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8 LAWRENCE ST - BUILDING INSPECTION t y The Commonwealth of Massachusetts CITY OF J Board of Building Regulations and Standards SALEM 1�1 Massachusetts State Building Code, 780 CMR Revised Mar 2011 Building Permit Application To Construct,Repair,Renovate Or Demolish a I One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Da .Applied: Building Official(Print Name) tignatftm .. Da e SECTION 1:SITE INFORMATION 1.1 ProperVddr�. �1_� 1.2 Assessors Map&Parcel Numbers Lla is this an accepted street?yyes_x_ 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❑ y SECTION 2: PROPERTY OWNERSHIP' 2.1 O xg 'of RL3 r�G�lZ%/ I ALe VW MIT Name nn[) C Stat ,ZIP � C7�� 3 3 No.and Street Te phone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply) New Construction ❑ Existing Building Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_. Other ❑ Specify: Brief Description of Proposed Work : .� i ca SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials L Building $ 1. Building Permit Fee:$ Indicate how fee is detenitined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6).x multiplier x 3.Plumbing $ 2. Other Fees: $ . 4.Mechanical (BVAC) $ List: i o 6 y 5.Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ ❑paid in Full ❑Outstanding Balance Due: V)Aaa SECTION 5: CONSTRUCTIONS SERVICES 5.1 Construction Supervisor License(CSL) l .r�O �AD /� ?�9 �/ p License Number L� Expiration Date Name o L Holder Type( ) -. n/� ^ '-/ `- , List CSL T e see below // /`�9" W Description No.and Street - ' �dNr l e.e- ,-, „/ ©/9� U Unrestricted(Buildings2am u el ing cu.ft. �/ t /� R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding c SF Solid Fuel Burning Appliances 0 70 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) /6 ?S-6 .7 �O f HIC Registration Number Ex tw ate HIC Comp or or HIC egistram Name 27 S Ut�`�In1 /Of¢ee- �_n A4(& (// r J Email address City/Town, [St�ate,,ZIP L ere hone TION 6t WORKERS'COMPENSATION:INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) ompensation Insurance affidavit must be completed and submitted with this application. Failure to provide will result in the denial of the Issuance of the building permit. ffidavit Attached? Yes ..........� No...........❑ SECTION.7a:OWNER AUTHORIZATION TO'BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR.APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize /mil/(d✓� &s4,AA,1 &92!6�G to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name be76i I hereby attest under the pains and penalties of perjury that all of the information contained in this applic s a and accurate to the best of my knowledge and understanding. Print Owner's 7Kadioriltgya ecc Signature) , ate 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.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (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" u u.ua.cua< ao:an me ntoaaooaoa rrs�t:u I©O02/002 HIC#167567 OL YMPIC EIN#27-3470462 Roofing—Siding-Painting Job#: Office: 978-887-5870 239 Boston Street—Toosfield.MA 01983 Fax: 978-887-5875 Shane McCarthy 14 Old Colony Dr. Wakefield MA 01880 (978)335-3655 Email:shanomecarthy@yahoo.com Job Location: 8 Lawrence Street—Salem,MA April 3,2012 Revised: May 21,2012 Dear Shane, Revised: May 24,2012 The following estimate is for the roof installation for the property located at the above address.The following paragraphs describe the work that will be performed. Installation Procedure • Strip existing roof on the entire house down to the roof deck • Price does not include right side deck roof or rear basement entrance roof • Price does include roof over front porch • Install an 8 inch white drip edge on all leading edges(rakes&fascia) • Install 6 feet of lee&water shield on all leading edges on upper roofs • Install feet of ice&water shield on mansard roofs • Transitional wells are optional and,incur an additional cost for the siding repair • Install new vent pipe flanges • Replace any rotted or damaged decking(we allow 32SF Q no charge,$70.00/sheet thereafter) • Replace any rotted or damaged ledger board(we allow 20ft.at no charge,S4.00/ft.thereafter) • Install 15 pound felt paper on all areas that is not covered by ice&water shield • Install new GAF Timberline Lifetime High Definition shingles or CertainTeed Architectural shingles • Install new ridge vent system • Install(5)Velux Fixed Skylights with Aluminum Flashing Kits Included Additional Soecrricatlons • Homeowner to choose color of shingles COLOR: • Our dumpsters are sent to a recycling facility;therefore no additional trash may be placed in them. The transfer station will charge us a fee for additional trash which will be passed on to the homeowner. • Chimney re-pointing and re-leading is not part of the roofing contract and will be quoted separately. • A new roof does not guarantee that them will be no ice dams • Ice dams are caused by poor attic insulation and not enough ventilation • We are not responsible for any of the cracks that may arise in any wails or ceilings • Please cover all your floors in your attic to protect from dust and debris • We will remove all of the job related debris from property and dispose in designated waste facility,including from the gutters • Permit costs vary from town to town and are not included in this bid • GAF Weatherstopper 50 year warranty applies to this property as it is residential property Initial the oodons you are ehoosinf below: Cost for Labor&Material for Roof. S5,895.00 �/ Cost to Upgrade Fell Paper to Deck Armor: s 195.00z Cost to Upgrade to Hand Nailing Entire Roof: S 165.00 Cost for Labor&Material to Re-lead&Re-flash Chimney: S 295.00::z Cost for Labor&Material to Install(4) 44 x 46 inch Velux Fixed Skylights: S 895.00 ea. Cost for Labor&Material to Install(1) 21 x 38 inch Velux Fixed Skylights: S 595.00 ea. ,Cost for Labor&Material to Remove Skylight and Plywood Over: S 95.00 ea. Cost for GAR-Elk Weather Stopper System Plus Ltd.Warranty: $ 250.00 �— Payment Terms: 1/3 deposit due upon signing contract: S 1/3 payment due upon start of job: $ 1/3 payment due upon completion of job: $ Total Amount Agreed To Be Paid: S Please sign and date all pages. Rendt to: Turnpike General Contracting Inc-P.O.Box 365,Tops(leld MA 01983 The following schedule will be adhered to unless circumstances beyond Tumpike's control arise: Work Scheduled to Begin: Job expected to be completed within 60 days of actual start date. Warrant • - pike Gen Contracti g Inc.guarantees all work performed for a period of two(2)years, if any problems occur we will cover the co of bor and serial to co M the problem and meet the customer's satisfaction. ich Orm rs, 'eelM er Shane McCarthy umpike General Co acti Inc. Date Homeowner Date TURNP-3 OP ID:CA a►�ofzo CERTIFICATE OF LIABILITY INSURANCE DAT 01/2DIYYYYI 1125N2 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: It the certificate holder Is an ADDITIONAL INSURED, the poliry(fes) 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 endorsements. PRODUCER 978.462-4434 CONTACT Chase&Lunt LLC NAME: P O Box 590 978.465-6204 PHONE 7730r- 47 State Street - E-MAIL (Al Na, Newburypon,MA 01950 ADDRESS: Marcos W.Shaffer INSURER 5 AFFORDING COVERAGE NAICF INSURERA:Scottsdale Insurance Co. INSURED Turnpike General Contracting INSURERB:COmmerce Insurance Company 239 Boston Street TGpsfield,MA 01983 INSURERC:Peerless Insurance Co. INSURER D:Hanover Insurance Company 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. LTR TYPE OF INSURANCEbill&VOL POLICY NUMBER MMm MM umTS GENERALLIABIUTY EACH OCCURRENCE $ ,,000,00 A X LOMMERCIALGENERALUABIUTY BCS0026080 10121111 10121/12 PREMISE Eao=v nw S 50,00 CLAIMS-MADE Fx-1 OCCUR MEO EXP(Any ore parson) S 5,00 PERSONALSADVINJURY S 1,000,00 GENERAIAGGREGATE S 2,000,00 GEN-L AGGREGATE UNIT APPLIES PER: PRODUCTS-COMPIOP AGO S 2,000,000 POLICY X LOC S AUTOMOBREUABILRY IEOMBINEEDn1SINGLEUMIT S 1,000,00 B ANY AUTO BDBRJM 1012011, 10/20112 BODILYINJURY(Permnon) S ALL OWNED SCHEOULED BODRY INJURY IPereraden0 S AUTOS AUr05 X HIREDAUTOS X ' SNMEO eO ElT $ S UMBRELLALIAB X OCCUR EACH OCCURRENCE S 6,000,000 A X ExcesSMB CLAIM'-MADE XLS0077698 10121111 10121112 AGGREGATE s 5.000,00 DELI I X 1 RETENTIONS 0 S WORKERS COMPENSATION WC 6TATU- 114 ANDEMPLOYERS'UABIUTY YIN ANY PROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT S . OFFICERIAIBMBER ERCLUDEM NIA (Mendaloryln NH) E.L DISEASE-EA EMPLOYE S If yea describe under DESCRIPTION OF OPERATIONS Chow E.L DISEASE-POLICY UMrr S C Inland Marine IM8883151 12101111 12/01112 Materials 250,00 D Commercial Crime 200939 01117112 O1117113 Limit 100,00 rDESCRmTON(u CPERATIONR I LOCATIONS tYEHICIE9(Attach ACORO 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I� y O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Unrestricted-Buildings of any use group which 1IIIj Miaesachusetts - Department of Public Safety contain less than 35,000 cubic feet(991m)of Scowl or Suilciing Reg!dations and Standards enclosed space. Cun+uvcn„n super,i,ur License: CS-080145 GEORGE VASILIADES rt: 5 PITCAIRN WAY I IPSWICH MA 69125 ' Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. ` �-�++ — +, Expration For DPS Ucensing information visit: www.Mass.Gov/DPS cornn5issioner 1012612013 I fie gC5 ��Oe of Consumer Aff ' , and Business Regulation 10 Park Plaza Suite 5170 Un t Boston,=ontractor chusetts 02116 ove Home Impr Registration Registration: 167567 TYpe: Supplement Card TURNPIKE GENERAL CONTRA Y Expiration: ,1014/2012 w GEORGE VASILIADES a 239 BOSTON STREET BOX 365 TOPSFIELD, MA 01983 4 r Update Address and return card.Mark reason for change, DPscnt A e0d-0v0aa10121e El Address ❑ Renewal Employment Lost Card �'PovRm,o,+we�g�,/�aaaa/eveaCd Ofitte of Consumer Affairs&.Business Regulation License or registration valid for Individul use only OME IMPROV MENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Re Expire . 