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26 CARLTON STREET - BUILDING JACKET .._lam.►.. Certificate No: 285-08 Building Permit No.: 285-08 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0026 CARLTON STREETin the CITY OF SALEM -------------------- ---------- - - ---- ---- ----- -- - -- - -------------------------- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY OCCUPANCY PERMIT FOR UNIT#1 This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires unless sooner suspended or revoked. Expiration Date Issued On: Tue Dec 4,2007 - --- ------- ------------- - - GeoTMS®2007 Des Lauriers Municipal Solutions,Inc. t/1 1 1 V 1 ►.Jl JLLJ1.J1♦ 1 BUILDING PERMIT Certificate No: 285-08 Building Permit No.: 285-08 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0026 CARLTON STREETin the CITY OF SALEM Address TowrVCity Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY OCCUPANCY PERMIT FOR UNIT# 2 This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires - ----- ---------------- unless sooner suspend or revoked. Expiration Date --------------'--- __-_ - -- - -- - ----- --. Issued On: Tue Dec 4,2007 ------------ — GeoTMS®2007 Des Lauders Municipal Solutions,Inc. t/JL 1 1 V 1 AJl JLLJl/111 ` s BUILDING PERMIT 0026 CARLTON STREET 285-08 GIS#: 9426 COMMONWEALTH OF MASSACHUSETTS Map: 41 Block: CITY OF SALEM Lot: 0038 Category: REMODEL Permit It 285-08 BUILDING PERMIT Project# JS-2008-000564 lEst.Cost: $38,000.00 �Fee Charged: $271.00 Balance Due: $.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Expires Use Group: NEXUS 11 SERVICES LLC CONSTRUCTIO SUPERVISOR-CS07399 Lot Size(sq. ft.): 3100 Zoning: B I Owner: PHILLIPS BRAD Units Gained: —Applicant: PHILLIPS BRAD .Units Lost: AT. 0026 CARLTON STREET 61-9—Safe# I I ISSUED ON. 12-Sep-2007 AMENDED ON.- EXpIRES ON. 12-Mar-2007 TO PERFORM THE FOLLOWING WORK.- RENOVATIONS TO 2 KITCHENS,2 BATHS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Building Underground: Underground: Underground; Excavation: Service: Meter: Footings: Rang PWO Rough: Rough: OXI Y14 Ille 7 Foundation; (t-*-'erg!7 -7 Final Fina I 0-�-f--rj f��C' Finali Q�L_ej Rough Frame:el. I D.P.W. Fire Health Fireplace/Chirfiney: Oil; Insulation- Meter: Flina: 14 House# S7ke: C-49 Water: Alarm: reasury: Sprinkle Sewer: rs: L'InVZ")� THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2008-000663 12-Sep-07 720 $271.00 GeoTMS@ 2007 Des Lauriers Municipal Solutions,Inc. _ + 5 r ; r �•CONDIT c� YSOYE AO CITY OF SALEM BUILDING PERMIT U 3, II Its, The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY n OF SALEM 111 T! Massachusetts State Building Code, 780 CMR, 7 edition Revised January Building Permit Application To Construct, Repair, Renovate Or Demolish a 1, ?d0d One-or Two-Family Dwelling This Section For Official Use Only Building Permit um r: Uate Applied: � t Signature: Build g Commissio er Inspector or liu-4dings Date SECTION 1:SITE INFORMATION L1/Property Ad ress: 1.2 Assessors Map& Parcel Numbers I Ja Is this an accepted street?yes v7 no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use t.ot Area(sq rt) Frontage(11) 1.5 Building Setbacks(ft) From Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (C1.G.L c.40,§54) L7 Flood Zone information: 1.8 Sewage Disposal System: Zone: __ Outside Flood Zone?Check❑ Private❑ Check if ycs❑ Municipal ❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: GH_✓CtG_-- lei^ �E G�1�0✓Ste_. S�I�E, Nam Aodress For Service: ova 91 Srgnatarc Telephone SECTION 