81 DERBY STREET - BUILDING JACKET �i '� ��y st,e
,�
.- srnr
v�.Ct 5 .s
CITY OF SALEM, MASSACHUSETTS
M' BOARD OF APPEAL
SAY -U 81 53
120WASIENGTONSTREET 4S�M,MAssacHUSEM0197o 'A
MmBFJUEYDRISCOLL TELE:978-745-9595 ♦ FAX:978-740-9846
MAYOR CILf CLw,tti". 5
May 4, 2016
Decision
City of Salem Board of Appeals
A petition of THE CHARLES HOPE COMPANIES, LLP, seeking a Special Permit from the provisions of
Sec. 3.3.4 and Variances from the provisions of Sec. 4.1.1 Table of Dimensional Requirements of the Salem Zoning
Ordinance, for maximum lot coverage, rear yard setbacks, and the number of stories to allow the
reconstruction, extension or structural change of an existing nonconforming structure at the property of 81
Derby Street (Map 41 Lot 275)(R2 Zoning District).
A public hearing on the above Petition was opened on April 20, 2016 pursuant to M.G.L Ch. 40A, § 11 and
closed on that date with the following Salem Board of Appeals members present; Ms. Curran (Chair), Mr.
Duffy,Mr. Copelas,Mr. Watkins,Mr. Tsitsinos.
The Petitioner seeks a Special Permit from the provisions of Sec. 3.3.4 and Variances from the provisions of
Sec. 4.1.1 Table of Dimensional Requirements of the Salem Zoning Ordinance, for maximum lot coverage, rear
yard setbacks, and the number of stories to allow the reconstruction, extension or structural change of an
existing nonconforming structure of the Salem Zoning Ordinance.
Statements of Fact:
1. Dan Bumagin,Project Manager of The Charles Hope Companies,LLP presents the petition.
2. The applicant,The Charles Hope Companies,LLP is the receiver of the property.
3. In 2003, the property was declared to be unlivable by the City of Salem and has recently been placed in
receivership.
4. In the petition date-stamped Match 29, 2016, the Petitioner requested a Special Permit pet Sec. 3.3.4
and Variances requesting relief from the provisions of Sec. 4.1.1 Table of Dimensional Requirements of the
Salem Zoning Ordinance,for maximum lot coverage,rear yard setbacks, and the number of stories to
allow the reconstruction, extension or structural change of an existing nonconforming structure.
5. The petitioner proposes to rehabilitate the currently existing two (2) family structure in an R2 Zoning
District and in the Salem Waterfront Historic District.
6. The property is an existing dimensionally non-conforming structure that does not conform as to lot
area,lot width, front yard setback, side yard setback,rear yard setback,parking and lot coverage.
7. As to parking, there are currently no parking spaces on the property and is a preexisting
nonconforming condition that can remain because the existing use of the property is the same.
d
City of Salem Board of Appeals
Project-. 81 Derby Street
i Page 2 of 3
8. The petitioner is proposing to construct a rear two (2) story egress and deck area that would reduce the
rear yard setback to 2' to 5' feet of the required thirty (30) feet required and provide a second means
of egress for the two (2) dwelling units.
9. The proposed rear deck and stairway increase the maximum lot coverage per dwelling unit from the
existing 50.6% to 62.4°/x.
10. The petitioner also proposed to add a dormer and lift the entire roof of the building by three (3) feet,
which exceeds the maximum number of stories. The petitioner proposes to have three (3) stories
where the requirement is a maximum of 2.5 stories.
11. The petitioner also proposed to construct a second story on an existing one story entry way.
12. The requested relief,if granted,would allow the Petitioner Special Permit to exceed the dimensional
requirements for maximum lot coverage, rear yard setbacks, and the number of stories and to allow
the reconstruction, extension or structural change of an existing nonconforming structure of the
Salem Zoning Ordinance.
13. At the public hearing no members of the public spoke in favor of,or in opposition to, the petition.
The Salem Board of Appeals, after careful consideration of the evidence presented at the public hearing, and
after thorough review of the petition, including the application narrative and plans, and the Petitioner's
presentation and public testimony, makes the following findings that the proposed project meets the
provisions of the City of Salem Zoning Ordinance:
Findings for Variances:
1. Special conditions and circumstances that especially affect the land, building, or structure involved
generally not affecting other lands, buildings and structures in the same district is that the structure
has code violations, impairs health, safety and welfare of the abutters and community and constitutes
a public nuisance.
2. Literal enforcement of the provisions of the Ordinance would create a substantial and unique
hardship as the receiver has no responsibility to remedy the code violations except where the revenue
would support it in their action as a receiver. The revenue generated from this property can have a
significant impact on whether the present condition of the property can be remedied at all. The literal
enforcement of the bylaw may result in revenue than may not support bringing the property back into
use and remedy the dilapidated property.
3. The desired relief may be granted without nullifying or substantially derogating from the intent of the
district or purpose of the City of Salem Zoning Ordinance.
On the basis of the above statements of facts and findings, the Salem Board of Appeals voted five (5)in favor
(Ms. Curran (Chair), Mr. Duffy, Mr, Copelas, Mr. Watkins, Mr. Tsitsinos) and none (0) opposed, to grant a
Special Permit per Sec. 3.3.4 and Variances requesting relief from Sec. 4.1.1 Table of Dimensional
Requirements of the Salem Zoning Ordinance, from maximum lot coverage, rear yard setbacks, and the
number of stories to allow the reconstruction, extension or structural change of an existing nonconforming
structure, subject to the following terms,conditions and safeguards:
Standard Conditions:
1. The Petitioner shall comply with all city and state statutes, ordinances, codes and regulations.
2. All construction shall be done as per the plans and dimensions submitted to and approved by the
Building Commissioner
City of Salem Board of Appeals
Project: 81 Derby Street
1 Page 3 of 3
3. All requirements of the Salem Fire Department relative to smoke and fire safety shall be strictly
adhered to.
4. Petitioner shall obtain a building permit prior to beginning any construction.
5. Exterior finishes of the new construction shall be,in harmony with the existing structure.
6. A Certificate of Occupancy shall be obtained
7. A Certificate of Inspection shall be obtained.
8. Petitioner is to obtain approval from any City Board or Commission having jurisdiction including, but
not limited to, Planning Board.
Special Conditions:
1. The petitioner may increase the height of the roof by two (2) feet rather than the proposed
three (3) feet.
Rebecca Curran, Chair
Board of Appeals
A COPY OF THIS DECISION HAS BEEN FILLED WITH THE PLANNING BOARD AND THE CITY CLERK.
Appeal from Ibis dedmon, if any,shall be made pursuant to Section 17 of the Massachusetts General Lams Chapter 40A, and shall be filed w ebin 20
days of filing of this deciaon in the office of the City Clerk. Pursuant to the Massach"as General Laws Chapter 40A, Section 11, the Variance or
Special Perrnitgranted herein shall not take effect until a copy of the decision bearing the certefuate of the City Clerk has been filed with the Essex South
Registry of Deed*.
I 41
Certificate Number: B-16-752 Permit Number: B.16-752
Commonwealth of Massachusetts
City of Salem
This is to Certify that theTwo Family Building........................... located at
Building Type
.........................................................................._81 DERBY STREET............................................................................ in the .....................................City of Salem
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY
Final ok US
CHARLES HOPE CO. /SPEC. PERMIT
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires ...............................Not APPttcabte unless sooner suspended or revoked.
E)piration Date
n �
Issued On: Tuesday, January 31, 2017
Commonwealth of Massachusetts
r ..
/ ` V
3 City of Salem
120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641
Return card to Building Division for Certificate of Occupancy
Permit No. B-16-752 PERMIT TO BUIL D
FEE PAID: $2,471.00
DATE ISSUED: 7/13/2016
This certifies that DRACZUK JEAN PIERRE
has permission to erect, alter, or demolish a building 81 DERBY STREET Map/Lot: 410275-0
as follows: Repair/Replace NEW ROOF, WINDOWS, SIDING, ELECTRICAL, PLUMBING, HEATING, TWO
(2) NEW BATHS, TWO (2) NEW KITCHENS PER BOARD OF APPEAL DECISION
Contractor Name: JOSEPH G. LEVIS'
DBA: LEVIS COMPANIES, INC / n �
Contractor License No: CS-030651 / —
G � 7/13/2016
Building Official Date
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official
may grant one or more extensions not to exceed six months each upon written request.
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same.
