113 BRIDGE STREET - BUILDING INSPECTION l i:� d
;,
a
Cite of Salem, ff1a!5garbu!6Ptt!6
i i s Public Propertp Department
jBuilbing Mepartment
One&a[em Breen
(976) 745-9595 Cst. 380
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer March 4, 1998
Elizabeth Murphy
5 Newhall Place
Peabody, Mass.01960
RE: 113 Bridge Street
Dear Elizabeth:
Due to a complaint received by the Neighborhood Improvement Task Force, I
conducted an inspection and found the following violations:
1 . You must prevent snow and ice from falling from the roof of 113 Bridge
Street, the driveway side of 113 1/2 Bridge Street by means of installing
a gutter or by installing snow guards . We have reports of snow falling
onto pedestrian traffic.
2. You have oil spillage around the area were the oil fill pipe is located
on the driveway side of 113 1/2 Bridge St. Please speak to youroil
delivery services to be more careful while delivering oil to 113 Bridge
St.
Please notify this department within fifteen (15) days upon receipt of
this letter, to inform us as to what course of action you will take to rectify
these violations . Failure to do so will result in legal action being taken
against you.
Thank you for your anticipated cooperation regarding this matter.
Sincerely,
Leo E. Trembla
Inspector of Bldings
LET: scm
cc: Jane Guy
Councillor Flynn, Ward 2
r
9
r W excc
NEIGHBORHOOD IMPROVEMEW171TASK FORCE
REFERRAL FORM . Dept.
n<
Salem Pian ^�
Date:
Address: //39G -
p <
Complaint:
W 77-
Complainant: Phon ' S
Address of C• mplainant:
D HA-I-R-M-AN KEVIN HARVEY
BUILDING INSPECTOR ELECTRICAL DEPARTMENT
FIRE PREVENTION CITY SOLICITOR
HEALTH DEPARTMENT SALEM HOUSING AUTHORITY
ANIMAL CONTROL POLICE DEPARTMENT
PLANNING DEPARTMENT ASSESSOR
TREASURER/COLLECTOR DPW
WARD COUNCILLOR
SHADE TREE
P�G4�in
PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO 1300E
S�.a-WITHIN ONE WEEK. THANK YOU FOR YOUR ASSISTANCE.
ACTION:
3�. Citp of *alem, 41a!6!5arbu!5ett5
t s Public Propertp Mepartment
jBuilbing Mepartment
®ne 16alem Oreen
(978) 745-9595 Cxt. 380
Peter Strout
Director of Public Property
Inspector of Buildings
_ Zoning Enforcement Officer
February 24, 1999
Ms. Elizabeth Murphy
5 Newhall Place
Peabody, Ma. 01960
RE: 113 Bridge Street
To Whom it May Concern:
This department has received complaints by your neighbor, relative to your gutter and
downspout spilling water on their driveway.
Please rectify this problem or call the Building Department to inspect or advise you on
solving this problem.
Thank you in advance for your anticipated cooperation in this matter.
Sincere ,
Peter trout
Zoning Enforcement Officer
Leo E. Tremblay
City Salem p
Budding Department
One Salem Green
Salem, Ma 01970
Dear Leo:
In response to your letter concerning violations at my property n 113 Bridge St.,
the following has been my course of action:
1. Although there was no noticeable oil spill, I did notify my oil delivery man and
advised him to please be careful when he delivers oil.
2. As far as installing gutters or snow guards on the roof, I prefer not to cover the
architectural features at the roof line. If someone from neat door has reported
snow falling, it must be because a car is parked illegally in the right-of-way.
Pedestrians from the house neat door can walk further away from the house.
Thank you for notifying me of the Neighborhood Improvement Task Force's concerns.
Sincerely yours,
Elizabeth Murphy
(Eftp of i§alem, 'q1a!5!6arbU!5ett!5
Public Propertp Mepartment
�p �Guitbing Mepartment
(One&alem green
(978)745-9595 Cxt. 380
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer March 4, 1998
Elizabeth Murphy
5 Newhall Place
Peabody, Mass.01960
RE: 113 Bridge Street
Dear Elizabeth:
Due to a complaint received by the Neighborhood Improvement Task Force, I
conducted an inspection and found the following violations:
1 . You must prevent snow and ice from falling from the roof of 113 Bridge
Street, the driveway side of 113 1/2 Bridge Street by means of installing
a gutter or by installing snow guards. We have reports of snow falling
onto pedestrian traffic.
