281 ESSEX ST - BUILDING INSPECTION (6) T6- ►q k 2L4 55-7 $132
The Commonwealth of MassachAN4fqCTIONq�SERVICES
Department of Public Safety
yU AlassachusettsState Building Code(780 CMR)20,U NOR
Building Permit Application for any Building other than a One or T`Jd` at�q q n
_(This Section For Official Use Only)
Building Permit Number. Date Applied: Build ng Official:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
� � I �ffie X z5f Llt, k i� �jU� Loam
No.and Street City/Town Zip Code Name of Building(if applicable)
�-
1 SECTION 2:PROPOSED WORK
n/1 Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below
ExistinK,Build ing❑ Repair❑ 1 Alteration Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix t)
Change 4,Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑
Is an Independent Structural Engineering Peer Review requires{`? ^\ r� Yes ❑ No ❑
Brief Description of Proposed Work: —L �-acavx lNr `\S e.eX1 C)dU� Ce �St n y 1n CAS
S a�1gc-h
SECTION 3:COMPLETE TEAS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): I Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)8r Area Per Floor(sq. ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ 12❑ H: H h Hazud H-1 ❑ H-2❑ H-3 ❑ 1-1-4-4❑ H-5❑
1: Institutional M ❑ 1-2❑ 13❑ 1-4❑ NL• Mircatile❑en R: Residential R-10 R-2❑ R-3❑ R-1 ❑
S: Storage S-1❑ S-2 Cl U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as a licable)
IA ❑ IB ❑ IIA ❑ fill ❑ IIIA0 IIIB ❑ 1 IV ❑ 1 VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CNIR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal:
Public❑ Check if outside Rood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑
required❑or trench or specify:
Private❑ or indentify Zone: or on site system❑ permit is enclosed Cl
Railroad right-of-way: Ifazards to Air Navigation: )i i b t rt C �... _u n i.: i ,•..�•,.:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed ❑ Yes ❑ or No❑ Yes❑ No ❑
SECTION 8: CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: _ Occupant Load per Floor
Does the building contain an Sprinkler System?: Special Stipulations:. _
N& DJ- �7i J b�
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
('ha,1_�iorino_'�-_�r•.:ab1 Essex S� 'l>n�� y04 �1` o_ur � �__�`��.
Name(Print), 'A. -" " No.and Street City/Town Zip
G-"'tiv
Property Owner Contact Information:
Title Telephone No.(business) "Telephone No. (cell) a-mail address
If applicable, the property owner hereby authorizes
Nome Street Address City/Town State Zip
to act on the property owner's behalf, in all matters relative to work authorized by this building permit application. _
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Company ame IM(.3rUv-Q- o CvrN:\Mc-kor 10'Raci2 Q-"�p 811 II110
w lltr �rr� � H C�n4 s� S� a�ect soS LS-o2z$ll 8�9 IS
Name of Person Responsible or Construction License Nu. nd Type if Applicable
ao Snowew urn /,Jbory I V!L& OISq
Street Address �— City/Towh State Zip
1k FZzi� 15-11 -- C.4,,iwr4,,, @c., ra l , l .
COn
Telephone No. business Tele hone No. cell 1— nail address
—�
SECTION 11:W_ORKF. lilt-,NSA IION INSURANCI'.AFFII.nAVFF M.G.L.c.152. 25C 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes O No ❑
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE'
Item Estimated Costs:(Labor
and Materials) "total Construction Cost(from Item 6)_$
L Budding S O.J Building Permit Fee-Total Construction Cost x_(Insert here
2. Electrical $ - appropriate municipal factor)=$
3. Plumbing $
-1. Mechanical (HVAC) $ Note: Minimum fee=$ (contact municipality)
s. Mechanical Other $ Enclose check p:ryable to
6.Total Cost $ d- - (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my nans below, 1 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.
Please print and sign name Title Telephone No. Date
Street Address City/Town tale Zip /
Municipal Inspector to fill out this section upon application approval: 644W fZA5�
Name Date
e
t -
Page 1 of
Proposal
Perry Brothers Construction j
P.0 Box 646 Newburyport,MA 01950—P.-(781)233-7611 F:(976)465-0929 www.perrybrothersconstruction.comi
„?