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
HIC #: 103772 -Persons contracting with unregistered contractors do not have access to the guarantyfund'(as set forth In MGL c.142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
u
oN �! R
"oo
i
t
ag,f le
t
at
Commonwealth of Massachusetts aQ
s,
City of Salem:
120 Washington St,3rd Floor Salem,MA 01970(978)745-9595'x5641
Return card to Building Division for Certificate of Occupancy
�Permit No. B_16:752 4 'PERMIT TO MEE PAID: $2,471.00 B
DATE ISSUED: 17/ 3/2016
This certifies that DRACZUK JEAN PIERRE
has permission to erect, alter, or demolish a building_, B1.DERBY STREET . _ Map/Lot: 410275.0
as follows: Repair/Replace NEW ROOF, WINDOWS, SIDING,ELECTRICAL, PLUMBING, HEATING, TWO
(2) NEW BATHS, TWO (2) NEW KITCHENS PER BOARD OF APPEAL DECISION
Contractor Name: JOSEPH G. LEVIS* — �- -----
DBA: LEVIS COMPANIES, INC 1
f. Contractor License No: CS-030651.
j�ie w
y,.
7/13/2016
Building Official Date
- This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within ZZinonths after issuance.The Building Official
may grant one or more extensions not to exceed six months each upon written request. `
- All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
` <4
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
{ This permit shall be displayed in a location clearly.visible from access street or road and shall be maintained open for public Inspection for the entire duration of the
work until the completion of the same. e
t
The Certificate of Occupancy will not be issued until all.applicable signatures by the Building and Fire Officials:are provided on this permit. -
HIC#: 103772 "Persons contracting with unregistered contractors do not have aecass to the guaranty fund"(asset forth in MGL c.1 42A).
Restrictions: S
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
tri ®f Salem
RaSwrr�ebn�rowaironr�rr¢a�etaltaemc
CW OF SEM Bll&MMG PERMIT
Asn PERMIMBEPOSIMINTHEVJINDOW
,�g '�py UNISPCCTION RECORD
WMAI
c s a
h
h5� ABn � t mYh DATE
}
A h. $s re
"�' -
7
v
{ „1 �t.
f
de h o 3i e/,,
s-
ig
ty
��
'r109t
.k sCC♦
.CO T
Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978)619-5685 FAX(978)740-0404
CERTIFICATE OF APPROPRIATENESS -REVISED
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction El Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: Derby
Address of Property: 81 Derby Street
Name of Record Owner: Charles Hope Company
Description of Work Proposed:
Renovate existing building per architectural drawings prepared by Annette Popp and dated 5115116 with the
condition that cornice board to be recessed to a 1112"reveal at the roof drip edge.
REVISIONS as presented on drawings prepared by Annette Popp dated 1012116:
• Installation of two condenser units at rear(south) of building;
• Installation of lattice and balustrade on entry stair to match similar elements on rear deck;
• Installation of house numbers. Numbers to be brass and comply with City requirements for size;
• Installation of new fir door with lights;
• Installation ofgas and electric meters on field(east)side of house;
• Installation of vents with preference that vents on west elevation be placed on the body of the house. All
vents to be painted to match body of house;
• Installation of pipes with condition that pipes are painted to match foundation.
■ Basement window openings to be filled in and parged to match foundation with option to retain window
openings on the west elevation and infill them with new windows. Applicant is to install landscaping or
fencing to screen pipes.
Dated: October 6, 2016 SALEM HISTORICAL COMMISSION
By:
The homeowner has the option not to commence the work (unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals)prior to commencing work.
�S2
.gONNT
Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(979)619-5685 FAX(978)740-0404
CERTIFICATE OF APPROPRIATENESS —CORRECTED REVISION
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction ❑x Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: Derby
Address of Property: 81 Derby Street
Name of Record Owner: Charles Hope Company
Description of Work Proposed:
Renovate existing building per architectural drawings prepared by Annette Popp and dated 5/15/16 with
the condition that cornice board to be recessed to a 1112"reveal at the roofdrip edge.
CORRECTED REVISION: Reduce height of all windows by approximately 8" and reconfigure gable
windows on the front (north)fagade from three (3) windows to two (2) windows per revised drawings
prepared by Annette Popp and dated 8/1/16. Applicant allowed the option to reduce only bathroom and
kitchen windows by approximately 8".
Dated: August 18, 2016 SALEM HISTORICAL COMMISSION
By: C t t� f I p/UL
The homeowner has the option not to commence the work(unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals)prior to commencing work.
r
. ON01T
cl
Salem Historical Commission
120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970
(978)619-5685 FAX(978)740-0404
CERTIFICATE OF APPROPRIATENESS - REVISED
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction x❑ Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: Derby
Address of Property 81 Derby Street
Name of Record Owner: Charles Hope Company
Description of Work Proposed:
Renovate existing building-per architectural drawings prepared by Annette Popp and dated 5/15/16 with
the condition that cornice board to be recessed to a 1112"reveal at the roof drip edge.
REVISION: Reduce height of windows on east elevation by approximately 8" and reconfigure gable
windows on the front(north)fagade from three (3) windows to two (2) windows.
Dated: August 4, 2016 SALEM HISTORICAL COMMISSION��
The homeowner has the option not to commence the work (unless relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings(or any other necessary permits or approvals)prior to commencing work.
Salem Historical Commission
120 WASHINGTON STREET, SALEM,MASSACHUSETTS 01970
(978)619-5685 FAX(978)740-0404
CERTIFICATE OF APPROPRIATENESS
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction O Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District,as per the requirements set
forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: Derby
Address of Property $LL7 ,t�treet
Name of Record Owner: Charles Hope Company
Description of Work Proposed:
Renovate existing building per architectural drawings prepared by Annette Popp and dated 5/15/16 with
the condition that cornice board to be recessed to a 1112"reveal at the roof drip edge.
Dated: May 25 2016 SALEM HISTORICAL COMMISSION
By:
The homeowner has the option not to commence the work (unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals)prior to commencing work.
o STREET PERMIT
Citp of Oaiem
Office of 3nopector of 9putibino
G;fy.71VI.-
Jlrm;ss;on;s Fierebry y;uen fo L4L:,%r( S Ce.. o
!o occupy)or +M/7�f"i��' �^ purposes
in fron!of esfafe �I• � � '7 YZ 1�+1 7PId
of sidemaf of slreel
`,71iis permi/is lmiledlo �c.-T7J f7 1'Z--.�- po I �, su6'ecf fo fie .
prouis;ons afl6e ordnances.andslalules;n relaf;on to c5lrnels andI e 9nspecl;on
andCionslrucl;on of Tu;ld;nys;n I e G;fy of c zkm.
Dirac/ergl'.rfL6!m cService* " hxrpac%�.21ui(dnyn _
cSiynalury gf.App/ri%c/ � /
CITY OF SALEM, MASSACHUSETTS
BUILDING DEPARTMENT
120 WASHINGTON STREET,3RD FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR THOMAS STTIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
January 13, 2015
CharlesHope Companies
Alan Hope
370 Great Pond Road
North Andover Ma. 01845
Re:81 Derby Street
Dear Mr. Hope,
I am writing to you in your capacity as receiver for this property. The single family home at 81 Derby Street has
the following Building Code violations;
#1 Brick chimney has several bricks that have dislodged and the chimney present a hazard to life and limb
when it fails. 780 CMR section R1003.1 thruR 1003.11
#2 Several windows have fallen apart leaving the building open to the weather. Also ,the roof is failed also
allowing water infiltration. 780 CMR section R301
#3 Exterior stair.The only stair to the home is failed creating a dangerous condition for the Public as well as
First Responders. 780 CMR section R905
#4 Fire detection-the property has no working fire detectors or carbon monoxide detectors. 780 CMR section
R314
In addition,the building continues to be broken into ,requiring it to be re-secured. There are no working water,
sanitary or wiring systems in this building. Additionally a second egress would have to be constructed before
the home could be re-occupied .The interior ceilings and walls have mostly failed due to water infiltration.
Please forward your timetable to make these corrections with immediate attention to the exterior items.
