8 FLYNN ST - BUILDING INSPECTION The Commonwealth of Massachusetts
t Board of Building Regulations and Standards FOR
Massachusetts State Building Code. 780 CMR, 71h edition MUNICIPALITY
\ USE
Building Permit Application To Construct, Repair. Renovate Or Demolish a Re,i.,ed Atnuurr
1� One-or Two-Fancily Dwelling 1, 'rHi8
(� This Section For Official Use Only
\� Building P;Iceg
it Number: Date Applied:
Signature:
Commissioner nspector of Buildings Dal
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map & Parcel Numbers
F�»n St t SM\Qm r' ()tS' I C7
L la 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 11) 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.B Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑
Public❑ Private❑ Check if yes❑
SECTION 2: PROPERTY OWNERSHIP[
2.1 Owner of Record:
sa,q , mN n\Ci-1 o
Name(Print) Address for Service:
"i �f R£CLt `634�
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply)
New ConstructionTOExisting Building a Owner-Occupied 49 Repairs(s) q Alteration(s) ❑ Addition ❑Demolition cessory Bldg. ❑ Number of Units_ I Other ❑ Specify:
Brief Description of Proposed Work : - r a vS
P Qf me r��
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs: Official Use Only
Item (Labor and Materials)
1. Building $ 1. Building Permit Fee: $_ 13 Indicate how fee is determined:
❑Standard City/Town Application Fee
2. Electrical $ ❑Total Project Cost(Item 6) x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees: $
Suppression)
Check No. Check Amount•. Cash Amount:
6. Total Project Cost: $ ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) 42S,0n2\-t3 S 11 U g
of ,n t'a 4l if_W1 License Number Expiration Date
Name of CSL- Holder 1 List CSL T V
?.O vtG �j�V e�l� rnF C51Ct\S Type(see below)
address=a' \ ,) T Description. t
^� 1f � U Unrestricted(up m35.000Cu. F.)
R I Restricted 1&2 Family Dwelling
Signature M I Masonry Only
f11 R a'L1 n\A, RC Residential RoofingCoverin
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Imsmllation
D Residential Demolition
5.2 Reg r H Improvement Contractor(HIC) 1: 4 3S7
1, r, G i
HIC Co any Name or HAC Regi;arant Name I Registration Number
ax 1i C� /�z/tiOA
Address Q� (�'L1 �1 l 9 S� xpiration Date
Signature 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 ........... 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
I, ( "n �odl\S�Q�\ , 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.
���tr�I
Print I 4/1 y1clr
Signature of Owner or Authorized Agent Date
(Signed under the pains and penalties ofperjury)
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 and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.116 and 110.115, 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"
CITY OF SALEM
140) PUBLIC PROPRERTY
DEPARTMENT
KIMBERLEY DRISCOLL
MAYOR 120 WASHINGTON STREET ♦SALEM,MAssACHusETTs 01970
TEL:978-745.9595 •FAX:978-740.9846
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information // Please Print Le0bly
Name(Business/Organization/Individual): g9l"n 1 k 1S\fA , l_C .
Address: P4 . (fix LAGb
City/State/Zip: C� \141 S Phone #: A�tB a L� aq fib
Are�you an employer?Check the appropriate box: Type of project(required):
Lam
1. }am a employer with� 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time)." have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. _ �• Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions
myself [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs
insurance required.] t employees. [No workers'
comp.insurance required.] 13.❑ Other
*Any applicant that checks box 01 most also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information.
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: W. �i4 I)AVds, GC.Dvp
Policy#or Self-ins. Lic.#: WC 2 '31 b6—O U Expiration Date: V 1\ID}c
Job Site Address: Qi�]�r.n« City/State/Zip: ScJw,Lmt 14\-n n
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 certify under the pa'_s and penalties ofperjury that the information provided above is true and correct
Signature: s�2 Date: �A I0
Phone#: q1°6 qZl % Ir(,
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
-`� CITY OF SALEM
' PUBLIC PROPRERTY
DEPARTMENT
n %13'N I h.l
\l.'1IN 12C VVAil It\ ££T • SAU M, NiAii I.\CI It IL ii�:91C
rn:978-745-1595 * P%X:978-7-W I)m
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 730 CNIR section 111.5
Debris, and the provisions of vtGL c 40, S 54;
Building Permit # -, _ is issued with the condition that the debris resulting from
(his work shall be disposed of in a properly licensed waste disposal facility as define by v1GL c
