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7 WEST AVE - BUILDING INSPECTION i. . IA"ST-BE f4L-E lD APPROVED $Y T4IE ` SpBCT[1Ft ,PF,tl91R TP.A PERMIT BEWG GRANTED CITY OF SALEM Date Is Property Located in Location of the Historic District? Yes_No�t Building 7 L4� 5T Ay 2 Is Property Located in the conservation Area? Yes_No BUILDING PERMIT APPLICATION FOR: Permit to: Siding,f Installg, Construct Deck, Shed, Pool, whichever apply) Roof, Reroof,, (Circle w pp Y) Repair/Replace, Other: PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: undersigned hereby applies for a permit to build according to the following Theu Y 9 specifications: Owner's Name min Cc) k1ejTe Address & Phone c� S Ave SrIc-+� (`)7'3) 46q - I<3L Architect's Name Address & Phone Mechanics Name 4 Address & Phone �a l%4 What Is the purpose of building? Nkopm S1 e&Tro( K cna T 1e S Material of building? -T�I e�, If a dwelling, for how many families? Will building conform to law? . Asbestos? IN U Estimated cost jj tqL)_., city License # N A State License # Home Improvement Lit. a 1,94�356 Xi naTure of Applicant S 9 PP SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE r3c-1 (IrOOrr), Ki �ChPry Sti°'l goct can F11,,Pr7j iej MAIL PERMIT TO: �7 � S�d� � 3 No. b�� APPLICATION FOR PERMIT TO LOCATION PERMIT.. GRANTED J P APP �VFD INSPECTOR 61F BUILDINGS T m e } OLYMPIC Painting,Roofing&Siding office 978-535-0943 515 Lowell Street—Peabody,MA 01%0 facsimile 978-535-2008 Jim Collette Essex Management Group P.O. Box 2098 Haverhill,MA 01831 978-469-1232 978-521-5520 fax Job Location: 7 West Ave 9 Salem,MA 2nd Floor March 2,2006 Dear Jim, The following estimate is for the interior work to be done for the property located at the above address. The following paragraphs describe the work that is to be done. We believe that a good job requires excellent preparation and a clean surface to apply the paint and obtain the highest quality of adhesion. We recommended using Benjamin Moore or California®Paints. 4 Remove and install sheetrock in bathroom and kitchen 4� Install tiles on bathroom floor and around tub Install tiles on kitchen floor 4- Cover all floors with drop clothes in the areas to be painted 4- Patch and sand before priming 4 Apply one coat of primer to walls,trim and ceilings ,k Apply one coat of acrylic latex paint to walls,trim and ceilings J. Color selections are final and any changes may result in an additional charge • Customers are allowed one sample at no additional cost. Each additional sample will be$15.00. 4� All work will be performed on a timely basis and in a professional manner We will remove all job related debris Initial options you are ehoosinQ below: Cost for Labor&Material for Bathroom Sheetrock: $ 420.00 Cost for Labor&Material for Kitchen Sheetrock: $ 800.00 Cost for Labor&Material for Bathroom Floor Tiles: $ 200.00 Cost for Labor&Material for Bathroom Tiles Around Tub: $ 450.00 Cost for Labor&Material to Paint Interior: $2,675.00 Payment Terms: 50% deposit and 50%upon completion Warranty: Olympic Painting&Roofing Company hic. guarantees all work performed for a period of one year. If any problems occur will cover the cost of all labor to correct the problem and meet the customer's satisfaction. George Vasiliades,Preside `dim Collette LMCS, Inc. d/b/a Olympic Essex Management Group ' \I ; .ttCERT1FICATE OF (INSURANCE ` . }M 9I29/2005 1.4 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hilb Rogal& Hobbs Of Ma LIC HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 101 Federal Street, 12th Floor ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Boston, MA 02110 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY =k.COVERAGES ;k. Manchester Construction orp Street - A 01960-0000 GES c CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY�ONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS.OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. co LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE BAT