45 WEATHERLY - BUILDING INSPECTION r )
The conunonwealth of ItMassachutsetts
1
Department of I'ublic Safety
1t ! '•• j .\hin.,Irhu+ells titefr lluilJing C,�,lr•(i;tll 1.\IK)
0 J\ Building Permit Application for any Building other than a One-ur TivrrFamily Dwelling
(I leis tirclion For Offiri•d Ucc(hdv)
liuildiul; Permit,Number
__. _. Date All )Iied: Iuilding official:
till -1-ION I: LOG\IION(['lease indicate Block Y and Lot p fur locations for which a street address is not available)
No. .unl Street Ci(y;Iowo /it,Code Name of Building(itdpplitable)
SWI'ION 2: PROPOSED WORK
--
F, ilum al .\I:\Sla lr Code u+cJ _ If New Gntslruclion check here❑ur check•III [hat appl\' in the two rotas below
I(sivtit I Building [IRopair❑ :\Iteration � AdditionDemolition❑ Delition p (Ploase fill )ut,old submit.\ppeodi.x I)
Change of L'se ❑ Change of Occupa»ry ❑ Other ❑ Specify:
Arc building plans•unl/on'onstnacliun documents being supplied as part of this permit application? Yvs ❑ --NoA_---_
le an bnlepa•ndent Structured Eli gine-fill• Peer Review required? Yes ❑ No
Brief Description of Proptew•d Work:.__ Q �C
:
Y,Jg cevdsnl �;
_"Jr L.� -r
SECTION 5:COMPLE'rE-FffIS SECTION IF EXISTING BUILDING UNUERCOINC RENOVATION,AUUI'HON,OR
CHANGE IN USE OR OCCUPANCY
Check here if on Fxisting Building Investigation and Evaluation is enclosed (See 7,40 C,\IR.") ❑ -
E+isling Use Group(s): =8PUILDING
Proposed Use Cnmp(s):_.______..___ST AND AREAFxisting ProposedNo.of Floas/Stories(include b,tsentent le
Dotal Area(sq. ft')•and f ohm Height(ft.)
SECNON 5: USE CROUP(Check as licable)
EA: AsscmbIyA-I ❑ A--'❑ Nighklub p A-1 ❑ A4C3 A-5p B: Business p E: Educational ❑F-I ❑ P2❑ fl: Ili h Hazard !i-1 ❑ 11-_'❑ I l.t ❑ I I-i❑ II-5 putional I•I p 1-2❑ 1.11❑ 1-4❑ M: Merantile❑ It: Residential R-I❑ R-2❑ ft•.1❑ RA❑
.S: Storage SI ❑ ti-'_p U: Utility Cl Special Use❑,nxl plomse describe below:
Speri.tl Use
SEC PION 6:CONS rnucr[ON IYPF- (Check asa applicable)
n1311B I1.1 ❑ flu ❑ 11 A 11111 ❑ IV ❑ VA C3 \'II ❑if:(`rioN 7:SII E INFORMAI ION(refer to 781!C.MR I II.0 fur details nt each iteut19nod Lune Infunttatiun: Sewage Disposal: trench I'crmit UchriaRmmuval:ock d„ubidr 19o,�d Lvov❑ Indo. enunloyVIX. Imnch trill not be I icvinvd Ili,(,nsal�ilr inde nlih /,an•' - „r,,n +ne st,lent p wgoired Cl or Irvnclt or.per 11%
prnut is rnrlusod ❑
It,m ilruad righl-m-way: I laiards tip .\ir.New igation: ! a
\'aa 1l,I,h,.mhh• Is<I rw I re 1,ob in.u rl,nrt.I pp It.,t It d re%d' Is lhru rrelrw„v It II;, '
,r 1.,nnrnt t„ Budd rn ,r,l 0 lc, 0 „r\'„$\ )„p \„ L1
l Sl IIO,N 8: ON IT.YI'OF CI It Ill'WA 11:OF O( L'pAN('Y
iI ,I,hru rl C•ale L ,r l,nul,l+) It l•e,y(', nyrut h, mt l'„nl•.m11aJ pull,„gym. ______-__ _
hr 1'mllinl;,, nl.uu.,n I,IoAlor tit.from' <I,ru.11' Iq,ol.lh, ,w
t
SR IIUN `): I'ItUI'FRTY UWNI[lt ,\Utll(1RIYAlION
\ uuc Intl Wdwss,,t l nymrty Octmr
City/ fawn
,Nmle Wrillt) No. and Strut
I'ral,rrlV Ownrr Canter l lnlunnalwil \{\
ho q �l ram_—��_�_.