3: DESCRIPTION OF PROPOSED ORK'(check all that apply) New Construction❑ Existing Building Owner-Occupied Repairs(s) Alteration(s) ElAddition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify: Brief Description of pro osed Work-2:�E - o�Q 6'.. .n 1-� //av p, A ppmo 2 CkTE r iiv SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor mid Materials) Official Use Only 1.Building $ 9,0 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ El 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. ash Amount: 6. Total Project Cost: $ paid in Full ❑ Outstanding Balance Due: / -7 7q fp SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) r •d S0� ��y G�9� License Number Rxpiration Date dam of CS7.I folder ZO�Zr List CSL Type(see below) U Addy Type Description tl Unrestricted(up to 35.000 Cu.Ft.) R Restricted 1&2 Family Dwelling u ature M Masonry Only RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5 Registe ed Home Improvement Contractor(HIC) �C Companyame or HIC Registrant me Registration Number � 6 /ol�p�.2o1 Adapess Ira aq�,01t i Expiration Date nature 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 a(rdavit 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 1, li /l/C/C [ "�� FrA✓ as Owner of the subject property hereby authorize e2 V ✓,•d 9Q� to act on my behalf,in all matters relative to w nk authorized by this building permit application. Sigrature4owner Dale SECTION 7b: OWNER` OR AUTHORIZED AGENT DECLARATION r r`SON �.a+v�` 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. P t�S,O. Print S rre of Owner or Authorized Agent Date nzd under the pains and penalties of peFitay) 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 HTC.Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.R6 and 110.R5,respectively. 2. When substantial won is plamred,provide the information below: Total floors area(Sq.Ft d'O (including garage, finished basement/attics,decks or porch) Gross living area(Sq. Ft.5 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" CITY OF SAI_ aM, 2ANSSACHL'SEITS BL1LDl1GDEPAR .%i&-N-r j 120 WASHINGTON STREET,3w FLOOR TEL. (978) 745-9595 FAX(978) 740-9846 KI,fBERj EY DRISCOil mA MAYORDI THor s ST_PIERRS DIRECTOR OF PUBLIC PROPERTY/BL'ILDLVG CONMSSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Piumbera Applicant Information �� /Please Print Legibly NaMe (BusirnsslOrganizatioNlndividmi): J X-"J� V,;, . Q t �O,, 7 Address: 1l1 7'Q 1^d'r� (0 U t /F s•6� 4�6 2 C— y -�{' City/State/Zip: Da /1r 9 Phone #: &-ZL) 92 Are you an employer?Check the appropriate bw. Type of project(required): LEI I am a employer with 4. 4krI am a general contractor and 1 6. []New construction employees(full and/or part-fame).• have hired the subcontractors 2.Q 1 am a sole proprietor or partner- listed on the attached sheet.t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. Q Demolition working for me in any capacity, workers'camp.insurance. 9. Q Building addition [No workers comp. insurance 5. Q We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.Q I 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 S comp. insurance required.] 'Avw applirar that checks box 91 must also fill out the section below showing their work,,'compensation.policy irformuin, r 1 hxtteawsx9s soli,submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicting such. =C.mtrmxur that cheek this box must attached an additional sheet showing the name of the subcontretor and their worker'comp•policy information. I um an ermployer that Is providing workers'compensation lnsurancefor my employees. Below Is the polley and fah site information. Insurance Company dame: IN PA jdn CPT�✓ nA c.A� r �, ✓�ar�/K SG{UiC(S Policy#or Self-ins. Lic.