E POLICY EXPIRATION DATE A ORKENB COMPENSATION NO EMPLOYERS'LIABILITY E PROPRIETOR] LIMITS ARTNEFLVEXECUTNE FFICERBARE: �„ -Y- . INCL0 EXCL❑ 2791321 9l25/2005 9/2512006 TATUTORY LIMITS THEIR oveOgc APPIICS IO MAOpem9 0,1y. EACH ACCIOENT $ 100.000 DISA9E POLICY LIMIT $ 500.00 DESCRIPTION OF OPERATIONSNEHICLES/SPECIAL ITEMS DISEASE-EACH EMPLOYEE $ 100,00 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL gl DAYS WRITTEN NOTCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KING UPON THE COMPANY,ITB AGENTS OR REPRESENTATNES. AUTHORIZED REPRESENTATIVE The Commonwealth ojMassechusdis Department ojlnduslrid Accidents O,dlee ojlnwstigadons 600 Washington Sled Boston,MA 02111 wwmMeMSMOAts Workers'Compensation Insurance Affidavit BniWers/Contradors/Eledrichwa/P)ambers ADD1iewd Information Please Print Legibly Name L, ,11clO &Orr; Mc=n rin, �iFr �o�sl vd, Cn r Address: S 15 Lowe ll S1 City/S Phoae#: ?�S S 35 - 0,% Are�on n et?Chock t!r appropriate boas' ?!; Type of project(required): I. I am a employa with, 100 4 01 am a general contracbr and I employed(8tn ard/orpwt t®e}• Lavehued ie a ocnuaclon d' [_-]New oonstractioa 2.❑ I am a sole proprietor or partaer- listed on the attached short t � ❑ Remodeft ship and have no employed These sab-c ontracton have 8. ❑ Demolition woes fqr ma in ow eapacity. /'�,i"211 . 9. �g addition (No t,o�g+amp,ine� S. ❑ we ate>A corpt>Zation'aod its' regoired.l., offieert have then I0.❑ Electrical repairs or addition 3.❑ I am a homeowner.doing all work right of es ampdcn per MG;:- 11.Q Plumbing repairs orr addition myscIE[No wosW.eomp e. 152,410i an4 we have'no 1cof npaira irtaatanoertxptirtA;jt, emybyees.ow,wodwi' 2❑It/ comp msmanoe"regntia 13.❑ Other o *Any epptical that cbeeb boot 01 rout W o fill wAd o action below Avwbg Qmt wo,�W=Womb a pHW Via. t 110"M nms wtp eob®t ttb SM&A9 bd eaing fty m doing all wort and t mM*`COW& ikAsubm*anrwaffi&r*b&=dnU=A tCMMtrMeton dot c3Met Ob boi'=W uhebed a s1AWW dint Mbowmg ft nerd bf thmbean6eelen 01166 WOeAM'mo41obeP Irwgientp/oyardratbpttgxwrksn'eontpsratctfosbtsrnMsjanr�eb;pfoyeed DelowbdMpelkposJJoBslti InaarauCCCompanyName < nrn (�anic�S PFFo,c1'�nr 1 ter:nC< Policy#or Self ices.Lice# 2 `71 3L I Expiration Date. Job Site Address % ��,T Av4 �c:.►t�:, C$ylstaDrft �SG c.'Attach a copy of the wortere compensallon polley deelarados page(skowfng the policy number and expiraflon dads). Failure to secure covaage as required under Satan 2SA of MGL c. 152 an Ind to the imposidon of criminal penalties of a fine up to$1,500.00 and/or one-year imPimument,as well err civil penalties is the from of a STOP WORK ORDER and a fine of up to$250.00 a day against to violow. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA far innuance coverage verification. I do benbyc#A*andwA#Adw map#nab/ea ojpfffi"that the Jaj#nedlon provld#d above Is tow and correct Sinadue: Date `l 0 6 Phone# 979 - 1�3 5 _0'14 3 Offleld use maL De gar wrft#la&k and,m b#coar~by eiqurM►w oaletal CW or Town Pwn&U m g Issuing Authority(circle one): 1.Board of Health L Building Department 3.City/I'own Clerk 4.Electrical Inspector I Plumbing Inspector 6.Othw Contact Person: Phone 0: Information and Instructions ' u for tbcir employees• Massachusetts General Laws drapers 152 requires all emPleyea_lo iOV under any contract ofhi% Pursuant to this statute, an ewrpfoyas is defined as"...every.Person in the service of another under express of implied.oral Or wri cM* arsoei d^corporation of other�entity,Of any two of more An�,yp is defined as"an individual.partnership, a deeW d employer,or the of tbc,forCioIDL Cogagod is a joistenterprise, > the.1e� a Howevee the receiver of Unrlee of an b&i&A P or Direr legatl entity,a terein a slat oe a Ofe4" owner of a dwell6og bouse having not more than three apartmnu and who resides therein.or the ocap>rns �m dwelling boost of another wbo employs Persons to do mamteasece'conatrucron a rCPa an emQbyer•' or on die gtonnds or building i at%"not because of loch employment