Ilde frleplunte No. (businoss) felrphune No. (cell)
It applicable, the properly owner hereby atithuriics
r2�sek� L3__NUm — slam -- Zi---
Mime Street Address Cit11 I'uwn P
to act un the pro crt wn is t ii df in all matters r I ttivn to w rk tuth rind by this building permit applicaliun.
SECTION 10:CONS'I'RU(-f1UN CONTROL(Please fill out Appendix 2)
If buildin•is Ics.v than li3OU1 cu ft.of enclosed s,,tee and ur nut under Cunstructila Cuntrul then check here❑antl skip Seetiun lit
11).1 Registered Professional Responsible for Construction Cuntrul
_--I'cic hone NU. e•tlla It ddd rC59 Registratimi Number
Nance(Registrant) V
titrcct Address City/town State Lip Discipline Expiration Date
10.2 General Contractor
Company Name
N,une of Person Responsible for CmiOruch in License No. and Type if Applicable
21�j!�J n�n\nrt S �_ �' — — --�q�-
Street Address City/town State Zip
p�� ca37 O o i
IK•-- e-mailaddrost
fclr ,hone Nu, business Tclu,hone No, cell
SECTION 11: ttt �rprr.:;t t',MI-I N' I It I\ i.;�a n:.).�� I .0 I u ,,n M.G.L.c. 152. 2512 6
,k Workers'Compensation Insurance Affidavit from the\IA Dcparhnent of Industrial Arxidcnro must be nnnplcted and
submitted with this application. Failure to provide this affidavit will result in the denial of the 's-4uance of the building permit.
is a signed Affidavit submitted with this a lication? Yes No ❑
SECI'ION 12:CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs: (Labor
Item and \latcrials) total Construction Cost((rum Item h) 'S__--
I. Budding S b k 0uilding Permit Fm, -Tohd Construction Cust x_(Inser here
2. Elwrical S0 O d appropriate municipal faot,r) .Y
\ I'lumbi»){ b Nutt: \lininmun fee '3 __—(contact numieil+alitvy
{. \Icch mtictl (IIV:\C) 5 2.Ob
i. \Icrhanie,tl llthcr) Q Enclose check parable to
,,. final C,Ist (contact nmutic ipality)mid write chick number here
SI'-Cf[ON 13:SIGNA I'UIQ OF BUILDING PERMIT APPLICANT
Ili enwring nrr name belmv. I hrrcbv ,utv"t under the p,Iins ai pcm,dlics I •vr ury th,rt.tll of the in(unnatiun rtInt,uncd in this
•'PPIic.Itian is true mud a,k unite to the bast It my klw%,Irdg it, Ind • d-
�itook 9) 12
I'Irasr pro» en,l .I+;n n.u»e ...t(1le \(Y.S• II•Icphuno\o. 17.»c
- ` yt.tte
: "Toil \d,lrc+s A
\tunicip.Il In+Vector to fill out this section upon tpplicatiutt lVprt)val:
' 1
< C.
