24 CHERRY ST - BP APP 17-22 The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
Massachusetts State Building Code, 780 CMR, Ts edition OFSALEM
Revised January ---
Building Permit Application To Construct, Repair,Renovate Or Demolish a 1, 2008
One-or Two-Family Dwelling
This Section For Official Use Only
-Q ' J Building Permit N be,.. Date Applied:
i /\ Signature:
vBuilding Commissio r/Inspector of Buildings Date
SECTION 1:SITE INFORMATION
1.1 Pro a Address: 1.2 Assessors Ma &Parcel Numbers ,P ��yy P
QSV C Xnsy'r-U SL SO ( J -a e9l 97
Lla Is this an acce ted street?yes1G no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
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?
Public El Private El — Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ow 'of Record:
FFctm stern d s �a e'
N� rintpD Address or Service/ ry
Ltl i ACt�t sral uw M a1$ -1
Signature Telephone
SECTION 3:DESCRIPTION OF PROPOSED ORK'(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied Repairs(s) Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work 2:
c .NA
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ a k�o 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $ .
q ` Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 6l0$9{,), co 0 Paid in Full 0 Outstanding Balance Due:
w
+ ' SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervis r(CSL) O' tm is I
s License Number Expiration Date
5 �taVr� �Q� _ _—.-
- �e of CSL- lder
o List CSL Type(see below)
Address Type Description
U Unrestricted(up to 35,000 Cu.Ft.
R Restricted 1&2 Family Dwelling
Signature M Masonry Only
G 7 R- oq k 3 RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
4Add
istere Home ImprovementContracto (HIC �k ,�All
pan Name HIC rstrant Name � Registration Number
q7 — i6f_�(I Expiration Date
Ar
TelephonerE ION 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 ...70 No........... ❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, I(/1 fio W s,Ynaw'w 1 as Owner of the subject property hereby
authorize " ' C to act on my behalf, in all matters
relative to wo k authori ed this Iding permit application.
(NP&A �VMJR�A 09��0109
Signature of Owner Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
I, Ck!c" r91S �&U I %W I Q Do ,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.
P mt Name
�A\�_ \ o I�o�►
n re of er o ooze gent Dale
the paiYK and penalties of a 'u )
NOTES:
L 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 l I O.R6 and 1 I O.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
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"
W rsrtsss William Sarnowski HIC#154326EIN#56-2618812
24 Cherry St. Roofing Siding • Painting
Salem,MA 01970_
(p978)745.2283 _---
-W August 7,2009
Dear William, _
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. In addition to installing your roof, I would like to offer you the opportunity to obtain a warranty directly
from GAF or CertainTeed. We, as GAF Master Elite Certified Installer and Certified CertainTeed installers have the ability to provide
you with a 25-30 year labor warranty directly from the manufacturer.To view the benefits of Stripping vs. Going Over the existing roof,
please visit our website @ ww.w.olvmpicroofine.com -
Installation Procedure
4- Strip existing roof on the entire house down to the roof deck
Yk Install an 8 inch drip edge on all leading edges(rakes&fascia)
4, Install 6 feet of ice&water on all leading edges
=l Transitional walls are optional and incur an additional cost for the siding repair
4 Install new vent pipe flanges
4b Replace any rotten or damaged ledger board(we allow 30ft. at no charge,$3.00/ft.thereafter)
it: Install 15 pound felt paper on all areas that is noted by ic�r shielo
:l Install new ridge vent system
=L Re-lead and re-flash chimney
Additio e 1 S eci ncat'ons
4. Homeowner to choose color of shingles COLOR:
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.
='k Chimney re-pointing and re-leading is not part of the roofing contract and will be quoted separately.
4 Transition walls are an option,and if the existing flashing is in good shape,usually do not require replacement
d. During a roofjob,the nails could 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
,�k Please cover all your floors in your attic to protect from dust and debris
4 We will remove all of the job related debris ,,/W
4 Permit costs vary from town to town and are rt7IIk included in this bid
Initial the options you are choosing below: //``
Cost for Labor&Material for Roof: $5,995.00
Cost for GAF System Plus Warranty: $ 250.00
Payment Terms: 1/3 deposit upon signing contract S ��ll'�,1/3 work in progress $ ve'l 1 and 1/3 upon completion$ lJ ✓ '�
Remit to:Alpine Property Services Company,Inc,515 Lowell St.,Peabody,MA 01960
Total Amount Agreed To Be Paid: $ 6211,5204
The following schedule will be adhered to unless circumstances beyond Alpine's control arise:
Work Scheduled to Begin:_TBD_ Expected Date of Completion:_TBD
Warranty: Alpine Property Services Inc. guarantees all work performed for a period of one year. If any problems occur we will cover
the cost of all labor and material to correct the problem and meet the customer's satisfaction.