111. S 150A.
The debris will be transported by:
Gr�1\cAm Qt� oS
(name of haul
l'he debris will be disposed of in
(name u(latihty
7 l
1:ut�:(Ci+ J! lal:ilyf
v y.'.LIu;� pit ,1�(il-.l! a1y).li ldt
AC—ORD. a/u/ ooa CERTIFICATE OF LIABILITY INSURANCE U4111/ 2008)
o
PRODUCER (978) 922-6600 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Sterling Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
306 Cabot Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 493
Beverly, MA 01915- INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A:Commerce Insurance Co. COM
Glenn Battistelli Painting INSURERB:
Battistelli Painting Co. INSURER C.
P O BOX 754 INSURER D.
jBeverly MA 01915- 1 INSURER E:
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 OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L POLICYPOLICY EFFECTIVE
TYPE OF INSURANCE POLICY NUMBER D TE(MMDDNY) DATE(MM/OD/YN
LTR INSRO Y)) LIMITS
A GENERAL LIABILITY wv1751 02/26/2008 02/26/2009 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES EaEoccurrence $ 50,000
CLAIMS MADE FRI OCCUR / / / / MED EXP one Person $ 5,000
PERSONAL B ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 2,000,000
POLICYF-j JECOT LOC
AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT $
ANY AUTO (Ea exident)
ALL OWNED AUTOS / / / / BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS / / / / BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTYDAMAGE
(Per accident) $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO / / / / OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY / / / / EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE / / /' / $
RETENTION $ $
WORKERS COMPENSATION AND TOR STATTS OER
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? / / / / E.L.DISEASE-EA EMPLOYEE
If yes,describe under
SPECIAL PROVISIONS balsa E.L.DISEASE-POLICY LIMIT I$
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
(978) - Fax ( ) — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT
John Crowelly FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
8 Flynn Street INSURER ITS AGENTS OR REPRESENIATIVES.
AUTHORIZED REPRESENTATIVE
Peabody MA 01960-
ACORD 25(2001108) ®ACOR RPORATION 1988
q.M INS0251Dioafm ELECTRONIC LASER FORMS,INC.-(8W)327-0545 Page 1 of 2
LMG 4/11/2008 8 : 03 PAGE 002/002 LMG
Liberty Mutual Group
Liberty P.O. Box 9090
1Vliltual. Dover, NH 03821-9090
Telephone (800)653-7893
Fax(603)-245-5330
April 11, 2008
JOHN CROWELLY
8 FLYNN STREET
PEABODY, MA 01960-
RE: Certificate of Workers Compensation Insurance
Insured: GLENN BATTISTELLI
GLENN BATTISTELLI PAINT CO
PO BOX 496
BEVERLY, MA 01915
Policy Number: WC2-31S-455968-047 Effective: 5 /11/2007 Expiration: 5 /11/2008
Coverage afforded under Workers Compensation Law of the following state(s): MA
Employers Liability Limits); Sole Proprietor/Partner Coverage Election:
Bodily Injury By Accident: $ 100,000 Each Accident The workers' compensation
policy does not provide
Bodily Injury by Disease: $ 100,000 Each Person coverage for:
Bodily Injury by Disease: $ 500,000 Policy Limits GLENN BATTISTELLI
As of this date, the above-referenced policyholder is insured by Liberty Mutual Fire Insurance Co
under the policy listed above.
The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions, and is not
altered by any requirement, term or condition of any or other documents with respect to which this
certificate may be issued.
This certificate is issued as a matter of information only and confers no right upon you, the certificate
holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage
afforded by the policy listed above.
If this policy is cancelled before the stated expiration date, Liberty Mutual will endeavor to notify you of
such cancellation. � Fe .
AUTHORIZED`REPRESENTATIVE
LIBERTY MUTUAL INSURANCE GROUP
Thv Certificate is executed by LIBERTY MUTUAL INSURANCE GROUP..mspccts smh uutuatne as v affo&d by tlnse companies.
cc: Insured: Producer of Record:-
GLENN BATTISTELLI STERLING INSURANCE AGENCY INC
GLENN BATTISTELLI PAINT CO P O BOX 493
PO BOX 496
BEVERLY, MA 01915 BEVERLY, MA 01915
4/11/2008
0kT�c�geAeguatlins'La&tan oardo ui ui ar s
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvement to-hoactor Registration
Registration: 104352
Type: OBA
Expiration: 7/13/2008
GLENN BATTISTELLI CONSTRUdT COTf3 J
Glenn Battistelli
t ,
PO BOX 496
Beverly, MA 01915
Update Address and return card.Mark reason for change.
