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8-10 CEDAR AVE - BPA-12-988 ly - � ) 7 I'Ile Connnonwealth of NidShachll5CltS 1: ',� tt Board of Iuilding Regulations and Standards CI I'1' OF a s !9 Stassachusetts State Building Code. 780 C NIR `ALEM Heri.,ed 1/,11.21 l 1tidding Permit Application 'ro Construct. Repair. Renovate Or Demolish a 0ov-or Two-Fantils• Uuellinp 6� This Section For Official Use Only n I� P—Buildin.S0.1116A ermit Number: _— D e Applicd: (Print N,une) Signa SECTION 1:SITE INFORMATION y Addrress• I.2 Assessurs,flap S Parcel Numbmn acce ted street? es no Map Number Parcel Nunmhcr 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq It) Frontage(11) 1.5 Building Setbacks(R) Front Yard Side Yards Rear Yard Required Provided Required provided Required Provided 1.6 Water Supply:(M.G.I.e. 40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Ihtblic❑ Private❑ Zone: _ Outside Flood Zone?Check il' yes❑ Municipal❑ On site disposal st stem ❑ SECTION2: PROPERTY OWNERSHIP' 2.1 Ow rr of a ord• /�J y�1 Nane Pr,nit 1 1 C u .Statc.Z.IP �AKd/Fa aE AS1- ; 5 No.and Steel Telephone Email AJdnss SECTION J: DESCRIPTION OF PROPOSED WORKS(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ Alterotion(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Numberof Units_ I Other Spccily: Q 1 Brief Description of Proposed Work': SECTION 4: ESTL,MATED CONSTRUCTION COSTS 11ei11 Estimated Costs: Official Use Only ILabor and Materials) I. Building S I. Building permit Fee: S Indicate how fee is determined: 2. Electrical S ❑Standard Cityry•Town Application Fee ❑Total Project C•ost'(Item 6).x multiplier _ 1. Plumhi°g S ?. Other Fees: S- J. .\lech.ulical ,II\ W) S List:._ --- —_------ �� �. \Iech.mic:d 'Fire 1u,neuionl S rota \II Fees: S — ('heckNo. ('heck :\momir C•,sh \mount: o Tutnl l'rnjcs Cost S y69 �/S' — 1 O Pail in Full ❑Outstanding l3ahmce Due: aze SE("PION S: CONSI-RUcrION SERVICES 5.1 Construction Super%isor License(C'SI.) �i I innsx�unhcr ry ration );ne ' \onleol'l'.SLIInIJer '1)pe Description ,,. .mJ SIrtR I4lrestriacJ UluddinL's a it) 15,11110 al. IL1 4A ,� c L dZ.. �L��SQ�/. R Hnlricted I:F2 f.Imil D,wllin Cilsi own,Alote,LII' � � •\I \lusun RC RmOin Cocain ..._. K'S Window:old%iJin SF SuI d hurl Ilurning,\pplianccs Insulation l'cic hone 1(1lail aJJress D Demolition 5.2 Rrgl feted Ilome InpruvementCJuntrncfor(HIC) L fi A7V 7 — INC I(egistrtliun Numhwr .vpiru m Uale IIIC Coo pw uu• r IIIC' Re islmt None Nu. Swot Email address City/Town. State ZIP rele hone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L e. 152.1 25C(6)) Workers Compensation Insurance afrdavit must be mpleted and submitted with this application. Failure to provide this affidavit will result in the denial of the Issue a of the building permit. Signed Affidavit Attached? Yes .......... Ild No...........O SECTION 7s:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this ulid ng permit application. Print Owner's None(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. & 'CZ4,4,4.I� s I'iim Owner's or \uthurired,vgenl's N:unu I I•.Icctnnne.