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20 LARCHMONT RD - BUILDING INSPECTION (2) -14 — 2 The Commonwealth of Massachusetts INS7ap TICE Board of Building Regulations and Standards ALEM W Massachusetts State Building Code, 780 CMR Z01A(adplV Building Permit Application To Construct, Repair, Renovate Or Demolish One-or Two-Family Dwelling This Section For Official Use Only ' -- Building Permit Number. Date.Appliedtf' 3 Building 011icial(Pont Name). Signaturo � � J/Date V SECTION 1:SITE INFOR+IVIATION' 1.1 Property Adddrress:4P♦C ti Jyt o0 3 lLd 1.2 Assessors hlap Sr Parcel Numbers 1.I a Is this an acce ted street?yes a no Map Number Parcel Number z_ } 1.3 Zoning Information: I.4 Property Dimensions: lM^' 'Zoning District Proposed Use Lot Area(sq 11) Frontage(Il) 1.5 Building Setbacks(R) Front Yard Side Yams Rear Yard =0!ner'of Provided Required Provided Required Provided .O.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood ZoneT Municipal❑ On site disposal system ❑ — Check if es❑ SECTION2: PROPERTY OWNERSHIP!` d: M A rti M 0, i q fl � r��r Ks ll� � t7tinc(Print) City,Sta e,ZIP ? QID arck ?vl-yo- �� -76- $U - J060 No.and Street Telephone Email AJJruss SECTION 3: DESCRIPTION OF PROPOSED WORKS(check all thut apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s)Pd I Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify: Brief Description of Proposed Work-: I a ¢ ridkr*fA 0wj LEY U r 0C uc 71L L c ho+ ^ a SECTION 4:ESTIMATED CONSTRUCTION COSTS Itcm Estimated Costs: Official Use Only Labor and Materials 1. Building S I s 3 1. Building Permit Fee:S Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Costs(item 6)x multiplier x 3. Plumbing s 2�*,qther Fees: S d. Mechanical (HVAC) S List: 5. Mechanical (Fire S Total All Fees:S Suppression) 5 3d L - Cheek No. Check Amount: Cash Amount: 6.Total Project Cost: .s ❑Paid in Full Cl Outstanding Balance Due: Li SECTION 5: CONSTRUCTION SERVICES 5.1 Constructiotn Supervisor License(CSL) laCj-I��S �' L ' 1$� k 10 Ile 4 1 C rR t p License Number Expiration Date Name of CSL Holder List CSL'rype(see below) Q.o , btix aa Type - ', - � Description No. and Street h r{Q C.. 0 1 ID rJ'� U Unrestricted(Buildings u p to 35,000 cu. 11. R Restricted I&2 R tinily Dwelling Cityfrown,State,HIP M Mason RC Roofina Covering WS Window and Siding SF Solid Fuel Burning Appliances a ►6 - 3 -7 6 - 5a V 1 I Insulation 'rcle hone Email address D Demolition 5.2 Registered Home Improvement Contractor(NIC) / 6 0R3 )(o- rod' 1Z ovi a 16 C r a HIC Registration Number Expiration Date HIC Cupmp.my N,me or HICSRIstrant Name • o �OJ� No. a d Street^ 1_ mq �'` , 7p y 7y Email address Ci /Town,State 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 Is§uance of the building permit. Signed Affidavit Attached? Yes ..........❑ No........... ❑ SECTION 7a:OWNER AUTHORIZATION.TO BE COMPLETED WHEN. OWNER'S AGENT OR CONTRACTIORRAPPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize Par C r C l� t9 act on my behalf,in all matters relative to work authorized by this building permit application. 9E FConkrer f ) t " /9 I� Print Owner's Nmne(Electronic Signature) Date 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 in this application is true andd... curate to the best of my knowledge and understanding. `IZonaId Cr4 ;CJ ,,../l� Print Owner's or Authorized gent' Name(Electronic Signature) Date 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 got have access to the arbitration program or Guaranty Fund under 1I.G.L.c. I42A.Other important information on the HIC Program can be found at ww.v mass.eov.'oca Information on the Construction Supervisor License can be found at www.moss.