44 IRVING ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts
F(JkkI
Board of Building Regulations and StandardsCITY OF
Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 201
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building Official(Print Name) Sig 4 r Date
SECTION 1:SITE INFORMATION
1.1 rty Add ss , 1.2 Assessors Map& Parcel Numbers
-_( �-✓-7
I.Ia Is this an accepted street?yes '_ _ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Tuning District Proposed Use Lot Area(sq ft) Frontage(11)
1.5 Building Setbacks(rt)
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' J r
2.1,0 n r of ecord��/�/!/
Nm e(Punt) Statc,tZIP
o.and Street 'I ephone T Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s)AT Alteration(s) ❑ I Addition ❑
Demolition ❑ Accessory Bldg. El Number of Units Other ❑ Specify:
Brief Description of Proposed Work': /
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t CA-6m E-E_rI 10 1 L FT L-L�N.CEN EEA-U _i A-4D Wo a;9 rZoeR t oo S
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PPL4ce F,2yWrj70oR tn1r7a L( 2t7oF0{EK pqu ({o0M 19 I14r 41.1 INS IDr.
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
❑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: $ � ❑ Paid in Full ❑Outstanding Balance Due:
��7 -590—&� -7c� '7
I �
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) C5 D O C.
14 V G O 4 /n (l.j I C R License Number Expiration Date
Name of CSL Holder y
I `i tv E 9S"TPR PL d+ C C List CSL'fype(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
M FF I-D end, 61 jq 021 Yg—V5-0 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Mason
ry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
1,17-/o -0.33" [F VG Al U.II CA f'4,C'v a(C-ftT I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
dVAT P,/yl? Ft M GHQci4 l754w ( v zor
HIC Registration Number Expiration Date
FI IC Company Name or FIIC Registrant Name
25' GLe1) 11Uf 7,¢ JYQetCIRROCN7-4r@ GMA(I
No.and Street Email address
&yc-2F7-7 MA 02/yy U2-587•9747
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.......... [B3 No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize �J p'(V( ad;Q I t 4 G 4,I,I A
to act on my behalf,in all matters relative to work authorized by this building permit ap li ation.
�( A Milld� c ,a wul
Mrit�On eePs Name(Electronic Signature) Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below, 1 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.
I
Print Owners or Authorized Agent's N. e(Electronic Signature) Da
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 can be found at
www.mass.gov/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 Cost"
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Office of Consumer Affairs&Business Regulenon
ROME IMPROVEMENT CONT
RACTOR
aglstration 1j5420 Type II
Expiration 5/10/2015 i
a Individual 1I
1 f NATHANIEL M.GARC q
yj4 �!
?-� NATHANIEL GARCIA'��r 'y
26 GLEDHILL DR. �f
v . i
fqE EVERETT,MA02149
f I _ ,Undersecretary I
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor x"a'""
License. CS-099454 Mc
HUGO A MUJICA, t
14 Webster Place
, _> ..
Malden MA 02148 -
- ---d - " "d Expiration
Commissioner 05/12/2016
�h CITY OF S:1LE\,[) ANSSACHUSETTS
BLILMIr,DEPAft-M&NT
120 WASHLNGTON STREET 3'
FLOOR
17EL. (978) 745-9595
F-Ax(978) 7.10-9845
KI�ts ER LEY oluscou
NLAYOA -n-lO.%LAs ST.P1ERM
DIRECTOR OF PUBLIC PROP ERTY/St:MDLNG CO%WISSIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 730 UAR section It 1.5
Debris, acid die provisions of tb1QL c 40, S 54;
Building Permit !#this work shall be is issued with the condition that the debris resulting from
lll, S ISOA. disposed of in a properly licensed waste disposal facility as defined by ti1GL c
l'he debris will be transported by:
(name of hauler)
I'he debris will be disposed of in
— (name of facility)
—_---(address of ficility)
gild it
applicant
i�te
CITY OF SzU_ENI, NLNSSACHUSETTS
i�a t BUIIDINGDEPAR-tMEIiT
120 WASHINGTON STREET, 3aa FLOOR
T EL (978) 735-9595
F.A_x(978) 740-9846
KI\BERLEY DRISCOLL
T
fAYOR HomAs ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING CO',NISSIONER
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information /Please Print Leeibiv
Name(Business Organization••Individu:J): ' l
Address:
City/State/Zip: Phone !t:
Are you an employer!Check the appropriate box: 'type of project(required):
I.% I am a employer with__ 4. 0 I am a general contractor and 1 6. New construction
employees(full and/or part-time)." have hired the sub-contractors
2.0 1 ate a sole proprietor or partner- listed on the attached sheet,t 7. ❑ Remodeling
ship and have no employees These sub-contractors have S. (] Demolition
working for me in any capacity, workers'comp. insurance. 9. 0 Building addition
[No workers' comp. insurance 5. 0 We are a corporation mid its
required.] officers have exercised their MR Electrical repairs or additions
3.0 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions
myself. [No workers'comp. C. 152,§1(4),and we have no 12.0 Roof repairs
insurance required.) t employees. [No workers' !3.❑ Other
comp. insurance required.)
•Any applicant dot cheeks box At must also fill out the section belowshowing their worker'compensation policy initlrmation.
'1 lomcow'ners who suhnnit this affidavit indicating thcy arc doing all work and then hire outside contractor must submit a new aaidavit indicating such.
:C,numelun that check this box most anachod an addltiortl ghost showing the mmne ofthe sub-comnetors and their worker'comp.pulley infomtation.
I unr an employer that is providing workers'conspeasation inssurance for my ensplayees. Below is the policy and Job site
Insurance Company Name: G
Policy B or Self-itis. Lic. 0: .__ Expiration Date: e
Job Site Address: ( ��j �T City/State/Zip:
,Attach a copy of the workers'compensation policy declaration page(showing the pulley number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a
ins up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and aline
of up to S250.00 a day against the violator. Ile advised that a copy of this statcmunt may bs: furwardad to the Oflice of
Ineestiguiionx of the DIA For insurance coverage vcrilication.
I do hereby certify ender the paLts• p hle. of perjury that the beforniatlan provided above is true and corree
re
Phone 1'
OJJic•ial use only. Do n pf write in this area,to be completed by city or town eigic•ial
City nr Town: _.._._ . . PermiUlAcense k '
Issuing,\ulhurily (circle one):
1. Board of health 2. Building Department 3.Citylrnwu Clerk a. Electrical tatspector 5. Plumbing Inspector
6.Other
Contact Person: __ __ Phone 8:
44 Irving St, Salem MA
Scope of Work and Work Contract
Ocean City Development LLC and Nathanael Garcia(Nael Carpentry)
Contract Terms and Conditions
NOTE: all permits must be signed off by the Building dept./punch list items must be corrected prior to
final payment.
Insurance
Contractor Agrees to carry necessary liability,property and workers compensation insurance.Contractor
requires sub-contractors to carry necessary liability and workers compensation insurance.Insurance must
be coverage in the amount of$1,000,000 liability insurance and$500,000 workers compensation.
insurance.
Hold Harmless
The independent contractor hereby covenants and agrees to defend,indemnify and hold harmless the
owner,its agents,officers,directors and employees of and from all liability,claims,actions,causes of
action,lawsuits and demands including attorneys Fees and costs,fines and/or penalties for personal injury,
bodily injury,death (including personal injury,bodily injury or death of the independent contractor's own
employees) and/or
property damage arising out of or in any way related to the independent contractor's work or operations
for or on behalf of the owner on,about or away from the owner's premises or associated with the breach
of the construction agreement or the construction specifications.
Contractor to accept all deliveries,i.e.cabinets,appliances,etc.Contractor must be available to correct
any necessary defects originated by city/town inspector,Ocean City Developments inspector or Buyers
Inspector
Scope of Work Labor Only
Exterior:
• Replace / Sofit /facia where necessary for metal covering
• Add gutters downspouts
• Replace basement windows where necesary, OCD will determine
• Repair screens/windows/all windows to operate correctly
• Point foundation where necessary
• Replace basement door/steel
• Seal and point chimneys/ add cap
• Roof/ replace small back section / roof over front overhang /repair any shingles if
necesary
• Windows/ (3) on 1 st floor porch/ replace
1
• Side house with vinyl/trim out exposed wood
• Remove yard debris
• Remove top 1/2 of old swing
• Remove old fireplace in yard/ brick
• Patch small section of cement in rear yard/
• Paint hand rails if applicable
• Paint exposed wooden components where necessary
• Cut metal post in yard/remove small shed 2x3
• Repair/ paint the front door over hang/driveway side.
