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9 HOME ST - BUILDING INSPECTION 5�0� LAG '(07 3Z The Commonwealth of Massachusetts REH IANSPECTIONAL S RVI�fi OF Board of Building Regulations and Standar s EM Massachusetts State Building Code, 780 CMR SA51L � 'vr Ir,�JUt 34 �+slju tar 2011 Building Permit Application To Construct, Repair,Renovate r emoltsh a One-or Two-Family Dwelling This Section For Official Use Only 4 Building Permit Number: D to Applied: ft _ Building Official(Print Name) Si D te/ I SECTION 1: SITE INFORMATION I.1 Pro erty Address: 1.2 Assessors Map& Parcel Numbers (� �1 Home Sir 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 Rl 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' 2.1 Owner' 1G14�0\ ft' 9�f + /� O�`l0 ysn Name(Print) City,State,ZIP 1-\ \�csmc Sk fnl`l- A-aPl3o No.and Street Telephone Email Address n SECTION 3:DESCRIPT N OF PROPOSED RKZ(check pil that apply) „ - New Construction❑ Existing Building le Owner-Occupied GVI Repairs(s) Alteration(s) ❑ Addition ❑ Demolition ❑ 1 Accessory Bldg. ❑ Number of Units Other ❑ Specify: . Brief Description of Proposed Work2: k utn `tA.a cAh2 p tuc�CX>; C t5 2 t SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ `� S 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (BVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ a.S 0 Paid in Full 13 Outstanding Balance Due: . �EC3'IOXV$i C©NSTR�IC'�©N SER�C�S, s ;>� M `'"t'• hnh^' 5.1 Construction /,rSupervisor License(CSL) 6-OS-1 r ( , C (3 //rjP s /A\Q�V\ Jy�O'C�iY11 License Number Expiration Ex_p"ilratioon6Date 1 Name of CSL Holder 1 g �L'eu�\\ �• List CSL Type(see below) No.and Street . _ TYPe "` DesMphon A ,,�A A U Unrestricted Buildm s u to 35,000 cu.ft. N -A �` / Dal(e o R Res Crty/Town tric ed 1&2 Famil Dwelling ,State,ZIP M Masonry RC Roofing Covering WS Window and Sidin Q� r SF Solid Fuel Burning Appliances ] ]nsulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) ' I F'iP I/ 7S Mom/ �('Yef O n�e (Y�Q C 2\1Y 1C\ Cs CZ7 V P HIC Registration Number Expiration Date FI�C Com any Name or HIC Registrant Name No.and Street g0-01 Sb Email address Cit /Town,S te,ZIP '�O �Telephone SECi¢{i�x6 WJ Its'C{11PaSAQ� NSitA�CE AiYHAVd3(I�i Ii L c 1fi2 25Cf ) y ; Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuan of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SEC77ON 7a OWNER AII' '3IORI,^t,A�➢OI1`Ti�$E,k;(IMP�'El1'�D W1I�N / 1,as Owner of the subject property,hereby authorize J�1^cx.c\Yl to act on my behalf,in all matters relative to work authorized by this building permit application. k&/f Print Owner's Name(Electronic Signature) Date ��EC3;;(©P1;7I+ �W'WNER,fl1�.�'I1d3lOR `IL�ib,�GE�'p,FACI,A$>�'];��N n i By me q'ngm e elow,I hereby attest under the pains and-penalties of perjury that all of the information containa pli ation is true and accurate to the best of my knowledge and understanding. Print Owner's o ' gent's Name(Electronic Signature) Date w r 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(1-DC)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.