\i gna ture) D 'a NOTES: I. :\n Owner who ubtains a building permit to do his.her own work,or an owner who hires an unregistered contractor Inut registered in the Hume Improvement Contractor(HIC) Programl.will no have access to the arbitration program ur guarant) fund under M.G.L.c. la?A. Other important information on the HIC Program can be found at w w,s m.i,, ��, .-,.i Infonm:uiun on the Construction Supervisor License can be found at w>, � ���•n �: � �p, 2. \Then substantial wurk is planned, provide the infurmitiun below; row hour area(sy, n.) - 1 including garage. finished basement attics,decks or porch) G'.'_ living area uy. R.i Habitable ruunt count _ _. _.. . .. \umber of lircplaccs \umher of hcdroo ms - -. .. . . . . l \umherofhathrounts.... .. __ ♦umberufhalfhalhs _ IN pc at'he,uing i)'telll - - \'omhcr of Jccks• porches O+ell f,pu i,I cooling ')'teal Ihlilo'eJ .. I 1, "l oi.d Pr jvo Square Footage-Intl) hc't,b,ntutcd 1-or I1aa1 11rojoO Coil" r NSCAP 98 Main Street Peabody, MA 01960 Agency: NSCAP Client Application#: PROGRAM: Keyspan/2012 F7110935 Job Number: 0 Work Order# 0 Work Order Date: 05/02/12 Job Limit: Primary Contractor: A&M General Contracting Per Unit $4500 00 Other Contractor: Manchester Electric Client: Elise Caputo K+T Yes=1 No=O Street: 8 Cedar Avenue K&T: City; State;Zip: Salem, MA 01970 Telephone: (212) 725-0503 Stand Alone: No Fee Code ;•2 Blower Door Test: Yes=1 No 2 .. s.: Inspect Knob & Tube: No Elec. Contractor: Attic Insulation Estimated Actual Cost Est Cost Act Cost Attic flat R38 open $1.47 '41 Attic flat R30 open 462 $1.37 $632.94 Attic flat R20 open $1.29 Attic flat R10o en $1.21 Attic flat/slope R30 restricted V $1.48 Attic flat/slope R20 restricted $1.42 Attic flat/slope R10 restricted $1.30 Attic kneewall R13 $1.31 Attic kneewall floor R30 restricted $1.48 Attic/kneewall floor transition DP $2.52 Finished attic access $105.00 Temporary attic access $78,75 Crawls ace RI9.w/ of vapor barrier' $2.53 Garage-ceiling/floor floor R30 $2.10 Thermadome $180.00 Roof vent- large $95.00 Roof vent-small $80.00 Turbine vent $168.00 12" stack vent $152.00 Pro pa vent $4.00 Gable vent(all sizes) $92.00 Soffit vent $27.00 Ridge vent(lin. ft. $23.00 Attic air sealing 2-part foam 2 $75.00 $150.00 Vent d eribath exhaust fan 1 $89.00 $89.00 Ke s an/2012 Estimated Actual Cost Est Cost Act Cost Wall Insulation t" "' " Single nailed asbestos/asphalt R15 DP $2.21 Double nailed asbestos/aluminum R15 DP $2.31 :'rfn,+ Brick/stucco R15 DP $2.89 `l, , "• Interior wall blow-plaster RI DP $1.90 aii: Clapboard/wood shingle/vinyl R15 DP 464 $1.79 -$830.56 Test drill 4 sides $60.00 Perimter wrap R5 $1.91 Air Sealin Door kit 3 $45.50 $136.50 a .