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37 HILLSIDE AVE - BUILDING INSPECTION (2) 1+z� The Commonwealth of Massachusetts £C �VkQ M a Board of Building Regulations and StalfcfEDT,IONAL SERV IC `5 CITY OF Massachusetts State Building Code, 780 CNM SALEM t it, Revised Mar 2011 (� Building Permit Application To Construct, Repair,Re'altAd AmPshlk 0 1 (f' One- or Two-Family Dwelling 1 This Section For Official Use Only i Building Permit Number: Date Ap ted: I Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1 Pro e A dres • 1.2 Assessors Ma &Parcel Numbers '1 � 11 ttl v� p 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) 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? Municipal ❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2 Owner'of Rec d: u St CrC\Q Saf er v,�� c) Name(Print) City,State,kip 31 Vlllk�NAQ—.Pvye S,$ „ No.and Street Telephone Signature SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ 1 Accessory Bldg. ❑ Number of Units_ Other M-Specify: fWA Brief Descption of Pro used Workz: t' rn� a C A- SKI, SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ (p� 0 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 6sn 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 2123 5/24/16 Glenn R Battistelli License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 11 Broadway-R/P.O. Box 496 Type Description No.and Street U Unrestricted(Buildings up to 35,000 cu.ft. Beverly MA 01915 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances `- (978) 927-8956 �/J r�/�h I 1 Insulation Telephone Signature D Demolition 5.2 Registered Home Improvement Contractor(HIC) 172456 7/3/16 Glenn Battistelli LLC HIC Re istration Number Expiration Date HIC Company Name or HIC Registrant Name 281 Dodge St No.and Street Signature Beverly MA 01915 (978) 927-8956 City/Town, State,ZIP 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 Issuance 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 I, as Owner of the subject property, hereby authorize Glenn Battistelli to act on my behalf,in all matt rs relative to work authorized by this building permit application. 9 Print ner's Name(Signs ure) Date e SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION 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 my knowledge and.understanding. Glenn Battistelli �2-4 li� I 41-WIVU, Print Owner's or Authorized Agent's Name(Signature) ate 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. c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dos 2. When substantial work is planned,provide the information below: Total floor 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 halfibaths 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" _ \ 3 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, 7th Floor _ Boston,Mass. 02111 '`Worker's Compensation Insurance Affidavit Building/Plumbing/Electrical Contractors Applicant information: _ r - Please PRINT legibly s name: Glenn Battistelli LLC address: P.O. Box 496 City: Beverly state: MA zip: 01915 phone# (978) 927-8956 p work site location(full address): �j� 1��I�Q 1 -(L SII4f'S'..1 nmzt I am a homeowner performing all work myself. Project Type: ❑ New Construction ❑ Remodel I am a sole proprietor and have no one working in any capacity. ❑ Building Addition x❑ I am as employer providing workers'compensation for my employees working on this job. _ companyname: Glenn Battistelli Construction LLC address: P.O. Box 496 !I - city: Beverly phone# (978) 927-8956i 1 insuranceco. Travelers Indemnity policy# UB 4258 P048-14 ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation policies: company name: address: city phone# insurance co. policy# _ company name: address: city: phone# insurance co. policy# [Attach additional sheet if necessary - - - - - -— Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify of er the pains and penafties ofperiury that the information provided above is true and correct Signature Date ��Z�i 101 Print name Glenn Battistelli Phone# (978) 927-8956 OS Ir official use only do not write in this area to be completed by city or town omcial city or town: permiNicenseq Q Building Department QLicensing Board Qcheck if immediate response is required O S,kesmem's Office Health Department contact person: phone q: O Other (revisM Sep.2003) - 7 GLENN BATTISTELLI, LLC PAINTING-ROOFING-SIDING-CARPENTRY-VINYL REPLACEMENT WINDOWS KITCH ENS-BATH R OO MS-PORCH ES-DO R MERS-ADDITIONS-MASONRY P.O. BOX 496 is BEVERLY, MASSACHUSETTS 01915 BBB. bbb.