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1 HIBERNIA LN - BUILDING INSPECTION (2) . , • � l 1 (o,. C� �CloOb4�s � � .Y�� ' The Commonwealth ofMassachasetts�'� '" Board of Building Regulations and Standards CIT'Y OF � Massachusetts State Building Code, �so crpg�, ��� _� p n� s'u.EM 'R�v�sed Mar 20I1 Building Permit Applicarion To Construct,Repair,Renovate Or Demolish a One-or 7`wo-Family Dwe[ling _ _ . - _fi'.. _� � This Section For Offici Use Only.._--., r � , _„- -._ . _ W � Bwldwg Eemitt Numliei;:: , . - a � , ';Date pplie'd: . ' _ , � - - ' ^ ,w, ,, .., . ..., . . . ���.aa �.. � V' . .... . �. „ � e. 't•''Sw !� '�,,; { . . � *' � ! 3/ .. � `Buildiag'OffiCiel,(Printfleme) ..:� e •� . •_ .^T �Sigaa[�ae R. "� ... � : - � ,Date- " � S � _ �. �.:. ,^:. -+.e ;�^. .SECTION i:STCE IIVNURMATION; .� " � 1.1 Properly Address: ;.2 Assessois Mep&Percel Numbers � 1 HIB RNIA AN A M,MA 01970 07 nn94-9�0 � 1.1 a Is this an accepted streeY?yes_ no Map Number Parcel Number r 1.3 Zoning Infotmation: 1.4 Property Dimenaions: �� CONDO 1 Zoning District Proposed Usc Lot Area(sq fl) Frontage(ft) 1.5 Building Setbscks(ft) . Front Yard Side Yards Reaz Yard Required Provided Reqti�ed Provided Reqa'ved Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zoee informafion: i.S Sewage Disposal System: Zone: Outside Flood Zone7 Public❑ Privflte❑ — Checkifyes0 Municipal O On site disposal system ❑ . .,:.- ..s.._. .- �__- -- - -- ----- - — ` -SECTION 2:�PRUPERTY OWNERSH�'. - 2.1 Owroer'of Record: .IAM�rFS�� FAI I (�N SALEM.MA 01970 N1 HIB�ERNIALANE C�Ty'�'� 978-744-8645 No.and Street - �Telepho� Emai]Address . . . ..._ . __ _ . Sl�]�`--,�IQN 3•DESCRIPTION OF PROPOSED WORK'(check all tha!apply)�. `.. New Construqion❑ Existing Build'atg Pf Owner-Occupied $ Repaics(s) � Alterxtion(s) ❑ Addition ❑ Demolition 0 Accessory Bldg.O Number of Units Other Specify:Replacement BriefDescription ofProposed Worlcz: REPLACE 6 WINDOWS & 4 DOORS NCLSTRU�TURAI (`HAf`f F ,,.._ =_t_ - --- :- _ - -- - - `_ _ _ -- . ' . , SECTIOPi 4:ESTIMATEDCONSTRUCITON GOSTS S , ;, .. .�� -_ - � - - ' ' Item Estimated Costs: � Oftieial�Use Onl , .. abor and Meterials � " t Y ,� 1.Building $ 1 j;Briilding'Permit Feet�$ Lidicete how fee is detennined: 2.Electrical $ 0 Standard'City/Town Application Fee ,...-� , � 0 Totat Project Cost�(Item�xmnlfiplier � _x` � t 3.Plumbing $ 2. Ofhei Fees:. $ -- ' ` t« _ ' , 4.Mechazrical (HVAC) $ List' - ' ' . 5.Mechanical (Fire Su ssian $ Total All Fees!$ • Check No.. Cheek Amount: Cash Amoimt: ' 6.Total Project Cost: $ 24,395.00 O Paid'in Full _ O Outstanding BalanceDue: ��� �.�13 l� - = ��� SECTION S::CONSTRUCTION SERVI6ES - � 5.1 Construction Sapervism License(CSL) 90125 10-0 6-16 Jamie Moirn LiceoseN�m,ber ExpirationDate �Name of CSL Holder U List CSL Type(see below) 86 Gardiner St - :.. _ No.and Sveet �'IYPe .: ', • � Desviption• . . ,. Lynn, MA 01905 U Unresaic[ed uildi s u m 35,000 cu.ft. R Restricted 1�2 Feaul Dwellin City/Town,State>ZIP M Maso RC Roofm Coverin WS Window�d Sidin SF Solid Fue7$uming Appliances 508-351-2214 I Insulation Tele hone Email address D Demolition 5.2 Registered Rome Impruvement Contractor(HIC� 170810 12-2 3-17 Renewal b Andersen Y HIC Registration Number Expiretion Date HIC Company Narne or HIC Registrant Name 30 Forbes Rd No.and Sheet 508-351-2214 Emai3 eddfess Northborough, MA 01532 C' lTown,State,ZIP Tele hone SECTION 6:WORKL+RS'CQMPENSATION INSURAPTCE AFFIDAVIT(M.G3:.c 152.§ 2$C(�)� �. — • - _ _ __ _ _ _ _ - . . . . Workers Compensation Insucance atSdavit must be completed and submitted with tlus applicaUon. Fazlure to provide this affida�it will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes.......... No...........❑ SECTION 7a:OWNER AUTEIQRiZATION,TO BE CQMPLETED WHEN ,, , « ^ � OWIVER'S AGENT O1tCONTR?iCTOR:APPLIES FOR�BDI[.DING PE1tMIT ' ' I,as Owner oftha subjed property,hereby authorize Jamie Morin to act on my behal�in all matters relffiive to work authorized by this building pecmit applicallon. SEE CONTRACT Print Owner's Namc(Electronic Si�ature) Date SECTION"76:'OWNER�OR AUTHORiZED'AGENT DEGLARATION_ By entering my neme below,I h y a st unda the pains and penalties of perj�y that ell of tha information contained in this application is trua and cc�aate to the best of my knawledge and understanding. JAIME MORIN �'��p �� � Print Owner's or Autho � d A Ys Name(Elechonic Signature) Date �.___ _ NUTES• , .I. An Owner who obtains a building peimit to do lus!her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),wili nos have access to the erbitration pmgram or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be foimd at ww�v.mass.eov/oca Infarmation on the Construction Supervisor License can be found at www.mess.eov/dos 2. When substantial work is plazmed,provide the information below: Total floor area(sq.ft.) (including gaiage,finished basemendattics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathraoms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Squace Footage"may be substituted for"Total Project CosP' . �/ CITY OF SALE►'1�I� 1��t1SSt1CHU5ETI�5 .� Si:II.DL�IG DEPAriYatEN7 1�WASHiNGTON$iRBETs 3�E3.00R 'I�..{97H)745-9595 FnX(978� 74Q9846 KIaffiERL.EY DRISCOI.L MAYQR 1�tODdAS ST.P�RIt6 DiRt+LTOH OF PI�HLIC PROPEA'IY/HI:II�iNG CO�QSSiONER Construction Debris �isposat AffidavYt � (required for all demolition anci renovarion work) in accordance with the sixth ediGon of the State$uilding Code,780 CMR s�tion I 11.5 l�ebris,aad the ptnvisions of MGL c 40,S 54; • Building Pe►mit# is issued with the condition that thc debris resulting fium tlus work shall be dispo�d of in a properly licensed waste ciiaposal facility as defined by MGL c 111,S I SOA. The debris wi(i be traneported by: Renewal by Andersen (asmo ofheWer) The debris wil(be disposed of in : Renewal by Andersen (mme of faciliry) 30 Forbes Rd, Northborough, MA 01532 (nddress of facility) ' of pemtit applicaqt ���0 = l � �� ,�,ri�rzaa ; R�n�w�l Agr��ment Gacument �nd �'ayr��nt T�rrn� ��," ��.5�n �b�a fSsnra'�Ilir Am�Ce�+a�u uFBarSro l+um4t P�114�i ' -` ` . . 1e�R�x*�e:Pc,ne�M•al6vpax�k.r�mLl�: 1YNoc*i4alar.e ar� ' � �17q61� salem.ren.o797p .uma �c ..��e.x. �1 EmC�s";X��,13 hW(ch�`arma9h,FYf�.4�'a53E �"#97"m}7+19z'i5•9s !f'C�:S�?3�3:,9-22W iF3i:I'JG�3P§�C<:ak�72 V?k��nc7qnf7K!e2t�cn'49r+s�c.�.2�Cmr��x91n � d:e�e�re�°iesi��'l N��n�1x l�t114€ Fp1�9l1 f���PI.r�Gt lilsg;,05��d�'1� ��:�•t�+e��o«(.s1 S��4uc +1�lefrc,�+r,1 F#'Ib�^rnla Lane, S�IQar1�_MA 0197Q ��r��y"lelepk�c���e`^ua�sd�e.-�'�7$Ji44-6fid� S�xsmui�s�ey�7'�9e��li�ai�\^uiiel,e�- @hunacw auuail_��fg21G�'{ON1WSt.qCt t',�aeina�rt�r��ftail; IL4c��5crC+� lecerk�a ��d iaclg�n,i'sn+er�,11}'r,t;irc�y�� �+sintl�,�ar i0�c gri+�+�u'��:u naG���.�e serwi�es,y�2[rn�cswi'I 7ay An41Rrx�e��.8 G,ill+�ci it4���,wi!hy ,f4u.Jc+s�ii wf 1.9f+x��,ini'����iriaacM1u�i°�, l��u�:�a���sei�e w[��r Klsemt�idiv.ieia6 s;r,;,u9la�wa�o1�i11e€wt 6i� �Ipl.v t's�r,�esre 93w�a���7�+�i ueuh I'-�,�airaai_e "�Ncr�n�� N�7ai�ie nl'[�n9iC���iehy�. 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E:DG7ERIC}li 4'�'l�k�r. INgE@iGaRkv�la�le, Ctil,�ab: 5ash Fki4: T�enper�r.EFG���ea�E. 5�niart5u�h wyitF�Tr9¢adat�cck Gl�ss, �1��u��rm; r�iba�i4r, �iutd��,se, �.uw,il�a��y�uot Il�K. Cc�ler iltAatched, Scr�eens G1�P�rg. �irylle �Styae:�i+a Gr�il�es, Pu3isc: Non 2QX I�tCI 1 AP�CIn�t�uy: t^71f4Minry +�dultA�?. Glnelin�, f;1. �k�Orut�s 3�.tiM1swu.S, I:J Faan�n� EM7�'161�J!P11N'h#!d.'tP+I��W4�+f� 'sMhi9,n, �9t�,sst �a3h All: hlbj� Pi5ef0erfeailrA SYn�r•CSerrr�,viaJa He3tLbele G��5i, �Ca �a�Cern, s1a��d�rr�re� 5at�n o�i€�;r_i. ��scrn.rraa5een€ ��rr�h�it��ler �olar ��p�r_'h, Full Screen, �irfiBle'SCyl�s No Grilles, @�'tlisr t:fln 2Q,� [9�+f� � ANfn��ol+.r: Clidfnr� -Cddu6tlp. PIp�llnq, '1;1. Fk��Avn!'�'�dieu�,. CJ � I's��n5�+� �`%'(��CI4�'`M�"�61a.�t14��H8�19 �41�14�. �6'ri,B9�L5�xIY A'll; Nfi1��1 �Stet[w'nawnr,e 5murt5n�n�viah Ht�tLcf_rk �`alass. CCir��ac�Fn. Sertspere�l G��lass, @tierd�er�r'Satin hli�ckel, 5sr��ne�9vuScene �vi1Ti Evteri�r tiolur lkiai¢[Ea, xuFl Srrc,en, GrifL�E��#�Ye; 190 Gsilles, � �4is�c:� Non . 2(YA Cietl � �tra6� �e�t�t; ,�47d Saria��"nrmi�=5I5lwicl, Glicfii��, 1" P.,im:�: .��Livt�,+ 5i�iizsrotir�, I_xTC�'[�� �h�de, FN`I'E�tIQp.'+�I�.i��,.�l���^. Saafl atll, Tethp�ert�d Hwyh Per(. �a�5un !xilh Neatlt7[k GP�s, eia�d�a�aec; AIGan�. Gol'��ust� Auxliner�Forsp Lack,��alUr 1��9xtrhed; S��eeenr,�fi9fdeng, GcBlle 54y�e:��4a GriFh�, V�iis�: IVun . .._. . _ . _ . ...._ _ ._. ..._ . . . ____. .._._ . . ____ . . _..._ _ __. . �I+IMDOV�S:6 PA710 DAORS:A 5PECIAUY:0 M115C: 0 TOTAI 5�4,.345 _ ._ . _ _ _ . — _ _— . �,a� ke�de�arl A,��I+edrnrw Ou r,er�ra��dt�'t+1�'a axr�t,iri�nnerr,�°t'�uFra,v ��,y . �i 'r' �• tm:k im µ�d78d�,�'��'��t�ir��v',���. �c-'�b KortaP.+'Jt�rit rvLh'• tlrr�.�V°i9. � ��" �€ � �N • F .