258 LAFAYETTE ST - BUILDING INSPECTION (2) g C-A SH
A` The Commonwealth of Massa ED
SERVICE`
I Department of Public Sal
Massachusetts State Building Code(780 CMR) ''CC
Building Permit Application for any Building other than "-IPtil�I]&ling
(This Section For Official Use Only).
Building Permit Number: Date Applied Building.Official:
SECTION 1:LOCATION(Please indicate Block.#and Lot#for locations for which a street address is not available)
7,50 e- e Sa a-ly" b l p (�r�Pyt s Fm.� OA-Aw-
No.and Street City/Town Zip Code dame of Building(if applicable)
SECTION 2:PROPOSED WORK
Edition of MA State Code used A If Ne Construction check here❑or check all that apply in the two rows below
Existing BuildingNl Repair Alteration Addition[] Demolition ❑ (Please fill outand submit Appendix l)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes SK No ❑
Is an Independent Structural Engincorin Peer Review required? Yes ❑ No M.�t'�
Brief Description of Proposed Work: 14 reZX51' d C C'�
Lire- YYI' G o GI a
c
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SECTION 3:-COMPLETE.THIS SECTION IFEXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY.
Check here if an Existing Buildin Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION I BUILDING HEIGHT AND AREA.
Existing Proposed..
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft)and Total Height(ft) 7
SECTION 5:USE GROUP(Check is applicable).
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ F B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ H: Hi Hazard H-1❑ H-2❑ H-3 ❑ H-4 H-5❑
I: Institutional I-1❑ I-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2 R-3❑ R-4❑
S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ HA ❑ UB ❑ HIA ❑ IIIB ❑ IV ❑ VA VB ❑
-SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: ewage Disposal: Licensed Disposal Site
Public EIS Check if outside Flood,Zone Indicate municipal A tench will Ve c p�
Private❑ or indentify Zone: or on site system❑ required cl trench or specify: M
permit is enclosed❑ r OK
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable Is Structure within airport appr h area? Is their review com`plett ?
or Consent to Build enclosed❑ Yes❑ or No lil" Yes❑ No
SECTION lli CONTENT OF CERTIFICATE OF OCCUPANCY -
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
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SECTION 9: PROPERTY OWNER AUTHORIZATION
r Name and Ad_dress_of Property Owner
MeS M4 ojJ7Q
Name(Pr' t) No.and t�S eett 1 Cr /Town r Zip
erty Own r Contact Information: �'M�1 axe'r rci
Title Telephone No.(busin s) Telephone No. (cell) mail addr
applicable, a proper owner hereby authorizes
Name Q 0 Sheet Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
.SECTION I&CONSTRUCTION CONTROL(Please fill out Appendix 2) -
F buildin is less than 35,000 cu.ft of enclosed Tace and/or not under Construction Control then check here Wand skip Section 10.1
.10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Nurnber
Street Address City/Town State Zip Discipline Expiration Date
10 eneral Contractor
C any Name
t3rz �s -
Name of P Responsi u truction ,License . and Type if Applicable
a2 ►A A o t945
Street Address City/Towppn� State Zip
791
Telephone No,(business) Telephone No. cell e-mail address
SECTION 11:WORKERS'COWENSATION INSURANCE AFFIDAVIT M.G.L..c.152.§25C 6
A Workers Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the}'ssuance of the building permit.
Is a signed Affidavit submitted with this application? YesS( No ❑
-.SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE -
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=$
1.Building $ r
10150 Building Permit Fee=Total Construction Cast x_(Insert here
2.Electrical $ appropriate municipal factor)_$
3.Plumbing $
4.Mechanical (HV AC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $
Enclose check payable to
6.Total Cost $ (contact municipality)and write check number here
SE, 13:SIGNATURE OF BUILDING PERMIT:APPLICANT
B entering my name below,I he by a est de the pains and penalties of perjury that all of the information contained in this
a ication is a and a ate t the f y led and understanding.
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Please pi d si ; , `Z ��'e 1 Tiler Telephone N S Date
tr �dl�.l
Street Address City/Town State Zip /
Municipal Inspector to fill out this section upon application approval:
Name - Date
1
Paul Haggett & Co.