#: C c2 — .3 4 S— 36'!C?9' —(9-2?Expiration Date: Job Site Address: aC G _CArl'raAl 91`-- City/State/Zip: 5-4z t-, Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 2SA of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. He advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do hereby certify er the pains and penahles of perjury that the information provided above Is true and correct. i•n�t re' Date: Phon # La Ir 10 a 11 Ofchd use only. Do not write in this area,to be completed by city or town agiciaL City or Town: Permit/I.lcense# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.C)tyfTown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other . Contact Person: _ Phone#• TE ACORD CERTIFICATE OF LIABILITY INSURANCE D 6/11/O2010) TN 06/11/2010 PRODUCER 617.783.1160 FAX 617.783.2062 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rapo & Jepsen Financial and Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1103 Commonwealth Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Boston, MA 02215 Phil Conceicao INSURERS AFFORDING COVERAGE NAIC# INSURED Brother's Services Inc. INSURER A: Essex Insurance Company 415 Main St. #1 INSURERS: Liberty Mutual Insurance Co. Medford, MA 02155 INSURER C' INSURER D: INSURER E' COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ITION LTR NSR TYPE OF INSURANCE POLICY NUMBER DA ECMM/DD/YTVYV DATE(MM DIVE POLICY D/YYW) LIMITS GENERAL LIABILITY 3DC1704 06/15/2010 06/15/2011 EACH OCCURRENCE $ 1,QQQ,QQQ COMMERCIAL GENERAL LIABILITY PREMISES Ea occunenoa $ 50,000 CLAIMS MADE D OCCUR MED EXP(Any one person) $ 1,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,.000 1 1-1POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ee accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC2-31S-361679-029 04/06/2010 04/06/2011 TORV LIMITS ER AND EMPLOYERS'LIABILITY Y/N B ANY OFFICER/MEMBER EXCLUDEDXECUTIVE❑ E.L.EACH ACCIDENT S 100,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1QQ,QQQ U Yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ SQQ,QQQ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Pr of of Insurance Phil Conceicao ACORD 25(2009101) ©1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4 CITY OF S.M-FENl, UNSSACHUSETTS BU DLNG DEPAR-MLN T • i+• 120 WASHL\GCON STREET, 3'n FLOOR L o w TEL- (978) 745-9595 FA.`C(9713) 740-9846 KIN IBERIEY DRISCOL L MAYOR THomAs ST.PmRm DIRF.crOR OF PLBLIC PROPERTY/BL'RDUvG CONMSSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGI, c 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: (name of hauler) The debris will be disposed of in : t� (name of facility) (address of fa lity) _ signature of permit applicant _ D6�1a2��to date Jcb:isufr.dx Brothers Services Inc. 415 Main st. Medford—Ma 02155 Contract# 0412—Page 1 Costumer name WORK to be PERFORMED AT: Chuck Hennigar 26 Carlton st Morgan Talbot Salem, MA The following paragraphs describe the work that will be performed: • Strip existing siding on the entire house ; (2 layers ) • Remove all windows and doors casing ; • Wrap the entire house with Tyvek paper ; • Install aluminum flash on the bottom where the sheeting meets the foundation; • All joint flashing at the siding seam will be recommended by manufacture; • Will be installed PVC trim at roof lines and decks following