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19 OSBORNE HILL DRIVE - BUILDING JACKET 48420 P4 www.pendaflex.com MADE IN USA 30%PCW CutLesse File Folder •FEWER PAPER CUTS Certificate Number: B-14-1394 Permit Number: B-14-1394 Commonwealth of Massachusetts City of Salem This is to Certify that theDevel Land Building located at .......... ............. ................ ...... ............. Building Type 19 OSBORNE HILL DRIVE in the City"qf ....................... ............ ........ ....... �Sqlqm—...11-1--1.-.111111-111-1....11 1 Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY 19 Osborne Hill Drive DJBIASE CORP This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ..............................Not Applicable..... unless sooner,suspended or revoked. Expiration Date Issued On: Monday, December 01, 2014 Certificate Number: B-14-1394 Permit Number: B-14-1394 Commonwealth of Massachusetts City of Salem This is to Certify that the Devel Land Building located at ........................._............. Building Type 19 OSBORNE HILL DRIVE in the City of Salem ... .....__...._ ......_..... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY 19 Osborne Hill Drive DIBIASE CORP This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ........................................... pplicable unless sooner suspended or revoked. .. Not A Expiration Date Issued On: Monday, December 01, 2014 (�'' " Commonwealth of Massachusetts Citv of Salem 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595,x5F41 Return card to Building Division for Certificate of Occupancy Permit No. B-14-1394 PERMIT TO FEE PAID: $1,750.00 BUILD DATE ISSUED: 9/812014 This certifies that OSBORNE HILLS REALTY TRUST PAUL DIBIASE TR has permission to erect, alter, or demolish a building 19 OSBORNE HILL DRIVE Map/Lot: 8017" as follows: New Construction - 1-2'Family CONSTRUCT NEW, SINGLE FAMILY DWELLING Contractor Name: DIBIASE CORP. DBA: Contractor License No: CS-27147 9/8/2014 Bulidihd 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 conVin to the approved application and the approved construction documentsfor 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 riot be issued until all applicable signaturesby the Building and Fire Officials are provided on this permit. - - x: H IC#: 'Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A). ,X Restrictions: Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER, r' Commonwealth of Massachusetts y � City of Salem e 120 Washington St,3rd Floor Salem,MA 01970(978)745.9595 x5641 Return card to Building Division for Certificate of Occupancy Structure CITY OF SALEM BUILDING PERMIT PERMIT TO BE POSTED IN THE WINDOW Excavation . Footing INSPECTION RECORD - Foundation • - - Framing Mechanical '.Insulation 191 to b tt (l INSPECTION: BY _ DATE Chimney/Smoke Chamber Final ,p Plumbing/Gas " Rough:Plumbing Rough: Final Electrical SenAceA Rough etc 0 Final Fire Department Preliminary Final Health Department ° Preliminary Final Dw 7 ProfessYonal Land':Surveyois`8 Civil Engineers MORTGAGE,INSPECTION. ra , :, .; ESSEX SURVEY.SERVICt' - _ 1958 -_ 1986 PLOT PLAN LAND` OSBORN PALMER 1911 - 1970 LOCATED IN BRADFORD 8 WEED 1885 -.1972 Y SALE MASS. 4Y Cr ' N' I�7.GG 1, it 190 t� U N r� ZIT l 2 S Loc Z6 r1G 11 ptn r - 1,410 y I, Christopher R. Mello, A Registered Land Surveyor, Do Hereby Certify That The Above Mortgage Inspection Plot Plan Was Prepared For In MoConnection With A New rtgage And Is Not Intended Or Represente TO Be A Lan Or Property Line Survey. No Corners Were Set. It Cannot Be Used For Establishing Fence, Hedge Or Building Lines. No Responsibility . Is Extended Herein To The Land Owner Or occupant. This Plan Shall Not Be Accepted For Recording, _ The Location Of The Structures As Shown Hereon This Plan Has Been,Pre Is In Compliance With The Local pared For Applicable. Conveyancing Purposes Only For The Zoning By-Laws In Effect When Constructed;' 0i Above Party And Is Not To Be Used With Respect To Horizontal Dimensional %otN f �'4�, For Boundary Requirements Or Chapter 481 Of 1987. Measurements. Cm ST ' LR N"x R. °NI Subject Property Is Located In to FLIA L Zone Ort'-A Federal Insurance t9 313„7 z 'p /. �0stration Designated Flood NJ SU Hazazd Area, er Map L 501 2 , \ tea Dated � "DATE:' OG( 7 2Gl�f REFERENCE: BK 96 Z PG 7,, 104 LOWELL STREET PEABODY,MASS.01960 F Home Energy Rating Certificate Rating Nuumbermber Regi296673288 Certified Energy Rater Nicholas Abreu 19 Osborne Hills Drive Rating Date 12/1/2014 Salem, MA 01970 Rating Ordered For Osborne Hills Realty Trust Estimated Annual Energy Cost __ � Use MMBtu Cost Percent 5 Stars Plus Heating 61.3 $507 24% Confirmed Cooling 2.8 $136 6% HERS Index: 69 Hot Water 18.2 $135 6% Lights/Appliances 24.8 $1196 56% General information Photovoltaics -0.0 $-0 -0% Conditioned Area 2092 sq. ft. House Type Single-family detached Service Charges $157 7% Conditioned Volume 17788 cubic ft. Foundation More than one type Total 107.2 $2130 100% Bedrooms 3 Criteria McC11dh1Ca1 $ystefns Features - - This home meets or exceeds the minimum criteria for the following: Heating: Fuel-fired air distribution, Natural gas, 95.0 AFUE. Water Heating: Conventional, Natural gas, 0.68 EF, 75.0 Gal. Cooling: Air conditioner, Electric, 13.0 SEER. Duct Leakage to Outside 66.62 CFM25. Ventilation System None Programmable Thermostat Heat=Yes; Cool=Yes Building Shell Features Ceiling Flat R-44.4 Slab None Sealed Attic NA Exposed Floor R-30.0 Vaulted Ceiling NA Window Type U-Value: 0.300, SHGC: 0.280 Nicholas Abreu Above Grade Walls R-21.0 Infiltration Rate Htg: 4.42 Clg: 4.42 ACH50 Conservation Services Group Foundation Walls R-0.0 Method Blower door test 50 Washington Street Lights and Appliance Features Westborough, MA 01581 Percent Interior Lighting 10.00 Range/Oven Fuel Electric Percent Garage Lighting 0.00 Clothes Dryer Fuel Electric Refrigerator (kWh/yr) 691.00 Clothes Dryer EF 3.01 Dishwasher Energy Factor 0.78 Ceiling Fan (cfm/Watt) 0.00 REM/Rate-Residential Energy Analysis and Rating Software v14.5.1 This information does not constitute any warranty of energy cost or savings. O 1985-2014 Architectural Energy Corporation, Boulder, Colorado. The Home Energy Rating Standard Disclosure for this home is available from the rating provider. Ila The Commonwealth of M WSERVICES tm Deparent of Public S Massachusetts State Building Code(780 CMR) �p � Building Permit Application for any Building other than�%nKd§r27WoFarttl3i y&'elling (This SectionF -O ,Use Only) Building Permit Number. Date.Applied: - I Building Official: SECTION 1:LOCATION(PI ase indicate Block#and.Lot#'f or locations for which a street address is not available) 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❑ 1 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 o/ON F�1 Is an Independent Structural Engineering Peer Revi�eew re�qQcared?,`1� [ f Ye ❑ No Brief Description of Proposed Work: C�si'f U1 IVEl1) Sinolp t MI IV Dwalino SECTION 3:COMPLETE THIS SECTION IF.EXISTING BUILDING UNDERGOING RENOVATION,ADDITION;OR CHANGE;EN USE OR OCCUPANCY Check here ff an Existing Building Investigation and Evaluation is enclosed(See 780 OAR 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❑ M High Hazard H-1❑ H-2❑ H-3 H-4❑ H-5❑ 1: Institutional 1-1❑ 1-2❑ I-3❑ 1-4❑ 1 M: Mercantile❑ R. Residential R-1 R-2❑ R-3❑ R-4❑ S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6i CONSTRUCTION TYPE Check as applicable) IA ❑ Ill ❑ IIA ❑ UB ❑ 1 ILIA ❑ IUB ❑ 1 IV ❑ 1 VA ❑ VB ❑ SECTION 7:SITE INFORMATION:(refer:to•780 CMR 111.0 for details on each item) Water Su pi Flood Zone Information Sewage Disposal: Trench Permit Debris Removal: Public t� Check if outside Flood Zone❑ Indicate municipal A trench not be Licensed Disposal Site Private❑ or indentify Zone: or on site system permit is enccll❑ required trench or osed❑ Railroad right-of-way: Hazards to Air Navigation MA Historic Commission rev iew Process: Not Applicable❑ . Is Structure within airport approach area? Is their review comple d? or Consent la Build enclosed❑ Yes❑ or No❑ Yes❑ No SECTION 8:CONTENT OF CERTIFICATEOF OCCUPANCY Edition of Code:-at—Use Group(s): KM Type of Construction Occupant Load per Floor: Does the building contain an Sprinkler System?: 90 Special Stipulations: SECTION9: PROPERTY OWNER AUTHORIZATION Name nd Address Prope Owner Name(Print) No.and Street C* /Town Zip KProper Owner Contact Information: , l aisasp_ __ 7$1-334 - q '9C' 7$1�' _ 7021n �� Title Telephone No.(business) Telephone No. (cell) e-mail addres if ap rlicable,the property-owner hereby authorizes R ASP LOT, P. O. �X V LpnQix 0�ffi0 Name Street Address rty/Town .State Zip to act on the property ownefs behalf,in all matters relative to work authorized by this building permit application. SECTION ios CONSTRUCTION CONTROL(Please fill out Appendix 2) building is less than 35,000 cu.ft of enclosed ace and/or not under.Construction Control then check here 0 and skip Section 10.1 10.1 Regis d Professional Res onssiib�le for Construction Control TeleIhone No , l mail s Registration Number Street Address f O Cityr own State Zip Discipline Expiration Date 10.2 General Contractor Company Name I I � � 111 `��F'�_ CS 2'7I �! �1 Construc#iQ I V Sod ,Name of P Responsible for Construction rc No. and Type if Applicable O MX * 780 L 1 -OL9io Street Address t ity/Town n State II Zip g&- 90cn 781-844- oZ In 6ib�fk,6rneS, cnrvt Telephone No.(business) Tel hone:No. cell e-mail address SECTION IL WORKERS!MMPENSATION'INSURANCE AFFIDAVIT G.L.c.152.§25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes❑ No 0 SECTION,12•CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building- $ 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 $ 6 (contact municipality)and write check number here SECTION,11.SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I he attest under the pains and penalties of perjury that all of the information contained in this application is true and accura a of ge and understanding. Q- _ M --O&c[-- Please print and siouna # .H.R.T t Ti _ Telephone No. Date Street Address Cit) own JYJSSttaaLtee --(1�Z4tip�Q[—fl--(v1 Municipal Inspector to fill out this section upon application approval: Name _ Date A CERTIFICATE OF LIABILITY INSURANCE DATEIMWDWYYYY) a/2/201a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS.NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE:A CONTRACT-BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holderis.an ADDITIONAL:INSURED,the:policy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an.endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEC` Select Dept ect 66807 Eastern Insurance Group LLC PHONE (508)651-7700 FAC, .