• Regular door sweep 3 $15.75 $47.25 Automatic door sweep $23.00 t Air sealing 2-part foam `"•' 3 * $75.00 $225.00 Sash lock $9.50 Glass replacement $44.00 Blower door setup 1 $45.00 " $45.00 S k i{ Total Air Sealing Cost: - $453.75 'li, Heating S stem Measures Duct insulation& seal seams (sq. ft. _110 $3.10 $341.00 H dronic pipe insulation to 1" R5 $3.41 1:., ^ H dronic pipe insulation 1.25"+R5 $3.68 Steam pipe insulation to 1.25" R5 $5.51 Steam pipe insulation 1.5" -2"R5 $6.35 Boiler/furnace replacement $0.00 Pro ram repair $500 max.) $0.00 'Actual Total does not include$175.00 K&T charge. $2,497.25 ]Est Total AUDITOR: _ Doug Cranford $0.00 Act Total NSCAP 98 Main Street Peabody, MA 01960 Agency: NSCAP Client Application#: PROGRAM: Keyspan/2012 f20236 Job Number: 0 Work Order# p Work Order Date: 05/02/12 lob Limit: Primary Contractor: A& M General Contracting Per Unit $4500.00 Other Contractor: Manchester Electric t" Client: Joseph Downing K+T Yes=1 No=O Street:I 10 Cedar Avenue,,, K&T: 0, City; State;,Zip: Salem,MA 01970 e Telephone: (617)682-2591 Stand Alone: No Ss >i Fee Code: 2 i Blower Door Test: Yes Yes=1, No=2 Inspect Knob& Tube: No Elec. Contractor: [Attic ttic Insulation Estimated Actual , Cost Est Cost Act Cost ttic flatR38 open $1.47 ttic flat R30 open 462 $1.37 $632.94 flat R20 open ' "`$1.29 Attic flat R10 open $1.21 , Attic flat/slope R30 restricted $1.48 Attic flat/slope R20 restricted ,$1.42 a ; Attic flat/slope RI O restricted $1.30 3„ Attic kneewall R13 $1.31 Attic kneewall floor R30 restricted . $1,48 1 �: Attic/kneewall floor transition DP $2.52 Finished attic access $105.00 :W;. Temporary attic access $78.75 - 3 Crawls ace RI w/poly vapor barrier $2.53 ' 1 Oara a ceiling/floor R30 $2.10 + Thermadome $180.00 Roof vent- laze $95.00 + e, Roof vent-small $80.00 Turbine vent $168.00 12"stack vent $152.00 P'ro a vent =$23.00 Gable vent all sizes Soffit vent s. Ridge vent fin. ft.Attic air sealin 2- art foam' 20.00Vent dr er/bath exhaust fan 1 $89.00 R p A � Keyspan/2012,' 7-77 7 77 tk 4'4t-o, Q a�- Estimated -W Actual Cost Est Cost 'Act Cost Wall hisijla—tjon?%. 0?P,,T evA� gzj� . 11' 1 1, Nl� V Single-hailed asbestos/asphalt R1.5 DP 1,4�S jDouble nailed asbestos/aluminunfR15 DP. lwk,$2.31 1Brick/stucco Rl5DP "M, $2.89 N 4 [Interior wall blow-plaster R15 DP.! f� $1.90 v" Clap board/wood shingle/vinyIR15DP 1k6i 464 S1:79 $830.56 Au E$60 Test drill 4 sides 9 'A'Y' V .00 00 Perimter WrM P,5 7-t'� �4;7A: NO 31.91 im 'n--tv V'V 't"777, IT v� f-r-S�ea I i n ,0 lzn g 7 Door kitW," 7-7777 �M$45.50 !oiittv -n .W' kn Regular door sweep!,,TP,. :I. $15.15 4! "y-14) !;"I -7777-- - Automatic'door sweepA. $23.00 3Air sealing 2-part foam! '--r11$75.00 $225.00 Sash lock4�, r Glass 'ac rep e�ment 4 $44.00 Blower doorsei�i !-PF,$45.00 $T5 00 7T V P, i. �!T'! A'!F� X! J Total Air Sealing Cost.- t�,,c i. $270.00 -x Heating SysLeg Measures 4171 Duct insulation&seal seams(sq. $3.10' Hydronic pipe insulation to I"R5 $3.41' -W Hydronic pipe insulation I i25 11 +R5 $3.68 Steam pipe insulation to 1.25"-R5 "I 5.5 11 Steam-pipe insulation 1,5"=2'R5 m $6.35 f7v1' Boiler/furnace replacement S, $0.00 IT'P, Program-repair($500 max.)YVq -W Aitu.1 Tend does not in I clude$175.00 K&T charge, $1,972.50] Est Total V14A rd g AUDITOR: Dou Cranford $0.00 1 JAct Total Q-I-Y UN SAIE.M. A`iSSACHl:SETTS q 131:ILL)ING DEPART\IF 120 W.\SH6VGTON STREET, 3ta FLOOR �v. w TEL (978) 745-9595 Rio((978) 7•10.98-16 K!