25 WEBB ST - BUILDING INSPECTION q
"-�A'MIAWT-BEfilz-e �Nr ''APPROVED By T44E
MPECT11B PFUDA TD�A.PEAWT.BEJNO GRANTED
CITY OF SALEM
No. Date
'A
Ward
it N Zoning District
Is Property Located in Location of ds-NdA
the Historic District? Yes—No Building
Is Property Located in
the Conservalfion Area? Yea—No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof,rnstall Siding Construct Deck, Shed, Pool,
Repair/Replace—, OE�: �p
PLEASE FILL OUT LEGIBLY t COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owners Name
Address & Phone Skryle, 335-- V/A�
Architect's Name
Address & Phone
Mechanics Name
Address & Phone It C e bA V, W(a N'ka, UNA a olzv
What Is the purpose of building?
Material of bullcling? If a dwelling, for how many families?
Will building conform to Iaw7 Asbestos?
t/16 Estimated cost I V6�Clty License Statel-Ic
Home Improvemaxit Lic. giv
Sign&tiJr'e'0f Aeplicant
SIGNED UNDER THE PEN
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
a 5�i�o
MAIL PERMIT TO: C"
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DISPDSAL OF DEBRIS AFFI
DAVIT
r DV1530n5 of MGL c �,L' , 554, 1 acknowledge that as a
In accordance Vth the p
all debris resulting from the
condition of Building Pomrned by t— Building "erM=L 5hmI be disposed of in
construction activity g waste disposal facility, as defined by MGL .c II1,
a properly licensed solid
S 150A. DV72 DAPS
The debris vill be disposed of at.: - ciiity
locatio—n of f�
Date
Signs
' . re of Pe, t ApPli t
Fully complete the following informations
(Please print clearly)
Name o Ps e`rmit Applicant
Bil-Ray Group
Firm liasne, if any 190 Cedar Hill
Marlboro, MA 01752
Address. Gity i Slate
:oouiras that debris from the demolition.. renovation. rehab
The above statute - or structure be disposed of .in .a properly
thml
or .other alteration- of buosalnfatr5tr ct defined by. l`eGL ei1l.' S1SOA and
licensed solid vesze di Sp S.Z are to indicate the location of tha facility az
building permits
or licenses.
600 V✓mn Lon �frael
gamesJ.Camooeu lJaalnn. i/lassacnusrlb 02f 11
comm,sScner
Workers' Compensation Insurance Affidavit
1
with a principal place of business at:
1114 -
f Up•,suwaw f
do hereby certify under the pains and penalties of perjury, that:
O I am an employer providing workers' compensation coverage for my empioyees working on
this job.
Insurance Company Policy Number
() I am a sole proprietor and have no one working for me in arry capaory.
O 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation P00cien
Contractor Insurance Company/Policy NUnsber
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
O 1 am a homeowner performing all the work myself.
I unoeratano Wt a coot of this fUte,nem+.�tie iorwaroen to we 0&0 of Invesotaoons of the DIA for coverate ver Aeaoon en0 mat byAre 001�r
coverate as re k rw uncer Section 25A of MGL 152 can uao to the rneoonon of On ere oenm"eontatrtt of a hse of on o S I.500.00 a1fYfR am
Yews'moroonnens as wee as ave oennoes m me form of a STOP WORK ORDER ano a foe of $100.00 a Oav MOM wa-
Signed this / day of
Licensee/ ermittee wV Building Department
Ucensing Board
Selectmen Office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 617.727-4900 X403, 404, 40S, 409, 37S
i
F.I.D.No. 11�-2�320449//-- 9EE��nR 69 ME Lie.No.DD1093
.lob# 5 �1(7�7 •1Vl /�"1' 1 .\mil NH Lie.No.
MA Lie.No.120456
HomeCentralw New York Dept.of Consumer
SALES: FOR ALL Affairs Lie.No.0730686
New York: SERVICE/REPAIRS The Service Side of Sears Nassau Lt..No.M2704150000
800-942-6111 PLEASE CALL Suffolk Lie.No.21194KI
Boston: 888-245-7294 190 Cedar Hill Road Yonkers 1397
BOO-SEARS-31 Marlboro,MA 01752 Westchester WC0613-1-187
Hartford Area: New Jersey Lie.No.L011664
SIDING CONTRACT Connecticut Lie.
Dept..00 3 Consumer
800-SEARS-99 Affairs Lic.No.p of C 4
Providence Area: Said,Furnished A restaffed by Bill Ray Aluminum Siding Corp,of Oueene,Inc. VT Lie.No.
888-732-7751 A Sears Aulte fond Confined, Rhode Island Lie.No.13707
888-SEARS--5'1F1/��,,,, I / 40 armed Road,Elmoni,NY 11003
TOLD -JR'-1 ILl DATE ��L—�t�-
ADDRESS PHONE(Home){/,�, ¢/
CITY ' STATE ZIP GY y7�PHONE(Work)fZ/a �s Gfy cC`ZC
JOB SITE ADDRESS In different) -a�'7� 1/S ! OY
APPLIED VINYL & ALUMINUM SIDING I Y-3o o3
General Descriptfo Work at Above Address: Approx. Start Date
Type of House rame; ❑ Masonry Approx.Completion Date
V'7, F err-yes_,/�r SPECIFICATIONS
Sears osprey of materials will be furnished and handled to these specifications:
PLEASE READ
TEMS
IN
UR
1 YES O SOLID VINYL SIDING CAREFULLY cover only Iwalllareas tl CHECKED
ed for sidin ARE
axespt those areas0designatDed below.Size
Col Pattern�ackager Custom corner posts color J
1A. f9' ❑ SIDIryG-will be applied to trial following areas only.
root Elovation ❑ NOLElevation El Ent Details: /ez�- LINF /
❑ Rear Elevation N-L'eitLF;svation Gg-e rial(SEE Deraa
❑ Other MTSEEE DErAlli ,1 iJ
2. IfY�] INSULATION-cover only flatwall areas designated for siding with inch insulation.
3. g ❑ Vse Sears approved GALVANIZED STEEL STRIP where contractor deems necessary.(Nat available with Neiite.)
4. ❑ Siding to be applied over existing foundation.
5. Use Sears approved PERMA TABS AND FINISH STRIP where contractor deems nersssy ry/n same color as siding.(Not available with Nadia)
6. ❑ WINDOW OPENINGS Zo /I/��� .�,r C D.
atom wrap with Sears approved vinyl clad aluminum# Color�"( / ✓/Y^'1T
❑Jump over castings with siding and"J"channel# Color
❑Channel existing window only(eq.Andersen type or previously wrapped) # Color
/ Details
7. 6r ❑ CAULK-all sills with rubberized color co-dedicated caulking.
8. ❑ @DOORS-custom wrap with SEARS approved VINYL CLAD ALUMINUM.#of Doors d Color
9. ❑ GARAGE DOOR FRAMES-custom wrap with SEARS approved VINYL CLAD ALUMINUM.Color
P Single ❑Double With Mull ❑Double No Mull
10. ❑ 'V FASCIA-custom wrap with SEARS approved VINYL CLAD ALUMINUM.Color
11. ❑ L;,�SOFFIT-(eaves/overhangs)cover with SEARS approved SOLID VINYL SOFFIT SYSTEM.Except area noted below.113 Vented.
Color.
12. III
ROTTEN WOOD-will only be repaired or replaced where specified on line item 427 listed below.Any additional areas needing a
fe(fair will be estimated upon their discovery and priced accordingly.(Does not include wood studs,or exterior sheathing.)
13. ❑ L9�Remove existing material on exterior of house.
❑Vinyl ❑Aluminum ❑Wood Shingle ❑Wood Siding ❑Other
es not include any asbestos removal.
14. ❑ PORCH CEILINGS-cover with SEARS approved SOLID VINYL CEILING MATERIAL in the following areas
15, ❑ L�gEAMS/COLUMNS-wrap with SEARS approved VINYL CLAD ALUMINUM(No circular or round columns).Color
t7 ❑ �et1TTERS/LEADERS-remove existing and replace with new custom seamless gutters and leaders.White—Brown
17. ❑ L9' $NUTTERS-provide and install pair SEARS approved polystyrene shutters.Color
18. ❑ L.;— STER MOUNTS-provide and install for exterior light fixtures only.Color
19. ❑ t3 ABLE VENTS-provide and install vents. Color No circular or triangle vents
20. p/} CLEAN UP property at completion of work.
21. [J,-] INSURANCE-all required WORKMANS COMP.AND LIABILITY to be maintained. Albiscoa i� e¢n App e�
22 F� ❑_,WARRANTY-mail to customer after completion and lull payment is received.
23, ❑ PAYMENTS-on NON-FINANCED orders installer is authorized to collect progressive payments. Ooeienee eaymem,mierezi wiu Acca,e.