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 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 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 Cosy' Project 31-56309- Signed Sales Agreement https://nitro.powerhrg.cornlprojec"ocwnents/4831569?pages=l 1 .. ,I Project 31-5&4Og-Sgned Sales Agreement 9JPEG(785 NB,85 1112) O Card and Steven SdtBURor NATIONAL HEADQUARTERS 3146309 yu...2501 Seaport Drive.am ntt m p 19013 r oweR June 12.2DI5 &REMOD m•EL V » f' r NANIW 16BBta CUSTOM REMODELING AND IMPROVEMENT AGREEMENT June tar a016 Buyarter(rdortadonmd Dae'1WOnat llwpmpww. Pri Number:31-SM Bwa12,Mar Carol Schooner (6171 m4dut(Sie.9nt w aolmagsemcouLot Steven SLAouffer N7a)lleddN(Home) A NOma Screen Seuff"W101a7) County:Eseaa �/✓ TawneNP: Buyers)listed a0me hereby)oln0y end severalty agrees b W rchasa the goods endror services of PDHar Herne Remodeling Group and Ito venOore('COMralxoy')in accordance vdR Iha Prices aM lemur tlesuibetl In Res a page tlocoment and the Product Spedfiwarnte,urhkh are IncarporaMd as part of the Agneamam(cdlecdvaly,this'Agreonenl"). This Agreement rePresema a cesh sale of goods arA cervkea. Buys+(s)agrees W pay the oust of Me goods antl services WrChecetl as daslxlced herein,repardloss of Omlrg or approval of any Srerrcing Buyers)may took brtheir WrclMae. Purdose Price: S7,S24.72 Pre Inatellatlon InaPectlon Oates: SD.DD 9Nwai wroem s.IdAaaa:tBa Down Payment Estimated Protect Start:8 to 7 weans Substantial Cornpatbn: Estimated Pmlect ComPletlon:1 to 2 days Method of Payment Chedt sn.nd.dvo,nedo.Bo la doamaen Wcorw+lonamn.,eero7actun n.Omm+ Cmu.6e/.mbd,w YdW W M cdwUa,a Menm�a Ew pabYNnMwn rvaawu. Buyo(a)hereby acknoweetlges receipt of a copy of the pamphlet. LeadSafe CartlSed Guide to Renovate Right,lnfomNng adddreare of Wiitt err aa�IBuuyer 9)m�cat�t isle a phlet from on Re data of me Agree. An be be�I�^"^elrlBceomem Property,at ttla BuyerteY Reliefs. This Agreement coroulutae the online agreement arid understanding between the parties,and this Agreement rePleoes any and all prior negotiations,mpmsenoloro,or agreemema,emerwrittenororal. Noamendment,modiftSUOnd "IVWofthis Agreement shall be vafd or effective unless R wrfOng and signed by both Parties Buyane)hereby arRncwieliges that Buyar(s)1)has reed that ortim Agreement End has owned it completed,signed,and dated copy of this A9reament.including the Iwo acoompamlrg Notice of CaRculatlon toms,on the date first written above and 2)was Drell/Informed of h15Mer right to cencel this transaction• Boyeals) on e documents.Rd also agrees and Understands ment ff m/Onsnoe change.a work with a MirdIparty,Me terms of that mooing will w contained Futura promotions not applicable. DO NOT SIGN THIS AGREEMENT IF THERE ARE ANY BLANK SPACES. 1 hoe need and roaelv6d Senn Page of tlda 6 Page agroomenL e ) P kesr N�q*eRRemodeling Group Buyers) of Mfifi l QZ),i-A tim8112715 .J -12115 bignawm of Remodeling Consultant BlgneNra re David Mock Carol SchaWler Steven Sehat fler YOU,THE BIJYER(5),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIONIGKT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. ORMl�gl� pp1l Junis 12.20161327 IIMIIIPIIMIWIIII�IIP�IWI�RiI Page 1 o18 1 of 1 7/31/2015 5:13 PM NATIONAL HEADQUARTERS `" -<.ti. Carol and Steven Schaufler 2S01 Seaport Drive,Chester,PA 19013 -y;,. i * POWER 31-56309 ,a,rse„eaeuq�p- June 12,2015 888-REMODEL 015 -- MA HICH 168616 PRODUCT SPECIFICATIONS Buyer(s)'Information and Description of the Property: Project Number: 31-56309 June 12,2015 Carol Schaufler Oare&Ayre .