587 Typo: 10 Park Plaza-Suite 5170 EPlxa 1 Supplement Card Boston,MA 02116 TURNPIKE GE _ O 15ING INC. GEORGE VAsitL 239 BOSTON TOPSFIELD,MA Ot Undersecretary Not valid without signature ACORD. CERTIFICATE OF LIABILITY INSURANCE 01/2 52 01 2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATON 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:H the certificate holder is an ADDITIONAL INSURED,the policy0es)must be endorsed. D SUBROGATION IS WAIVED,subject to the lanes and conditions of the policy,certain policies may require and endorsement. A statement on this cerOficale does not canter rights to the certificate holder in lieu of such endoraaraml(s). PRODUCER CONTACT NAME: PHONE FAX CHASE&LLW LLC (AA No,Em): FAX (A/C,No): POB 590 EMAIL ADDRESS: PRODUCER NEWBURYPORT,MA 01950 CUSTOMER ID P. 77BPK INSURER(S)AFFORDING COVERAGE NAIC0 INSURED INSURER A: TRAVELERS DIRECT ASSIGN111FN1 INSURER B: TURNPEE GENERAL CONTRACTING INC INSURER C: INSURER D: 239 BOSTON STREET INSURER E: TOPSMFLD,MA 01983 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THN IS TO CERTIFY THATTHE POUCIES OF WSURANCE LISTED BELOW HAVE BEEN ISSUEDTOTHE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOMREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE 16GUEO OR MAY PERTADL THE INSURANCE AFFOROEU BYTHE POUCIES DESCRIBED HEREIN IS SUBJECTTO ALLTHE TERMS,EXCLUSIONS AND CONORIONB OF SUCH POUCIES. UNTTS SHOWN MAY HAVE BEEN REDUCED BY PAIOCLAWS. INSR ADDLSUBR POUCYEFFDATE POMYEXPDATE LTR TYPEOFINSURANCE HOUR WVD POUCYNUMSER (MLNDMYYYY) (MPADMYYYV) UNITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMSMADE OCCUR. PREMISES(Ea occurrence) MED EXP(Any arse pmsml) $ PERSONAL as ADV INJURY Si GENL AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SWGUE $ ANY AUTO LIMIT(En acddord) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Par aufderd) NON-OWNED AUTOS PROPERTY DAMAGE $ (Par aceldold) UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIM CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKER'S COMPENSATION AND. WCUAMCRYLIMITS Men EMPLOYERS LIABILITY YIN U11-4939P155.11 1012V2011 I O222012 E.L EACH ACCIDENT $ 1,000.000 ANY PROPCRITORIPARTNERIMCU11VE N E.L.DISEASE-EA EMPLOYEE $ 1,000.000 CFFICERUMEMBER EXCLUDED? (Menderoryln NH) E.L.DISEASE-POLICY LIMIT $ 1,D00,000 It yes,daaddbe rode DESCRIPTION GF OPERATICNS ba. DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIRESTRICTONS/SPECIAL ITEMS THE REPLACES ANY PRIOR ISRN-ICIIE ISSUED TO THE CPRTMCATE HOLDER APPK11NG WORXPRS COW COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE Charles J Clark ACORD 25(2009/09) 19BB-2009 ACORD CORPORATION. All rights reserved. The Commonwealth of Massachusetts ":Pnnt Forq ' Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 low , www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name (Business/Organization/individual): / UA!v,4�ti/� Address: J-llr.J cr'� City/State/Zip: dt 13 Phone #: l 9 7 —S e7 D Aneyyou an employer? Clieck the appropriate BOX: — - 4. I am a general contractor and I Type of project(required): I.X I am a employer with ❑ g employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These subcontractors have g• ❑ Demolition workingfor me in an aci employees and have workers' Y ca P tY• 9. ❑ Building addition [No workers' comp. insurance comp. insutatice.t required.] 5. ❑ We are a corporation and its i0.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.El Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[Z Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' l3.❑ Other comp. insurance required] -'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and than hire outside contractors must submit a new affidavit indicating such.. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: / /`��/r✓Q� //l�� S/rrn/ Policy#or Self-ins. Lic.#: [J� ��I ✓?CJ/�<5 S // Expiration Date: Job Site Address: L 1 X( LZ City/State/Zip: cn 17'LILM /Vl/#' Attach a copy of the workers' compensation 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$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$250.00 a day against the d or. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D1A for insuydn96 coverage verification. I do hereb certt under the nU624,es er'u hat the in ormation provided above is true and correct. Si natu e _ ( ___ ___ Date Z '71 Phone#: 7 4F f 7 -76 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 Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: