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0005 BERRYWOOD LANE - BPA-13-278 04Sh_ Sr' rn- Fi1 i- 12- lRm The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY W OFSALEM Massachusetts State Building Code, 780 CMR, 71" edition Revised January Building Permit Application ons ct,Repair, Renovate Or Demolish a 1, 2008 One or Two-F ily Dwelling / This Sec qMcial U Only Building Permit Numb : to plied: Signature: Building Commissioner/In gs Date SECT N 1: SITE INFORMATION 1.1 Property Address: 5 eer d $t 1.2 Assessors Map&Parcel Numbers 1.1a 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 ft) Frontage(ft) U:5 Building Setbacks(ft) Front Yard Side Yards Rear Yard ' Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.4q§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: Keith Fraser 5 Berrywood St Salem, Ma Name�P Address for Service: 978.804.9591 Sigfiaeure Telephone SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building Owner-Occupied ❑ Repairs(s) XX Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed.Work : strip and re-roof 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 $ Su pp Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 5,600 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 100542 3/17/2014 Joseph Arone License Number Expiration Date Name of CSL-Holder List CSL Type(see below) R, RC, WS 18 Moun Vernon Dr Pelham NH Address Type Description �.� U Unrestricted(up to 35,000 Cu. Ft.) R Restricted 1&2 Family Dwelling Signature M Mason Only 978. 5.9483 RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) 160710 Joseph Arone HIC Company Name or HIC Registrant Name Registration Number 18 MOlnt Vernon Dr Pelham. NH 8/19/2012 Address 978.835.9483� 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 ..........lXX No...........❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 Keith Fraser as Owner of the subject property hereby authorize Joseph Arone to act on my behalf, in all matters relative t9 w k authorize y this building permit application. Si azure of Own Date SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION I Joseph Arone ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf. Joseph e Print Name Signature of Ow r or Authorized Agent Date (Signed under the pains and penalties of perjury) NOTES: 1. 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 I IO.R6 and I IO.R5,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"may be substituted for"Total Project Cost" 777 ri 7 r � pr a r Contract Keith Fraser, Homeowner, desires to contract with Arone Exteriors of 18 Mount Vernon Dr Pelham, NH, to perform work on the property located at: 5 Berrywood S_. t Salem, Ma. 1. 3ob Description: See attached proposal. 2. Payment Terms: See attached proposal. 3. Time of Performance: See attached proposal. 4. License Numbers: See top of this form. 5.- Permits and Appeon Issas well as the Arone erior stss will be re responsible for determining and obtaining necessary p 6. Materials: All materials shall be new, in compliance with all applicable laws and codes, and shall be covered by both the manufacturer's warranty and a 15 year warranty on installation through Arone Exteriors. uld 7. Change Orders: Should unforseen events of the attached original propo alit those terns shalestimates, or �be the Homeowner decide to change any part discussed and a 'Change Order' form will be signed by both parties outlining the new details. 8. Site Maintenance: Materials shall be stored in the following location: Work shall be performed between the following io guns,.etc.) only during these hours. We agree to use equiment (generators, p We will use our own equipment but may request the use of an electrical outlet. 9.