manufacture's rules ; • 1" x 8" PVC will be installed at the bottom of the entire house (water table ) • Install 1"x 6" PVC (azek board) on the Outside Corners ; • Install PVC trim @ windows and doors • Install pre-finished fiber cement with a 15-year paint warranty ; Additional specifications • All trims and corners are white ; • Siding is 4" exposure ; • Siding will be Hardie Plank from James Hardie and the color is (evening blue); • Minor repairs will be done at the soffit with no labor chargers , but materials supplied ; • we will remove all of the job related debris ; • Brothers Services will pull the permit from the city of Salem with the cost paid by I"and 2"d floor. (not included on the contract) • We are NOT doing anything on soffit and face boards. Brothers Services guarantees all work (LABOR) performed for an unlimited time, if any problem occur we will cover the cost to correct the problem and meet costumer's satisfaction!! Contract#0412—Pa¢e 2 I" Floor $ 9.815.00 2Na Floor $ 6965.00 TOTAL $ 16.780.00 Payment Terms: 1/3 deposit 5593.33, 1/3 work in progress 5593.33, 1/3 upon completion 5593.33 Julio Cesar Da Silva - 781 706 3291 —juliotac2@hotmail.com K Chuck Henm M rgan Talbot Office of Consumer Affairs&Business Regulation' HOME IMPROVEMENT CONTRACTOR Registration:. .164512 Expiration: . 10/192011 Tr# 289763 Type: DBA STRAIGHTLINE CONSTRUCTION CO. DEYVIDSON CARDOSO 8 DYER AVE.#1 EVERETT, MA 02149 Undersecretary �lassacbusetts- Department of Public 6afet) } Board of Builtlin_ ti Rcwlafions and Standards Construction Supervisor License License:-CS 102268 - - Restricted to: 00 DEYVIDSON CARDOSO PO BOX 3396 EDGARTOWN, MA 02539 J� Expiration: S222012 ( numi�sinnrr Trtt: 102268 CITY OF s .&Nt, NL Lxs&-kcHUSETTS BUMDLNG DEP.jkwnMNT 130 WASHINGTON STREET, 3"FLooR II FAX(978)740-9846 vvvx� KIaBExIaEY nxlscou. MAYOR THomAs ST.PmRRB DIRECTOR OF PUBLIC PROPERTY/Bt:MDING COMMSIONER APPLICATION FOR THE CONSTRUCTION, REPAID RENOVATION,CHANGE eN USE OR OCCUPANCY,OR DEMOLITION OF ANY BUILDING OR STRUCTURE This Secd"la►Oflletei Use OnIF is Pa.. Projpo1 pals Est Pmod Dalm start End: camm ft . 1.0 SITE INFORMATION Location Nemec Buddirg: Property Addraas. oa6 e!ZvA[rw sr Assessors MapJBlocic LoYPancek �! QWNEfl;iw_IyFORMATION 2.1 Ownw of L wW Name Address: �q g+w FiT1Ls o. Telephone: ( 4779) 2.2 Owner or lessee of bsdlc o or structure Name: Addresx Telephone: 3.0 AGENCY OR AUTHORITY AUTHORONG CONSTRUCTION h Agency Name Address: Agency Project Number Project Manager Name: Tal: 4.0 PROFESSIONAL DESIGN SERVICES:. 4.1 Registered Architects Name: Seal and Signature Address: • T Fmc -, 42 Rplstr+rr+d Prateis1011al t:rtgineus: Nara admtlonar shells r riswaafy all alte4r b avvlimpon) Name: seat and Slgnat me- Ai&mw Telephone: Fax Name: 3sa1 and Stgnahuir+ . Address: Telephone: Fax Am of Responsibility: Name: Seal and Signature Address: Telephone: Fax: Area of responsibility: 5.0 DESIGN AND CONSTRUCTION UTILIZING MGL C 112 SECTION 81R EXEMPTIONS (See note below) Contractor Name: Address: Area of responsibility: 'Limn Number Date of Expiradm Telephone: Contractor Names.., Address: Area of responsibility: License Number. Date of Expiration: Telephone: Fax: Contractor Name: Address: Area of responsibility: License Number. Date of Expiration: Telephone: Fax: Note: For portions of work ubUzbV exemptions of MGL c. 112 s.81R complefe the section above. Use additional sheets if necessary and attach to application. i CITY OF S.U.&M, NL L).ss xa-iUSETTS BL'ILDLNG DEPARTMENT 130 W\SHINGTON STREET, 3"FLOOR c� TM (978) 745-9595 FAX(978) 740-9846 KL%.tBEar EY DRISCOLL S T ♦MAYOR ttodtns 'r.PiERRl3 DIRECTOR OF Punic PROPER2Y/BunmiNG CO.%L%ussioNER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: /VnarrFSTw (namc of hauler) The debris will be disposed of in (name facility) �i✓GMrotco7� /b/ (address of facility) signature of permit applicant date a�nr�srirax 6.0 PROFESSIONAL CONSTRUCTION SERVICES: ` 8.1 General Contractor N t x VS C:.Z.,eu aw T O SICAI Address: 5 E r-tER ALD �PJ VE L^f r.l nj /-1A �CEJGZ # 0 �3�� l Ric # 12nn + Telephone: -T$l -760 a D 3 0 Fax: 1$ I Jr 1 7 004ZA , Responsible in Charge of Construction: GE.r7 W (-t �tE 7.0 CONSTRUCTION DOCUMENTS -to be prepared by applicant Item J as Applicable 7.1 Plans (Note 1 this page) Submitted Incomplete Not RegWr d s 17.1.1 Architectural 7.1.2 Foundation 7.1.3 Structural 7.1.4 Fire Suppression 7.1.5 Fire Alarm 7.1.8 HVAC 7.1.7 Electrical 7.2 Speciflcations 7.3 Structural Peer Review 7.4 Structural Tests & Inspections Program 7.5 Fire Protection Narrative Report 7.8 Existing Building Survey 7.7 Workers Compensation Insurance F 7.8 Other Documents (Specify) I (Energy Narratives, etc. Note 1 Areas of Design or Construction for which Plans are not complete at the time of this application must be identified herein. Work so identified must not be commenced until this application has been amended and proposed construction has been approved by the Department of Public Safety District Building Inspector having Jurisdiction. 8.0 COMPLETE THIS SECTION FOR N�EV11 CONSTRUCTION ONLY For Existing Buildi s Proceed to Section 9.0 Number of Storm above Number of Stories Below Grade Grade- Story Height Fbgr Area Per Floor Total Building Height Total Building Area Above above Grade Grade Total Building depth below: Total Building Area Below Grade _ Grade Brief Description of Proposed Work: 0.2 USE aROUP AND CONSTRUCTION CLASSIFICATION(New Construction Only). USE OIiSOUP' USE GROUP SU"ATEGORY CONSTRUCTION (�ais.aPplel (�as aPP�b�� CLASSIFICATION A . Assembly A4 A-2 A41 A-4 1A 8 Business s 1 B E Educational 2A F Factory U 20 H High Hazard H-3 H-4 2C Institutional, 1-3 3A M Mercantile , 38 f R Residential. R-3 4 S Storage 5A U Utility 58 Mx Mixed Use Specify: Sp Special Use Specify: 9.0 COMPLETE THIS SECTION FOR WORK IN EVISXING BUILDINGS ONLY For new consUuction complate sect o Addition Existing o� Renovation x Number of Stories Renovated Change in Use NOW Demolition Existing 1990 Approximate year of Area per floor(sf) Renovated ys p construction or renovation /eDo New of existing buk*V D &ice Description of Proposed Work ��,, 6rif «,s •4�r1 Pl r 6ef.Ls 7 Wfres/ svrvrrc, mod d4 skow , c wall %l Gwn In (Ai 5) o� SCL A- h-k O f- c..2 U f b� V„4c�.o+ an� hn44 oV. Scco� '�-iao�: RcPSiY'<<tl Saco�l eArzs� �'or k: UU V 9.1 USE GROUP AND CONSTRUCTION CLASSIFICATION(E%W'i-,Bultdinge Qnt),. EXISTING ..PROPOSED Change: CONS „STRUCTION USE Group(*) InCLASSIFICATION Use Hazard Use . Hazard, Hazard "' .. Group Index group Index Indek A Assembly 1A a B Business 1 B E Educational 2X F Factory 29' ; . F H High Hazard 2C Institutional. 