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IWOM a
��. CITY OF SALEM, MASSACHUSETTS
�a" a BUILDING DEPARTMENT
120 WASHINGTON STREET 3" FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR THOMAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
July 30, 2013
Bay Contracting
84 Lincoln Street
Boston Ma. 02135
Re:51-71 Lafayette Street—Salem
Unit# 507
Dear Sirs,
The owners of unit#507, the Walkers,have asked me to take look at the patio door in their unit. The Walkers
explained that workmen, from your company ,damaged the frame while removing the door in order for your
company to make flashing repairs. The Walkers then explained that your company had glued the jamb together
as a satisfactory repair. In my opinion this falls under the workmanship clause in the State Building Code and
that thejamb should be replaced by your company and at your companies expense. If you disagree,please let
me know'
Overall, this Department is awaiting submittals of the windows and glazing panels that have been selected for
this project.We are looking for the product sheets outlining the performance options (r-value,fenestration
rating,etc. . Please forward this information at your earliest convience. If you have any question, please contact
me directly
Thom t.Pierre
�tr2�"� U�Z
Building Commissioner/Director of Inspectional Services
f----
The Commonwealth of Massachusetts
t(� ownof
Board of Building Regulations and Standards
UU ;t Massachusetts State Building Code, 780 CMR. 7'"edition1a *:kN=J*dW&
Building Permit Ap anon o Construct, Repair, Renovate Or Demolish
One-ot Two-Fantdr Divelling
Thl Section For Official Use Only
Building Permit#No r: Date Applied: ^• �� (�
Signature: Lt"az
Budding C16mmiss1ePedJ#Tftc1or of Buildings Date
SECTION 1:SITE INFORMATION
1.1 Pr erty Ad ress+�• 4(tV - 6 *1 i4 ,1.2 Assessors Map Ar Parcel Numbers
Mx�h�t� /�7tt�D&t2s' g5
1.1 a Is this an�cepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq 11) Frontage(9)
IS Building Setbacks(R)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public O Private❑ Zone. _ Outside Flood Zone? Municipal❑ On site disposal system O
Check if ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ownart of Record: ` q
'(MOO
XName(Pr nt) l Address for Service:
Signature Telephone
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check ad that apply)
x New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ I Alteration(s) O Addition Cl
C)emolition ❑ Accessory Bldg.O Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
_ z rka.c
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Cum Estimated Costs: Offlelal Use Only
(Labor and Materials
L Building $ I. Building Permit Fee:f Indicate how fee is determined:
2. Electrical s ❑Standard City/Town Application Fee
Cl Total Project Cost'(Item 6)x multiplier x
3. Plumbing s 2. Other Fees: $
4. Mechanical (MVAC) 5 List:
5. Mechanical (Fire
Suression) s Total All Fres:S
Check No._Check Zoom: Cash Amount:
X6.Total Project Cost: so pQ D • ❑Paid in Full ❑Outstanding Balance Due:
�a
GHIEGK I1-tS a � �l P�('V167rt/
r,
SECTIONS: CONSTRUCTION SERVICES s
5.1 Licensed Construction Supervisor(CSL)
' Ltcen,e Number Expiration Date
N of CSL-H Ider r- 1List CSL Type(sce below)
��:� �.sxC�
Address T Description
XNUS T U I Unrestricted(up to 35.000 Cu.Ft.)
R Restricted I&2 FamilyDwelling
5i8 M I Masonry Only
RCResrdcntial Roofing Coverin
Telephone WS Residential Window and Siding
L9� p C?CJ Z SF Residential Solid Fuel BurningAppliance Installation
O Cl gg D Residential Demolition
5.2 ItIgistered a Improvement Contractor(HIC) u 3
HIC Com y Name or HIC Registrant Registration Number
N
Add /
Expiration Date
Signature Te ephonc
i SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.a 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...........fir No...........❑
SECTION 7—OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR C,ON-T`-RACT/O�R APPLIES FOR
JBUILDING PERMIT
1, 61Le/d I I t f�'1 t7/NNf� BL�O1 LYW Bi�C� t—f$L—Gdf-�' as of subject property hereby
authorized'i/2rlsf7r✓l(/ RF.rwA ^L� �EA.r1r)lyt3S�yiitbito act on my behalf,in all matters
relative tow a thorized r ilng permit appl ation. ��f/
Si wn
Signature of Oer /� . Date /
�7—� S TION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
1, ( _ � \ tV(-,)r r 1 Pt> ,as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are We and accurate,to the best of my knowledge and
behalf.
