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83 CONGRESS STREET - BUILDING JACKET �'3 lc Ziac, S t�� CITY OF SALEM MASSACHUSETTS BUILDING DEPARTMENT 120 WASHINGTON STREET,3" FLOOR TEL. (978) 745-9595 FAX(978) 740-9846 KIMBERLEY DRISCOLL MAYOR THomAs STYIERRE DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER Yoleny Yhoa 83 Congress Street Salem Ma. 01970 R.E : Building Code Violation-106 Boston Street Dear Owner, This Department has received and confirmed a violation of the State Building Code 780 C.M.R. Specifically, the chimney on the home is in disrepair and in danger of falling. State Building Code 780 C.M.R section 101.4.4 requires an owner to maintain in a safe and operable manner all systems in a building. You are directed to have a licensed individual secure a building permit and to begin repairs within 30 days of this notice. Failure to respond will result in municipal Code tickets and further enforcement activities. If you feel you are aggrieved by this order, your Appeal is to the Board of Buildings, Regulations and Standards in Boston C"f 6�D Thomas St.Pierre Director of Inspectional Services/Building Commissioner cc. Jason Silva, Councilor Ryan, Fire Prevention 4q °' C-K 1 QoLi RECEIVED rAIY-6 t cv � The Commonwealth of Massachusetts RVk CITY OF ( Board of Building Regulations and Standards r�. Etil Massachusetts State Building Code, 780 Clvl!$Olb MAY I 1 194PAJar 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a U I One-or Two-Family Dwelling ff� This Section For Official Use Only ...Y Building Permit Number: Date Appliedi: ( Building Otticial(Print Name). Siymature Date SECTION 1:SITE INFORMATION I I Property Address: 1.2 Assessors Map&Parcel Numbers R3 17o�ert e�� S� I.I a Is this an accepted street?yes no Map Number Parcel Number 1.3 'Zoning Information: 1.d Property Dimensions: Zoning District Proposed Use Lot Area(sq R) Frontage(11) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided rPlull Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Municipal ❑ On site disposal system ❑ lic❑ Private❑ — Check if es❑ po y SECTION2. PROPERTY OWNERSHIP! 2.1 OwnerrgfRecord: yJ/ ©�Q�A �rrA PY7 �p �i'!G♦` t7ame(Print - Crry, rate,ZlP 813 � No.mid Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK](check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ Altemtion(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Desc"r�,'p�tion of Pro posed Work': CS r' SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official�Jse Only Labor and Materials o I. Building S o ZED I. Building Permit Fee:$ "Tndicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing S 2 Other Fees: S 4.Mechanical (HVAC) S List: 5. \lechanical (Fire S "Total All Fees:S Suppression) - n Check No. Check Amount: Cash Amount: 6. Total Project Cost: ❑ Paid in Full ❑ Outstanding Balance Due: M�1a✓� �L kq 1 I - SECTION 5: CONSTRUCTION SERVICES t 5.1 Number Construetion Supervisor License(CSL) t J License: Expiration Dale tip / 114 'An d2 hJ� h � /S Name of C,SLLL Holder / List CSL Type(see below) / /c"7 //d V �¢ -Type . . '.- - Description ! No. and Street - {k y 0 U Unrestricted(Buildings u -to 35,000 ea. 11.) Q✓9 JS fI� R Restricted I&2 FamilyDwellin Cityfrovvn,State,ZIP M masonry RC Rooting Covering t WS Window and Siding iSF Solid Fuel Dunning Appliances I InsulaDemolition ' cle hon Em e ail:eddresy D Demolition e 5.2 Registered Home Improvement Contractor(HIC) /d 8 ! J/ /1 Q M P / Q n�/S � c�N HIC Registration Number Expiration Dane e 1 f�C��240 or 1 J C fgts tit/ nme t vii w .� G i No. and Stre t �,Z Email address i4 �r�, fide Sct ��d9 Mo 78/-dS9 d f City/Town, State ZIP Tel e hone 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 IsSuanc f the building permit. ASigned Affidavit Attached? Yes .......... No........... ❑ SECTION 7a:OWNER AUTHORIZATION:TO BE COMPLETED.WHEN " OWNER'S AGENT OR CO NTRACTORAPPLIES FOR BUILDING PERMIT i I I, as Owner of the subject property,hereby authorize t9 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:OWNEW OR AUTHORIZED AGENT DECLARATION f 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.. / 1llalrr�e tahgrs J-/ ! -7//6 mint Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: ! I. 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 Lial have access to the arbitration program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program can be found at www mass "'Woca Information on the Construction Supervisor License can be found at wwev.mass.