3A M Mercantile 38 R Residential 4 S Storage 5A U Utility 58 Mx Mixed Use Hazard Index Sp Special Use ' Note: Include Hazard Index Modifier for Construction Type as applicable 9.0 CONSTRUCTION COSTS(See 780 CMR Appendix L) Total Construction Cost Building Perm*Fee Chedc Number (1) y(1)x$0.001 10.0 AUTHORIZATION OF STATE AGENCY FOR AGENT TO APPLY FOR BUILDING PERMIT(when applicable) on behalf of dw au#xxb Mq Stets Agency or Authority. hereby aulluxim to apply br the building permit for project number. Signature Date 11.0 SIGNATURE OF BUILDING PERMIT APPLICANT —� GE D ►�� — n� �c�s �t, ,oJ Name q 4 07 Signature Date 12. Certificate of Occupancy required uired on completion of project? _Yes No Inspectors Note CITY OF S.AL&N4 NNIASSACHLSEM • BuILDLNG DEPARTSMNT 120 WASHINGTON STREET,3m FLOOR 'ILL (978) 745-9595 FAX(978) 740-9846 ICIJIBERLEY DRISCOLL �1AYOR THOMAS ST.PlEl" DIRECTOR OF PUBLIC PROPERTY/BL'ILI)MG CO.MMSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Busins Organization/individual): tjEyf1S 1� Cf75t�1�`l Imo/ Address: �4 Cr-tclzA Cb Dl2►VC City/StatcMp: L11 )rJ MA O)4r�%D+ Phone N: -7% ( 76a 2 0 3o . Are you an employer?Cheek the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ 1 am a general contractor and I ❑New construction employees(full and/or part-time)." have hired the sub-contractors employees am a sole proprietor or partner- listed on the attached sheet t �• Remodeling ship and hove act employro These sub-contractors have 8. Demolition working for me in any capacity, workers'comp.insurance. 9. ❑ Building addition (No workers'comp. insurance 5. ❑ We are a corporation and its required.) officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152.§1(4),and we have no 12.❑Roof repairs insurance required.)t employees. [No workers' I3.0 Other comp.insurance required_] *Any applicant that ttss;ks box MI must also fig out the$Kura below showing their worktss'compensation policy infomution. t I hvrwouvrum who submit this affidavit indicating they are doing ail walk and then hire outside contractors must submit a new affidavit indicating such :Cwtmtan that check this bas must aunchod an additional shoes showing the none of it,sub-eomoc'.and their workers'comp.policy inf smahos. /am an employer that it providing workers'compeamdon lnsarance for my employee& Below Is the pollcy and Job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation polity declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. /do hereby certify rider fir ins a n ojpe try that the information pravrded above Is true and correeL Sien:uure: Date: Phone_X _T%I T60 2030 Ofluriad use only. Do not write in this area,to be eornpleted by city or town oJJ&hti City or Town: Permit/1.Icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department J.Cityfrown Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: -- Phase#: I 11/00/2006 09:50 FAX 978 531 4857 B R XCCARTRY 0002 GieLMR: NEXUS ACORD. CERTIFICATE OF LIABILITY INSURANCE TwaacaL THO CEWIFICATE IS I=UEDA3 A MATIEROF INFOFUSATWN Conifer Insurance Agency,Inc. ONLY AND CORFER3 NO RIONf9 UPON THE CERNFICATE 10 Centennial Otive MOLDER.THIS CERTOWATE DOER NOT AMEND.EXTEND OR ALTER 111E COVERAGE AFFORDED BY 171E POLICIES BELOW. Peabody ,IRA 019811 978532S4" INSURERS AFFORDING COVERAGE MAICa DEWAcn mfumBNA: ProBUlmors Specialty Inwranea Co. 33618 Nests 0 Services LLC m ummA, Slaty Indenvilty,Insurance Co. P.O.Box 2823 umuAw c wobum.MA GIBBS Mm�R �'� NNRI:AE COVERpOES ` THE POUGES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUMM NAMED ABOVE FOR THE POLICY P 1001sYCATED.NOTWrTNSTAWINO p ANY REOWRMENT.TEAM OR CONDITION OF ANr CONTRACT OR OTHER DOCUMERrNRH RESPECT TO RANCH THIS CERTIFICATE MAY BE ISg1ED OR MAY PERTAIN.THE INSURANCE AFFOPMW IW THE POLICIES DESCRIBED HEREIN S SUaIECT TO ALL THE TERMS.ERQUSIOMS ANT