��ov-'dys . 2. When substantial work is planned,provide the information below: 'total floor area(sq. ft.) ' (including garage, finished basetnent/altics,decks or porch) Gross living area(sq. 11.) Habitable room count Number of f 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. "foul Project Square Footayc'may be substituted fir"Fotal Project Cost' Q-1-Y OF &U-EM� lL-1SS:ICHL;SETTS T BuiL wc;DEPARTMEINT 120 MiisHLNGTON STREET, 3sa FLOOR TEL (978) 745-9595 FAX(978) 740-9846 KIMBERLEY DRISCOL r;y1:,�YOR THOhtAS ST.PIERRS DIRECTOR OF PUBLIC PROPERTY/BL:mDr\lG ComMISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Informatints / Please Print Leeibly Name IIlusincss,Orgysiratinrv'Individual): �Orle� d- t�f4J 6111Q CrGr �tAd Ct,� Address: f] - Q7'o� aA aZ City/State/Zip: 40.1+ ^ 'fib Mk Phone a Ib - 370 - A-,i ly Arc you an employer!Check the appropriate box: 'type of project(required): I. I am a employer with fy 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or pail-lime).• have hired the sub-cantractors 2.❑ Into a sole proprietor or partner. listed on the attached sheet = 7. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working ror me in any capacity. svmkers'comp. insurance. )• ❑ Building addition INo workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repuirs or additions myself.[,No workers' comp. c. 132, §1(4),and we have no 12.0 Roof repairs insurance required.] t cmptoyecs.[No workers' 13.❑ Other comp. insurance rmcquircd.J -Any applicaM dot ducks but 91 must alsu all out the section bclowshowing their workers'cumpewdon policy infinmmlon. - 'I h,meownes,rho submit this amcinvit indicating they am doing all work and then hire outside cantmetme must suhmil a nCw amdavit indicating such. $'numctnra thol chak this bus mtut attachd an atldidunaf chol showing the name of the suboorancture and their workers'comp.pulley infunnmion. I unr can surpluyer drat it pruvlJing Ivorksrs'rumpeusadon lnruruueejor my anp/uyers. ffeluw Ix the policy and job slid iufiinsrulinn. ,�.1. (� Insurance Company Name: / ra��,_ _r_5--1 rV r'+ C0soak � • Co. 7 v �U 1;3 s 8 / Policy it or Self-ins. Liu. 0: _ qqy a Expiration Dole: `j 'r �`5 Job Site Address: 2 U � a 0C.h M on ¢ A ! City/Stale/Zip: S"t f C,M n A A Itacb a copy of the workers'cam palliation 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 ofa line up to S1,500.00 and/or one-year imprisammcnt,as well as civil penalties in the form of a STOP WORK ORDER and a line of up to S250.00 a day against the viotamr. I)e advised that a copy of this stalement may Iw rurwarded to Ilse Office or In vestigotions ul'die MA for insurance coverage verification. /du hereby verdjy under tliee pains and pr+tohicv ujperjury that the/njarmudon provided above is true a+rd c•orrect`� O%/iriul use unly. 170 not+vrire its Ilds area, to be completed by city of larva a/Jlviul City nr Town: Pcimit/I.lcenseN__. Issuing Aulhurily (circle one): 1. liourd cal IleAth 2. Building; 0upartmcut I.ciiyfrimn acrk J. Electrical inspector 5. Plumbing Inspeetur 6. Other i Contact Perms: _ Phone 1: _ I Massachusetts - ,Xpartmt'.