7 GRAND TURK WAY - BUILDING INSPECTION (2)r -
Z '$25�C)R51A
The Commonwealth of Massachusetts
'I Department of Public Safety
Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION (Please indicate Block It and Lot#for locations for which a street address is not available)
7 6-mn -lud Way olq-70
No.and Street City/Town Zip Code Name of Building(if applicable)
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Building❑ Repair I Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑
Brief Description of Proposed Work:
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Factor F-1 ❑ F2❑ H: Hi h Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional 1-1 ❑ 1-2❑ 1-3❑ I-4❑ M: Mercantile❑ R: Residential R-1❑ R-2❑ R-3❑ R-4❑
S: Storage 5-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA IB ❑ IIA ❑ IIB ❑ IIIAO IIIB ❑ 1 IV ❑ VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
Public❑ Check if outside Flood Zone❑ Indicate municipal❑
A trench will not be Licensed Disposal Site❑
Private❑ or indentify Zone: or on site system❑ required ❑or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: NIA Historic Commission levies•Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
(V1 A l�-- QO N• o S�T1 i `3'� Z g
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
0116 71 1 e hm -7 Grand T.A Way 5a4rn 0/170
`Name(Print) No.and Street City/Town Zip
Property Owner Contact Information 7:
73 3yf- c189
nwwer
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
T r,6o,d Cihp�ohQ 13GTUrn��t )U �x yn/l vf�73
Name Street Address City/ own State Zip
to act on the 2rol2erty owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0 and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control e
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„P ��eph �6No. e-mail ad /ur..ej address v !77 'e i3tration Number
046 (
Street Address City/Tows State Zip Discipline Expiration Date
10.2 General Contractor
.Aic�ate Lemcde
Company Name IC. 0,,,/ �d/����t �a143 !0• 3 15
Name of Person Responsible for Construction License No. and Type if Applicable
ti gr�sFol �• , _rrx I nit o t y7o
Street Address City/Town State Zip
1 7f- 53+-11 7Y
Telephone No. business Telephone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L,c.152.§25C 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes 13 No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1. Building $
Z jig— Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$
3.Plumbing $
4.Mechanical (I-IV AC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $ '
Enclose check payable to
6.Total Cost $ 2 J 7 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to the best of n know dge and understanding.
_Rr 46 1 C.Y44�nh�
63�Please rint and sigq ame itle Telephone No. Date
'rc �OvG ara�y�i, m� 0I'77cZ_
Street Address City/Town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Date
Sanctuary Condominiums
c/o Crowninshield Management Corp.
18 Crowninshield Street
Peabody, MA 01960
(978)532-4800
July 14, 2014
Ms. Miha Ciucur
7 Grand Turk Way
Salem, MA 01970
RE: Replacement Windows —Sanctuary Condominiums
Dear Ms. Ciucur:
Thank you for your inquiry regarding window/slider replacements at your unit. Please be
advised that the Board of Trustees for the Sanctuary Condominiums does not object to
the replacement of these windows or doors providing that they match in appearance (no
crank outs or French doors, unless replacing a crank out, etc.) from the existing, they
must fit in the existing opening, molding size must remain the same and they will not
allow grids etc.
We also require the permits be pulled in advance, and that a copy of the final approved
permit once completed is also submitted to our office. We also require that you hire only
a licensed contractor, with adequate insurance.
You will most likely need to show a copy of this letter to the Building Department in
order to obtain your permit.
Should you have any questions or require additional information,_please feel free to call
me directly at(978)532-4800 ext#232.
Sincerely,
CA
Regional Property Manager
Crowninshield Management Corp.
Managing Agent for the Sanctuary Condominiums
cc: file
Ine"�Urr M'onweaRn of lY�aJ'3 Cnlil'eIlJ1 r _
Departmen!ofIndustrialAecidents
O ff, e pf Investigation
1 Congress Street,$uite 00
Boston, MA 02114-20 7
www.mass.gov/dia
Workers' Compensation`Tnsura ee Affidavit: Builders/ ontractors/Electricians/Plumbers
Applicant linform ion Please Print Le ibl'
Name (Busii,t:ss/organi' tion/Individual)' i I Orel nenk
Address: 51 1
t
City/State 5/Zip: (} p1A7, 0. Phone 636-717 1
Are you an employer? GI heck the appropri to ox: Type of project(required): I
1.❑ T am a employer with 4. ❑ 1 am a general contracto and I
employees (full anor part-time):• have hired the sub-con ctors 6. ❑ New construction:
2. 1 am a;sole proprietor or partner- listed;on the atiachedsh t; 7. ❑ Remodeling
shipand have no ern to ees, These sub-contractors h 'e
P Y S. ❑ Demolition
working for mein i my capacity,, employees and have wor ers'a comp. insurance.1 9. ❑ Building addition
[No workers' comp) insurance p•
required.] f( 5. ❑ We.are a corporation li its 10.❑Electrical repairs or additions
I❑ I am.a homdo - erdoin all work' officers have exercised t eir 11. Plumbing
g ❑ g repairs or additions
myself. [No workers'comp. right of exemption per GL. ,
insurance required: f c. 152 §1(4);and we ha vrio
12.❑ Roof repairs
employees. [No.workers 13.❑ Other I
comp. insurance require, ;]
•Any applicant that: lice box rdI must also, out the sectionlbelowshowing their workers'c pensation policy information
?Homeowners wh'osubmit this�fftdevit indicating they a ,doi g all work and then hire outside wntractors'must submit anew affidavit indicating such.