CITYOFS.U.E.%[9 \rLkSSwkCHl;SETTS
UL'ILOI`G DEPAal" lE.\T
It`') ��1` ': •r�:;l 120 \Y AMLNGTON STREET, )`a FLOOR
L1:
„y TIEL (978) 745-9595
Rkx(978) 710.9846
,1.\l3ERLEY DR)SCOLL
Llt YO Z Tliontis ST.PlERRB
MIC ECTCA CF MLIC PROPERTY/0L'RDNC CONOIISSIONER
Workers' Compensation Insurance AtT(davit: fluilders/Contracture/Electr(ci•rny Plumbers
%liplleant Inribrmatinn Ptaase Prhat LenIh1Y
.V ii 111C lntlll'MKt)f�gallallel41nd1Vi'IILd): �`/� ^✓� ��e ` VY/ 70��"'�-d
Address: 2— (1
CitylStatelzip: Phones
�a� 63Cf— /00/
,ire you in cmployer'f Cheek the approprlate at 'rype of project(required):
1.❑ I am a employer with 4. am a general contractor and) 6. ❑Now construction
employees(full and/or part-time).• have hired the subcuNnctars
2.❑ 1 ain a Bole propricfor or partner lived on the attached oiled. t Z ❑Remodeling
.hip and have no employees These subcontractors have 8. C] Demolition
working liar me in any capacity. workers'comp,insurance. 9• C� Ouilding addition
[No svurkers'comp. insurance 5. 0 we are a corporation and its
required.) ofticers have dsarcised their 10•❑Electrical repair$or additions
5.C] I am a homeowner doing all work right of exemption per MGL 1 I.❑Plumbing repairs or additions
myself.(No workers'camp. C. 152, 11(4),and we have no 12.Q Roof repair$
insurance required.) t umpluyees. (Yo workers'
comp. insursncerequired.) tl.QOther
.1,ry yplh:ua der Olucks boa/I muu atw,011,mr the welim butow.hawing their raYm'mmpnudun pultay�nrlu.noeon.
I?. nVuwncv who wlinlil this.taldavil indleaaing they Jim doing alt Iwrk and AM hire ao'"$talnmataa mlua nrhmit s new alatdavir indicting.ueh 4\mlmctun Thal chak this box must anachud.m.Wdulwvd.hat Ihuwing the Maine a/tha,UtscunlM"and'halt warkm'cump,polity Infamutlae.
/we un anpluyer/huNf pruvfJLrX worAen'rumpresorlun Lr.rurunee�or my emp/uyrett Bduw/a r/u polity and Jub sire
in`u/gtal101r.
In,ur; C utce mnpany Nmne: w (-Lr�)$
Policy 4 or Seir-ins. Liu. n: XJ- 'C ` qq 20(2 Expiration Date: ry lab 5ita.1dJress: �'� eCJ-�C�C!"�j�� �-nn CityiStald/zip:
.uracb a copy of the workers' companutlos pulley declarallon page(thawing the policy number and rtplration data),
h'.liluru to wettru euverag s as required under.Section 25.\of MGL c. 112 can lead to the imposition of criminal penalties of i
rid:up ro 11,500 00 und/ur mu-year imprisonment, as well as civil penalties in the farm of a STOP WORK ORDER.and a line
of tql to 52,10,00 a Jay r;ainst the violator. Ile advi.;ad that a copy of this aAwinunt may be iurwardcd to the ollicu or
la rr�ligationx of the OIA I:ar insurmrca tovcrage v•ri liwliun.
