86 ESSEX STREET - BUILDING JACKET ro
$6 ESSEX STREET r '.` r `ter
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• January 11 , 1984
AGR Sprinkler Systems , Inc. Re: Salem Housing Authority
P.O. Box 98 �Wtssex S-t”
North Attleboro, Mass. 02761 � /k/"a 50-Washington Sq. S.
Sprinkler Plans
Sirs:
I have this date approved the submitted sprinkler plans, received in the
mail , with a postmark of January 6, 1984. Your application made on our
Form ME dated 11/23/83 has been approved this date and is being returned
within this enclosure.
It shall be noted that each pian is marked with a note concerning the
required cap on each standpipe. This cap shall be a 21" National Standard
Thread by lir" Iron Pipe threadedreducing cap, to permit the use of 11" hose,
with City of Salem Couplings.
It shall be noted that these plans replace the plans submitted by Kyriakides-
Zarelli , Architects , Inc. , marked FPI , FP 2, FP 3, and FP 4 which were
provided originally.
It shall also be noted that this system is not providing complete building
coverage, and shall be considered a partial sprinkler system.
Plate at the exterior Fire Dept. Connection shall read "Sprinkler and
Standpipe". A gauge shall be provided at the top of the system for tests.
It shall be noted that a complete test is required by appointment, prior
to acceptance of the system. The installer shall provide this office with
a copy of the 200 Ib air test report and upon completion a copy of a final
certificate of installation and completion, shall be provided the Fire
Prevention Office.
RYOapa
fy ysubmitt
CvidJ. Gag in
Salem Fire Marshal
cc: Building Inspector
Salem Housing Authority
Kyriakides-Zarelli Architects , Inc.
file
City of Salem
3
y BUILDING DEPARTMENT
J�fa11NL�•
t
FIELD
/CORRECTION NOTICE
h J !
LOCATION S c.R x l rl�n j Sc .0 PERMIT N/0.
ISSUED TO � A t a-rvi j p05 U f CIA I yy "1' 5 it, <�U �^
PERMIT HOLDER AND/OR/ALL RESPONSIBILE PARTIES. /
NOTICE DELIVERED TO �� aDn � f , Za1Ln�/( �GJJ�f /`mcy > ! BS7'I^
Upon inspection, violations of the C' :z �n Sec. ��� /L� , were in evidence.
The following orders are hereby issued for their correction: a r.-e al 7` e A.
1 ,r I A r
f P/a r /n TG / A 5 5
A 7 k
U/ ' / d i
1y fi 1, C/
PLEASE CALL FOR INSPECTION WHEN CORRECTIONS HAVE BEEN COMPLETED. ACCEPTANCE
AND APPROVAL BY AN INSPECTOR OF THIS DEPARTMENT IS REQUIRED AND MUST BE CORRECTED
ON OR BEFORE ( 't � ' tr.{ �� (tI QG64.2l C, f`1 TSS1v
ju -,
71 jf 1
DATE /' f7._. y-// V BY
uu INSPEC/TOR
FIELD COPY
H cwmrq
City of Salem
BUILDING DEPARTMENT
w. 4
G(MNE
FIELD CORRECTION NOTICE
LOCATION f 5 S x , /I 7 TJJ;//w 5` !r!` PERMIT NO. `
ISSUED TO a ht �ju5 1-1C �, a Acle i7y C�tpM/�.a � P. Su ( ,., _Y'A
PERMIT HOLDER^A-N�D/OR ALL RESPONSIBILE PARTIES.
NOTICE DELIVERED TO R0 � Ou PGdlf �7tl t
/ L
Upon inspection, violations of the V I '`�J'h `(�-6 Aa Sec. � / � were in evidence.
The following orders are hereby issued for their correction: T a Jti?
7�j, `>c ,mac (� 3rd/ .. —� = ✓ ,
A ! <.� fi y l'��' /&f L.31 t-'u r f h 7
1. 71 C6
Cl/ 7 "
PLEASE CALL FOR INSPECTION WHEN CORRECTIONS HAVE BEEN COMPLETED. ACCEPTANCE
AND APPROVAL BY AN INSPECTOR OF THIS DEPARTMENT IS REQUIRED AND MUST BE CORRECTED
ON OR BEFORE L-Cc4,'{' 7 / <<I G� UC L L;9a1 5 u c.