^ovldns 2. When substantial work is planned,provide the information below: 'rotai fluor area(sq. R.) (including garage, finished basement/attics,decks or porch) Gross living area(sq. 11.) Habitable room covert Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches 'rype of cooling system Enclosed Open_ 3. "total Project Square Footage" may be substituted for"Total Project Cost" { Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 - Boston, Massachusetts 02116 Home Improvement Contractor Registration - - - Registration- b11123 Type: DBA - Expiration: 1 1/251201 6 Ti260215 AFV11 AICAN DOOR WINDOW & INSULAT16 l ---- -- — - LLIAM DOLANGIS tAi LEY AVE i — -- --- - ------ - SAUGUS, MA 01906 Update Address and return card.Mark reason for change Card Address (J Renewal EmploymentLost�1 SCA1v Massachusetts Department of Public Safety ®� Board of Building Regulations and Standards License: CSSL-100824 D�41 Construction Supervisor Specialty WILLIAM J DELANGIS15 BAILEY STREETSAUGUS MA v Ji r r"jZ;:;; � Expiration: Commissioner 0610512018 The Commonwealth of Massachusetts Department oflndustrial Accidents Office oflnvestigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information t / / Please Print Legibly Name(Business/organimtionnndividu t): Address: Ai q City/State/Zip: Phone#:?�� Are you an employer?Check appropriate box: Type ofproject(required): 1.El am a employer with S, 4. 0.1 am a general contractor and I 6. ❑New construction employees(full and/or part-time)." have hired the sub-contractors 2.❑ I asole proprietor partner- listed on the attached sheet.t ❑Remodeling shipip and have no emploo yees These sub-contractors have 8. ❑Demolition workers' comp. insurance. 9. Building addition working far me in any capacity. ❑ g [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions .required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roof repays t employees.[No workers' insurance required.] 13.❑Other - comp.insurance required.] •Any applicant that checks box III muss also fill out the section below showing their workers'compensation policy information. t Homeowners who subunit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name ofthe subconnacros and their workers'comp.policy information. I am an employer tkw is providing workers'compensation insurance for my employees Below is the policy and job site information. I Insurance Company Nanm - ' f Policy#to Self-ins.Lic.#: t, Expiration Date: L D Job Site Address: City/State/Ztp' ' Attach a copy of the workers'compensation policy declaration page(showing the policy umber and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonmeut,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded io the Office of Investigations of the DIA for insurance coverage verification. l do hereby certify under d pence of, ry that the information provided above a true and correct Slenatur� /t q p p14, ;J.41' Date, Phone#: — - O /-76 a Official u7��Vm te in this area,to be completed by city or town ojjkW City or T Permit/License# Issuing A ): 1.Board ing Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector6.Other Contact Phone#• 2073422121 p.18 Work Order North Shore Community Action Programs,Inc. Job Number: Pena �'tl r1'�', Q '� 2� h 119 Rear Foster Street,Building 13 Work Order Date:4/29)2016 Peabody,MA 01960 Ownership:Renter` - Phone:978-531-0767 -••--•---••......_.- American Door,Window,&Insulation Auditor.Marc Lorah 15 Bailey Avenue Email:aflorah@nscap.org nscap.org Saugus MA 01906 Cell:978-587-5104 Email.wdelangis@comcasLnet Phone:978-531-0767 a777 Phone: 781-231-0244 Ana Pena NGRID Gas $4,234.89 83 Congress St Total $4.234.89 Salem Ma 01970-5509 Safety Issue(s):Lead Paint Possible aathoriud Actual Measure Description Qh• Price Total Qty Total Comments Basement Insulation Sill/mudsill seal&insulate to R-19 148 $2.58 $381.84 148 $381.84 I Talk to owner about cutting sheet-rock Ceiling Doors 1"THERMAXor equivalent on 1 S60.00 $60.00 1 $60-00 interior bulk head door door Automatic Sweep single flange 5 S27.30 $13650 5 $13650 Weatherstrip s/Q-ton or equal 5 $53.55 $267.75 5 $267.75 Front&back to Apt door to basement and interior bulk head Misc Measures Clothes dryer vent including 1 $105.00 $105.00 1 $105.00 Exhaust Duct Labor per hour 2 $70.00 $140.00 2 $140.00 cat sheet rock to access ceiling in basement Other repair bulk head door 1 $150.00 $150.00 1 $150.00 cut bulk head to to fit new hinges and lock a�"fit Date:4/29,'2016 Page9 1