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302 LAFAYETTE ST - BUILDING INSPECTION The Commonwealth of Massachusetts Department of Public Safety Massachusetts State Building Code(780 CMR) Wcv� Building Permit Application for any Building other than a One-or Two-Family Dwelling 1 - _ (This Section For Official Use Only) DDD 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) 30�2 /-6/c/9'wn-- ST 61-?h m /' P 0/(776 No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below Existing Building 61' Repair Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) - Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Spedfy: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work Slt?in A✓V/� ROdF SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY . Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.it) Total Area(sq.ft)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E Educational ❑ R Fact P-1❑ F2❑ I IL• High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1❑ I-2❑ I-3❑ I-4❑ 1 M: Mercantile❑ R: Residential R-1❑ R-2❑ R-3❑ R-4❑ S: Storage S-1❑ S-2❑ ,U. Utility❑ I Special Use❑and please describe below: Special Use: SECTION 6.CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB ❑ MA IIIB ❑ 1 IV ❑ I VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information Sewage Disposal: Trench Permit. Debris RemovaL- Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site Private❑ or indentify Zone: or on site system❑ required❑or trench or specify.13 IJ 2KE permit is enclosed❑ li'OOP/NG 77 90f Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their revi w completed? or Consent to Build enclosed❑ 1 Yes❑ or No❑ Yes No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor. Does the building contain an Sprinkler Sysbem?: Special Stipulations: SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner '30o2, 7- r 5PlF-m 1 M/9 vl 7D Name(Print) No.and Street City/Town Zip Property Owner Contact Information: srFvp »N�srs-tr2u5rFe 9�� aSaD 900.13���oU�23r, PP-H)3,ODIJ W6 61�&O Title - . Telephone No.(business) Telephone No. (cell) e-mail address' If applicable,the property owner hereby authorizes RIL3i�,/ AU/1KF &o Fin/c a /3�2as� Name Street 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 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0 and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control RHIph /3urrE G17"tl ///o Name(Registrant) Telephone No. e-mail address Registration Number - $y PHDDU ey— t N J7QHCc.t r MA OLS> CS S Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor P,QtIDA 17//2/fF kocr—j/YG Company Name AA/nh Au2/cc 1-1-r /0'7 / �f6 7- aq -20 Name of Person Responsible for Construction License No: and Type if Applicable A) Cyeal-/ 5r LztarF�-/E/' /wA-_ O FZ, o Street Address City/Town i,� State Zip d �-�0 ! // O f�/qLPN�' 2F1LVfl �lftK� ce/v! Telephone No. (business) Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.15Z§25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. _ Is a signed Affidavit submitted with this application? Yes❑ No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $/�a,(JQ� Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ _ appropriate municipal factor)=$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ /s a o a (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the airs and penalties of perjury that all of the information contained in this application is true and accurate o e be t of m ed a and understanding. Please print and sign name Title Te p e No. Date 1,0 040-ocK Ny n2 01 Street Address City/Town S Zi e Municipal Inspector to fill out this section upon application approval: '"vr 5 Ias f3 e Date CITY OF SM E:�1, 1�I.xSSr1CHL'SETTS B1:n DING DEPART%MNT p• 130 WASHINGTON STREET, 310 FLOOR bf TEL (978) 745-9595 FAX(978) 740-9846 KIN jBgRLELBY DRISCOLL MAYOR THo&w ST.PmRRE DIRECTOR OF PUBLIC PROPERTY/BIaLDING CONMUSSIONER 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: hN/2KE R00FIN6 MP-5/4 T2UCK (name of