Re rds,
Thomas St.Pierre
'�L 1111/1 fN��liY "W"Wim w 211E
.tl�11 mAli�•JyMq OIIANf'�p
CITY OF SALEM
J oft,�Lrr
1.J
affo owa Z
o O' i..w.. of
PIONOr Ulftd In
• M GONIMMIllmMgt . Yak.w
PNmk toe MAU" P� MOUCAUM MR:
(Ck*WWWM lWh TWO N Slip' ConWW Do*, god, Pool,
K"UMLOWLMLYaCOWLEnLYTOAVMMAYfiMPVACE p
TO THE iNBP®CTOR OF DAUMN e ,
hNKbl► �POM�s for p«mk b buNd �p b tlM.toNoip
0~* NMn»
llddrw a pw r/, s rneFA-7—
y No
Add�Ms a Phom ( 1
Mop Now
No PAPMo1M�iq► RC'S/�eNc
�� brrr ,y�S �.r..d.• 1p _
Elk oor DDD• QU uJ r rr uow�•
2� � � 1�aaeearre
slow P■NALTY
o!lCllra AP wok IO w " OF
� o All-
r w,
wa PEIWNTTQ "�� boea/ S%. w
NCL ` A` J
APPLICATION FOR
PIMMW70
LOCATION '
Ft try S�
PEF* T GRANTED
APPROVP
X-C Z
OF OPLEPM
-7 0 , po
7 7--
The Commonwealth of Massachusetts
4 . Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code,780 CMR SALEM dMar
Revised Mar 2011
Building Permit Application To Construct,Repair, Renovate Or Demolish a
One- or Two-Family Dwelling
n This Section For OfficialjJse Only
1" Building Permit Number: Date plied:
c� l-" l5
b1 M
1 Building Official(Print Name) Signature y„ Dates
SECTION 1: SITE INFORMATION -'z1
r�
_ c2
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers . 1V >m
I S l () Ra6 l Strer-'- r -<
1.la Is this an accepted street?yes V/ no Map Number Parcel Number > Cn o
L� 1.3 Zoning Information: 1.4 Property Dimensions: <
IV— cn 7�
n
Zoning District Proposed Use Lot Area(sq R) Frontage(ft) rn
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 V'_ Private❑ "Zone: _ Outside Flood"Zone? Municipal L9 On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHH'"
2.1 Owner of Record:
;R rn h LS 1 aw Ka P fii l , I uk. 6010 &teM ra l J� 0 & vtn
Name(Print) ' I City,State,ZIP � IA �� 67
ICAj, 6eCet(1 fly- �7
No.and Street Telephone Email Address
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 Units Other ❑ Specify:
Brief Description of Proposed Work': C I e0. l ct
Wo Jis Q-- Cec ( I hec —tb sia rl"R
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard CityfFown Application Fee
2. Electrical $ ❑Total Project Cost"(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List: .
5. Mechanical (Fire $
Suppression) Total All Fees: $
( Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ ( C) O d 0 ❑Paid in Full ❑ Outstanding Balance Due:
JL
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
II � CS � 3 aGlSl j -'7 ��
�nSem h U S IL Ul S CO+Mrr�e T rC License Number Expiration Dale
Name of SL Holder
List CSL Type(see below) (,(
/3 4 flea sa .it_
No.and Street Type Description
y�
lc/ U Unrestricted(Buildings u to 35,000 cu.ft.
0-0-0 4-k A y'J o yo r^ `n�A R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
6 � -77�2 C�.U L«G U 2 t^ 17_[I h YI Q I Insulation
"Fete hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 10 a T 7 -7 _9 l4
70-,Q J�Lp-u tC/ Le-U is Cl o ypi oo to I s 2 it t HIC Registration Number Expiration Date
HIC Company Name or C Registrant Name o
� p�leac� nk �t lv vlsc_o P yerrzan n��
No.and Street Email address
Nonk{, r r1Q Q V:5�
City/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 ......_..,V 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: OWNEW 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.
L-e-uLC rvl Dayt IeS �1�c �J-DCQ h L-P uis
Print 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 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. oQ v/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned, provide the information below:
Total floor area(sq. ft.) (including garage,finished basementlattics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halfibaths
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"
\ > � p
P
` i ' �
� TheCommonwealthofMassachusetts , c�t ` �'�" .
�, �E�'�f� � V�C�f ti:.
Boazd of Building Regularions and Standazds gpI,EM
� � Massachusetts State Building Code,780 CMR v� M 20 '
' (n Building Pemrit Application To Construct,Repair,Renovate Or Demolish a
G�� 3UL "� � 2� 4� .
li r One-or Two-Family Dwelling
� T�is S,ect�on Pur 01�ci�• e .
� Buitt�g Peamft Aiumi�er: ,. Date plied: _
I
i
i . ��el�
. � Etiuldiug OfSs�(����3 .. �: . � �Signat+ae ��.
I_ �EC3TON 1:S1TE II+S�OR�4IA7TDi�i
E
C1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
Et Du-b�, .�_ �-Ilo 2'ls-o
1.1 a Is this an accepted street?yes ✓ no Map Number P��N��
13 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Ares(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
geyuir¢d pmvided Requimd Provided Required Provided
1.6 Water Supply:(M.G.L c.4Q§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone? Muuicipal Q✓On site disposal system ❑
.. Public Nf Private❑ CLeck if es� .
SECTION.2: PROP$1t'1'I'(Y�'S'I�IEILSHIP1 .
2.1 Owuer'of Record: �'��� p
��acz�tc �e.,. p;�rr� �
Name(Pnnt) City,State,ZIP
No.end Street Telephone Email Address
SECTIOtY 3:DESCRIPI'IOl!T,OF PROPO�ED VVOItK�(ehe all tLai apply)
New Construction❑ Existing Building Owner-Occupied ❑ Repairs(s) Alteration(s) AddiUon ❑
Demolition ❑ Accessory Bldg.❑ Number of Units 2- Othes ❑ Specify: �
Bri'e"f�Description of Proposed Worl2: •�-Je�s S'�i �'-�e- ' i ` "'�'b �
/'�.Q�a� ' 2 b 2 be.n
�CTION 4:ES7'IMATEll CONSTRUCTION CU3TS
Eswnated Cosu: pffiEial UB¢Only .
Item . Labor and Materials - - � - -- �� '�-
1.Building $ 2 g 3�oSo �• B���°g Permit Fee'$ Iadlcate:haw fee is deteanined:
�3tanda�d Gl'ry/fuw�n App#ication Fee
2.Electrical $ 2 ro �� ❑Total Praject Cost'(Item 6)x muttip}ier x
3.Plumbing $ 22 0�i9 2, Other Fe¢s; $
4.Mechanical (HVAC) $ 2'L/Oo0 List: _
5.Mechanical (F've $ tl Total AI1 Fees:$
Su ression
Q�eck No. Check Amount: Cash Amoi�i:
6.Total Project Cost $ 3 S,3 O;j 0 p p���{. . ❑putstaad�ng&aisnce Dues ..
�a � /
�� ���� ��S v ��
���e�`�P 'I �3 �6
8EC3'I01N 5: COIY�7'RiTCCfQ}V S�VIG�S
i � - 51� ConstrucUon Supervisor License(CSL) �� �s/
. . — �i'� l7 �--�I S License Number Expiration Date
' Name of CSL older U
List CSL Type(see be]ow)
��� ��Ca$0.n�} S'k: .., .
No.end Strcet - �`� �-�BB�����-
_ �O��� ��0�� A ^ 4 � ���� � U Unrestrided � �'din u to 35 000 cu.R ..
������ R Restricted 1&2 F�il Dwellin
CiTy/I'own,Stffie,ZIP M M
{�j( � � �1� �� � RC RooSn Coverin
�'"r�{'� � WS Window and Sidin
��8-�O�]2��3 ��vTS Lo� �izan• sF SolidFuelBwningAppliances
I Insutation
Tel houe Email address D Demolition �
SZ Registered Home Improvement Contractor(HIG� f�3 •77Z
��^ � �'v� HIC Registration Number E�cpiration Date
HIC Com any Na(m�e or HIC Registrant Name + � �
I—�T �24Sa�l.i- S�1'� 1�/'ISLo� v4'icen.+�
No.aPd�Street Email address
�1/0�-�. ah��,� �lA ol��' 9��-Go7-z���
Ci /fown State T.IP Tel hone
SECTIaN&W031KEA3°COMPE1�tSA3YON t�i6UBA1�iC�.AA'I�'IDAVIT(M.G:L.c.152.4 ZSC(6�)
: _ _
Workers Compensation Insurmce affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the deaial of the Issuance of the building petmit.
Signed Affidavit Attached? Yes .......... No........... ❑
SECTtOS+T 7ae OW�I�R AIT3'H�3RIZA�"IOSV Tb BE COA4PI.ETEA WHE1H
qWNER'S �N�' ��9 GT R APFL[�$��� ' p
I,as Owner of the subjec[property,hereby authori 2� �
to act on my behalf,in.all matters relalive to work a rized by this ' g permit application.
`U S'-P /I � � (rP.tt,J �" � � �
Print Owna's N e(Electronic Si�ature) . Date
SECTION�:OWNER' OR AUTH07tiZED�GENT D�CLAAATIOW
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 ccurate to the best of my knowledge and understanding.
� _ �� � (�
Print er's or Authonzed AgenYs Name(Electronic Si�aMe) Dete
, N07'E3: . .