/du hrrrby rrni/y nuJtr dr p� ur,J/ru Ir. perjury drat rill L,0unrrur/mr pruvidrJ uGuur it trot nnJ rurrrrt
rr .•.r p
q//rriv!rt le�nJy /).It,tr�vrirr in drir area, m�r runrplrreJ Sy riry ur ro wn uJJlriuL
City nr I'„'rn; i'ermit/Llcenle i
Illuim4.\uliwrily
I. L'o.rN nl 1(calth !, ILtiiding Ocp.lronci'I 1, f ;tylr,mn Clerk 1. 1•:fectric.,1 In.pcclur i. I'lumbinq Incptc htr
i, Ihhtr
Cam l.tct i'crw°' - I hone h
CITY OF S.1�f, AkSS.ICf-i(.'SETTS
8tttotvC DEP.1RTtE�ir
I'0 lV.liHtVOTON STXZXr, }'o FZ.00It
Itt 197() 143.9595
KIMBERF Y DRLSCOLL F.Vt(973) 114984
MAYCIA M<).�W ST.PMUA
Dim r04orP1.8t1CPROPIRTY/at;MnvCCO.%01I3310NEit
Construction Debris Dfspasal Atfidavit
(required ror 311 demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 790 C,41R section 111.S
Debris, and the provisions of MGt a 40, 3 54;
Building Permit M is issued with the condition that the debris resulting rrom
ibis work shall be
1 11, 3 I SOA. disposed of in a properly licensed waste disposal racility as defined by MGL c
The debris will be transported by:
(name ul hauler)
The debris will be disposed orin :
..___ . (name o ..
Jdreu at
4n� aafperm,f ipphcint
07/30/2012 MON 16: 18 FAX 2001/001
ACORD 07/30/2012 CERTIFICATE OF LIABILITY INSURANCE /` /2012
PRODUCER (978) 922-0086 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Carmen-Kimball -Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR .
48 Beck£ord Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PO Box 73
Beverly MA 01915- INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A TeChn010 Insurance Cc
Sheldon Frisch Development Inc. INSURERS:Essex Insurance Cc
p G Box 811 INSURER C:
218 Humprhey Street INsuRER D:
Marblehead MA 01945- INEURERE:
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 AOO1 TYPEOFINSURANCE POLICY NUMBER DATE MM10DIVE DPOLIATE(M!UD TION LIMITS
LTR NERD
B X GENERAL LABILITY 3DX8834 04/15/2012 04/15/2013. EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABIUf1' PREEMMISE5 EsEaNm,�, E 50,000
CLAIMS MADE OCCUR / / / / MED EXP(A' . .) E 5,000
PERSONAL S ADV INJURY $ 1,000,000
GENERALAGGREGATE E 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-OOMPIOP AGO S 2,000,000
POLICY JECaf LOC
AUTOMOBILE I AMIJW / / / / COMBINED SINGLE LIMIT S
ANYAUTO - (Ea aof )
ALL ORNED AUTOS / / / / BODILY INJURY' E
SCHEDIJMDAUTOS (Fe'Pe,eon)
HIRED AUTOS / / / / BODILYINJURY S
NON-O MEDAUTOS IFereabeN)
PROPERTY DAMAGE S
(Pe a ern0
GARAGELABIUTY AUTO ONLY-EA ACCIDENT E
ANY AUTO / / / / OTHER THAN EA ACC E
AUTO ONLY: AGG S
EXCESSNMMe:LIA LIABILITY / / / / EACH OCCURRENCE E
OCCUR CLAIMS MADE AGGREGATE i
E
DEDUCTIBLE / / / / - $
RETENTION S E
A WORKERSCOMPENSATIONAND WC990001B 03/31/2012 03/31/2013 X roR I'�4NiTs
EMPLOYEFW U MUTY
ANY PROPRIETORIPARTNERI ECUTIVE EL EACH ACCIDENT E SOO,000
OFFICERMEMBER EXCWOED4 / / / / E.LDIEEASE-EAEMPLO E 500,000
Nyes,tlumlre ultlx
SPECWL PROVISIONS Inkw E.L DISEASE-➢OLICY LIMB S 500,000
OTHER
OESCPoPUON OF OPEMMONSrtACATIONSNEM0.EElERCWMONSADDED BY ENDORSEMEWWECAL PROVISIONS
Sob Site: Congo Unit Remodel: 45 Weatherly Drive, Unit 86, Salem, MA
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER MLL ENDEAVOR TO MAIL
10 DAYS W WTTEN NOTICE TO THE CERTIFICATE HOWER NAMED M THE LEFT,BUT
City of Salem FAILURE TO 00 SO SHALL IMPOSE NO OBUGATION OR LABILITY OF ANY KIND UPON THE
Building Inspector INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED AEPRESENTATME S
Salem MA 01970-
ACORD 25(2001108) oACORD CORPORATION 1988
INS025(mw).w Pae1 m2
Office of Consumer Affairs and Business Regulation
10 Park Plaza -- Suite 5 170
Boston, Massachusetts 02 116
Home Improvement Contractor Registration
Registration: 104546
Type: Private Corporation
Expiration: 7/1412014 Tr# 226592
SHELDON FRISCH DEVELOPMENT INC.
