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102 LEACH ST - BUILDING INSPECTION ; ► The Commonwealth of Massachusetts Department of Public Safety \laestchu.eu.�letrBmidmgl',rdrl%80C\IR).�ra'rnthEdition City of Salem Building Permit Application for any Building other than a I. or 2-Family Dwellin (this Stcliun For Official Use Only) Building Permit Number: D,Ur Applied: Sudding Inspector: \ SECTION I: LOCATION IPlease indicate Block 0 and Lot 0 for locations for which a street address is not availablie) V X /07 Ce-CA Ch S4 <a(Op-0A .No.and street CRY /Town Zip Caxlr Name of Budding(it applicable) SECTION 2:PROPOSED WORK It New Construction check here❑or check all that apply in the two rows below Existing Building❑ 1 Repair O 1 Alteration O 1 Addition❑ 1 Demulition O (Please fill out and submit Appendix 1) ChangrufUsa O Changro(Occupancy O 1 Other O Specify: Are building plans and/ur cunstruction documents bring supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work: I SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDMON,01 CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Evaluation is enclosed(See 780 CMR 3402.0) O Existing Use Group(s): Proposed Use Group(s): r Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as a llcable) A. Assembl A-1 ❑ A-2r ❑ A-2nc O A-3 O A4 O A-5 O B: Business O E. Educational ❑ F. Facto F-1 O F2 O H: High Hazard H-1 O H-2 O H-3 O H4 O H-5 O I: Institutional I.1 ❑ 1-2 O 1-3 O hl O M: Mercantile O R: Residential R.10 R-2❑ R-3 O R4 O S: Storage S-1 ❑ 5-2 O U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as Applicable) IA O IB ❑ IIA O lie O IIIA O IIIB O IV ❑ 1 VA O VB ❑ SECTION 7:SITE INFORMATION (refer to 790 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public O Check:l outside Fhx„1 Lone❑ Indicate municipal O A trench will not be Licen.ad Di>pu.d Site 13 required❑or trench ur .paede: 1'nvaty❑ or mJenofc Zone: ur on .rtr.c.trm ❑ permit I.vnclo,ed O _ Railroad right-of-way: Hazards to Air..Navigation: lIa I h•b•n, l.• Rr,i,„ \,,t 4pphcoblec L StrLMMU,rnhm.urpurl al+pn�ach aria' I. their re+tvw complc ed.' r l• •n.cot to I lu d,l cnc6 w•d O Fv,❑ or No O Ya•*❑ \n ❑ SECTION 8:CONTENT OF CERTIFICA rE OF OCCUPANCY I ,i�li,m t l , dc. __-- Lwt�r,n,pl.l. fapc ul Con.t roc u, n: lkcui•an( Lua,l per Floor .I Ihv. the bwhhnt;c,noein.u+�pnnAlcr?a.h•m' �pa•a'ial?hpulanans SECTION 9: PROPERTY OWNER AUTHORIZATION .Name and .\ddrrss of ProF,vriv Owner Name(Print) .No.and Street GIs—/rows Lip I'ru).c•rh• thcner Contact Inlurmauu,n: - X �dawi . ,ordaN 3q8 -',H 5- — Tille Telephone Nu. (business) relephone No. (cell) a-mad address If applicable, the properly owner hrrebv authurncrs Name Sirm Address City/Town Slate Zip to act.m the roperty owner's behalf, in all matters relative it,work aulhunerd by this building armtt a + licatit, SECTION 10:CONSTRUCTION CONTROL (Please fill out Appendix 2) (If building is less than 35,000cu. Mot cnck.sed s a.•e and/ur not under Comtntclion Control then check here O and.du S"Iwn IU.1) 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town - State Zip Discipline Expiration Date 10-2 General Contractor I G)atn-carl© Zat.ltbraad� 0y1frod)n! Company Name: 7ot...,bromo CsC jOZCj4ti Name of Perwn�y,Rrsptmsible I Construction pp�� License No. and Type iI p licable 1/ 19 CofdsDr'l dl0 Or �UT/:D� � 01ri0 b Street Address City/Town State ?ip r�>r -fig-y 35 I __ /n rp a�r��rfirac EI✓t A , I Al2 Telephone No.(business) Telephone No. cell - e-mail address S URANCE AFF157AVII(M.G.L c. 132 26C(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 affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes O No O BECKON 1L•CONSTRUCTION COSTS AND PERMIT FE8 Item Estimated Costs: (Labor and Materials) Total Construction Cost(from Item 6) =f 1. Building f Building Permit Fee-Total Construction Cost x_(Insert here 2. Electrical f. appropriate mum ipal factor)=f J. Plumbingf 4. Mechanical (HVAC) f Note:Minimum fee=> n(contact municipality) 5. Mechanical (Other) f . �� Enclose check payable to X6. Total Cult f y 00, (contact munici alit )and write number h r SECT( N 13:SIGNATURE OF BUILDING PERMIT APPLICANT Hy entering my name below, I hereby altesl under the pains and penalties of perjury that all of the information cnntatned in this epplicalwn is true and accurate to the best of my knowledge and understanding. 19ca.e prnn..nd ogn name fitly f.¢•F twe.\o. Uate Strvel .Wdrvss 0t.