be deemed to be N shd wkblald the hnaaee or MJ Mt^,l, 132,425C(�also states that every state or!Deal ng ergM� Is the eommosweso for say renewal of a license or permit to operate bushsm or to eostt&act trset bsUdisgs applieast whe hss not psvdsad aeeeptabte erfdnes of comPUasee with the lasarasee coverage regsir ed." Additionally.MM Chapter 15Z 125C(7)states`Neither the commonweabh nw any of id political srbdivisiom shall ofpublic weds until acceptable evidence of compliance with the insutswce eons into any contract f or the performance requiremmu of this chapter b ban presented 10 the oonttacuog attt>tOtrty" airn e address(es)and ,by ockio$ ) APPllants alteration ao4 if flog affidavit comPletelY.by ela�g»re bo:ea that apply to yuar Please fiA the wo ere)nsme( b s along with their certificate(s)of iusuranc� Limited Liability Companies 014 or Limited I•iakilit Partnerships UY)with no employees Odles rhos the members or partners,are,not rW*ed to carry.workers'compensation insurance. If an ILC.or LLY does bane ��a policy is re, n t r Be advised than this affidavit may be submitted to the Deparmteot of Industrial A��y for confirmation of insurance coverage At, be snit to dp said date the a}fldaviL Tlu affidavit sbould being the DcpxrUnmt Of be returned to to city or MR dw de application for the permit or license is required dd to obtain a workers' ludusuiaf Aeeideulk S1t�You�,e any gnerdo"M regarding the law or if Yon mereured should enter their corgenwtioaPnLCyC$ the Depneat at the number ljstad below' Self-insrred cgmPame+ self insmanca6ecie number on amon City or Two O(ficisls Please be sure that the affidavit is complete and printed legibly. The Department has Provided a space at the bottom ofthe as affidavit for you tb fill out m the eventber cow stigations has to contact you regarding be used as a reference number. In additio4�an aPP llicant Please be sure it fin in the permn/hc use applications in any given year need�submit one affidavit indicating current that mot submit multiple P licant$bona write"all locations in (City or poft—J. Of necessary). undo NodJob Site Address"tbC �l;'Py the city err lawn may be provided to dae mwinj Aw"p oft! aflldavrtthsthaabono®aalbtstY lam.= applicant as proof that:a valid affidavit is on file for flumre permits of tictmeaL new af$diivit iuutbe tilled out each or citizen is ob�ing a license or permit not related,,many business or commercial vesture year.Where a toms owns Nar required to complete Cher alHdwk (le.a dog license at permit to barn leaves cte.)said person•u The Ofl3a of hrvatigauiom would h1e to clank you in advance for your cooperation and should you bave any questions. please do net hesitate 0 give a a CAL The DcparonenPs addceam telepbone and fur mnabs: The Commonwealth of Massachusetts DgW1Med of Industrial Accident Office of Intradgnfdong 600 Washington Strut Boston,MA 02111 Tel. #617-7274900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia I CITY OR SALEM9 MASSACHUSETTS • • PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON $TRE[T, 3RD FLOOD $ALlM, MASSACHUSETTS 01970 STA14LCV J. USOVIC2, JR. TELEPHONE: 978-745-959$ EXT. 3a0 MAYOR FAX: 979-740-994a Salem Building Deoa_�.+� - Debris Dfspma Form In accordance with the provisions of MGL c40 S 54 a condition of your Building Permit is that the debris resulting from this�work hall be disposed of in a properly licensed solid waste disposal facility as defined by MGL Chapter III, S 150 A. The debris will be disposed of in: (Location of Facility)_ L", 1;4<Jx Signature of Applicant 31 � 0� Date "i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 080145 Birthdate: 10/26/1963 Expires: 10/26/2007 Tr. no: 8042.0 Restricted: 00 GEORGE VASILIADES 515 LOWELL ST PEABODY, MA 01960 Commissioner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR I Registration: 124356 lug Expiration: 6/12/2007 Type: Private Corporation Olympic Painting/George Co., Inc George Vasiliado 515 Lowell st. Peabody, MA 01960 Administrator