12 GLOVER ST - BUILDING INSPECTION 1 •
What is the current use of the Building?
Material of Building? if dwelling, how many units?
WIN the Building Conform to Law? Asbestos?
Architect's Name
Address and Phone ( )
Mechanic's Name
Z a k A's fa
Address and Phone 2 u (Z e c TnI cd
Construction Supervisors
�sors License# 6�f 4 z6 l HIC Registration
Estimated Cost of Project$ o 0 Permit Fee Calculation
Permit Fee S Estimated Cost X$71S1000 Residential
Estimated Cost X S41151000 Commercial---------- ---An Additional S5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of perjury --
Date 7
)ki
Cal
— EITY-OF
PUBLIC PROPERTY
DEPARTMENT
KIN010M."ORMCOU
WAval 130 WAMUNGWO 5[1M
"Mak WASSAoILsll-S 01970
Tm-9711-71S-9M•It=M7i0.9W
APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION.
DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building:
-- --- - Property Address:-
properly is Located in a;Conservation Area Y/N K}_Hlstoric Dl bk2 Y/N.LJ_
2.6 OWNERSHIP INFORMATION
2.1 Owner of Land _
Name: Rn G No T-M an!
Address:
Telephone: �j' I g - 1 2 - `� 3 2
3.0 COMPLETE THIS SECTION FOR WORK IN EXIIIIINQ BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
grief Description of Proposed Work: �pPl�Le L
S� Ze K23
— _-----Mail Permit to: (� ----- --
,�`.� CITY OF SALEM
3 1` ''i PUBLIC PROPRERTY
DEPARTMENT
dIU:'rKLEY!�KIk:UI1.
\L Ii,K 120 WA91tV(:'iJN STREET * SAL FM. MA�SAG%U,IL I-IS 019/C
TF[.:978-745-9595 •FAx:978J4G9846
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 730 CMR section 111.5
Debris, and the provisions of v1GL c 40, S 54;
Building Permit # _. . __ is issued with the condition that the debris resulting from
di
this work shall be sposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 1.50A.
The debris will be transported by:
(nam,'-6t'hauler)
The debris will be disposed of in
(name of facility)
. � � �_ ladirasa of tuC�lilY) .
� �,:aturo of pern,i[app.ieln[
l0 28 0�
. 2007 FRY' - - /
AM, CERTIFICATE OF LIABILITY INSURANCE 06/28/20
PRODUCER (978)744-7110 FAX (978)741-2059 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Soucy Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. 0. Box 4467 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
201 Washington St. I —i—
Salem, MA 01970 INSURERS AFFORDING COVERAGE NAIC ft
INSURED Remodeling Services, LLC nuLRER n' The Travelers
--------------------------- ----------
P.O. Box 426 IvsLFERE'. Associated Employers Ins. Co
Beverly, MA 01915 INS-PER c.
:ARER D
v_LRER E ----_ --
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 CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE 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. _
W, 9R ADD POLICYEFFECTNE POLICYEXPWArION
LTRI TYPE OFIN6'JRANCE POLICYNUMBER A I T LIMITS
DENERAL LIABILITY -680-783L6880-TCT-07 01/01/2007 01/01/2008 EALHOCCURRENCE II 500,000
DAMD£—RENTED
X COMMERcuL CENERALIIABLITY R�FSIF,„"TIA"„ £ 300,000
OL 41W MACE TJOOQIR MED EXP:Anyove wsap 5,00
p PEPsnauL s ADv rvdDRr £ 500 00
GENERA_AGC-RE3ATE $ 1,000,000
GEN AGGREZATELIMI?AP�E_PER PRODUCTS-COW10PAGG $ _1,000,00
IL 7POLICY I JEC LUC
r AUTOMOBILE UASILIN
(ENTWINED 9fJEl_E LIMIT S
<MY V JPJ (Ea rsndant)
ALL C'4NI AUTOS RODLY INJUR"
SCHELLLED A ITO' (Pa PBlra) S HIRED AUTOS BODL'(IIIJUR"
I nI0N.0\NED AUT0,4
(Par aca,Jo.I) S
^ROPERtvpRMAi+E '
' -- (Par acdbaHj
GARAGELIABILRY ALI ILY-EAACOID-NT S
~IFILT.9JTD OTHER T� °AACC S
-) AUTO FL1) AGG S
EXCESSIUMBRELLA LIABILITY EACH OCCURRECE £
J OTC W CI-AW,V.SDP AGGRE3ATE S
E
DEDU,TELE S—_—_--_—
EF_TEN-IaJ i $
WORMERS COMPENSATION AND WCC5006129012007 01/01/2007 01/01/2008 X T! STAn- T
EMPLOYERS'UABArtY EL.EACH ACCGEIII S 100,00
B Aw PRCPRE-OR,FARTNERIE>PCUTIVE
LERIMEaEER EXCLL LED? EI.DlS. ASE-EA EMPLOYES S 100,00
Ilya,,der..c,!ba Jnur
..-FECIa,L PROVI�ION$calorr EL DIEEA9E-POLC'ILIVIT £ 500,00
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS,VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDERCANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUNGINSURER WILL ENDEAVOR TO MAIL
City of Salem 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE,LEFT
Attn: Building Department BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
120 Washington Street OF ANY MIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE&
Salem, MA 01970 AUTHORIZED REPRESENTATNE
Paul Soucy
ACORD25(2001/08) FAX: (978)740-9846 OOACORO CORPORATION 1888
q:
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed.A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
i
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing irsurer(s),authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
it
I
i
ACORD 25(2001108)
�o>�waite�l4(s�,j�( eMeQ$,
BOARD OF BUILDING REGULATIONS'
License: CONSTRUCTION SUPERVISOR
s '
Numt> bS 048261
• B"tr ,¢g1Qk1 r y 4 .