DATE I — /'� '�BY
J INSPECTOR [`
FILE COPY
pOHO1Tq, '
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CITY OF SALEM
MASSACHUSETTS !�
JEAN A. LEVESQUE
MAYOR 4 L" •
r
June 24, " 1983 qu
un
William J. Farrell , Executive Director
Salem Housing Authority
27 Charter Street
Salem, Massachusetts
Dear Mr. Farrell :
This is to advise you that I have authorized the following departments
to waive the necessary fees relative to the rehabilitation of the Phillips
School for Chapter 689 Handicapped Housing:
1 . Building Permit Fees
2. Electrical Permit Fees
3• Public Property Fees for Water & Sewer Connections
and Inspection
4. Fire Department Fees as Required
The only fees not to be waives are the Gas Inspector and Plumbing Inspector
as these fees represent their salaries.
Very truly yours,
�
JEAN A. LEVESQUE f
Mayor
cc: J. A. Condon
R. T. McIntosh
A. V. Fletcher
Capt. David Goggin
V..0 0a0Ij,�.
J� 1
DR
_ Qui# g of Mem, � tt zcl zz�e#
Pourb of �yyeal
s
DECISION ON THE PETITION OF THE SALEM HOUSING AUTHORITY REQUESTING A COMPREHENSIVE
PERMIT FOR THE PHILLIPS SCHOOL SITE AT 86 ESSEX STREET
A hearing on this Request for a Comprehensive Permit wzFKZ4ld on January 20,
1982, with the following Board Members present: Douglas Hopper, Chairman; Messrs.
Hacker, LaBrecque, Feeherry and Associate Member Martineau. b1rc-es�`o `�tliA $1 £ring
were sent to abutters and others and notices.of the hearing were properly published
in the Salem Evening News in accordance with Massachusetts General Laws. In addition,
a notice of the hearing was sent to the Salem Historical Commission. That Commission
was invited to attend the hearing on this request, and a representative of that
Commission did .attend. The Petitioner requests ,a ComprehArc:ive Permit pursuant
to Mass. General Laws Chapter 40B, §§ 20-23 and asks that this Board
authorize the proposed rehabilitation of the Phillips School site into eighteen
units of housing for the handicapped.
The Board of Appeal , after consideration of the evidence presented at the
public hearing and after viewing the property makes the following findings of fact:
1. The proposed use of the site is supported by the Planning Board as
well as other city agencies.
2. The needfor housing for the handicapped was well-documented in
evidence submitted to the Board.
3. The Phillips School site is particularly well-suited for the
rehabilitation and new construction proposed by the Petitioner.
4. The only objection to the proposed project which was raised at the
hearing were concerns voiced regarding the fact that the design of the
project has not been finalized thus raising the issue of the impact of the project
on abutters in this unique historic area.
On the basis of these findings of fact and other evidence presented at the.
public hearing, the Board of Appeal, unanimously voted in favor of granting the
requested Comprehensive Permit. A Comprehensive Permit is granted to the Petitioner
on the following terms and conditions:
1. Petitioner may use the site for no more than eighteen units of housing
for the handicapped. -
2. The final design of the rehabilitation and new construction must, however, .
be approved by the Salem Historical Commission which Commission shall have the right to
approve all aspects of site development, parking, landscaping and construction ;of this
proj ect.
