330 LAFAYETTE ST - BUILDING INSPECTION The Commonwealth of Massachusetts
o � I
Department of Public Safety
\Iassac husetts Sick Building Code(7S0C\IR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit dumber: "-- _-- Date Applied: - -- Building Official: —_--_--"--.,—_
SECTION 1:LOCATION(Please indicate Block Nand Lot p fur locations for which a street address is not available)
No. andStrect City /Town Zip Cute Name of Building(if applicable)
SECFION 2:PROPOSED WORK _
Edition ul MA State Code used If Now Cunslruilion,hock here D or dteck all that apply in the two rows below
Ixisting Building ❑ Repair❑ Alteration ❑ AJJit ion❑ Demolition ❑ (please fill out and submit Appendix 1)
Change of Use ❑' 1 Change of Occupancy ❑ Other,,lfa'Specify: P*^__l\ A. De,
Are building plans and/ur amslruetion documents being supplied as part of this permit application? Yes ❑ No
Is an Independvin Structural Engmecrin, Peer Review rysryired? Yes ❑ No ❑
Brief Description of Pruposcd Work:_ tlN PAre_< i4 &
SECTION 3:COMPLETE TFIIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here Ban Existing Building Investigation and Evaluation is enclosed(See 780 CNIR 34) ❑
Existing Use Grmp(s): . Proposed Use Grrmp(s):
SECTION 4: BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Fluor(sit. ft.) 3
1-utnl:\era(sq. ft.),md Total height(ft.)
SECTION 5: USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4 D A-5❑ B: Business ❑ F.: Educational ❑
I: Pactm F-1 ❑ F2❑ FL• kli h Flazard 1-1-1 ❑ H-2❑ FI-t ❑ 11-4❑ 11-5❑
I: Institutional I-I ❑ 1-2❑ 1-3❑ 14❑ iVl: Mercantile C_ R. Residential R-10 It 29 R-3❑ R-4❑
S: Storage 5-I ❑ S-2❑ U: Utility❑ Special Use D and please describe below:
Special Use
SECTION 6:CONSTRUCTION TYPE (Check as a licable)
LA IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ I VA VII ❑
S ECrION 7: SITE INFORJIA'IION(refer to 780CM11 111.0 for details on each item)
Water Supply: Flood Lone Information: Sewage Disposal: 'french Permit- DCbrfs Removal:
Public ❑ Check if outside hood Zone❑ Indicate municipal ❑ A trench Will not be Lironsvd Disposal Site❑
rv1(uircd ❑or Ir mli or specify:..____. ._.
I'riv.mu❑ ur indcnlily Zone: or on site cynlcm D permit is cnclosid ❑
Railroad right-of-Way: Hazards to it Nal'igatiun: \i + F.i., . . :
\aor Applaablr❑ Is Sl nlctum within airport,tl,pn�ach orva.' Is lhvir rre iew cooiplrlad'
Of con,ent to Budd en,lowd ❑ 1 cs ❑ nr.No❑ )cs❑ \'o ❑
ShC7IUN 8: CON 7liN'F OF CF:R FIFICA I F OP OCCUPANCY
FJi li,m of C:odo: -" _.. L\r Grtip(s): _ I\i+vol Conslru,lion: 0,c up.mt Load l,vr l ool .