Interior. cosmetic Reno/ 2 /3 days to complete as gene ronin apt
1st floor apt.
Kitchen:
• Repair 12x12 block ceiling /add trim around / paints
• Replace ( gas )stove / OCD will purchase
• Repair cabinets / handles / paint
• Paint/ patch bottom portion of walls/ paint trim
• Laminent floor
• Replace kitchen faucet/
• Trim off counter top / side
• Bottom outlet loose / outlet at stove goes to 2nd floor/correct
• Replace entrance door/ metal
• Add door bell if necessary (battery)
Bathroom:
• Tile floor/vinal
• Replace sink faucet
• Check tub/shower for leaks, repair if necessary
• Touch up tub where rusted
• Caulk tub
• Paint bath ceiling/ paint trim
• Remove wall paper paint
• Replace toilet if necessary
Room off kitchen:
• Laminet floor
• Paint walls/trim
• Add closet doors
2
Living room:
• Laminet floor
• Paint walls/trim
• Replace dropped ceiling tiles where needed / paint grid/tighten grid supports where
needed to level
• Add bifold door
Bedroom
• Replace door/broken
• Repair hole in ceiling/touch up paint on ceiling
Porch:
• Fix walls where necessary
• Paint floor/walls/trim
• Replace (3) windows
Lighting
• Replace with Home Depot lights where necessary / contractor ceiling lights
Heating I hot water :
new boiler for 1 st floor/ (supplied by sub contractor) /convert to gas
- existing gas water heater/ reinstall for 1 st floor only
Electrical:
- rewire the aprox 4 outlets that are on the second floor panel
Hall going up:
• Repair walls /ceiling / must be in paintable condition/
• Repair railing/ balastors, stair treds where necessary
• Paint floor, balastors, railings, walls ceiling, doors
• Replace exterior door/ apt entrance doors where necessary ( front rear )
• Rear halls ; same as front hall work
3
t ,
Heating/ hot water:
• Convert/2 nd floor/3rd floor to base board electric heat I wall thermostates each
room
• Cable in all rooms
• Add new hot water heater/electric
• Remove oil tank
Lighting :
• All lights per design ; installed
• A center lights, vanity, over sink light, bath vent combo
• Censor lights in halls
• Exterior lights at doors
• Basement/ basement stair lights
Attic :
• New attic door/ lock
• Clean attic
• Repair floor board where necessary
Windows :
• Repair where necessary / replace if can not be repaired
Basement:
• Clean debris
• Add cement columbs in place of temp columbs where necessary
• Sister any compromised joists
• Sand and paint all cast iton pipes
• Patch walls and floors where necessary
• Paint/ patch/ stairway to basement
Demo/ disposal/
s
1f 3 i
ACCEPTANCE
By signing below, Nathanael Garcia (Nael Carpentry) and Ocean City Development LLC
agree that the above work will be completed for the agreed upon price noted below and
in the agreed upon time frame noted below. Ocean City Development will allow a 5
day grace period above and beyond the agreed upon date below to complete the work.
Ocean City Development LLC agrees to pay for the work 4 payment.
Project Start Date: April 30, 2014
Price: $45,000
Payment Schedule:
$11,250 Payment 1
$1,250 Payment 2
$11,250 Payment 3
$11,250 Payment 4 upon project completion
Amount Of Days To Complete Project: 35 Calendar days
Amount Of Days To Complete Project: 35 Calendar days
Additional days of work due to approved overages: Contractor Name:
Nathanael Garcia(Nael Carpentry)
Print Sign Date
Ocean City Development LLC
william mandell / .�L May 8 2014
Print Sign Date
7