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55 FORRESTER ST - BUILDING INSPECTION ( The Commonwealth of Massachusetts t►� Board of Building Regulations and Standards CITY !`y j Massachusetts State Building Code, 780 C'MR, 7"edition OF SALEM Revised Junuurr Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For ORcial Use Only Building Permit Nu bar: Date Applied: Signature: &h //u Building Commissions/ nspectorof Buildings Dates SECTION 1:SITE INFORMATION 1.1 P,9Party Address: 1.2 Aaaaaon Map dt Parcel Numbers S F©Rl,E!S'TE12 SZ L la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zuning District Proposed Use Lot Area(sq 11) Frontage(R) 1.5 BuildingSetbacW(R) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.O.L c.40,§54) 1.1 Hood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public❑ Private❑ — Check if es0 Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Nume(Pram) Address for Service: 41 Signature Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check I tdat apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alterations) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify: Brief DD ccriiption posed Work': E/h I-f /.v Li9C,C .�Le/ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: 011iclal Use Only Labor and Materials I. Building s I. Building Permit Fee:S Indicate how fee is determined: 2. Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5. Mechanical (Fire s Su ression Total All Fees:S Check No. Check Amount: Cash Amount: 6. Total Protect Cost: S�/l � 0 Paid in Full ❑Outstanding Balance Due: r SECTIONS: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervlsor(CSL) OFso 3 v3 Fp 12,5711U C7 Al D51—0 License Number lispimtion Uate Name of C'SI--I Ioldcr t I List C'SL"type(see below) d/ ✓GS C Z T Description U I Unrestricted(up to 35,000 Cu.Ft. It I Restricted Ik2 Family Dwellingi Signature _ M Mason Only 978 �3/ 04'S 1 I RC I Residential Roofing Covering I"elephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D I Residential Demolition 5.2 Regbtercd7oe Home Improvement Contrite RuC77UrJ (HIC)C 53 a� i s < � I IIC Company Name or IIIC Registrant Name i Registration Number AJJress�J Expiration Date Signature O�C.Jc� Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. I52. S 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 ..........O No...........O SECTION 7s: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. SianaturcofOwner Date SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION 1, ,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. `TiL1O U Print N Signature of Mwner or Authors ed Agent Date Signed under the pains and penalties of 'u 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 W1 have access to the arbitration program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 7110 CMR Regulations I IO.R6 and I IO.RS,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 healing system Number of decks/porches Type of cooling system Enclosed Open ). "Total Project Square Footage" may be substituted for"Total Project Cost" i { � ' 110PdE If��PR r �•, ' r,a E " . mwg Registrppon t"- t � 108953 Cxp¢aGan 8/28/2010 Tri% ..7a• ' :Tppc Ltd,Uabif,y Corpdr ` ;MELO'S CONSTRUCTION ''f oustino N1eIo n - 3v JCNN INGS CIr2' fi0dy 01960 Massachusetts- DepMrtment of Public Safeh Board of Building Regulations and Stan arils Construction Supervisor License License: CS '80393 Restricted to: 00 FAUSTINO N MELO 34 JENNINGS CIRCLE PEABODY, MA 01960 Expiration: 3/1/2011 ___—. t'.numissiont•r—.