%,Town • ale ) Zan Mumcipal inspector to fill out this section upon application approval: \ame Wit CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT 1��V'.lwMu...w)14 Wl�I°�'t:%7�•.•aylMM 1,•:1'r': Construction Debris Disposal A111davit (nyuircd rut all demou Lion alrl renovation work) In accurdaltce with the si.xtlt edition orthe State Building Code. 730 CMR section 111.3 pcbris. and the provisions or MGL a IU, S $s is issued with the condition that the debris resulting fitom Building Permit M.- 1 license waste disposal racility as defined by MGL c This work shall he disposed or in a Properly t 11. S I JOA. The debris will be transported by: (lug ut hauler) The debris will be disposed of in �n r-riP a`5 --'�— (narrlr w rx 1flyi— !n - (:,d,lr,,,Ilr laa 11 — 1 .gnat lFlwrmirappliearlr half i.I•n..0.S. CITY OF S.UY. NI, ISSACHUSETTS 3UMDLNG DEp.%gT%wN-r 110 W.%.iHcvGTON STnave, 1'a FILmn TZL (974 745.9S9S F.%x(978) 744961d KINmEugY "'SCOLI. IIIOMASIST.Plulis MAY01< 010acrOa of PL eLIC PW►WAT T/2U=L%IG CO%OASSSO.N ER Wurkarat Compaltasllon Insurance AMdevit: Oallder%fContrseton/Flectr(elsnsimU lbers %ttnllcsnt lnformat101e Pleean[dltl.tllllbt Vatna lernrw,�prgawlranelvllwiwtdnll: y ;C4 K!"Q rtO I�A t4Abl-,10 D - Address- t-0 I cily/salirirl: oqC, I/ P%. . 5-09- 76 2-1/R 5 .\n you as employer!Chack the appropriate Mat Type of prole"(regdrea 1.❑/Lam a cmplays,witb a. Q 1 no a vnwd caaaracese ad I a ❑Now contestation OU p ;=( done a have hirer the aa►cavaracure 2. 11 amla Sob proprietor•r pwuwa limed an tMasaehd✓haft= 7. ❑Remothlins +hip area have no omployerve, Three estY eatureaeera have L Q Detnnlitiaw .working fa ma is any capacity. wotkere'Comp.ithatrasoa 9. Q Qui Whig addition IN*worker'tomµ inwnnce J. Q We an a carpeted"end is 10.Q FJsenieal repair a additilts n•4W�1 ollleue hew etawdad Jim* ).Q 1 am a 1lanuowew doing ad work nab oraaatlptiee per MOL 11.0g tepain a additions myniF(No waken m'cap. a 13Z/1(4Snd a we haw no 12• repein inaarattte teveil+L)► :mp',), a We workerP 13.0 Othae cornµ inlauaam re4keLl i — •A"+Pry the dMM 11011100 illlle a4w as W Wr MUM bow -wft♦tear Wwaew'cwtpetwtlra p1Yy laaaneeea '1 J wwwwam who sub"ell✓Saliva iaelwrll 6 AW s dais 1e Welk ally OW NO ON"cwWmmm OWN Mee"a am&away*waabaiw awk r,.wwttrw der crows ebb bat alra arw4r aW a4ali�J w1`/14ewly l4e w r/lbe rbwaaarae W d.b✓+lbw'wT pllry?a�etea� law ea rw/Irye/rMr bpsevN6eg was iira'Cowpwadra/mfatuwce jiw xW ealrfryws Sde1e O rAa pAk�sw/�li r/le injerlwadua ln.urunce Company Nome: Policy e or Selfina. Lie.m Expiration Derr: Job lire Athhte: CityiStastZipe .anaea a cop of the no here'compeacalke policy declwalks pop(shnolse$be palk7 asaMr and esplretlow date Failure to te"u t coverage as regaired under leplotl 25A of MGL R 152 can led to the imposition of criminal penaltlee ore f ne up to S 1.500.00 Selma ono-year imprisaemtrlt,ore well te civil prnollies in an form of a STOP WORK OROEK and a fine Of up to 52J0.00 A day jlpintl the violator. 14 adrisull that a cups of this 11aleman may be rwwwdad to the 0111ee of htcc.0 aaliulu ul'dto OIA for inautance coverage vritkatwa /Jr horAp c /jr unJb A so yen✓/Net rj/rr/try rAM/Ai injirMdM prrviJin/rMw is nw rwI i rvrrd j P`ur:e a: /7/WNI rlr rn/y. Or aN srirr iw this rrrq N!e•rtwo/rMa by riy N reaw��/jll•ird City or funs: eermiul.kense a__. Muing Authortly(circle nnel: _ I ❑uard u(Ilealtk 1. Rulhllag I)cparlment ). ciq/roww clerk A. flouricd Intpector !. Plumbing Intpeeter 6. Other L,.t1ac1 Pcrton: _ _ .. Phone a: ��n�racti� HIC#162257 CSL#102095 (508)769-4351 625 Winter St. Framingham,Ma 01702 gzcontracting.info ............................... ........................................ ...................................... ................. ................................... ............................... THIS AGREEMENT made am '0 t Q�n 2010 by and between Giancarlo Zambrano, herein rcalled�heC ritract r and (Sio.ncov4o Zckv ,brgno hereinafter called the Owner. Witnesses, that the Contractor and the Owner for the consideration names as follows: Giancarlo Zambrano contractor and the home owner nal Abe dl cAOL�Am Article 1. Scope of the Work The Contractor shall furnish all of the materials and perform all of the work shown on the Drawings and/or described in the Specifications entitled Exhibit A, as annexed hereto as it pertains to work to be performed on property at 10Z Le o,ch St, Soaletnn/' l Roof. sq Asphalt CecAcv� 4x�C cxv\A die)�no, ct �aY over- -cover house and shrubs to prevent damage from shingles J ✓� .� ')(strip and haul away all roof related materials (asphalt) � e nail all loose boards nstall leak barrier where needed(valleys,patrusion walls,and ft eaves) Yinsta P8 inch aluminum drip edge (_white or brown) re flash dormers and patrusion walls install ridge vent -- install_lb tar paper sheets plywood CDX or OSB -—T—re lead chimney Article 2. Time of Completion The work to be performed under this Contract shall be commenced on or before LkM_ kG , 2010 and shall be substantially completed on or before Q wta 2009. Time is of the essence. The following constitutes substantial commencerrfent of work pursuant to this proposal and contract: Article 3. The Contract Price The Owner shall pay the Contractor for the material and labor to be p rformed under the Contract the sgr� of foU P_c- -kW1_ SW�d Sye r\ VV_LO � _2� dollars ($ Lk O , subject to additions and deductions pursuant to authorized change order. Article 4. Progress Payments Payments of the ContraQt Price shall be paid in the manner followingb according draw schedule 1#down ,aO 1/3 when material delivered . 00 1/ when complete Article S. General Provisions Any alteration or deviation from the above specifications, including but not limited to any such alterations of deviation involving additional material and/or labor costs, will be executed only upon written order for same, signed by Owner and Contractor, and if there is any charge for such alteration or deviation, the additional charge will be added to the contract price of this contract. If payment is not made when due, Contractor may suspend work on the job until such time as all payments due have been made. A failure to make payments for a period in excess of 7 days from the due date of the payment shall be deemed a material breach of this contract. In addition, the following general provisions apply: 1. All work shall be completed in a workman-like manner and in compliance with all building codes and other applicable laws. 2. The contractor shall furnish a plan and scale drawing showing the shape, size dimensions, and construction and equipment specifications for home improvements, a description of the work to be done and description of materials to be used and the equipment to be used or installed, and the agreed consideration for the work. 3. To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 4. Contractor may at its discretion engage sub-contractors to perform work hereunder, provided Contractor shall fully pay said sub-contractor and in all instances remain responsible for the proper completion of this Contract. 5. Contractor shall furnish Owner appropriate releases or waivers of lien for all work performed or materials provided at the time the next periodic payment shall be due. 6. All change orders shall be in writing and signed both by Owner and Contractor, and shall be incorporated in, and become part of the contract. 7. Contractor warrants it is adequately insured for injury to its employees and others incurring loss or injury as a result of the acts of Contractor or its employees or sub-contractors. 8. Contractor shall at its own expense obtain all permits necessary for the work to be performed. 9. Contractor agrees to remove all debris and leave the premises in broom clean condition. 10. In the event Owner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. 11. All disputes hereunder shall be resolved by binding arbitration in accordance with rules of the American Arbitration Association. 12. Contractor shall not be liable for any delay due to circumstances beyond its control including strikes, casualty or general unavailability of materials. 13. Contractor warrants all work for a period of20 years craftsmanship and 30year material following completion. I rr Signed this day of 2010. Signed in the presence of: Witness Witness Name of Owner: !Yl a A 1 a By (Signature): ow�aj Name of Contractor: Gi carlo Zam no By (Signature): Street Address: 6 5 Winter St. City/State/Zip: Framingham,Ma 01702 Telephone No.: 508-769-4351 Fax No.: 508-620-2836 x - MassaclBtsctI.-Depnrtment n1'Public S:deh Nerd of Building Rc_ulations and Standards Construction Supervisor License License: OS 1d2095 - Restricted to: 00 GIANCARLO ZAMBRANO 11 B COLDSPRING DRIVE SUTTON,MA 01590 Expiration:Sri 2013 t'..mmi..invr TN: 102095 A �e'�Joomom�m�xounrdn�2i. BYrrd Y7BYIMing Regvla0ovl and ood5 Snodnrda HOME IMPROVEMENT CONTRACTOR Re9lsbatlon: 162257 Ittt Expint ion: 2/92011 TW 2W377 I Type: Inswual GIANCARLO ZAMBRANO GIANCARLO ZAMBRANO 118 COLDSPRING DR. SUTTON,MA 015W Ad.I.Jeo tsr