22 BARNES RD - BUILDING INSPECTION (2) Y
gPW0B1AWT-9E fNA9 M G APPROVED 8Y THE
JMPZC=PWR TO A`PERMIT AB NO W1ANTkD
I\ C CITY OF SALEM
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Permit to: BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, emot nttWl Siding, Comow Deck, Shed, Pool.
Repair , Olher.
PLEASE FILL OUT L=BLY a COMPLETELY TO AVOID DELAYS IN PROCESSIM
TO THE INSPECTOR OF BUILDINGS: '•
The urtdersipnsd hereby applies for a permit to build ac corckig.to the following
speoiNcaft s:
Owner's Name VhLcl '<
Address a Phoney ?-)r►'n�S �C�Gd ( q 181 7 q q- 7478
Architect's Name
Address & Phone ( i
Mechanics Name 7 no(— V) cku - i�-P_C
Address 6 Phone 33 G�eq f- ' S� 1��U U ( £sc3 to lg_ 71cCo
What Is the paposa of bull W
MOEN of buldtrg4 N a dwelYq,for how mmy Ion"?
we&A"cart.to kw? Asttrstw?
Etirnnrrd oat GYJ• °=' ay uo r 81ata Lloww r
Sipnature of Applicant
SKiNED UNDER THE PENALTY'
OR PERJURY
DESCRIPTION OF WORK TO BE DONE
reo�)ove e r i.s" a/•e s
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MAIL PERMIT TO:;�4I �fe13P�f °
15(.pt;r7C�1� Cl(lS it 7
33
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CITY OF SALEM9 MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MA 01970
TEL. (978)745-9595 EXT. 380
FAx (978) 740-9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS
AFFIDAVIT
In accordance with the provisions of MGL c 40, S34,I acknowledge that as a condition
of Building Permit# ,all debris resulting from the 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, S 150A. I ,
The debris will be disposed of at: 5 O Ptrber rSl ��Tcrl r�
Location of Facility J
Signature of Permit Applicant Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
Sear� e)f
Name of Permit Applicant
Firm Name,if any
O (4(o Q
Address, City& State
The above statute requires that debris from the demolition, renovation, rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIII, S150A, and the building permits or licenses are to
indicate the location of the facility.
Lepartment of Industrial Accfaents
Office of Investigations
600 Washington Street
Boston, Massachusetts 02111
Workers' Compensation Insurance Affidavit
Application Information Please PRINT legibly
Name:
Location:
City. - Phone#:
0 I am a homeowner performing all work myself
❑ I am a sole proprietor and have no one working in any capacity. - -
am an employer providing workers'compens(aiiioon,for my employees working on this job.
Companynamea�(+�( t�ILQ��IAL�SI /
Address')�
Citv. - ( _ ` Phone#: — Lo I �-
Insurance Company: Policy#:
❑ 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:
Company name:
Address:
City: - Phonc#:
Insurance Company: - policy#:
Company name:
Address:
City: Phonic#:
Insurance Company- policy#:
Attach additional sheets if necessan.
Failure to secure coverage as required under Section 25A of NAG L 152 can lead to the imposition of criminal pen al tics of a fine up to SIS00.00 and or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a
copy of this statement maybe forwarded to the Office of Investigations of the VIA for coverage verification.
I do herebpter der file patirs wid penalties of perjury that the information provided above is true
pand correct
Signature:— Date: ( (3 Print name: e� n Phone: ZW}
Official use only Do not write in this area to be completed by city or town official.
City or town: Permit/License# 0 Building Department
0 Licensing Board
❑ Check if immediate response is required. ❑ Selectman's Office
0 Health Department
Contact person: Telephone#: ❑ Other
(revixd 3195 PIA)
i
ACORD . CERTIFICATE OF UABIUTY INSURANCE
of MWOMMATIGM
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TIE-POLICES OF WBURANCE L*MD HBM HAVE BE$I MGM TO THE BOUED HWW ABOVE FOR 7NE POLICY PERgD 00M,A7E0, MOTNMWTAN0810
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AOORD 26 1W
Board o[Buildfu`Regulations"d Standards
HOMEIM MENTCONTRKCTOR
R4428
066,
- - - Corporation' _
SUPERIOR IN
SEAN GREEN
33 GREAT RE)
S+MRLEY,MA OT064- .AdoriNat*ator' .
Suf0, ►
rior
INDUSTRIES INC.