2. You have oil spillage around the area were the oil fill pipe is located
on the driveway side of 113 1/2 Bridge St. Please speak to you oil
delivery services to be more careful while delivering oil to 113 Bridge
St.
Please notify this department within fifteen (15) days upon receipt of
this letter, to inform us as to what course of action you will take to rectify
these violations. Failure to do so will result in legal action being taken
against you.
Thank you for your anticipated cooperation regarding this matter.
Sincerely,
Leo E. Tremblay
Inspector of Buildings
LET: scm
cc: Jane Guy
Councillor Flynn, Ward 2
GUM INSURANCE COMPANIES®
PERSONAL LINES DIVISION
8 VISTA DRIVE
SOUTH LYME,CT 06376-0701
203/434-6500
FAX 203/434-0520
MAILING ADDRESS:
P.O. BOX 701
SOUTH LYME,CT 06376-0701
TO: X) Building Commissioner or Inspector of
Buildings
( ) Board of Health or Board of Selectman
( ) Fire Department '
RE: Insured:
Property Address:
6lq-� 6
Policy Number: t��
Loss of: WAq v ) 0` dAje 4D lGt_ JAW,
Claim Number: V?,q—jb 97JvJ
Claim has been made involving loss, damage, or destruction of
the above-captioned property, which may either exceed
$1 ,000.00 or cause Mass. Gen. Laws, Chapter 143 , Section 6 ,
to be applicable. If any notice under Mass. Gen. Laws,
Chapter 139 , Sec. 3B is appropriate please direct it to the
attention of the writer and include reference to the
captioned insured, location, policy number, date of loss, and
claim number.
On this date, I caused copies of this notice to be sent to
the persons named above at the addresses indicated above by
first class mail .
6ti1kt !V - ham
Date: 2,� I gJ q q Adjuster
GREAT AMERICAN INSURANCE COMPANY•AMERICAN NATIONAL FIRE INSURANCE COMPANY•AMERICAN ALLIANCE INSURANCE COMPANY•AGRICULTURAL INSURANCE COMPANY
SUBSIDIARIES OF AMERICAN FINANCIAL CORPORATION
J.DIMENSIONS 3 M. DEMOLITION OF STRUCTURES:
48. Number of stones ............................................................
49. Total square feet of floor area pp Has Approval all floors,based on exterior oval from Historical Commission been received
dimensions ......................................................................... for any structure over fifty(50)years? Yes_ No–Z
50. Total land area,sq.ft. ................ Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed........... ..........._..........................................
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
52. Outdoors........... . Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed ............................................................................ Electric:
Gas:
54. Number of full......:........6...................... Sewer:
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial...................................... BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No (If yes, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ No (If yes,please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No_
Is property located in the S.R.A.district? Yes_ No
Comply with Zoning? Yes_ No_ (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No (If yes,submit documentation/if no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ No
Is Architectural Access Board approval required? Yes-_ No (If yes, submit documentation)
Massachusetts State Contractor License Salem License#
Home Improvement Contractor# 1114, 57 Homeowners Exempt form (if applicable) Yes_ No
CONSTRUCTION TO BE COMMENCED WITHIN SIX (6) MONTHS OF ISSUANCE OF BUILDING PERMIT
If an extension is necessary, please submit
CONSTRUCTION IS TO BE COMPLETED BY: in writing to the Inspector of Buildings.
V. IDENTIFICATION - To be completed by all applicants
Name Mailing address-Number,street,city,and state ZIP Code Tel.No.
Owner or
Lessee
2. fan ii �� f Fv g o/9�S Psi
Contractor Builders
AQ
!C /- y,,Q p�/�j' License No. ��j95'
Archllec3. t or OC4AEL A J- '
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his authorized agent and we agree to Conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
ltlulq
No. 3 City of Salem Ward _
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT•Applicant to( /ms
complete all items X.