CONDITIONS OF SUCH POLICIU.ABW ATE LASTS SNOYM MAY HAVE SEEK REDUCED BY PAID CLAIMS. TVFEormEY1MYR PIXIC mmon a TYY UNITS A LIAfYIn 5010896 0111121815 081UM7 EACHOCCURREACE 51 ad0000 T IRFROIY.00IBMLweanW4AU11AMM Qamn WDTDw ,PA=e 0PD Ded:1.500 FeeDRMLaATAr1lnrar of 00 OBIp1ALNGOAEQAW 32AW908 eerLAeoAEaAneuRvrAmIEl Fee Pwoum-RNa~Amc 11 000 Iarcv M. B AvwNDaaELMauurt 3116632 1ttlem 11%0RI7 ; LPYt a rVRrAlrrD ALOWNEDVTOS 60Dar Faun 3250,000 X foMDmsPAUIOS IrswNY�l X Nn®Auroa X AOHOwrFAwurof IOOO.ODD AROPERTYRVIMAEE st00.000 RPRSNmms aARAW UANKAT AMOAIY-FAAGIOen f AYV AUTO OTIERT ERACC s AUTOD V. 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ACORD 25(2001406)1 of 2 4=12 Rea O ACORD CORPORATION 1988 Z .ol e6b :60 90 60 AON Fee Due W.10V' City of Salem, Massachusetts Ck.# ^� 3 FIRE DEPARTMENT- FIRE PREVENTION BUREAU Rec'd by: -- ? s 29 Fort Avenue Salem Massachusetts 01970-5232 I` '( (Date) APPLICATION FOR PERMIT To: HEAD OF FIRE DEPARTMENT In accordance with the provisions of the Mass.General Laws and/or the Salem Fire Code,application is hereby made for a permit to install approved fire alarm devivioces / -c/ j� /� j�J /J Location: 6 CAP � T(2/V SV Owner. '8eceu � P/( ?L' e/ Installer. �. / 0 L, �e 1� ,p /� Tel# Installer's Address: `JD y^/.ir{�6v/�(�M y"y' d�Si oC o v�;p: T-� License n Type of Occupancy: - -._ =UST TYPE AND LOCATIONS-OF-DEVICES ON REVERSE SIDE,OR PROVIDE PLANS, Installation subject to final inspection and-filling oof"Certificate of Completion,by installer.Installer s be-present-- - Date of approval: 2T�° (signature of A&4 Date of expiration: �� 7 lAooress) Form i81F(Ray.04/92) DO NOT WRITE BELOW THIS LINE ------------------------------------------------------'----_•_-_ -------------—..»----------------------------------------- Fee Due$20 99• T 30, t,p City of Salem, Massachusetts Ck.# 1.23 9 FIRE DEPARTMENT.-FIRE PREVENTION BUREAU Rec'd by: 29 Fort Avenue Q e Salem, Massachusetts 0197D-5232 (978) 745-7777 A2 Office Hours:(8-9 AM.)and(1-2 P.M-) i (Date) PERMIT TO INSTALL • FIRE ALARM DEVICES Permit is hereby granted to install approved fire alarm devices.All equipment and wiring are subject toapproval of Salem Electrical Dept !O/L Location: l 4/- / i l'7' Owner. Br,4d t tt`-/ / i ( /i,,o-r Installer. tr AJ 0 ✓ 1C & license Installer shall note special equipment required, as listed on reverse side. UPON COMPLETION,THE INSTALLER SHALL REQUEST AN APPOINTMENT AT LEAST ONE WEEK PRIOR TO TEST,BE PRESENT FOR THEJST,AND SIGN A CERTIFICATE OF COMPLETION. ® (Sigrvtture of Fae CWKx () Date of expiration:_T (rime) (THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES) Form x81 F(Rev.04/92) (OVER) ADM I ___ Estimate DATE _ESTIMATE# Nexus 11 Carpentry and 08/24/2007 74 Construction Design P.O.Box 2823 Woburn,MA 01888 781-760-2030 or 781-760-2031 Fax 781-599-7009 ADDRESS Brad Phillips 26 Carlton st. ` Salem,MA 01970 Activity Quantity Rate Amount Week starting 08/19/2007 •Demo of specified walls on first and second floor. Removal of ceilings in kitchen, 1 0.00 0.00 dining room and bedroom on first floor. Removal of ceiling in living room on second floor. Disposal of all materials in dumpster provided by contractor. Demolition and removal of garage. •Moving of interior front door for first unit Removing and supporting wall between 1 0.00 0.00 new kitchen and new dining room. •Remodel first and second floor bathrooms,new floors and and new fixtures. 