� J- Qt:,rP�u1fi �eaae�+' 7�6 Sanctuary Condominium Trust c% Crowninshield Management Corp. 18 Crowninshield Street Peabody, MA 01960 (978)532-4800 June 15, 2016 Mr. James Fallon 1 Hibernia Way Salem, MA 01970 RE: Replacement Windows— Sanctuary Condominiums Dear Mr. Fallon: Thank you for your inquiry regarding slider and window 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 sliders providing that they match in appearance (no crank outs, etc.) from the existing, they must fit in the existing opening, molding size and glass size must remain the same and they will not allow grids or French doors, 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 Deparhnent 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, � .fanza Jill Fama, CMCA Regional Property Manager Crowninshield Management Corp. Managing Agent for the Sanctuary Condominiums cc: File The Comatoxweaftk df .Vassackinerrs Or e, of hwesdgadoas _ QUO �3'asitlrrgfan .�Y ger Boston, AL4 0 111 wtrw.nw,&,gom,1dia Workers' Comllensat lan lassmmance fit ldavil; 3vitdk�s/�'oatracly �s� ectrdr3g �uan�ca Ants s?nf'omauon P109601111d hl Name i}iitsiness�i?rhe ationMdi.idua it, RENEWAL BY ANDERSEN Aildreb,S: 30 FORBES ROAD City/Statei7ip_- NORTHBORO,MA 01532., pholw i?: 508-351-2200_ - Arcpa an employer^ Check Jre appropriate box: TYPe of profrct (required), 1.L_I l am a empleyar with -,30 4. Q 1 am a Sweral . ontraetor and I 6. ©.New cono atom ! employers ('full and or pa: time);" have hired the inti-cotow.ors I s� 2..n 1 am a sole propeloor or partner- listed nn the attached sheet. = ?. TMJ RRemodelinp ship and have no employees ac.w sub-;:wrtromors have S. Q !)emohNtut working for me. in any "Way- No ' ' in:;rtra^.cc Workers camp; trnWaan2e. A. Q N'e arca :orporation itv p ❑Building addition workers tnp. [ ao required.] and officers have exercised their I O.L Electrical repairs ur additiyns y 3. 0 1 am a homeowner doing all work right yf em-uption per'NIM. I L,Q Plumbing r7epaus or auditions tnywif. INo workeW comp, c. 157, 41(41, and w have no 12.0 Roof repairs insurance requhW.] t amplovem [, io aorkerc III 13.0 Other i stomp. instu'anee eequimll 'AD),j pilcant Ilia :dw} 4cna muaapn:fdl:wt thc.v.-:.tum aluw;�{at,-;np Bair eut::+.s'.vtaNvCaati::n pailey*: aina&".. t ]Moat wN =%ho4u:60itthip;:l vftW kiAMI&LAIC}A":doing ail %W), tinli am, afkMvi nnffWtW ti.xtn:r,~;ors true znerhlhMx ivr: Haat atalrau mt Wel t..mal ditret.A,M. na the Hatt! ns rc wb �n7mrmri;.>mtl tine woncac' wmp, pNicq imams I am an earployer tkar it proplAW warit'ers I cornprasadon lnsamwe/6r jW enWeyeer, Befog B Ike P 40"'motfon. t+ S mtdJobslre Insurance Comhagy Name:; OLD REPUBLIC INS. CO. Pulicy#" olf-ink. Lie.>Y;_..nyNSr 3Il5lOTQ� _ _._ i?'xpi.:at on Neto: 10-011116 _ --- lobSiteAddress, 1 HIBFRNIALANE_Gdtysttttr"Lip; SALEM MA 01970, Attach a cope of the workers' compensetion policy d"isrutiwt ;rage (shoring the Palley number and expiration trate). Failure to secure coverage as requirc d under Section 25;1 of 1161- c. IS' can lead to the cnposition of criminal p yua►ti•:s of a fine up to $1,500.00 andlor ane - fear intprisonme% as well as cavil penah e;S in the form of a STOP WORK C )RDER and a fine of up to $:50.00 a day against the violator. Be advised that a copy of this statarnent may be fimvardad to the Office of Investigations of the DIA for insurance coyersge verification,. 508-351-2200 O/*hd ase only. Doo not write ht tkis area, to be eoritpleted by ci& or town VA.W, City or Town: Issuing Authority (circle one): 1. Board of Health 2, Building Department 6. Other Perr�it/i.deense aY 3-Cityfrowo E3er6 4. Elceuical Inspectar 5. PlUtubing inspector Pbooe ANDECOR-01 YADAWO 'A40C> KX `lam CERTIFICATE OF LIABILITY INSURANCE DATE(Mavii Y Y) 10/1/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate hostler In lieu of such endorsement(s). PRODUCER Willis of Minnesota Inc. Wo 26 Century Blvd P.O. Box 306191 Nashville, TN 97230-5191 "MME: Willis Certificate Center PHONE .877 945-7378 ac E oti xo : 888 467-2378 ADDRESS, 6: Certificates illis.com INSURENS) AFFORDING COVERAGE MAIC$ INSURERA: Old Republic Insurance Com {ren 24147 306440 INSURED INSURER B: INSURER C: Renewal by Andersen LLC INSURER 0; 30 Forbes Road Northborough, MA 01532 INSURER E: NSURER F: CUVERALieb CERTIFICATE NUMBER: 0EYMt0M M„Meece. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF WSURANCEIm AUTHORIZED REPRESENTATIVE POLICY NUMBER POLICYEPF LIMITS A X COMMERCULLGENERAL LIABIUTY CUUMS-MADE OCCUR 306440 EACH OCCURRENCE $ 1,000,00 PREMISES En omxmenae $ 500,000 MED EXP Airy mm pamm�) $ 10,00 PERSONAL ADV INJURY $ 1,000,00 7(F.a BERL AGGREGATE LIMIT APPLIES PER: X POLIGYFIPRO- ❑ PRO- LOC GENERAL AGGREGATE S 4,000,000 PRODUCTS AGG $ 4,000,00 S OTHER: A AUTOMOBILE X LUIBILITY ANY AUTO MWTB 305438 10/01/2015 10/01=16 MBINED SINGLE LIMIT acidW $ 5,000,000 BODaYINJURY(Parpamon) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (For accident) 3 HIRED AUTOS NON-OWNEDGEDANA AUTOS Peremidanl $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAa GWMS-MADE GREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN �ICERIMEMBER EXCLUDED?ECUTIVE NIA MWC30543i00 10/01/2015 10/07/2016 ER STATUTE ER IFL L EACH ACCIDENT $ 1,000, DISEASE -EA EMPLO $ 1,000,0DEYSCRdesaON (Mandatory In NH) OFOPERATIONS pelowL DISEASE -POLICY UMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, AdtlHbrul RamiNm 8enatlRle, may tw atlaclletl M mem apace la mquxetl) CERTIFICATE HOLDER CANCELLATION %31968-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Evidence of Insurance %31968-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Ma saehueette.-QepaltmeM of Pubke Safety Board of Building Regulations and Standards Construction %peniser Ucanae; t�.i i.l�4jd i 3 � yu ^` Expiration t:o;ihNuionns 70101NBrtf. - ��is (F+o��:mto9WM¢�O�f �pd�pd �!•• ue of Consumer Afialrr & Busiaesa Regulation �, ME IMPROVEMENT CONTRACTOR Registration;: 110910 Type: =� ExplratiQaF jjjiijofZ, Supplement Card RENEWAL BY ANDS ON LLC J . y JAIME MORIN w •. 30 FORBES RD -•-,.••—<�•,•;,_--- NORTHBOROUGH, MA 01532 Underwntary ir— PRODUCT PERFORMANCE Andmeai NRC Cartirfled Total Unit Performance (mndved) ! 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