( Steven Schaufler (617)529-9930(Steven's Cell) solmag@comcast.net 4 Home Street (978)745.3341 (Home) E-Ma#Ad.es i Salem,MA,01970 County:Essex Township: Buyer(s)listed above hereby jointly and severally agrees to purchase the goods and/or services listed on the accompanying specification sheets, in accordance with the prices and terms described in the Custom Remodeling and Improvement and the Product Specifications (collectively,this"Agreement"). Pre Installation Inspection Date: Your pre installation inspection is tentatively scheduled for Sat 6/27 between 3:1Op and 4:1 Op. Windows-SL 2700 Inclusions: Includes metal reinforced meeting rails and nighttime safety locks on double hung windows only,welded corners,foam injected frames,Sashlite technology, Heatshield, Duraglass, exterior custom capping, installation, clean up and haul away of all job related debris. It is agreed and understood by and between the.parties that the Product Specifications,along with the Custom Remodeling and Improvement Agreement,constitutes the entire understanding between the parties,and replace any and all prior negotiations, representations,or agreements,either written or oral. The Product Specifications may not be changed, modified,or varied in any way unless such changes are in writing and signed by both Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read the Product Specifications. I have read and received each page of this 3 page agreement. Power Home Remodeling Group Buyer(s) Buyer(s) /06/12/15 /06/12/15 106/12/15 Signature of Remodeling Consultant Signature Signature David Mock Carol Schaufler Steven Schaufler YOU,THE BUYER(S), MAY CANCEL THIS 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 AN EXPLANATION OF THIS RIGHT. June 12,2015 13:27 IIII II I IIIIIII IIIII IIIII III II III I II IIII Page 1 of 3 NATIONAL HEADQUARTERS ,. -a Carol and Steven Schaufler 2501 Seaport Drive,Chester,PA 19013 - p, s POWER 31-56309 1117� - June 12, 2015 888-REMODEL .. .. ... MA HIC#168616 Project Specifications Windows: kitchen 1 34.0"x34.5" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None l! OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None Windows: - livingroom 1 29.5"x47.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None OPTIONS: Color-White/White: Grid Pattern: None I Removal Wood I Additional Details None @ Windows: livingroom 1 29.5"x47.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None C OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None Windows: office 1 33.0"x48.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None !1 OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None Q Windows: francescas room 1 32.0"x47.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None l9 OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None _. Windows: francesras room 1 32.0"x47.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None June 12, 2015 13:27 IIIIIII II IIIIIII IIIII I II(III(IIIIIII IIIIIII ' Page 2 of 3 a NATIONAL HEADQUARTERS Carol and Steven Schaufler 2501 Seaport Drive,Chester, PA 19013 " POWER 31-56309 June 12, 2015 888-REM0DEL .. ... MA HIC#168616 Project Specifications Windows: bedroom 1 1 32.0"x48.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None Windows: bedroom 1 1 32.0"x48.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None !! OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None Windows: Bathroom 1 26.5"x35.0" WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None S OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details Special Options (ie.Full Screen,Obscure Glass,etc)Full Screen No I Obscure Glass Double Hung: Both Sashes I Specialty Color No I Different Color Capping No I Trim Options No I Frame Options No I Remove and Reinstall No Windows: Shutters 12 1.0"x1.0" WINDOWS: Models SL 2700 Styles Shutters Types No Hinge Configs Louver ' OPTIONS: Color Tuxedo Grey I Additional Details None IMAGE NOT AVAILABLE June 12,2015 13:27 III II I IIIII IIII III III II I I II IIIIIIIIII Page 3 of 3 41 N,assac tlusatts - Depar-Imery 01 Public Safely aiii.wr I'll: Aa'-R-- bL License: CS 057645 t �'.