1. An Owner who obtains a buildiag permit to do his/her own work,or an owner who hires an unregistered contrac[or
(not registered in the Home Improvement Contractor(HIC)Program),will nnt have access to the arbitration �
prograzn or guazanry fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
�ti�vw.mass.eov,'oca Information on the Construction Supervisor License can be found at ww�•.mass.eov/dps
� 2. When substantial work is planned,provide the information below:
Total floor azea(sq.ft.) (including garage,Snished basemenUattics,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 heating system Number of decks/porches
Type of cooling system Enclosed Open
� 3. `"fotal Project Squaze Footage"may be substituted for"Total Project Cos["
C
, v�' 't� I
�'�, ��
���
Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS OY970
(978)619-5685 FAX(978)740-0404
C�RTIFICATE OF APPROPRIATENESS
It is l�ereby certified Lhat the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstniction � Alteration
C Demoli.io.^. G� pair.tirg
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: Derbv
Address of Propertv 81 Derbv Street
Name of Record Owner: Chazles Hope Companv " `
Description of Work Proposed:
Renovate existing building per architectural drawings prepared by Annette Popp and dated 5/I S/16 with
the condition that cor-nice board to be recessed to a 1 1/2"reveal ut the roofdrip edge.
Dated: Mav 25. 2016 SAL�M HISTORICAL COMMISSION
ca ��✓�✓� / �(i�--� '
By: � �
The homeowner has the option not to commence the �vork (unless it relates to resolving an outstanding
violafion). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate pennits from the Inspector of '
Buildings (or any other necessazy permits or approvals)prior to cotnmencing work.
���conwla,�,;�
�°y4 '�' Y`'°' CITY OF SALEM MASSACHUSETTS
$--`-x {` m�
`�pi " BOARD OF APPEAL
9���,��c�.at
.!�, .: .... �
�'�'� t2oavnsr-�croNs��r�SATFr,�,�nssAcr�.us�.rso���o .`.1�15 f�AY -4 �A £3� 53
KinssF�u.ErDiuscOi.i. TEt,E:978-745-9595 � FnX:978-740-984G
MAYOR
ClTw C_._..., , .: „ �",. •.
May 4, 201G
Decision
City of Salem Boaxd of Appea2s
A petition of 1�IE C7�ARI,ES HOPE CO,'�IPANI�S, LL,P, seeking a Special Pem�it from the provisions of
Sec. 3.3.4 and Variances from the provisions of Sec. 4.1.1 Table ofDsmen,rional kequi�z�ne��t.r of the Salein Zoning
Ordinance, for maximum lot covesage, rear yard setbacks, and the numbex of stones to allow the
reconstcuction, extension ot structural change of an existing nonconforming suucture at rhe pzoperry of 81
Derby Sueet (Map 41 Lot 275)(R2 Zoning Distnct).
A public heanng on the above Petition was opened on Apri12p, 2016 pursuant to M.G.L Ch. 40A, g ]1 and
closed on that date with the following Salem Board of Appeals membets present: Ms. Curran (Chair), ivir.
Duffy, Mr. Copelas,iv1r. Watkins,Mx. Tsicsinos.
The Peritioner seeks a Special Permit from the provisions of Sec 3.3.4 aad Variynces fiom the pxovisions of
Sec. 4.1.1 Table ojDin:eszaona!Beq�emexrr of the Salem Zoning Ordinance, for maacirnurn lot covesage, rear
yazd setbacks, and the number of stones to allow the reconstruction, extension or structural change of an
existing nonconfortning structure of the Salexn Zoning Ordinance.
Statements of Fact:
1, Dan Butnagin, project Managex of The Charles Hope Companies,LLP piesents the petihon.
2. "The applicant,The Charles Hope Companies,LLP is the xeceiver of the property.
3. In 2003, the Proputy was declared to be unlivaGle by the City of Salem and has zecendy been laced in
zeceivuship. p
, 4. In the petidon date-stamped i'vlazch 29, 2016, the Pe[itioner requested a Special Permit ez Sec. 3.3.4
. and Variances requesting relief from the piovisions of See 4.1_1 Table ofDrmennonalBeq�z'�rsnentt of the
Salem Zoning Ordinance, foi ma�mu�
lot c v
o era e
,reat ard setbac
allow the reconstruction, e7ctension or structuzal change of an existing o�n on onning b���.e nes to
5. The petitioner proposes to sehabilitate the currendy e�asting two (2) family strvchue in an RZ Zoning "
Disteict and in the Salem Watesfront Historic Disttict.
6. Tl�e properry is an e�cisting dimensionally non-confonning structure.that does not confonn as ro lot �
azea,lot cvidth, front paxd setback, side j-azd setback,reaz pazd setback, pazlang and lot cwerage.
7. As to paelang, there aze cue=endy no parking spaces on the pioperty and is a preexisang
nonconfornvng condirion that can remain because the eacisting use of the pxoperry is the saxne.
, City of Salem Board of Appeals
Project: 81 Derb}�Sireet
Page 2 of 3
8. Tbe petitioner is ptoposing to construct a reaz two (2) story egxess and deck azea that wouid reduce the
rear yard setback to 2' to 5' feet of the re9uired thicty (30) feet requited and piovide a second means
of egress fot the nvo (2) dwelling units,
9. The proposed reas deck and stairvvay increase tlie maurnum lot covetage per dwelling,�nit {rom the
�, e�s[ing 50.6% to G2.4%. �
10. The peTitioner also proposed to add a dorme=and ]ift the entire roof of the Uuilding by t}�ree (3) fee�
which e�cceeds the maximum number of stories. The petitiones proposes to hace tthree (3) stories
whete the requirement is a maaciu,um of 2.5 stones.
71. The peutioner also proposed to construct a second scory on an e�cisting one story enhy way,
12. The reyuested relief, if grdnted, would allow the Pehtionu Special Pernvt to exceed the dimensional
requireruents for maxiwum lot covuage, reaz yard setbacks, and the nuxuber of siories and to allocv
the reconstrvction, extension oz structural change of an eacisting nonconfomung structuxe of the
Salem Zoning Ordinance.
13. At the public 6earing no membe=s of the public spoke in favor of, oi in opposition to, the petition.
The Saiem$oazd of Appeals, aftu cazefiil considetation of the evidence presented at the public heazinp, and
after thoxough teaiew of the petition, includinp the application narxauve and plaas, and the Petitioner's
presentation and public tesdmony, makes the following findings that the pioposed project meeu the
provisions of the City of Salem Zoning Ordinance:
Findings for Variances:
7. Special conditions and circusnstances that especially affect the land, building, or S���e involved
generally not affecting othex Iands, buildings and sttucnues in the same district is that the structuce
has code violarions, impaus healt6, safety and welfaze of die abutters and communit�• and consritutes
a public nuisance.
2. Litesal enfoscement of the procisions of the Ordinance .vould creaxe a substantiai and uni9ue
hazdship as the xeceiver has no zesponsibiliry to xemedy the code vio]ations except wheie rhe sevenue
. would support i[ in theit action as a xeceivei. The sevenue genera[ed from this property can have a
significant impact on evhether the present condition of the ptoperty can be ieinedied at all. The literal
enfoxc�mene oF che bylaw may res❑lc in reveuue than aiay not support bringing the property back into
use and remedy the dilapidated propecty.
3. The desixed relief may be granted wicl�out nullifying or substanaally dexogating fxom the intent of the
district or purpose oF the City of Salem Zoning Otdinance.
On the basis of the above statements of facts and findings, the Salem BoaLd of Appeals voted five (5) in favo=
(Ms. Cuuan (Chait), Mr. Duffy, Ivli. Copelas, Ms. Wadtins, Mr. Tsitsinos) and none (0) opposed, to giant a
Special Permit pe= Sec. 33.4 and Variances requesting relief fiom Sec: 41.1 Table of Dimensional
Requiremenu of the Salem Zoning Ordinance, fxom maxinaum lot covexage, iear yazd setbacks, and the
number of stories to allow the xeconstrucvon, extension oz structuxal change of an e�cisting nonconforming
strucmre, subject to the following tenns, conditions and safeguazds:
Standard Conditions:
1_ The Peadones shall comply with all ciry and stace starutes, ordinances, codes and iegularions.
2. All constxucrion shall be done as pe� che plaus and dimensions submitted to and approved bp die
Building Commissionei
City of Salem Board of Appeals
Project: 81 Derby Street
Page 3 of 3
3. A11 cequirements of the Salem Fire Depaztment zelative to smoke and fite safetc- shall be stricdy
adhered to.
4. Petitioner shall obtain a building�ermit pnor to be�inning any�onstruction.
5. Exterior finishes of the new construcrion shall be,in hazmony with ihe e�tisting sttu���
6. A Certificate of Occupancy shall be obtained
7• A Cudficate of Inspecrion shall be obrained.