PROPOSAL SUBMITTED TO: - PHONE DATE
Chad Bennett 512-689-0503 10/31/2014
STREET JOB NAME ESTIMATE NUMBER
281 Essex Street Unit#404 3386
CIY,STATE AND 21P CODE JOB LOCATION j
Salem, MA 01970
PARTITION WALLS
-Frame new partition walls per plans
-Install wall outlets to code and switching as needed
-Install windows and doors suplied by owner
-Biueboard and skim coat plaster walls smooth finish
-Trim door,windows,and baseboard with trim to match
-Fabricate and install cabinet box for book shelf
-Shelving to installed by others
GENERALSPECS
-Use poplar stock for all trim work
-Use 314" paint grade birch plywood for cabinet box for book shelf
Paint by owner
We propose hereby to furnish material and labor-complete in accordance with above specifications,for the sum of:
Twelve Thousand Seven Hundred Fifty and 0/100 Dollars ( $ 12 750,00 )
Payment to be made as follows:
1ST PAYM'T $5000.00 2ND PAYM'T $5000.00 3RD PAYM'T
$2750.00
All material is guaranteed to be as specified. All workto be completed in a
workmanlike manner according to standard pmatioes. Arry alteration or
deviations from above specifications involving extra costs will be executed only Authorized
upon written orders,and will become an extra charge over and above the Signature:
estimate. AN agreements contingent upon strikes,accidents,or delays beyond
our control. Owner to carry fire,wind damage and other necessary insurance.
Our workers are iWty covered by workman's Compensation Insurance. NOTE This proposal maybe withdrawn by us if notaccepted within mays.
Acceptance of Proposal - The above prices,
specifications,and conditions are satisfactory and are hereby accepted. Signature:
You are autohodzed to do the work as specified. Payment will be made
as outlined above.
Date of Acceptance: Signature:
Proposal
Pagel oft
Perry Brothers Construction
P.O Box 646 Newburyport,MA 01950-P:(781)233-7511 F:(978)465-0929 www.perrybrothersconstruction.com
PROPOSAL SUBMITTED TO: PHONE DATE
Chad Bennett 512-689-0503 10/31/2014
STREET JOB NAME ESTIMATE NUMBER
281 Essex Street Unit#404 3386
CIY,STATE AND ZIP CODE JOB LOCATION
Salem, MA 01970
- Contractor to provide all permits and inspections as needed
-Certificate of insurance to be issued to owner
-One year guarantee on workmanship
-Remove all debris
We propose herebyto furnish material and labor-complete in accordance with above spec fications,fortha sum of:
Twelve Thousand Seven Hundred Fiftv and 0l100 Dollars ($ 12 750.00 )
Payment to be trade as follows:
1ST PAYM'T $5000.00 2ND PAYM'T $5000.00 3RD PAYM'T
$2760.00
All material is guaranteed to be as specified. All work to be completed in a
workmanlike ikr mannerabove
specifications
io s involving
exboec Any alterationeratio executed
deNaOons from above specifications invohring extra costs Will be executed only Authorized
upon written orders,and will become an extra charge over and above the Signature-
estimate. All agreements contingent upon strikes,accidents,or delays beyond
our control. Ownerto carry fire,wind damage and other necessary Insurance.
Our workers are fully covered by Workman's Compensation Insurance. NOTE:This proposal may be withdrawn VM If not oepted wMhin Sys.
Acceptance of Pr000sal - The above prices,
specifications,and conditions are satisfactory and are hereby accepted. Signature:
You are autohorized to do the work as specified. Payment will be made
as outlined above. t t
Date of Acceptance: 't-t Signature: �_
�tetwds �tdndd�e�e�� ��t
C/O GIBRALTAR MANAGEMENT CO., INC.
P.O.BOX 627
BEVERLY,MA 01915
Tel.#:978-922-2202
November 14,2014
Chad Burnett
Candice Rebbe
281 Essex Street,Unit 404
Salem,MA
Re: Unit work
Dear Ms.Stokes,
Per your request to proceed with work within your unit please note the following:
I. Unit owners are responsible to make certain that any work does not change the exterior
appearance of the building.
2. Any contractor hired must be a licensed contractor in the State of Massachusetts.
3. Contractors must produce evidence of insurance with a minimum of$1,000,000 liability
coverage and compliance to State workman's compensation insurance.This may be faxed to
978-522-8429.
4. Contractors must apply for and obtain any required building or alteration permits from the City
of Salem.
5. All debris and trash from the work must be removed from the job site.
With the above requirements,the unit owner may hire the contractor of their choosing.
Please ask the building department to call me if they have any related questions for the association.
Thank you,
Robert M.Polansky,Managing agent
Latitude Condominium Trust
The Gibraltar Management Co.,Inc.
Managing agent
4-4
V4
i
s
,
fill
t
�.
L Y {
;i
�3
f t 11(
a _
¢II
it
i
41
lz
j i f Ij
1
:;_.,«.�..._..,.r-»......._..._.»...:.,...,.,__..,..r.....-..�.....,.„..-..;.�,..,...�.-......w+m., �M,...,a.«:.n,,.w+..=+,i,:.«w.•,.m>...swi=<,,.�w-e"�
tjr i
L f i
i
I' �
OW/1812014 10:47 7818901198 INSURANCE AGENCY PAGE 03/03
^ aLSB.u�ran t.o�t t%/,Lt7/'LUNG W:lb:42 AM PAOE Z/002 Fax server
CERTIFICATE OF LIABILITY INSURANCE DATErMNUDOMYYY)
min
IS T89UED AS A MATTER OF INFORMATION ONLY AND CON NO RIG UPON THE CERTiFICA ER. H NOT AFFIRMATIVELY OR NEGATIVELY AMEND.EXTEND OR ALTER THE COVCRAaE AFFIS
CEIDEO BY THE LDER.p*LW FT BELOW.
OF INSURANCE DOES NOT CONE RTUI A COMRACT BETWEEN THE 1SSUHPG INSLRIEW,AWMMZED REPMMEMATME
An HOLDER
ONImte holder Is An ADDITIONAL INSURED,the P011COMal roust be elldersed it SUBROGATION IS WAIVED,subject to the
of BTA POBIy,ONtebl PAIkI�IMW r0fulre rod e"I NemNtL A stalmneM on this dertlfldete does not center rights to the
AUdT s
PRODUCER OOWACT
PRESS BAUMAN It TURNER I PHONE FAX
460 TOTTEN POND RD ST E 630 (AM.No,Extr. tAM.HOP
WALTHAM.MA 02451 E•SUUL
ADDRESS:
22Wai,
IMURER(S)APiOMONG OOVERAGE NAICM
INSURED PMEMR
A: TRAV6USRSPRaMTY CASUALTY COMPANY OF Ah2RICA
PERRY BROTHERS CONSTRLiCTTON INC 0:
C:
PO BOX 1546 D:NER'RURYPORT.MA OT950Fe
COVERAGES CERTMATENUMBER: REYISON NUMBER:
AnfR gIT.TBn1M CdIMtlN CF MY CONTRACT M OTNp1 DOCUNFArf WRN RASP1 TD WNIONTHI6OEIfriICInEMAY9e BgFD OR MY PERGM.TNEetT;UAANC6
PAID S, ���NMUPSff� INSR%otl�gg ANe TO&L THE TE 0oWfff7WG W SUON MAIMS.MR
LRIR9ANDWN YAY NAVee�Jt REDUDW BY
LTR TnrE OP INSURANCE AIR POUCYMFoa YPYPCpRH
L R POLICY NUYeER (NMD1TYTM RBACOIw" UIRTS
GENERAL LIAWLITY CN OCCURRfiNCfi B
COMMERCIAL GENERAL LIABILRV
CLARA MADE 71 OCCUR, AMAGE TO RENTED S
RELiISRB 6a anarmnnl
DFxP(AnY wH NAmI S
GENL AGGREGATE LOAM APPLIES PER: 6RSONAL A ADV MURV Is
POLICY C3PR 1ECTOLIX: EIYERAL 4GGREGATE s
RDOUCr3-COMP/OPAGG
AUTOMOBILE LIABILITY S
ANYAUTO EDSNGLfi S
ALL OWNED A1TrO5 LMR(Ee RmlderEl
S
SCHEDULE A1JT05 OILY WURY
PAr VVII&A)
HIRED AUTOS ILY WUM A
NON-OWNEDALROS Par xceieerL
PflOPERTYDAMAGE S
Per accmr4j
UMBRELLA LIAB OCCUR EACH EXCESS OCGIIRflPNCE S
LL CLAMS•MADE GREGA S
DEDUCTIBLELS S
RETENTION S S
A WOFPCERT COMPENSA71pN AND x WC SMMOAY OTHER
ENOILOYEFM LIABIMY YM USQQMNS}1a ASNARR1a W1412016 WCST
aRr PROPERRDAmARTNAR/Fxr:t1,rfNE
OPPiCEPUS.PFE Fxa.GDSD? ®WA E.L EACH ACCIDEM
B 000 IlAnaexrye Idll
xm aatdPoconde, EL.DISEASE-EA EMPLOYEE S 500,000
aecPIPrIDnOFOMRATONShobe E.L.DISEASE-PDuoYLnBT S BOO,DOD
DESCRIPTION OF OPERATIONS+LOCAWDNE 7VEH CLMESTR M NSNSPMML rnw
"M"PLACES ANY PRIOR CMrmcATP,TS M70 THE CMtTLWCATP.MOLDER APPRCrINO WORMS COW COVERAOR.
CERTIFICATE HOLDER CANCELLATION
TOWN OF NEWRTTRY SHOULD ANY OFTHEABOVE DESCRIBED POLICIES BE CANCELLED
35 HR3H RD. BEFORE THE EXNRATtONN DATE THEREOF,NOTICE WILL BE DELIVERED
N ACCORDANCE WITH THE POLICY PETOVISOWA
RY,MA 01951
ALTMORI;ED REPRESENT VE •`T9EWDU {{
"'Bated':',;,"At::L,Y. '`fw.•
4CORD ( IOMS) The ACORD naM end W90 910 wellIAMCd me1IRL D}ACORD t RD All IIBtItdlCBeryeTL
99/17/2014 13:56 7818901198 INSURANCE AGENCY PAGE 03/03
-ACt?RDi CERTIFICATE OF LIABILITY INSURANCE outasu I
THIS CERTIFICILTE 18 IBSUt p A9 A MaTT6R OF INFORMAriON ONLY AND CONFERS NO RIGHTS UPpN THE CERTIFICATE HOLDER 17/2014
BELOW, TTE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE LDElPOLICIES
BELOW. THIS OERTIMATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING ORDER By AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
T: C6 8N ,t1 P� Must DO tM terms and COIIORIens of Ma Po9Cy,06rlatn Polh:tes may�4uire an erWuser5 M A CATION A U.MPJM to
eDUCERats Aoldsr In Ihlu of such ondorsemarM(6j, �abmeltt on this aer88eain does not confer rights to the
PRODUCER
Press, antenna L Turner
460 Totten Fond Rd, snits S30 (7el)890-0050 . (781)890-1198
aTalt:hoe, 10L 02451-1965
ergo IAePORmN000velnoe Napa
INBUR® Perry O 8 one Oa, TAQ. fXSLIRERAt weatera world
P 0 Fox 646 EYSURER 9: Safety
Newburyport, MR 01930 Rrmane,
INVII D:
INSVREII E I
COVERA6ks CERTIFICATE NUMBER:Ciey of W®wbury part
TH O REVISION ML8IABER:
CERTIFICATE VAyBE STANOWG ANr REQTAN 7WT:TERM OR CO N E O 1Iff
EXCLUSIONS MAY 8E IB6UED OR SUCH p0LjN.IHE INSURANCENbf7lON OF ANY CONTRACT OR OTH III DOCUMENT 4VrTH RESPEC7 TO WHICH THIS
E%CLU3I�i3 AND COf�TTIONS OF SUCH POLICIES.UNRTB SHOWN MAY KAVEVY THE BEEN POLrAW
REDUCED BY PDBEDA EW IS 6UMCT TO ALL THE TERI
rNe OP IISURaNCE
OEeMeal UQNI P011OY rDIIeER Ulm
X OOMKERCUU•OENERALL, e,L EACH OCCURRENCE s 1,000,00
CtA ®OCCI. NPP 8201246 091 a N roe !
A 10)2014 09/10/20te meD EXP ane aweal a 5,00
PERSON4aAOVIjURY S 1,000,00
OENLAGORWATELO4TAPPLIESPFA WAIVIALAOMMOATE 9 2,000,0001
X POLICY T LOG PROOUCTS•COMWOP AGO a 1 006,000
AVIOYO&LS LINelllry !
300989006ff201014 06111PtW6 eA m ! 1,000,00
ANY AUTO
a �OI aC X s eODILY INJtnrlPwpgypAl a
X HIRED AVTOS X eODLLY IAUURY(Pmaogae.xl a
Y111811I LW OCCUR !
Excess Uas OLAnLTr Ave EACHOGCVRRENCE !
ORD RETEMTIONt AGfN1EOaTE !
AAtNryON LAN RIM !
R� YFK
EXCL G� NIA E.L.EACH ACCIDENT
�j�c�p� III��JJJ.JI !
"wdRRT1«7 OF OPERATIONS bow E.L DBEAN-EA EMPLOYE !
E.L.OMEAN•POLICY Lnlr !
'PROW OF OPERAToes/Lot"ON!/VEHICLES EArNNN ACpgp lal,AOeIanl RameAa SPAeaaiA.Imam peal M nWNa61
?RnI9CATH1IDlaER
CANCELLATION
SHOULD ANY OP THE ABOVE tHMCgWay PO{dt,P se CANCELLED eHPORE
rn ExgRAnON DATE THEREDP,NOTICE BELL aE OELRAEREO II
ACCORDANCE WITH In POLICY PROYEHONj
Town of Newbury am+rort�D aTNe
25 aigTa Road r---�--..
SOL 01951
CA AN RjG
'ORD 25(2010" The ACORD name and logo are 1e91910nad ma ACORD m*wved.
p ca t
L
P
i
�bi .uemexeero�+9oalmW4
ro
,
4
r �
4
r '
4
.. i
1-4
enr
it Irm,
00,
camw
1M ^
WAVWW
3fi�4tt�T�1'�. H
O
- '� ., .-,- •+`{�3flYiilTtlL�H�tJM3"7jWfP, `p
OLVONM
x
4' A
' r„a'sxss+irasmsrer'
' S
y
_ a
9
,
x
s y .
y. .
C . l
.4