70 MARLBOROUGH RD - BUILDING INSPECTION (2) 1 1
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The Commonwealth of Massachusetts § Vz'--
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Board of Building Regulations and Standards ; (
Massachusetts State Building Code,780 CMR MUNICIPALITY'
� 1016SPeL U i
Building Permit Application To Construct,Repair, Renovate Or Demolish a R t d r 1
One-or Two-Family Dwelling
This Section For Official Use Only
I Building Permit Number: I Date Ap ied:
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Building Official(Print Name) Signature Dare'
SECTION 1: SITE INFORMATION
L� 1.1 Property Address: 12 Assessors Map&Parcel Numbers
70 Marlborough Road 09 0035
L la Is this an accepted street?yeses no Map Number Parcel Number
1.3 Zoning Information: 1A Property Dimensions:
Zoning District Proposed Use Lot Area(sq It) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yazd 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: 18 Sewage Disposal System:
Zone: _ Outside Flood Zone?
Public 13 Private❑ Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Ivo Tafua Salem, MA 01970
Name(Print) City,State,ZIP
70 Marlborough Rd 978.552.9721 ivotafua@yahoo.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition 13 Accessory Bldg.❑ Number of Units_ Other ® Specify: Roofing
Brief Description of Proposed Work2: Strip and Re-Roof w/6' Ice &Water + 30 year asphalt shingles
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials
1.Building $ 6,991.00 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Costa(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: $ 6,991.00 ❑Paid in Full Outstanding Balance Due:
�cj�P I O TO R•Q .
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-064063 03/15/2018
David E Tomolillo License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
56 Wilson St.
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
Medford 2155 R Restricted 1&2 Family Dwelling
Cio tate,Zaso
M Masonry
RC MasoRoofin Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
(781) 838-0789 Solar@hh.team IInsulation
Telephone Email address D Demolition
52 Registered Home Improvement Contractor(HIC)
158936 03/18/2018
Hallmark Homes Associates Inc.
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
56 Wilson St Solar@hh.team
No.and Street Email address
Medford, MA 02155 (781) 838-0789
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 .......... W No...........13
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 Hallmark Homes Associates. Inc.
to act on my behalf,in all matters relative to work authorized by this building permit application.
Ivo Tafua 12 September 2016
Print Owner's Name(Electronic Signature) Date
SECTION 71b: 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 applicati :Veaccura[ to he best of my knowledge and understanding.
David Tomolillo � 12 September 2016
Print Owner's or Authorize gent's ame(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 D91 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.gov/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.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"may be substituted for"Total Project Cost"
i CITY OF S.UYN1, INLkSS.A.CHUSETTS
• BUILDIING DEPART%I&NT
130 WASHLNGTON STREET,3"D FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KIIIBERL.EY DRISCOLL
MAYOR THOMAS ST.PmRRS
DIRECTOR OF PUBLIC PROPERTY/BUILDING CONWISSIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit# is issued with the condition that the debris resulting from
this work shall be disposed of in a property licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
In House Disposal
(name of hauler)
The debris will be disposed of in :
(name of facility)
(address of facility)
signature o permit applicant
09/08/ 2016
date
Jcbriull'Ja;
Serving Greater Boston for Over 25 Years!
HALLMARK Dave Tomol]Ilo
KALI.PARK ROMW RIMODB NG CSL#: 064063 HIC#: 158936
Standards & Quality are out Priority!
SolarCity Quote — Re-Roof
August 29,2016
Ivo Tafua
70 Marlborough Rd
Salem,MA 01970
(978) 552-9721
ivotafua@yahoo.com
Roofing Specification:
MP1&MPZ Only
• Remove old comp shingles down to the existing roof sheathing
• Remove all nails and replace up to 32 square ft of plywood,if needed
• Additional plywood will be charged at$55.00 per sheet
• Apply 6'of Water Shield along the lower eaves
• Install new vent pipe water diverters where needed
• Apply 15 Ib.felt underlayment as protective base
• Install 8"aluminum drip edge along entire roofline perimeter
• Includes [40'1 roof ridge ventilation system and [42'] color matching caps
• Chimney
• Apply Water Shield around the chimney
• Re-lead perimeter of[ 1 ]chimney(s)with new lead
• Install new secondary chimney step flashing
• Removal of roofing debris by dumpster
• Total number of roof squares [ 15 ]
• Owens Corning""TruDefinitlon®Duration®30-year Architectural shingles.