3. The Salem Historical Commission shall not, however, impose any 'dneconomic"
conditions on the Petitioner as the term "uneconomic" is defined in Mass. Gen. Laws
Chapter 40B §2.
s�
.r
DECISION - SALEM HOUSING AUTHORITY RE: PHILLIPS SCHOOL SITE
at 86 ESSEX STREET
Page 2
January 20, 1982
JAN 2G 15 PH '6Z
FILE 0
4. In the event that an impasse develops between the Petitioner
and the Salem Historical Commission, that impasse shall be broughtGltbCutHblx S4LEF1,�4hSS
attention of the Salem Board of Appeal at its next available meeting
for immediate resolution.
nthony M. Fee+#}''er y, Secz�etary
i,
M1 T._ SL--I? ME U. G..-i. - -
-
OF R-10?D CR 3S A."iD 'iui'J G ! V.;
- - BOARD CP APPEAL
A COPY OF THIS DECISION AND PLANS HAS BEEN FILED WITH THE PLANNING BOARD AND CITY CLERK .
ItU CI �� T�L11�y C �T auC 11151`
Aire figpartnunt �Hcnbquurfcrs
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November 25 , 198 ,
A . G . R. Sprinkler Systems , Inc . Re : 86 Essex_Szre_e.t.�,
P . O . Box 98 a/k/a—50—S
0 "sh i ng n �Sq .�South
Attleboro , Mass . 02761 Salem Housing Aut 4*r� y
Sirs :
I have received six sets of sprinkler plans for approval . The 4`I1P
plans submitted are for the first floor and the second floor levels .
These are apparently intended to replace the FP- 1 and FP-2 which
were originally submitted by the architect , subject to final review .
Several on site changes have been made , which are acceptable . However ,
I have not received a plan for the third floor level , which would
replace original plan FP-3 and the riser diagrams originally shown
on Plan FP-4 .
In addition it shall be noted that on the original Plan FP-3 , an
inspectors test gauge and pipe are shown and shall be required on
a plan for the third floor . I can not approve the pians until
• a third floor plan is submitted and typical riser diagrams are
provided . This will include a standpipe riser also .
Please provide this office with the additional plans .
am returning your check # 12707 along with our required Form #81E ,
which must be submitted , with your signature on the application .
Resubmit the plans needed with the check and application .
Respectfyil)ly yopur
{� 4�' C 2tKPC 1 Itl
Capt . David J . Goggin
Salem Fire Marshal
cc; Salem Housing Authority
Building Inspector
file
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INSURANCE SERVICES OFFICE
�; �� OF MASSACHUSETTS ,� 4y
s o ,
176 FEDERAL STREET,ADDRESS MAIL:BOX 2067,BOSTON,MASS 02100 �,✓
TZLZP"ONEi(617
)426-4606
WILLIAM CARTER. JR.. MANAGER July '14, 1981
City of Salem
86 Essex Street
Salem, MA. 01970
Gentlemen:
File 20-18885
RE: Phillips School
86 Essex Street
Salem, MA.
The Insurance Services Office develops fire insurance rates for individual
properties based on our insurance rating schedules. A significant contrib-
uting factor to your fire insurance rate is the automatic sprinkler system
that is installed in your property.
Our records indicate that the sprinklers protecting your property are manu-
factured prior to 1920. The reliability of your sprinklers is questionable
based on studies performed by Underwriters' Laboratories, Inc. which demon-
strates a high failure frequency of some older sprinklers. Therefore, our
rating procedures require that these sprinklers be completely replaced.
Prompt compliance with the foregoing is necessary for continued rate recog-
nition of the protection afforded by your automatic sprinkler equipment.
Our rating procedures provide that such a replacement program may be sched-
uled over a period of three years without rate penalty in the event you find
it impractical to replace all old sprinklers at one time. This program con-
templates replacement of at least one-third of your sprinklers each year.
We would appreciate notification within 60 days as to your plans to initiate
a replacement program.
The procedure outlined in this letter is for the purpose of developing a
fire insurance rate. It is not for the purpose of making property loss
prevention or life safety recommendations and none are made.
Very truly yours,
Ra1pEorre 1�1 �'"��L},�
Assistant Supervisor
Pricing Services Department
kdc:dr Ey: K.A. Connor
Form 8A
The Commonwealth of Massachusetts
A Department of
ui Public Safety
`I Massachusetts State Budding Code(780 CMR)
Ulf Building Permit Application for any Building other than a One or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: . Building Official
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
S+ S,IOAA MI) �1�( I� x�tne Alrloyb
No.and Street City/Town Zip Code Name of Building(if applicable)
- SECTION 2:PROPOSED WORK -
Edition of MA State Code used If New Construction check here❑ or check all that apply in the two rows below
Existing Building❑ Repair❑ Alteration ❑ Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑
- Brief Description of Proposed Work:
✓ D
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable) .
