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175 FEDERAL ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts CITY OF ' Board of Building Regulations and Standards i". $AI EM Massachusetts State Building Code, 780 CMR�gpF AURECEIVE Revised Mar 2011 Building Permit Application To Construct,Repair,Renovatb'Vf MNAL S RVICES One-or Two-Family Dwelling This Section For Official Use Only ' b A Building Permit Number: Date Applie 9 a? 1 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: S� S'Q18w1 M� ty 1.2 Assessors Map&Parcel Numbers 1 5 F�eiraj L l a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 50 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—v/ Zone: _ Outside Flood Z ne? q Private❑ Check if yes Municipal VOn site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'ofRecord: + Sal Cm 1 n n t7 0'9 �p� rat,��t i�i wl2 C3ergmatl 1"I 0 Name(Print) City,State,ZIP ( t CIJ. Cr3 I ' I�+5 F.edtmi S+ *a (pI*�T84ff_550 LrvnI1 h 0+ umai 1.(o rq No.and Street pAOM Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WOR10(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied)( I Repairs(s) �( I Alteration(s) ❑ I Addition ❑ Demolition A I Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed W orV-. eDa C aplace Pam t a SECTION 4:.ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $%00 t -1 3 1. Building Permit Fee:$ 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: j 5.Mechanical (Fire r $ Su ression Total All Fees:$ I 2 Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ Q 1a J 11 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Richar La 1�'$�-oo s la ate d V�f,�. �' License Number Expirati Date Name of CSL Holder List CSL Type(see below) 5'b nl. M afn S t t N,o.AandStreet Type Description 1�'l )'d d I �o n M A Q �9 t�9 U Unrestricted(Buildings u to 35,000 cu.ft. rd City/ State, v R Restricted M2 FamilyDwelling M Masonry RC Roofing Covering WS Window and Siding SF I Solid Fuel Burring Appliances o (D •a 51 nc�h_a�.-vlh� Ndhoo. I Insulation Telephone Email address Demolition 5.2 Registered Home Improvement Contractor(MC) H HIC Company Name or HIC Registrant Name IC Registration Number Expiration Date No.and Street Email address City/Town,State ZIP 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 Issuance 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 to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information ed in this application is true and accurate to the best of my knowledge and understanding. Print Owner's o A orize Agent's Name(Electronic Signature) Date/ — 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 can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.,gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basementlattics,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"maybe substituted for"Total Project Cost' A� .CERTIFICATE OF LIABILITY INSURANCE UA5/13/2DDIYYYY) 5/13/2014 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 terns 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 CONTACT NAME: insureon(BIN Insurance Holdings LLC.) PR°RE . 800-688-198, 1% No: (877)826-9067 rj insureon 1301 Central Expy.South,Suite 115 Ao"REss: Allen,TX 75013 PRODUCER CUSTOMER ID INSURERS AFFORDING COVERAGE NAIL N INSURED INSURERA: Preferred Contractors Ins CO RRG LLC 12497 Richard Lavoie dba Richard's Remodeling and Repairs INSURER B: 56 North Main St INSURER C: Middleton, MA 01949 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. INSR DDL UBR POLICY EFF POUCYEXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDNYYY) (MM[DDrfYVYI LIMITS GENERAL ABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 000 PREMISES Es occurrence $ CLAIMS-MADE ✓OCCUR