Po, l,uiWint{,ontain.m Sprinkler S>tvm.' i.d Slipulatinns:
Ma, -Fo
�_OrlyrolC-71O�
SECTION 9: PRU19[I('IY OWNI:I( AUIIK)I(IZAIION
Name, nl Addrss of Pruprrh'Om ref
:r
Name(Print) No. and Street City/Town -Lip
Property Owner Contact information: ``ot
I'ille telephone No. (business) Telephone No. (cell) a-mail address
If applicable, the property owner hereby authorizes
------ 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 a p tlication.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
1f build ill g is less than)5.0011 cu.ft.of endosed space and/or not tinder Constriction Control then check here O and skip&•ctiuu 10.1)
10.1 Registered Professional Responsible for Construction Control
Name(Registrant) - Telephone No. c-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor l
PP-0 — raz(^-N/-Cc [07�}1/C1C :u AFL /C
Company Name GS �9
(�f1`�One J�err�(7�
SName of Person Responsible for Construction I� License No. and Type if Applicable
2l SeM1r� I� )�RAr.,rt ! At eim
Street Address City/Town /I'' State Zip
-_ In ,/ e
�! Dsg$ l�1i K� Pa �D2Mnuc(i & SSMR•7 Gory
Telephone No. business Telephone No. cell a-utail address
SECTION 11:Set n:r.i I,",t t IMI'l Nsn flx t,.I.va n:.�.`ev x 111�,',x'I I M.G.L.e.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 affialavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this h lication? Yes O No O
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs: (Labor
and Materials) Total Construction Cost(from Item 6) -S_
I. Building 5 )3 1 ZS Building Permit Fin-Total Construction Cost x_(Insert here
'_. Electrical 5 appropriate municipal factor)-S
1. Plumbing $
4. :Mechanicol (HVAC) 5 Note: \lininuun fee=.5 _(con Lwt municipality)
3. Mechanical Other) 5
Fndusc rh.v�k payable to
n. Total cost 5 (amttact numicipality)and wr,ite check number here
SECTION 13: GNA"rURE OF BUILDING PERMIT APP' LICANT
ISy enh•ring my nantc below. I hcrcbv a0est der the gins and penallics of perjury I11.4 all of the infonn,ilion contained in this
application is true and acrurale to the be my kn sledge and underst.umling. /
-- ---- -- - ---. ---- ..._..-- J tv-A/
I base print and .ign itai tat I"i e telephone No. Date
tilnrl ddR•s5 Cily/ f�nvn State .- --Zip )�
Municipal Inspector to fill out this svctiun upon application approval: _ _ '� __.____ _--_
ne Dale-
13
/3 pctz
� 30
1
<: CITY OF SM.EM, %L1SSACHUSE'ITS
I Bu ILDING DEPAwFMFNT
120 WASHLNGTON STREET, Ya FLOOR
TEL 978) 715-9595
FAX(978) 740.9846
jNtB RI EY DRISCOLL THosL�sST.PtEaxa
L�Yoa
DIRECTOR OF PUBLIC PROPERLY/BI:ttDIVO C0N61I5SIUNER
Workers' Compensatlon Insurance AtTid•rv(t: Bu(Iders/Contructurr/Electr(c(ans/Plumbers
koolleant informatloe Please Print Leeibiv
V(Illte llimitte+.o UrWlnuali,ln,IndiviJu•JG 1 4,d YTXzMA✓"� GONS *'�'l''t/� RCN
Address: iL- j 2�
City/Smtc/Zip: DO-1% U U+ Mk 0111L Phund -7 76 ir - <*
Are you in employer!Check III#appropriate box- 'type of prnJeet(required):
1./y��y I at"a employer with 4, 0 I am s general contractor and 1 6. ❑Now construction
( mnpioyces(fall and/or part-lima).• have hired the sub-conlrsctors
2. 1 am a sale proprietor or partner- listed on the attached.+hest. t 7, ❑Remodeling
ship and have no employees These sub-contractors hevo V. ❑Demolition
working for me in any capacity. workers'camp,insurance. 9, 0 Building addition
(No workers'.comp.insurance 5. 0 We are a corporation and itt
required.) officers have exercised their 10.❑ Electrical rtpsirs or additions
J,❑ 1 am a homeowner doing all work right of exemption per MGL I I.0 Plumbing repairs or additions
myself. (,No workers'Gump. c. 152, §1(4),and we have no 12.0 Roof repairs
insurance required.) I employees. (No workers' 12.❑Other
comp.insurance required.)