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ 1 H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional 1-1 ❑ I-2❑ 1-3❑ 1-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below: -
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ 1 VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: Sewage Disposal: Licensed Disposal Site❑
.Public Check if outside Flood Zone❑ Indicate municipal A trench will not be P -
Private I-] orindentify Zone: or on site system require or trench or specify:
permit is nclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No Yes❑ No ❑
SECTION 8:CONTENT OF CE T ICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
1 a
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Pro erty Owner
9-7
Name(Print) 13 1 No.and Street City/Town - Zip
Property Owner Contact Information:
9--& IVY- �V31
Title Telephone No. (business) Telephone No. (cell) - e-mail address
If applicable,the property owner hereby authorizes
Name Street Address - City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this budding permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O and skip Section 101
10.1 Registered Professional Responsiblep for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Compzhy Name -
���of b53
Nam" f Person Responsible or Construction License No. and Type if Applicable
Street Address City/ own State Zip
Telephone No. business Telephone No. cell e-mail Iddress
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152.§ 25C 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes O . No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$ -
1. Building $ j2j (3 OJ Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)_$
3. Plumbing $
4.Mechanical.(HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $ Enclose check payable to
6.Total Cost $ pt' 000 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
nnapplication is true and accurate to the best of my knowledge a understanding.
�Dc hML le�j 4 1n - 1' 71/ j)a
Ple print and si n name �+ Title Te phone No. Date
I i
1-0 cz VtI 2) `� .� 0)1s-L
Street Address City/Town e Zip
Municipal Inspector to fill out this section upon application approval: "' 7
Name Date
r
DI`'ISION 1
General Administrative Requirements
1.01 GENERAL SCOPE OF THE WORK
A. The Work of the Contract consists of:
1. Temporary removal and protections of nine upper attic and 2 lower attic ventilation louvers
at the tower of Phillips School 689-1 Family Housing at 86 Essex St.
2. Removal and disposal of all blocking and plywood around and at back side of louvers.
Repointing as may be required to properly repair brick and stone.
a. Installation of new pressure-treated wood blocking to permit installation of new
plywood panels. - _
3. Cleaning,minor re-pointing and preparation of masonry surfaces,at interior and exterior
side of louver openings for installation of new Work.
4. Installation of new 16oz and 20oz.brake metal formed flashing as designed.
5. installation of new%"thic'lumess painted MDO,plywood, including solid pressure-treated
wood blocking&shims at all louvers,including selective ventilation,as designed.
6. Re-installation of nine upper attic and two lower attic aluminum louvers,including paint
touch-up of damaged paint finish and including complete separation for copper components
from aluminum to avoid galvanic reaction of dissimilar metals.
7. All gaskets,grommets and sealants,grouting and re-pointing as necessary to insure
separation of dissimilar metals and a complete weather-tight installation following masonry
industry and Brick Institute of America best practices.
& Install approximately 10' length of 1 %"diameter copper drain line,including elbows and
connectors to existLrig black iron drain line at interior tower floor pan drain. Core through
brick wall at side of tower and extend pipe out IT'from face of exterior wall as scupper.
See partial roof and tower plan in Section 1.05 below.
9. Work either shown on the Drawings or included in the specifications unless specifically
indicated not to be done.
90. Work outside the Project Site as called for in the Contract Documents and as rexinire, for
the perthrmance of the Work.
If. Providing and restoring,where appropriate,all temporary facilities.
12: Temporary storage and protection of louvers which are removed for installation of flashing.
8.02 TIME OF COMP➢,E T ION
The Work shall be commenced at the time stated in the Owner's Notice to Proceed and shall be completed
within 40_consecutive calendar days thereafter.