s in sections:1, ll, Ill, IV,and I
I. AT(LOCATION) 113 d R1�6E /r ZONING STICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING )CROSS STREET) (CROSS LOTET)
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING -All applicants complete Parts A -D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION"USE MOST RECENT USE
1 ❑ New building Residential Nonresidential
2 ❑ Addition(It residential,enter number of new 12 ❑ One family 18 ❑ Amusement,recreational
housing units added,it any,in part D,13) 19 Chruch,other reli pus
13 �wo or more family-Enter number { g
3 ❑ Aheration(See 2 above) of units....................................................... l0 21 ❑ Industrial
21 ❑ Parking garage
4 0 Repair replacement 14 ❑ Transient hotel,motel,or dormitory-
Enter number of units .........................-
22 ❑ Service station,repair garage
5 ❑ Wrecking(N muttttamily residential,enter number23 ❑ Hospital,institutional
C]of units in building in Part D,13) 15 Garage
24 ❑ Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
7 ❑ Foundation only 17 ❑ Ocher-Specify 26 ❑ School,library,other educational
27 ❑ Stores,mercantile
B.OWNERSHIP 28 ❑ Tanks,towers
8 Erprivate(individual,corporation,nonprofit
institution,etc.) 29 ❑ Other-Specify
9 ❑ Public(Federal,State,or local government
C.COST .(Omit cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
machine shop,laundry building at hospital,elementary school,secondary school,college,
parochial school,parking garage for department store,rental office building,office building
10. Cost of improvement ......................................................... $ at industrial plant.If use of existing building is being changed,enter proposed use.
To be installed but not included n gem
q n
in the above cost 'C� [MCC /ems// t-Ifyeas
a. Electrical........................................................................... '
b. Plumbing ......... f/y AZAV
c. Heating,air Conditioning.............................................
d. Other(elevator.etc.).....................................................
11. TOTAL COST OF IMPROVEMENT S i ODI)
III. SELECTED CHARACTERISTICS OEOMILDING -For new buildings and additions, complete Parts E-L;demolition,
complete onlyParts J& M, all others ski IO IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ® Gas 40 Public or private company Will there be central air
31 Wood frame 36 ❑ Oil 41 ❑ Private(septic tank,etc.) conditioning?
32 ❑ Structural steel 37 ❑ Electricity 44 ❑ yes 45 If No
33 Reinforced Concrete 38 Coal H. TYPE OF WATER SUPPLY
❑ ❑ Will there by an elevator?
34 ❑ Other-Specify 39 ❑ Other-Specify 42 ® Public or private Company 46 ❑ Yes 47 ❑ No
43 ❑ Private(well,cistern)
JDB //3 2rz./br-,- S7- SA2 ✓/y /1 A
CONSTRUCTION ENGINEERING SERVICES
12 Pleasant Street SHEET NO. of
NEWBURYPORT, MASSACHUSETTS 01950 �z CALCULATED BY DATE 4 -t 9-24
(508) 465-2216
CHECKED BY DATE
SCALE
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Kwan ml�svge sr�/zsi/rbaea�®.rK.,wam xm.of n i.m aa.wor¢mu rxa Imo-ana+m '
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building / _ FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19 Fire Grading
Building V /�
Permit Fee $ / �6 C7 Jnr Live Loading
Certificate of Occupancy $ Approved by: Occupancy Load
Drain Tile $
Plan Review Fee $ l
/,2f
TITLEV
NOTES AND Data - (For department use)
466
tAll iroLatiw�S wiG Qe ,✓ gy ' V425'
#aeY; a9_-y'E OgDs 4//1t ,rejW fW 414 �1vvvSo
G CZ �Dl �✓/�L O� /z�lAc� t✓i7 8 V— 2x/o AS
.t/
PERMIT TO BE MAILED TO: 8 �FjGQ Sf 'QEj/ /LjA -9
DATE MAILED:
Construction to be started by: Completed by:
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
SITE OR PLOT PLAN •For Applicant Use
7b
k4�
r
f �aXem, assarhnse##s
� Aire Bryartmerd Xeadquarters
Tames Prennan
Y FECFIVE0M4SS. 48 Pfage#e *treet
(f[hief CITY OF. Salem, cma_ 01970
Dec. 9, 1980
Building Inspector Gauthier Re:H. A.1V, C Occupancy
One Salem Green 113 Bridge Street
Salem, Mass.
Sir:
The fire department finds this occupancy requires some attention
in regards safety of the occupants. As agreed upon after inspection
the items are under your jurisdiction and it is understood that
a letter will be sent on. the subject to the owners of record and the
occupants, by you.
For your information the following addresses are noted:
Owner of Record: Edward and Kalliope IuMurphy, 5 Newhall Place,
Peabody, Mass. 01960
Occupants mailing address: H. A.W. C. Community Office, 9 Crombie St.
Salem, Mass. 01970 % Ms. Carol Bergman
Hot Line phone 744-6841
Present office phone 532-1680 (to be changed
to a Salem number shortly)
Suggest mention be made of broken plaster over boiler in basement.