Residential Remodeling Contractor
33 Russell. Street #2 — Marblehead, MA 01945 781-696-5439
PROPOSAL/ CONTRACT
October 15, 2014
Customer: Contractor:
Greystone Manor Condominium Trust Paul Haggett& Co.
c/o Leslie Management 33 Russell Street#2
P.O. Box 946 Marblehead, MA 01945
Marblehead, MA 01945 781-696-5439
CSL#96526
HIC# 129828
Property Address:
Greystone Manor
258 Lafayette Street
Salem, MA 01970
GENERAL DESCRIPTION OF WORK:
This proposal is a fixed amount for the project of revitalizing the rear deck and stairs of Unit #5.
We will completely re-build the entire assembly as follows:
• Remove all existing decking, trim, stair stringers.
• Build entirely new 2 X 10 pressure treated deck frame replacing the existing rotted
assembly.
• Build a new stair stringer assembly also replacing the existing with PT framing.
• Install four new 4 X 4 Pressure treated railing posts in the same locations of existing.
• Build new framework for lattice enclosure under deck. Including access hatch to match
existing.
• Install new PVC trim to cover all framing.
• Install new Azek Slate Grey PVC decking with hidden screws. All cut ends will be
rounded over for a finished look.
• Install Azek railing systems:
o Post sleeves, caps and skirts
o Composite rails and balusters
0 5 ''/z" square full height post sleeve around roof support
• Use stainless steel fasteners where appropriate.
• Paint all new PVC latex semi-gloss white
In order to obtain a building permit it may be necessary to secure the services of an architect or
structural engineer to provide Construction Control over the project due to the cubic footage of
the combined buildings. This fee may cost between $400 and $700 depending on the provider.
The Building Inspector may not require this oversight if we are simply replacing the existing.
1
Paul Haggett & Co.
Residential Remodeling Contractor
33 Russell Street #2 — Marblehead, MA 01945 781-696-5439
TOTAL COST OF PROJECT: UNIT#5 REAR ENTRY DECK AND STAIRS:
LABOR: $5,140
MATERIALS: $2,810
WASTE DISP.: $ 50
TOTAL: $8,000
MATERIALS INCLUDED IN THE ESTIMATE FOR THIS CONTRACT:
• All carpentry related materials required to complete the project described above.
BUILDING PERMIT:
A building permit is required for all work associated with egress therefore all railing heights,
rise/run of stairs, type of stair railings must comply with the current building code. The building
permit fee will be approximately$75.
If drawings are required to obtain the permit this fee will be$100.
EXTRA WORK:
Our standard policy on "Extra Work" is as follows:
Any work requested and/or required due to any unforeseen circumstances, which are not
described herein, shall be considered "Extra Work" not included in the total project estimate. A
change of specifications or the addition of items not included in the project estimate shall also be
considered"Extra."If, in our professional judgment we determine that unexpected material
replacements are necessary and/or we need to respond to deficient or sub-standard structural
components, this work will also be considered Extra Work. All Extra Work shall be performed
on a time and materials basis at $55/hour per man. A cost estimate for Extra Work and its
impact on our completion schedule will be provided when possible and practical via email as
soon as possible.
No Extra Work will be performed without prior email authorization. Temporary verbal
authorization may be provided in order to maintain progress but must be followed up with an
email exchange within 24 hours.
CERTIFICATES OF INSURANCE-
On signing of this contract Certificates of Liability and Workers Compensation insurance shall
be generated to Greystone Manor Condominium Trust.
Scheduling: We would be able to begin work mid to late October 2014 if contract signed before
10/03/2014
2
Paul Haggett & Co.
Residential Remodeling Contractor
33 Russell Street 92 — Marblehead, MA 01945 781-696-5439
CONT. EXTRA WORK:
All "Extra Work" charges will be invoiced separately on the completion of each aspect of
the extra work and are due for payment in full upon receipt.
In the event the customer cannot be reached in order to authorize Extra Work which is critical to
maintaining progress and is in excess of$100 but not more than $300, he/she can pre-authorized
Paul Haggett& Co. to proceed by signing below. Pre-authorization notwithstanding, continual
efforts to contact the customer shall be made to secure verbal authorization for this"Extra
Work."
Customer's pre-authorization signature Date
POTENTIAL EXTRA WORK FOR THIS PROJECT:
• Rot along the perimeter of the house where existing deck framing meets the sheathing.
• Request for additional work.
TERMS AND CONDITIONS/PAYMENT SCHEDULE:
*** All invoices presented are due upon receipt***
*** All payments shall be made payable to Paul Haggett& Co. ***
PAYMENT SCHEDULE: v
Payment#1: $4,000-"Contract signing deposit" 50%of total project cost paid at the signing
of this contract.