1.03 SELECTION CR➢TER➢A
A. In addition to any provisions of the General Conditions, the Contractor will be selected based on the
lowest base,bid and upon demonstrating successful completion ofthefollowing criteria:.
Completion of at least three projects during the past 3 years,involving the installation of copper flashing
and brick masonry repairs. Three projects involving both roofing and siding may be used to satisfy both
of the above project types. Only completed projects should be listed in references. Projects which are
partially complete do not satisfy this requirement. Owner or client references, including daytime
telephone contact information for Owners/clients shall be listed on contractor reference form, provided
after the bid form in bid documents.
DHCD 07/01/11 Division 1
C 149$10k-$25K 1 of 5
1.04 PREVAILING WAGE SLATES AND OSHA SAFETY TRAINSNa
A Bidders shall include in their bid wages calculated from the wage rates established by the
Massachusetts Department of Labor and Workforce Development and subject to M.G.L.c.149§26 to
27H inclusive. A list of the wage rates for this project can be found at the end of this section.
B The Contractor shall certify that all employees working on this project have successfully completed a
10 Hour Safety and Health Training Course approved by the United State Occupational Health and
Safety Administration(OSHA). This certification must be submitted with the payroll certifications
require by paragraph A above.
1.05 EXISTING CONDITIONS
t
Front Upper&Lower Attic Louvers at Tower- Interior Attic View of upper attic louvers
mom;;
IIg, _•
45 r fr
11 r.'It � y �' !i i •;
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+ s 1
` 'G
Front Building and right side oftower at Charter Street Rear and left side view of tower.
I
I
PARTIAL ROOF&TOWER PLAN
DHCD 67/01/11 Division 1
C 149$10k-$25K 2 of 5
1.05 COORDINATION OF WORK
A. Owner will provide a tenant coordinator to mediate tenant complaints or concerns,if any arise.
PART 2-PRODUCTS
2.01 WOOD BLOCKING
A. Solid Wood Blocking shall be No.2 grade or better pressure-treated Fir or Pine,KDAT to minimum 15 psi
with copper azole or other AWPA approved preservative treatment. All lumber shall be grade stamped with
stamp of approved testing agency to show preservative method and retention I eve]; as well as KDAT..
B. Solid wood blocking shall be separated from aluminum louvers to prevent direct contact of dissimilar metals.
2.02 MIDO PL9'WOOD
A. 'W"' Exterior Grade with waterproof glue. Douglas Fir, 5-7 ply thickness to match the existing
sheathing. Note: southern ye
B. Plywood Grading: Comply with Product Standard PS 1, "Construction and Industrial Plywood".
C. Certification and Marking: The producer shall include a Certificate of Inspection with each
shipment. Grade mark each panel in compliance with applicable standards of Product Standard PS
D. Moisture Content: Provide plywood which has been seasoned by kiln drying to a moisture content
not to exceed 19%. -
2.03 WOOD BLOCKING r
A. Vvhere pressure-treated wood blocking is specified,provide minimum 15 psf Copper Azole or ACQ treated solid
wood, grade -s tamped by treatment agency to indicate method and content of preservative treatment. All p.t. wood
used shall be KDAT to maxinfum 19%moisture content.
2.04 ANCHORS, FASTENERS,AND PLATES
A. Bolts, Replacement Plywood Clips, Nuts, Studs,Rives: FS FF-B-575. FF-S-1362 and FF-R-556.
B. Expersiun Shields: FS?F-S-325;group,type, class and style best suited!:r the purpose. -
C. Lag Screws and Bolts: FS FF-B-561;type and grade hest suited for the,rnrpose.
D. Nails: FS FF-N-105; type and size best suited for the purpose. Hot dipper galvanized for exterior use.
Toggle Bolts: FS FF-B-588;type and class best suited`or the purpose.