•.vuy uppaum Jar ahveka but el mul.taw 1111 out Ihr+aclluo below.hewing their waken'campvnudun pu0,.y inngrmmlen.
'1 bvnvuwnve wha,uhmif Nor rtrlAnvit Indiearina ihty an doing ell writ and Ihaa him uu11iJe eamnetor,moot tohrnll a new a0ldavi1 indicating.wh.
$'.mlc,ewn Thal cheek this hour mwl aoaahod un addiduevd Awl showing the numa o/the rub.curomton and Ihalr workee',amp.pulley Infomoeaam.
/ran an employer that it pruvidhrx lvorkers'cumprusadon htraranee far my employers Below/s the polfey and job site
lufonrrudon. _/
Insurance Company Name: C ZNSuR eOF- AN'
Policy 4 ur Self-ins. Lic. 4:716i ege/1/ 4Z 5'7_ Expiration Dote:
Job Site Address: 10?--,o L�tAyeY*e -S-l" /•City/state/2ip: :54,H EL ^ `A Q 1 T 7v
.Vlach a eopy of the workers'compensation policy declaration page(showing the policy number and expiration data).
Ki lures to wcuru cuverage as required under.Ssction 25A at•bfGL c. 152 can lead to the imposition of criminal penalties of a
rir.c up to 51,500.Uo and/or one-year imprisonment.,as well as civil penalties in the farm of o STOP WORK ORDER and a lino
of up to SIAM a Jay against the violator. Ile advised that i copy of this..+latement may ber furwardcd 1a ilia Office of
I,Ivrslig,lliuns,Il'Ihe D I:arinsuranca covcrags veniicaliun.
l du herrby r y ugder the puinr alga penaltlrr�r/perjury thus the infur,nudmr provide)a uve iv trur and carrect
r i pp /�j p ILL
U/liciul nee only, Oa nor wife in this area, to be cuugplered by city or/own ,jjlriad
City nr fawn: __ I'crmitiLlccri
1„uing.\ul hurily (circle one): _—
I. Ilo.lyd of 1N1114 1 Iluildin-Ucparlment 1. ('ityi form Clark J. Electric It hl,pector 5. Phlmhint; Inopecror
f,. I111er
Cnn1.Ic1 P.r{nil: Phone d:
CITY OF s,V Em, AkSSACHUSETTS
JLLWLNG 1]eP.,xnLLN-r
I '0 W-UnNGTON Srxl2r, )'O FZ.00II
CEL k978) 745-9591
K1113FRLAY OMWOLL FAX(974) 1 40-984d
NWOA f amUST.PMUA
01MUTC11 Of PC SLiC PROPlItTY/eC QA1NG caumISdION Eft
Construction Debris Disposal At'tidavit
(required for sU demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 190 C,�iR section 111.1
Oebris, and the provisions of MOL c 40, 3 54;
_.. Building Permit-a is issued with the condition that the debris resulting from
ibis work shall 3 I JOA. disposed sposed of in s properly licensed waste disposal facility as defined by NIGL c
Ill,
�The debris will be transported by:
(name 01'haul�r)
The debris will be disposed of in :
(ram•of fauduy) '-
ddra! of fivibly)
ln�Nra afpermit rpphcint
�, t
Lafayette Condo Association
330 Lafayette Street
Salem, Ma. 01970
Pro-Formance Construction
21 Spring Road
Dracut, Ma. 01826.
Re: Roof repair to be done at 330 Lafayette Street
I,Jose Bisbe, Co Owner and President of 330 Lafayette Condo Association,authorizes Pro-Formance
Construction Inc.to do repairs on our 330 Lafayette Street property in accordance with association by-
laws. Y P p Y Y
laws. Said repairs constitute the repair of our front porch roof and support, main entrance stairs and
pertinent facade.
Regards,
Jose Bisbe
President, 330 Lafayette Condo Association
Construction Contract
This agreement is made by Pro-Formance Construction Inc (Contractor) and jose bisbe (330
lafayette st condos) (Owner) on the date written beside our signatures.
Contractor
Pro-Formance Construction Inc
21 spring rd
Dracut, Massachusetts 01826
Daytime Phone Number: 978-761-0588
Evening Phone Number: 978-761-0588
Fax Number: 978-975-9971
Email Address: mikeproformance@gmail.com
Mailing Address:
21 spring rd
dracut, Massachusetts 01826
Federal Employer ID or Social Security Number: 45-2671223
Massachusetts Home Improvement Contractor Registration Number: 161179
Registration expires on 4/9/2012.
Pro-Formance Construction Inc is incorporated in the state of Massachusetts.
Pro-Formance Construction Inc will be referred to as Pro-Formance construction Inc throughout this
agreement.
Owner
jose bisbe(330 lafayette st condos)
330 lafayette st
Salem,Massachusetts 01970
jose bisbe(330 lafayette st condos)will be referred to as Owner throughout this agreement.
The Construction Site
3301afayette st
salem,Massachusetts 01970
I. Project Description
A. For a price identified below,Pro-Formance construction Inc agrees to complete for Owner the
Work identified in this agreement as the deck repair and new roof.
B. The deck repair and new roof is described as follows:
Install new .060 rubber roof. Remove and reinstall railings. Repair or replace as needed. Repair
porch ceiling as needed. Replace deck boards and frame as needed and repaint all areas that where
replaced. Do a complete inspection of deck and roof anything not included in this contract that needs
to be addressed will be brought up to the condo board.
H. Contract Price
A. In addition to any other charges specified in this agreement, Owner agrees to pay Pro-
Formance construction Inc $13,125.00 for completing the Work described as the deck repair and
new roof.
Page 1
M. Scheduled Start of Construction
A. After we get the building permit
IV. Scheduled Completion of Construction
A. Work under this agreement will be Substantially Complete within 14 calendar days after the
date construction begins.
V. Cutting and Patching
A. . Pro-Formance construction Inc will ensure that cutting and patching required to make building
parts fit together properly is done by those skilled in the trade. Work completed by Pro-Formance
construction Inc will have the neatly finished appearance characteristic of professional grade
construction.
B. Pro-Formance construction Inc will ensure that alteration Work done on existing building
components does no damage either to the property of Owner or to Work done by others.
C. The color, texture and planes between existing and new materials might not match exactly. Pro-
Formance construction Inc will use due diligence to create the best match possible. Owner
acknowledges that patched surfaces may be detectable when construction is complete.
VI. Permits and Fees
A. In compliance with Massachusetts General Laws 142A, Section 2(a)(10), Pro-Formance
construction Inc has: (1) Provided Owner with a list of building permits required to complete this
Work, (2)Advised Owner that it's normally the obligation of a Contractor or Subcontractor to obtain
the required permits for their Work, and(3)Advised Owner that homeowners who secure permits for
Work on their own homes are excluded from the guaranty fund provisions which appear in
Massachusetts General Laws 142A, Section 5. Pro-Formance construction Inc accepts responsibility
for securing building permits for the deck repair and new roof.
Description of the permit:new roof
Name of the permit issuing authority: salem ma
B. Pro-Formance construction Inc will pay the building permit fee, Plan check fee, business
license fees for Pro-Formance construction Inc and Subcontractors, and charges levied by
government for testing, Inspection and Re-Inspection of the deck repair and new roof.
VII. Payment Plan
A. Owner will pay to Pro-Formance construction Inc the Contract Price in installments consisting
of an initial payment,progress payments, and a final payment on completion of the Work.
VM. Initial Payment
A. Upon execution of this agreement, Owner shall pay to Pro-Formance construction Inc
$4,375.00 as an advance on the Contract Price.
