10 WHEATLAND ST - BUILDING INSPECTION 70
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Lc_\ The Commonwealth of Massachusetts
SALE
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Board of Building Regulations and StandardsE�E\VE y\�ES CITY OF
Massachusetts State Building Code,780SPM�ZR�tip�AL SEA Revised Ma 2011
Building Permit Application To Construct,Repair,R ovate Or Demolyslt a\. \Z
9 One-or Two-Family Dwelling \ \ 1�
This Section For Official Usq_only
l Building Permit Number: Date Ap ted:
( Building Official(Print Name) Signature - Date
SECTION 1:SITE INFORMATION
1.1 Pro7
jyjAddress- 1.2 Assessors Map&Parcel Numbers
1.la Is this an accepted street?yes no_ Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front 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❑ Zone: _ Outside Flood Zone?Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ownerl of Record:
Name(Print) City,State,ZIP
24
No.and Street Telephone ' Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work':_RS-z- (NGz A-P\.N R110 tACU.= 23t DC j �s
V-Dal t>7 02 �r-
LUtMAGalP12t�To npec4 na�AcfC�ty� As
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materials Official Use Only
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $
6. Total Project Cost: $ Check No. Check Amount: Cash Amount:
s OU ❑Paid in Full ❑ Outstanding Balance Due:_
J
'-r
loll - gas- l( IS
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) O D
LA[C /7�& 1 �i /.,n Y 'License Number Expiratwn Date
Name of CSL Holder oy
` 'Q� e f 4�22r'l J List CSL Type(see below)
No.and SStree't// "h—��-- — Type Description
a?J'// S , C U Unrestricted(Buildings u to 35,000 cu.ft.
� 6 v City/Town,Stale, R Restricted 1&2 FamilyDwelling
ZIP M Masonry
RC Roofing Covering
WS Window and Siding
O
SF Solid Fuel Burning Appliances
S I Insulation
Telephone a Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Ex vatio at
HIC Company Nam or HIC Registrant Names �—
�'7
Nq.a Stet ^ /�, Email address
t /Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.C. 152.§ 25C(6))
Workers Compensation Insurance affidavit 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.
Signed Affidavit Attached? Yes .......... ❑ No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,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.
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNERS OR AUTHORIZED AGENT DECLARATION
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 my knowledge and understanding.
Print Owner's or Authorized gene's Name(Electronic Si ature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dIls
v/dus
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. fl.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
I
Repair Co.,. Into
465 N. Main Street,W. Bridgewater, MA 02379
'r www.beamrepair.com
781-447-7324 or 800-732-8330
JUNE 3,2015
ANN HARRISON
10 WHEATLAND STREET
SALEM, MA 01970 C—646-415-0089
We propose to supply the expertise.equipment, license, insurance, liability and workman's compensation
and guarantee to do your project in a workmanship like manner.
JACK, BRACE AND HOLD STRUCTURE SO AS TO BE ABLE TO:
I. WE PROPOSE TO REMOVE AND REPLACE 23 FT OF DAMAGED EXTERIOR SILL, ON
BACKSIDE OF HOME,WITH PRESSURE TREATED LUMBER.
2. EXCAVATE AND REMOVE ASPHALT AND GROUND SOIL DEEP ENOUGH TO WORK ON
EXTERIOR SILL AND INSTALL 12"CONCRETE APRON 2"ABOVE ASPHALT TO DEFLECT
WATER.
3. REPLACE-I-TEMPORARY LALLY WITH-1-CONCRETE FILLED STEEL LALLY,
PRICE STOCK AND LABOR: $9,500.00
PAYMENCSCHEDUELE:
$3,200.00 UPON SIGNING OF CONTRACT(RECEIVED 6-2-15 CHECK#3873
$ 3,200.00 WHEN JOB 1S 50%COMPLETED
$ 3,100.00 UPON COMPLETION
NOTE: WORK TO START ON MONDAY JUNE 8,2015.
Customer: ]
Contractor. Awl (/
Note(s):
• ]'permit is required customer will have to coordinate with building inspector,tor inspections and
pov. i)r permit.
• No wiring,plumbing or painting. If any permits, engineer drmvings etc., are required: it will be
an additional cost.
• Also clue to jacking: minor plaster cracks, door adjustments and ripples in wallpaper may appear.
• Due to the nature of this type of snmctural remodeling, our work dots may be interrupted fa.
various reasons. However, we will meet our agreed apat completion date.
Lic. #039-793 Structural Repair is Our Specialty Reg. # 107-609
[�J/t� U.'6HtI)IOIY[UC[llCiL 6`�.%!�L(lJi2f�111¢l�J
\ Office of Consumer Affairs&Business Regulation'
Vxx
ME IMPROVEMENT CONTRACTOR
gistration: 167609 Type:piration: 8l5I2016.. Private Corporation
BEAM STRUCTUAL REPAIR CO.
Walter Murphy
275 HOLMES ST '- -
HALIFAX,MA02338 "'�, Undersecretary
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor
License: CS-039M
" vv`�rcrrs n
Wager W Marphy.` \
275 Hoes Street 7�f i
Halifax MA 02338
��.—.1J�6(Jc• 'rjev` Expiration
Commissioner 01/22/2017