F. Wood Screws: FS FF-S-I 1 I; style best suited for the purpose. Hot dipped Kalvanized for exterior use.
G. Steel Plates and Shapes: ASTM A36,galvanized for exterior use.
H. Primer: Shop primer for ferrous metal;zinc chromate with a synthetic resin vehicle.
2.05 PAINTS&SEALANTS
A. One-part 100%silicone sealant at all interior and exterior louver and trim perimeters and seams"
B. Type S,grade NS,class 100150—Dow Corning790,GE Silicones,TREMCO Spectrem I or equal
PART III-CONSTRUCTION ADMINISTRATION
3.01 SAMPLES AND SUBMITTALS
DHCD 07/01/11 Division 1
C 149$10k-$25K 3 of 5
A. The Contractor shall provide the following shop submittals for the Architect's approval prior to ordering
materials:
Copper flashing-Incl.sample of 16 oz and 20 oz.
MDO plywood- cut sheet
Paints-cut sheet
Fastener-cut sheet-listing all fasteners
B. Submittals shall be stamped by contractor to verify that at a minimum they contain the. following
information for each of the materials specified: manufacturer,and model (if applicable),material,gauge,
thickness or weight of material, material finish,dimensions. Submittal missing such information may be
considered incomplete and be returned to the contractor without review.
C The contractor hall be responsible for preparing and submitting all submittals in a timely fas
hion so as
not to delay project. Lead times and availability of materials shall be confirmed by contractor prior to
sending shop submittals.
D. Under no circumstances shall contractor substitute materials to those approved in shop submittals,
without prior approval of Architect.
3.02 CONDUCT OFTHE WORK
A. Existing Buildings. All units will be occupied during construction. The Contractor shall take all
necessary precautions to ensure the public safety and convenience of the,occupants during construction.
B. Unless specifically authorized by the Owner,the Work must be conducted between the hours of 8:00
A.M.and 4:30 P.M.on Monday through Friday. No work is to be done on holidays,Saturdays,or
Sundays other than for emergencies
3.03 SHUTDOWN OFSERWCES
A. The Contractor's attention is especially called to the fact that the continuous operation of services for this
housing development is mandatory. If any unit is to be left without heat, hot water,domestic water,
electricity,gas,sanitary facilities,or any other services for more than an eight hour period,the Contractor
shall submit a letter and obtain written authority from the Owner before proceeding.
B. If such a shutdown is unacceptable to the Owner, the Contractor shall make, and pay for, alternative
arrangements to insure that services are provided.
3.P.4 PROTECTION AND ACCESS
A. The Contractor shall, at all times. leave an unobstructed way along walks and roadways, and shall
maintain barriers and lights for the protection of all persons and property in all locations where materials
are stored or work is in progress.
B. The Contract shall take special measurers to protect the tenants from nDsc, dust,and other disturbances.
C. The Contractor shall take necessary precautions to insure against fire during construction. The
Contractor shall be responsible to insure that the area within the contract limits is kept orderly and clean
and that combustible rubbish and construction debris is promptly removed from the site.
3.05 TEMPORARYFACHH,HTIES
A. Temporary Water - The Contractor may make use of the water available at the site for construction
purposes.
B. Temporary Electricity-The Contractor may make use ofthe electricity available at the site,metered and
paid for by the Owner,provided that the Contractor shall supply the proper adapters and extension cords.
Where heavy duty electric equipment drawing a current in excess of 15 amps is involved,the Contractor
shall provide temporary electric work to supply this power.
DHCD 07101/11 Division 1
C 149$10k-$25K 4 of 5
C. Temporary Toilets—The Contractor shall provide.an adequate number of portable toilets as required by
their workers and shall pay, for all costs associated with installing, maintaining and removing toilets
during the Work. The location of portable toilets shall be coordinated with the Housing Authority
representative. Toilets shall be secured during times that work is not taking place.
D. Temporary materials storage and vehicle parking- There is limited parking and site storage area for
materials, dumpsters and vehicle parking. Contractor may make use of lawn and mulched lawn areas
for temporary storage and parking, provided plywood, tarps and other protective devices are used to
minimize damage to landscaped areas. Contractor shall coordinate locations for all such storage and
shall restore damaged areas prior to project completion at no additional cost to Owner.
