164 FEDERAL ST - BUILDING INSPECTION (3) t
\� The Commonwcalth of Massachusetts
Town of
Board of Building Regulations and Standards
.Massachusetts State Building Code, 780 CMR, 7m edition Building Dept
Building Permit Application To Construct, Repair, Renovate Or Demolish a 1tkv@m kmo
One- or Tyro-Furnilt Du elling
This Sectio or O tat Use Only
Building Permit Numb /. Date A lied:
Signature:
Building Commissioner/Inspector of Buildings Date
SECTION 1: SITE INFORMATION
perly Address: 1.2 Assessors Map& Parcel Numbers
«rr e4l S.'T/lr {rr
Ma Number Parcel Number y
1.1 a Is this an accepted street?yes ✓ no p
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq R) Frontage(R)
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.S54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal O On site disposal system O
Public O Private O Check if ye.M
SECTION 2: PROPERTY OWNERSHIP'
2rOwn e 'of Record:
(�.AIr.U,EI C3,s486
(Print) Addre s for S ice:
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK'(cheek that apply)
New Construction O Existing Building❑ 1 Owner-Occupied O Repairs(s Alterations) O Addition O
Demolition O Accessory Bldg.C) Number of Units_ ter O Specify: �C3P1 Hsc/Cs- O
Brief Description of Proposed Work':-Lti A/� /US`.-) LA q K 0 — 2T F
D v t=tC 021 ! L AFG X-
Ti✓JTA�/ �iC6— /Hr !/ .57-ocr/Cr .c!'P uJ 'J�' W'f-�i/JF L�00
Cr/ Ser-FinJC9L�5' i
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs: Official Use Only
kch
Labor and Materials fI. Building Permit Fec: f Indicate how fee is determined:
❑Standard City/Town Application Fee f ❑Total Project Cost'(Item 6)x multiplier x
S 2. Other Fees: S
. eHVAC) S List:
S .Mechanical (Fire S Total All Fees. f
Suppression)
�1 e7a Check No. _Check Amount: Cash Amount:_
6. Total Project Cost: f G 7 ' 0 Paid in Full O Outstanding Balance Due:
r•
l
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
�r�0j�57o�FfcYL 2 . ce y Cs /a l9G� �/ Z 20/Z
�e L¢vroc Number E.pirw/n Date
N4mc ul'CSL- Hplder fir— Lis CSL T (J
ype(s,'v lwlow)
AJ ss Type I Description
C.= U I Unrestricted(up to 55,000 Cu. Ft.)
Signature — R Restricted I&2 Family Dwelhn -
92� 7�1a o�a� M Mason Only
RC Residential Rcofinx Covering
Telephone WS Residential Window and Sidi
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Registered Home ImRrovement Contractor(HIC)
G- rtlsY fF�?2 /2 ros w, / �,�/9/�
�,o-0�0 �F CIF �
HIC C mpan Name or HIC Re trans Name Registration Number
P d , lSa`"5 7 20,T
- /cV 7yG--OX9 Expir on Date
ignaturc 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 Issuanc f the building permit.
Signed Affidavit Attached? Yes .......... Er No........... O
SECTION 7a: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 building permit application.
Signature of Owner Date
SECTION 7b:OWNER/ OR AUTHORIZED AGENT DECLARATION
1, C'c�frysJ`DO�i�r Z 40 e ,as Owner or Authorized Agent hereby declare
that the statements and information on the f regoing application are true and accurate, to the best of my knowledge and
be al .
(Signalitfineof Owner or Au horized Agent p
ale el
(Signed under the pains and penalties ofperjury)
NOTES:
I. 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 Vl 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 I O.RS, respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq. Ft.) (including garage, finished basemenVanics, decks or porch)
Gross living area(Sq. Ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halfbaths
Type of heating system Number of decks/porches
Ty pe of cooling system Enclosed Open
1. "Total Project Syuare Footage" may he substituted for"Total Project Cost"
CITY OF SALLM
PUBLIC: PROPRERTY
DEPARTMENT
Construction Debris Disposal .at'lid.nit
(re\luired Iilr all demolition and reno% IIion wurk)
In accurdance w III the sixth edition of the State Building Code, 780 C•R)R section 11 1 5
Dcbris, and the provisions of.tiIGL c 41), S 54;
Building Permit )) is issued with Ote condition that the debris resulting from
this work shall he disposed of in it pruperly licensed waste disposal facility as detined by MGL c
1 11, S 150A.