ROOFING GUTTERS RUBBER ROOFS
March 24, 2005
Philip Hardcastle
22 Barnes Rd
Salem, Ma 01970
978-744-7978
617-293-6119
Roof Will Be Hand Nailed Only
1. Details of area to be completed.Strip Roof and Install a Complete Roofing System on entire Home..
2. Remove existing layers of asphalt shingles and dispose of properly.
3. Completely de-nail roof and re-nail roofing boards as needed.
4. Replace any rotted or broken wood(roofing boards) at no cost up to 100 Linear feet.
(Additional Linear feet available at $3.50 per ft. and$1.85 per sq. ft. for Yz" plywood or 5/8
plywood at $2.25 per sq ft.)
5. Apply six feet of Certainteed Winter Guard along the eaves of the roof,three feet along the
sidewalls, three feet around chimneys and pipes,three feet in all valleys and three feet along the
rakes.On porches complete Ice shield.
6. Next, apply a Certainteed Roofers Select felt paper to the remainder of exposed roofing area.
7. All wall flashing will be inspected and replaced as needed. Any and all rotted or damaged trim or
siding that needs to be replaced to ensure proper flashing will require a Master Carpenter and will
be billed out at an Hourly Rate plus material cost if completed by Superior Industries, Inc. Any and
all lead or copper wall flashing which needs to be replaced or installed will be done so at an
additional charge.
8. Chalk lines every five inches.
9. Install eight-inch aluminum drip edge to all rakes and eaves (mill finish).
1-888-618-ROOF (7663)
978-425-0812 Fax
33 Great Road • Shirley, MA 01464
Serving New England
10. Install pipe flanges as needed.
11. All shingles will be fastened using 1 %<-1 'h hand nails.
12. Apply a 30 Year Certainteed Architectural AR Shingle.
Color: 1�'glbowr/ sb kt-
13. Re-lead chimney, If we do not Re-Lead for any reason you will get a refund for Re-Lead work, Or
if we do not have to Re-Lead. See under Job cost.
14. Install a Certainteed Air Vent on the House to allow for proper ventilation.
15. Install4" x 16"Rectangular Eave Vents. (No) has no soffits.
16. Work site shall be cleaned on a daily basis and all areas will be gone over with a magnet to pick up
the nails.
17. Superior Industries will supply the customer with any and all permits pertaining to the job.
18. Superior Industries will furnish a Certainteed SureStart warranty that entitles homeowner to fifteen
full years of non-prorated coverage including labor,materials,workmanship errors and disposal
costs.
19. Superior Industries will supply the customer with a liability($2,000,000.00) and workers'
compensation($1,000,000.00)insurance certificate. (All workers are employees, not
subcontractors.) Massachusetts License#144428. Better Business Bureau#83356.
20. Any alteration or deviation from the above specifications involving extra costs will be executed
only upon written orders and will become an extra charge over and above the estimate.
21. All additional carpentry work will not be started until roofing contract is paid in full,unless
otherwise stated in contract.
22. Payment to be made as follows: 1/3 deposit due upon signing, 1/3 due halfway through the job and
the balance due upon completion of the job.
All Jobs to be started Within 30 days after contract is signed& deposit is paid
(Pending Weather)
** Quotes are Valid for 30 days only **
Bob's Cell#978-265-4464
Job Cost: $ 5,625.00 Complete Roormg System (30Yr)
$ -500.00 Winter Discount
$ 375.00 Re-Lead Chimney
Total Cost: $ 5,500.00
ACCEPTANCE OF CONTRACT
The above prices,specifications and conditions are satisfactory and are hereby accepted.
You are authorized to do the work as specified. Payment will be made as outlined above.
Superior Industries, Inc. Homeowner or Authorized Signature
�C�'
Authorized Agenttame:
Date Date
We now accept Visa—MasterCard Discover—American Ezpressl
Credit Card# V# Exp.Date:
Prior to Superior Industries commencing th ,Roofing project, a Superior Representative
must inspect for m d.
(Sales Rep Signature) Customer Signature)
Comments: We cannot Install soffit vents there is no soffit and vented drip will stick out to far and then
gutters will fail. Owner does not want to replace gutters.(3 star warranty)crawl space with ridge vent.Also
on porches complete Iceshield.
AMEMMBEEq� 1 ® M`Ste�i El�ih
SHINDL[ROOFER'
gBeed� INDUSTRIES, INC. ���R>«v"0CA
ROOFING CONTRACT
Sales Rep: IL4 x! 414yo
This ROOFING CONTRACT(this"Contract")between contractor(the"Contractor")and owner(the"Owner")named below
OWNER CONTRACTOR
Name: SUPERIOR INDUSTRIES,INC.