1 0.00 0.00 •Remodel Kitchens on first and second floor with cabinets supplied and payed for 1 0.00 0.00 by owner. •All floors will be sanded and fininshed 1 0.00 0.00 •New walls and ceilings will be plaster and old walls with be patched and repaired 1 0.00 0.00 with drywall. •All interior walls and trim will be prepared for paint and primed. Walls will then 1 0.00 0.00 be painted with eggshell paint and trim in a semi-gloss. Owner will specify colors. (Three per Unit) •Plumber- Plumber will be provided and payed by owner and will be responsible 1 0.00 0.00 for plumbing permit and inspections. •Electrician-Electrician will be provided and payed by owner and will be 1 0.00 0.00 responsible for plumbing permit and inspections •HVAC-HVAC contractor will be provided and payed by owner and will be 1 0.00 0.00 responsible for plumbing permit and inspections •All supplies will be payed for directly by owner. 1 0.00 0.00 •Estimated Cost of project. 1 38,000.00 38,000.00 Owners signature: -- TOTAL $38,000.00 Date: 8Ia7/0 1 �j Accepted By: Accepted Date: TA-iY 4� .a 9Y I 3 0C4 00 0 00.0ma€ 00,000,8Ei �I BOARD OF BUILDING ]An License: CONSTRUCTION u .Number q� ;- 07399t Birth1i 6y T1� rGERALO W 'ISf EMERALD DR LYNN,-MA 01904 .,Co I i0m'""_ Rex "'toffs nn✓nT�CTOR� gaord of Boildin8 T CON NDIX Mp VE►A9N 7 log Regislra,.��7 1912009 Tr8 133317 1t Gerald Whde Gerald W t lte Emerald Drive Lynn, 0190'i l 4 Application for Permit to: P604044"V$ 4V �e 2 [Z4+ h .O& ZtOA,44/� )WtTµ IAafk o �s Location 2a � f. Permit Granted = , Approved for of Buil gs t Owner. Brad Phillips 26 Carlton st. Salem, MA 01970 25'-9" 7'-9" 7'-4" 7'-2" X. -------------- 3'- "x 6'- 9Lt 3'-0"x 4'--8" 3'-0"x 4'-8" w ih N A Cl) N O V t, Entry k _ k in 03 ih 12'3" Dining Room w o >i A r co � e V Bed 1 a w -6"x 6'-8" "' o ---------------- co k A N N 7=0" 5'3" w 2' 11"x -8" ro o k X p A ' N Living Room Bed 2 X a V, cc r` r „ i �^ N 12-3 iv q x _ CD M+�„ Bath : 3'-0"x 4=8" N 4'-4" 4'-5"—�' I� 4r_7" T-8" k"x 6'8 a r" r 8rr 1 9-1�— -6" ao N X _ O N _r " Kitchen to 1st Flop X ' - H�PPROVED a Subject to approval /aiy cw't�E aa,hority.ha�r:ngs� 'OLctio5. CITY of 8AMEW, t\ PLANS EAPPROYED SO-I,EL'l C.Y..-t'1'I.ICAi ]�CF TYPE AND IWTMN Of FI@C ALL Fig PROTECTION MICES.".°CiOL'sT="T•i0 k FI'„L TEST AND INSPECTION,FOR COMFLETL COM''44 ANOF YdITH THE FIRE CODE. 17'-0" l I Owner. Brad Phillips 26 Carlton st. Salem MA 01970 25'-10" 8'-2" 9.6„ 8 2n 3'-0"x 4'-8" 3'-0"x 4-8" Stairwell N o X O Bedroom 1 a x 2, -.,6 8 office 00 /2'-2" 13 2n ------------- 2, ,_8„ N h ;o -6"x 64 / N Living room❑ s k � c Bedroom 2 to 0 10'-0 2.4 `h 2' a Bath k N 2, n n,_OOp , x Kitchen a N k P `" 2nd- fa? d' k O N M 3'-0"x 4'-8" 12'-11" 4'-0"-4 I Owner.Brad Phillips 26 Carlton st. Salem MA 01970 25'-9" 7, 9„ T, 4„ �, 2„ 3,_6„ 3'- "x 6'- '9Lt 3'-0"x 4'-8" 3'-0"x 4'-8" Zh M Entry k J Q F 2'-7" ' Bedroom 1 w 2, „x 0 k �A o V N CT k 00 Nco , Kitchen/ W dining - 60 O k k o Livingroom 12'-3" L. F 00 00 d Bath3-0"x 4'-8" CN ' N 4'4' 4'-5"I� [- 6"x 6' 8' -- I co N 1 9'�L -6l' N ` � N N , tl� Bedroom 2 k 1 steer. ' cn prod loom J' 1 T-0" Owner.' Brad Phillips 26 Carlton st. salem MA 01970 25'-10" 8'-2" 9,_6„ 8,_2„ 3'-0":4-8",L 3'-0"x 4'8" Stairwell a o10'-51'-s' Bedroom 1- x 2 8 0 LO office CO 5'-1" 2' „x 8" N "? -1 1- ^ LO 8"x 6^'� N Living room❑ o k ^ CO Bedroom 2 ' k O LO 2'-4" s. 5 „x Bath k N � _t 21 „ 8„ CO 2nd Root Kitchen N k proposed ^ a io CV) ap v k 0 N M 3'-0"x 4'-8" "' 12'-11" 4'-0" Owner.' Brad Phillips 26 Carlton st. Salem, MA 01970 26'-1" Basement N a a --X-6"— 5'-T' Z- . . r cn CA 1 T-0"