8. Petitiones is eo obrain approval fxom any C��y Boaxd or Coinrnission having j�,*;,�caon inc]uding, but
not limited to, PJanning goazd.
Special Condirions:
1. The petitioner may increase the height of the roof by tcvv (2) feet rather than,the proposed
three (3) feet.
�� ��reAn -y, /�.G
Rebecca Curran, Chazt
Boazd ofAppeaLs
A COPY OF THIS DEGISION H9S BEF_N FIL,ED tYiITH Ti-�p.�,�NNNG BOt1RD��iD THE CITY CI.gRi�
APPea1J��thir decinon,f a�,,rhaJl be made�xrtuQnF to,fediox 17 o,Jtbe Mo.rracbureYYr Genera!l.amt[bapder¢OA, and rha!!be f'iled n,i�h�n p0
dayt of fr&ng af[hr.r deczann in t/�c�re of tbr Gty Ckrk pxrivant To Ihe tYlarrarhuJem Grnerall.n�,r Cbaptm 40A, SecTion 7 7, ;be V�nce or
Jpacial Pem�itgranted herzin.rha!!not k�ke��/un/�(a�p),of tbe detinon bearii.r8 the cen�cote o�'ye Cs�,Cferk bor been fi(ed wilb Ihe E'trex Soutb
I�eBs.rty ofDeedr.
.� �
� Construction Contract
This agreement is made on the date written above our signatures between
Contractor Name: Levis Companies Ina (Contractor) and
Owner Name: Charles Hope Companies (as Receiver) (Owner).
Owner Name: (Owner).
Contractor
Contractor Name: Jose h Levis
Address 154 Pleasant Street
Address
Ciry North Andover , State: MA Zip: 01845
Daytime Phone Number: 978-687-2783
Evening Phone Number: 978-815-5635
Fax Number: 978-687-3042
Email Address: levisco verizon.net
Federal Employer ID or Sociai Security Number: 04-3144874
Massachusetts Home Improvement Contractor Registration Number: 103772
Registration expires on 07/ 09/ 16 .
Contractor Name: Joseoh Levis will be referred to as Contractor throughout this agreement.
Salesperson who solicited this contract: Joe
Owner
Owner's Name:
Address:
Address: 81 Derbv Street
City: Salem , State: MA Zip: 01970
Day Phone Number: 978-815-4022
Cell Phone Number:
Fax Number:
Email Address:
Owner's Name: _Charles Hope Companies_will be referred to as Owner throughout this agreement.
The Construction Site
Address: 81 Derb Street
City: Salem , Massachusetts Zip: 01970
Page 1
' I. Project Description
A. For a price identified below, Contractor agrees to complete home improvements (identified as
the Project in this agreement) for Owner.
II. Contract Price
A. In addition to any other charges specified in this agreement, Owner agrees to pay Contractor
$ 353,050 for completing the Work described as the Project.
III. Scheduled Start of Construction
A. Work under this agreement will begin within 10 Calendar Days after the following
contingencies have been met.
1. All appropriate building permits have been issued.
IV. Scheduled Completion of Construction
A. Wark under this agreement will be Substantially Complete within 150 Calendar Days after the
date construction begins.
V. Documents Incorporated
A. This agreement incorporates by reference certain disclosures and notices required by federal and
state law.
B. This agreement incorporates by reference certain documents which define and describe the Work
to be done. The following documents aze incorporated as though included in full as part of this
agreement.
Speci�cations
Specifications dated / /
Consisting of sheet(s)
Prepared by
Last changed on_/ /
And further identified as
i. Proposal (Estimate or Bid)
Proposal (Estimate or Bid) dated 06/ 25 / 16
Consisting of 1 sheet(s)
For the amount of$ 353,050
Entitled 81 Derbv St
And further identified as
Reference to Contractor's proposal dated 06/ 25/ 16 is for convenience only. Other Contract
Documents identify the Work to be completed under this agreement.
VI. Ownership of Plans
A. Plans, Drawings, Specifications and copies prepazed for use in consh-uction under this agreement
aze the property of Contractor. Contractor retains a11 common Law and statutory rights to these Plans,
Drawings and Specifications. Owner agrees that these documents will not be used on any other project
and, with the exception of one record set to be retained by Owner, will be returned to Contractor on
request. ,
Page 2
,�
VII. Scope of Work �
A. Contractor shall supervise and direct the Work and accepts responsibility for construction means,
methods, techniques, sequences and procedures required to complete the Project in compliance with the
Contract Documents.
VIII. Cutting and Patching
A. The color, texture and planes between existing and new materials might not match exactly.
Contractor will use due diligence to create the best match possible. Owner acknowledges that patched
surfaces may be detectable when construction is complete.
IX. Compliance with Law
A. Contractor and Owner mutually commit to use reasonable care to meet the Requirements of
state, federal and local Law when discharging their responsibilities under this agreement.
B. If Law enacted after the Contract Date changes the Scope of Work under this agreement,
Contractor and Owner will execute a Change Order adjusting the Contract Price and Contract Time to
accommodate the change in the Scope of Work.
X. Permits and Fees
A. In compliance with Massachusetts General Laws 142A, Section 2(a)(10), Contractor has: (1)
Provided Owner with a list of building permits required to complete this Work, (2) Advised Owner that
it's narmally the obligation of a Contractor or Subcontractor to obtain the required permits for their
Work, and (3) Advised Owner that homeowners who secure permits for Work on their own homes are
excluded from the guaranty fund provisions which appear in Massachusetts General Laws 142A, Secrion
5. Contractor accepts responsibility for securing building permits for the Project.
Description of the permit: Complete rehab, 2 new kitchens, baths, windows, sidine, roof,
electrical, and plumbing.
Name of the permit issuing authority: Cit of Salem
A. Contractor will pay the buiiding permit fee, Plan check fee, business license fees for Contractor
and Subcontractors, and chazges levied by government for testing, Inspection and Re-Inspection of the
Project.
XI. Payment Plan
A. Owner will pay to Contractor the Contract Price in installments consisting of an initial payment,
progress payments, and a final payment on completion of the Work.
XII. Initial Payment
A. On initial delivery of materials to the Job Site, Owner shall pay to Contractar $ 0
B. The initial payment is refundable to Owner, less actual cost to Contractor, if Owner is not able to
obtain a commitment for construction financing in an amount adequate to complete the Work.
XIII. Progress Payments
A. Schedule of Progress Payments
1. Progress payments are due as each phase of the Work is completed.
a) Amount due when Job Phase 1 is complete: $ 88,262.50
Page 3
, b) Job Phase 2 is complete when Rough framin is complete
c) Amount due when Job Phase 2 is complete: $ 88 262.50
Job Phase 2 is complete when Roueh inspections are complete
d) Amount due when Job Phase 3 is complete: $ 88.262.50
Job Phase 3 is complete when Insulation and blue boazd/plaster aze complete
e) Amount due when Job Phase 4 is complete: $ 88,262.50
Job Phase 4 is complete when All final inspections aze completed.
B. Processing of Progress Payments
1. No less than 2 Calendaz Days before each progress payment is due under the terms of this
contract, Contractor shall provide Owner with an application for payment (invoice) in a form which
complies with generally accepted trade practice.
2. Except as provided otherwise in this agreement, Owner shall pay the amount due within 2
Calendar Days after approval of any applicarion for initial, progress or final payment.
XIV. Interest
A. Payments due and not paid under the Contract Docuxnents shall bear interest from the date
payment is due at an annual rate of 1 % percent.
B. When payment is withheld pending settlement of a bona fide dispute on the quantity, quality, or
timeliness of the Work, interest shall accrue only on the amount ultimately paid.
C. Payment of interest does not abrogate or replace any other rights Contractor may have under this
agreement.
D. Any interest which remains unpaid at the end of any 30-Calendar Day period shall be added to
the principal amount due and thereafter shall accrue interest at the same rate as the principal.
XV. Final Payment
A. Contractor will submit an application for final payment to Owner when the Work has been
completed in compliance with the Contract Documents. If Owner agrees that Work has been completed,
payment is due Contractor for the entire unpaid balance of the contract amount (including any
Retainage).
B. Making of final payment constitutes waiver of all Claims by Owner against Contractor except
those Claims previously made in writing and delivered to Contractor and those obligations otherwise
provided by this agreement or by operation of Law.
C. If completion of the Work is delayed unreasonably at no fault of Contractor, Contractar shall be
entitled to final a ment f r all Work c m I i 1 '
p y o o p eted ( nc udmg Retamage) w�thout prejudice to the right of
Contractor to complete the Project at a later date and without prejudice to the right of Owner to make
Claims against Contractor for Defects in Work completed.