3.06 CLEANING UP
A. Conduct cleaning and disposal operations to comply with all Federal, State,and local laws, ordinances,
and regulations.
K. Provide on-site containers for collection of waste materials and rubbish, to be located with the approval
of the Owner.
C. At the end of each day's work,remove,and legally dispose,all waste materials and rubbish from the site,
END OF SECTION
DHCD 0710MI Division 1
C 149$10k-$25K 5 of 5
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
wIUaFRIF.Y UJIMAXn1
MAY(* 12.."WA%HV%6T0NSUWr a SAt.FSt.MASSACIn.I'!:'I'IY0197,^.
TILL-978-743.9595 a FAX:979-740.9946
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricfans/Plumbers
An llcant Information Please Print Leeibly
Name tausincsstorpniruiotvindivlduui): 1�/�SS�L C"OVJSY/�' (/l-6a;I �aJ�
AddreSS: yam/ ffY',7LSnk? /9 Y?.
City/StateiZip: sly a .s cc AA 0/9 07 more H: 7 S!/ - S 7.7
Y
%rc you an employer?Check the appropriate boa: Type of project(required):
1.911 am a employer with CZ 4. ❑ 1 am a general contractor and 1 b. ❑ New construction
employees(fu11 and/or part-time).• have hired the sub-cumnctors
2.El am a sole proprietor or partner- listed on the attached sheet t ?• ❑ Remodeling
ship and have no amployeat Them sub-ccatuaetill have V. ❑Demolition
working for nut in any capacity. workers'comp insurance. 9. ❑ Building addition
[No workers'comp. insurance 5. ❑ We am a corporation and its
required.) officers have exercised their 10.0 Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp. C. 152,¢1(4),and we have no 12.0 Ruof repairs
insurance required.) t employees. [No workers' 13.❑Other
comp insurance required.)
•Ally 4pliaua Itut rhvMu boa NI meet ant GII wet ate secliee bciuw 4ilmliog Ibk*wurkwit'cwtlpenstakm puli y infiunruk,
'I I.mha,wiwn,who submit this arRdwit indicating it"are.tiny all trark and[it=hie outside caturaston mul nuts,,[a now arn&vit in scaling stick.
�r'unttxwn lhu chuslt thq beet mW anaelRd am atWllipW slletl showing the name of ale sebKonttatlela and their workers'sTM"p.puliry infar111allun.
1 um an employer that Is providing workers'compensation Insurance for my employees Below is the policy and job site
Grforuuntion /
insurance Company.Name: Y / __ ...1i4S(/Y_cv✓!c�-_�u ytc t G
Policy N or Scif-ins. Lic. ri:AX 611F7519 Expiration Date: D '�S1y- U g — 1
Job Site Address: rSJ Cr x ej C` Cuyrstatwzip:,c>/y/LrL //IN D%%/? 76)
Attack a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of.1GL c. 152 can lead to the imposition of criminal penalties of a
fins up w S1.500.00 and/or one-year imprisomncnt, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against llte violator. lie advised that a copy of this statement may be forwarded to the Office of
In.esngauotu of the DIA for insurarce coverage verification.
l do hereby rertijy rde� s mr a7i of rjury that r/re iuforrnalion provided above iis/true and correct
0—o al are only. no not write its this area,to be cowipleted by elly of town o/j/ciai
City or,rown: _ Permitfl.leense M
Issuing Authority (circle one):
1. Iloard of Health 2. Building Department 3.Citylfown Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: _ Phone q•
Information and Instructions
Massachusetts General Laws chapter 132 requires all employers to provide workers' compensation for their employer&
pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of him
express or implied,oral or written."
An esrpfoyw is defined as"an individual,partnership,assocnaton,corporation or other legal entity,or any two or more
Of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or tto_ of an individual.Patmecalup...e. iatioa of other legal amity,employing employees. However the
owner of a dwelling house having cosmos dab three apartments and who residue therein,err the oaupant of dw
dwelling house of another who employs persons to do maintenance.construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152.¢2SC(6)also states that"every state or local licensing agency shag withhold the issuance or
renewal of a license or permit to operate a business of to construct buildings In the commouweslth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally.MGL chapter 152. §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of Public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
please fill out the workers'compensation affidavit completely.by checking the boxes that apply to your situuution and if
necessary,supply sub-contractor(s)name(+).addm*cs)and Phone number(s)along with their certificatc(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees Wier dram the
members or partners,ace not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and dute the•affidaviL The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the low or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town OMCISIS
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom.