Openings in chimneys (2) and other pourous areas of chimney.
Rear egress from all floors to be kept clear and available.
WaD
y subm tte�
l
oggin
Salem Fire Marshal
cc : Health Dept. (Lubas)
file
d
r
f
• e '
� • f
< poMoi Ago t / 1}i -
;' r j �it1 I71cT�k111.� �l �Zb > � ��
Public 11ropertu it ai#utettf
s" �a�"� ii:lllillili ±1c zirtnten#
Robert E. Gauthier
0 iw -5alrm OSrrrii
715-0213
December 16,1980
H.A.W.C. Community Office.
9 Crombie Street Re: H.A.W.C. Occupancy
Salem,Ma 01970 113 Bridge Street
c/o Ms. Carol Bergman Salem,Ma 01970
Dear Ms.Bergman:
Inspection of 113 Bridge Street by myself, Captain David Goggin,
Fire Marshal, and Joseph Lubas-Health Department shows:
1. Exitways were very poorly maintained and cluttered. It is necessary
that all egresses be kept clear and available in case of fire.
2. Plastered ceiling at boiler area should be repaired.
3. Doors from common areas should be repaired.
4. Trash in basement should be removed.
5. Openings to existing chimneys should be properly sealed.
6. Existing chimney on south side of building should be repaired.
Excessive heat at plastered wall indicates that the chimney should
be repaired or replaced.
Immediate attention should be taken to clear up these conditions. The
safety of the occupants, especially the young toddlers and infants rest in
your hands.
Would you kindly call this office for an inspection as soon as these
matters have been attended to.
Very truly yours,
Robert Gauthier
Director of Public Property
RC:m 77, (
cc: ea&tDeD Dgtt614:bBs)Goggin)
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
Massachusetts State Building Code, 780 CMR,7 h edition OF SALEM
Revised January
J / Building Permit Application To Construct, Repair,Renovate Or Demolish a 1, 2008
One-or Two-Family Dwelling
This Sectio r Official Use Only
Building Permit Number: �,,�, a ppli d: / j
Signature: -"Q "" ��' / •3//o
Building Commissioner/Ins or of Buildings Date
SECTION 1: S T INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
JlyzzyLE VX96 '-
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning Dist—net Proposed Use Lot Area(sq ft) Frontage(R)
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? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP[
2.1 Owner[of Record: - -
Name(Print) Q Address for Service:
Ir/I.r 3 78 - 5 9 y - 171 y
Signature Alf Telephone
,.+SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) Alteration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work2: ?e t�CL —rD JZ�^2 aS; "o t JG7, 2_ C^L A.J
�.�eA C.L. z si7+'ut�I�L1C.. P"S C�1E�SA2Y
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
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 $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire Suppression)
$ Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.11 Licensed Construction Supervisor(CSL) Cf �61 sd �3 Z
tG 03� � /"'C GGA u�L License Number Expiration Date
Name of CSL-Holder
List CSL Type(see below) l>
Address Type Description
�� U Unrestricted u to 35,000 Cu.Ft.
> R Restricted l&2 Family Dwelling
Signature7&,,,,�C0— 7 C/ ?_7 M Masonry Only
RC Residential Roofing Coverin
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance:Installation
D Residential Demolition
5 � Re�r'stered Home Improvement Contractor(HIC) Ary2O g,
'%a3c/LT HG4 aoJF l r.I
HIC Company Name or HIC Registrant Name Registration Number
/Y A�,4 Age:/tx-i .. 5=- Afez'Fa,27-, ivs .4-- �Z 3�>
ress 4 � ��� /�y Q y$7 Expiration Date
Signature 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 ..........`{x No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, G V Q m A G K;ti h gy, c()h d 0 T r e 9 S u rer s Owner of the subject property hereby
authorize 7,anetmr p to act on my behalf, in all matters
relative to work authorized by this building permit application.
7/9/2010
Si nature of Owner Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
I; /i„/"���� 1,4C p...,,.0 t as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are[rue and accurate,to the best of my knowledge and
behalf.