—__--______Tr#: 12192_ ._f ,4coRoe CERTIFICATE OF LIABILITY INSURANCE 12/4/2009 PRODUCER (978) 532-5445 FAX: (978) 532-2217 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION H.K. McCarthy Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER_ THIS CERTIFICATE DOES NOT AMEND. EXTEND OR 10 Centennial Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. - West Entrance Peabody MA 01960 INSURERS AFFORDING COVERAGE j NAIC# INSURED — ---�-----^ -- WELBEa-_National Grange Ina Co T N.elos Construction LLC -__3;National Grange Mutual Ins Co 114788 c/o Faustino Melo Travelers Indemnity of j as666 34 Jennings Circle ---- Peabody MA 01960 , IN_J-ERE- COVERAGES --=_"CL=S OF SNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THEROLICY PERIOD INDICATED.NOTWITHSTANDING F=0Ui3E!::ENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR -Y°ERL=.IM THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OFSUCH AGGJ 'EGAT'c LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IN II ':'S 'L TYPE OF INSURANCE POLICY NUMBER ' POLICY EFFECTIVE POLICY E%AIMPI% Y, LIMITS GENERALUABILITY 4 EACH OCCURRENCE S ,. SOOL000, _ - i�AMaGETO REATED I -- X COMMERCU4 GENERAL LIABILITY ; I PREMI$sFS(Ea ocwrrerge) 5 _ $001_000., A iCWMS MADE XIOCCURB23662 Yl/26/2D09 I11/26/2010 MED EXP LMgplre person) $ _ 10,_000_ PERSONAL B ADV INJURY S 500,000- - GENERAL AGGREGATE _!$ S 000 000 L._E.car' - - PRODUCTS-COMPlOP AGO j S 1,OOOi000 ._.i x _C� ry -- COMBINED SINGLE LIMIT $ 8 - Y.exa3s26 ' 9/21/2009 ' 9/21/2010 1 BODILY INJURY $ 250,000 X j(Per person) _-.-- X BODILY INJURY — X _. __ m. .m� Il 13 500.000 PROPERTY DAMAGE —_=$ i (Per accident) AUTO ONLY-EA ACCIDENT $_-,_.-____ OTHER THAN EA ACC _E_ '1 AUTO ONLY: AGG E -- j a-='.vo _+tc_.-._• �..c�.)ry '' EACH OCCURRENCE $ -- - -_••,,:M, DE ""]AGGREGATE --- V. kK RS:CVPENSATION VVC STATU -i IOTM' _ AI M Ot RS LIABILITY ' YJN - 'T.ORY LIMIIS� ER j Rn -,ORAARTNER/E%ECUTIVE ' ELEACRACCIDENT OIC $ _ 11000,000 . 4/ EMBER-EXCLUDED? F .� ;(Mandatory in NH) ❑'1BOB78141146509 jl2/4/2009 - 12/4/2010 E.L.DISEASE EA EMPLOYEES 11 000,000 If.teTaas eaunbe rider SA'61AL PROVISIONS below I j E.L.DISEASE-POLICY LIMIT j$ 1 000 000 OTHER ,_....LES.EXCLUSIONS ADDED BY ENDORSEMENT]SPECIAL PROVISIONS CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 5 :a=os e B DATE THEREOF,THE ISSUING INSURER WRL ENDEAVOR TO MAIL IO OAYS',WRRTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Ii AUTHORIZED REPRESENTATIVE' J� t _ John McCarthy/LG4 �1iY/ ACORD 25(2009/01) 1 ©1988.2009 ACORD CORPORATION. All rights reserved. INS025;>:a;�: - The ACORD name and logo are registered marks of ACORD - CITY OF SALEM PUBLIC PROPRERTY i I 4�1 DEPARTMENT I'.O: •111 "MIS i 1 �a'.W a�1..J,V 11 atf f e�.\I I\I. fit.\N\1 111 J 1 ..I'/ . t_C •� raaa Construction Debris Disposal AI'lidavit (requited lirr all dtemolition:utd r,enovatiun work) In accunlaltce with the sixth edition of the Slate Building Code. 730 CMR section 111.3 Debris. and the provisions of MGL a 30. iss issued with the condition that the debris resulting m Building laerfnit IY � 1 licerwd waste disposal facility as deflned by MGL c this work shall he disposed of in •a p per Y 111. S 130A. The debris will be transported by: I1tanis or hauler) The debris will be disposed of in : A? (11mm of aul lty / fI r r��/� //'1�ylM�/•7GiA� S T L `��v'v �'yll� ,\ I;Idllre+a of IW1111y► :I011alum or Ircrnlir applicant ,lace Melo's Construction LLC BBB 34 Jennings Circle Peabody, MA 01960 Kris "mmj. — Telephone: 978-531-0811 - E-mail: FaustinoMeloAmsn.com MEMBER Fausdoo,Melo,General Manager Unrestricted Mass Builders license No. 80393 Contractors Registration No. 108953 Proposal w to: Phone CP Cg 52-1 4 Address: City,State,and Zip Code -i2 T— l -p r Job Description: rob Location: We Proposed hereby to f nnish tratuials and labor-compkfe m aocademe with the speci6catims listed below,for thc nth of. ,"✓G TNo �� '4 y'o S' x NU aJ 02 i n up l-pollen �o C�C>, Installation of Paymeau: L c'For2 c Payments will be paid in thirds.The first installment