�m of PI.ibiic Satr-4 Board of Building Requicittons and Standards Construction Superviukr License CS-092929 RONALD G CRAW PO Box 292 HUN-nNGTON NA 07/2012015 Office of Consumer Affairs&Business Regutatiou License or registration valid for individul use only before the expiration date. If found return to: a�Y�Ld IJOME IMPROVEMENT CONTRACTOR ellistraton: 161323 Type: Office of Consumer Affairs and Business Regulation Expiration: 1011412016 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 CRAIG WINDOWS RONALD CRAIG 9 PARK RIDGE DR. HUNTINGTON,MA 01050 Undersecretary r Permit Services 401 246 2868 p.6 Next Step Living, Inca CT HIC06M(Pli-MAOCABR 0162111•Rl Canhactcr Reg.07185 SPECIFICATION SHEET hate of contract: Wednesday,August 27,2014 Custemer(s)Name(,): Molly Kelley Gutemer(q Street Address: 20 Larehmont Rd City: Salem State: MA 21p: 01970-2438 Cu-toner(s)Ilame Plmoa of: (978)880-3080 Custemer(s)Etnbik Phone g: Penoll(s)Required: Yes Pcmdt Nundo"(s): Cit1'rro n.1)I...dng Permins): Scheduled Inspection Date: The Onuumer(s)listed above hereby joisnly and severally agrees to ptnchose the goods and/or scevieca listed below,in accordance wilh the prices and tttms described on this Specification Sheet and the froze and the reverse of the accompanying HOME IMPROVEMENT AGREEMENT,of which this Specifieatias Sheet is a part. Oracrlpt(ou of the Project and Desc-tlpNom of the Significant Materials to Be Used:(1)delivery of windows equipment,(2)complete iawallation to manufacturer's gsecilicalions,and(3)cleanup after installation Scope of Work:NSL shall perfomt all work and supply ell nalcrials tl s ibed on the Work Scope attached to this Agreement and will be responsible for any and all equipment's,supplies and a ppurlenmst items as may be required and necessary to perfurot all wank described on the Work Scope and any performance reasonably inferable from it,including clean-up associated with NSVS work- Cost General nsderials and labor greater than S5DOf HEAT Loan Eligible Window S 15,362 Amount To Be Pinarced S Amount 25,3G2 It N ugra-ed and understood by and belwcen the parties that this Specifieatian Sheet,nlong with the HOME IMPROVEMENT.AGREEMENT, constitute,the entireundersteading between the parties,and there are no verbal understandings changing any of the lerms."is Spec ifiealion Sheet may not be changed or its tc,',na modified or varied in any way unless such changes are in writing and signed by both Cmamnerts)and Contractor.Cuslumer(s)hereby acknowledges that Customers)has read Ibis Spetifrealion Sheet. NEXT STEP LIVING, INC. By: Pete Ladd 11, A 8/27/2014 Print Name Ling raluie - Date CUSTOMER(S) 6A, Molly Kelley v 8/27l2014 Print Name Signature Date Print N ame Signature Date ©BLLP2013.N SL.LTMARI 1 Permit Services 401 2462868 p.5 Next Step Living, Inca CT HI1.0929266•MA DCASR 11162112 Ri Contractor Reg.23718S IMPROVEMENTHOME Date of Contract: Wednesday,August 27,2014 Cuitme er(s)Name(s): Molly Kelley Casmecr(s)Strvet Address: 20 Larehmont Rd City: Salem Slate: MA Zip:01970-2438 Cuslotocr(s)Homc/Toue R: (9791880-3080 Custemer(si Motile Phone N: Permit(s)11"nired: e3 PerrNt Numher(s): City/County Issuing Permu(s): Scheduled Inspection Date: Custoncr(s)jointly and severally agrees to purchase the products amidIc rsenices of Next Step Living.hip C'Contmnor")in accordmnce with the items and conditions described on the front and reverse of this Home Improvement Agreement("Agrecrncnl`)and the mixlied specification slmeel(s). Customer(s)hereby agrees to sign a completion uxtifrcuu;after Contractor has comple Ld all Durk under this Agnxmeni. E5T'IaIATED STARTINGDATE: Wednesday,Septeniber10,2014 EsTirzATEDCONIJ-LETION➢ATE:Wednesday,September 24,2014 PAYNIFNTMET1100.