323R LAFAYETTE ST - BUILDING INSPECTION (2) The Commonwealth of Massachusett'
;;tSPECI'lONAI SER ICESCITY of
, tp
Board of Building Regulations and Standards
i Massachusetts State BuildingCod 780 CIi,�g SALEM
e, ,., MAR 30 Q "ised Mar 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
N Building Permit Number: Date Applie :
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
1.I a Is this an accepte street.eyes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(it)
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'
/,24. Owner'of Record: (� �/� ,,p
\ k Zn t fSl1 .t� 4 +V�n n P� �A S� Q XVl r V�r \ (Z C�--y ,
Name(Print) City,State,ZIP
Ali ➢�a PttaP `) A- 21�-D(3a ('v�Lht h„o1cu�, p, ��
No.and Street Telephone Em d Address Yrt0.i .
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ -
Demolition ❑ Accessory Bldg. ❑ Number of Units Other (0 Specify: tJrt>v$
Br f DescriptioIn of Proposed)Work': 1 -
I.lA M.L.A.I Q�t2cQ bn JCT�t Q (\ 0 R Aft 0> 1.J1 vJA
Z�`�<J
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: official Use Only
Labor and Materials)
1. Building $ 0 — 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 (FIVAC) $ List: r) V/
5. Mechanical (Fire $
Su ression Total All Fees: $
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCTION SERVICES
5.1 ^Construction S(uper'vviisor License(CSL)
License Number Expir ion ate
- Name of CSL Holder
l List CSL Type(see below) ( yj
No.and Street
A )0 '� � �' '�te YA 1 o Type Description
�/� U Unrestricted(Buildings up to 35,000 cu.ft.)
I, R Restricted 1&2 Family Dwelling
City/To n,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
.� la •'"1 . �t � I ��4„I�� I Insulation
Telephone Email address D Demolition _
5.2 egistered Home Improveme t Contractor(HIC)
� tA� g- ���C � a �r�3mb E
I HIC Registration Number -E irati Date
Kf Company Na e or HIC Registrant Name
No.and Street Email address
Ci / o�te,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 .......... No ........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR
BUILDING PERMIT
TS l�
I, as Owner of the subject property,hereby authorize I„/Iti/;�Ulm `� y D
to act on my behalf,in all matters relative to work authorized by this building permit application.
A Print Owner's ctronSignature) ate
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained ' this application is true and ac urate to the best of my knowledge and understanding.
lrfim6,ner's or A orized Name(Electronic Signature) bite
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 HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www mass eov/dns
2. When substantial wgr tkis planned provide the information below:
Total floor area(sq. ft.) 1�7i(�( )_-- (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"
f/ J X�XJ1lY iit!d(t {�fJII(n'i(fYYtftv'£tf
Offite of Consumer#ffnvs&Rus�iaess Regolatian
Li ...../,,HOME IMPROYEMENF CONTRACTOR
,. Registraion: . 'tyg634 Type:
Expiration 5I2T20t7 DBA
ED BYRNE WINDQW CA. _
EDWUND BYRNE
766 WESTERN AVE
LYNN,MA 07842 Undersecretary
Massachusetts-Department of Public safety
Board of Building Regulations and Standards
€n�anU st d3cs Sn.vX<t6�'
License CS-010870
.rIK
P".,
EDM(JND d BYBy"18 Woodrow TerrSce ,M
Lynn MA 01904= ,.
'�• Expiration
commissioner OTIOW2017
E.B. Window and Siding Co. Invoice
756 Western Ave
Rt 107 Date Invoice#
Lynn MA 01905 3/25/2016 52462
Bill To
Anthony Damien,
323 R Lafayette St
Salem MA 01970
P.O. No. Terms Project
Description Qty Rate Amount
Three lite casement window by Alside,English Red exterior, 2 950.00 1,900.00
installed
Two lite casement window by Alside, English Red exterior, installed 4 710.00 2,840.00
Single casement window by Alside,English Red exterior,installed 1 440.00 440.00
"1'empered glass upgrade 1 60.00 60.00
Exterior finish, English Red 7 200.00 1,400.00
Angie's list: Double strength glass upgrade:NO charge 7 0.00 0.001'
Scope of Work: 0.00 0.00T
Remove windows and prepare opening to receive replacement units. 0.00 0.00'P
Existing interior and exterior trim to remain 0.00 0.001
Add insulation wherever possible 0.00 0.001' j
Install new Alside units 0.00 0.001'
Seal units with Titebond lifetime caulking 0.00 0.001'
Dispose of all job debris! 0.00 0.001,
Alside units feature a lifetime warranty! 0.001 0.001'
"lmank you fur your business.
Subtotal
Sales Tax
Total
Payments/Credits
Balance Due
Phone# Fax# E-mail Web Site
781-592-9747 781-592-9746 ebwindow@rnsn.com www.ebwindow.com
E.B. Window and Siding Co. Invoice
756 Western Ave
Rt 107 Date Invoice#
Lynn MA 01905 3/25i2016 sza6z
Bill To
Anthony Damico
323 R Lafayette St
Salem MA 01970
P.O. No. Terms Project
Description Qty Rate Amount
Discount -340.00 -340.00
0.00 0.00T
acceptance otproposal
authorized signature
Thank you for your business.