- Yard Sign: Home improvement projects often generate inquiries from neighbors. We have modest yard signs listing our name and contact information. Please check the box below if you agree to the following: ® Arone Exteriors may place one yard sign in front of the home for the duration of work being completed. Once complete, it is the responsibility of he contractor to collect the sign unless other considerations are arranged up front 10. Payments: In general, we do not require any payments up front and only request that payment be made in full upon completion of the work. If products requested require aplace that special order, we do request a deposit in the amount of $ special order with the manufacturer. pg 1 013 11. Legal info from the State: All home improvement contractors and subcontractors shall be registered (which we are, see license numbers at the top of this contract) and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, Ma 02116 617.973.8700 Owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. Failure to pay in full for the work completed may result in a lien or security interest on the residence as a consequence of the contract for the sum of labor, materials and lawyer fees. The contractor and 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 party 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. The signatures of the parties apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed seperately by the parties. The homeowner has a three day cancellation option under MGL c93 s48: MGL c 140Ds 10 or MGL c255D s 14 as. Arone Exteriors will grant a 15 year labor warranty on all work completed. The manufacturer's warranty will depend on materials selected. 12. Additional Notes: Dg 2of3 _ o : - .. Y6 .Epp � _"• F.i^� -� { u� � �: i0 :4y< A � ♦ 'r � � a � cox r f. a. Name Keith Fraser Address 5 Berrywood St Salem, Ma 01970 WORK PERFORMED (Main house only): BENEFIT: ✓ Obtain necessary town permits. ✓ Install atarp from edge of roof to ground ._„^_ ✓-Protects home and landscaping from de_n __y,s _,,__.,.,_._ _ . .._ ----- ---- - - - � ✓ Removal of old shingles reveals any defects in Strip main house roof to bare wood. ✓ Nail loose deck boards. decking that might otherwise go undetected. It also provides a flat surface to lay new shingles ✓ Replace rotted wood (up to 32 ft. of for a better looking roof.-- deck board material and labor ✓completely strip and re-lead chimney. ✓ Flashing diverts water away from the structure or penetration and keeps it on top of the shingle. ✓ Replace pipe boots on all vents. ,� Vents become less visible for a cleaner look. ✓ Paint vent pipes to blend with,roof. _ __ __ - Apply ice &Water shield to first six feet of ✓ �at wanly terproof adheres le when go ydouhwood deck wood roof, and all protrusions. providing protection from the elements as well as ice dam build ups. ✓ Apply Premium High Performance Deck Armor`. ✓ 600% stronger tear strength than the felt, breath roofing.syst „ to the remainder of exposed deck boards, ,_ _ ✓' and prevents MM able r This he ps to direct water off of the roof, preventsem, ✓ Install eight inch metal drip edge. wicking under shingles, keeps water from running down fascia behind soffits and walls, and reduces water back_up_causing-ice dams. m, _. bl ✓ Superior appearance, practically priced, durabl ✓ Install ' at base of eaves .__ ✓ Prevents le a 'starter course aks and window o e ✓ Install GAF Timberline, Owen's Corning Includes Lifetime limited warranty. Duration or Certainteed Landmark architectural shingle_.,._.__ __. . _.. ✓ Install ridge venttlation. ✓ Prevents condensation problems (false leaks), i deterioration of deck, mold growth and premature deterioration of_shingles. „___ --- d Cap_ridge vent with matching shingles -�Will be used to remove all debris and nails from the ✓ A dumpster is supplied in this quote property and neighboring properties. **Customer may want to cover any items in attic and vacuum 6/ Remove debris from all gutters. _ ..._ _ r _., upon completion of work. Proposed Payment_ _.. . (NO DEPOSIT REQUIRED UP FRONT UNLESS A SPECIAL ORDER ITEM) Total payment of $5,600 - Homeowne' r Signature Date C ractor Signature Date No other documents are part of this contract. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES p9 3 of 3 J t' CITY OF &UEM, .I.-1SSACHUSETTS • BUMDDIG DEPARTMENT • r P 120 WASHIINGTON STREET, 3�FY.00R T 1_ (978) 745-9595 FAA.(978) 740-9846 KINIBERLF-Y DRISCOLL MAYOR THoxttc ST.PtERR& DIRECTOR OF PUBLIC PROPERTY/BUIMLNG CONMaSStONER 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: Arone Exteriors (name of hauler) The debris will be disposed of in : Rooftop Recycling (name of facility) - 369 Codman Hill Rd Boxborough, Ma (address of facility) si a of permit applicant date JcbrivlT.du - Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supers is"SrVcialt�,. License:CSSL-100542 JOSEPH M ARONE 18 MOUNT VERNON DRIVE L Pelham NH Q3076s'elivi e J° Commissioner Expiration 03/17/2014 _ � �_ ✓/ze V�an7rf�zo�rr,�oea�i a�✓f�,aaaactivaelta Office of Consumer Affairs and dusiness Regulation - 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration _- Registration: 160710 Type: DBA ' - Esixodion: 8/192012 TM 700574 ARONE EXTERIORS _ JOSEPH ARONE 60 CENTRAL STREET - "-- STONEHAM, MA02180 -_-- --- - - update Addms and rohnn Para.Mark.on for ehnnge. Address ❑Renewal ❑Employment ❑Lost Card apsca�a wvavV`amiae � License or inn6an valid for individul are only OR fC tamer Again&B NegN<tioo C HOMEIMPROVEMElfCONTRACTOR liviretbae tl rptnandeR Iffoandreturnta' d Rep stmtmrr ;160710 Typo: Offire of Consumer ANains and Business Regulation �IWN12 DBA E i ad 10 Pork Ft.. Suite 5170 ���, p Boston,MA 02116 ARO'NE EXTERIORS fµ JOSEPH ARONE / ///////�/ fi0 CENTRAL STREETL/���f STONEHAM,MA U180�1. V.&,ve,r<mry _—/NutvalidwltM1aulsignals- �., OP ID:AC ,ta�oRoQ CERTIFICATE OF LIABILITY INSURANCE °"�'10/03/1=311""' 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 978-462-4434 NAMEACT Chase&Lunt LLC 978.466-6204 PHONE Pam: uc No: P O Box 590 47 State Street ED ADDRESS: N MA 01950 PRODUCER Michael (Conhn CUSTOMER Io#:ARONE-1 INSURERS)AFFORDING COVERAGE NAIC# INSURED Arone Exteriors INSURER A:Northland Insurance Companies 18 Mount Vernon Drive INSURER B:Liberty Mutual Group Pelham, NH 03076 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE-MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ NSR TYPE OF INSURANCE POLICY NUMBER MMMI UIV1 W MMID VDIYEYYY LIAlIT3 LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,D0 oo A A I COMMERCIAL GENERAL LIABILITY IWS084526 1oNOn1 10110112 DP�MAGETO RENTE EENTE 8 50+00 CLAIMS-MADE a OCCUR MED EXP(Any one INJURY $ 5100 PERSONAL BADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 G�ENI'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG E 2,000,00 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ i i (Ea accident) F ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS I BODILY INJURY(Per accident)I $ SCHEDULEDAUTOS PRO=tl))AMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ 'UMBRELLA LIAR OCCUR 4EACHOCCURRENCECE $EXCESS UAS CLAIMS-MADE SEDEDUCTIBLE RETENTION EWORKERS COMPENSATION WC-31S.369961-611 10/31/2011 10131/2012 !OTH- AND EMPLOYERS'LIABILITY y/NANY PROPRIETOR/PARTNEWEAECUTIVE❑ NIA NT $ 100,000OFFICERIMEMBER EXCLUDED? 100,000(Mandatory In NH) EMPLOYE $ H yes,deacnbe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below I i DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ADach ACORD 101,Additional Remarks Schedule,N mare apace Is required) VIA FAX 866-280-9621 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Service Magic Inc. 14023 Denver West Parkway Building 64,Suite 200 AUTHORIZED REPRESENTATIVE Golden,CO 80401a / - U U ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD The Contntonwealth of Massachusetts Department of Industrial Accidents Office of Irtvestlgations fit i 600 Washington Street �, c= Boston, MA 02111 f tvww.tnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Naine(Dusinessi0r,anizationrhtdividnal): Joseph Arone dba Atone Exteriors Address: 18 Mount Vernon Drive City/State/Zip: Pelham, NH 03076 Phone#: 978-835-9483 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 2 4. ❑ I am a general contractor and I 6 ❑New construction employees(full andlor part-time)." have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached street. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity- employees and have workers' Y P n'- 9. ❑Building addition [No workers' comp. insurance comp. insurance.' • required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] c. 152, §1(4),and we have no employees. [No workers' 13-EgOther replace roof comp. insurance required.] "Any applicant that checks box 31 must also fill out the section below showing their workers'compensation policy information. t Iiomrowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'con3pensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Chase and Lunt Policy#or Self-ins.Lic. #: WC-31 S-369961-011 Expiration Date: 10/12/12 _ t v 2A — � Job Site Address: 2 $L CitylState/Zip: .1ud��a 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 tl wins and penalties of perjury that the information provided above is true and correct. Sig=ture: Date: 3/7/2012 Phone#: 9 8-835-9483 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: t.