MED EXP(Any one person) $ 5.000 A PCIC5014PCA521394 5/122014 5/122015 PERSONAL S ADV INJURY $ 1•000.ODD GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2.000.ODO POLICY PRO LOC $ AUTOMOBILE LIAMILITY COMBINED SINGLE LIMIT $ , (Ea accidem) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ ' SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS - (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA UAB OCCUR - EACH OCCURRENCE $ EXCESS LIAB- CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION VJC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N LIMITF ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ H yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS[VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space Is required) INSURED'S COPY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Flichard Lavoie dba Richard's Remodeling and Repairs THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 56 North Main St ACCORDANCE WITH THE POLICY PROVISIONS. Middleton,MA 01949 AUTHORIZED REPRESENTATIVE ©1988.2009 ACORD CORPORATION. All rights reserved. QTY OF SALEK MASSAGE-TUSEM Q dt1 BUILDING DEPARTMENT 120 WASHINGTON STREET,31D FLOOR TEL.(978) 745-9595 F KIMBERLEY DRISCOLL FAX(978)740-9846 MAYOR THomAS ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR, Section 111.5 Debris, and the provisions of MGL c40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste deposit facility as defined by MGL c 111, S 150A. The debris will be transported by: � r orQ a� (name of hauler) The debris will be disposed of in: (name of facility) (address of facility) Sig tur o plicant ac� � Date Marcia Kirkpatrick From: Adam Krauth <adamkrauth@gmail.com> Sent: Wednesday, October 08, 2014 3:05 PM To: Marcia Kirkpatrick Subject: 175 Federal St License Info Hello, Attached is license info for contractor at 175 Federal St. Thanks, Adam f+r�N# v9µ� '� :•NdL4 eµ �hi s irh�t z a 1�Mi'r°i'.airr'f�a���'(ii,��Ru PditlA���N�� v 1� I e i(f�h s# xuks i {m+b,n a i3ts i e a�xw i i i`r�� iGYr y i!v ♦{ "�{ p ��if � �.{ ,4 5�{d f udVUL` 1i��1-ii�� AtGil1'C{i� � N°_ v, te•'r �.a t µ�?�'; s, ''t x "+� i r a{:,L{�, y a � €k of F rr'm 7a,�u!,.i i N tq 4 y d i 3�is i �,`:`. 1 v i§i pr i f N"+b� R i{ {y6 {yr• ^#i r{i v �Ih r ' �r� {a IR IF 1 Details http://elicense.chs.state.rm.us/Verificafion/DetaiIs.aspx?agency_id=1... The Official Website of the Executive Office of Public Safety and Secunty(EOPSS) Nass.Gov Home State Agencies Licensee Details Demographic Information Full Name: ALFIO T BERARDI Gender: Owner Name: License Address Information Address: (Address 2: City: Saugus State: MA Zipcode: 01906 Country: United States License Information LSDoingBusiness o: CS-065282 License Type: Construction Supervisor n: Building Licenses Date of Last Renewal: 3/4/2014 : Expiration Date: 2/26/2016 tatus: Active Today's Date: 11/3/2014 License: iness As: nge: License Renewal Prerequisite Information No Prerequisite Information Discipline No Discipline Information Documentum Close Window ©2011 Commonwealth of Massachusetts Site Policies Contact Us 1 of 1 11/3/2014 11:44 AM o �I Salem Historical Commission 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (978)619-5685 FAX(978)740-0404 CERTIFICATE OF NON-APPLICABILITY It is hereby certified that the Salem Historical Commission has determined that the proposed: ❑ Construction ❑ Moving 19 Reconstruction ❑ Alteration ❑ Demolition ❑ Painting ❑ Signage ❑ Other Work as described below does not involve an exterior architectural feature or involves a feature covered by the exemptions or limitations set forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: McIntire Address of Property: 175 Federal