hauler) The debris will be disposed of in : �'Gr�/�o�y mr-rrvsr�=rz st�ria�c, (name of facility) P7- J , PI,�fI,90DX 6196,0 (address of facility) si lure of permit applicant 3 dat dcbrivfiduc Appendix 1 For the demolition of structures the building permit applicant shall attest that utility and other safety. service connections are properly addressed to ensure for public s ty. Please fill in the information below and submit this appendix with the building permit application. The building permit applicant attests under the pains and penalties of perjury that the following is true and accurate. Property Location (Please indicate Block# and Lot#for locations for which a street address is not available) No. and Street City/Town Zip Name of Building(if applicable) For the above described property the following action was taken: Water Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Gas Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Electricity Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Appendix 2 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required for this.The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where plicable No. Item - Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing include local connections 9 Gas(Natural,Propane,Medical or other 10 Surveyed Site Plan(Utilities,Wetland,etc. 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report - 15 Existing Building Survey/Investigation 16 EnerRy Conservation Report 17 Architectural Access Review 521 CMR 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction.Work started prior to approval may be subjected to triple the original permit fee. Registered Professional Contact Information Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town/Town State Zi Discipline Expiration Date CITY OF S.UE.NL4 TUNSSACHUSETTS BUILD +IN`G DEPARTJMAIT • 120 W ASHINGTON STREET,3`u FLOOR �j TEE- (978)745-9595 FAx(978)740-9846 KI\fBERI.EY DRISCOLL LLAYOR THObIAS ST.PIERRB DIRECTOR OF PUBLIC PROPERTY/BUMDING COMMISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anplicant Information Please Print Leeibly Name(BusinessiOrganizatiotvindividual): /4 KC F1 NG Address: -�`7 N 5 r21� City/State/Zip: I&WLE—rlEld f'YI19 DI6Q-'G Phone#: 7,Fl Are an employer?Check the appropriate box: Type of project(required): 1.LI 1 am a employer with - 4. ❑ I am a gencrrl contractor and 1 6 employees !1 an r part-time).* have hired the sub-contractors El New construction 2.❑ 1 am a sole proprietor or partntr- listed on the attached sheet t �• ❑Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition workingfor me in an ca aci workers'comp.insurance. Y P ty• 9. El Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its requited.] officers have exercised their I0.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 LEI 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 appliaul that checks box 91 must atw fill out the section below showing their workers'compensation policy infurmatlon. r I Inmeowncm who submit this affidavit indicating they ace doing all work and then him outside cont mcrors must submit a Crew affidavit indicating suck =Cumtwxom that check this box must attached an additional sheet showing the name of Me sub-contractors and their wodcps'comp,policy mliumotion. I am an employer that is providing workers'compensation insurance jar my etuplayees. Below Is the policy and Job site information. Insurance Company Name: 0 UCl C6,1- A`"1-_21(?19/Y S✓YS/r 2/3/V CF CCU Policy#or Self-ins.Lie.#:_� Z Z L( 1-0/ 9 k 1Y VO-S- ) 3 Expiration Date: 3- / '--2-0/ S/ Job Site Address: 30-Z 5T Sp)rm MGYCity/state/Zip: 011/ 70 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. l do hereby cer ' It r se a nd enaldes ojperJury that the information provided 7bois True/rd'Coffee . i mat ve• Date: 0/ Phone.Y: t� Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Ifealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other . Contact Person: Phone#: i From:Linda J Caruso FaxID:SALEM03 Date:5212013 12:01:34 PM Pace:2 oft RALPJBU-01 LCARUSO A`ORO' CERTIFICATE OF LIABILITY INSURANCE DA5f211YD13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(a). PRODUCER CONTACT NAME: Salem Five Insurance Services,LLC PHONE FAX 445 Main Street N Na Ea1:(781)933-3100 5126 ac,Na: (761)933-9046 Woburn,MA 01801 nu RIESS. _ INSURER(S)AFFORDING COVERAGE NAICC INSURER A:Penn America Insurance INSURED INSURER B: Ralph J.Burke Roofing INSURER C: Attn.: Dan Burke 27 Byron Street INSURER 0: Wakefield,MA 01880 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOL SUSHI POLKY NUMBER MM/OCYOlYYYY MMFF NOmYP LTR INSR VNO LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500,000 A x COMMERCIAL GENERAL LIABILITY TBD 511712013 5/1712014 PREMISES Ea acwRence S 100,000 CLAIMS-MADElxl OCCUR NED EXP(My one person) $ 5,000 PERSONAL A ADV INJURY S 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO S 1,000,000 X POLICY JEO LOC S AUTOMOBILE LABILITY COMBINED SINGLE LIMIT Ea acciese ANYAUTO BODILY IMURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Peraccident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS PERACCIDE UMBRELLA UAB OCCUR EACHOCCURRENCE $ EXCESS LIAe CLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTIi- ANOEMPLOYERS'LIABILRY YIN TORYLIMIT9 ER ANY PROPRIETORIPARTNERIEXECUTNE❑ NIA EU.EACHACCIDENT $ OFFICERFAEMBER EXCLUDED. (Mansatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe weer DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Atlach ACORD 101,Additional Romance Schedule,II more space is"ueed) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Salem THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010f05) The ACORD name and logo are registered marks of ACORD 03/28/2013 03:44 17812462042 PAGE 01 ACORD,N CERTIFICATE OF LIABILITY INSURANCE 03/27/20 ' PRODUCER (781) 245-3954 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Wakefield Insurance Agency,Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O.Box 557 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 63 Albion St Wakefield MA O1B80- INSURERS AFFORDING COVERAGE NAICN INSURED INSURERA: Ralph Burke Roofing INSURERB.Baf*tY Indamnit 27 Byron Street INSURER C:ZVRICH INSURER V Wakefield MA 018130- INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY THE INSURANCE AFF OR ORDED BY ITT THE F ANY POLICIESDESCRIBED DCT OR OTHER HEREIN DOCUMENTS UBJECT TO ALLECT THET MICH THIS CERTIFICATE MAY BE ISSUED S, EXCLUSIONS AND CONDITIONS OFOSUCHY POLLIICIES, AGGREGATE LIMIT$SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 74UTOMOIULS ADD POLICY EFFECTIVE PDLICY EXPIRATION OMITS TYPE CF INSURANCE POLICY NUMBER DATE MNVOONY DATE MMRSOIVYRAL UABILITI / / / EACH OCCURRENCEDAMAGE TO RENTEDOMMERCIAL GENERAL LIABILITY PRFM18E8 EaPramrence CLAIMS MADE ❑OCCUR MED EXP A Rm mm)PERSONALS ADV INJURYGENERAL AGGREGATE S AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO 1 PROOLICY JECT LOC LIAIPULW / / / / COMBINED SINGLE LIMIT S (Ea ecUMDU ANYAUTO B ALL OWNED AUTOS 1614563 Dl/D1/2013 01/D1/2010 ROOKY INJURY S 250,000 (Per peraonl X SCHEDULED AUTOS HIREDAUTOS / / / / (PO,DI Y.IN^11gY f 500,000 NONaOVMED AUTOS / / / / PROPERTY DAMADE i SOD,DDO (Pw arr.DanB OARAOE LIABILITY AUTO ONLY-EA ACCIDENT f ANY AUTO / / / / OTHER THAN EAACC S AUTO ONLY: AGO S EXCEDBNMBRELULIABILITY / / / / EACH OCCURRENCE f OCCUR r I CLANSMADE AGGREGATE S f DEDUCTIBLE RRnWION S IIII S WORKERS COMPENSATION AND / / / / TORYLANIR ER EMPLOYERS'UASILITY 100,000 ANY PROPRIETORNARTNERIEXECUTIVF G.L.EACH ACCIDENT S OEFICERMEMBER EXCLUDED? 