Page 4
Massachusetts Home lmprovement Disclosures
Massachusetts General Laws 142A, Section 2(a)(8) requires that home improvement contractors and
subcontractors register with the Director of Home Improvement Contractor Registration. You may
� inquire about contractor registration by writing to the Director at One Ashburton Place, Room 1301,
Boston, MA 02108 or by calling 617-727-3200 or 1-800-223-0933.
You may cancel this agreement if it has been signed at a place other than the contractor's normal place
of business, provided you notify the contractor in writing at his/her main office or branch office by
ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day
following the signing of this agreement. See the attached Federal Right of Rescission form for an
explanation of this right.
Massachusetts law grants lien rights to builders. Any construction contractor, subcontractor, tradesman
or material supplier who is not paid can record a lien on the property being improved. If not dischazged
by payment, this mechanics' lien will become a security ]ike a mortgage on the property.
Massachusetts General Laws 142A, Section 2(a)(8) provides that, "No contract shall contain an
acceleration clause under which any part or all of the balance not yet due may be declazed due and
payable because the holder deems himself to be insecure. However, where the contractor deems himself
to be insecure he may require as a prerequisite to continuing said work that the balance of funds due
under the contract, which are in the possession of the owner, shall be placed in a joint escrow account
requiring the signature of the contractor and owner for withdrawal."
Massachusetts General Laws 142A, Section 2(a)(8) requires that the property owner receive, at the time
of signing, a copy of the contract signed by both the contractor and the owner. No work shall begin prior
to the signing of the contract and transmittal to the owner of a copy of such contract.
Massachusetts General Laws 142A, Section 2(a)(8) requires that this contract include a notice disclosing
all warranties and the rights of Owner under this agreement. Except as provided elsewhere in this
agreement, Contractor makes no express warranty. Owner waives, renounces and disclaims all implied
warranties of fitness for purpose; merchantability, habitability and good construction.
Page 5
' Signatures
This contract is for immediate acceptance. Any delay in acceptance beyond� /�j/__�.�will require
renegotiation of the terms of this agreement.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!!
This agreement is entered into as of the date written below.
Owner's Names: , Owner
o�.-u�, u�-- "7— )—I �
(Signature) (Date)
Charles Hope Comnanies��� af ('l,..,(,�,, /�,� Ca�,,,�tiµ��
(Printed Name)
(Signature) (Date)
(Printed Name)
Contractor Name: J e h Levis , Contractor
7 '_ � � �i
� nat e) (Date)
� ase-p'k G Le � �s �� r Ps� d o,�-
(Pdnted Name and Title)
Page 6
. . � •
LEVIS COMPANIES, INC.
GENERALCONTRACTORS
SPECIALIZING IN REHABILITATION OF OLDER PROPERTIES
154 PLEASANT STREET
NORTH ANDOVER, MA 01845
OFFICE: (978) 687-2783 PAX: (978) 6873042
e-mail: levisco@verizon.net � �
Charles Hope Companies Inc.
370 Great Pond Road
North Andover, MA O1S45
June 25, 2016
RE: 81 Derby Street Salem, MA
Levis Companies Inc to secure alLnecessary building permits and insurances to
remodel the building located at 81 Derby Street Salem, MA. Complete gut rehab
consisting of framing and installing a neiv roof, new hardie plank siding, new
windows, 2 new kitchens, 2 new baths,2 new heating systems. All new plumbing
and electrical to code.
Total Cost $353,050.00
e
. /
� RESIDENCES AT 81 DERBY
,,:�°._�. �� � SALEM MA 4
�. �. ..� .:� �
'T' �`a �i�� � rporoseovEesvecnve 1 . .
���� . I �k� ������ �. ,� � -
,�,. � � � � � � �i .,y,�� � � � �� -
� � I .,
I I � I , � �� �
4 u= �
� ���IIUi_�y..'v � �, � � , e �' �� � �1z
i' 8r. .
' I . '/ � � � ,� � I4� i���i �
' E �—_ �5 ..� '
. 2't^
�i.
- "`�4 , � o:,
: '=A1' ea' . ��.
-ti^ �J.y.. . • vi
�\ My . J�p�
I �X S{5 i * `� I �I
� �.. \ .. . _.��4� � _�y< • •
\ � A � II
� �� }� ' _ A � � � I �
\� �.r� ¢ Y'. k �� I I . .. ." .
� .� � � �•�. �� ���� � �'
ti
� I� r � �\\ ., �: -""o-�.`r*�s..,, g_
6 i
� � y . *F 'I{� � �•� ,�,; :,�g: � - DRAWING LIST
X
GENERAL NOTES - "�'^ ���� .. �Y� � - sHeera SHEETNAME
F:
� i� no.a cavEasHEer
� 1.Mwa�XNelcmnpNMP_BITEptllmqmlG ICu '� ."7jR pp.t yTEPUN
�wCanRWBIMvn � PwNaMUIBWp B� 4 .� Y^n
y�� P1.0 9q5EMENi RRIi
mmommne�oe�wrer.awr �emeeeemominenm,� �- '-.� i n�.i r�aslaooattnx RESIDENCES
.��n�oaaw�me.mmnmm�uoeawamnr��no�.mm.ixe � niz secoxoaooAanr AT81
�na��..nn m..�.��rorar.mn�urno�...a
�m.�m�.. i � n�a TMiRovioa�aun
z.ui�,e�nmbl�a�aaneWumei� vnMsnai vam � nr.a aoora.w OERBY
Detlp^bulb�6. � AI.a REFLEGTEOCEIWJOPIAN
],NlNruclWalelpmnleslu�EeelxeEhyqticMalenglnx� q30 E%iERIORELEVRipN$
���Ym'bec¢�bsFziN¢Meatlmelllqo�peRermin �w
YeErifeEbteNmNean�lnconetlucUonticcunenlat A3.1 E%iE0.10RELEVAl10N5
S.NINmena'waenCmn41[vrse�tllpt9elE�enR]. A],E E%(EPqPELEVAilONS a '
6.T�emJxb�NtllWelnellrewa¢ary[a�mlqepppvab 0.➢.3 EKlENORELEVATIONS W���^^° y
anON¢qtllonau�ui�Mlypw. Pap BVILpNGSECTONF '�
].TM�re'elmXee[NLareyp�ippyyyEy�aMFetian. .
B.tl mnpeclppe�ellNallNe�abeibmwnlyfltlEmnEitianf � . P M.1 BVk�INGSECTOIJO S
en fulMunMYaMUawSEnqmmMm.eneMatYule n+x BUILOIMCBECTONs S
MONGOtlunEerlNimmrecl. � P50 qiCXENFlRSiFlqOF
9,Myre�IMlowbomtlqeeOmlmenmMiAerereG���y q5.1 pTLNEN5ECd10RLGIX1 SCHEMATIC
IMwmeraoNe�pWeamuSOere+tretlanOpwomJb/ ABO EMERIOPOETRILS
meeiwwmciynaimoe�awnrnonnew�x. . DESIGN
�o.uiw,nnon..mmem�.anui.anwingeevPr�+cmo,. ea.o owr+su�ow�uoows —
mmpxm wmd2m..n.11eppry W NI Wnerami$ wRCX11EciVRPI:Is
� mmpanerrlfenEmMltlona,uMmWerlym]vaRJ ,��
otlemiw. GnnObYl'19 CAVERSNEE!
1 t.Cere a�ell Ge tlFan mt m GemaBe mry autl:y m remeln
Wclmn
1R.Corhretls Mel pw'9eWe,plum0 er9 kvN w�kc¢ikr '.
NelaRYon altl ufev.wk mM a0qb�*a. '.
A0.0 �
,
� .4
/Y / �
% � % �
, �� � . �
31\�i \ �
/ // \ \\
% / `� \\
�� � A
,
.�� � \
���`� � ,/� �\ �
.
.� l • y ��
s��� \ / '�� \
�s�h \
� C � . f 4 \ \
\\\ CY'� \ `\\
�f
\� \ �
\ —�� �\\)
� ��` .. ���\� /a`
b
\ ..� � � "� \ \., /p yd�
�. � � �
� � � � �� � �
.� �� � / • ;i /
. � 5� , �.
� �� ,g.�% �,
� � �'
b
/ � \
� � / � � \
\ �I�/ �
� �� � ��
�� � '�•➢�// �� fb$/ \
\ Y 1 / h
� � � \�` . . ��. 3 �
� ` �a \ � '' � ,=�
�� ��� .�, �
� -�� �-� �<< a,.
