The URL can be used to link to this page

64 HAWTHORNE ST - BUILDING INSPECTION 2-0 3 The Commonwealth of Massachusetts Board of Building Regulations and Standards RNENE0E�T�'OF Massachusetts State Building Code,780 CWPECT JOR�,L SE RV IC S}CLEM Revised Mar 2011 1� Building Permit Application To Construct,Repair,Renovate Or Demoli'l, a 1Q; 53 One-or Two-Family Dwelling 1015 OEC r' This Section For Official Use Only I Building Permit Number: Date Applied: 7 Building Official(Print Name) Signature Date /1 SECTION l: SITE INFORMATION ty I 1.1 Pipe lde S 1.2 Assessors Map&Parcel Numbers Il 1 la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 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❑ Private❑ Zone: _ Outside Flood Zone? Check if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 r'o ecord: c e(Print) City,State,ZIP No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify: - _� Brief Description of Proposed Work': Yt Y' oy 1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and Materials Official Use Only 1. Building $ 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $ Alodo 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire oppression) $ Total All Fees: $ Check No. Check Amount: Cash Amount: 6.T tal Project Cost: $13 6,00 ❑Paid in Full ❑Outstanding Balance Due: C©NTCz . Plv ► z1I—I I ( s SECTION 5: CONSTRUCTION SERVICES ff5.1onstruction Supervisor License(CSL) License Number Date Name of CSL Holder rype( )��s d/Pr. List CSL T see below Type Description No.and Street `(� t� U Unrestricted{Burldin s to 35,QQ0 cu.ft. L] R Restricted 1&2 Famil Dwelling City/T--own,Sdite,ZIP M Masonry -� (j/ RC RoofingCovering fJGLt?t�2CS WS Window and Siding SF Solid Fuel Burning Appliances �9Z0 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number ExpirationDate HIC CompanNa�mne or HIC Registr Name lUlr>.c ra fr -- _� (T told-i torr 7 t Email address Ci /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.......... 0 No...........❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize_f�/4.LL. to act on my behalf,in all matters relative to work authorized by this building permit application. 1;/ f pl b/ . Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'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 a and accurate to the best of my knowledge and understanding. �� or/m f� Pnnt wner's or A nrized Agent's Name(Electronic Signature) Date NOTES- 1. 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.O.L.c. 142A.Other important information on the HIC Program can be found at www.masLgoy/oca Information on the Construction Supervisor License can be found at www mass.gov/dos 2. When substantial work is planned,provide the information below: Total floor area(sq.8.) (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 Cost" OtTiee of Cansnmer Affairs&Bnsiaess Regnlot wa II - ME IMPROVEMENT CONTRACTOR istratiom J65633 yt xpiration:F3l77T2D1£.; LLC EDDIE MAC'S HOMEQP.^O EAIT LLC t E . . EDWARD'MACFARLAlp�.a r' 115 SYLVAN !Il , DANVERS,M01923 •�� r*laipUcdesc i PF °F 1It Massachusetts -Department of Public Safety {' �f Board of Building Regulations and Standards Construction Supervisor License: CS-901.276 " ' EDWARl}LMACjt' 'f 115 SYLVAN ST, s DANVERS MA iRF� r y Yp1 lr ✓ .�Y ..'r"' Expiration.: .� - Comrrriss`ibner 06120=16 EddieMac's Home Improvement Statement of Work Version 0.0 12/03/15 Presented by: Ed MacFarlane Time and materials ". Tristan Whitman 64 Hawthorne St Salem Ma 01970 a' • :3� Second floor bathroom renovation 3' H. } } Schedule of rates [Include fixed-rate costs for items such as equipment and hourly rates for employee time and service.) Demo bethroom to studs and update I the electrical, plumbing and building to meet 2015 code re irements i Install fan light combo in shower area, R15 insulation in exterior wall, new tempered glass replacement window with privacy glass, 'h i greenboard, 6x6 the in shower area, steel and porceline 5' tub, 12 x 12 I I floor the 2 sq ft allowance Install baseboard, paint entire bathroom with 2 coats of Ben Moore Install customer provided toilet, sink and accessories (towel bar, t.p. dispenser ect Payment terms 22 12/3/2015 Statement of Work Page 2 Statement of Work Due at signing $7000 Due when sheetrock is installed $4000 and ready for tape At completeion of above listed $2500 job description Total i $13,500 Statement of work Assumptions Work will be completed as job description states. Change management process If changes to statement of work occurs where customer is requesting more than what is stated in this document, there will be a change order in place to account for difference in work scope and cost. If any issues surfaces due to unanticipated conditions of the home, Eddie Mac's Home Improvement will notify customer of change order. All changes will be charged based on Time/Materials. Engagement related expenses Additional material and labor costs will be charged for any change order. Labor rate is at $75/hr per worker Professional services agreement We warantee all craftsmanship (not materials) for 3 years. EMHI is not responsible for any malfunction of materials (incorrect stain or grout colouring, unsatisfied with tile design after agreement, fixtures/appliances..etc) purchased or requested by customers. 12/3/2015 Statement of Work Page 3 Statement of Work . Acceptance and authorization The terms and conditions of the Professional Services Agreement apply in full to the services and products provided under this Statement of Work. IN WITNESS WHEREOF, the parties hereto each acting with proper authority have executed this Statement of Work, under seal. [Client name] '7-E 1 S ICS W [Services provider name] Full name Full name Title Title Signa�� Signature / �d �� Date 7Date 12/3/2015 Statement of Work Page 4