Pri ame / /2G/cam
Signature of Owner o Authorized Agent Date
(Signed under the pains and penalties of 'u
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 and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.R6 and 110.115,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 Cost"
CITY OF S�U.E:Nt, .L%LXSSACHUSETTS
• BUILDING DEPARTNEENT
• 120 WASHINGTON STREET,San FLOOR
TEi_ (978)745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR 'it•IodtAs Sr.P1ERRl3
DiP.ECt'OR OF PUBLIC PROPERTY/BL'ILDLNG COMMISSIONER
Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leelbiv
dame(Business.organizatioNmdividual): IDLIi�)
Address: IV�✓�2E�s�g�. r mil;
City/State/Zip: AA .I 02.-,rr Phone #: ���OO'OS187
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ 1 am a employer with 4. ❑ 1 am a general contractor and 1
employees(full and/or part-time).* have hired the sub-contractors 6. El New construction
1 on a sole proprietor or partner- listed on the attached sheet.t 7• El Remodeling
ip and have no employees These sub-contractors have 8. ❑Demolition
workingfor me in an ca ci[ , workers'comp.insurance.
Y Pa Y 9. ❑Building addition
[No workers'comp.insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions
myself.(No workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs
insurance required.)t employees.[No workers' 13.❑Other
comp. insurance required.]
Any applicant that checks box bl most alas till out the sactioa below showing their workers'comprnaation policy information.
t I ttxrteowren who submit this affidavit indicating they arc doing all work and then hue outside eonuacan mutt submit anew affidavit indicating s tch,
:Cresson that check this box most anached an additional shm showing the ones,of the sub•oontractora and their workers'comp,policy information,
l am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site
information.
Insurance Company Name:
Policy#or Self-ins. Lic.#: Expiration Date:
Jab Site Address, City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 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 hereby certify
under lire pains anddlienallies of perjury that the information provided above is true and correct.
Sienalure:
I
Phone x: t�'7 rs' -SGo — 0Y7-7
Official use only. Do not write in this area,to he completed by city or town ojjicial,
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Ilealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing inspector
6.Of her
Contact Person: Phone#:
CITY OF S.ULE`I, .NAxsS.ALCHLSETTS
• &;II.DLIIG DEPARTMENT
• 120 WASHLNGTON STREET, 3' FLOOR
'I-EL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOI L
1l
MAYOR -tOdIAS ST.PIERR&
DIRECTOR OF PUBLIC PROPERTY/BUIO DING CO%WISSIO,iER
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 properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
-FA yyrx� —as-+7,oa tac—
(name of hauler)
The debris will be disposed of in :
(name of facility)
fi,e4)xSZuizy A-
(address of facility)
signature of permit applicant
date
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OWNER/CONTRACTOR AGREEMENT
q. Robert McGlauflin
14 Wareham SL Medford, MA
978-500-0487
RMCGlauflin@RDMWoodwarking.com
MA CSL#078044, MA HIC#135473
DATE: July 8.2010
OWNER'S NAME: 1798 Dwinneff Quimby House Condo Trust
ADDRESS: 113 Bridge Street Salem. MA -
PROJECT ADDRESS: Same as above
A.PARTIES
This contract('Agreement)dated as of the last date of signing by a signing party('effective Date*), by and between 1798
Dwinnel Quimby House Condo Trust('Owner"); and Robert McGlauflin ('Contractor). In consideration of the mutual promises
contained herein, Contractor agrees to perform the following work, subject to the terms and conditions below:
Contact P rson for ndo,Associa1 /
Name: �V4h CtC b OVIpO �re9S�' �
Unit#: O p ep
Phone#: -1 1 kl (Cemork):
(This person shall have the ability to authorize the contractor to complete additional work on the behalf of the condo association.)
B.GENERAL SCOPE OF WORK DESCRIPTION
REPLACE REAR DECK AND STAIRWAY:
- Demo&'dispose of existing deck.
- Chip patio and dig three(3) holes for 4'deep footing as needed.
- Place concrete for footing and patio repair as needed.
- Frame new pressure treated deck with same configuration as existing.
- Install pressure treated decking with galvanized nails.
- Build new railing with 2x2 pressure treated balusters.
- Repair rot caused by existing improper deck flashingfconstruction. This work will be conducted on a time and material
bases at($50.00)fifty-dollars per man-hour and(5%)five-percent mark up on materials/services secured by the contractor.
Due to the nature of this work no estimate can be given, however the condo association will be updated as necessary of the
extent of the repair.
Contractor will secure the required Building Permit with the City of Salem as the homeowner's agent.
(Owner who secure their own permits will be excluded from the Guaranty Fund provisions of MGL Chapter 142A.)