The debris will be transported by:
wamc(it hauler)
I he debris will be disposed of in
11�*ff6 4zo—s � O
133 (lame kit IacI Ily)
I:Iddrev. . IJI I II I V)
cfc
/p. .iCndlu nt pi nna dlglhk ant
.Illy
CITY OF S.U.E.`I, ,'L%L-ksSACHUSEM
BVI1D4YG DEPART-MEINT
.4�,,. ....... . .. .... —120W.+iHINGTONSTREET: 3se-FLOOR ,
TEL (978) 74S-9595
F.%X(978) 740-9846
K15(gEtIEY DRISCOLL
VSAYOII "I?IOMASST.P�Jtits
DIRECTOR OF PL BLIC PROPERTY/BL:MDLNG CO.%L%(ISSIO%EA
Workers' Compensation Insurance Affidavit: Hui lders/Contractors/Electriclans/Plumbers
11pilcant Information Please Print Legibly
�Ia117C IBusincsrOrtamtation.InJrvtduall'`-r'/�/�a��{�7Z, F� r CO yK�L� .s� _ _
Address: /P C) &6,e (moo S
City/State/Zip: 53,,I«tff 0/976 Phone N: 9 7� f 7 yO —D/0
,%re an employer!Check the Appropriate box: Type of project(required):
I. I am a employs with `- 4. ❑ 1 Am a general contractor and 1 6. ❑New construction
employee(full and/or pan-time).• have hired the sub-contractors
2.❑ 1 aun a sole proprietor err partner- listed on the attached shreL : 7. ❑Remodeling
;hip and have no cmployem Thee sub-contractors have B. ❑ Demolition
workin for me in an capacity. worker'comp.insurance.
g Y P ry• 9. ❑building addition
(No workers comp. insurance S. ❑ We are a corporation and its
required.)
officers have exercised their 10.0 Electrical repsirs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL 1 1.❑PI ing repairs or additions
myself[No workers'comp. c. 132.f 1(41 and we have no 12. Roof repairs
insurance required.)t employes.[No workers'
comp. insurance required.) 13.❑Other
'Any apphcars nay chotha bag Ae MUM slats fin oat eM sectia•belay showing their warkwa'Cwreperteti,m policy in(urnsaa a
t i hvneuwree who rstbarn this affidavit indloting they ae doing all work 3M then like outside aonrockes Must submit a new anldsvit indicating such.
:C.eteraeson rha cheek ehia bas mud attached an a,Witio al shun showing gat tome of the sukavmraege and that workers'comp.put icy inarmsuaa,
I eta an employer that Ire providing workers'rompenradon Insuronee for my emp/oyesa. Below/it rhi policy and/off sip
informaniora,
In.urance Company Name:
Policy g or Self-ins. Lic.p: CJC 007 yZ22l Expiration Date: 23 ZD/O
lob Site Address:_IA !�Z 22_572 a` ,/ S 1- 0r970
,%ttach a copy of the workers'compensation policy declaration pap(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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties is the form of a STOP WORK ORDER and a fine
of up to 5250.00 a day against the violator. Ile advmad that copy_of_this statement-may-be furwarded-to-the-Office of --
Inveangatiuru ul'the DIA for insurance coveralls vcrincatiun.
I da hereby rri Jir flier priwa mrd yens/His olper/try that the infpntat/ow provided about is rrws an/aurrrea
Dat 8 _ Zd 26Ur
Ofriel use duly. Do not write in this area, to be'utnpleted by city or town a/f cial
City or ruwn:
hsuing.whoray (circleone): i -
1. Ruard of llvalth 2. 9udiling Department 3.City/town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
l„ntact Person, _ —. _. Phones:
(1
RAPID ROOFING
GENERAL CONTRACTING COMPANY
P.O. BOX 605 SALEM, MASS. 01970
MASS. LIC # 144946/128253/CS101965
RAPID ROOFING IS A DIVISION OF COYNE&SONS CONTRACTING
978-740-0101
GO OVER ROOFING ESTIMATE
TO. 8/20/2009
PETER& DONNA BIMBO
164 FEDERAL STREET
SALEM, MASS. 01970
978- '3-q,l -- ZG�/ 2
25 YR 3-TAB CERTAINTEED
BLACK ROOFING SHINGLES
GO OVER ESTIMATE. # 09-0082
WE AGREE TO.
