt(30dxlr the contractor. Witnessed,that the owner and the contractor owner and LVfAVROS CO NC here in sftirG+�ed for the considerarions named agree sa' ate all of the work As written on the Pmpos al The contractor shall furnish 29 as"the}abor amd m� to complete and accepted by the owner. AMdt 2 Tune of Com evo st�k be completed rw more- . The work to be performed under, this Cbwngits to the scope of wor'; by Then 3 DAYS weather perm'mmg The owner will add to the completion-date. i l Article 3 The Contcaa P�i� i The contract price as agreed upon is $6 000.00 RE ROOF BACK SIDE AN REPAIR LEAKS I, A 1 4 Pco¢res P^vments 40%wben we scut, rest when we fmisll "slaaE be bt x low tic 1 1& half% interest per month on any unpaid balance, t11t attorney Fermi and hold s followia c of owner if collection Procedures most be implemented.non payment or customer hold backs, g ° P`e' job as outlined in contract will result court proceedings. t 5 Wa FACTORY WARRANTY The contractoorx warrants his workmanshipfor 3 YEARS AND 25 YEARS Article fi Ch^ ee onlers we' and signed by boot the owner and contractor And shall be incorporated in an Change orders most be in w ' become a part of the contract p .. lye 7 ,rite or wi The contractor will provide the owner a copy of his current insurance certificate. r Tchmts ss d s [o ancel contract from theday o acceptance. A REEDTOTIDS OF 11/30/ 2009 A VROS* * Tel: 978 977-918 Y ST#3 PEABODY,MA 01960 � )-