�,-' 1? MARK E MORAIl'ql 18 NEWELL DR - N ATTLEBORO MA 02760 �'p 1 Ext3iraT*on Commissioner '. 09Y18/2015 ffice of Coasumer Affairs A Business Regulation OME IMPROVEMENT CONTRACTOR Registration 3E86*6 T a. Expiratlai3 318320 c7.- Supplemeal- POWER HOME R1=MOVEELING'CROUF LLC. MARK MORDINI 2501 SEAPORT DRIVE STE B110 -ems' --- CHESTER,PA 19013 ` Undersecretary ` =1FF DRI9ER S _ WCF,NS 1v � ;LA�+� is EEY. e1&REWEOL bR 1 ' N'ATfLFBOROUGH'm OZ7603i26 [ 0 / DD 09-11-A16 Fsv DMSAD9 Z'Ae tt.rrg-w-19mwealth ofbfaysachufea¢ 006, :� •/ ,'�i`rtiSrr.�.,.,r (_l.4 UL,GI=2O i.F 1!`l / M � Ci i�r L t' =r THE v FLrti'i-=_e G, 4-.,j7'FG�,?-V, F ?,7J.StC2IIt„a�aSSJ.t�g� pr�, fid�less: S%i r(it 6 rc \, fir a Are voa an erepM4'er?Check the:,ppropriate TjVe of proieet(required': - 7.'fi 3 aw z employer wEL C� cmp}nyc�{fi;ll�d±mrpar.bme).�. _ - 2.r 1 am a sdlc J. 0 New con- muction U ]nnm+erormparmerstdp and Lave ase�rloyet"s'ori;ing for me in �Y capacity.rNc w&Yera'eon,anaanee ngnbt ] & dRemodcag ad a g'sli work mysclt.[No wo&k r cramp.ip_�rea,�ed.]i 9. ®Demo3ib® z.�1 am a Pmmeowner and wiD b;hbiug convsetms tc conmict all wort on sy pro➢e�'- ]wr11 I4�El addition ensm< 0convcuor_'either havc-wom s`compan=on insnzoce a ae aoic I rOpzeton-wit nc employyce- ]l.0 7eptiT.,w ad B.60m C 12. i I wnb= 7 `.1 3 am s penerd comma ad I 1w c-bi 'he-abconaacton limed on Y7'x aiYnched sleep. g �R�+n o3 Y.{14;LOYis 7hcse rob-oew ctr-hive enipioyees anc h2 v<V�kers'coin;.,-m-s�.: 4�_�]Roof 7e3ziTf 6.E]V:e arc a corpnrapon and its officers have exercised their right IF exemption 14.©Other 152,El(4),and we have no em ] ' per MGL c. P oYees.[No workers'comp.itutsmce required.] . 'Any applicant that chcAo box III must also fill osst iLe srmon be]ow showing then workers' t Homeowners who submit ibis affidavit indwaUng they arc doing all work and then hire o�idee vvnnnetors—banemus,so nnit a new affidavit indicating such. tConhactors that check this box must attached an additional sheet sbowmg the name of the sob- employces. If The sub-co�ac7ozs hove 7 ecs,the m� p °pIIa�'tO13'°Bd whether or�t those entities have �P oy' y .art rm�de their vvorkem,comp.policy number. I ------------ am an employer that is providing workers'Compensation insuran infonnatiorre ce for rrry employees Below is Phe policy and job site Insnremee Company Namc. LL Out Cn 7f ri o ryfl,Ai P E Policy#or Self--ins/.ILie.#: Z 6 f y 0 D. WOO Expiration Date:_ J ID'( `pZ©I[S' Sob Site Address:`I '_ Sk CityBtate/Zip: 1e f /Vv+c 01-16 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violatioa punishable by a fine up to$I,SDD.DD and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S25D.DD a day against the violator.A copy of this statement may be forwarded to the OMce of Investigations of the DIA for insurance coverage ve" I do hereby [i the pains and pertahies of perjury that the information provided above is true and correct. Si e: 3 (/1S pp Date: / hone#: J�L>"&�z.Dl4—t51S(� F nly. Do not write in this area,to be completed by eity or town offww : Permit/License# rity(circle one): ealth2.Building IDepartmeat a.Ci"rlbwn Clerk 4.Eletxricel Inspector 5.Plumbing Inspector i Contact Person: Pteo®e#: . 3 ) 6 it i t�!/CC CCUELE cr S � � ,Y .� ice. �_R tr•,.. ;� C.`. E .i 6r.�. 1 . EIR3 .&11 a u.l=r d' H� kA ;yx� m i� Y iir#Cy. $ {}ffi .Yf1 �•. �. p'i9Lf�I. � � �''� s�r�� +? Q0 V �.•R + . . . lu� "v'°ue�t, 'f '+,s�jC�s �erffr&�pF�a��r Ai?3.d14r,�t�i^�.t�fnr6atSejcS n •'!�i��a 3-#'" 074 . 14 y-,t,t: