BAKERS ISLAND - BUILDING INSPECTION (37) o f I
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
*� Massachusetts State Building Code, 780 C MR, 7ih edition OF SALEM
Revised Juntrury
Building Permit Application To Construct, Repair, Renovate Or Demolish a 1. 20011
One-or Two-Fumily Dwelling
This Section For Offt ial Use Only
Building Permit Number: D to pplied: L D
Signature: ' tJ
Building Commissioner/Inspect ui dings
i
SECTION 1:SITAfNF6ltMATION
LI Pro erty Addre 1.2 Assess rs Map& Parcel Number
Meld y
I.1a Is this an accepted street?yes no / Map Number Parcel Number
1.3 Zonnlo lnformatlon: 1.4 Prop7,/rty�Yensions: IVIA
Zoning District Propose Use Lot Area(sq 11) Fro (It)
ntage
I.S Building Setbacks(B) 0 i O r I
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
0 P� Plod
1.6 Water Supply:(M.G.L dJ40,§54)L11.7 Flood Zone Informatloo: 1.8 Sewage Disposal Sys m:
Public O Private e: _ Outside Flood Zone?
Check if esO Municipal O On site disposal system O
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owpqr'of
l of uR -20>1 2" Sg 2 ` J
l
Name(Print) Address for Service:
cop, n
Signature Telephone
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building O Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition j!9
Demolition 1}f Accessory Bldg.❑ Number of Units_ t ❑ Specify:
Brief Descriptio of P sed Wprk': / th '
Tor T v
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Offlclal U Only
Labor and Materials) Use y
I. Building IS 2 1. Building Permit Fee:S Indicate how lee is determined: !
2. Electrical S ❑Standard Cityrrown Application Fee
❑Total Project Cost(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: S J /
4. Mechanical (FIVAC) S List:_ J Z �(
5. Mechanical (Fire S
Suppression) Total All Fees:S
Check No._Check Amount: Cash Amount:_
6.Total Project Cost: S 2 13 Paid in Full ❑Outstanding Balance Due:
t '
SECTIONS: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) /9/�(S ZZ b/0
kW4 License Number Extitration Date
Name of CSL-I older t List CSL Type(see below) 0 L
,may,,� r Descri lion
:\JJress ✓ D U Unrestricted u to35.000Cu.Ft.
R Restricted IB2 Famil Dwelling
Signature M Maso Ord
- RC Residential RoofingCovering
Telep ne Z y j/ J WS Residential Window and Sidin
9 � Z$ , 7 / SF Residential Solid Fuel Bumin Appliance Installation
d L D I Residential Demolition
5.2 Regist Ho Imp vement Contractor(HIC) Z!Z&
�—, l Fo��&iv , Regist ion umber
IIIC Company N;un III 'Reg a, I N, e
K'J r� Z Zo J
AJdmss� /� Gi9'��i��� Expiration Date
r v
Signature Telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 2SC(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 ..........A No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I S 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.
Sianaturc of Owner Date
SECTION 7 ERt I CENT DECLARATION
i as Owner or Authorized Agent hereby declare
that the stateme is and information on the foregoing application are true and accurate,to the best of my knowledge and
behalf.
/� c�/Prfl?n
APrim Name
Signature Owner or Author' a Agent Dale G 6
(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&of have access to the arbitration
program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and I IO.RS,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 Z
Number of bathrooms V2 / Number of half/baths
Type of heating system /10� Number of decks/porches
Type of cooling system � lr✓l-tP Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
I
CITY OF SM-E.`I, NWSACHUSETTS
BLILDLVG DEPARTMENT
120 W.%smlNGTON STREET, Y FLOOR
TML (978)743-9595
FAX(978) 7449&W
KIN®ERLEY DRISCOLL
HAYOE T1/ONIAS ST.PRIIRs
DIRWMR oP M BLIC PROPERTY/n MDac CO-%L`asSIO-%ER
Workers' Compensatlon Insurance AMIlavit: guilders/Contractor/ElectrlclanalPlumbOrs
slselleant Infarmallota Pleaaa PrintLesiblll
Vallle Iaunrtna.Oreanusnonlrabr.mul):
Address:
City/StatdZip o!9 Phone A. 9�R- 2k(- 2 //
Are yots to employer'Check Ike appropriate bear Type olProject(regsl►"IN
1.❑ I am a employer with 4. 0 I ant a Simard contactor sail 1 & fj Now construction
employee(IWl Miller part-tins).• have hired the t &Corrracans
2. 1 am a solo proprietor or ptruwr listed an the attached shoat: y 0 Remodeling
ship and have no employee Theo sub•4omroames have V. Q Demolition
workers for me in an ca i women'tromp insurance
g Y Oes 4• 9. 0 Building addition
l No worker'comp insurance S. 0 We an a cos mwm arid i0
required)
officers have emareiaed their 10.0 Electrical repairs or additions
).0 1 am a homeowner doing all work right of axemprice par MOL I I.0 Plumbing repairs are additions
myself.INo worker'comp. C. I3Z f 1(41 and we have no 12.0 Roof repairs
insurance required)► employees'LNe workers' 13.00
comp insurance rerpintiLl
•Any Jpyaor ntr chssae bat gt m+r ales 10 an the saris tiers aedq aVr+wte' Iaki iaftMod—
'i i wuwnw who wbod irk aredwk itdlndtte they an Jowa YI watt and then hlta movids comeme we mast rWsb a was arlldwk inNerine mob,
l.wtrswa drr.Yeek tW es mW sessile/ere aaehiwwl chi�M der ratge of ty er►retalYYw red tA.k�erheta'taaap Paler ieeawrlet.