• Providing all Insurances,Licenses and Permits
I authorize Hallmark Homes Associates,Inc.to obtain all necessary building permits on my behalf.
Materials and Labor: $6,788.00
Permits&Admin: $203.00
LQuote Total:
Hallmark Homes Associates,Inc.• 77 Alexander Rd 814,Billerica,MA 01821• (781)838-0789• www.HallmarkHomesRemodeling.com
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Solar City Portion
70 Marlborough Rd
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Hallmark Homes Associates,Inc.• 77 Alexander Rd#14,Billerica,MA 01821• (781)838-0789• www.HallmmkHomesRemodeling.com
DocuSign Envelope ID:5C99A888-C090AB53-8979-B8D08A537746
Purchase Order
Solarcity
3055 CLEARVIEW WAY Purchase Order No. P079851 RR
SAN MATEO CA 944023709 Date 8/30/2016
Tax Reg. Number 02-0781046
Vendor: Ship To:
Hallmark Homes Associates Inc. Seth Flamm of Solarcity
PO Box 885 Re-Roof Project Manager I Las Vegas, NV
Medford MA 02155 "See Notes for Project Information"
Phone: 702
Tax Reg. Number
Contract Number: PO Request 08/29/16
" Changed Since the Previous Revision
Shipping Method Payment Terms Confirm WithPa e
Net 30 2
LIN- Item Number Descrilytion Rea. U/M Ordered Unit Price Ext.Price
Shi in Method Reference Number - FOB
4�g
None
15 RESI-REROOF-Kyei JB-0161054 Each 161.00 $1.00 $161.00
SERVICE SUB-PERMIT None
16 RESI-REROOF-Tafua JB-0192310 Each 4,072.00 $1.00 $4,072.00
SERVICE SUB-LABOR None
17 RESI-REROOF-Tafua JB-0192310 Each 2,716.00 $1.00 $2,716.00
SERVICE SUB-MATERIAL None
18 RESI-REROOF-Tafua J&0192310 Each 203.00 $1.00 $203.00
SERVICE SUB-PERMIT None
Subtotal $28,550.00
Submit invoices(incll.work dates)and lien Trade Discount $0.00
releases to:Accounts Payable,
Freight $0.00
APase include
S larCity's O, Fax#650-362-2109. Miscellaneous $0.00
Please include SolarCily's PO,Job#&Project
Tax $0.00
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Stg ad by: oowsi9nedby: Order Total $28,550.00
Sfllnt. �{tWAY'�UOSRE94Ei�... EaawBIOWA44
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Authorized Signature
DocuSign Envelope ID:5C99A888-C09D-4B53-8979-B8D08A537746
Purchase Order
Solarcity
3055 CLEARVIEW WAY Purchase Order No. P079851 RR
SAN MATEO CA 94402,3709 Date 8/30/2016
Tax Reg. Number 02-0781046
Vendor: Ship To:
Hallmark Homes Associates Inc. Seth Flamm of SolarCity
PO Box 885 Re-Roof Project Manager I Las Vegas, NV
Medford MA 02155 "See Notes for Project Information"
Tax Reg. Number Phone:( 702) 550 - 9922
Contract Number: PO Request 08/29/16
^ Changed Since the Previous Revision
Shipping Method Payment Terns Cordirm WithPa e
Net 30 1
LIN Descrition - Reg.Date U/M Ordered Unit Price Ext.Price
Shiooina Method Reference Number... FOB
1 RESI-REROOF-Kellman JB-0101721 Each 2,693.00 $1.00 $2,693.00
SERVICE SUB-LABOR None
2 RESI-REROOF-Kellman JB-0101721 Each 1,796.00 $1.00 $1,796.00
SERVICE SUB-MATERIAL None
3 RESI-REROOF-Kellman JB-0101721 Each 167.00 $1.00 $167.00
SERVICE SUB-PERMIT None
4 RESI-REROOF-Forster JB-0261992 Each 2,544.00 $1.00 $2,544.00
SERVICE SUB-LABOR None
5 RESI-REROOF-Forster JB-0261992 Each 1,974.00 $1.00 $1,974.00
SERVICE SUB-MATERIAL None
6 RESI-REROOF-Forster JB-0261992 Each 166.00 $1.00 $166.00
SERVICE SUB-PERMIT None
7 RESI-REROOF-Burns JB-0215899 Each 1,794.00 $1.00 $1,794.00
SERVICE SUB-LABOR None
8 RESI-REROOF-Burns JB-0215899 Each 1,196.00 $1.00 $1,196.00
SERVICE SUB-MATERIAL None
9 RESI-REROOF-Burns JB-0215899 Each 135.00 $1.00 $135.00
SERVICE SUB-PERMIT None
10 RESI-REROOF-Wildman JB-0263273 Each 2,950.00 $1.00 $2,950.00
SERVICE SUB-LABOR None
11 RESI-REROOF-Wildman JB-0263273 Each 1,568.00 $1.00 $1,568.00
SERVICE SUB-MATERIAL None