:Contractors that check this box titust attached an additions sheet showing the name of the su ntractors and state whether or not those entities have
employees. If the sub-cuntracto have employees:theymustp ride:their workeis'comp.poliq ynumber'
I ant an employer that is providing workers'compensation insurance for nt employees.. Below is The policy and,jobsiie..
information.Insurance Company Nat f
Policy#or Self-ins Lic.,e.
Expiration Data
Job:Site Address: arrr a i fie tN a ] 0 0
,._ 1 .. .- .City/Sta"te/Zip: 11'i(i' �y�
Attach a copy of tfie wor ers' compensation 66, ty declarati n page(sba Wing the policy number and expiration date):.
Failure tosecure coverage)as required under Section 2M of MGL c..152 can lead to the.imposition of criminal penalties of a
fine up to$1,500 00 and/or one-yearimprison, eni,as well as civil penalties in the form of a STOP WORK ORDER and a'find.
of up:to.$250.00 a day against the violator. Be advised that a copy, of iWstatement maybe forwarded to the Office of
Investigations of the DIA I r'insurance coverage verification.
do'hereb eerti ;u" 'r 4ep-gins and Penalties 'Apefiury that the in or'nt h provided above is true and correct.
Si ature: Date
Phoned: —7/7
O cial.ttse only. Do idiot write i i this area to(be completed by city or to ' offrciaL
City or Town: Permit/Lice e# _
Issuing Authority(circle one): I
1.13oard of Health:2.Bmlding D6
partine t1A.City/Town Clerk 4.E lectricall Inspector 5.Plumbing inspector
4.Other ( .
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4 � i
tr x S
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��" �Office of Consumer.Affairs&Business Regulation License or registration valid for individul use only
-4r-H�bME IMPROVEMENT CONTRACTOR before the expiration[late If found return to:
+1: �' Office of Consumer.Affairs and Business Regulation
P Registration: 148688 Type 10 Park Plaza-Suite 5170
Expiration: 10/1812015 Supplement and Boston,MA 02116
LOWE'S HOMES CENTERS INC
RICHARD CHALONE
136 TURNPIKE RD. SUITE 100
SOUTHBOROUGH, MA 01772 --- - ---- -- _
Underseeretary Not valid without signature
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:1.. •r.3.CERTIFCATE 1S"ISSUED A8 A fAATWER"OF INFORMATION ONLY AND CO NO RIMM UPON THE:CERTIFICATE HOLDER.THIS
,_-". : TiTi''SCATE DO£S,NtjT APFIRMA7lVElY OR NEt1ATIVELY AMEND, EXTEND OR TER THE COVERAGE AFFORDED BY THE PjTt.C
I 6ELOW. THIS CGR71F1CATE OF INSURANCE"DOES NOT CONSTITUTE.A CONTRA(T-BETYVEER THE 1118D0+G OISURERS). AUTHORO:ED'"
j__1I12PRESENTATIVEDR PRODUCER,AND THE CEO TIFlCATE HOLDER
IMPORTANT: if the aeri icato holder is an ADDITION iUL INSURED,the poncy&s)mum he endarsed. IfSUBROGATION 13 WAIVED,subject,to�
aw terms and conditions of the polky,conain poikiss,may*uire an w4mement. A Uft mam on this ceAlSea o does riot oonfer rights to pw
:weeitieatR holder.in lieu ofattth ondoraolnen S. `
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7. .iIS i� a::O CER-rwy h1At THE POLICIE9 OF INSURPNC6IUSTED"BELOW HAVE SEEN ISSUETO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
IVOI ATFO. NOTWRHST{WD1NG ANY REQUIREMENT,TERM OR CONDITION OF ANY'CON OR OTHER DOCUMENT NTH RESPECT TO N UCH THIS
gF.wrWiCATE MAY BE`ISSUED OR MAY PERTA N.THE RISURANCE AFFORDED BY THE E$DESCPJWU HEREIN IS.SUWECT TO ALL THE..TEE"t
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CONTRACT# 0 004J?d
`MA,SSACHUSETTS SERVICES SOLUTIONS INSTAkLED SALES CONTRACT
- LOWESA ORIZEDR ESENTATIV I I NUMBER ,,. CUSTOMERty
F-
STORE NO ST EET ADDRESS r S' STREET AODRESS.�
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o9 _ . 1,er^. z T 1
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r' p, CITY STATE ZIP -
STATE ZIP ,
O/97LI
TELEPHONE 9 Yti
_. TELEPHONE
" OATS LOWES HOME CENTERS LLC'S M4 HIC NO taBSBB CASH _� .� .' CXMGE
FEIN 56LIi8358 GRaD
�yThU k mty a yuob M Ne mxquMse allarom pa ba EeY;v.Tli C eglam,gM pon papnen[UIMn OaYment Ilw aNb agreemeM;.lixiWing Me apwlMalty cOmpbba PIE-W IryU
:aaw M me r m�s afro cpnauwu III am �m s apwmemana y mar aaaenaa elm Mmdrm.ns nerem dell ce rereired m n rein es mr•caMaa.•
,;PLEASE READ P1L TERMS ANO CONfImgY9 ON THE REVERSE SIDE OF1HI5 PMaE ANO FOLLOWING PAGES BEFORE SIGNING
p" INSTALlAT10N aTREET A0ORE55 •• CITY •".:• STATE ZIP tl
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NOTICE TO CUSTOMER-PRICE CALCULATIONS:In order[o property perform the installation of certain Goods,the Contract Price may inclutlo more