24 ALL DISCOUNTS APPLIED.
25 111 ADDITIONAL WO -not specified above.AilT� yr^��L 7�i71r,✓Fi i L✓7 N(�T.USr
� u
Cash Sale Total$ Lessde`�p sit 33%$ Cash Balance$ r Other Payment(if any)$
❑ CASH kY�ANCED$ ,, does not include interest �-.�,/- Balance on Substantial Completion
If financed,balance payable in---bkt monthly installments of approximately$ Ye6 �, per month,payable by"Owner'to contractor,but
if financed by Owner then Owner will pay said amount to the lending institution plus such interest and credit service charge of said lending institution
payable directly to the lending institution loaning such monies to"Owner'and wlI execN a Retail Installment oblig tion and any documents required by
suchEley,,,��l inefiWtioninwnnectidn with s id ono, // �/ (zr�/ C
26. Lle IJ WORK NOTto be done f�Ca /�C�ff7 5•�C o{t Alf 07 1
S-fX-�e Sr f a 'f�f� �ei�r.cbf- �EIL.rn/,C S 1io t�._.w
vY1—�✓lre:YGZ
27. M<1 Detail of non-structural carpentry included, a/it lso tJ Lr
Nalice:It financed,any holder of this Consumer Credit Contract Is sub- SALESMAN HAS NO AUTHORITY TO CHANGE ANY TERMS OR MAKE
ject to all claims and defenses which the debtor could assert against ANY REPRESENTATIONS OTHER THAN CONTAINED IN THIS AGREE-
the seller of goods or services obtained pursuant hereto or with the MENT AND"OWNER"REPRESENTS THAT NONE HAVE BEEN MADE TO
proceeds hereof.Recovery by the debtor shall not exceed amounts paid OR RELIED UPON BY"OWNER".YOU ARE ENTITLED TO A COMPLETE-
by debtor hereunder. LY FILLED IN DUPLICATE ORIGINAL OF THIS AGREEMENT.
"OWNER REPRESENTS TO HAVE READ AND RECEIVED A DUPLI- "YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY
CATE ORIGINAL OF THIS AGREEMENT AND TO BE THE AUTHO- TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
RIZED AGENT OF ALL "OWNERS" OF THIS PROPERTY UPON AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED
WHICH THE WORK OR THE MATERIALS ARE TO BE SUPPLIED, NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF
NOTICE TO THE HOME OWNER(S),GUARANTOR(S),LESSEE(S), THIS RIGHT.ON ALL ORDERS CANCELLED AFTER THE RECISION
CO-SIGNER(S). PERIOD, CUSTOMERS WILL BE RESPONSIBLE FOR A 20%
Contractor,at the expense of owner,shall procure all permits required ADMINISTRATIVE AND RESTOCKING FEE.
by law as follows. THE COMPANY WILL DEPOSIT ALL MONIES RECEIVED FROM
1. Owners who secure their own permits will be excluded from the
guaranty fund proint ions of MSL Chapter 142A. IN AN ESCROW ACCOUNT AT CHASE MANHATTAN BANK 8105-1-
2. Any person who shall have co-signed, guaranteed or signed any 062089 WITHIN FIVE BUSINESS DAYS OF ITS RECEIPT.
credit application or note relating to this agreement hereby accepts Dale
to he hound re His agreement. Do not sign this agreement before you read it or it it contains any blank
3. is a t r e represents that the contents on the back to this agreement space or if it does not contain eve hmg ag dad upon.
is a True part hereof and has been read and accepted by Owner.
4.ALL INSTALLA OY LABOR GUARANTEED 1(ONE)YEAR. L Z( d
DATE
Print � ,
Salesman's Nam Signature",44[I r /�1
-r�`
Salesman's sII $ign Here)
C((1//
License No. Signature
SEE REVERSE SIDE FOR ADDITIONAL TERMS AND CONDITIONS Rev.3/01
SEP-26-2003 FRI 01 :51 PM BIL-RAY/ROCKY HILL,CT FAX NO. 86U b13 Ms r. uL
A'+>t.AF:-,i. CERTIFICATE OF LIABILITY INSURANCC 0C�8
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vroourAaTRIO ECS cy, rise. ONLY AND CONFiRl NO RIGHTS UPON THE CERTIFICATE
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