4-- Address Renewal f`j Employment :; Lost Card
DPS-CAI 0 SOM-05106-PC9490
Board.ofBu, lug eguliaona7aa .tao ar 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
Registrat t% 104352
.:, One Ashburton Place Rat 1301
Expirailpn_ _ /2008
.. -F=�__.-- Boston,Ma.02108
GLENN BATTISTE§IL ION
Glenn Batlistelli -tQ�,c�
11 BROAD WAY Ri'`-
®everly, MA 01915 Deputy Administrator Not valid without signature
`�. -�i»iPrnonnwzt�i'o�./�vsearrza�rrr�¢�syX�ld :.
',
GLENN'.BATTISTELU,,-
>��--, �'f/�y� It IN0.ROOFING�IDING-CARPENTRY VINYLREPLACEMENT WINDOWS
„+ a KITCHENS-BATHROOMS=PORCHES-DORMERS-ADDITIONS
P..O:BOX 49,6
BEVERLY, MASSACHUSETM-01915
(97 DIRECT LINE (978))927"956:
FAX(978)921-9202 CELL(617) 962-1235
ESTABLISHED 1974
GLENN BATTISTELLI CO., hereby agrees to perform the."following services for:
at -17L
Home Phone BuslnessPhone
Sealerapplied toaH v}ery�nyt pipes and c�hylrnneys
Sva!flKs4. Ma5Y T T,,Yv
All Flashing will W4 inspected q�,` u * L s k
rc ., , t ' �. // h "(;+`' `h . 3;
Roofing Nails will bes t'+ �`my�ches * t #
9a' aa"YR. ,SAy�e
Grounds will be,cleaned of all roofing materials ,a 7 fi�,^
All,workmer,are covered with Public Liability-and Workmen s�Gompe'nsation
All work will will be orm ro kmn,like manner.
Chalk lines ill ' used to line-up-the shingles
Roofing Shingles are"self Sealing.
While installing the new roof', we will protect your homeTa_ndplantings from debris.
Roofing Shingles to be delivered T A a/ t
Install new fiberglass paper to roof boards when stripping of shingles is required`.
All shingles will be secured with_four. nails.
'. .•. ,�>:,�,,.,,, s.._'a-,.0 ..v9+..:rt w r^7YhyT'a*'�'Gdksr:M'+F.
State andlocal'builtling codes, along with manufacturers specifications Will be'adhered fa aFaTl trnies."
Color'of Roof to be
All worlds pfFiced as sp cific. The po sible occurrence of rotted roof boards or poor flashing will warrant an additional cost
of
The homeowner is responsible for covering their articles within the attic.
Work is to be commenced on
Payment.is to be delivered S b6k)4
Apply _ inch aluminum drip edge to the following areas:
_Year Workmanship,Guarantee. _Year M terial Guarantee
Roofing shingles to be VQ �0 S� e�� t `y {'k`j* � '1
Y
,d/SL`r .�P t .w _ C"dL A'l/�. �D G.�'S• i
.!l
A,gteed by Homeowner Agr6bp by Con r`dt
/ X
Ref: Page Dat6 3 Day Cancellation Notice Required
Page 1 of 1
Card 1 of 1
Location 8 FLYNN STREET IF Property Account Number Parcel ID 10-000640�
Old Parcel ID 41 --
Current Pro a Mailin Address
Owner NOT AVAILABLE ?a}�n 3 CP ro �cqW� Sttateate
Address '6 Zip otc�'10
Zoning R1
_ Current Property Sales Information
Sale Date 1111211998 Legal Reference 15237-53
Sale Price 158,900 Grantor Seller ROHAN CHRISTOPHER M
Current Property Assessment
Card 1 Value
Year 2008 Building Value 140,600
Xtra Features Value 500
Land Area 0.156 acres Land Value 136,600
Total Value 277,700
Narrative Description
his property contains 0.156 acres of land mainly classified as One Family with a(n) Ranch style
building, built about 1959 , having Vinyl exterior and Asphalt Shgl roof cover, with 1 unit(s), 6 total room
s , 3 total bedrooms , 1 total baths , 0 total half baths , 0 total 314 baths .
Legal Description
Click Property Images to Enlarge
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http://salem.patriotproperties.com/summary-bottom.asp 4/10/2008