Sheldon Frisch
P.O. BOX 811
Marblehead, MA 01945
Update Address and return card.Mark reason for change.
Address Renewal Employment Lost Card
istration valid for individul use only
License or re-
Office of Consumer Affairs&Business Regulation e,
before the expiration date. If found return to:
nOME IMPROVEMENT CONTRACTOR
Office of Consumer Affairs and Business Regulation
.-.ff-4---fZegistratjon: 104546 Type: 10 Park Plaza-Suite 5170
-;Expiration, 7/14/2014 Private Corporatic n
Boston,MA 02116
SHELDON FRISCH DEVELOPMENT INC.
Sheldon Frisch
218 HUMPHREY STREET
Marblehead. MA 01945 Undersecretary Not valid without signature
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Sapersisor
License: CS-051135
�Qp}� `1�'t.f is 9 -
SEMLLIGNIN
P`O_,DDO_X�8�1�1
v. oaff i
Marblehead MA tll Y`
Al Expiration
Commissioner . 07114*014
ich
ildi of auy use p )Of
restrided �' bic feet(991r )
V^ 1ess 35>�
�c10 Space
of the Massachusetts .
ssess a anent edition of this license•
Failure to po Code is cause for revocation Grn/pvs
State��cowns formatwn Vista
132"
66" 30" 36"
3611�30" 30" 36"
W2730B W3012B 1230 WDC2430R
W361224 � �1� `
N 3 inch tall filler B27B 307GAS RANGE LS m u
LAU,Ill
_. .-
3/4 incf frig panel o
i
CV _ w W 1
d W1230 W24306 W1230R
00 n -
N
0 Nu
W 1
VLC1884R
4 rollouts modified to 21 inch deep
All dimensions size designations This is an original design and must Designed: 7/25/2012
given are subject to verification on TECHNOLOGIES not be released or copied unless Printed: 7/26/2012
job site and adjustment to fit job applicable fee has been paid or job
conditions. order placed.
sheldon-weathersly-7-25 Legend Drawing#: 1
Verizon I MyVerizon 2.0 1 Verizon Message Center - 45 Weatherly Drive, Salem MA Page 1 of 1
Verizon Message Center
Tuesday,Jul 31 at 10:52 PM
From: EastCoastPro@aol.com
To: swfrisch@verizon.net
Cc: habrams@masmed.org
Subject: 45 Weatherly Drive, Salem MA
Hi Sheldon,
I would appreciate if it you would send me the layout of the cabinets for my files.
4Please use this e-mail as approval from the Weatherly Drive Condominium Trust to allow this work to
i.proceed. I will need a separate insurance certificate naming the Weatherly Drive Condominium Trust,c/o
East Coast Properties, LLC,400 Highland Avenue,Salem MA 01970 as a certificate holder.
Please let the contractors know that Weatherly Drive is a fire lane, and I suggest that contractors park in the
visitor parking areas in the condominium,which are located on the two sides of 70 Weatherly Drive. You may
also have the trucks parked in the driveway the belongs to the unit.
Cyndy
East Coast Properties, LLC
Cyndy Anselmo
400 Highland Avenue,Ste 11
Salem MA 01970
Tel 978-741-2003: Fax 978-745-9684
EastCoastPro@ a ol.com
NOTICE OF CONFIDENTIALITY
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http://mail.verizon.com/webmaii/public/print.jsp?wid=vz widget_Mail0pen_0&type=mai1... 8/1/2012