Goods than actually will be installed based on the measured square footage of the Project Area.As a result,the parties agree that the IumPsu a Price
stated in this Contract is calculated upon both the value of estimated Goods required to fulfill the Contract(including waste),which may exceed the actual
square footage of the Project Area,and the labor which may be estimated based on the amount of Goods required to fulfill the Contract(including waste).
By signing this Contract below,Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may
not be refunded once the Installation Services are performed.
Contract Total
Are permits required for this installation?:iA Yes [ ]NO •applicable tax included ?�
NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right By signing this Contract,Customer
acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure
from renovation activity to be performed In Customer's dwelling unit. .
NOTE: If rotted wood is discovered during installation additional charges will apply.You will be given a quote and a change order
must be completed and signed by the customer for any additional charges. Customer must initial.
'Any work or material not apeclfled Is not included In this contract.Any changes or additions will be at an additional chame for me material and labor.
PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees and independent
Installation Services will be performed and all work performed at the Premises related to this sirContract,End irrevocably
to of the Premises where
y grants to Ls all right,the and
interest in and to the photographs for use in all markets and media,worldwide,in perpetuity.Customer authorizes Lowe's to copyright,
ht,use and publish the
photographs in print and/or electronically,and agrees that Lowe's may use such photographs for any lawful purpose,including,but not limited to,marketing,
advertising,publicity,illustration,training and Web content.By initialing here,Customer agrees to the foregoing. [Customer to initial to the left].
Work IsVIM—
�ofom rice upon reasonable availability of Contractor andlor any special order of cus[grmer made Goods)which is anticipated to be
„'•r i`� [fill in date].Estimated completion date Is YO//f/,'r [fill in date].
Said estimated substantial completion date is nopp ppff the essence.A statement of any contingencies that would materially change said estimated substantial
completion date is as follows:
(if applicable,insert a statement of such contingencies).
IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full.
COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00:
Customer to Pay In Full; OR [ ]Customer to use the following payment schedule:
(1I eposit $ to be paid upon signing contract Deposit should be 1/3 the total contract price;and
(2)PaymentofIII to be paid anytime after this Contract is signed and before commencement of installation,t We authorize Lowe's
to do one of the following(check appropriate box below):
( ]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed;
or
( ]Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and
(3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction.
NOTICE RFGARDINrg ARBITRATION AGREEMENT FOR CLAIMS O\F D BY M.G.L. 142A
LOWE'$AND OWNER HER MUTUALLY AGREE IN AOVA[JCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT
LOWE'S MAY SUBMIT SU DI PUT O A PRIVATE ARBITRATION SERVIdE WHICH AS BEEN APPROVED BY THE SECRETARY OF THE EXECUT-
IVE OFFICE OF CONSU RA AI AND BUSINESS REGULATIONS AND THE OWN R ALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION
AS 14
By: Date:
Lowe' Nome Centers,kLC
BY:Y+ Date: y
Owner Signature:',
THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED
BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE
SECTION ABOVE IS NOT SEPARATELY SIGNED BY THE PARTIES.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND
CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.
BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE
TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS
CONTRACT.YOU ARE E TITLED TO A COPY F THIS CONTRACT AT THE TIME OF SIGNATURE.
WITNESS OUR H D(S) NO EAL(SI BELOW THIS�DAY OF H20rs I- o4G`
Loyre's om C nt 'LC
T -.
. ,
1 1
Lowe s—Rulhonzed eresen V
Owner Coowner or With
Customer acknowledges receipt of a true copy of this contract which vas completely filled in prior to Customer's execution hereof.You,the buyer,may
cancel Nrls Witaid transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation
form for emotion o1 any
t me p