IX. Progress Payments
A. Schedule of Progress Payments
Page 2
1. Progress payments are due as each phase of the Work is completed.
I. Amount due when Job Phase 1 is complete: $4,375.00
Job Phase 1 is complete when roof is complete.
II. Amount due when Job Phase 2 is complete: $4,375.00
Job Phase 2 is complete when job is complete.
X. Final Payment
A. Pro-Formance construction Inc will submit an application for final payment to Owner when the
Work has been completed in compliance with the Contract Documents. If Owner agrees that Work
has been completed, payment is due Pro-Formance construction Inc for the entire unpaid balance of
the contract amount.
XI. Insurance
A. General Requirements
I. Pro-Formance construction Inc shall carry workers' compensation insurance and public liability
insurance as required by Law and regulation for the protection of Pro-Formance construction Inc and
Owner during progress of the Work.
Massachusetts Home Improvement Disclosures
Massachusetts General Laws 142A, Section 2(a)(8) requires that home improvement contractors and
subcontractors register with the Director of Home Improvement Contractor Registration. You may
inquire about contractor registration by writing to The Office of Consumer Affairs and Business
Regulation, Home Improvement Contractor Registration, 10 Park Plaza, Room 5170, Boston, MA
02116. (617) 973-8700.
You may cancel this agreement if it has been signed at a place other than the contractor's normal
place of business, provided you notify the contractor in writing at his/her main office or branch
office by ordinary mail posted, by telegram sent or by delivery,not later than midnight of the third
business day following the signing of this agreement. See the attached Federal Right of Rescission
form for an explanation of this right.
Massachusetts law grants lien rights to builders. Any construction contractor, subcontractor,
tradesman or material supplier who is not paid can record a lien on the property being improved. If
not discharged by payment, this mechanics' lien will become a security like a mortgage on the
property.
Massachusetts General Laws 142A, Section 2(a)(8) provides that, "No contract shall contain an
acceleration clause under which any part or all of the balance not yet due may be declared due and
payable because the holder deems himself to be insecure. However, where the contractor deems
himself to be insecure he may require as a prerequisite to continuing said work that the balance of
funds due under the contract, which are in the possession of the owner, shall be placed in a joint
escrow account requiring the signature of the contractor and owner for withdrawal."
Massachusetts General Laws 142A, Section 2(a)(8) requires that the property owner receive, at the
time of signing, a copy of the contract signed by both the contractor and the owner. No work shall
begin prior to the signing of the contract and transmittal to the owner of a copy of such contract.
Page 3
Massachusetts General Laws 142A, Section 2(a)(8) requires that this contract include a notice
disclosing all warranties and the rights of Owner under this agreement. Except as provided elsewhere
in this agreement, Pro-Formance construction Inc makes no express warranty. Owner waives,
renounces and disclaims all implied warranties of fitness for purpose, merchantability, habitability
and good construction.
Page 4
Signatures
The signatures that follow constitute confirmation by those signing that they have examined and
understand the Contract Documents and agree to be bound by the terms of these documents.
This contract is for immediate acceptance. Any delay in acceptance beyond 5/9/2012 will require
renegotiation of the terms of this agreement.
If this contract is not signed by Pro-Formance construction Inc at the time it is signed by Owner,
Pro-Formance construction Inc shall, within 15 days thereafter, either give Owner written notice of
rejection of the contract or sign the contract and supply owner with copy of the signed contract. The
notice of rejection or signed contract will be delivered to Owner either personally or by certified or
registered mail. In case of rejection, any payment made by Owner will be returned with the notice of
rejection.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!!
This agreement is entered into as of the date written below.
jose bisbe (330 lafayette st condos), Owner
(Signature) I (Date) SIGN
(P Name)
2 77
��3ignature) (( (Dat )
(Printed Name) 4AWAE-
Pro-Formance Construction Inc, Contractor
(Signature) (Date)
(Printed Name and Title)