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73 WHALERS LN - BUILDING INSPECTION R -cc f 44 3,z—J_21 i f"WI .=: Hwy The Commonwealth of Massachusetts -i Department of Publ 0f$47r� I A 10. 12 Massachusetts State Building Code(780 CMR) Building Permit Application for any.Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) b,0 Building Permit Number: Date Applied: Building Official: t� SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) V, r ant Sa m 01170 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❑ 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 Cl No ❑ Brief Description of Proposed Wo k: I ,.. I ► w/ b SECTION 3:COMPLETE' SECTION I 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: Factor F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5 ❑ I: Institutional 1-1 ❑ 1-2❑ 1-3❑ 1-4❑ 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 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ VA VB 11 SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: A trench will not be Licensed Disposal Site 11Public ❑ Check if outside Flood Zone❑ Indicate municipal ❑ required El or trench or specify: Private 13or indentifv Zone: or on site system❑ permit is enclosed ❑ Railroad right-of-way: Hazards to Air Navigation: \t lhytu,is(,)u mi -;un a,�, ,, T, c�=a: 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 CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: �IIz Mf-\1,L- -11D G SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner A!iPubeA, M" I3 Wha o LoAt slim 01970 Name(Print) No.and Street City/Town Zip Property Owner Contact Information Off 23/2- eTitle 1 •7aP"l i Tttl (business)No.hone Tele hone No. cell e-mail address P ( Telephone If applicable,the property owner hereby authorizes ame Stre tAddress City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) (If buildin•is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1. 10.1 Registered Professional Responsible for Construction Control ` / f''�) .C640"t _1(4 Name(Registrant) Te eph c o. e-mail a,crT.d�r!ss c Registration Number Street Address City/Town S� Zip Discipline ptr�e 10.2 General Contractor Co ��ny Name Gael ��It Name of Person Res onsiblg for Construction License No. and Type if Applicable S Jf�� ?.(AA, �m �►l� of y�o Street _Addre�ss�Q-�(1�(' City/Town State Zip q-j ftp Tele hone No. business Telephone No. cell e-mail address SECTION 11:V4OF.E1Z5, CO\11 FNSATION INSURANCE APl'[DAVll(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❑ No ❑ 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 $ ((� (contact municipality)and write check number here SECTI N 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby att t u r he ins nd penalties of perjury that all of the information contained in this application is true and accurate to e cf k o 1 d a d understanding. h bhQ Please rint and si n na e Title Telephone o. Date Lcw�) � � � �ow►m2nR. GTu�f L(pZi{tl�l'h, �— 13 Street Address City/Town State Zip Q����/'�� Municipal Inspector to fill out this section upon application approval: _.F 110 Name aate �A Mariner Village Condominium Trust cla Crowninshield Management Corp. 18 Crowninshield Street Peabody,MA 01960 (978)532-4800 August 31,2016 Ms. Alizabeth Marcy 73 Whalers Lane Salem,MA 01970 RE: Replacement Windows/Doors—Mariner Village Condominiums Dear Ms. Marcy: Thank you for your inquiry regarding window replacements at your unit. Please be advised that the Board of Trustees for Mariner Village Condominiums does not object to the replacement of these windows or doors providing that they match in appearance (no crank outs,French doors, etc.)from the existing,they must fit in the existing opening, molding size must remain the same and they will not allow grids etc. We require that permits be pulled in advance, and that a copy of the final approved permit once completed is also submitted to our office. We also require that you hire only a licensed contractor, with adequate insurance. You will most likely need to show a copy of this letter to the Building Department in order to obtain your permit. Should you have any questions or require additional information,please feel free to call me directly at(978)532-4800 ext#232. Sincerely, a Regional Property Manager Crowninshield Management Corp. Managing Agent for Mariner Village Condominiums cc: File sv.-� the t..umrnuaweuua ud xnussucxxuserrs L.._._._- - -- Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 s` Boston, MA 02114-2017 www,mass.gov1dia Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individua /►�l): / liehael T)e Mlk Address: 5 $rjs-61 City/State/Zip: (} D lg7 a Phone #: 97�- 536-717)l Are you an employer? Check the appropriate box: Type of project(required): I.❑ I am a employer with 4. ❑ I am a general contractor and 1 employees (full and/or part-time)." have hired the sub-contractors E] New construction 2. 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ((( ship and have no employees These sub-contractors have g ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. t y. Building addition required. 5. ❑ we are a corporation and its 10.