The URL can be used to link to this page

102 LEACH ST - BUILDING INSPECTION (2)-TW The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Revised Mar 2011 Building Permit Application To Construct,Repair,Renovate Or Demolish a One-or Two-Family Dwelling This Section For Offic' 1 Use Only Building Permit Number: Da /App ied: Building Official(Print Name) Signature 4V Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers / 2-r$SV 'l3och Sl S./Vie 04,445'li - 251 3 3 — o z5-�0-0 Lin Is this an accepted street?yes ✓ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: (299 a 3 .0 -4 aC"a— 50 Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) ' 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 1111" Private❑ Zone: _ Outside Flood Zone? Municipal Gk 6n site disposal system ❑ Check if yesu-� SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Ace c-� 5a6r, ma 01Q4-0 Name(Print) City,State,ZIP 10 2 l O'r-h Sl. , L{3.g-T kr o205% / /,,o IJo.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction❑ FExisting Building❑ Owner-Occupied 62,' Repairs(s) M1 Alteration(s) ❑ Addition ❑ Demolition ❑ 1 Accessory Bldg. ❑ Number of Units 3 Other ❑ Specify: Brief Description of Proposed Work : ('0rnoyt. feaAClu 7—x 'yf 15b Nor J?oxo h IS c >.1, 0� ,__$onlaw 7xR W epr 9x6 i S—ram f,�2 t •m c,t\,;,� 'S o.�i \p n, Q SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials 1.Building $ t7 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 (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 560 0 Paid in Full 0 Outstanding Balance Due: Y l SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ck A .4-6 Z_ 510�� Z !t h 1�,gyp IO'a-Ab License Number Expiration Date Name of CSL Holder LA r 1�R&dn List CSL Type(see below) No.and Street `J Type Description U Unrestricted(Buildings up to 35,000 cu.ft. R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances Li��531Sri39 S.l¢de.Ma ad@ 'Ntrk ,Alyr -,C I I Insulation Telephone Email address D Demolition 5.2(Registered Home Improvement 11 Contractor(HIC) Lf © (? "0'. U0N do r Lvl 1 Y s l7uv-t��2 L S2X LQ w�'1 1 • 'rC/O� Expiration at HIC Company Name or HIC Registrant Name HIC Registration Number Expiration Date `1 Wlar-(or.... '(L11 S[2V2 Mg[rc.JA(P_ N Street Email address Mter;" MIn O ftl Q}k-Ss,�s39 City/Town, tate,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 I,as Owner of the subject property,hereby authorize ( iSP» �Hn C� /Ylcr. 2.l q n a�rrrravJ to act on my behalf,in all matters relative to wor authorized by this building permit application. n -7- 27 - 1) Print Owner's Name(Elec on S nature) Date SECTION 7b:OWNER' 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 and accurate to the best of my knowledge and understanding. Print O ner's or Authorized Agent's Name(Electronic ' ature) 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 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/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" PRODUCER — THIS CERTIFICATE IS ISSUED AS A MAITEK OF INFURmA IIUN .Phil Richard 6 Associates Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 491 Maple Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 102 Danvers, MA 01923 INSURERS AFFORDING COVERAGE NAIC# ,;ylTjlgED INsvREA A. TRAVELERS Columbus Property Services Inc INSURERB! ACE PROPERTY 6 CASUALTY INSUR Mr. Handyman of South Essex NSuPERC: SAFETY INSURANCE County / 5 Elm St. INS UIeR D: Peabody, MA 01960-4405 INSURERE: COVERAGES THE POLICIESOF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOOINOICATEO.NOTWIT HSTANOINi 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 TOALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS. _ _ .... .. ........... ... ._.._. _. _ ._.._...... _._.._....__—____.. SR ADD' Policy NUMBE0. I P TE INTO-QCLINE POT CY EXPOOTYYYYI IRATIONTYPE LIMTS GENERAL LVLBLITY I EACMOCCURRENCE s 1, 00,000 DAMAGE TO RENTED 3 100,000 A X CDMMERCIAI GENE RALLNBIIITY 16803264 R495 B/6/l0i 8/6/11 I CUkIMSMAoe QX OCCUR ME EXP IAN,ro P.am) s 10,000 PeasoN La ADVIWURY s 1.000.000 GENERAL AGGREGATE s 2,000,000 CEN'L AGGREGATE LSAT APPLIES PER PRODUCTS,DoAPIOP AGO S 2 000 000 X POLICY r,7 PR LOC AUTOMOBILEUABUTY I COWINEDSINGLELIMIT � f 11000,000 C ANY AUTO 6204208 8/2/10 8/2/11 maec6on) ALL O W M D AVTOS aOirDILY INJURY s X SCHEDULED AUTOS HIREDAUTOS BODILY INJURY S )Per 4coaenp NONOWNED AUTOS PROPERTY DAMAGE S IPPramN4�q GARAGE LIABILITYAUTO ONLY-EA ACCIDENT 3 MYAUIO OTHER THAN EAACC 3 AUTO ONLY. AGO S EXCESS I UMBRELLA LIABILITY EACHOCCURRENCE 3 OCCUR CLAIMS MADE AGGREGATE 3 S S DEDUCTIBLE i RETENTION 9 WC STATU- i OTM-I WORKERS COMPENSATION X AND BAPLOYEW LIABILITY la MYPROPE 9RFXRTNEWEXECU� Y� C46346063 8/9/10'. 8/9/11 E.L.EACH ACODENr 3 500,000 EL.ol3use-u eAm OYeeS 500,000 B440040rT In NMI egYAdodaA,9 a« EL.DIS EASE-POLICY LIMA s 500.000 SVE DIAL PROVISIONS pow OTHER 1 ) DE SCRIFTION OF OPERATIONS I LOCATIONS I VENT CUES I EX CLU90NS ADDED BY E FDORSEMENT I SPECIAL PROVISIONS EVIDENCE OF INSURANCE MR HANDYMAN INTERNATIONAL LLC IS INCLUDED AS ADDITIONAL INSURED ON GENERAL LIAHILTTY POLICY BI6803264R495. CERTIFICATE HOLDER CANCELLATION S HOULO ANY OFTHE ABOVE OESCRISEDP OLICIE9 BEGAECELLE09EFORE MEE WRATION DATE THEREOF,ME ISS LING INSURER HALL ENDEAVOR TO MAIL 15 DAYS WRITTEN MR HANDYMAN INTERNATIONAL, LLC NOTICE To THS CGATRFICA%HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 50 SHALL ATTN: LEGAL FRANCHISE ADMINI S— IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON ME INSURER,ITS AGENTS OR TRATOR/FAX N 734-822-6571 REPRESENTATIVES. 3948 RANCHERO DRIVE AVTMORRED 0.EPAESENTAWE ANN ARBOR, MI 48108 STEPHEN TURNER ACORD 25(2009101) © 198B,2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TRAVELERS URPLUSLISEXCESSANY SURPLUS LINES COMPANY Hartford, CT MASTER POLICY CERTIFICATE OF INSURANCE Master Policy Number: 105097997 Certificate Number: 105 This Certificate of Insurance is an endorsement to Business Services Dishonesty Policy no. 105097997 issued to Mr. Handyman International, LLC. ITEM 1. Named Insured and Address: Mr. Handyman of South Essex County, 5 Elm Street,Peabody, MA 01960 ITEM 2. Coverage Period: From 04/01/10 to 04/01/11 12:01 a.m. standard time at the Named Insured address shown above in Item 1. Notwithstanding the foregoing, coverage shall cease immediately upon the effective date of termination or cancellation of the Master Policy. ITEM 3. Retroactive Date: 04/01/2008 ITEM 4. Aggregate Limit of Liability: $25,000 ITEM 5. Single Loss limit of Liability $25,000 ITEM 6. Deductible Amount per Single Loss: $500 Countersigned: TRAVELERS EXCESS AND SURPLUS LINES COMPANY oriud KepHsentative =`! Secretary President 4/26/2010 Countersignature Date Countersigned At ISSUINGCOMPANY ACE PROPERTY 8 CASUALTY INSURANCE Workers' Compensation NCCI CARRIER CODE and Employers Liability 12254 Insurance Policy Information Page POLICY NUMBER New F—xl Renewal Rewrite Symbol: NWC NumberC4 63 46 06 3 PREVIOUS POLICY NO. 1-1 Individual F-1 Partnership Symbol: NWC Number: C45791439 Fx] Corporation a Item 1. FOLUMBUS PROPERTY SERVICES INC Inter/Intrastate ID No.: Named 5 ELM STREET Insured PEABODY MA 01960 Federal Employer ID No.:203198912 Mailing Address Employer's ID No.: PIIC CODE: 1751 For other named insured see Extension of Information Page-Schedule of Named Insured,WC 99 99 99 A For other workplaces see Extension of Information Page-Schedule of Other Workplaces, WC 99 99 99 B Item 2. Pollcy period: From 08-09-2010 To 08-09-2011 12:01 A.M., standard time at the named insured's mailing address. Item 3A. Workers'Compensation Insurance: Part One of the policy applies to the Workers' Compensation Law of the states listed here MA Item 3B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500.000 each accident Bodily Injury by Disease $500,000 policy limit Bodily Injury by Disease $500,000 each employee Item 3C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND,OH,WA WY, AND STATES DESIGNATED IN ITEM 3.A Item 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. - SEE EXTENSION OF INFORMATION PAGE-CLASSIFICATIONS If indicated here, interim adJ',ustments of premium will be made: Minimum Premium collected in MA $ 500, ❑ Semi-Annually u Quarterly ❑ Monthly Total Estimated Premium $ 10324. Deposit Premium $ This policy includes these endorsements and schedules. - SEE SCHEDULE OF FORMS AND ENDORSEMENTS WC999999D PRODUCER NAME AND MAILING ADDRESS TPA INSURANCE AGENCY INC 10 NEW ENGLAND BUSINESS CENTER SUITE 303 ANDOVER MA 01810 t PRODUCER CODE. 249634 04-3296168 SML MARKETING OFFICE. ACE COMPLETE s ISSUE DATE. 07/27/2010 r�ry oia sma, �,n (Authorized Representative) WC 00 00 01A (06/03) Copyright 1987 National Council on Compensation Insurance INSURED COPY TRAVELERS J� One Tower Square, Hartford, Connecticut 06183 BUSINESSOWNERS COVERAGE PART DECLARATIONS CONTRACTORS PAC POLICYNO.: I-680-3264R495-IND-10 ISSUE DATE: 08-02-10 INSURING COMPANY: THE TRAVELERS INDEMNITY COMPANY POLICY PERIOD: From 08-06-10 to 08-06-11 12 :01 A .M. Standard Time at your mailing address. FORM OF BUSINESS : CORPORATION COVERAGES AND LIMITS OF INSURANCE : Insurance applies only to an item for which a "limit" or the word "included" is shown. COMMERCIAL GENERAL LIABILITY COVERAGE OCCURRENCE FORM LIMITS OF INSURANCE General Aggregate (except Products-Completed Operations Limit ) $ 2,000,000 Products-Completed Operations Aggregate Limit $ 2,000,000 Personal and Advertising Injury Limit $ 1 .000,000 Each Occurrence Limit $ 1 ,000,000 Damage to Premises Rented to You $ 300,000 Medical Payments Limit (any one person) $ 5,000 BUSINESSOWNERS PROPERTY COVERAGE DEDUCTIBLE AMOUNT: Businessowners Property Coverage: $ 500 per occurrence. Building Glass : $ 250 per occurrence. a BUSINESS INCOME/EXTRA EXPENSE LIMIT: Actual loss for 12 consecutive months Period of Restoration-Time Period: Immediately q '-� ADDITIONAL COVERAGE : Fine Arts: $ 25,000 a o c_ Other additional coverages apply and may be changed by an endorsement . Please _ read the policy. oW o. o m= SPECIAL PROVISIONS: COMMERCIAL GENERAL LIABILITY COVERAGE IS SUBJECT TO A GENERAL AGGREGATE LIMIT MP TO 01 02 05 (Page 1 of 02) 000005 i Y I , I BUSINESSOWNERS PROPERTY COVERAGE PREMISES LOCATION NO. : 01 BUILDING NO . : 01 LIMIT OF INFLATION COVERAGE INSURANCE VALUATION COINSURANCE GUARD BUSINESS PERSONAL PROPERTY $ 10,000 RC* N/A*Replacement Cost 0.0% COVERAGE EXTENSIONS: Accounts Receivable $ 25.000 Valuable Papers $ 25,000 Other coverage extensions apply and may be changed by an endorsement . Please read the policy. > aft. MR. 31 �r e a MP TO 01 02 05 (Page 2 of 02) 71. Office of Consumer Affairs& usioess Regulation. " HOME IMPROVEMENT CONTRACTOR, :' '•I i RegisVa n-., a/ 12011,Expiration-., 8/9%2011. TnY 287388 Type�2 MR. HANDYMAN OF.SOUTH ES$EX COUNTY STEPHEN MORAD U-K* R i 4 MORGAN RD t Y� IL IN MA 018&7F7 Undersecretary ;I Department of Public, Safct• 1 Board ofBuildirp, Re ulations and Standards '. Construction Supervisor. Licensee - '. License: CS 94762 Restricted to: 00 F�£ STEPHEN MORAO 4 MORGAN ROAD WILMINGTON, MA 01887 �i-•� ��E Expiration 2/17/2012 f'nnunisiunrr Tr#: 17248