Xoto C-�—i
Print N d
/ "LI S 00
Signatu n r �n
Authorized Agent Date t /
(Signed under thebains and penalties of
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 3&have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and I IO.RS,respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq. Ft.) (including garage,,finished basement/attics,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. '"Total Project Square Footage-maybe substituted for"Total Project Cosi'
CITY OF SALEM
PUBLIC PROPRERTY
-�07
DEPARTMENT
,•.li M 1 \ gal\I .'l l
12: ).\II \t• M.l\\\a 111 V 11)191:
'ItYurkers' Cumpensation Insurance 11,I1"iduttit: lfuilderVCuntracturs/Electrician%/Plumbers
kpldicam li fnnnrtion Pleaxe Print Leeihlr
VJITCIIIu,I�lcayt)r;;an✓anmrinJn�.luall' l 1`oCCIo r (7 N<�\
PJ L) TIL
\Jdrds,;
City.Stare.zip 7e�o�^ MA 019 -? 0 I'huncrl: �3� 7_
Are Iola An employer:'Check he appropriate bus: 7•jps orpruject(required):
I I I .un A cmpluyer wish 0 0 1 :un a general contractor and 1 6. ❑ new eunstruenun
t.�uplo)ees(full an11'ur Pitt-lime) • hale hircd the sub-cunlracturs
2.0 I am A sole proprietor or partner- listed on the anachc l sheer. 7- ❑ Remodeling
Alp anal have no e+npluyces These sub-contractors have 11. Q Demolition
working for me In any capacity. worker' comp. Insurance. 1) 0 DudJmg Addition
I No workers' cnlnp. nisurance S. 0 We+ve a enlporstion and its
I r
odiee" have cxereix- 1heir 10.0 Electrical repair or additions
eyuircJ.]
3 ❑ 1 in,A hnmeuwncr Jural{All well tight of exemption per NfGL I1.❑ Plumbing repairs or additions
Inysclr. [No workers, comp. c. 132. q 1(4), and we have no 12.0 Ruar1'mpairs
Insurance required.) r anployces. [No workers'
U ❑Other
i comp. in.urancc required.]
•\... ..,grhud that chcckx bas Of mall alto till oat Ihu.clan Imlow Jwwma Ihtar wudwi cunlpunadiarr 1rlhcy ndurnLliura
'I lumvuw ran xhu a14mi1 this anlJavil Inlliwma IN)ars Jona At wurk and Ihcn him uutuds cuYrxlu s mail.0"i,a nsw tlf:Jsvil oJiuhna rad.
4,aln.u.n Ihsr emit this box maw auaheal.m aJdlliunal died k,,-i.ry Ilw rnnw of IM rllb'<amoenars and their Wuhan'comp puhry InWrmanun
/,,,,, uu eurpluyrr tour/r pruridine rvorlers'eutnprn anion in.xurnnar/iar Yry trip/uperr. Be/rrry is rhr pis/fay raid/lib ails
111lYlIIIYtnIA
In,orance Conlpaoy Vmne 1
Polity d lir Sclr-ins. Lit. M: __.. . Ewpiraoun D;te, Se 5�t'
�I ��rf v1vmow 1
)lib Site -\ddress:�G Lir�''��=1-- �L ---. City:Stats Zip. 75LL, . tAA il1cf`j6
.Mitch It espy of file workers'cumpenunun puiic) declaration page(showlnp the policy number and expiration date).
FAdurc h1,ccure cu\emse as required under Sccuun 23n ul'\IOL c. 132 can lead to the imposition of criminal penalties o(3
time tip ro i 1,3110.00 And/ur line-)ear impris.nunent, Aa\cell As ac J pcnallles in the t'unn of a STOP WORK ORDER amt a fine
.\fop u. i230 WA Jay .Iguuut the volator. Ile ad%viidl that A copy of this alutrmcnt may be iurw.udcJ lu the Office of
I I\,.I i•,I u•nls ul :hc 01A :M io,m race ass:aye ICI die Alton.
/,/v her,by..rllw I'll ler t n I'd + Iry of per/ary but the inlurmYtfon provided abate is true and a orrecr.
i
11 - ..11ye • 00C
q �1
r1,,u.",,nj:
Inu it: Yu miul.icen\e s\urhurov (ctrtlenoe):
nl of 11`11th !. Iluddin� Dtl,iruoc111 I l d\.Tuns Clcrk J. L•'ktclrvc.d lis\pacror �. Plumbinq In\pcclor
ivrcl 1'a nue: .. Phone to:
Information and Instructions
7C.,
Gcncral Laws chapter I Q Pcquues iII ca ililo)crs to pro,PJe workers• compensation lin thea.uit tv tats ,ramie, an rmrptotre a dating as " eier) pc„on in @ic iervtve ofmother,unkr any :onoact of hire,
it
-nphcd. 0111 or ,u nten.”
in .•tnpluprr 1%JctineJ as "an individual, partner,hip, issociativsi :orporatiun or athcr legal ennry, or any two or more
..P Pre forcgu,cg engaged .n a joint cnicrpnsc. and rah luding the:cgal rcpre,cnt,itives at i Jecea,ed eniplvvcr, of the
re,avcr yr ttaatee of .at utdtvi,lual, piumership,association or uther legal cnnty,cmpluymg ervsployces. However the
uwner of a dwelling house having not more than three apartments and who resiJes therein, or the occupant of"
,1,.;thug ttvv.,e of another who employe persons to do maintenance,cvn,trucnao or tepasr walk on such dwelling house
ar.u: the eroun,ta ar huilJing appurtenant thereto shall not because of such employment be decmeJ to be in employer "
NIGL chapter 152. 425C(6)also;tares that "every state or local licensing agency shall withhold the issuance or
renewal are license Air ptntiit to uperate a business or to coestruet buildings in the commonwealth tar any
applicant wise has not produced acceptable evidence utcumpganee with the insurance coverage required."
s.Jditiunilly, MGL chapter 152, 4?2501) sfaicsi"Neahei the commonwealth nor any of its political subdivisions shall
enter into any cunsraet to the perforawnn:e of pulshc work until acceptable ev idcoce ui cumpliance with the insurance
regwramcnts of this chapter have been presented to the contracting authority."
Applicants
Please f II out the workers' compensation affidavit completely,by checking the boxes that apply to your siwa+ion and, if
necessary, supply sub-contractors)name(s),address(cs1land phone nunrber(s)along with their cernficale(s)of
insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP) with no employees other than the
member or partners, are not required to carry workers'compensation insurance. If an LLC or LLP docs have
employees,a policy is required. Be advised that this atTrdavit may be submitted to the Department of industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and data the affidavit. Par affidavit should
he tenoned to the city or town that the application for the permit or license ill being requested,not the L)cpartment of
industrial Accidents. Should you have any questions regarding the taw or if you are required to obtain a workers'
compensation policy,pitase call the Department at the number listed below, Sclt insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
please he iurc that the affidavit is cumptcte and printed legibly. The Department has provided a space at the buitum
of rhe affidavit for you to fill our in the event the Office of Investigations has to contact you regarding the applicant.
I'I.,ise be lure to till in the pcnniulicense number which will be used as a reference number. In addition, in applicant
+Mn roust submit multiple pennit:lietnse applications in any given year,need only submit one affidavit indicating current
policy information l if necessary)and under"Job Site Address"the applicant should write -all lucatiuns in tcity or
tawny.*'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 new affidavit must be tilled out each
v ear. where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
t i e. a Jag license or permit to bion leaves cte.)said person its NOT required to complete this affidavit.
I h. t)tjice,d lave,tigatiuns would ir:c w Utank )nu in advance fur your coperanon anJ shuuld you have .uty qucatwns,
I,leise Ju Plot heioate to give us a call.
ncc U:parnncnt'i address, telephone and rax number,
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of lavesUgaidans
600 Washington Street
Boston, MA 02111
Tel. is 617-1274900 ext 106 or 1-977-MASSAFE
Fax M 617.727-7739
,1 - ,i.,Pi www.mass.govldis
CITY OF SALEM
1 � PUBLIC PROPRERTY
DEPARTMENT
I�. A , II•..i..•'\\;;Ilr � l\II \I, \t\•.0 I . ..I'I
Construction Debris Disposal Allidavit
(rcyuiied for all demo llion and renovation work)
In accordance \%ith the sixth edition of the State Building Code, 780 C'MR section I 1 1.5
Dcbris, and the provisions of MGL c 40, S 54:
Building Permit 1t is issued with the condition that the debris iesultin.- from
this work shall he disposed of in it properly licensed waste disposal facility as defined by MGL c
I I I, S 150A.
The debris will lie transported by:
�. sl1
(name of hauler)
I he debris will be disposed of in
(nalnr ul lacdny) -
2A,
I aJJrea.u(I]nlnvl
�IIIWI Ie qt lli 111111 .11)IIIICaIII
,IJI,
Salem Historical Commission
120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970
(978)745-9595 EXT.311 FAX(978)740.0404
CERTIFICATE,OF NON-APPLICABILITY
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
';Ej Reconstruction ❑ Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other Work
as described below does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District: Ded2y Street
Address of Property: 94 Derby Street, 47-9
Name of Record Owner: Town-end House Condominiums
Description of Work Proposed:
Reconstruction of decks attached to the rear of the wooden building, with no increase in dimensions. Non-
applicable due to being non-visible from Derby Street.
Dated: October 21. 2008 SALEM HI RI :OMMiSSION
By:
The homeowner has the option not to commence the work (unless it rel tes 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.