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0017 EMERTON ST - BPA-13-1006 t cool I y� The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Revised Mar 2011 Building Permit Application To Construct, Repair Renovat emolis One-or Two-Family Dwelling This Section For Official U Only Building Permit Num er: Date App ied: Building Official(Print Name) Si'nature Date SECTION 1: SITE INtqHM5VTION 1.1 Propger�tyress; , SL / 1.2 Assessors Map& Parcel Numbers —1�2C ram! L l 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 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: Public❑ Private❑ Zone: _ Outside Flood Zone? Check if yes❑ Municipal ❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP[ 2.1 Owner'of Record: / ��o1naS -i lklee Cr'A�i.t� Sa�erNt M h 61 S7d Name(Print) - City,State,ZIP /7 Fmerf-o„ SY. c1A-7Yi4-633q � f rds79 @ j&4dco,coykN No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ 1 Existing Building R/ Owner-Occupied V Repairs(s) Alteration(s) KIAddition ❑ Demolition W/1 Accessory Bldg. ❑ Number of Units Z Other ❑ Specify: Brief Description of Proposed Work': ,Q(� ]/I[ C.11, O2 !'�iflS7�1EL •.K e SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and Materials Official Use Only 1. Building $ 12 5,90 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 cession $ Total All Fees:$ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $1 Z !�(�� 0 Paid in Full 0 Outstanding Balance Due: SECTION5: CONSTRUCTION SERVICES 5.1 Construction Supervisor"Liic�ense(CSL) 11 A/ �� / x / ,pm)r. , rn,4ic_.t ,A1 ,P License Number E piTration Date Name of CSL Holder �n d A t/� List CSL Type(see below) 4 V " No.and Street /� '/ Type Description ® /[ U Unrestricted(Buildings up to 35,000 cu.ft. City/Town,State,ZIP/ J Restricted 1&2 FamilyDwelling Masonry RC Roofing Covering �f d �' WS Window and Siding �� /�� /TQ/ /r[�:�t � SF Solid Fuel Burning Appliances fJ t {x/(J � [�O� �(/ � I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) ! WW-AAMs f SOXP; �� i 73i4� 11 1 HIC Registration Number Expi anon Dale HIC Comp y Name or HIC Registrant Name N at treet W O 9�9 gZiL O/ 1 t Email address City/Town, Stat ,ZIP Tele hone C l 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 Issuan,�6 of the building permit. Signed Affidavit Attached? Yes .......... No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT +,. I, as Owner of the subject property,hereby authorize �/1 '0 + 4-o/�4 to act on A�my behalf, in all matters relative to work authorized by this building permit application. � a .�C. a . A i_ �'�—/S Print Owner's Name(Electr i 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. 1)M V19%"PAp7 l�l �,W4) r lGs :NG y/ / 3 Prin t Owner's or Authorized Agent's Name(Electronic Signature) Date 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 can be found at www.inass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dl)s 2. When substantial work is planned,provide the information below: Total floor 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" I'he CofFmmnweaRh of Alassach,usetts Deparinzent oflndias trial Accidents Office of Investigations 600 Washington Street w Boston, MA 02111 . WWW.Mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/1ElectriciausllPluratbers Ap tic nt Informatio Phase print I e ibl/ Name (Business/Organization/Individual): Address: / 7 e7 City/State/Zip:- A ©` 15 Phone #: qrzZ' �llJ Are you an employer?Check/he appropriate boa: Type of project(required): 1.❑ I am a employer with 4- ❑ I am a general contractor and I 6. ❑New construction ' have hired the sub-contractors employees(full and/or part-time).'- 2.