Payment#2: Building Permit Fee& drawing fee. A framing plan drawing will be required to
obtain the building permit. That fee will be$100. Once we've obtained the
Building Permit an invoice will be presented for drawing and permit fees. Permit
fee is based on $12/$1,000 of total construction cost.
Payment#3: $4,000—Balance of project cost, plus dump fees, due upon satisfactory
completion of all work described herein.
3
Paul Haggett & Co.
Residential Remodeling Contractor
33 Russell Street #2 —Marblehead, MA 01945 781-696-5439
SIGNATURES:
Placeme f both party's signatures below and receipt of the Deposit this contract shall be
consid `ed finding f both parties.
ffh(el L m( 4._4 ; <)�mci U/1,5Ifs
Paul a t Date Kimberly Lord Date
Contractor Authorized signor only
Property Manager
Greystone Manor Condominium Trust
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UL HAGGETL `#
33 RUSSELL ST.92
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MARBL,E,MP MA 01945 — �-`
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htassacfiusetts-Department of PubliC Safety ,
$oa�d of Bmldmg Regulations and Standards
Construction Supervisor
License: CS-0
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PAULF.HAGGEO
RRussellSt.#2
Marblehead MA b'
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Expiration
Commissioner 05/15/2016
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f CITY OF S U EN4 NAAISSACH SETTS
BUIIMING DEPARTSWUNT
• N• 120 WASHLNGTON STREET,3-FLOOR
TEL (978)745-9595
FAX(978)740-9846
KIJfBERLEY DRISCOLL
T
MAYOR HOStAS ST.PIP1tRIi
DIRECTOR OF PUBLIC PROPERTY/BUILDLNG COSLUISSIOV ER
Workers' Compensation Insurance Affidavit: Builders!Contractors/Electricians/Plumbers
Applicant Information i Please Print Leinibly
Valve(BusimsOrganintioNlndividual): ,,n n 6
2
Address: J ��J _ Gf�,/
City/State/Zip.U-mil`ab WA— I �"l At
Are yo employer?Check the appropriate box: Type of project(required):
I. I am a employer with -5; 4. ❑ 1 am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).* have hired the s h ctmrmctors ,�,�
2.❑ 1 am a sole proprietor or partner- Ly
listed on the attached sheet.: 7. icemodeling
ship and have no employees These sub-contractors have S. ❑Demolition
working for me in any capacity, workers'comp.insurance. 9, ❑Building addition
[No workers'comp, insurance S. ❑ 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 1 L❑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' 13.❑Other
comp.insurance required.]
'Any appiicum tuu cheeks box At must also fill out the section below showing their woskets'compensation policy infumtatton.
'I lumeuwtnas who submit this affidavit indicating they am doing all work and thm hire outside carttactvm most submit a new affidavit indicating such.
=Contmaom that check this box mot attached an additional sheer showing the name of the sub-cmunmfiam and their"it=,mmp,policy intarmotfon.
saaaaaaeal
1 am an employer that is providing workers'compensation insarancefor my a ployees. Below is the pulley and Job site
information.
Insurance Company Name: - -`I—tA�—�—
Policy d or Self-ins. Lic.0: Expiration Date �: JEj
Job Site Address: Q
City/State/Zip: 92 " , I'LTT" y 70
Attach a copy of the workers'comp nation policy 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
ofup to S250.00 a day the violator. 13e advised that a copy of this statement may be forwarded to the Office of
Investigations of the IA for tsumnce cov ago verification.
1 do hereby certify tastier re abler perjury that the ntformadon provided above is true mad correct
Si mat ire: Date: t/ /
OfUrAd use only. Do nor write in this area,to be completed by city or town official!
City or Town: PermitnIceme
Issuing Authority(circle one):
1. Beard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person• ._ _ Phone#:
CITY OF SM E.NI, -NANSSACHUSETI'S
• BUILDING DEPARTMENT
130 WASHNGTON STREET, 3" FLOOR
TM (978) 745-9595
FAX(978) 740-9846
KIN
tBERL.EY DRISCOLL
:MAYOR THo.%w ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BU UDLNG CONWISSIONER
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
l 11, S 150A.
The debris will be transported by:
(name a ler)
The debris will be disposed of in
(name of facility}
(address of facility)
sisna a of n tt applicant
I oll� (1L�
date
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