\t p E U-EY D R)SCC l-L THOANS ST.PIFAU A1YOZ DtRECCaR OF Pl:9LIC PROPERTY/BCRDfNC,CO\t\If55tUNEi Workers' Compensation Insurance AlVdavit: Builders/Contractors/Elet:tr(cians/Plumbers ti 1 illeant information i ase Print Le?ihl .Nainc tllueitws Ornglnirationn,lmlividu.d): Address:��7 CityiStatc/Zip: !Z 6 dJ y klA o/ 1,46 Phune hl: 7 :Z� 7 Z \rc u an employer!Cheek the appropriate Dart Type of project(required): I. I am a employer with14 4. Cl I am a general contractor and I S. ❑Now construction enlplayecs(flit and/or part-time).• have hired the subcontractors 2.❑ lam a sole proprietor ar partner- listed on the mfachcd shae� t 7. ❑Remodeling ,hip and have no employees These subcontractors have V. ❑ Demolition working for me in any capacity. workers'comp. insurance. 1). 0 Building addition (No workers*.comp. insurance 3. ❑ We are a eorporalion and its required.( officers have exercised their 10.0 Electrical repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. (\o workers'sump. c. 152, §1(4),and we have no 12.❑ Uof repal insurance required.)r cmpluyees. (Nowarkred 13. Others/I//�.ffVSr��A comp. InxUrsnCe mgUilr.'d.j ' ;.vn d is w y applh:un W dross bat r1 Must oho fill out the ell"bulew showing their"Ines,compenud rm un Policy innaedon. 1 h.neuwrrre wha'uhmil this a1rlMvit indic"Ing they are doing all wars and then hire uuni&CCrIMlere mlat ruhmit a new utrlJasil indicating tuck :t'.mtmcton thel nc�sk this box moat anwhed an.WJulund ahmi showing the nwnu ohhe sub-euntracWn and thole wortm'comp.policy Inrtxmadon. 1 urn an rurp/uyer that/it providing rvorkert'cumpwuatlun lnsuranee for my employees Below 1s du policy and job site injarnration. 14 Incur Lice Company None: /��,�1 �S//-I�..•.�.- �/. �1 �7 O Policy 4 or Self-ins. Licio, 4: I`// 4 RAi pJ �.] 4 of oC Expiration Date: 20 p-7 lob Site rlddmss: /S �,� ���/4� (, Cityislute/Z t-Imm, �� o r C 0 •titacb a copy of the workers' compensation policy deelaratlan page(showing the policy number and expiration data). 1- idure to wvurc coverage as required under.Section 23A of NIGL c. 132 can lead to the imposition of criminal penalties of a tire up Ica il,500.00 and/ur one-year imprisrinmcni.as welt as civil penallies in rho farm of a STOP WORK ORDER and a line •:fop as 5230.00 a Jay against the violator. Ile advised that a copy of this,tananent may be furwarded to ilia Miieu of Insc,tigatiane�ti die Dlr\ fur insunnce coverage veriticaliun. 1,10 her err i r rr his that the h1junnullun pravideJ above •s true rr J corrt'et i�.. •, t !' �/-7 �• Bata: 5�� U//icru!rue�rnly. /7u,rat,writ!Lr this area, to he rumpleted by sirs ur lawn n//lriu[ City fir l'uwn:. __. _ _ PcrmitiLlccase I,w sin; \uthurily (circle unc): 1. Ilwird ul Ileallh !. liulfdlm, I)ep.lrtntenr I. City,faun Clerk I. 1-1octric it (oglccrnr i. Plumbing lotpeetor G. 0111cr l'nul.t el I'crs r.. I hone r: CITY OF S.U-&N[, AUSACHUSETTS JLLMOIG DEP.itAT% L,`T I 10 W-UNLVGTOW SMAT, }r FtOOA Ill. k973) 145-9591 KJUMALBY DRLSCOLL P.Vt(97� 114984d MAYOR l�roarAs ST.1sSE1ris 