Street Name of Record Owner: Adam Krauth &Nicole Bergman Description of Work Proposed: Reconstruct existing rear deck. There will be no changes to the design, layout, material-type, or color. Non-applicability due to work being in-kind repair and replacement. Dated: October 1, 2014 SALEM HISTORICAL COMMISSION By: *14* The homeowner has the option not to commence the work (unless it relates to resolving an outstanding violation). All work commenced must be completed within one year from this date unless otherwise indicated. THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Buildings (or any other necessary permits or approvals)prior to commencing work. Harry Wagg From: Nikky Bergman [nikkybergman@yahoo.com] Sent: Monday, November 03, 2014 9:04 AM To: Harry Wagg Cc: Adam Krauth; anderson vervloet Subject: 175 Federal St Porch Repair Attachments: IMG_0149.JPG; IMG_0148.JPG; IMG_0150.JPG; IMG_0153.JPG; IMG_0147 copy.JPG; ATT00001.txt; PlotPlan175FederalSt.pdf � 1 LILJ [MG_0149.JPG(161(MG-0148.JPG(157[MG-0150.JPG(134[MG-0153JPG(127 IMG-0147 ATT00001.txt(230 PlotPlan175Federal KB) KB) KB) KB) copy.JPG(121 KB) B) St.pdf(388 ... Morning Harry, I'm glad I got to speak with you this morning regarding a permit to rebuild our back porch at 175 Federal St. I hope these pictures will be what you need, but if not let us know and we will have drawings made. We have the historical certificate to rebuild as is, which is what we would like to do. Attached is a plot plan, for your convenience. I have copied our contractor Anderson and my husband Adam so they are in the loop. Thanks very much and have a lovely day, Nikky Bergman 401-524-2412 www.nikkybergman.com 1 Harry Wagg From: Harry Wagg Sent: Monday, November 03, 2014 12:11 PM To: 'Nikky Bergman' Subject: RE: 175 Federal St Porch Repair Hello Nikki - I received your photos. They will do nicely. Before the Building Permit can be issued, your contractor will need to come to the Building Department with his insurance information (liability & workman' s comp) and sign the Permit Application. Thank-you, Harry 978-619-5643 - hwagg@salem.com -----Original Message----- From: Nikky Bergman [mailto:nikkybergman@yahoo.com] Sent: Monday, November 03, 2014 9:04 AM To: Harry Wagg Cc: Adam Krauth; anderson vervloet Subject: 175 Federal St Porch Repair Morning Harry, I'm glad I got to speak with you this morning regarding a permit to rebuild our back porch at 175 Federal St. I hope these pictures will be what you need, but if not let us know and we will have drawings made. We have the historical certificate to rebuild as is, which is what we would like to do. Attached is a plot plan, for your convenience. I have copied our contractor Anderson and my husband Adam so they are in the loop. Thanks very much and have a lovely day, Nikky Bergman 401-524-2412 www.nikkybergman.com 1 • e 3NL � • � Y 4Y,Y IF _ e g .. .�. $ � � � �:.r° +1 � '� +�.�r•.a"s�s�P�. h -ter t , Y 'Yy� � Y w q, IJ 7s ' s �. �'� a � � � a " t- n�YS - IWO 'a ISL INt h � k yy�gy� q'• ��X.,' f}_^rjy-- r 1 WIT WL l -owl q r 1 q J 11 1 till Ill Amm h ram. + „JJ jM�y a P 4 r = 4 a I i t� � � +fir �•;,�;,, ++4T 1 s E 7 1 P ' 11 i p. • A ft)�, i ,'Sr� , .J4so , usiI. 11� -, ;is-2 n i c3 `4 e F �dirk Y Q S i � q ,. �R ems• :. � �, E `ABC 5 � � �' � ! � .dF� • F �,.. "� .. .. p n��. .�'�3'�YP'.aYgv .!•n o F v . . n�tl y`� L. __! } � �X �n.pp� _MBA ,.. • �..»