18 WILLIAMS ST - BUILDING INSPECTION 8 g CV
The Commonwealth of Massachusetts CITY OF
Board of Building Regulations and Standards SALEM
Massachusetts State Building Code,780 CMR Revised Mar 2011
(� Building Permit Application To Construct Repair,Renovate Or Demolish a
One-or 71vo-Family Dwelling
,\ `Thit 8ecdon For 0ffioial,Use ,
V°
Building Per�i#;i+ry>mther . . 1 appa�rl:
� sf
�;mmr�x�� slgaaime e
arcrit N.�:SM#Ni DII1w1A TIDN
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
12 wWnms
L la Is this an accepted street?yes_ no Map Number Farce]Number
1.3 Zoning Information: Am 1 1.4 Property Dimensions:
Zoning District Proposed Use 1 Lot Area(sq fl) Frontage(it)
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:
Zone: Outside Flood Zone? Municipal❑ On site sal stem ❑
Public❑ Private❑ — Check if es❑ P disposal SY
SECTION 2.PROPRRTYQWN=SIiIIa
2.1 9wnert f Reu d: Cn/���� G
K , Phut) 6( l a c I Q r n �city,sem,Z
Name(Print) ,
i n 5-+ 7y g&_5
No.and Street Telephone Email Address T
SECTION 3:DESCRUPMN.OF PROPOSED WOMO(ehe&all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repays(s) AReration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify:
Brief Description of Proposed World: S' ( c>
KCTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: olucial Use Only
(Labor and Materials
1.Building $ 1. Building Permit Fee:$ Indicate how fee is determinedi
Standard Cityffown Application Fee
2.Electrical $ O Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: S
4.Mechanical (HVAC) $
5.Mechanical (Five
$ Tocol All Fees:.$
Suppression)
b(7 C'edc No. Cheek Amount: Cask Amount:
6.Total Project Cost: $ ❑ Balance Due:
J �(r}�.� ❑Paid in FSili Outstanding
SECTIONS CONTRUCT[ONSERVIC136
5.1 Construction Supervisor License(CSL) C5-
10107
01� 7 6
f or c �iQl r O
License Number Expiration Date
Name of CSL Holder
�
; List CSL Type(see below)
-
M 1 t M� STT- Type pesc ptlon
No.and Street
VRC Restricted&2 Family Dwelling �.ft. ...
Nfasomy
Roofin CoverinS window and Siding
Solid Fuel Burning Appliances
Insulation
Tel hone Email ad Demolition
5.2 Registered Home I provement Contractor/(HIC)
CD, Mx( -, (1) l 4;CIK� \ r C C Registration Number Expiration Date
HIC Company Name or HIC Registrant Name i
o.and treet _C,t Email s
Ci /Town State ZIP Tel one-1
SECTION 6;V!'Q3iEM,CoMpENSATION INCE AF gDAVIT(A1 G[ c.152.§25G(�)
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 .......... No...........0
SECTION 7ae ONMER AUTHORMA TFD TO BE CONOLEMIR N
q MR'S NT O' OR F ..!. H1G PMI'T
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
0
� XI i
Print Owner's Name(Electronic Si ) Date
SECTION 76r OWNER'OR AUTHORMED AGENT'DECLARA'1TON
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 true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized Agent's Name(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 not 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
w�vw.mass.2ov!oca Information on the Construction Supervisor License can be found at www.nutss.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"
OW OF SALEA MASSAa-LEE 7T
BULrI GDVAXnffNi'
1201 A9ffMaM8nr>an,PROM
I1sL(478)75.9595.
% FAS 740.9M
D�ERiBYDdZLS00t:L
A&YCR 7?�a�rssST.P e
Dm u3mcrFEWWPRoPB W/BUMW4GoCMffMCNM
Construction Debris DisposaiAffidWit
(required forall demolition and.renovition work)
In accordance with the sbM edition of the State Building Code, 780 CMR, Sects 111.5 Debris,
and the provisions of MGL o40,S S4; &dww Permit fi is issued with the
condition that the debris resulting from this work shall be disposed of in a properly lroensed
waste deposit facility as defined by MGL c ill, S 1564.
The debris will be transported by.
(name of hauler)
The debris will be disposed of in:
(name of facility)
(address of facility)
Signature of applicant
vc� �
—°— Date
f
r.
Estimate
ldcensed E Insured
"The right hand for the job" Date Estimate#
=MOB w
7/29/2016 628
271 Western Ave Suit#211D
Lynn MA 01905
Name/Address Project Address
Kimberly
18 Williams St.
Salem MA
Description Total
The following Estimate for the property located at above address.
The following paragraphs explain the work that Mendez Contractor will carry out.
SCOPE OF WORK:EXTERIOR PAINTING
EXTERIOR PAINTING
• Scrape off and light sand any loose paint with a paint scraper
• Power wash the exterior
• Fill in cracks and holes with a paintable caulk or putty
• Re-nail any loose clapboard and trims
(Note:any(rotten wood)carpentry we will do an additional charge)
• Apply oil base primer over surfaces
• Apply 2 coat of white exterior paint on trims
• Apply 2 coat of exterior paint on body
TOTAL FOR LABOR AND MATERIAL 2,625-00
TOTAL FOR LABOR AND MATER
CLAPBOARD SIDING INSTALLATION
-Remove old clapboard siding
•Install new Tyvek ,
•Install new flashing on top of windows and doors
•install new ice and water shield 4"wide around windows and doors(3 windows in total)
•Install new PVC trims and comers
•Install new water table 1"x 10"
•Install new clapboard siding
•All penetrations shall be property sealed
TOTAL FOR LABOR AND MATERIAL 5,425.00
TOTAL FOR (water table and 3 windows) 625.00
Total
Page 1
Estimate
Licensed S lnIured
°Tberlghthandforthejob- Date Estimate#
"MMIM 7/29/2016 628
271 Western Ave Suit#211D
Lynn MA 01905
Name/Address Project Address
Kimberly
18 Williams St.
Salem MA
Description Total
At
ctorVlHome Owner
Walt r ridez ales Manager
t
www.mendezcon ctor.com
Payment terms: .0 000.00
$4,000.00 down payment
$3,000.00 upon the job is in progress
$ 1,675.00 upon the job is completed
NOTE: Any alteration will be approve by all parries before is done Total $8,675.00
these may result an extra charge.
Page 2