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7 WHEATLAND ST - BUILDING INSPECTION (2) � 1 The Commonwealth of Massachusetts G !!! Board of Building Regulations and Standards CITY /I ]�� g ' OFSALEM Massachusetts State Building CtRle, 780 CMR, 7 edition Rrrisrr/Jmnngv Building Permit Application To Construct, Repair, Renovate Or Demolish a /. 1NAV V One-or Two-Family Dwelling This Section For OFicial Use Only Build' ermit No r• Date Applied: ' gna re 4 J SU,jD Huilding um ssioned Inspector of Buildings Date �— SECTION 1:SITE INFORMATION 1 Property Address: 1.2 Assessors Map& Parcel Numbers 7 GUHE)4L.An/D S'T I.la Is this an accepted street°yes no Map Number Parcel Number IJ Zoning Information: 1.4 Property Dimensions: Zoning District Proposal Use Ld Area(sq 11) Frontage(11) 1.3 Building Setbacks(B) From Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private O Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if es❑ y SECTION 2: PROPERTY OWNERSHIP' 2.1 Owners of Record: C If E i L L L; _ 7 LV#EA L-AN()Name 1Print) T Address for Service: 979 -7y,V—99,2c) Signature Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Unit_ Other ❑ Specify: Brief Description of Proposed Work': KVe7 Jl^ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Oflleld Use Only Labor and Materials I. Building Is 1 I. Building Permit Fee:f Indicate how fee is determined: ❑Standard Ci !Town Application Fee 2. Electrical S ❑Total Project Cosl'(Item 6)x multiplier x J. Plumbing S 2. Other Fees: S 4. Mechanical (IIVAC) S List: 5. Mechanical (Fire S Suppression) Total All Fees:S �� f7 Check No. _Check Amount: Cash Amount: 6. Total Protect Cost: S 0 Paid in Full 0 Outstanding Balance Due: r SECTIONS: CONSTRUCTION SERVICES 5A Licensed Construction Supervisor(CSL) n��_ �f�IUSTiU (7 rnl,L� License Number l:tpiratiunvaic Name of CSI.• I lolder List CSL fype lsee below) ✓ G t ��-' f Descri ion .%ddrea U I lnresuicled u to 3 nnn Cu.Ft. R Restricted l R2 Famil Uwellin M M. Ord Signature _ C/7g RC Residential Roolin V--in felephone WS Residential Window and Sidin SF Residential Solid Fuel Ramina Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) j p 6 a I II(Cum any Name or HIC Registrant Name Registration Number d'YJF Lo 5 G plysTlLUG Ti`0,✓ )-L L g_� g'""' ' � (� Address _ Expiration Date ��c+VsU i CJ 65 G i/Z qJ�-S3/ P Signal Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 152. f 25C(Q) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this afftdavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ..........O No...........O SECTION 7n:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. signature of Owner Dale SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION 1 ,as Owner or Authorized Agent hereby declare Print that the statements and information on the foregoing application are We and accurate,to the best of my knowledge and behalf. Vve"T I i — Signature of Ownerr/or!r AAul�honzed Agent Date 7Anwn the sins and penalties of 'u NOTES: er who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor stered in the Home Improvement Contractor(HIC)Program),will ad have access to the arbitration or guaranty fund under M.G.L.c. 1J2A.Other important information on the HIC Program and tion Supervisor Licensing(CSL)can be found in 790 CMR Regulations I I O.R6 and 1 IO.RS, respectively. bstanlial work is planned,provide the intormation below: rea ISq. Ft.) (including garage, finished basement/attics.decks or porch) Gross living area(Sq.Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of healing system Number of decks/porches Type of cooling system Enclosed Open 7. "Total Project Square Footage"may be substituted Ibr"Total Project Cost" ' I $$$ 34 Jennings Circle Peabody, MA 01960 �— Telephone: 978-531-0811 - E-mail: FaustinoMelo(almsn.com rew.ars.e MEMBIER Faustino Melo,General Manager Unrestricted Mass Builders License No. 80393 Contractors Registration No. 108953 SubmittedProposal to: ne um 'LA ELG 979 7y 2 - — p A City,State,and Zip Code S AL 9),m M rr O c 7 r7 Job Description: Job Location: Job Phone: WNeAT Sr 7/7 93 Z We PropoW hereby to turvish melenals and labor•eamplate m eaoerdanse with the spo ificatiaoe fisted below,far the sum of. S;K yb nAn//) AA/^n r1L11ffJk& (s 6 75oO01 Installation of Paymeph: Payments will be paid in thirds.The fast mstallmmt will be paid before the job begins.The second payment will be obtained in the middle of the)ob.The last payment will be obtained after the job is completed, Now:This proposal may be withdrawn by us Authorized Signature: if not accepted within 20 days. Date: e thereby Subaan SpedMdnr sad-snake for. THE INSTALLATION OF A NEW ROOF To protect the homeownees property,Blue Tarps will be used to cover the siding,bushes,and grass during gripping. All of the layers of roofing will be stripped,and all protruding mils,screws,and/or staples will be removed. Ice and water shield will then be installed at the bottom of all edges,around all chineys,skylights,and into all valleys. Fifteen(15)pounds of felt paper will be installed onto all other area of the roof heck. The 8"aluminum dripedge will then be installed to all roof edges. Any existing pipes will be covered with new ribber flanges. The roofing material to be used will be ,_-?o yQ -7-77miseWL i AJ9 The homeowner is responsible for the selection df the roof color. Also, the homeowner may select Baer hand or paeumaide miters for the nailing application of the new roof. Ail the debris will be cleaned and nroneriv disposed of on a dailylok.Magnetic brooms will be used to extract all nails from your property. We will protect your property as best as we can,however, some foilage matting,breakage,or marring could occur. We cannot accept responsibihy for possessions inside of the house,or debris falling into attic areas. The customer should protect verso at Edo 'nos, Extra work to which an ad(fitionm cost Will be added to the above pnee. Replace Rotted Roolboards Gutter Repairs Remove Aluminum Siding Relead Chimney(s) Install Skytight(s) Remove Old/Rotted Wood Replace Facia Boards Repoim chimney Install Garage Roof Install Ridgevent Install Azek Board Install Insulation Install Roof Louvers Install Window Trim Install Tyvek Paper Install Aluminum Gutters Install Shutters Cover Alummtm Windows, lnstall Aluminum Downspouts Remove Vinyl Siding Repay Vinyl Siding Install chimney cep Porch Repairs Rebuild Chimney Additional Notes: I? Mo,rc ctU e'naaF' s and RSPB r i✓rN/ r7e�/F✓G 57Sn mxfsr"y L -nuo rvcv al I SIa'vr G✓T/1 h 3 so, Do jze'Oa z aoK r7ortr ✓E of n GN'nrN y Sao R ` LA0y W L. /L — Total Amount for Additional Work: W manufacturer to be free of defects for S years,see manufacturers warranty for details. Ali labor performed under contras shall be of good quality and free from defects not inherent in the quality required or permitted for a period of 10 years. This warranty excludes remedy for damage or defect caused by abuse,modification,improper or inmllicent maitenance, improper operation,or normal wear and tear under Donna]usage. This warranty shall be limited to the work performed by Melds ConsUuctiorL LLC and limited to either repair or replacement by Melds Construction,LLC at its sole descretion and election. Any and all claims are waived unless made in writing to Melds Construction,LLC within 21 days after the occurrence of the event giving rise to such claim. This warranty shall not extend beyond any limits imposed by applicable law. Payment and Penalties-Upon substantial completion of all work under this contract,customer shell-within 3 days-make the final and full payment of the contract price. Any and all unpaid balances shall accrue with interest at 5%interest per month. You agree to pay all court costs and collection expenses incurred by Melds Construction,LLC in the collection amount you of any amount you owe under this contras,including and without any limitation of reasonable attorney fear. Acceptance of the Proposal: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified,payment will be made as outlined above. Payments are to made as per wn within and or invoice. The proposal may be withdrawn within 20 days. Date of Acceptance: JCS/ /r 'ZD/U Signature: CITY OF SALEM PUBLIC PROPRERTY DEPAR"I'MENT III '��Y-�1;.