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15 JUNIPER AVE - BUILDING INSPECTION The Commonwcalth of Massachuscits Board of Budding Regulations and Standards i %lassachuscits State Building Code, 780 CMR, 7*editionla #*Wdmb*Ao pt Building Permit Application To Construct. Repair. Renovate Or Demoli One. or Tiro-funiUr Du effing Amiga This Section For Official Use Only Building Perm N�uurnbb�e�r, Date Applied: l/' Signature: '-v'^ �1.�" 2) Lllo Q 1 Building Commissioner/Inspector of Buildings Date SECTION I:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& ParcelENumbers UI.I a Is this an accepted street'' es no Map Numberer 1.3 Zoning Information: 1.4 Property Dimensions: Zonmg District Proposed Use Lot Ana(sq It) Frontage(it) 1.3 Building Setbacks 111111) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40.S34) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zorn? Municipal O On site disposal system ❑ Public O Private O 1 Check if vtsC1 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: �iAJO CuTT n>9 Name(Print) � e,�s for Serve �J -1 � 7 Signature Telephone SECTION J: DESCRIPTION OF PROPOSED WORK'(check 01 that apply) New Construction O Existing Building O Owner-Occupied O 1 Repairs(s) Iterations) O Addition O Demolition O 1 Accessory Bldg. O Number of Units_ Other Specify: Brief Description of Proposed Work':r CO•-y 2 l ! -T—C N�cz'CD �p �oG iN ON erNivs/ c s al/ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and M21V I. Building f I. Building Permit Fee: f Indicate how fee is determined: ❑Standard City/Town Application Fee 2 Electrical S ❑Total Project Cost'(Item 6)x multiplier x J Plumbing S 2. Other Fees: 4. Mechanical (HVAC) S List: S Mechanical (Fire S Total All Fees. S Su ress on Check No. _Check Amount: Cash Amount:_ 6 Total Project Cost: ❑ Paid in Full O Outstanding Balance Due: ()o PJ e- 11� SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) e�!5 2Q12 L,icnse Number pir ion Date �� ol'CSL Helder Lot CSL Type buv below) (J aQ max lsS� L�rtr rr�a, - rrA, s l TDescription /2t, - U Unrestricted(up to 35.000 Cu. ft. R Restricted 1&2 Family D%ellin �gnatnr / / .N .Mason Only 7�� (�/ RC Restdenual Roofin Covering Tclephone wS Restdenual Window and Siding SF I Residential Solid Fuel BurninX Appliance Installation D I Residential Demolition ':er.6°2407r!,w7f c�ttraet°r(Hlc) / /i5/9�/6 HIC 5o , yCS� cL,� egisuauoQn Number mHJUATent e 7iCJ ZQ Q Expiraticifi Date [tWhis gnan" Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. 2SC(6)) orkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide affdavit will result in the denial of the Issuance of the building permit. grtedARJavitAttacheJ? Yn.......... No........... 0 CTION 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 to act on my behalf,in all matters relative to work authorized by this building permit application. Si nature of Owner Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION ), ��•�// S �P 64'!_. (L0 i 5--e , 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 behal P-6 � � Co wc� SK Signature of Owner Aulhorized Agent to Si ned under the pains and penalties ofperjury) 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)Programi, will gI have access to the arbitration program or guaranty fund under M.G.L. c. t 02A. Other important information on the HIC Program and. Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and 110 RS,respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq. FL) (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 halfbaths Tvpe of healing system Number of decks/ porches Tv pe of cooling system Enclosed Open 1 "Total Project Square Footage"may he substituted for-'Total Project Cost" • CITY OF SALEM PUBLIC PROPRERTY DEPART.IENT Jay„w. Construction Debris Disposal .at'tidmit (reJluiICd Iur all demo I1 fit,11 and rcnovauun \voJk) In accurdance Ith Ole sixth edition of the State Building Code, 7S0 C•AIR sccuon I 11 5 Debris, and the provisions of%IGL e 40, S 54; Building Permit it is issued with the condition that the debris resulting from this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c 111. S 1511A. The dchris will be transported by: Ina Jc ul hudcr) I he debris will be disposed of in d 5 d s1K �O (na e,rr l.Jei rly) aCu�lm • ,rf p:nnn .ygrhi.Jnl !JIC CITY OF Sm_E.ms AxSSACHUSETTS BILUMLNG DEPARTMEIIT -- 120 WASHINGTON STREET', )'a FLOOR TEL (978) 745-9595 FAX(978) 740-9846 K1�tBERIEY DRISCO[1 —Z — MAYOR tiohkns ST.PITs2tRa DIRECTOR OF PL eLIC PROPERTY/BUITDLYG CO%L\DSSIO%'ER Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectricianslPlumbers Anpllcant Information Please Print Legibly Nalne Idusimw orpniratiorvindcvidwl): �d9 iili0 2110lJFiV�c Cym Address: ,1�, BdX lies �196�/ /� City/Statc/Zip: Z AW Phone All: 9 2c ,ire ea employer'Cheek the appropriate box. Type of project(required): I. I am a employer with 4. 0 I :tint a gu'neral contactor and 1 6. ❑New construction employees(full and/or part-time).• have hired the sub-contractors 2.0 1 airs a sole proprietor or partner- listed on the attached sheet. : ?• ❑Remodeling ship and have no employees These sub-contractors have g. 0 Demolition Workingfor me in an capacity. workers'comp.insurance Y P tY• 9. 0 building addition I No workers' comp. insurance S. We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.0 I am a homeowner doing all work right of exemption per MOIL 11.0 Plumbing repairs a 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- 'Any comp. insurance required.) applicant out checks bon II moist 21w fill wt the moon hetow showing their woken'compensation policy infurmadon 'I I.vtwuwrnsaa who submit this affidavit indicting they am doing all work and then him outside contractors must ruhmit a rww antdevil indicting once (',moo ton thin eh.vk this bent mua attxbed an eldifio d had.howing ate mwree of Ito tali o eacton and their worker,'cony,policy infametion. l am an employer that is providing workers'romparsadoe/narrence for my employees. Bellowlsthepolleyandlobtlar information. ^ insurance Company Name: ff/ Policy N or Self-ins. Lie.p: �� ©B `2 �Z2 2 5`/ Expiration Date: ? M/o Job Sire Address: /0' CJ vW i�iSn d L1 City/StatdZip:�46P,07 r� � ,%nacb a copy of 1be workers'compensation policy declaration page(showing the policy number and dsplradom date). Failure to wcure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5230.00 a day against the violator. lie advived that a copy of this slatement may be forwarded to the Office of Invcsngatiors ul'tiro DIA for insurance coverage verification. l do here Xc der the pains and penalties of perfary that the fnformoNan provided above is trace and e:urreca Data! Ph,onc 4: iOflaial use only, Do oar write in this area, to be rump/eted by miry or town offleiaL I City or I•uwvn: -- __ Pcrmit/I.lccnse#__. Lsuing Aulhurily (circle unc)r I. Ilwrd of lleallh 2. Duiiding Department J.City/town Clerk 4. Electrical hupccio► 5. Plumbing Inspector 6. Other