6 BALCOMB ST - BPS-10-965 NEW ROOF R
V The Commonwealth of Massachusetts 6
CITY
Board of Building Regulations and Standards
'^ Massachusetts State Building Code, 780 CMR, T°edition OF SALEM
Revised Junuary
Building Permit Application To Construct, Repair, Renovate Or Demolish a l• =0014
One-or Two-Family Dwelling
This ion For qfficial Use Only
Building Permit Num I A Y,15AleApplied: If I I IO
Signature: '
Building Commissions Inspector B m Date
S C ION I:SITE INFORMATION
1.1 Property Address it 1.2 Assessors Map& Parcel Numbers
1.1 a Is this an accepted street?yes no Map Number Parcel Number
' 1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq 11) Frontage(11)
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 disposal system ❑
Public❑ Private O Check if es❑ P po y
SECTION2: PROPERTY OWNERSHIP'
2.1 OwnerrofReeord: (D rl8k (D POULo c�r �k It Yr1 i
Nnme ��t) Address for Service:
ki'oiv>tiG0 o,,ti 4 3Uo 123Y
Sig rc Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
1 1 Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Ofliclal Use Only
Labor and Materials
1. Building S4< 1. Building Permit Fee:S Indicate how fee is determined:
❑Standard Citylrown Application Fee
2.Electrical S ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: S
4. Mechanical (HVAC) S List:
5. Mechanical (Fire S
Suppression) Total All Fees: S
/ Check No. Check Amount: Cash Amount:
6.Total Project Cost: S 1_I>�, ❑Paid in Full ❑Outstanding Balance Due:
et
6g
�r`"fra�ta >•
f
It
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) ;LicerikNumber
s p ue )
I:spi tiun U e
N:une SYC�SI. IuI VVV ee below) n
.4JJress "i 1 u to JS,lR10 Cu.Ft.tdgnature Only
Q�'� RC Rrsidential Roulin Cuvrrin
Telephone WS Residential Window and Siding
SF I Residential Solid Fuel Burning Appliance Installation
U I Residential Demolition
5.2 Registered Uome Improvement Contractor HIC)
111C Coln an Name r tlIC R islmnt Nam—• Registration Number
a � „ s t= ��cs � Z z� 1 ) I
Address `
Expiration Date
atrt tum Te ephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.4 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 .......... No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, I&A as Owner of the subject property hereby
authorize— ��j�G-. 4�z 44- Z4 (��C�01 to act on my behalf,in all matters
relative to work autlt'ori by this building rmit application.
pnnaL, //L I t7 £�
Si ure of Owner Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
1, .bY6f � de- c ,as Owner or Authorized Agent hereby declare
that the statement nd information on the foregoing application are true and accurate,to the best of my knowledge and
beh,41f, Aa i
Jes
Print Nhme
Sign ure of Ow r Authorized A Da e
(Signed under the pains and penalties of perjury)
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 pef 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 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
J. "Total Project Square Footage"may be substituted for"Total Project Cost"
00- YJnrestricted
IG-1 2 Family Homes
�* Ma.machusetts- Department of Public Snietc
�• Board or Building Re rulatians and Stanch •ds
Construction Supervisor License Failure to possess a current edition of the
License: CS 80145 - Massachusetts State Building Code
Restricted., 9'-" is cause for revocation of.this license.V<s'
to�i 00,
' 7- 4fi. Refer to: WW •Mass.Gov/DPS
GEORGE`�A'S1LIA�S
5 PITCAIFM!%'
IPSWICH, 10f '::01938% In
Expiration: 1026=11
C nnibu,luner Tr#: 6238
Bo rd of Building Regulat4oiis an e 6
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement'Contractor Registration
Registration: 154326
Type: Supplement Card
Expiration: 2/27/2011
ALPINE PROPERTY SERVICESb;5;1.NC::'_ = — - ---
GEORGE VASILIADES --
11 WILSON STREET
SALEM, MA 01970 _ Update Address and return card.Mark reason for change.
Address ❑ Renewal ❑ Employment Lost Card
DPSCAI b 40M.00108-DBSLIF0RMCA10a2120W
CW Qoow,mloruoealH o�.�aeaac�iieeCd_..
Board of Building Regulntions and Standards License or registration valid for Individul use only
j before the uiexpiration date, if found return ds
HOME IMPSOVEMENT CONTRACTOR
Board of Building Regulations and Standards
Reglstratfon> 154326 One Ashburton Place Rm 1301
rsrz
E3rptfatton:;` j272011 Boston,Ms.02108
Typos, 'Piement Card
ALPINE PROPEF2iYERVIES.0
GEBF�GE VASILIADEb'�.•z
11 WILSON STREEI" :: °.. .`
SALEM,MA 01970 Administrator Not valid witho'1rt sigantu re
i I
I
a
The Commonwealth of Massachusetts
_ Department oflndustrial Accidents
— Office ollnuestlga®ons
600 Washington Street, 7`h Floor
Boston, Mass. 02111
Workers'Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors
APolicant information: F Please PRINT'leeibly
t
name: —/
address: o? �1 ('& ➢ten.,
city ��l/l S, f ly. (c� M4=- state: mrr zip: D t' Z y2 nhone#
work site location(full address), )�•�. �� ��& QLq3�
❑ I am a homeowner performing ail work myself. roject Type: ❑New Construction E Remodel
❑ Il am a sole proprietor and have no one working in any , city; ❑ Building Addition
am an employer providing workers' compensation for my employees working on this job.
company name:�i�1 v ll C
Aaddress: n i D0541
city: TP a -- Phone#:
``
insurance co.. T7`'I"6"1 h l� l i �'(��.LN.G - 47_ Policy# "t 0 0
❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers'compensation polices:
COMDanv name•
address:
city: phone#:
insurance co. policy#
4 - --_ - - - - - --1
company name:
address:
city: phone#:
insurance co. Policy#
Attach additional sheet if necessary.