Address: Z 7 R I�.IJ AC ,1 ti 33 Great Road
City: L�2 A_ er Shirley,MA 01464
State: is fL_Zip: (%19 70 888-618-7663 Ext
Mailing address(if different): %7 7 -A, Cell Number
Address: Registration#: 144428 Exp.10-4-06
City: Federal Tax ID#:043518271
State: Zip:
Day: _.i`I]7 % 4•Y 1 i % Evening: U I% G ° J' 611 c Alt: + / 1- Y 2 6 - //7 0 r I3 I
We propose hereby to furnish material and labor—complete In accordance with specifications below:
Existing Roof consists of#of Comp layers ,7 #of Wood layers Ridge to instanllSF,r.�GLG I✓s�iri if
Roof to Install: Manufacture /.F& e!Ii riiN5 P Type 30 4A• .�I Ai��rrF4!%:/n;91. Color 1?4e xAnYY Sfr4ky
Drip Edge ❑ Vented Drip Edge (Color) E�Iite-leatl Chimney ❑ Soffit Vents (4-X16")Approx.Quantity
This contract is dated /1=-l—E/ /O t (Month/Day/Year). The work under the Contract is scheduled to begin
on or about 7 /�/Cj (Month/Day/Year)and is scheduled to be substantially completed on or
about �Z`f/r'� (Month/Day/Year);provided, however(i)such scheduled dates of
beginning and completion are subject to change due to unforeseen circumstances,and(u)the Contractor shall have no obligation to begin work until the
Owner has paid the Initial Advance(as hereinafter defined). The scheduled dates for beginning and completion are estimates only,and the Contractor
shall have no responsibility or liability for reasonable delays in beginning and completing the work hereunder. In addition,the Contractor shall have no
responsibility or liability for any delays arising from permitting requirements,the Owners loan approval and funding,loan disbursement,acts of God,
weather,strikes,lockouts,boycotts,or other local labor union activities,job changes requested by the Owner,inability to secure materials,labor shortages,
failure of the Owner to make payments when due,delays caused by inspections,changes caused by inspectors,delays by the Owner In making
selections,or any other cause beyond the Contractor's control.
The work described below is to be performed at the following property(the"Property"): 2escri Z f3 Nmd y S R SiB�
The following is a detailed description of the work to be performed and the materials to be used in the performance of this 'rap:Refer to abashed esdmffie.
Such work and materials are hereinafter referred toes the"Work," This Contrail shall not be Contractor
r requiring the Contractorat perform any
work or to install any items or materials except expressly set forth above. f the event that the value.
for determines that certain materials are not
readily available,the Contractor reserves the right to substitute materials of equal or greater value. - j o Td i..
Prior to the Contractor beginning the Work,the Owner shall pay to the Contractor the sum of$ !lX&!I''r/SQ��•a (the"Initial Payment")in
advance,which amount(if this Contract is for Residential Contracting)shall not exceed the greater of one-third of the total contract price or the actual
cost of any materials or equipment of a special order or custom made nature,which must be ordered in advance of the commencement to the Work.
Thereafter,the Owner shall make progress payments to the Contractor as follows: 1/3 Deposit-113 Middle Payment-1/3 Final Payment.
The owner Is signing below to acknowledge that the Owner has been advised of this cancellation right described In detail on the back of
this Contract and also on the notice of cancellation form.
l OWNER:
e
Print Name: r /''' ``� Print Name:
ALTERNATIVE DISPUTE RESOLUTION
(SEE BACK SIDE OF CONTRACT,NUMBER 39,FOR DETAILED DESCRIPTION)
THE CONTRACTOR AND THE HOMEOWNER MUTUALLY AGREE THAT IN THE EVENT THE CONTRACTOR HAS A DISPUTE CONCERNING THIS CONTRACT,THE CONTRACTOR MAY
INITIATE ALTERNATIVE DISPUTE RESOLUTION THROUGH ANY PRIVATE ARBITRATION SEPVICES APPROVED BY THE DIRECTOR OF CONSUMER AFFAIRS AND BUSINESS
REGULATION,UNDER PARAGRAPHS IA)TO(a),INCLUSIVE,OF SECTION FOUR OF THE HOMEIMPROVEMENT CONTRACTOR LAW
d ,
CONTRACTOR: UPERIOR INDU RIES,INC.By: bk (�'.,"fnMnb(��/"/ Date:
OWNER: A 'Print Name: / r�✓�Ct �
OWNER: Print Name: Date:
BY SIGNING THIS CONTRACT YOU ARE ACCEPTING ALL TERMS AND CONDITIONS
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
CONTRACTO SUPERIOR INRUSGTRIES,INC."By://Y4,JI= A,�,rs n�� / ��`Date: �/2^J C
OWNER: "" A -j� Agg�iprint Name: ��/'S/')/P/4' Wl; C�4{bate:�7/G`y��U�
OWNER: Print Name: Dale:
V- 1 T
'Aatiiaii:+.: �N�:u'NlA MEMBER