(981)586-8244 233 West Central Street 'MAIL .selectwork@easterninsurance.com INSURE S AFFORDING COVERAGE NAIC It Natick MA 01760 wsuRERAAcadia Insurance Compcqty 31325 INSURED INSURERS: DiBiase Corporation, DUC Residential LLC INSURERC: _ Osborne Hills Realty Trust INSURERD: P O Box 760 - -'- INSURER E Lynnfield MA 01940 1 INSURER F: COVERAGES CERTIFICATE NUMBER3faster 14-15 / -GL Only REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE.LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR:CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,:THE INSURANCE.AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR nPE OF INSURANCE AV B POLICY EFF POLICY EXP POLICY NUMBER M DDI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ENTED R A - E scar e $ 250,000 A CLAIMS-MADE OCCUR 0191229-17 /23/2014 /23/2015 MED EXP(Any one person) $ 5,000 PERSONAL S ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 1,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OS _ SCHEDULED BODILY INJURY(Per accidere) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Peraccitlenl $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ LIED RETENTION$ Is WORKER S COMPENSATION 0286788-15 /23/2014 /23/2015 VJC STATU- OTH- ANDEMPLOYERS'LUIBILITY YIN X TQRVIIMITR go ANY PROPRIETOWARTNERIEXECUTIVE EACH ACCIDENT 8 100,000 E.L. OFFICERIMEMBER EXCLUDED9 NIA (Mandatory In NH) - E.L DISEASE-EA EMPLOYEt $ 100,000 III" f Yea,do TIC0 uMer DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS'I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule.If more space he required) CERTIFICATE HOLDER - CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Salem ACCORDANCE WITH THE POLICY PROVISIONS. Salem, MA 01970 AUTHORIZED REPRESENTATIVE John Koegel/KABlC �'�� ACORD 25(2010/06) ©1988-2010 ACORD CORPORATION. All rights reserved. I1119025(qnimR)ni Th.ACr1Rr1 ark.of Annlon r Professional Land Surveyors B Civil Engineers ESSEX SURVEY SERVICE. 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD 8 WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN SAL Eh MASS. OPT SGI. 41 1376� 7Z,6 i� '6���ic s�Us�5 �r 16T lz 50 �A�IGSCYI OG,E[�il� H 36 r�, i4 1 14111 05 I hereby certify to the � Z61_4 . Building Inspector that the pro- ZONE: fi LOT AREA: k4e LOT FRONTAGE: rP/oA- posed construction shown conforms to the dimensional zoning of FRONT YARD: 4 /_- SIDE YARD: 1661 REAR YARD: '`% �i /rL� . Mass. SCALE: t �✓ /%H q cs 1 .�e i DATE: ��,a�, a 3 �'(id� lfL-V dG�JC l7 16/� f ,LLO � m1 REFERENCE: � BK 4I1JZ PG 7� stopher R.1Me116VPIS'.73,1317, 104 LOWELL STREET S- PEABODY, MASS. 01960 777 7 (978) 531-8121, CA V. 1l70\ =04 CnnA Professional Land Surveyors Et Civil Engineers ESSEX SURVEY SERVICE. 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN S/d� ✓i MASS. d t� It li V� G� 4 us �til""LUI�� �, ILr'� L- '/j C s w.n I hereby certify to the 9XZet?"i f p� Building Inspector that the pro- ZONE: LOT AREA: �'L LOT FRONTAGE: kNVz posed construction shown conforms f to th dimensional zoning of FRONT YARD: IJ1.1 SIDE YARD: i6 FT REAR YARD; -3G;`' � Lam!`/ Mass. OF A9 SCALE$ fit, F^�S �s q TOPHER yG tt . DATE: QLN is Zr i ���# REFERENCE: EK 46 PG 79 Christopher R. Mehlo VPtS'33fi31, ''/STEM a 104 LOWELL STREET` :U ' PEABODY, MASS.01960 (978) 531.8121 FAX:(978) 531-5920 CITY OF SALEM ROUTING SLIP ,NeiN Construction_ Certificate of ,Occupancy LOCATION aZ4gZ& ATE ASSESSORSU=p��---DATE 93 Washington St. t 93 � 4 D , `Fd a ar 't -, s �w UaShitgf St. r,a PUBLIC SERVICES DATE b(�[�� 120 Wash' ton t. WATER _DATE_ tL-, 120 Washington St. n CROSS CONNECTION `✓ DATE ?.d NO kill Oidn 5 Jefferson Ave PLANNING DATE ( � 120 Washington St. CONSERVATIO TE 120 Washington St. E ItiE GTRl t� x�i z" l" ,i S° i��� g �1 vJ12 E rx —a�4" I �5 a> . .4 War z c,7 n FIRE PREVENTION `1 0,4-�� DATE 9 1'L tN 29 Fort Avenue ayt HEx1aLtT'�H2�uitu(i�,1�1'iw�;.n4�'tr2a,d AI 1L11 VV4i hi'ngton t. �& " BUILDING INSPECTOR �P�, DATE LYd � 120 Washington St. i