(axe eon emp/sys that At ptorldhig trerAers'comwasubee lsseereeeeja s4 esop livers Rehm is otir poky eard/lotk site
in/o►neeBwi
Insurance Company Name:
Pnlicy 4 or Sail-irs.Lit.
NN://�_ ) �[/ ) Expiration Data:
Job Yin Addnse: [.�Idl[(/'" .S/ LL4'/1(ll . l�ao`l' LO City/StatdZip a
.smack a copy d The werlters'coaps"aden pWey"lie Wp(slowing tbs pNky sambes a asplratloe delo�
Failure to st.•ctrrs covens as required under 4cction 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
ring up to S 1.500.00 and/or one-year imprisonment,as well as civil penalties is the farm of a STOP WORK ORDER and a line
.sf up to 5230.001 day against the violaror. lie advivd theta copy u(this statement maybe forwarded to the 0171ce of
Iitv.angariuns.tars MA for if coverage vvritlaatiott
l do hereby errrljp n1 aooin d penglNes ajp<r/urY'Aaw AN infsrnetlon provided'how i iron end vw►ect
ran: 4, �
Pr,. a•
2.41
-I n/J&igl r,e wJys roe mar eosin ion this area fe be vgfnp/rind by city or felon ri/jAvrA i
City or ruwn: errmiV1JccnseN
Issuing.%whor ay(circle line):
I. IlwrJ of IlraUh 1. Budding Dopartmvnt ).city/room Clerk !. flatrical In+pecnr S. Plumbing In+prtfor
6. tither
L-.ntacl Perron: - _ Phones:
CITY OF SALEM
PUBLIC PROPRERTY
j•1 b
DEPARTMENT
I'.li: MI I1 "Mlv 1'1 I
\I .1''N I:e\� �•1II\I.. L`I�1 Ntl'T 1).111 fl,%1.\K 11 I II r 1 •.1'I'.
I'rl:'ITt-NS•'1475 �F\!c:'llt•Ta}'IIIA
Construction Debris Disposal Affidavit
( ' uired fur all demolition and renovation work)
In •rccunlance with the sixth edition of the State Building Code, 130 CMR section 111.5
Debris, and the provisions of MGL c 40.S 54;
Building Permit N is issued with the condition that the debris resulting from
this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c
S 150A.
The debris will be transported by:
0/
1 mmae of hauler)
, 'he debris will be disposed or in
�' , yoA ,04(moot ul aci It
—Tdlht�N,Il li•aur)
Itnature of INarrnit applicant
Jatt '
I,In I•dl.Sr
Date: April 18, 2010
Subject: Working Contract: Phase III
The Anchorage- Rice/Walton cottage on Baker's Island,Salem, MA.