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the parmidlicelue number which will be used as a reference number. In addition,an applicant
that must submit multiple permitilicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A now affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
i'hu Ot iix of Investigations would Cue to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number.
The Commonwealth of Massachusetts ' a
Department of Industrial Accidents
O®ee of lsvestiptla s
600 Wadungttltl Street
Boston, MA 02111
Tel. # 617-7274900 ext 406 or 1-977-MASSAFE
Fax M 617-727-7749
Revised 5-26-05 www.mass.gov/dia
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
Ta:,*M745--)M F.\x:971.7it1914
Construction Debris Disposal .Affidavit
(required for all demolition a{x1 renovation work)
In accordance with the sixth edition of the State Building Coda. 780 Cb1R section 111.3
Debris.and the provisions of v1GL c 40. S S4;
Building{ Permit 0 _ _ is issued with the condition that the debris resulting from
dis this work shall be posed of in-a properly licensed waste disposal facility as defined by v1GL c
t 11. S 130A.
The
debris will be transported]by: r
-1 au f
0 of hauler)
me debris will be disposed of in :
(name of t."Illty)
,..d.:res. of Ihci6IV) .
.14
BOARD OF BUILDI G Kit UL'�(.TIO $ s e
'LicenseY.'C'O NSTRUCTIPN ySI�PL2t/'ISO ' ,�
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Numbe0G4^"' i�,0&4,Y5��
r Birthday=O6(26F1
�G�.' Exp1-" °• TS'nO�84551 i
RICHARD MASTRORI ItO�� 41, � �
87 GRAVES RD
REVERE, NA 02151�
-:% Administrator
a _ ;
•'tea%T.YtitY.9Yl>h�c'0.�R Y `J���yM1S'S cyY"�•.rvY`3t �.
co-'~a3'800-eten�ese�
1A•fdasonry"only
1G-.1&2 Famiy a cu -
Fzilure to pos3essa curtent etlition of the
Massachusetts Slate Builtling Code .
.is cause for mvocalwn of this license.
I
�y
i
8881 344 7233
i - O1G SAFE CALL CENTER (
EI77tOF _.._
PUBLIC PROPERTY
DEPART14iENT
1:I WfFJLLY D�LSCIMl
%rwroa 130 WAsuNGToM S`RF=•S" Lsj, 01970
TEL 9714745-MS•FA=976.740."o
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY FMSTINGI
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: A a4-\ 0 A Li ' Building; jjl I / y
--
Property Address:-- - -- - -- ----- - - _ � - -— - --- _ -� . . . ----
Property is located in a;Conservation Ares YIN�_H WWft District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: ,,.
Address: 7
70
Telephone: e-1 - 9, I
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition *Renovated
Renovation Number of Stored
Change in Use .5
Demolition
Approximate year of Area per floor (
construction or renovation
of existing building New
Brief Description of Proposed Work:
i
V r
Mail Permit to: - -
What is the current use of the Building?
Material of Building? If dwelling.how many units? /.� .
WIN the Building Conform to Law? Asbestos?
Architect's Name g U o "cK. J-Y1 r'
Address and Phone �Co>?� �/ `a "^LO
�Mechanles Name
Address and Phone
Constriction Supervisors License# CS �y 3 S HIC Registration#
Estimated Cost of Projed i Parnfl Fed Cakwiatlon
Permit Fee S Estimated Cost X$7/$1000 Residential
Estimated Cost $11/S1oo0Commercla4-------- _. . .. _
An Additional$6.00 is added as an
Administrative charge.
Make sure that all fields are property and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit ui e a s
specifications. Signed under penally of perjury
Date �-lo
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