[] Electrical repairs or additions ] 3.EII aro a homeowner doing all work officers have exercised their 1 l,❑ Plumbing repairs or additions myself. I o workers' coo right of exemption per MGL Y� � P� 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.[(� Otheri�LLL� comp. insurance required.] x *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy inibrmaLion. r Homeowners who submit this afrdavil 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 name of the sub-contractors-and state whether or not those entities have employees. If the sub-contactors have employees,they must provide their workers'comp.policy number. 1 ata an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. insurance Company Name: Policy#or Self-ins. Lic. 4: LL � r _- Expiration Date:^ p Job Site Address: �_� WD4.�5 L"'a City/State/Zip: ie Y1M119 a 1 Attach a copy of the workers compensation policy declaration page(showing the policy number and expiration e). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb cern ung� rte ins and enalties o efu that thein ornration provided above is true and correct. Simtature: GSI .� _ Date; q � i Phone ft: 179-5.3 -7�7y Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License r# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing inspector 6.Other Contact Person: Phone#: Massachusetts Depactmm�t Board of Building Reglts'int ; License: CS-082193 , 4 Construction Supervisor MICHAEL T DEMILIX S BRISTOL ST 1 ?� ' SALEM MA 01970 a ^ { Commissioner 10ft17<irtT a`. �XGG Zd�Business — i 11iJCIC14it'JG� IJ Office of Consumer Affairs Regulation I 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration ..- Registration: 148688 -- _ - Type: Supplement Card LOWE'S HOMES CENTERS LLC. Expiration: 10/1812017 RICHARD CHALONE -- —" 136 TURNPIKE RD. SUITE 100 — SOUTHBOROUGH, MA 01772 -------- --- Update Address and return card.Mark reason for change. SCA i o 20M.0sr1 I Address r, Renewal f-1 Emplovment Lost Card W0," rrr�//ofGijfi,llric�uw//.t __me of ConsumerAffairsd Business Regulation License or registration valid for individui use only s z' before the expiration date. If found return to: 5 OME IMPROVEMENT CONTRACTOR t1„ �U - - Office of Consumer Affairs and Business Regulation $ egistration: 148688 Type: 10 Park Plaza-Suite 5170 Expiration: 101182017 Supplement Card Boston,MA 02116 LOWE'S HOMES CENTERS LLC. RICHARD CHALONE djlid 1000 LOWES BLVD _MOORESVILLE;NC 26117 Undersecretary Notvawith, t signature # 00107R4]; g� 'My R,- £aiG!'tV111 '01LU� "`s3}•3`" a .. •,r ».r' ... 'Se it ,ts� _ ..:3.` '._w t-U�".. } s7 LOWE'S AUTHORIZED REPRESENTATIVE NUMBER `,,, CUSTOMER µ 67 _ . v STORE NO. STR ADDRESS %"f �, STREET ADDRESS 1� / ra STATE ZIP §" A CITY STATE ZIP /441 t� nVL � m711 C)r fix; I, TELEPHONE. _i_jj. TELEPHONE _ 42- 4k 9q *... L9 7 Y M 6 DATE LOWE S HOME CENTERS LLC S MA HIC NO 148688 FEIN 564748358 r Cadre ceVR(.E " INSTALLATION STREET ADDRESS CITY STATE ZIP r Iii NOTICE TO CUSTOMER—PRICE CALCULATIONS: In order to property perform the installation of certain Goods,the Contract Price may include more Goods than actually will be installed based on the measured square footage of the Project Area.As a result, the parties agree that the lump-sum Pdce stated in this Contract is calculated upon both the value of estimated Goods required to fulfill the Contract(including waste),which may exceed the actual square footage of the Project Area,and the labor which may be estimated based on the amount of Goods required to futfill the Contract(including waste). By signing this Contract below,Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may not be refunded once the Installation Services are performed. Contract Total Are permits required for this installation?: [1t]Yes [ ] No "applicable tax included �f NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. NOTE: tf rotted wood is discovered during installation additional charges will apply.You will be given a quote and a change order must be completed and signed by the customer for any additional charges. Customer must Initial `Any work or materialnot specified is not included in this contract.Any changes or additions will be at an additional charge for the material and labor. PHOTO RELEASE: Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photographs of the Premises where Installation Services will be performed and all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right, title and interest in and to the photographs for use in all markets and media,worldwide, in perpetuity.Customer authorizes Lowe's to copyright, use andpublishthe photographs in print andtor electronically,and agrees that Lowe's may use such photographs for any lawful purpose,including,but not limited to,marketing, advertising,publicity, illustration, training and Web content. By initialing here, Customer agrees to the In . [Customer to initial to the left]. Work is to cojnmerl�e upon reasonable availability of Contractor and/or any special order or c .tom made Good(s)which is anticipated to be 1l S ff/� [fill In date]. Estimated completion date is [fill in date]. Said estimated substantial completion date is not of P essence.A statement of any contingencies that would materially change said estimated substantial completion date is as follows: y '�4 iNr's' . (if applicable,insert a statement of such