6ZLUB-1325CS2-3-09 03/01/2013 03/01/2016 E.L.DISP SSE-fA EMPLOYEES 100,000 R Tm.IIN01"Under 500,000 SPECIAL PROVISIONS WID.v E.L.DISEASE.POLICY LIMB 3 OTHER DEDCRIPTION OF OPEIATIONSILOCAMONBNENICLEEEXC WEIGHS ADDED RY EMOORSlMSNTBPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLMIW BE CANCELLED BEFORE THE EXPIRATIOR DATE THEREOF, WE EDUIN9 ,,BVRCR WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO WE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Building Department ILUA TO DD BD BHUL IMPOSE MO O8UGAT0N OR LIARILITY OF ART KIND UPON WE Balsa, Town Of NSUR ITEAOENTE RREPRSBENTATIVEB_ A DR EM TV! ACORD 26(2001100) OACORD CORPORATION 1986 INS025(o,w),Do PepPT 02 05/22/2013 19:07 FAX 2003 Salem Historical Commission 120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970 (978)519-5685 FAX(978)740-0404 CERTTFTCATE OF APPROPRIATENESS It is hereby certified that the Salem Historical Commission has determined that the proposed: ❑ Construction ❑ Moving ❑ R.eco.nstniction ❑ Alteration ❑ Demolition ❑ Painting ❑ Signage ® Other work as described below will be appropriate to the preservation of said Historic District, as per the requirements set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: Lafayette Street Address of Property 10? T afhyptte_Stre t Name of Record Owner: 302 Lafayette Street Realty Trust Description of Work Proposed: Replace roof with: 1. 3-tab roofing in black or charcoal grey color, or 2. CAG/Elk Grand Slate architectural shingle in black or charcoal grey color Dated: April 4. 2013 SALEM HISTORICAL COMMISSION B y: L.{ The homeowner has the option not to commence the work (unles it rclatcs t`�o resolving an o/utstanding violation). All work commenced must be completed within one ycar from this date unless otherwise indicated. THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Buildings (or any other necessary perrnits or approvals)prior to commencing work. 05/22/2013 19:06 FAX 0002 a r µ g Salem Historical Commission 120 WASHWGTON STREET, SALEM,MASSACHUSETTS 01970 (978)619.5685 FAX(978)740.0404 CERTIFICATE OF APPROPRIATENESS It i.s hereby certified that the Salem Historical Commission has determined that the proposed: ❑ Construction ❑ Moving ❑ Reconstruction ❑ Alteration ❑ Demolition ❑ Painting ❑ Signage 0 Other work as described below will be appropriate to the preservation of said Historic District, as per the requirements set forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: Lafayette Street Address of Property Name of Record Owner: 302 Lafayette Street Realty Trust Description of Work Proposed: Replace roof with GAF ELK Slateli.ne shingles in the color antique slate or with previously approved 3-tub roofing (Certificate issued on 41412013). Dated: May G, 2013 SALW HISTORICAL COMMISSION By. hL The homeowner has the option not to commence the work (unless 1t relates to resolving an outstanding violation). All work commenced must be completed within one year from this date unless otherwise indicated. THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Buildings (or any other necessary permits or approvals)prior to commencing work. Mr. Steven Anezis 302 LAFAYETTE STREET REALTY TRUST SAS ��J7 ., /T1�• L H RA P J BURKE A Family Business Since 1941 Roofing — Gutters Rubber Roofing DANIEL M.BURKE RALPH J.BURKE,JR. TELEPHONE 781 245-1110 FULLY INSURED-LICENSED 27 BYRON STREET, WAKEFIELD, MA 01880 March 27 , 2013 Contract price for labor and material to re-roof all roofs including porches. remove all roof shingles replace rotted/broken roof boards up to 100 square feet re-hail .loose boards install aluminum drip edge 6 feet of ice and water barrier- " heavyweight felt paper or CERTAINTEED Synthetic roof underlayment CERTAINTEED LANDMARK ARCHITECTURAL shingles, hand nailed, or CERTAINTEED XT. 3 TAB shingles reflash all vent pipes and chimney install rolled rubber roofing on upper dormer remove all roofing debris from the yard The total cost of the roof work is $15,200. 00 due in two payments. The first payment of $7 ,600 . 00 is due when the contract is signed. The balance of $-7 ,600 .00 is due when the roof work is complete and the debris is removed fPom the yard.. S I GNATURE: CONTRACTOR: . / All workma�I izr64teed twenty years. Please remove or cover all items in attic, as dust and roof particles may settle on attic floor. Thank you