®rg (978) 922-6338 (978) 777-4499 DIRECT LINE (978) 927-8956 FAX (978) 921-9202 CELL(617) 962-1235 gbattis298@aol.com ESTABLISHED 1974 GLENN BATTISTELLI CO., hereby agrees to perform the following services for: .�! at 3 7 /�i Oj S �' � e Ae Home Phone- 7 '� 7 7�' Business Phone Sealer applied to all vent pipes and chimneys. All Flashing will be inspected. Roofing Nails will be l// inches. Grounds will be cleaned of all roofing materials. All workmen are covered with Public Liability and Worker's Compensation. All work will be continuous and will be performed in a workman like manner. Roofing Shingles are self Sealing. While installing the new roof, we will protect your home and plantings from debris. Roofing Shingles to be delivered D -� j zj - u "q Install new fiberglass paper to roof boards when stripping of shingles is required. All shingles will be secured with eight nails. State and local building codes, along with manufacturers specifications will be adhered to at all times. Color of Roof is to be All work is priced as specific. The possible occurrence of rotted roof boards or poor flashing will warrant an additional cost of -&Z/ D a // O- The homeowner is responsible for covering their articles within the attic. Work is to be commenced on Payment is to be delivered /rs cs Apply _ inch aluminum drip edge to the following areas: fly e z, Year Workmanship Guarantee. - -3- 0 Year Material Guarantee ' Roofing shingles to be �•-2, /� /� .� Ae_ e ; 7 ry5�, o LS r12 a S!P ZD Agreed by Homeowner Agreed by Contractor Ref. Page � �6 ` /�_ Date 3 Day Cancellation Notice Required Office of Consumer Affairs and Busmess Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 172546 Type: LLC Expiration: 7/3/2016 TN 25503 GLENN BATTISTELLI, LLC GLENN BATTISTELLI 281 DODGE STREET r BEVERLY,MA 01915 , Update Address and return.,it.Mark reason for change. rJ Address ❑ Renewal C Employment C Lost Card mail a aneanl _ Once or Como 6:Busmess Reaaladvo License or registration valid for intliridul use only OME IMPROVEMENT CONTRACTOR before the expiration date. Iffrmadreturnto:m gist6on: 172546 Type: Once"Consumer ARaim and Business Regulation Expiration: 7WO16 LLC 10 Park Plaza-Suite 5170 _ Boston.MA 02116 GLENN BATTISTELLI,LLC GLENN BATTISTELLI 281 DODGE STREET BEVERLY,MA 01915 UvJerseerebry Not valid without signature Massachusetts-Department of Public Safety Board of Building Regulations and Standards Commuctian Supersisor ! 3 License:CS-002123 Glenn R Battutelli;� P.O BOX 0 496 Beverly MA 01913 if Jt " Expiration Commissioner 05/242016 TE MMMM A p® CERTIFICATE OF LIABILITY INSURANCE DA04120/2016 oa/zonols THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS BEELOW. THISDCERTIFICATE O IINSURANCE DOES NNOOT CONNSSTITUTEEACONTRACTTBETWEEN THV EEIISSUINGORDED BY THE POLICIES INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: t the ceratem holder Is an ADDITIONAL INSURED,the polloy(les)must be endorsed H SUBROGATION IS WANED,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 endosemen s. PROMICER E: T HaTbick STERLING INSURANCE AGENCY, INC. ° ONE 976 921-4205 FAX IaY mD L Tharbi2 c sWding4nsurence.com 306 CABOT STREET.P.0 BOX 493 UMPER S AFFORDwGCOVERAGE RAICP BURLY MA 01915 INSURER A: TRAVELERS INDEMNITY CO OF AMERICA THE 25666 INSURED INSURERS: GLENN BATTISTELLI LLC DISURERC: INSURER D: .� P 0 BOX 496 INSURER E:,- 13EVERLY MA 01915 INVUREa : COVERAGES CERTIFICATE NUMBER: 48268 REVISION NUMBER: 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. INSR TYPSOFINSURANCE a POLtCYNIJUSER pvammrrT PMMINYY P LIMITS CORNERCIALGENERALUABUTY EACH OCCURRENCE f CUVMSFMDE 0 OCCUR M SE.1 E E MEDEXP wope f NIA PERSONAL S ADV INJURY f GENL AGGREGATE LIMIT APPLIES PER GENERAL-AGGREGATE f POLICY❑jERCGT- F-1Loc PRODUCTS-COMPIOP AGO f f OTHERCOMBINED SINGLE AVIONOSBELIASUTY EA nt f ANY AUTO SODLY NJURY(PW Pon ) f ALL OWNED SCHEDULED NIA BODILY INJURY(Per sodit t) f AUTOS NA m PROPERTY DAMAGE f HMED AUTOS AUTOS (Per 8a " f UMBRELLAUAB OCCUR EACH OCCURRENCE f EXCESS UAB C AWS*IADE N/A AGGREGATE f DEO RETENnONs E 70MCERMINEXCLuNEW? X A Y YIN A NIA Nw 6HU13426SP04815 06/08/2015 061mo16 EL ENCH ACCDEMElDISEASE-EA EMPLOIGN OFOEL DISEASE-POLICY LIMIT f W0,000oN of OPERATIONS 1#m� N/A oEauhu+tPTloxoFOPEaAnoaslLocAnonSlvovcLEs WcolmhoLAEalrloAAlRemarMeBchedWe,ma/bPnmtlheexMmeapxP4mavtreG) Workers'Compensation benefits Will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 OB B,no authorization is given to pay Claims for benefits to employees In states other than Massachusetts it the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was Issued(unless the ezpiratkm date on the above policy precedes the issue date of this certificate of insurance). The status of tnls coverage can be monitored daily by accessing the Proof of Coverage-Coverage ved0cation Search tool at www.mass.govllwd/workers-compensationfmvesUgations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ray Simard ACCORDANCE WITH THE POLICY PROVISIONS. 37 Hillside Road AVTHOR@DRECRESENranVE Salem MA 01970 �"lM L Daniel M.C .CPCU,Vice President—Residual Market—WCR. ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD DATEOWDONYYY) Ac oR ® CERTIFICATE OF LIABILITY INSURANCE 4/20/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS BELOWCTHIS CERTIFICATEFOF IINNSURANCEE DOES NOT LCONSTITUTEE ATCONTRACTTBETWEEN THEEIISSUINGFFORDED By THE POLICIES INSURER(Sh AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. be endorsed. SUBIROGATION IS WANED. IMPORTANT: B the certificate h holder b an ApO Policies INSURED,the policy(les)ann endorsement muststatemDm on this certificate does mrt Coder ftft to the the terms and conditions of the Polley,certain poBGse mary reW ceAlBCatB holder In lieu of such endaseme B. PRODUCER Sterling Insurance Agency, Inc. NE (978)922-6600 ( .analnz-7650 306 Cabot Street MCI P.O. Box 493 INSURERS AFFORDINO COVERA E NAIC0 Beverly MA 01915 NSUMMA:SCOttsdale Insurance Co. INSURED INSURE B: me11RE C: Glenn Battistelli LLC INSU O: 11 Broadway w E: Beverly HA 01915 COVERAGES CERTIFICATE NUMBER:CL1311700054 REVISION NUMBER: 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. r06OF=URANCEIWSR PoUrYEFPmmmuffinm EXP A GENERALUASILIV P82112253 /26/2026 /26/2027 EACH OCCURRENCE f 1,000,000 X COMMERCIAL GENERAL LUISU" f $0,000 CLAOAS40DE ®OCCUR ACED EXP VVg�pR) f 5,000 PERSONAL a ADV MUURV f 11000,000 GEIERALAGGREGATE f 2 000,000 GERL AGGREGATE LWITAPPLIES PER PRODUCTS-COMPIOP AGO f 2,000.00 POLICY Lot f Auroaoen.EUAmurr s ANYAVTO BODILY INAMY(P>PW Mr) f A�ONNEO SCHEDULED SOOLLYINURY(P>ecafto f NIREDAUTOS AUTOON 8 � f i UMSREUA UAB OCCUR EACH OCCURRENCE f EXCESS GAS AGGREGATE f f WORNERSCOMPENSATION IVA: A OTK AND EMPLOYERS YASIUW y/R AM= NImdAanrY W NNIPARiNEPoE%EgmW A EL EACH ACC®ENT f E - EA S tl O�ifOs-0 Qr TI EL.oasEASE.FOLICY LUOT f IT DESCRmimoFOPERAIIMILOCAYIMIVENRLes(111MCN ACORD tw,AEAtlIa1M R�mN1u SeImAUIe.Nmon�ptn ln,eWlnd) Workers Compensation to be sent under separate cover. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN Bay Simard ACCORDANCE WnN THE POLICY PROVISIONS. 37 Hillside Road AUTHORaED ASPRESEMIATNE Salem, HA 01970 Rick Mooney/NANCr ACORD 26(2010105) 0191101-MO ACORD CORPORATION. All rights reserved. INS026(m OMM The ACORD name and logo are registered marks of ACORD Unofficial Property Record Card - Salem, MA General Property Data Parcel ID 14.0142-0 Account Number 0 Prior ParcellD 42-- Property Owner SIMARD RAYMOND E Property Location 37 HILLSIDE AVENUE ELLEN C Property Use One Family Mailing Address 37 HILLSIDE AVENUE - Most Recent Sale Date 91111989 Legal Reference 59452-275 City SALEM Grantor THERIAULT ROBERT FJBARBARA JEAN Mailing State MA Zip 01970 Sale Price 210,000 ParcelZoning R3 Land Area 0.241 acres Current Property Assessment Card 1 Value Building 222 900 Xtre Features SDO Land Value 126,200 Total Value 349,900 Value Value Building Description Building Style Cape Foundation Type Concrete Flooring Type Hardwood #of Living Units 1 Frame Type Wood Basement Floor Carpet Year Built 1958 Roof Structure Gable Heating Type Forced H/W Building Grade Average Roof Cover Asphalt Shgl Heating Fuel Oil Building Condition Avg-Good Siding Vinyl Air Conditioning 0 Finished Area(SF)2447.4 Interior Walls Drywall #of Bsmt Garages 0 Number Rooms 6 #of Bedrooms 3 #of Full Baths 2 #of 314 Baths 0 #of 112 Baths 1 #of Other Fixtures 0 Legal Description Narrative Description of Property This property contains 0.241 acres of land mainly classified as One Family with a(n)Cape style building,built about 1958,having Vinyl exterior and Asphalt Shgl roof cover,with 1 unit(s),6 room(9,3 bedroom ),2 bath(s),1 haN bath(s). Property Images m Disclaimer:This information is believed to be correct but is subject to change and is not warranteed.