94 FREEDOM HOLW - BUILDING INSPECTION The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
Massachusetts State Building Code, 780 CMR, 7 h edition OF SALEM
Revised January
r Building Permit Application To Construct,Repair, Renovate Or Demolish a 1, 2008
r--
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
t Signature:
Building Commissioner/Inspector of Buildings Date
SECTION 1:SITE INFORMATION
1.1 Pro erty Address: C(� 1.2 Assessors Map&Parcel Numbers c --IG d"DU l.XvI�VY! C O
1.1a Is this an accepted street?yes_ no Map Number Parcel Number m
1.3 Zoning Information: 1.4 Property Dimensions: D rn
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) p
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❑ Private❑ Zone: _ Outside Flood Zone?Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
21 Owner of Record: ' )
Nam
Address for Service:
ems,' ., �, �"l2S-`l yy •"1 a,��
ign Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORIe(check all that apply)
New Construction❑ Existing Building❑ 1 Owner-Occupied ❑ 1 Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work2: 2 yl
LJ 1 �OrJ�S
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
1.Building $ I. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town
2.Electrical $ Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $ �-
4.Mechanical (HVAC) $ List: o eA
5. Mechanical (Fire $
Suppression) Total All Fees:S
6.Total Project Cost:
Check No. Check Amount: Cash Amount:
T (�� ❑Paid in Full El Outstanding Balance Due:
-7
e"p—
SECTIONS: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
/S-vl 6 2 --10 >
Lu-t �L4Yyam_ License Number Expiration Daze
Name of CSL.Holder List CSL Type(see below) U
Addr Type Description
U Unrestricted(up to 35.000 Cu.FL
Siq�ature R Restricted 1&2 Familv Dwelling
✓/ �-s Ala J�� M Masonry Only
RC Residential Roofing Coverin
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
k Registered Home Improve ent Contractor(IIIC)
tC Company Name or HIC Re strant Name Registration/Number
Aldo l:l l.e C�ea >, F 1,
_"��l.,)� •q 7 V E pimti Dale
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 Issuan 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
[, 144-,�e;Y 1 �J l_-5<�M tJ GL.� 'e as Owner of the subject property hereby
authorize I v1 ID ej-:, - to act on my behalf,in all matters
relative to work authorized by this building permit application. 1
Si at of Owner Date �
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
I,- FL&z 4 0 A _ ,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
f-h At
4t n ✓J C. v AA_
Print Name� O
Signature of Owner or Date r
(Signed under the pams and 26naltici of r ury)
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. a 142A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and 110.R5,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"
= � the Commonwealth of Massachusetts
Department of Industrial Accidents
aOffice f Investigations
600 Washington Street
z Boston, MA 02111
" — www.mass.gov/dia
Workers' Confpensarion Insuran-c— Afdavit: Builders/Colntractors/Flectricia>ns/Ptumbers
Als begat Wolrmatiop
N2n1e_jBustaess/Orc-an;m'ionllnatvidual): - C - .• t.��1 Vl ��U� '�- •�I I�\ YIC� Go • _... ..
Ciry/S?te/zip; Y 1 v� 11q DIC10S Phone L:
Are you aim eslpDoyer?Check the appropriate box: 'type of projeet(required):
i.f � am z employe with . ❑ I ara a general contractor and I
employees(5il1 and/or part-ate).=
have hir--d the sub-contractors S. New conshucdou
2.❑ I am a sole proprietor or partner- listed on the reached sheet. 7. ❑ Remodeling
ship and have no employees . 4 These sub-contactor,have 8. _I Demolition
employees and have workers'
working for me in any capacity. 3
comp. insurance; 9. El Building addition
.. [NO workers' comp. insurancep '�
required.) 5. I_J �A%e are a corporation and;'t 10.I Electrical repa ir or adait O
3. I am a homeowner doing all work officers have exercised heir I I.❑Plumbing repai s or additions
myself. No worker' comp. _ right of exemption per MGL 12 ❑ Roof repairs
insurance required.]i C. 152, §I(?), and we have no
employees-[No workers' I3� Other Ke ID\.T 01 yty
.. - comp insurance required.],Any applicant that checks boK fl must also fill out the section below snowing their worker'compensation poiicy iwon-_�tioe.
' Homeowpers who suomit this affidavit indicating they ar-doing all work and they,hi,.ouside conoctor must submit a new affidavit indicating such.
iCoatzetors that check this box mns atLacbed an additional sbeet showing the name of the subcontactors and state whether of not these entities have
employees. I the sub-con�. ctors have employees;they met provide their worker'comp.policy nurnber.
I.;'mod an employer that is providing.workers'compensatior insurance jor rw employees. Below is the policy and job Site. -
information. _ -
- _--.--1,isiurpT_ce Company me: I ` � �.f ( 7 t 0S lt�L�h l'� �p
.___..°okay#ozrSelr _c5._L1C_ --: WC Expiration Date: - j a�i 3) k
_ . .. 1.ob,SiteAddress:gL) FM QAC,100jk�2110-1o, City/State/zip:
rincb m eopy ox tic sdo=Diers'compensation polmey deeDaratiom page(shovers kle policy s1ntm-Lmr and e,p5irot on date).
Failure to secure coverage ns required under Section 25A ofNIGL c. 152 can lead to the imposition of criminal penalties of a
5s1e up to$1,500.00 and/or one-year umprisorsmem, as well as civil penalties in the;O— o;a S s^Oa tiVOP,0P17ER and a fne
. Of up to$250.0c,a day ag3n t tie"v'iolaxor. Be advised that a copy ofth2i s:::cement may be'io_win ded to the 0 ce of
In-ve5dgat?on s of The DLn fa,insurance cove:ze v`srihcatlorl.
p do here-by ce.,,t§4 u.;&3 ?:tee ppeam Ems p eNetsNgWCS mfpeajxry tdzQt'j01C it�%®r,• stioa,,r,rmvided above is craze and cotre�2 -
Sienat re: / // ///� Date: '
: _Phone#: .-? _�fl • yob • 7 7V -7.