TTVQ110"� 008. Tr.no: 162ti2". :
WWI
d Jn
8'ECKFt)RD S
BEVERLY MA 01915=P. ` £
e m Commissioner �
—J/ee Tda�n- ieafds-..
Board of Building Regulations and Standards
• HOME IMPROVEMENT CONTRACTOR
Registration:-,151244
Expiration 5f;?3t2008
ar{ dj'y I-L Liability Partnership
REMODELING SERVICE}"S�LLCI
STEVEN SCIALDONE
478 RANTOUL ST ,,;i
I'r BEVERLY,MA 01915 Deputy Administrator
i�
Remodeling Services
P.O.Box 426
Beverly,MA 01915
Phone 978 922 5413
Remodeling Services Remodelingservicesonline.com
REMODELING CONTRACT
THIS AGREEMENT. Made as of May 17. 7007
Between the Owner:
Bob\omtand
12 Glover St.
Salem. MA 01970
And the Contractor: Sieeen Scialdone
Remodeling Sen ices LLC
For the Project: Deck
ARTICLE I. SCOPE OF WORK
1.1 The Contractor agrees to remodel the above mentioned project according to the plans,drawings,
modifications and specifications set forth here in:
Remove existing Fir Deckin_and iron railinc. from 2" fl. deck.
Install ptcssurc treated 4s4 posts to receive net% railing system
Attach posts with galvanized lag bolts too-stability
Inst:dl T 3 G I c4 Fir decking
Railings: Installation of 5 sections of white"Trademark" railinc; system
Trademark post sleeve to go o%cr pressure treated 4c4
Disposal of all old d cking and railing and any associated debris to be removed by contractor
Proof of Worker's Pomp. and Liability Ins, pro%ided upon request.
ARTICLE 2. THE CONTRACT PRICE
2.1 The cost for remodeling the project as specified in the construction documents shall be set at the
sum of$4.650.00 subject to additions and deductions pursuant to authorized change orders and
allowances.
CSn048261
HIC#151244
Remodeling Services
M
P.O.Box MA MA
} Beverly, 01915
/ 1 Phone 978-922-5413
Remodeling Services Remodelingservicesonline.com
2. 2 The Owner and the Contractor acknowledge that the payment schedule is as follows:
S a3 SO Down Payment
S t<
S
S Upon completion of job.
ARTICLE 3. INSURANCE
3.1 The Contractor shall purchase and maintain needed Workmen's Compensation and Liability
insurance coverage as required by law and deemed necessary for his own protection.The
Contractor will provide copies of insurance upon request by homeowner.
ARTICLE 4. WARRANTY
4.1 At the completion of this project.Contractor shall execute an instrument to Owner warranting the
project for 2 yrs. against defects in workmanship or materials utilized. The manufacturers warranty
will prevail. No legal action of any kind relating to the project, project performance or this contract
shall be initiated by either party against the other party after 2 yrs. beyond the completion of the
project or cessation of work.
ARTICLE 5. ACCEPTANCE
5.1 Upon completion,the project shall be inspected by the Owner and the Contractor,when agreed
upon,a list of any remaining items necessary to comply with the contract documents shall be made
by the Contractor.
WITNESS our hand and seal on this 7/ day of .20�'
fully understand By execution of this document. I agree to have read and aH statements and implications of
this document. I agree to explicitly abide by and follow the above conditions as listed in this agreement.
cl�lo
Contractor Signature Owner Signature
Steve Scialdone
Owner Signatttre
CSa048261
HICN151244