contingencies). IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full. COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: fy�� Customer to Pay in Full; OR [ ]Customer to use the following payment schedule: - ' t`)Deposit $ to be paid upon signing contract.Deposit should be 1/3 the total contract price;and (2)Payment of $ to be paid anytime after this Contract is signed and before commencement of installation,IM/e authorize Lowe's to do one of the following(check appropriate box below): [ ]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or [ ]Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and (3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c.14 LOWE'S AND OWNER HEREBY_MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT LOWE'S MAY SUBMIT SUCH..fASP T. O A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF.THE EXECUT- ' IVE OFFICE((��F f•C)�SUME AFF ANp BUSINESS REG. iLATJONS ANI,;4THE OWNER:SF AI-LiB RV( ARED- S6 WIT V SUCH;kRBLTRATtON -r r.v, n w I � _ dfr [LPA r NOTICE TO CUSTOMER–PRICE CALCULATIONS: In order to property perform the installation of certain Goods,the Contract Price may include more Goods than actually will be installed based on the measured square footage of the Project Area.As a result,the parties agree that the lump-sum Price stated in this Contract is calculated upon both the value of estimated Goods required to fulfill the Contract(including waste),which may exceed the actual square footage of the Project Area,and the labor which may be estimated based on the amount of Goods required to fulfill the Contract(including waste). By signing this Contract below,Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may not be refunded once the Installation Services are performed. ontract Total a� Are permits required for this installation?: [)(J Yes [ 7NOT7-app'licable tax included NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. NOTE: If rotted wood is discovered during installation additional charges will apply. You will be given a quote and a change order must be completed and signed by the customer for any additional charges. Customer must initial. 'Any work or material not specified is not included in this contract.Any changes or additions will be at an additional charge for the material and labor. PHOTO RELEASE: Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photographs of the Premises where Installation Services will be performed and all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and interest in and to the photographs for use in all markets and media,worldwide, in perpetuity.Customer authorizes Lowe's to copyright,use and publish the photographs in print and/or electronically,and agrees that Lowe's may use such photographs for any lawful purpose,including,but not limited to, marketing, advertising, publicity, illustration,training and Web content. By initialing here,Customer agrees to the foregoin [Customer to initial to the left]. Work is to co nle.•/i.;e pon reasonable availability of Contractor and/or any special order or c "tom r made Good(s)which is anticipated to be [fill in date]. Estimated completion date is [fill in date]. Said estimated substantial completion date is not of tj,p essence.A statement of any contingencies that would materially change said estimated substantial completion date is as follows: f.r)Gee..i'ssa/' (if applicable, insert a statement of such contingencies). IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: OCustomer to Pay in Full; OR [ ]Customer to use the following payment schedule: Deposit $ to be paid upon signing contract. Deposit should be 1/3 the total contract price;and (2)Payment of $ to be paid anytime after this Contract is signed and before commencement of installation,I/We authorize Lowe's to do one of the following(check appropriatebox below): [ ]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or [ ]Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and (3) Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. - NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c.142A LOWE'S AND OWNER HEREBY UTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS ADISPUTE CONCERNING THIS CONTRACT,THAT LOWE'S MAY SUBMIT SUC ISP j, O A PRIVATE ARBITRATION SERVICE WHICH-HAS SEEN APPROVED BY THE SECRETARY OETHE EXECUT- IVE OFFICE,EE �SUME AFF AN©r8US1NESS REGJjLATjONS ANIS THE O,WNER7SHALLb REQUIRED TO SUBMIT to SUGH ARBITRATION AS PR'..^r' M. 142 . By: Date: Low(E on '[e L; /l BY: Date: S-/2 5& Owne ignature THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPARATELY SIGNED BY THE PARTIES. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT. BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.YOU ASE ENTITLED TO A COPY OOOVHIS CON 11ACT qT THE TIME OF SIGNAT RE. WITNESS OUR HANP(S')A SEA S)BELOW THIS;23 DAY OF ✓'s.L ate. Lowe' Hom to AJLowe's AuthorizedRe re ntative Co-owner or Witness Customer acknowledges receipt of a true copy of this contra M which was-1;mptely filled in prior to Customer's execution hereof.You,the buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation form for an explanation of this right. FILE COPY ®2004 byLowes."Lowe's and me gable design 55102 REV. 12/13 are registered trademarks of LF Cotporabon.