(select one option) PURCHASE PRICE: $ 25,362 BCash BCredit Card DOWN PAYh1ENl': $ 21536 Check R Financing B.AI..ANCE DUE ONSUHSTANTIALCOMPLETION: $ 22,826 Cnstumcr(s)acknowledges receipt of"Renovate Rigel: Important Lead Hazard Infomsation for Families,Child Care Providers and schools". Custpmcr(s)rceeivcdthis pamphlet on the dale ofthis Agreement,before commencement of work. (Customcr'sbtisialsP5K (Akode islandCnszoners Only)Cuslumer(s)acknowledges receipt ofraiuired Contractors'Registmtimn and Licensing Board consumer eluoation materials. (Customer's Initials_) fRkade Island Customers Only)Not(ec to buy":(1)Do not sign this Agreement if any of the spaces Intended for Ilse agreed terms to the extent of then available information are left blank.(2)You are entitled to a copy of this Agreement at(lie time you sign it.(3)You may at.anytime pay off the fall unpaid bulance due under this Agreement,and in so doing you maybe entitled Io receive a partial rebate of the finance and Insurance charges.(4)Mir seller has no right In unl infully enter your premises or commit any breach of the peace to repossess goods purchased under this Agrenrcem.(5)You may caps(this Agreement fi t1 has not been sighed at the main office or a branch office or the seller,provided you notify the seller at Iris err her main office or branch office shown in the Agreement by registered or cerflfsed small,which shall he posted nor later Than midnight of the third calendar day after the day on which the buyer signs the Agreement.excluding Sunday and any holiday on which regular mail deliveries are not made.See the accorninanying notice of cancellation farm for an explanation orbuyer's rights. Customer(&)agrees and understands that this Agreement consNtnles the entire understanding between she parties,and that there are no verbal understandings changing any of the terms of this Agreement Custonei acknowledges that Customer(s)(1)has read Ibis Agreement, understands the terms of this Agreement,and lint received a completed,signed,and dated copy of this Agree tut,bacludbeg the Iwo accompanying Notices of Cancellation,on the date first written shove and(2)was oratly informed of Customer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IFTHERE ARE ANY BLINK SPACES. / NEXT STEP LIVING, INC. By: Pete Ladd 81270014 Print Name Lic.N ' Ifina re Date CUSTODIER(S) P�, "l Molly Kelley % I Q 8127J2014 Print Name Signature Date Print Name Signature Date YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. EIBLLP2013.NSL.CTMARI CITY OF SALEM, MASSACHUSE TI S BUILDING DEPARTMENT .-r Al ` 120WASHINGTONSTREET,3mFLOOR TEL. (978)745-9595 F KIMBERLEY DRISCOLI. FAX(978)740-9846 MAYOR THomAs ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BUILDING 00MESSIONER 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 c40, 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 deposit 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: 0u R p4µ rra4 i- Al' S ; dt (name of facility) (address of facility) Signature of applicant / / - Zu — tv Date ENE RGYSTarc •ulanfie, , In All 50�Std'fe's , ECOVIEW OF GREATER R� BOSTON kR 477 DOUBLE HUNG Vinyl frame, TRIPLE GLAZED Naknal F60effir n Low E Coating 0.018(2); 0.148 Rating Coura l4' Argon/air filled WB1776-A01 EWGK-49-00069-00001 ENERGY PERFORMANCE RATINGS U-Factor(U.S/1-P) Solar Heat Gain Coefficient owls Qmj 7 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance I Condensation Resistance ®.39 61 Manufacturer stipulate,that these ratings conform to applicable NFRC pracedures for detwmining whole product performance. NFRC ailing are determined fora fixed set of envlre mental conditions and a specific product size.Consult manufacturers literature for other product performance intimation. wwww.nfrc.or r