❑ I am a sole proprietor or partner- listed on the attached sheet- 7. ❑v'Remodeling These sub-contractors have g. Demolition ship and have proprietor employees mein any capacity. employees and have workers' working for 9 El Buildingaddition [No workers' comp.insurance comp.insurance-$ [1 5. dWe are a corporation and its 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required-] =Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. III t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tConnactors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp-policy number. I am an employer that is providing D'LOrlien'Compensation insurance fol.nay en ployees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: / yy� / 70 Job Site Address: -1-�� City/State/Zips J �` � 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$.1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 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 Certi' 8d der the alas andpenalties Ofperjmry that the informinion provided ahDve is true and Correct. Si attire // Date• 611141 , Phone# FOffcialuse only. Do not write in this'area, to be completed by city or town official Town: Permit/LicenseAuthority(circle one): d of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector r t Person: Phone#: -�: � ��r (/ niiiiirnirrnr�rr�/� r/Jn�'(rr.l.lrrr•�rr:1r�//1 : Oi lice of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 021 16 Home Improvement Contractor Registration Registration'. 173846 Type, Corporation Expiration: 11/20/2014 Trp 23384c �vIARCHAND & SONS CONSTRUCTION CO VVILLIAM MARCHAND 7 1NELLMAN ST BEVERLEY, MA 01915 Update Address and return card. Mark reason for chan;c. --', Address Renewal ' Employment Lost C:iid tri llr�of Cousu nrer:xlrairs & liusmess Regulation License or registration valid for individul use only ri- 'nOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: � -Registration: 173646 Type: Office of Consumer Affairs and Business Regulation -.- 10 Park Plaza - Suite 5170 :Expiration: 11/20i2014 Corporation -- Boston, MA 02116 ra;-.-.. SONS CONSTRUCTION CO INC. I � __ r C1515 Uridersecrelary Not valid without signature )IM Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supcnisor 1 & 2 Femil.N License: CSFA-046506 ]� DANIEL F MAIICjiAN ►'- 4 DEARBORN AVE y , BEVERLYMA 61915 ' ' cJ, � , 'x ` Expiration Commissioner 01/04/2015 MARCHAND & SONS CONSTRUCTION COMPANY INC. Mr. & Mrs.Tom Gifford = Eq=R9A0, BEVERLY, MA 01915 17 Emerton Road Phone 978-922-0115 or 978-922-4442 Salem, MA 01970 Fax 978-921-6675 RE: Misc. Dear Tom & Helen, Please consider the following prices for various projects discussed at your Emerton street home. Windows CED #19 Supply and install vinyl replacement windows by Harvey Industries: • One cellar unit as previous two • One in master bedroom • Two in kitchen Quote: $2200. Kitchen door C@ #19 Replace existing with new 2-8 x 6-8 (6) panel fiberglass door(Therma—True, smooth-star) . complete with keyed knob and dead bolt. Trim interior and exterior to match general decor. Quote: $2050. Note: For a 9-lite door instead of the 6-panel (no glass) please add$70. Back Entry's In my opinion,the back entry's are beyond repair. I propose the following: • Demolish entry's and dispose of debris • Construct new open deck 3"x 11-1/2'with_a set of steps each end • (2) new concrete piers with 4 x 4 PT posts to support deck • 5/4 x 6 PT decking and treads • 1 x 8 PT risers • Baluster style railing as follows ■ 4 x 4 PT posts ■ 2 x 4 PT rails ■ PT Balusters Although we will make a weather-tight connection between the new deck and the house, any other issues with the house wall will need to be assessed when the structure is removed. Quote for Deck: $6113. Please note there are no allowances in any of the previous for painting or rot repair. Also, a building permit may be required for some of these projects. Although we intend to secure one,the cost is not included and will need to be billed as a separate item. I trust you will find the previous information in order. Please do not hesitate to contact me if there are any questions. We at Marchand &Sons Construction Company Inc. are fully licensed, insured, and registered in Massachusetts. We thank you for considering us for your household needs. WRega,4s, Dan Marchand DFM/am L i z¢ k6$ zs lot x 3V 71 �t�Tt( � z-- Zx tb �T q %z C RADe' 7y Pt ct c, 134L-c s� 978-922-Q,15 I Q /�' ��{'}J.-r.�l!Ci/IUL�a -- 978-922-4442 ! 1 Ca ,,{{8V— FA. 9ee-921-6675 17 - �'1 0N Sect M� MARCHAND & SONS t,_ -`_gu CONSTRUCTION COMPANY INC. i7 u1m-�rrAAf S1- a OqN MARCHAND BFVERIV, M/{ 01915