/ A Do not sign this contract if there are any blank spaces. µ rt
itional provisions follow and are incorporated herein by this reference) r
1AU
vros Moutsoul ,General Manager William Sarnowski
Alpine Propel ervices Company Inc., Homeowner -
d/b/a Olym(5ic by(Name)
Tel: (800) 535=4312 • -Fax: (978) 535-2008 � 515'Lowell Street Peabody, MA 01960
1-888-5 OLYMPIC • www.OlympicContractors.com
15 Tanguay Avenue 1 Rockland Cemetery Road
Nashua. NH 03063 LT-1, c :... .e or plod
i
f
A�o CERTIFICATE OF LIABILITY INSURANCE DATE(MMpDYYYYI
PRODUCER (617)471-1220 FAX: (617)479-5147 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION _
Amity Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR _
500 Victory Rd. ALTER THE COVERAGE AFFORDED BY THE POI folFS BELOW.
Marina Bay
North Quincy MA 02171 I INSURERS AFFORDING COVERAGE NAIC#
INSURED INSUREA,1First Mercury Insurance
Alpine Property Services Co., Inc. IN$URERa Safety Insurance I
DHA .Olympic `' :INSURER c Atlantic Charter Ins.' Group .___ '- -
515 Lowell Street INsuRER o:Great ADlerican
Peabody MA 01960 INSURERS
COVERAGES
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 OFSUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN R CC'L POUCYNUM BR POLICY EFFECTIVE POLICY E%PIRATIGNI LIMITS
LTN
11 GENERA MY �I EACH OCCURRENCE 5 1000,000
DAMAGE TO REIN
gIFAC ENERAL WBILTIY MISES eccvneMA 5 50 000
CLaD:LS MAOE ❑X OCCUR DO1186-2 6/14/2009 6/14/2010 MED E%P nn,nnn e.) s Excluded
d $10,000 PERSONAL L ADV INJURY 5GENERAL AGGREGATE s . 2 DOO 000
GGREGATELIMR APPLIES PEA: PRODUCTS-COMPIOP A62 5 2 000 000
ICY X PR6 LOC
SILEUASILR•Y COMBINED SINGLE LIMIT 5 1,000,DDO
Y AMD LEA ocddon0
B X ALL GINNED AUTOS 1702651 1/9/2009 1/9/2010 BODILY nMURY
5
X SCHEDULED auras (Per person)
X HIRED AUTOS BODILY$UURY 5
X NDN�OWNEDAUTOS IPer acddUUl
X Co11 Ded $L,Onu PROPERTY DAMAGE
X C nod $1.000 (Pere 00 5
ANY CANAGEMBILTY
I I AUTO ONLY-EAACCIDENT 5
AUR TN EA AGO 5
TO ONNLY: AEGIS
I A I FXCEsS I UMBRELLA UASBTrf I I EACH OCCURRENCE IS $.000 0, 00
X OCCUR EICLAIMS LMOE ICU5m000117-3 6/14/2009 5/14/2010 AGGREGATE s 5,000,000
5
X DEDUCTIBLE I5
X RETENTION 5 10,0011. S
L. WORKERS LOMFEASAnON I X WC STATL•LIMB OTH
me EMPLOYERS LIABILITY . !
ANY PROPRIETONPARTNENE%ECUTNE YIN X EACH ACCIDENT s 500,000
OPFTCERIMEMBER EXCLUDED?
/5/2010 500,000
(MAnftbaq In NMI CVD0754902 1/5/2009 1
UYmm..HOeWOW4tt E.L.DISEASE•POLICY UW 5 500,000
6PEDIALPRO"no"6 pelw,
ORIERynl=d Wane
D I r Miscellaneous Tools ( 5670041301 2/28/2009 2/23/2010 $5,000 Limit
6 Equipment I i Deductible
OESLRIPgON OPOPERARON91 LGLARONSIYEHICLB I E%CLIISONSA00ED BY ENDOgSEMENTf SPEWLL PROW5ICN3
_.. _ CERTIFICATE HOLDER .. ... -.CANCELLATION:.. _. . : . . . .
SHOULDANYOFTHEABOVEOnCRIBEOPOLIMMBECAN°ELMBI RETHEE%PMATION
OATB IHEiTECF,THE I58NND INSURER MALL ENDEAVOR TO MAIL 5O DAYS INWITEN
NDRCE W THE CERTIFlCATE HOLOSR NAMEDTOTHE LEFT,BUT FARURETO DOSO SHALL
IMPOSE NO CSUGAVON OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORMD REPRESENTATIVE
Lisa Polito/LP
ACORD 25(2009101) 01988.2009 ACORD CORPORATION. All Tights reserved.
INSD25(2004o1) The ACORD name and logo are registered marks of ACORD
AI'.Db.'LUUS Utl:YA ---1TATE(MMIDOIYYYY)
ACnRD TM CERTIFICATE OF LIABILITY INSURANCE Dvousoes
-- -- KNIGHTPRODUCERI Prone(6TT)OST•5nIX FAR 15TT E M"02 THIS CFND CON E IS ISSUED AS A MATT HI OF INFORMATION
KNIGHT INTERNATIONAL INSURANCE GROUP ONLY AND CONFERS NO RIGHTS UPON THE CERDflCA76 -
S00 VICTORY ROAD HOLDER THIS CERTIFICATE DOES NOT
,PMEND,EXTEND OR
MARINA BAY ALTER THE COVERAGE AFFORDED 6Y TNEPOOCIES SELOW.
QUINCY MA 02171
INSURERS AFFORDING COVERAGE NAIC6
INSURED M1 CUSDRER A: Atlantic ChRAGr insurancIX CIXmpany
ALPINE PROPERTY SERVICES CO.,INC. WSURER S:
DBA OLYMPIC INSURER R
11 WILSON STREET WSURERO:
SALEM MA 01970
INSURER E.
COVERAGES
THE POUW OF INSURANCE LISTED 6ELOW NAVE SeeN ISSUED TO n1E INeVREO RANED ABOVE FOR WE POUCY PERIOD INDICATED,NDTNRTHSTANONG
ANY RESU1RENENT,TERM OR CONDITION OF ANY CONTRACT OR DUIER DOCUMENT VAIN NFSPECT TO WHICH n 1&LER STnTE WY BE ISSUED OR
PODLIET�RB.TAR, TE IWITb SN,E AFFORDED
MY Tl BEEN IIC D D S D MUWM NSD L�IAIINN„IS SUGIECT TO ALLT TFJWS,EXCLUSIONS MD CONOn1ONS OF SUCH
ure
TYPEOF W$UMNCE POULYmu"m v =WSCNve v-USYF mm. LIMITS
Lm mnt AAre
aamsRALUA6IDIY EACN OLLURNENCE 6
OBNMERCUA GIiNEIW.LWBIYIY RUN4ETOREIRID 5
PMWOr]
D SAPAE❑OCCUR N®.EW.(AnYon<PeNohl S
PFRSONAl6AOY1NNRY 6
OFNFAALAGGREGATE , 5
GENLAGGREGARLWRAPPLIES PER PRODUCTSCOMPIWAGM. 6
POUCY PO. LOP
AUTOMDBILELIAG6JTIT CONBWE05WGLELWIT S
ANYAUTO Me Wdd-A
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PROPERTYDIJMGE S
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mr AUIV OTHFRTHIW EA ACC 5
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OCCUR F-jLWMSMAOR AGIXREGATE S
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DEDUCTS.E S
RETENTION S S•
woRHT:nscoarSxBAnox Axo WCV00764902 01106109 01105/10 TCWuumm 1 1--,TM
EWLINEA6'UABERT GLEACHACGDEW •i 6D0,000
A. RCPSIuexow EL OL9eASe•FA EniPLOYEE S 500,000
rpgmmm.omu EL DISEASE?OD:TL IO IS .600.000
BPETJ.IL OgOPlnlnlID blw
OTHER'
DESCRIPTION OF OPERASIDNSILOCATIONSIVEHICLESIFXCLUSIONS ADDED BY MOORSEMENT/SPECLAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
ENOND ARY OF THB ABOVE Delmom mums BE CANCEDm e6ORETHE
&X VON DATE THEREOF.THE ISSUNG INSURER"U.ENDEAVPRTO MAL10 DAYS
WR TTEN NOTICE TO THE CERTIFICATE HOLDER NmIED TO THE LEFT,BUT•FAOUAE
TODD 606 WPOSe NO OBUGATIDN OR WMLOYOP/(NYMNOUPONTHELISURefL
AUTHORIYm REPPE5EWATNE ••
AuentlO.c Hdroltl.11Cn19h
ACORD 26(20011DB) CIXNBObw 8149 OACORD CORPCRATION 796E
.'�, i41,is+a�husett+ - Dcp.u-tnunr BoutlB ofPubliL S,Ifcn
ng Rcgul IhonsConstructiunS and St uulard.O Supervisor -.-.--
----
Specialty License License or registration valid for individul use only -License: CS SL 101003 -
-- ---- -" I before-the-expiration date. If found return to:
Restricted to: RF VyS - i Board of Building Regulations and Standards
STAVROS One Ashburton Place Rm 1301
11 WILSOfV STREET MOEET AS iBoston
SALEM, MA 01970 ... _ ..
---� Expiration: 12/14/201, ! Not without signature
('ommisnioner
Tr#: 101o03'
�>lie V� o `/mac c�
Boar o u> mg egul ions an tan ar s
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement,Contractor Registration
Registration: 154326
Type: Private Corporation
t ,
- Expiration: 227/2011 Tr# 279846
ALPINE PROPERTY SERVICES GO, ROJ
STARROS MOUTSOULAS
11 WILSON STREET
SALEM, MA 01970
Update Address and return card.Mark reason for change.
Address Ej Renewal Employment Lost Card
OP9-CAi 7 5OM-07107-PC8490
Board of Building Regulad ns and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Board of Building Regulations and Standards
Registra0dn 154326 One Ashburton Place Rut 1301
Expiratiotr._21272011 Tr# 279846 Boston,Ma.02108
;Type- Private Corporation
t . I
ALPINE PR PE INC.
STARROS MO 7.fi0011t5
vf=
11 WILSON STREET.^�z=-,;_.� Not valid without signature
SALEM,MA 01970 !i" Administrator.