�'. ,. ,._�..a. ARED wiry tj � Y a MORTGAGE INSPECTION PLAN 14-04146 LOCATION : 175 FEDERAL STREET BOSTON - cn'Y,STATE: SALEM,MA SURVEY INC. APPLICANT: CERTIFIED TO: .. P.O.BOX 290220 SCALE: V=30' CHARLES rOVVN,MA 02129 PREPARED: MAY 6,2014 T(61l)242-1313;F(61l)242-1616 WWW.BOSTONSURVEYINC.COM 50 00 X 0 rn v o k ri 3.r/_ ore i 2.5 sty. - #175 50.00' FEDERAL STREET FLOOD DETERMINATION REFERENCES tt According to Federal Emergency Manaporncnt Agency maps.the h! ti6jO nr jcrinrprovcmeNs on anspropeny tall in as area dcsignaled as DEED/CERT: 27552-507 �zH or a1q�s��K PLAN REF: ASSESSORS ZONE:X02 90 ' . COMMUNITY PANEL No. Z5009G OLOU NOTE: To show an accurate scale this plannmsr 6c primed �� G GE � • EFFECTIVE.DATE• _j-Zoa onlegnlsiacdp.po,(8.5"s14^) � LL NS Thcpcnnenerusnoequra me epprnsinmmly localcd on the gni dasslrawn Thcy either con(ommd(o(hael6nek rcqui cmm�ts M11J SearchResults Page 1 of 2 he Qfnaa 4Jel?sito of the 6'ccu;it3 015ce of�ub7ic Safety and Secw t CEbPSSj blass,Ge✓Fiome State Agencies Search Resul • Select th licensee name below for more information. (If your search produced more than one page, you may select pag gumbers at the bottom of this screen.) • Select the S for a Person or Search for a Facility button to perform a new search. • Select the Pw File button to view a sample of the fields included in a file you can download. • Select the Dad File button to download a text file of your search results at no charge. • Select Publimation Request Form for a form to order a data file. Search for a Person '.. V Search for a Facility j Preview File IL Download 9 icttt e Name License Type License Status Address Number LAVOIE MICHAEL EN3E-040748 ineer 3rd Class Active ROCHESTER MA 02770 N LAVOIE NATHAN SCS-091173 Con ruction Supervisor Null and Void PELHAM NH 03076 MLAVOIE BU-107297 Oil Bu r Technician Certificate Active MERRIMAC MA 01860 IVORMANDL LORMA RT-019128 Refrigerat Technician ctive MERRIMAC MA 01860 NORMANDL LAVOIE, PATRICK BU-115172 Oil Burner Te nician Certificate Expired Medford MA 02155 D LAVOIE PATRICK FM2F-052040 Fireman 2nd Cla Expired Medford MA 02155 D LAVOIE PATRICK PJ-127187 Pipefitter Journeyma ctive Medford MA 02155 D LAVOIE, PATRICK RT-021375 Refrigeration Technician ctive Medford MA 02155 D LAVOIE, PAUL EN2E-003241 Engineer 2nd Class Renewal- WOONSOCKET RI —Incomplete 02895 LAVOIE PAUL A HE-115922 Hoisting En ineer Ex ired ALTHAM MA 02453 LAVOIE PAUL A HE-115922 HE-2B- Front end loader/backho Expired ALTHAM MA 02453 LAVOIE PAUL I CS-012325 Construction Supervisor ctive MILLBURY MA 01527 LAVOIE PAUL M CS-104773 Construction Supervisor live Ashland MA 01721 LAVOIE PAUL N 11-100027 Construction Supervisor a Fall River MA 02724 LAVOIE PETER F CS-071806 Construction Su ervisor cti Westport MA 02790 LAVOIE, PETER M HE-110670 Hoisting Engineer ctive 01453 STER MA 01453 LAVOIE, PETER M CS-013459 Construction Supervisor dive LEOMINSTER MA 01453 LAVOIE, PETER M HE-110670 HE-2A- Excavators Expired LEOMINSTER MA 01453 LAVOIE, PETER M HE-110670 HE-1C-Telescoping booms w/o Expired LEOMINSTER MA cables 1453 LAVOIE PHILIP S CS-025731 Construction Supervisor Active rly MA 01915 LAVOIE RANDY P MAAB-000395 MMA Amatuer Active LAVOIE, O RAYMONDJ CS-000893 Construction Supervisor Active MILL RY MA 01527 LAVOIE REGIS L CS-069122 Construction Supervisor Active MATTA (SETT MA 02739 LAVOIE REJEAN BU-030888 Oil Burner Technician Certificate Active Salem NH 79 LAVOIE REJEAN HE-112288 Hoisting Engineer Active Salem NH 03 9 LAVOIE REJEAN HE-112288 HE-IC-Telescoping booms w/o Active Salem NH 0307 ables LAVOIE REJEAN HE-112288 HE-2B- Front end loader/backhoes Active Salem NH 03079 LAVOIE, RICHARD CC-011284 Security Systems- Cert. of dive Springfield MA 01104 J Clearance LAVOIE, RICHARD CS-093460 C K I onstruction Supervisor Expired FITCHBURG MA 01420 LAVOI_E ROBERT Renewal - NEW BEDFORD MA HE-121352 Hoisting Engineer Incomplete 102740 http://elicense.chs.state.ma.usNerification/SearchResults.aspx 10/8/2014