•Fi+ ♦ I ��: 'i'BV='r.i In Construction Debris Disposal Affidavit (retluircd for all dentolition and renovation work) In accordance \kith the sixth edition ofthe State Building Code, 780 CNfR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit 1t is issued with the condition that the debris resulting tom 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: (name of hauler) I he debris will be disposed of in (twine ul laci «yy) ttdJrcss ul lacrJtl V1 agtatme ut permit applicant ,fat, DATE(MMIDOIYYYY) a c� CERTIFICATE OF LIABILITY INSURANCE 121412 0 0 9 ( .3)532-5_145 WAX: (978) 532-2217 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR _--'- ce ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. !M 01960 I INSURERS AFFORDING COVERAGE NAIC# S6,tz ! INSURER A National Grange Ins Co '14--cs cc=. -t e:ction 1�7. c INSURER a:National Grange Mutual Ins Co 147ee melo INSURER C:Travelers Indemnity of 25fi66 a7F'°="i g-s Circle INSURER D: Peabody MA. 01960 I INSURER E: COVERAGES n E?0+ 25 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. WSR ADD1 ' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS TYPE OF INSURANCE I Ij GENERALLIABILITY EACH OCCURRENCE S 500,000 DAMAGE T RENTED X ( COMMERCIAL GENERAL LABILITY PREMISES Ea ocwnex,e $ 500,000 A ( -CLAIMS MADE EXI OCCUR KPB23862 11/26/2009 11/26/2010 MED EXP(My one person) $ 10,000 PERSONAL S ADV INJURY S 500,000 __— GENERAL AGGREGATE S 11000,000 l � GEN'L AGGREGATE LIMIT AP(P�LI�ES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 �X POLICY I I PrC I LOC ! AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ { ANY AUTO (Ea accbanl) $ I WALL OWNED AUTOS M91143926 9/21/2009 9/21/2010 BODILY INJURY $ 250,000 1 (Per Person) X i SCHEDULED AUTOS X HIRED AUTOS I BODILY INJURY $ 500,000 X I NON-OWED AUTOS (Per eeudan0 N PROPERTY DAMAGE $ (Per accident) 6 GARAGE LABILITY AUTO ONLY-FA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ 1 AUTO ONLY: AGO S 1 I EXCESS I UMBRELLA LIABILITY - EACH OCCURRENCE $ t OCCUR CLAIMS MADE AGGREGATE S i $ I DEDUCTIBLE $ 1 RETENTION $ $ C 1 WORKERS COMPENSATION M-I IT WC LI OTH- AND EMPLOYERS'LIABILITY _ EACH A ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.ECN ACCIDENT S 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) IISOB7814M46509 12/4/2009 12/4/2010 E.L.DISEASE-FA EMPLOYEE S 1,000,000 Ues describe under E.L.DISEASE-POLICY LIMIT S 1.000.000 AL PROVISIONS bebw � OTHER I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION For Insured r 8 Purposes DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ��_7" 0�1��1��♦'// John McCarthy/LG4 9o^' ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(2oosot) The ACORD name and logo are registered marks of ACORD i piTrcc`t {oa`fumi`$ a"ir $ i5e u n License or registration valid for individul use only fr50L1E Off?ROVEMENT CONTRACTOR before the expiration date. If found return to: egh-�ation" 108953-`'. Type: _ Office of Consumer Affairs and Business Regulation ' _ - tO Park Plaza-Suite 5170 s ✓fin: 8128/2012 Ltd Liability Corpor Boston,MA 02116 i -V- 1gf.' Undersecretary Not valid without signature I I i i i m tvs.ichu etts Department of Public Safet} Board of utld rig; IZy:;.ulatious and Standards 4 _ cons' uction Supervisor License 4 License: CS 80393 '• 't Restrictedto: 00 � 9 t , FAUSTINO N MELO 34 CIRCLE PEABODYABODY, MA 01960 e Expiration: 3/1/2011 t'unnniesi„aer Tr#: 12192 �. J• . C i