C.LUMP SUM PRICE FOR ALL WORK ABOVE' $8,850
This Agreement will expire 15 days after the date at the top of page one of this Agreement if not accepted in writing by Owner and
returned to Contractor.
Ill.GENERAL CONDITIONS FOR THE AGREEMENT ABOVE
D.EXCLUSIONS
This Agreement does not include labor or materials for the following work:
1.PROJECT-SPECIFIC EXCLUSIONS:
-Electrical work
-Plumbing
-Paint, sealing, staining.
(These services if required/needed can be secured by the contractor as a change order)
-The above Lump Sum Price does not include any of the rot repair work.
2.STANDARD EXCLUSIONS: Unless specifically included in the'General Scope of Work'section above,this Agreement does
not include labor or materials for the following work:Plans,engineering fees,or governmental permits and fees of any kind.Testing.
removal and disposal of any materiels containing asbestos(or any other hazardous material as defined by the EPA).Moving Owner's
property around the site.Labor or materials required to repair or replace any Owner-supplied materials.Final construction cleaning
LCantradgr will lea sit is n-broom swept condition).correction of existing out-of-plumb or out-of-level conditions in existing
Contractor Owner
i
structure.Correction of concealed substandard framing.Rerouting/removel of vents,pipes,ducts,structural members,wiring or
conduits.Removal and replacement of existing rot or insect infestation.Failure of surrounding part of existing structure,despite
contractor's good faith efforts to minimize damage,such as plaster or drywall cracking and popped nails in adjacent rooms or
blockage of pipes or plumbing fixtures caused by loosened rust within pipes. Exact matching of existing finishes.Repair of damage to
roadways,driveways,or sidewalks that could occur when construction equipment and vehicles are being used in the normal course of
construction.Cost of cortactirgAestinglremediatirg mok}Rungus/mildew and organic pathogens unless caused by the sole and active
negligence of Contractor as a direct result of a construction defect that caused sudden and significant water infiltration into a part of
the structure.
E.DATE OF WORK COMMENCEMENT AND SUBSTANTIAL COMPLETION
Commence work: Contractor will file for Building Permit with the City once contrail has been signed by all parties and
start work upon receiving building card from city.
Since the extent of the of the rot repair portion of the work is unknown it is not possible for the contractor to provide a
date for substantial completion at this time. However, the contractor understands that time is of the essence and will
work faithfully on this project thru completion.
Not including delays and adjustments for delays caused by.holidays;inclement weather;accidents;shortage of labor or materials;
additional time required for Change Order and additional work;delays caused by Owner,Owner's design professionals,agents,and
separate contractors;and other delays unavoidable or beyond the control of the Contractor.
F.CHARGES FOR ADDITIONAL WORK:CONCEALED CONDITIONS,DEVIATION FROM SCOPE OF WORK,AND
CHANGES IN THE WORK
1.CONCEALED CONDITIONS:This Agreement is based solely on the observations Contractor was able to make with the project
in its condition at the time the work of this Agreement was bid.If additional concealed conditions are discovered once work has
commenced or after this Agreement is executed which were no visible at the time this Agreement was bid,Contractor will point out
these concealed conditions to Owner,and these concealed conditions will be treated as Additional Work under this Agreement.
Contractor and Owner may execute a Charge Order for this Additional Work.Contractor is released,held harmless,and indemnified
by Owner from all pre-existing mold,fungus,mildew,and organic pathogen problems and is no responsible for costs or damages
associated with correcting,containing,testing,or remediatirg the same.
2.DEVIATION FROM SCOPE OF WORK:Any alteration or deviation from the Scope of Wok referred to in this Agreement
invoking extra costs of materials or labor will be treated as Additional Work under this Agreement resulting in an additional charge to
Owner as set forth herein.Contractor and Owner may execute a Change Order for this Additional Work-
G.PAYMENT SCHEDULE AND PAYMENT TERMS
1.PAYMENT SCHEDULE:
•First Payment 30%Upon all parties signing Contrail 2 283.00
•Second Payment 30% Upon passing Rough Inspection by the City: $2,283.00
•Final Payment Balance upon Substantial Completion of all work deemed satisfactory by all Parties $2284.00
•The Rot repair portion will be paid by weekly due upon submittal of invoice by Contractor.
2.PAYMENT OF CHANGE ORDERS/ADDITIONAL WORK: Payment for Additional Work is due upon completion of
either all or part of the Additional Work and submittal of invoice by Contractor.
H.WARRANTY
Your satisfaction with our work is a high priority for us,however,not all possible complaints are covered by our warranty.Contractor
does provides a limited warranty against material defects on all Contractor and subcontractor-supplied labor and materials used in
this project for a period of one year following substantial completion of all work.This warranty covers normal usage only.You must
contact the Contractor at the address on page one of this Agreement in writing for warranty service immediately upon discovering an
item in need of warranty service.If the matter is urgent you must also call the Contractor and send written notice of the need for
warranty service.Failure to notify the Contractor of the need for warranty service within ten days of discovery of a warranty item may
void this warranty.Additionally,Owner's hiring of others or direct actions by Owner or Owner's separate contractors to repair a
warranty item are not covered by this warranty and will not be reimbursed by Contractor.
No warranty is provided by Contractor on any materiels furnished by the Owner for installation. No warranty is provided on any
existing materials that are moved and/or reinstalled by she Contractor within the dwelling or the property(including any warranty that
existing/used materials will no be damaged during the removal and reinstallation process).One year after substantial completion of
the project,the Owners sale remedy(for materials and labor)on all materials that are covered by a manufacturers warranty is strictly
with the manufacturr,qpt with the Contractor.
Contractor—
�S r Owner
Repair of the following dams and related damages of every kind are specifically excluded from Contractor's warranty:problems
caused by lack of Owner maintenance;problems caused by Owner abuse,misuse,modification,or atterstion:and ordinary wear and
tear.Damages resulting from mold,fungus,and other organic pathogens are excluded from this warranty unless caused by the sole
and active negligence of contractor as a direct result of a constnction defect which caused sudden and significant amounts of water
infiltration into a part of the structure.Deviations that arise such as the minor cracking of concrete,stucco,and plaster;minor stress
fra hires in drywall due to the wring of lumber,warping and deflection of wood;shrinking/cracking of grouts and caulking;fading of
paints and finishes exposed to sunlight are all typical(not material)defects in construction,and are strictly excluded from Contradoes
warranty.
I.WORK STOPPAGE AND TERMINATION OF CONTRACT FOR DEFAULT.
Contractor shag have the right to stop all work on the project and keep the job idle if payments are not made to Contractor in
accordance with the Payment Schedule in this Agreement,or if Owner repeatedly fails or refuses to fumish Contractor with access to
the job site and/or product selections or information necessary for the advancement of Contractors work.Simutarreous with stopping
work on the project the Contractor must give Owner written notice of the nature of Owners material breach of this Agreement and
must also give the Owner a 14day plod In which to cure this breach of contract Owner to follow this same notice procedure with
Contractor if Owner alleges Contractor is in material breach of this Agreement.
If work is stopped due to any of the above reasons for a period of 14 days,and the Owner has failed to take significant steps to cure
his default,then Contractor may,without prejudicing any other remedies Contractor may have,give written notice of lamination of the
Agreement to Owner and demand payment for all completed work and materials ordered though the date of work stoppage.
Thereafter,Contractor is refarved from all other contracsual duties,including all Punch List and warrantrwork.
J.ENTIRE AGREEMENT,SEVERABILITY,AND MODIFICATION
This Agreement represents and contains the entire agreement and understanding between the parties.Prior discussions or verbal
representations by Contractor or Owner that are not contained in this Agreement are not apart of this Agreement. Any future
modification of this Agreement should be made in writing and executed by Owner and Contractor.
K.DISPUTE RESULATION
The contn;ctorard the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning
this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of
Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c
142A.
L ADDITIONAL LEGAL NOTICES REQUIRED BY STATE OR FEDERAL LAW
All home improvement contractors shall be registered and that any inquiries relating to a registration should be directed to:The Office
of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170,Boston,MA 02118,617-973-8700.
The Owner may cancel this agreement if it has been signed at a place other than the contractors normal place of business,Provided
you notify the contractor in writing not later than midnight of the third business day following tie signing of this agreement.
This agreement shall be governed by and construed in accordance with the laws of the commonwealth of Massachusetts.
Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the contract shall
not imply that any lien or other security interest has been placed on the residence.
- Don't be pressured into signing the contract Take time to read and fully understand it Ask questions if something is unclear.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Two identical copies of the wmraa must be oo npletod and signed.One copy should go to the hmm:owner.The odw copy should be kept by the contractor.
I have read and understood,
,aandd I agree all the terms and conditions contained in the Agreement above.
A� CONTRAC OR'S I 'NATURE
• DATE 'S S_ iGNATU E
Unit 1 vP►^-y
'S SIG
Unit 2
R'S N E
Unit 2R ,r/4 I
ER'S SI RE
Unit 3 .r
Contractor Owner
fI4*NSiMIlSfi13EfIW644ND APPROVED BY T44E
JUSMIDRR PR1DR TD A PERW BEING GRANTED
CITY OF SALEM
No.
9� - 04
Date _
Ward
Zoning District
Is Property Located in Location of )
the Historic District? Yes NO �p -
Is Property Located in
the ConeervatIon Area? Yee No_
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Cpnstruct Deck, ghed, Pool,
Repair/Replace, Other:_ �'�,�pp��fw'
v ,
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit toIbuild accorckig,to the.following
specifications:
Owner's Name —J
Address & Phone trr r'J' ( t
Architect's Name
Address & Phone If
Mechanics Name �t el�iP
Address & Phone _ �
What Is the purpose of building?
Material of wudlnp? 1 17,E If a dwe",for how many famYlse?
Wa building conform to law? yCi� %sDsetos? hU
Estlmated cost �`Sz5>�-) , GIy Licer"a state Licer,w e
Noise Improvement
1 Lfc. i
V .J 'Signature of Applicant
SIGNED UNDER THE PENALTY`
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO: 4-
i �
3
1
No.\ J /
APPLICATION FOR
�y PERMIT TO
AT'oo
LOCATION
PERMIT GRANTED
19
APPfIOVFD
v
INSPECTOR OF BUILDINGS
# = BOARQ `
ILi2 OF BUlLDI G REOULATIONS 5�
ense: pp �J N57RUCTI(JN SUI�ERVI$OR'Number
�4378
aqr
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+ 12/29p8 v ` Tr.no 84378 t,
RIC R ,' Restdcted QO .
' 94 LIME ST DEVj)VE x " .
ORT,
- b •.1J.paor.e.at�.11ydal..�al..b•
�.aw 1 uasm+ S.bw /I/a.re>.A 021/
caweeaa..
/ Workers
Comperwdon Imursnce Affidsyit
. . wkb.a princhw place of business:at:
do hereby'cersffy under s)w pains and penildes of pal.w sloe
() I am an employer providing workers' compensation coverage for my eioployeta working an
dab jolt.
Insurance Compaq I Pena Number
I am a sole proprietor and have no one working for me In airy capsdsy.
() 1 am a sok proprksor, general contractor or homeowner (drde ens) and how hired drs
contractors lined below, who have she folknring workers' compensation policiess
Contractor Insurance Compa y/PolleIr Number
Contractor Insurance Company/Policy Number
contractor Insurance Company/Policy Number
0 1 am a homeowner ptriorming all the work myself.
•I efepw"am a can of cede wwnww we be kin.rwd a. an (Mica it b"C*aseie of.w DIA fer ce.erare.eelacsem and era Urge a rasa
roman/ X ioawea after Seei.n 23A of MGL 15 2 can km.o ow nwea.ee of ow"m at"Wa eerueint 618 aae.1 w 04 I.MCM ewer sew
+son':+w.omwat a%a a drr wferia in Ore jam*I a STOP WORK OR.DD ER a.w/a ins of S 100A08 4a SPI w.w.
Signed chit • day of / `��✓U
.iccrsceiFcrmittee iuild.ns Department
ictnsinir Ecare
Seleamens Office
=ejlsh De;;gamier*
(+
_. eQe ec eke 77c
s
PUBLIC PROPERTY DEPARTMENT
120 WAsHiNOTON STREET, SRD FLOOR
SALEN.MA 01970 .
TEL (976)749-9595 EXTI 880
FAX (976) 740.984E
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of M(X c 40,S34,I acknowledge that as a condition
of Building Permit d_ . all debris resulting from die construction activity
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility,as defined by MGL c III,S150A.
The debris will be disposed of st
do of Facility
7 z�
Signature of Permit Applicant Date
FULLY complete the following information;
(PLEASE PRINT CLEARLY)
w1a x z
NEW of Permit Appli
Firm Name,if any
Address,City state
The above statute requires that debris fiom the demolition,renovation,rebab or other
a teradon of building or structure be disposed in a properly_licensed solid-waste disposal
facility as defined by MGL c1II, S 150A, and the building permits or licenses are to
indicate the location of the facility.
a