0fxEcrc&OfPLsLCPROP!li7Y/Ol'QDNGCa L<usstoVE1t Construction Debris Disposal At'tidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 190 CMR section 111.S Debris, and the provisions o(MGL o 40, S 34; Building Permit AI is issued with the condition that the debris resulting from ibis work shall be disposed of in a properly licemed waits disposal facility as defined by,11GL c I 11, S 1 SOA. The debris will be transported by: (nuns orhaukr) The debris will be dis used Orin : -ro 4WMP27�- (rddrar of rr;ihiy) u n�nusof�ermilrpphunt 7- 4 /v A&MGE-1 OP ID: SM ,a►�oRo CtRTIFICATE OF LIABILITY INSURANCE DaT03/22o/12 03/222 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: If 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 endorsements . PRODUCER 761-914-1000 CONTACT NAME: TGA Cross Insurance,Inc. PHONE F 401 Edgewater Place,Suite 220 aC No Ext: AIC No: Wakefield,MA 01880 E- L ADDRESS: John Scanlon INSURERS AFFORDING COVERAGE NAIC d INSURER A:Peerless Insurance Co INSURED A&M General Contracting, Inc. INSURER B:Guard Insurance Group Norman Dube INSURER C: 119R Foster St. Bldg 14 Peabody, MA 01960 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. ILTR TYPE OF INSURANCE INSR MD POLICY NUMBER INM/ODmYY MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CBP8833284 03/20/12 03/20/13 PREMISES Ea occurrence S 100,00 CLAIMS-MADE Fx_1 OCCUR MED EXP(Any one Person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000,00 POLICY PRO LOC $ AUTOMOBILE LIABILITY CEaOMBINED SINGLE LIMIT $ 1,000,00 accident rA ANY AUTO BA8762301 03/20/12 03/20/13 BODILY INJURY(Per person) S ALL OWNED X SCHEDULED ALIT BODILY INJURY(Pere.idanp $ OS AUTOS X HIRED AUTOS X NON-OWNED PROPERTYDAMAGE $ HIRED AUTOS �dAUTOS Per..ident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,00 A EXCESSLIAS CLAIMS-MADE CU8762501 03/20/12 03/20113 AGGREGATE $ 1,000,00 DED I X I RETENTION$ 10000 $ WORKERS COMPENSATION X YIN N WC STATU- OTH- AND EMPLOYERS'LABILITY LIMITS B ANY PROPRIETOR/PARTNER/EXECUTIVE MWC345622 03/20/12 03/20/13 E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 H yes,describe under DESCRIPTION OF OPERATIONS balm EL DISEASE-POLICY LIMIT I$ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SALEM-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Salem THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY ACCORDANCE WITH THE POLICY PROVISIONS. 93 Washington St Salem, MA 01970 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD OPS-GAt 50M-0G/04 G101216 Y7lF¢ �O%lt9)fO�GIMIFII� O�. �GLJJ(/Cl/fAlc[IJ Office of Consumer Affairs R B. mess Regulation HOME IMPROVEMENT CONTRACTOR Registration: 741124 Type: Expiration: 1/12/2014 Supplement Card A+M GENERAL CONTRACTING INC. MICHAEL FITZGERALD 5 SOUTH RIDGE CIRCLE LYNN, MA 01904 Undersecretary . . _ — �I a..arhu.ctt. - Drp:u'nncnt of Public 1100S Board of Buildin_ Rc_uiatiun. and •IanU:trd. ..instruction SuC�*+nsor Specialty License License: CS SL 99933 Restricted to: RF,WS,DM,IC MICHAEL FITZGERALD 9 WINCHEST COURT GLOUCESTER, MA 01930 LApu-anon: 6/19/2012 i . uuui..i.1n.r Tr,- 99933