� \ ��;,:,, . � ��� i
, , ,.i
�` � ���,k � � . .;j reesmeNces
y" \ AT 81
� \y/ \ �/ / //�� DERBY
\\ � � � � // ''��
\ \ � /r//���
��A V A\ /�� �-�;'� vu..... s
` l V
�"� �� j" �
/ \ � . 5
�`�\ /�J ��� SCHEMATIC
� � � OESIGN
snEv�w
���PROPOSE�SITE PLAN.
. ' noti 3Hs -1-0 '
A0.1
.�
� - Qo .
ti,
��
�2�,.DEMOLITION BASEMENT PLAN
l ai o; -p,0• �. /��,��1,
�_i 1/0°- i L �P �O ;A]3:'� P33 �.�.
�.M3 '�� `M2 � J �`.3
BASEMEfT 3
680 S
� 3 �
x
� � ^
\iao z
' �
, L�
�
�
aii
J
_I
'\"'�i
�—
/ :.
/ �
� _� ����1✓- �
1 . �� ,�,�
��
I �
����� RESIDENGES .
�..�F�� � AT81 �.
oerser
..�,...a,. 8 '��
� II
� SCHEMATIC
1 z OESIGN
i� �: n�.f m�,,..
�`�' �, anseuEurnnu
��'.PROPOSEO BASEMENT PLAN A1.0
nio/ 114•=1•L•
I�-. .r_.v .�_ .4 �
II II
Y���� .�1�� '. .II
.yy',�71 �till�
��
� � II� � II ' .
/
�L��
i
-_�
w�V� �
l��OEMOLITION FIRBT PLOOR PLAN
'�+/ 118'=1'-0' __ �
j� /q �o i\JJD Ni.� `/ E
\M2 �� ��� � � \M.1 " �
� �
Sa"_��.E•d•.�— 8'-tp 8'-ip 8'A 0'V ASQ i
..- �_� �
� - - - - _l.
� , i '" ii�•-�iT -��
CL ` 9
� 16SF � � `" � pTCHENlUINWG � I e� �' 1
i BE�R�OOM 1 ' =I I �TM�� '� 1_1289F � � �A
� 53 SF_ - r
'� I� � . _ - I_. �i
I � , I:�;� �: fi � �
,, ,
�.�ns.10 z ' I ' C�L��.� {I ___� � � - 1
�/
1 I
e . 1_J -- ��` - - I
/ �M��� iCSF E,s F � a�isF . M I, \ I '' �� � `' �
_ _ _ _ _
r �
, ,
�° I � I / F - - �
I { __ '
F i ` . \\�� � �i ' . I I � ' _
_ _ q '
I
. . 6EOROOM2 �- --� LIVING I � � �oece ^
� A105F� v_�ry 159SF ' I � p° N� w�.z,I
I I � I
I I I ' . '. �F i I \\ ' ', � �'� � RESIDENCES
. i ' . . 8 � I AT81
q DERBY
' _ _' -. _ _/ ' 1
� ' ENTRY � � �
I SP �CL I t
I �� �. , 18 SF ia�a� ..�...�m �
I � � � c
� - `i �
' Hewvwomcnnosrnw �� SCHEMATIC
.: �. � ... � z . � DESIGN
� __ _____-_ ' _��___ _ _ __ ______ _ _ _ _
�
�. nae � I w3a '.
/ rwsr aooR
�� �i'
PWI
/1 .PROP0.5ED FIRST FLOOR PLAN
��� 114 -1'-0
A1.1
— . ����:..::�--� .0
i� i 4
n q
n q ,
_ �i� �
. �_2 ��� ��L
-�„ iti -
_"�J
c—�u
�--�.�t �. �
/ 2\OEMOLITION SECONO FLOOR PLAIJ ff�� ,�\ /��
�A11�I lIH"=��-0° /� �l / R � ]���A3]J �
Ni
MS `�'l \M \MR �� `2
\ \ 1 2
3'-0' Bd \�g'-10' 8'-iP B'-ff 3'O
- / �/_ _ /
t.
. i i i . I _ 6d'
, . . , .. I� 5'a' � /-
\ I i I 4
i --NITCHEI I p� � -- �'..
�'��INING � - -1k2SFl �TM — -m.,
�� � �, I ,, ; ,�aisF I .I -- ..� �. .��_.I,: o aasF
� \�%:
_
I
� � I � . � I - �- ,1-�',`- i . �, H
!a • ' � k. � ' � I,
J� - - - - - - - - I � _ - - - - ," . '
� � � - ,� o o—' •
���� li - - I I- -I F °F � _ i ,.,.,:;�- --
�.0 1 , � I i .— ..�_. OECK
� � LIVING , i , I ' i ou
i � " . , .1]6SF I�� � I e
I I I bl 4
I I — �
. . . �-orv" '� MB3BSF�M � I i ' ���
I � i i . i i:. � I .
�� � �� �. � � ,��
� i, ' I I `-�
� O p �� RESIDENCES
— -- — AT81
� �\ � CL f f� DERBV
� �, 1$$F � � 13S
�HALL �� E �
39 S X t
umu.�.. }(
E
�
^ SCHEMAiIC
DESIGN
� � �a�i �n3.i� ' —
�/ L_i
s[cono F�ma
vuH
!1�PROPOSE�SECOND F�OOR A1.2
'�Pt.3i i/d =1.0••
.___�_._�Tr__�_,_a___�_� .�—
.�
�--ti-----
�_===��—=�
�_—==�—
�_— -- —
- - = - --
___--_--___�
�-����r� z��
r..a��.�.... . . �s��.��»m�md
�C P D /�3:iP33�� /E
!21DEMOLITIONATTICPL4N ����� ���a taz ��+ s�i�xrmEwvaece
�.a,.�i ve._�._o. •y �� �,r'�� _�-- ..
_ ,..�. .�. �
i i i
iam
/ / (
� . 1
.,�;�� � enrr� � . , .
»
i�;; ��/ii .'�� sssc � j�/.// i;;'%/.
� ... . ,'.: ,�. ,
: ��� �; $
ecrtess vnrmow ' _ _ __ '4 SF � / � .
a.�srxcrc�rwaovemnc � 1
-ooueienurvc� _ �
� ` ���'� .�.�BEDROOM3'.
� 605F�p � 1625F
�na.o � \ . . . .
�2 \ DX
��\
��+.J � � ci'v .
��' ( .. 195F � . , .
� BEUROOM2
16�SF —rxsi�HraEauNc� �
f CL � �
�/� �p 395F /
_ _ _ L _� _� _ _ _ _ _ _/_ _ _ _
CL
295F 'w . _ _ _ — - _ _ . �ai
�'/:' i, /���/��� .�.���' �:. ,/ � / /AC���/% � � �. z �a RESIDENCES
. . � . . �� AT81
. � � 1 � DERBY
� �
6'rvEIGXiCLENNNCE W�����T iQ
@
S
SCNEMATIC �
� � OESIGN
/A\ �
, P>' . A9.1 �I THIRDFILO0. ���
�%� �.� PWI '.,
,11 PROPOSEDTHIRD FLOOR PL4N A�•3 II
'�n� 1/4"_1'-0 i,
,�
; ��
� . a �_ � �>;!�3; /'•
�`niz \a+n 'u z ��� .,u
� _ �si�aeuooWcrt
. 10'/tY I 1L'/12
_� i
/
NEWPAISED ROJF-� � MEN'GFBIEDOORMER �
N I
� \ b
\ '
F30 Z
B
���
I AliO �
]'/tY
1'V
�
��R3�3
� ' �.%
' .. . ' 2 AJ3)
��
3'/12' T/1]'
� R415EOEMqVROOF
;�. /�
�_� \.�
RESIDENCES
AT B1
! 2�.PROPOSEO ROOFPLAN DERBV
�✓ 1�4._�,-0..
d
w....aw �
�
S
SCHEMATIC
DESIGN
0.0OF aV.N
A1.4
— _ — _ _ — _ — _ ze,R�=/j — _ — _ — _ _ _ BooFJ\`.,
ze-ivs
.V
IJ � -'
— _ _ _ — _ _ _ nne S _ nnrc_�
� ii�:�� _. _"- _ — r-a'
�8; 81 �- �
_ TI _ _ _._ _ �_ _ SECONDFL�R_„� _ _ �_ _ _ SECANOFLWR I"�,
B'-P J B'-8''.1
I��I �'�� rk l � _ � - L� -�.