--Official use only. Do not write in this area, to be completed by city or town official
City or Town: _Permit'License k
Issuing Authority(circle one):
L.Roard of Health-3. Ruildine Del artment_3..City/Town Clerk 4.Electrical Inspector 5. Piumbmma inspector
6. Other
Contact Person: Phone r:
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' Remstration. 128634 'type;
Expiration' 602015 DBA
ED BYRN€WNDfJW 00
EDWUND BYRNE
756 WESTERN AVE �
LYNN, MA 01902 Underseeretary
E.B. Window and Sidinq Co. Proposal
756 Western Ave. (Rt 107)
Lynn MA 01905 Date Estimate#
10/13/2014 42623
Name/Address Ship To
Katherine Gambale
94 Freedom Hollow
Salem, MA 01970
Rep
Description Qty Cost Total
Furnish and install Harvey Classic replacement windows. 5 0.00 0.00
All windows to have matching grid pattern to existing 5 0.00 0.00
All windows to have Climatech Glass(Double strength glass with 0.00
low e and argon gas)and half screens
Seal Windows in and out using Tile bond lifetime sealant 0.00
All Window to carry a lifetime warrantee to the original owner 0.00
including glass failure and breakage
Take away all job related debris � 0.00
Any building permit required to complete project to be added at cost 0.00
to the final payment
Total Project I 2,677.50 2,677.50
0.00 o.00T
acceptance of proposal
authorized signatur
$895.00 Deposit, Balance Due Upon ompl tio� n
We Zook forward to working with you!
Subtotal $2,677.50
Sales Tax (6.25%) $0.00
Total $2.677.50
Phone# Fax# E-mail Web Site
781-592-9747 781-592-9746 ebwindowr�msn.com www.ebwindow.com
11/06/2014 02:14PM 7815929746 E B WINDOW PAGE 02/02
1102014 QtWwk.c Prird Message
Print close
94 Freedom Hollow; 1 Freedom Hollow; 79 Freedom. Hollow,
Salem
------------ ------
.From: Cyndy Ansellmo (eyndy@ecpllc.net)
Sent: Thu 11/06/14 7:17 PM
To. tstpierre@satem.com(tstpierre@salem.com)
Hi Tom,
The Board of Trustees of the Village at Vinnin Square Condo Trust 11 have approved the installation of windows
as follows in the following units at the Village at Vinnin Square Condominium Trust 11:
94 FREEDOM HOLLOW 5 WINDOWS
1 FREEDOM HOLLOW 9 WINDOWS, I SLIDING GLASS DOOR; FULL SCREEN STORM DOOR
79 FREEDOM HOLLOW 5 WINDOWS
The work is being done by EB Window and Siding, 756 Western Avenue, Lynn MA 01905
Cyndy Anselmo
East Coast Properties, LLC
Real Estate and Property Management
400 Highland Avenue Suite 11
Salem, MA 01970
P: 978-741-2008
F; 978-745-9684
cyndy@ecpllc.net
https://blul72-mail.live.cmloVmaii.mvr/PrirftMessagw?mkt--emus ill
-' E.B. Window and Sidinq Co. Proposal
756 Western Ave. (Rt 107) -- -
T Lynn MA 01905 Date Estimate#
9/26/2014 42576
Name/Address Ship To
Bill Golding
I Freedom Hollow
Salem, MA 01970
Rep
Description Qty Cost Total
Windows:
Furnish and install Harvey Classic replacement windows. 9 482.00 4,338.00
All windows to have matching grid pattern to existing 9 22.00 198.00
All windows to have Climatech Glass(Double strength glass with 0.00 O.00T
low a and argon gas)
Seal Windows in and out using The bond lifetime sealant 0.00
All Window to carry a lifetime warrantee to the original owner 0.00 0.00
including glass failure and breakage
Take away all job related debris 0.00
Any building permit required to complete project to be added at cost 0.00 0.00
to the final payment
Doors:
Furnish and install ProV is 298 SH Black Self Storing Storm Door I 750.00 750.00
(build out required)
Furnish and install 6'0 x 6'8 French Sliding Patio door with new I 1,650.00 1,650.00
exterior casing.
Note:To add clear Colonial Beveled glass grids Add$322.00
Etched Colonal Grids 1 322.00 322,00
Angies List Discount 9 -40.00 -360.00
We look forward to working with you!
Subtotal
Sales Tax (6.25%)
Total
Phone# Fax# E-mail Web Site
781-592-9747 781-592-9746 ebwmdownmsn.corn www.ebwindow.com
Page 1
RE.B. Window and Sidinq Co. Proposal
756 Western Ave. (Rt 107)
�7Lynn MA 01905 Date Estimate#
9/26/2014 42576
Name/Address Ship To
Bill Golding
I Freedom Hollow
Salem, MA 01970
Rep
Description Qty Cost Total
0.00 O.00T
acceptance of proposal
authorized signat
1/3 Deposit, Balance Due Ui5cm Complett n
C
We look forward to working with you!
Subtotal $6,898.00
Sales Tax (6.25%) $0.00
Total $6,898.00
Phone# Fax# E-mail Web Site
{�{ 781-592-9747 781-592-9746 ebwindowamsn.com www.ebwindow.com I
Page 2