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13 HOLLY ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts CITY /1 Board of Building Regulations and Standards \ Massachusetts State Building Code, 780 CMR,7`h edition OF SALEM Revised January Building Permit Application To Construct, Repair,Renovate Or Demolish a 1, 2008 (� One-or Two-Family Dwelling �J % This Section For Official Use Only (_ Building Permit Number: Date Applied: Z !7 v ` Signature: Building Comn' ioner/Inspector of Buildings Date SECTION 1: SITE INFORMATION I, ro�p�e'/r'/t� resn,r 1.2 Assessors Map&Parcel Numbers 11.1 a lss this an accepted street?yeses 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.401§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public,N Private❑ Zone: _ Outside Flood Zone? Municipal['On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP` 2.1 Owner,of R�efford: is A. K2w�i�r� 13 Noll weet Name(Print) Address for Seri A `M67L) g18_qK4_ &9A0 Signature U Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building Owner-Occupied ❑ 1 Repairs(s) Od I Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ 1 Number of Units_f I Other ❑ Specify: Brief Description of proposed Work': UC GC L F fi G P n SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee `C� ❑Total Project Cose(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ �_ List: �J!/ 5.Mechanical (Fire Suppression) $ �— Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ ❑ Paid in Full ❑Outstanding Balance Due: �,�� V V �d`M-C� Cy�iJ✓l� SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) /_ +� I)A 8 p la. 91 N l�e i PO - Licenfssee Number Expi ion to oc N of CSL-Holder List CSL Type(see below) U l vLLt /I iLt to 01/ Addr Type Description / U Unrestricted to 35,000 Cu. Ft.) R Restricted 1&2 Family Dwelling Sr /' M Masonry Only RC Residential Roofing Covering Telephone WS Residential Window and Siding _ SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 istered Ho a Improvement Contractor(HIC) / ^ �1 2 x M SS tre STn (FAT I'I)y 1116 . � Y 7 HIC ompany Name or C Registrant Name ( Registration Number Ad s ad/9//a ll — ,� l — f Expiratio Date igna 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 ..........i6 No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT,OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, —t ill S >Q, V4 i no as Owner of the subject property hereby authorize XVT.<�_� e .> nre 'i,bw�vtr . to act on my behalf,in all matters relative to work authorized by this building permit application. Jt-We- A), 12010 Signature of ner Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION 1, ,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 behalf. Print Name Signature of Owner or Authorized Agent Date (Signed under the gains and penalties of r u ) NOTES: I. 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I O.R6 and 11 O.RS,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" Nlassachuseits- Department of Public Safetc Board of Building Regulations and Standards Construction Supervisor License License: CS 96283 Restricted to: 00 , WAGNER PINHEIRO p 18 THIRD ST MEDFORD, MA 02155 it i3r Expiration: 2tl7/2012 ('un..ui,m„,rrr Tr#: 14092 0-7 _ Board of Building Regulations and Standards ? HOME IMPROVEMENT CONTRACTOR' Registradona 162227 Expiration ;2a4/7t011 Tri 28029,1 ' 'I Tj'ot prNate Corporation �E XPRESS RESTORA710N ING WAGNER PINHEIRO�xz; ` • , 18.3RD5,1 .._� ` MEDFORD,MA 02'r Administrator A r t Contract Agreement P 'lilt I .. RE3 TO RA TION /IVC_ 4 � �y1 OM �: > Historical Restoration & Remodeling Services Contract Agreement Xpress Restoration, Inc. Mrs Iris A. Kamon 18 Third ST 13 Holy St Medford MA 02155 Salem, MA 01970 This agreement is made on June 21,2010, between Wagner. Pinheiro, President of Xpress Restoration,Inc. and Mrs,Iris A. Kamon,owner of the property. For valuable consideration, the owner and contractor agree as fallows: Wagner Pinheiro (president of Xpress Restoration, Inc)agrees to furnish all labor and materials to do the following work: Re shingle, prep and paint work as described on attached proposal. WITNESSETH The owner does hereby employ Xpress Restoration, Inc. do all the work of a Renovation Project as described on attached proposal ) in the total sum of$27.700.00, all in accordance with the drawings, and specifications which are attached hereto as Exhibit proposal and expressly incorporated herein by reference and made a part hereof.