Subtotal $6,300.00
Sales Tax $0.00
Total $6,300.00
Payments/Credits -$2.100.00
Balance Due $4,200.00
Phone# Fax# E-mail Web Site
78I-592-9747 781-592-9746 ebwindow@msn.com www.ebwindow.com
Lesley
Management
March 29, 2016
Re: Lafayette Street Condominium Trust,
323 Lafayette Street
Unit 2
Salem, MA 01970
To Whom It May Concern,
Please allow this letter to confirm Lesley Management, Inc., agent for Lafayette
Street Condominium Trust, is aware and approves the window replacement of
Anthony D'Amico, 323 Lafayette Street, Unit 2, Salem, MA 01970.
Please do not hesitate to contact our office with any questions.
Sincerely,
ELgab, t Lou.
Elizabeth Louf
P.O. Box 946 Marblehead, Massachusetts 01945
Telephone (781)639-0534 Facsimile (978)374-4852
Lesleymanagement@comcast.net
CITY OF S�Uxam, N'WSACHUSETTS
BUILDING DEPARimEENT
• 130 WASHINGTON STREET,3"FLOOR
TEL (978)74S-9595
FAX(978)740-9W
KISiBERLEY DRISCOLL
MAYOR THOA4AS ST.FtERRB DIRECTOR OF PUBLIC PROPERTY/BI:mowd cow%assIoNEA
workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant information Please Print Le ibi
Name(Busims&ofganintioNtnLiividuul):
Address: '� o I A ).P AJTLA-/I,� jj:�U KIA-L-
City/State/zip; Phone#:
Are you an employer?Check the appropriate box. Type of project(required):
I.P1 am a employer with(— 4. 0 1 am a general contractorand 1 6. ❑New construction
eiployem(full and/or part-time)." have hired the sub-contractors
2.0 I am sole proprietor or partner- listed on the attached sheet 7• ❑Remodeling
ship and have no employees These sub-contractors have g. 0 Demolition
working for me in any capacity, workers'comp.insurance. 9. 0 Building addition
[No workers'comp. insurance 5. 0 We are a corporation and its
required.] officers have exercised their 10.0 Electrical repairs or additions
3.0 1 am a homeowner doing all work right of exemption per MGL I1.❑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' 13.0 Other
comp. insurance required:)
;Any applicant that C11=11a box r 1 most also fin out the section below showing their workers'wmpensation policy inturmadon:
r I h meowners who submit this affidavit indicating they are doing all work and then hire outside contractor,must submit a new.arridovit indicating such
=t:�ntraYon that check this box must attached an additional sheet showing thu woe of dhe aE commnora and their warkpe'comp.policy information,
t am as employer that is providing workers'compensation htsarance for my employees. Below is the policy and Msite
information:
Insurance Company Name:
Policy ii or Self-:ins.Lic.#: �. )(a.. (Q y� ,S� Expiration bate: I
13)
Job Site Address:3,3a> R-- i alir 'e-iL— ��_City/State/Zip
Attach copy of the workers'compensa on 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 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. Be advised that a copy of this statement may be forwarded to the Office of
investigations of the DIA for insurance,coverage'veritication.
i do hereby rerlif�r the pains and Ponahles of perfwythat the information provided above is true and correct:
Po ,Y• � rCl
Official use only. Do.not write in this area,to be compkiedby city or town afftriaL
City or Town: Permit/1.1cense#
Issuing,Authority(circle one):
1. Board of Health 2.Building':M-partment 3.City/town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
CITY OF SMENI, NNLkSSACHUSETTS
BUUMI tiG DEPARTM&NT
120 WAsHLVGTON STREET, YA FLOOR
TEL. (978) 745-9595
FA..(978) 740-9846
KIJiBERI EY DRISCOLL
MAYORT'HO;titAs ST:PtERRs
DIRECTOR OF PUBLIC PROPERTY/BUMPING CONMMIONER
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:
601 4--y- JCL
(name of hauler)
The debris will be disposed of in
(name_of facility).
&ey 2� VV\ P,
(address of facility)
signature q petmlt am
dat
debriutT.dm
E.B.Window and Siding Co.
- IIIVOIC@
756 Western Ave
` :�..f v ¢a,xo- i
Rt 107 � Jry; ,Pats " 1 !Invoke#a€ m
Lynn MA 01905 =t
3/30/2016 52481
Bill To
Robert DiFazio
46.5 Essex st
Salem Ma 01907
` '`P D No ' b s ' Ye!'ITIS is' i Due Date "s_ila nm �Account#, ,;, = Project„i
3/30/2016
a
:.Sihdy i '{ tY WJ 6 .t , y 2NL '-,+ x v 1Rate"
,i.. v�, �' (-18SCf1 tlolt ,a` 1 .. °' , p€ '" i1 RatB .„ + An10Ugt
as ii „-�'..'. '�cn p. � k` ...5. �.�xt' ? .k.�. Qty a i a Ip
Install Fusion windows by Alside 0.00 MOT
Cover windows, rakes and fascia with custom bent 0.00 O.00T
aluminum
Install siding per Alside spec 0.00 O.00T
Install matching gable and dryer vents and other 0.00 MOT
accessories
Dispose of all job debris 0.00 O.00T
Alside products feature lifetime warranty! 0.00 MOT
acceptance of proposal 0.00 O.00T
authorized signature
deposit 1 a,1Jt7
balance on completion aQ L�0O
Sales Tax 6.25% 0.00
Thank you for your business. Total $32,900.00
Payments/Credits -$12,900.00
Balance Due $20,000.00
Phone# Fax# E-mail Web Site
781-592-9747 781-592-9746 ebwindowomsn.com www.ebwindow.com