will be paid before the job begins.The second paymcm will be obtained in the middle of the job.The last payment will be obtained after the job is completed. Note:This proposal may be withdrawn by us Anhonized Signature: if not accepted within 20 days. Date: e Hereby ashen Specifwuar sad EsnotaW car, THE INSTALLATION OF A NEW ROOF To protect the homeowner's property,Blue Tarps will be used to cover the siding,bushes,and grass during stripping All of the layers of roofing win be stripped,and all providing nails,screws,and/or staples will be removed. Ice and water shield will then be installed at the bottom of all edges,around all chineys,skylights,and into all valleys. Fifteen(15)pounds of felt paper will be installed onto all other areas of the roofdeck. The 8"aluminum dripedge will then be installed to all roof edges. Any existing pipes will be covered with new tubber flanges. The roofing material to be used will be -2 o Yr2 The homeowner is responsible for the selection of the roof color. Also,the homeowner may select of er hand or pneumatic uniters for the radmg application of the new roof. An the debris will be cleaned and properly disposed of on it datily Jalk. Magnetic brooms will be used to extract all nails from your property. We will protect your property as best as we can,however,some foilage matting,breakage,or marring could occur. We cannot accept responsibdty for possessions inside of the house,or debris falling into attic areas. The customer should protect personal belongings. Extra work In witich an adffifio&W ells a above pnce. Replace Rotted Roolboards 1100 Gutter Repairs Remove Aluminum Siding Relead Chimney(a) 3 Da Instal Skylight(s) Remove Old/Rotted Wood Replace Facia Boards Repoint chimney Install Garage Roof Install Ridgevent Install Azek Board Install Insulation Install Roof Louvers Install Window Trim Install Tyvek Papa Install Aluminum Gutters Install Shutters Cover Aluminum Windows Install Aluminum Downspouts Remove Vinyl Siding Repair Vinyl Siding Install chimney cap Porch Repairs Rebuild Chimney Additional Notes: RrMoylE, .1t.t.. �� �Z'` l��f`✓!1 I`�� -/�GAG.� i�Dlfp�',r_i> Total Amount for Additional Work: Warranty by manufacturer to be free of defects for e years,see rnamdacturces warranty for details. All labor performed under this contract shall be of good quality and free from defects not inherent in the quality required or permitted for a period of)D years.This warranty excludes remedy for damage or defect caused by abuse,modification,improper or insufficem maitenance. improper operation,or normal wear and tear under normal usage.This warranty ahan be limited to the work Performed by Melds Conviction,LLC and limited to either repair or replacement by Melds Construction,LLC at its sole descretion and election. Any and all claims are waived unless made in writing to Melds Construction,LLC within 21 days after the occurrence of the event giving rise to such claim. This wa ranty shall not extend beyond any limits imposed by applicable law. Payment and Penalties-Upon substantial completion of an work under this contract, customer Stan-within 3 days-make the final and fun payment of the contract price. Any and all unpaid balances shall accrue with interest at 5%interest per month. You agree to pay all court costs and collection expenses incurred by Melds Construction, LLC in the collection amount you of any amount you owe under this contract,including and without any limitation of reasonable alto fees. Acceptance or the Propaaal: The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified,payment will be made as outlined above. Payments are to made as per tequisittion end or invoice. The proposal may be withdrawn within 20 days. Date of Acceptance: S�/ 10 Signature