(after signed by both parties) The Contractor shall commence the work to be performed within 5 days from the date of the Notice to Proceed, and shall complete the work_40_days thereafter, or by August 1 st, whichever comes later, time being of the essence of this contract. Hold Harmless The Contractor agrees to defend, indemnify and hold the owner harmless from any liability or claim for damage because of bodily injury, death, property damage, sickness, disease or loss and expense arising from the Contractors'negligence in the performance of the construction Contract. Each Contractor and subcontractor is acting in the capacity of an independent Contractor with respect to the Owner. The Contractor further agrees to protect, defend and indemnify the Owner from any claims by laborers, subcontractors or material men for unpaid work or labor performed or materials supplied in connection with the Construction Contract. t y Contract Agreement Assignment of Contract The contractor agrees not to assign the Construction Contract without the written consent of the Owner. Change Orders The Contractor agrees not to make any changes in the schedule of work, design, or of the specifications without written authorization by the Owner. Lien Waivers The Contractor shall protect, defend and indemnify the Owner from any claims for unpaid work, labor or materials. Limited Warranties Contractor will complete the specified work in a substantial and workmanlike manner according to standard practices prevalent in Contractor's trade. Contractor warrants that the specified work will comply with all applicable building codes and regulations. Materials All materials shall be new, in compliance with all applicable laws and codes, and shall be covered by a manufacturer's warranty if appropriate, except as follows: All materials, appliances, cabinets, light and plumbing fixtures that were provided by home owner. .Change Order(Mid-Performance Amendments) The Contractor and Homeowner recognize that: Contractor's original cost and time estimates may prove too low_due to unforeseen events or to factors unknown to the Contractor when the contract was made; Homeowner may desire a mid job change in the specifications that would add time and cost to the specified work possibly inconvenience the Contractor; or Other provisions of the contract may be difficult to carry out because of unforeseen events, such as a materials shortage or a labor strike. If these or other events beyond the control of the parties reasonable require adjustments to this contract, the parties shall make a good faith attempt to agree on all necessary particulars. Such agreements shall be put in writing, signed by the parties and added to this contract. Failure to reach agreement shall be deemed a dispute to be resolved as agreed in Clause. Permits and Codes The Contractor shall obtain all necessary building permits, including those required by the City Of Salem, State Of Massachusetts.The Contractor will secure at his/her own expense any other necessary permits and licenses required to do the work and will comply with all building and code regulations and ordinances whether or not covered by the specifications and drawings for the work. Contract Agreement Dispute Resolution If any dispute arises under the terms of this agreement, the parties agree to select a mutually agreeable neutral third party to help them mediate it. If the mediation is deemed unsuccessful, the parties agree that the dispute shall be settled according to the laws of the state that apply to this agreement. Any costs and fees (other than attorney fees) associated with mediation and arbitration shall be shared equally by the parties. Attorney fees associated with arbitration or litigation shall be paid as follows: Each party shall pay his or her own attorney fees. Work Performance 1) The Contractor shall protect all work adjacent to the Contract site from any damage resulting from the work of the Contractor and shall repair or replace any damaged work at his/her own expense. 2) The Contractor shall replace and put in good condition any existing conditions damaged in carrying out the contract. 3) The Contractor shall take all precautions to protect persons from injury and unnecessary interference or inconvenience. 4) The Contractor shall conduct his activities in a business like manner and adhere to the reasonable wishes of the Owner in relation to his working schedule. Condition of Premises The Contractor agrees to keep the premises clean and orderly and to remove all debris as needed during the hours of work in order to maintain work conditions which do not cause health or safety hazards. Use of Utilities The Owner shall permit the Contractor to use, at no cost, power and water necessary to the carrying out and completion of the work. Use of On Site Loam Owner Agrees as part of this contract to allow the Contractor use of on-site loam to the degree available as necessary for the completion of the project. Inspection The Owner shall have the right to inspect all work performed under this contract. As well it shall be a condition of this contract that all work that needs to be inspected or tested and certified by the engineer as a condition of the Dept. of Environmental Conservation Permit, (or other State agency), or inspected and certified by the local health officer, shall be done at each necessary stage before further construction can continue. All inspection and certification will be done at the Owner's expense. Failure to follow this requirement will be grounds for termination of the contract. Contract Agreement Right to Stop Work If the Contractor fails to correct defective work or persistently fails to supply materials or equipment in accordance with the Contract Documents, the Owner may order the Contractor to stop the work, or any portion thereof, until the cause for such order has been eliminated. Payment Schedule Payments for work shall be as follows: 5%when contract is signed 40%when the work starts 35%when rough work is done 20%when job is complete Payments shall be disbursed based on the attached schedule of values. Within three days of notification by the Contractor of each stage of completion,the Owner or its designee will inspect and approve the work,or request any necessary adjustments in the work. The Owner agrees to make payments to the Contractor within ten days of approving work. No modification of this agreement will be effective unless it is in writing and is signed by both parties. This agreement binds and benefits both parties and any successors.Time is of the essence of this agreement. This document, including any attachments, is the entire agreement between the parties. This agreement is governed by the laws of the State of Massachusetts. Dated: 4TU" 20 �la.uP,.,fx�Cas,� ��Q c0.u-✓ � . PSCI-�n cn� Signature Owner Signature of Owner /�1ffQl�k COSrf}� t�A- 1/��5 A. KR-MDn/ Printed Name of Own Printed Name of Owner agner Pinheiro President Xpress Restoration,lnc. `I CITY OF S.U.E.Nt, )NLASSACF{L;SETI'S XMDLNG D tVAIMILNr 120 WAMNGTOIN STRREr. Yo FtOoat Tti. (970)74&9399 F.uf(971A 74496" KIJ®EA"Y C)"WOLL TItOaW ST.Fttiai NAYOz m ucr+oa OP R SLIC PWPRSITV/K QaNG CO-%L%a3StOdiri Workers' Compeesstlon Insu►ance AMdaeiC OuildwslContracterslEleetrlclansl insists bets >,nnlleant Infnrmatlon X Please /wire LedAltt Vatne IYrataw.sOrtalausna►Iloh.+duall: ®67P 5 S I�l l P r] T9 I oq 7.o0U Address: 1,6 Af ID 5 / oily/statdziR /��n /,�//� FNee employer!Cbwb the appropriate hash Type of protest(require* �npMyr wiV�— a. QI>Aapoet"eoaaraeste a.d1 ❑Nor canse+ssiaseoe IIWI aad/ar pan- sud yhavo hirer tie r►car.racer.tore pmprl.tw ><prtrteev Iistdm rMasathad shoatr"have no omployem Thee nttrewsnawa have s. Q DmwiWm Pater is uy capacity. wottemo corn}inwsaoeo. 9. Q DaiWing ackiwas tom'comp, insurance S. 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C�Sr � 1 0 Expiration n or ©%L 2 /1 ���q�•L�y tub Sire Adrhae i. hao g 7 City/JtauVZip: .\tract a copy of the werters'coeponalYs Valley doehnllss pop(sbewhog the polity ssmber mod aspl W rote)6 Failum to stun coversp as rsgtirwd uadw 7etlla.2SA of b/GL 0. 112 can Ind to the imposition oferlminai ponaldw oft rint up to S 1.100.00 an1Yor otta-year impriaonawts,ar well es civil penalties is the fans are STOP WORK ORDER ad a Ape Of up to S230.00 a day uyoinst the violator. IN adviaod thal a wpy of this stalemate maybe rwwurded to the Oillco of Il+rcall aallYna ut'+ho ILIA for inswuKe cowross v% ilkatwa /dw he►eby certi/y w/w tAe rwd larwr r/ TAN rAI iwlMMrIM ynn/rI rlers i wrap rw :wryer ClOoKlo t P<1 P� l A• �- O/riid raI md/t Oe nW.rriM iw rAir rreq N tI.rrwa/r/r/ily ri7 w/Iww n//ft•iet City or ruua: eermit/l.lcemse s__ t.awnt.\whorny(circle uael: I ltuard u(Ilrultb 1. Rudtllaa Mpartmrnt I. C•itr/fowo Clerk A. flectricai Geiprctor S. Plumbing Impecior 6.I)Ihot, l•altart Penaw: _ _ _ Phone a'. CITY OF SALEM i PUBLIC PROPRERTY DEPARTMENT 5letl'4• \I 1,!l:'17q••1S'/NM 1,.:1'/': I'FI:'l:1-.'14.1. . A t' construction DIpM )vit (reruralldemolitionK uvva ion worrk In rccunl uxe with the sixth edition of the Slate Buildins Code. 780 CMR section 1 11.3 Debris. and the provisions of MGL c 40. S issued Building Permit N��__ _ is issued with the condition that the debris ed by thorn his wink shall he disposed of in r properly license d waste disposal facility as defined by MGL c I11. S 150A. The debris will be transported by: IA/7/ oCrvt "t ti I Il0/iTf � II/ V+ST � � a �j lime ul IleUteri 'I'lle debris will be disposed of in (n:ulle ul xl ny I:,,WrN,N if rx lily► a alure nl Iwnnil jppliaant late