1. INSTALL APPROXIMATELY 12 SQUARE OR 36 BUNDLES OF
NEW 25 YEAR 3-TAB ASPHALT ROOFING SHINGLES
AND CAP SHINGLES. OVER THE EXISTING ONE LAYER OF ROOFING
SHINGLES, ON THE EXISTING MAIN ROOF AT THE PRESENT TIME.
2. INSTALL NEW 8 INCH MILL STOCK ALUMINUM DRIP EDGE ON THE
COMPLETE BUILDING, IN ALL AREAS BEING SHINGLED.
3. INSTALL NEW ROOF VENT PIPE BOOTS, FLASHING, AND ROOF BOX
VENTS, IF NEEDED IN THE AREAS BEING RESHINGLED ON THE
BUILDING.
4. REMOVE ALL ROOFING DEBRIS FROM THE PROPERTY ,
AND ALL THE WORK WILL BE COMPLETED IN A TIMELY MANNER.
n
5. TOTAL COSTS........................................................$ 2,400.00
MATERIALS AND LABOR INCLUDED IN PRICE.
WE HEREBY PROPOSE TO FURNISH ALL MATERIALS AND LABOR-COMPLETE IN
ACCORDANCE WITH THE ABOVE SPECIFICATIONS FOR THE SUM OF;.................
************* TWO THOUSAND FOUR HUNDRED DOLLARS ***************
$2,400.00 WITH PAYMENTS TO BE MADE AS FOLLOWS ;
$ 0 DOLLARS DOWN../ $ 2,400.00 DOLLARS DUE IN FULL UPON
THE COMPLETION OF THE WORK..
THIS PROPOSAL MAY BE W IT14DRAWN BY US IF NOT ACCEPTED WITHIN 21 DAYS OF SAID DATE.
ANY ALTERATION OR DEVIATION FROM THE ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS WILL BE
EXECUTED ONLY UPON WRITTEN ORDER,AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE
ESTIMATE.ALL AGREEMENTS ARE CONTINGENT UPON STRIKES,ACCIDENTS,OR DELAYS BEYOND OUR
CONTROL,
NOTE;
WE CANNOT ACCEPT ANY RESPONSIBILITY FOR ANY DAMAGES OR DEBRIS FALLING INTO ATTIC AREAS.
CUSTOMERS SHOULD COVER VALUABLES,GREAT CARE WILL BE USED TO PROTECT THE EXTERIOR
STRUCTURE BY COVERING THE EXTERIOR WALLS,OBJECTS,AND FOLIAGE WITH TARPS TO HELP PREVENT
ANY DAMAGES DURING THE STRIPPING OF THE ROOF, HOWEVER SOME DAMAGE AND MARRING COULD
OCCUR BEYOND OUR CONTROL.
HOMEOWNERS MUST MOVE ANY VALUABLES AWAY FROM THE BUILDING,PRIOR TO THE STRIPPING OF
THE ROOF.
NOTE;
IF MORE LAYERS OF ROOFING MATERIALS ARE FOUND THAN INDICATED ABOVE IN THE ESTIMATE.,THE
OWNER OF THE PROPERTY WILL BE IMMEDIATELY NOTIFIED,THE OWNER ACCEPTS ALL RESPONSIBLTY,
AND(AGREES)THAT ANY EXTRA CHARGES WILL BE ADDED FOR THE LABOR AND THE REMOVAL OF THE
EXTRA ROOFING DEBRIS,OVER AND ABOVE THE PRICE OF THE ESTIMATE.
THIS ESTIMATE IS RESPECTFULLY SUBMITTED BY
RAPID ROOFING COMPANY OF SALEM,MASS.
OWNER; CHRISTOPHER R.COYNE SR.
978-740-0101/978-223-7740
THE ABOVE PRICES,AND SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY
AND ARE HEREBY ACCEPTED.YOU ARE HEREBY AUTHORIZED TO DO THE WORK
AS SPECIFIED. PAYMENTS WILL BE MADE AS OUTLINED ABOVE.
DATE O 'C L! c e.(J 1 SIGNED /V
SIGNED
SIGNS
PLEASE MAKE ALL CHECKS PAYABLE TO..
CHRISTOPHER R. COYNE SR. THANK YOU !!
I �