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. 1 understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
l do hereby certify under f sins and penalties of perjury that the in or Lion provided above is true and correct
Signature Date
Print name Phone
official use only do not write in this area to be completed by city or town official
city or town: permit/license#_[]Building Department
[]Licensing Board
❑check if immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phone#; []Other
Vi,cd Sept_2003)
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ONLY AND CONFERS NO RIGHTS UPON'n1E;L;F)CT'FICAT�„
H.J.Knight Intemational Insuraocc Agmeles,Inc. HOLOM TUS CERTIFICATE DOES NOT AMIDN%-EILTENO CIR• _
500 V ictory Road-Marina Pay ALTER YHB COVERAGE AFFORDED BY THE POL W E5,hb-oYii
North Quincy.MA 02121 campA —^ PDB+GCOWRAGE.
'COMFANY
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Alpine Property Scrviccs Co.,Inc. P
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POBox 365
...._Topsfield,.MA;._.019g3. ., ... .coWPAlrr-.--.�.....�.:. .. ^' .. ..
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5/110
2-4-6 BALCOMB ST. CONDO TRUST �;y 200 l
f `'I RENEE E. GREEN TRUSTEE
1 111 6 BALCOMB ST. (Q
SALEM, MA- 01970
1.617
246 Balcomb Street Condo Trust A
6 Balcomb 01 Sovereign BanW
AttnSalem,MA 01 Green
V�_
(978 Renee Green .�
(978)360-1234
Job Location: ...
2.4&6 Balcomb St.—Salem,MA
Dear Roger, May 19.2010
The following estimate is for the roof installation for the property located at the above address.The following paragraphs describe the work that
will be performed. GAF-Elk Corporation Weather Stopper System Plus Limited Warranty offers you a full coverage warranty on defective
shingles—to be obtained directly from the manufacturer(see enclosed brochure).
Installation Procedure
.k Strip existing roof on the entire house down to the roof deck
4. Install an 8 inch mill finish drip edge on all leading edges(rakes&fascia) -
4. Install ice&water on all valleys
4• Install 6 feet of ice&water shield on all leading edges
4. Install new vent pipe flanges
4t Replace any rotten or damaged decking(we allow 32SF a no charge,$70.00/sheet thereafter)
4. Replace any rotten or damaged ledger board(we allow 30ft.at no charge,$3.00/ft.thereafter)
4. Install 15 pound felt paper on all areas that is not covered by ice&water shield
+h Install new GAF 3-TAB shingles
4, Install new ridge vent system -
4 Transition Walls—Remove existing clapboards on(4)transition walls on upper roofs and(2)transition walls on lower rear sections
of roof. Install ice&water shield 12 to 18 inches up sidewalls with new step flashing. Install new pre-primed clapboards.
Additional S ecitions
4, Homeownertochoose cwlorofshingles COLOR: lam' tco S'LT
4. Our dumpsters are sent to a recycling facility;therefore no additional trash may be placed in them. The transfer station will charge us
a fee for additional trash which will be passed on to the homeowner.
d. Chimney re-painting and re-leading is not part of the roofing contract. If you are in need of this service,we will provide you with an
estimate.
4. During a roof job,it is not common for the nails to break the sheathing during the nailing of the shingles
4. We are not responsible for any of the cracks that may arise in any walls or ceilings
4 Please cover all your floors in your attic to protect from dust and debris
4, We will remove all ofthejob related debris
4. Permit costs vary from town to town and are not included in this bid
Initial the options You are choosing below.-
Cost for Labor&Material for Roof: $7,150.00
Cost for 30-yr Architectuml Upgrade: $ 260.00
Cost for Labor&Material for Transition Walls: $1,495.00
Cost for GAF-Elk Weather Stopper System Plus Ltd.Warranty: $ 250.00
Payment Terms: 113 deposit 113 work in progress$ ad 113 upon completion$ �o
Total Amount Agreed To Be Paid: $ gc// V O
Remit to: Alpine Property Services Company,Inc,P.O.Box 365, Topsfreld,MA 01983
The following schedule will be adhered to unless circumstances beyond Alpine's control arise:
Work Scheduled to Begin: QD Expected Dale of Completion:4BD
aProperty
Property Servi Cot any Inc.guarantees all work performed for a period of one year. If any problems occur we will cover
r and materi to come the problem and meet the customer's satisfaction.
Project ana H�owners
ervices Company Inc., 246 Balcomb Street Condo Trust
d/b/a Olympic by(Name)