1�
�
—_- - - '�="�F�a�a°�—ty - - — __ �'� F��.�_'v
o-a �
=—� �=—=—=---,—= = i -
,�21,FRONTELEVATION-DEMOLfTION /3`�,E%ISTINGFRONiELEVATION
�. `.aaa� 1I8"=1'-0' �na.oj 1l8^=1'-0'
e\
pa.�
. _ ._____./ _ WMiERCOFEOGE
/N �ROOFHEIGMTINC0.EFbE SEEOETAIL$
I _ _ _ —/�� _ FOCF \
/ 3B'�1519'S
� / �/
I � �WVBLEXUNGWPoCWINOOWS�
f PtUMINUMCtA�WXrtE
'j WSVIATF.�CIKING,E%iEFIOP
___.....__. ...__ �.-_.:�.-� ' PPPIIE�Ml1MIN
�51 Y�'.�.'41 _ .
� C �� E%LEIZIORFIBERCEMEHTIAPSIOING
o _�
A
��(� � � � (HAR�IERMIKlM51�INGWRHpqKEPON
jFaV.1��y, ` Ia:t>3 ..—..-. -.. WIAP0.USTCCHNOLOGY�
'� lni� � � / FINISX'SYWPI
G9:2��'N9("[b"N)n QO�OP'.EVEMH�6WE
IT ac�a B ...
�LI T PjP +~�ID_p •� � �` _ _(T-� l�
�• �J
t
� b��i a
��� � �! '. 3�1 1 �I ,
a '!� I il I `�.
IF' ���.� I��I � I
�' �9yk I L
���� �.� �.� � ��
ys(�,,,��x���..�.�., .�,=�'
•"�����d�' .*c(��q'J _ _ _ _ __ _ _ SECONOiLB'�P S
ir+p�q r +} '.• � — ' ftESIOENCES
��yf�. _. . AT 81
• 4c����� I 1 �.J IIL � '�mwioeriewcsmexrraiva.weis DERBY
I" I�REI
� ��� � � ..,a..... a
I ,. �� WHIIETNMWATERTP�E �
S
_ _ _ _ _ _ � _ .�.� fIRSTFLWR l
4\ d�p � SCHEMATIC
!�� _ I _� OESIGN
4
EXI£FIOR
ELEVATIONS
11 �PROPOSEO FRONT ELEVATION A3.0
��n�.Jo va,,,•-u•
f � • �
PWF
30'.1 Y9' _ _ ROCF
]B'-15IC ��
e4
An-� — A1TIL �\
1].a'
n.+'ll
�J � Ilf �� �_ ��— � . ..
' SECONOFLOOR. . . .... . . _ _ —
. B-Y . i .. ._ __ ..... SECONOGLOOP_S
— 9'.Y
I �� � �, �:_ �
(� iY_R6TF\OpF T� � F�RSTFLOIXV
�J V.V _ O-p.
l
i��,WESTELEVATION-OEMOLITION J 3�'�,EXISTINGSIOEENTRV ELEVATION
'�a.i/ P8'=1b" `N.� 1I8'=1'-p'
�MJ MAO �AiJ '\M2
� AooF
,�.,�.- - - - - - - - - - - - - - - - - - - - - - - - - - - -
�;:z —_ —
��o e�, - - -�.Y.
� ., _. � . . .. .� �
ATi1C ._.____._ _ _ _
1i'-0' O` �onl — � ' ._. _ _ _ _ _ _ _
��nol��f� .o� " I . I II� �Ll�l
2� 4 M .� � � �. � � � � � �
"fl M1 �1 . . 6esa I'�
.�������' — -- -- � � � �;a���Jll�llll�llllll���a, _� �i�ll�l�ii
�,� � I �I�f,�l� �i il,,p�;
�
� sgmrvo��ooa
6-P— _4e� _ _ _ — � ' _ — _ — — — _ — _. — _ �..,:��.— �— _ —
-i.l�lrl.t�r •f J� —
•�q• r �t� — j " RESIUENCES
{g •'� I .. I i I .I II I I Fya c OERBV �
� � �l � �
. � I I � I� ' I.
� a
� � ��. .�._� ��� I I I �ilt P i ..�.,a.� � .
; � ;���.F�ooa- - - -���� ,IIIIIIII - - - - - - - - -- J1111 ��11JJ111JI1r!! � I � : — - :
�S, fI�i f��,i i . — �� SCXEMATiC
DESION
I E%(ERIOR
_ � � ` ELEVPTIONS
�i'•.PROPOSED WEST ELEVATION(ENTRV) A3.1
\n� 1/4._�.-0.
RB'-21 Y%F � 2g-Rj ygg �
Y� �II �--- .LL
_ _ — _.,� _ _ _`�mc � _ -�_"_ — - . -- lrnc_ �
� T.. ir.�� — _ — __ -_ —_ _ n'.g
S
, --� � -
��i �''
I
_ _ _ I.—.. _ � _ 6ELdIDF��R� _ _ _ _ _ � __ ._.— SELON�FLWP_ •
� B'-8' \ �-. _ ..._. . __. � 9•_9• �
'�11 I� � _�
._ _LL�TFLCOR \ . . . .. FIF5! GOR
� �
. .,..:." __ _._._ —. "_._"'- o,.a. . .--_- — _ — 0,-0,3
���i REAR E�EVATION-DEMOLITION /3��,E%ISTING REAR ELEVATION � e
''\��I iB•=1•-0n .�ay.t/ 1/B"_1 ' M.1
�\ � R
— za.5�V
\
�I�� ... \ ',...
� � I —
\
� — _ _ _ _ _ _ _ _niTlc I\
n'-�'lI
L {T
A � >y
�
t .�
- IIIlllllll �� (��► !��j�����������f
— — _ _ _ _ _SFLONDFLOOP_,\
� � ���� �I i a a. ,.
RESIOENCES
AT Bt
� . IIIII�II 1 DERBY
� -' �����) (��+�' �� ��;��'��9�i����1 F�qnF�o-�v .�...m
e
.,�.�. �
- - - - l��� a � - - - � �
, ..-
' ee.e,�6B�y _ ��e'." e scHernnnc
oEsicN
� E%iEHIOP
ELEVATIONS
��P QOPOS�ED REAR ELEVATION A3.2
C-� I(7 '7
Commonwealth o rt chusetts
Sheet Metal Permit
j /�p � Z01b OCT —1 A 1Ol 30 .
Date: ) Permit#
Estimated Job Cost: $ Permit Fe : $
Plans Submitted: YES_ NO Plans Reviewed: YES NO
Business License Applicant License#
Business formation: /11A
Property Owner/Job Location Information:
/ Z ILLS �kA I� 5
Name: L'S Int /J �' !.: Name:
Street: Street: i 107.4 a , S I r L
City/Town: � /1 gdDye r �'VI b)yql _ City/Tow q �j 7l
Telephone: Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES L,-' NO
staff Initial
J-1 /M-1-unrestricted license
J-2 /M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less
Residential: 1-2 family Multi-family Condo/Townhouses Other
Commercial: Office Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories:_3
Sheet metal work to be completed: New Work: Renovation:
HVAC Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:? Jf / /�
i
rACSL to ( Iz
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes❑ No❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation: YES NO
Progress Inspections
Date Comments
Final Inspection
Date Comments
Type of License:
By ❑ Master
Title
❑ Master-Restricted �-
City/Town
❑Joumeyperson Signaturelo
f Licensee
Permit# �—,
❑Joumeyperson-Restricted License Number:
Fee$ ❑
Check at www.mass.gov/dpi
Inspector Signature of Permit Approval
10 �
Commonwealth of Massachusetts
Sheet Metal Permit
10D1ate°C1030 Permit#
Estimated Job Cost: $ 7; Permit Fee $
Plans Submitted: YES/ NO Plans Reviewed: YES NO
Business License# Applicant License# L
Business Information: Property Owner/Job Location Information:
( Name Name: Qvus Ct)yl�l�AIut
5
Street: Street: g/ �tA a r L
City/Town: AmlaO c City/Townr�-o/ ,LP,
Telephone: `�oi -_��-�/� Telephone:
Photo I.D. required/Copy of Photo I.D. attached: YES ✓ NO
Staff Initial
J-1 /M-1-unrestricted license
J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less
Residential: 1-2 family Multi-family_L,�— Condo/Townhouses Other
Commercial: Office Retail Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft.✓over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New Work: Renovation:
HVAC Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
mate-0 -ro GCS. 10112
INSURANCE COVERAGE:
I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L. Ch.112 Yes❑ No❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy Ltd' Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
By checking this box❑,I hereby certify that all of the details and information 1 have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation:YES NO
' Progress Inspections
Date Comments
Final Inspection
Date Comments
Type of License:
By ❑Master
Title ❑Master-Restricted
City[Town ❑Journeyperson
Signature o Licensee
Permit#
❑Joumeyperson-Restricted License Number: oil
Fee$ ❑
Check at www.mass.gov/dpl
Inspector Signature of Permit Approval