Client: Posy Walton
Scope of Work for Phase III:
1. Secure building permit from City of Salem;
2. Provide client with liability insurance certificate;
3. Demolish existing 18' by 8'front porch and porch roof,
4. Remove'roof shingles and debris off island to approved transfer station;
5. Purchase and transport materials, including materials for footings,for new
18' by 12' screened porch and roof and landing and stairs to ground (Note: $700 allowance
for transportation by Double Eagle Charters is included in materials costs);
5. Deck framing to be pressure-treated;
6. Posts and half-wall to be framed in 2" by 4" Ipe;
7. Half wall cap to be 2" by 8" Ipe;
8. Decking to be 1" by 6"tongue and groove Ipe;
9. Roof framing 2" by code by span spruce;
10. Interior of half wall and porch open framing with 1" by 6" or 7"v bead on plywood
sheathing;
11. Roof sheathing, half wall and cheek of roof structure sheathing to be 5/8" CDX plywood;
12. Cheek of roof framing and exterior of half wall to be live edge siding to match existing
house. Live edge siding to be treated with Sikkens, as previously done;
13. Landing for stairs to have railing on east side and steps towards north and south;
14. Roof shingles as decided, however ice and weather shield to be applied to all of remaining
slope of east roof of existing cottage;
15. Flat portion of roof to be rubber roof;
16. Any fascia board and trim to be primed pine. Finish painting to be completed by contractor;
17. Foundation footings to be 4' of depth or to ledge. If to ledge,footing to be pinned to ledge;
18. Build and install screens for side of cottage porch and buy and install screen door;
19. Build and install canvas roller shades.
20. Secure building permit sign-off.
Schedule:
1. Work to commence upon receipt of building permit or permission to proceed from building
commissioner;
2. Completion mid-June (weather permitting), otherwise June 30, 210.
1
(Notes: 1. Estimate has three numbers that are allowances. Screens and shades, gas and
miscellaneous materials and Double Eagle Transportation allowance. Allowance line items are
exempt from the not to exceed amounts.
2. White cedar shingles for exterior siding are being replaced by live-edge siding. The
assumption has been made that this change will fall within the not to exceed number.)
Material Costs:
Cost of materials as described (including tax): $9,807.14
Terms for Materials: Half materials and tax in advance: $4,903.57
Second half of the materials and tax due May 15, 2010: $4,903.57
Adjustment of final materials balance, including balance from
Prior Phase to be reconciled at end of job
Labor:
Total not to exceed labor: $15,180.00
Schedule of labor payments: In advance $4,000.00
May 7, 2010 $4,000.00
June 1, 2010 $4,000.00
Upon substantial completion $2,180.00
Upon acceptance by customer-retainage $1,000.00
(Final sign-off of building permit may not take place by July 1, 2010.)
RobertT. Leavens
c/o E.M. Ware
84 Federal Street
Newburyport, Ma. 01950 p Zola
Massachusetts Construction Supervisor's License No. 6945 9'
Home Improvement Contractor's License No. 149273
2
Posy Walton
2600 Secota Drive
Hampton,Virginia 23611
1111w11
Acceptance of Conditions: �
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Location BAKERS ISLAND Property Account Number Parcel ID 46-0114-0
Old Parcel ID 11 --
Current Property Mailing Address
Owner NOT AVAILABLE City
State
Address Zip
Zoning R1
Current Property Sales Information
Sale Date 1/1/1900 Legal Reference 7365-187
Sale Price 0 Grantor Seller
Current Property Assessment
Card 1 Value
Year 2010 Building Value 31,900
Xtra Features Value 0
Land Area 0.391 acres Land Value 82,500
Total Value 114,400
Narrative Description
his property contains 0.391 acres of land mainly classified as One Family with a(n) Camp-Seas. style
building, built about 1938 , having Wood exterior and Asphalt Shgl roof cover,with 1 unit(s), 5 total room
s , 2 total bedrooms , 0 total baths , 1 total half baths , 0 total 3/4 baths .
Legal Description
Click Property Images to Enlarge
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Card 1 of 1
Location BAKERS ISLAND Property Account Number Parcel ID 46-0114-0
Old Parcel ID 11 --
Current Property Mailing Address
Owner NOT AVAILABLE City
State
Address Zip
Zo Ing R1
Current Property Sales Information
Sale Date 1/1/1900 Legal Reference 7365-187
4 Sale Price 0 Grantor Seller
Current Property Assessment
Card 1 Value
Year 2010 Building Value 31,900
Xtra Features Value 0
Land Area 0.391 acres Land Value 82,500
Total Value 114,400
Narrative Description
his property contains 0.391 acres of land mainly classified as One Family with a(n) Camp-Seas style
building, built about 1938 , having Wood exterior and Asphalt Shgl roof cover,with 1 unit(s), 5 total room
s , 2 total bedrooms , 0 total baths , 1 total half baths , 0 total 3/4 baths .
Legal Description
Click Property Images to Enlarge
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