Gattacl Person: _ -- -- Phone N: RAPID ROOFING GENERAL CONTRACTING CO. P.O. BOX 605 SALEM , MASS. 01970 978-740-0101 MASS LIC # 128253/144946/CS101965 RAPID ROOFING IS A DIVISION OF COYNE& SONS CONTRACTING CO. ARCHITECTURAL SHINGLE ROOFING ESTIMATE TO. 8/30/2009 GINO CUTITTA 15 JUNIPER AVENUE. SALEM, MASS. 01970 978-745-4405 JOB SITE ADDRESS. SAME RE; ROOF ESTIMATE# 09-0086 COMPLETE STRIP ( 1 LAYER STRIP) OF ASPHALT SHINGLES INSTALLATION OF 30 YR, ARCHITECTURAL ASPHALT ROOFING SHINGLES - ON ENTIRE MAIN HOUSE ROOF WE AGREE TO. 1. COMPLETELY STRIP THE ENTIRE MAIN HOUSE ROOF OF ALL THE EXISTING ONE LAYER OF SHINGLES ON THE ENTIRE MAIN ROOF OF THE BUILDING AT THE PRESENT TIME. (20 SQ.) 2. REMOVE ANY ROTTED ROOF DECKING BOARDS OR SHEATHING ON j THE ROOFS OF THE BUILDING, AND INSTALL UP TO 100 FT.OF EITHIER ROOF BOARDS OR SHEATHING- FREE OF CHARGE ( ONLY IF ROTTED AREAS ARE PRESENT). 3. INSTALL NEW WATER& ICE SHIELD ON THE EXISTING MAIN HOUSE ROOF OF THE BUILDING. ALSO ON ALL RAKE AREAS, VALLEYS, DORMERS, CHIMNEYS, OR FLAT ROOF AREAS OF THE ENTIRE BUILDING. w , 4. INSTALL NEW 15 LB. ASPHALT FELT ROOFING PAPER ON THE ENTIRE MAIN HOUSE ROOF OF THE PROPERTY.. 5. INSTALL NEW 8 INCH MILL STOCK ALUMINUM DRIP EDGE ON THE ENTIRE MAIN HOUSE ROOF OF THE PROPERTY. 6. INSTALL ALL NEW VENT PIPE BOOTS ON THE MAIN ROOF OF THE BUILDING AS NEEDED.. 7. INSTALL NEW ALUMINUM STEP FLASHING ON ALL AREAS OF THE MAIN HOUSE ROOF AS NEEDED. 8. INSTALL NEW 30 YR. ARCHITECTURAL ASPHALT ROOFING SHINGLES AND CAP ON THE MAIN HOUSE ROOF OF THE PROPERTY. 9. WE AGREE TO REMOVE ALL ROOFING DEBRIS FROM THE PROPERTY. TOTAL COST OF JOB..................................$ 6,500.00 WE HEREBY PROPOSE TO FURNISH ALL MATERIALS AND LABOR-COMPLETE IN ACCORDANCE WITH THE ABOVE SPECIFICATIONS FOR THE SUM OF.... $ SIX THOUSAND FIVE HUNDRED DOLLARS- $ 6,500.00 WITH PAYMENTS TO BE MADE AS FOLLOWS.................... $ 3,250.00 DOLLARS DOWN/$ 3,250.00 TO BE PAID IN FULL UPON THE COMPLETION OF THE WORK.... I RESPECTFULLY SUBMITTED BY' RAPID ROOFING CO. OF SALEM , MASS OWNER CHRISTOPHER R. COYNE SR. r A NOTE-THIS PROPOSAL MAYBE WITHDRAWN BY US IF NOT ACCEPTED WITHIN-21 DAYS. ANY ALTERATION OR DEVIATION FROM THE ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS,WILL BE EXECUTED ONLY UPON WRITTEN ORDER, AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE. ALL AGREEMENTS ARE CONTINGENT UPON STRIKES,ACCIDENTS,OR DELAYS BEYOND OUR CONTROL. NOTE; WE CANNOT ACCEPT ANY RESPONSIBILITY FOR ANY DAMAGES.OR DEBRIS FALLING INTO ATTIC AREAS, CUSTOMERS SHOULD COVER VALUABLES,GREAT CARE WILL BE USED TO PROTECT THE EXTERIOR STRUCTURE BY COVERING THE EXTERIOR WALLS,OBJECTS,AND FOLIAGE WITH TARPS TO HELP PREVENT ANY DAMAGES DURING THE STRIPPING OF THE ROOF,HOWEVER SOME DAMAGE AND MARRING COULD OCCUR BEYOND OUR CONTROL, HOMEOWNERS MUST MOVE ANY VALUABLES AWAY FROM THE BUILDING,PRIOR TO THE STRIPPING OF THE ROOF. NOTE; IF MORE LAYERS OF ROOFING MATERIALS ARE FOUND THAN INDICATED ABOVE IN THE ESTIMATE,THE OWNER OF THE PROPERTY WILL BE IMMEDIATELY NOTIFIED,THE OWNER ACCEPTS ALL RESPONSIBILITY,AND (AGREES)THAT,ANY EXTRA CHARGES WILL BE ADDED FOR THE LABOR AND THE REMOVAL OF THE EXTRA DEBRIS,OVER AND ABOVE THE PRICE OF THE ESTIMATE.... ACCEPTANCE OF PROPOSAL THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED. PAYMENTS WILL BE MADE AS OUTLINED ABOVE.. DATE OF ACCERTANC F 0`I IU i /09 SIGNATUR SIGNATURE SIGNATURE PLEASE MAKE ALL CHECKS PAYABLE TO CHRISTOPHER R. COYNE SR.