12 RESI-REROOF-Wildman JB-0263273 Each 166.00 $1.00 $166.00
SERVICE SUB-PERMIT None
13 RESI-REROOF-Kyei JB-0161054 Each 2,549.00 $1.00 $2,549.00
SERVICE SUB-LABOR None
14 RESI-REROOF-Kyei JB-0161054 Each 1,700.00 $1.00 $1,700.00
Hallmark Homes Associates, Inc. — David To1�Immtolmlilllllolfm
A Y VSETT8- DRnfE - MA IIIIIIIIIlIIIII IIIIIiII IIII
LICENSE
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Medford,MA 02155
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Massachusetts Department of Public Safety Construction Supervisor -
Board of Building Regulations and Standards Restricted to:
Unrestricted-Buildings of any use group which contain
License: CS-064063 less than 35,000 cubic feet(991 cubic meters)of
Construction Supervisor enclosed space. _
DAVID F TOMOLILLO 1
86 WILSON ST
MEDFORD MA 02155 l' ✓;^, Le i�jl..
/r' , Failure to possess a current edition of the Massachusetts
r--jZU l� Expiration: State Building Code is cause for revocation of this license.
Commissioner 03115/2018 OPS Licensing information visit: WWW.MASS.GOVIDPS
116—
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( e ,pavanroxuiea�(/rrJlZavac,luix! License or registration valid for individul use only
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: (58936 Type: Office of Consumer Affairs and Business Regulation
Expuatfon /'1r8?2P1a Private Corporation 10 Park Plaza-Suite 5170
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HALLMARK HOMES ASSOCI ESAC.
1
DAVID TOMOLILLO`,�
1 STONEHILL DR 1F4 .� -�+i Qwest0ldw
STONEHAM,MA 02160 'aUndersecretary ut signature
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®SHAD; o' 11-600526177
This card acknowledges that the recipient has successfully completed a
30-hour Occupational Safety and Health Training Course in
Construction Safety and Health
David Tomolillo
Jessie Vieira 8/4/11
(Tralner name—print or type) (Course end date)
The Commonwealth of Massachusetts
Department of Industrial Accidents
s 1 Congress Street, Suite 100
Boston,MA 02114-2017
` www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Leeibly
Name (Business/Orgmization/Individuaq:Hallmark Homes Associates, Inc.
Address: 77 Alexander Road / Suite 14
City/State/Zip: Billerica, MA 01821 Phone#: (781) 838-0789
Are you an employer?Check the appropriate box: Type of project(required):
L®I am a employer with 2 mployees(full and/or part-time)." 7, ❑New construction
2 I am a sole proprietor or partnership and have no employees working for me in $, Remodeling
any capacity.[No workers'comp.insurance required.]
9. Demolition
3.n I am a homeowner doing all work myself[No workers'comp.insurance required.]r
4.M 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition
ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions
proprietors with no employees. 12.E]Plumbing repairs or additions
5f:]I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof re airs
These sub-contractors have employees and have workers'comp.insurance.: X p
6.❑Weare a corporation and its officers have exercised their right of exemption per MGL c. 14.[]Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the time of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: The Travelers
Policy#or Self-ins.Lic.#:6KUB-SB29684-3-14 Expiration Date: 03/17/2017
Job Site Address:70 Marlborough Road city/State/zip: Salem, MA 01970
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verificgi
Ido hereby c I un er the pai s and penMieofperjury that the information provided above is true and correct.
Signafore: Date: 08 September 2016
Phone#: (7976 838- 89
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person. Phone#: