72 LORING AVE - BUILDING INSPECTION (5) What is the cunent use of the Building?
d', VA
Material of Building? If dwelling.tow many units?
Will the Building Conform to Law? Asbestos?
Architect's Name
Address and Phone
Mechanie's Name ro z✓�/aNd DC ao /^y L Gx d sf fa'1 �K c
,oU �jGIL �2G2 c�a /Z//i (�i (( `7� Z,6-67
Address and Phone fL //�
Construction Supervisors License 0 a/ ?;2 % HIC Registration 0
Estimated Cost of Projed S-21' yet — Permit Fee C"ladon
Permit Fee S�a -' Estimated Cost X$7/$1000 Residential
-- -- - - - Estimated Cost X$1 V$1000 Comrmerciel-
An Additional $5.00 is added as an
Administrable Charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of perjury
Date /1 2G/07
37
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PUBLIC PROPERTY
DEPARTMENT
SLLky MAffA011:Stl'IS 01970
Tm-Vt•745-MS•FNC 9711.740.96K
APPLICATION FOR THE REPAIR RENOVATION, CONSTRUCTION.
DEMOLITION.OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR WELDING
1.0 SITE INFORMATION
Location Name: fml Tyra. /2' Building:
Property-- - -
s= �Lor V t
Property is located in a;Conservation Ares YIN Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address:
..5A 17-01
Telephone: - / y 3 6
3.0 COMPLETE THIS SECTION FOR WORK IN E]c1RTrura BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use Now
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
j?-f. ��,� /a,� roar 7 IA-sV-17//
Mail Permit to: PO do k 2 ,4 -2 a z,-',
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
xvenr
121:'rwYe.Wili0lr$ttar a Sauer,Wswe.sttiz01470
tut:MAS."% a FAX:97Ne0.9846
Workers' Compeluatlos isgllraaoe Afftevir. RWidenicaubwMrWElee ►d.,,lMumben
A
NamerHuaraaslOrpai:ono•Ilrwhvrlvl/:�Cr6,1-1.1/UA,9 / K60' /n r / D/
AJdrma ,0D RS oK a6Z
City/uuwzip:��*Jlr/ t 17,(I/ Phone,w - 7y�i -G��B
Are You as employer?Cbsek the appropriate bo= type ofproJaet(rM�radh
L01
a empbyec with 9 4. Q 1 us a yenmal t:0etraeter and 1
* m(full s=Yer purwime).• have hired the subcontractors 6. Q Now coruaeuctim
a solo proprietor or par ner listed on do aeuehed shoot t 1. Q Remodawtg
and bsve no empleyoot These het�e x Q Dernolitior
ing ter ma is auycapacity. worker•Comp,inronano&
ooten•Comp.insurance s. O we an a Corporation ned its °• Q was additiosred) oA4cers haw exoeol their 10.Q Eleevieal repairs or additions
homeowner doing all work right orexampt(an per MOL 11.QPlumbing repairs or widiriom
L(No workers•comp. C. 152.f l(4),and we have no12.Q Ruofnpain
nce regoued j t r'm11101 Wo workers' 13.❑Other comp ittsuraaco tnquinxL)
n wpeaW ur etrcdrr ttr at rep•tea 0a w as wnear tuna ro.;ea aer eaaan'"N swa
rl aagr�rtlon 7•tI•r Mamma"aMamma"'C
' uerwtams m err smdrar todlod„a a•r sea duly ant aq&.W am ere eaarHreaataema Am"sub"sub".m aavun tint rardl a:laa our oft,, W addaY r Pl ,la,u.ar.;ryas mars of ar ak.crsearrsrs oar oar a saw amdr.e tadiodina r,A
plow that& r 4 e Pdttp intrnaaaaa
/ds da em OroWd/a worArrs'cos tataalow huaraaci jar sy earplayees Bdow/s the Br rtn0
...__,_ __ i+tierrrrtltte.:...�.r....,....e..�..,....G...,.�....../�.�.,_......,..W...�...._.._....�.�,...�., ._......._�.. -._.._..__Pa 7_. Ja#.x4._..
Insurance Company Vanw.— ire!/( Qfj7 r✓/!g U
I'olity a or Ur-ins. Lie.0._O Expiration Dater//�
Jub�itdAJ�trcsls 7Z Ll�r^/,vy �✓ Cityistawzip: &17- ;$t 1'2,i'rt.' :- - . .
Attack a copy of the workers'compensation policy declaration page(showing the Polley number and espirados date),
I*ai lure w wcure coverage as required under Section 25A ofMGL e. 152 can lead to the imposition of eriminal penalties ofa
fin.up to S1.500.00 and/or one-year imprisomticnr,ar well as civil penalliga in the form of a STOP WORK ORDER and a fine
.if up to 5250.00 a Jay against the violater. lie advised that a copy urthis statmruem nuy be lurward to the Offi of
ht%ca u uled ngaum 'Ihc DIA :'or oe.urarce covcr2v vcrirrcation. ice
/do hereby certi r�/L/ o sr/as and oene/4r ojYrdary that t/w fnjarsrl/aw
proruled show is true and correct
I)�
D/J7eiaf art oN#)t, AV wee wdrr IN nib airs,/a Ar evaap/rla/by�'or/aww o,� .Ild
City or Town: 1"trmit/1Jeesse III
Noting Authurily (circle alit):
I. Iluard of 1(ralth E. Building Department ). Citylrowa Clerk 4. Electrical lnspecror S. Plumbing Inspector
6.Other
Gnuaet Person: I'honc p:
Information and Instructions
.%tassxbusettY GcmraJ Laws chapter 132 squints all employers to provide workefi cotnpetsationrt foe emPloyo�
Pursuant to this 5laaae,as*a~in ddefinedere'..every Pei ilktbf aftVtee at another under Y e
eapr'ese,of unpliec oral of WOOL,
_ YtedaO�.Ootparar�at odrr legal esnty.or,any ttMO tt mete
u datied""n inavidoal.P ao► tadva of a deceased employer.or the
Anrhe faregoina ealprlt�in a joint eaterpnaa�and iaehatfiN�ktPd repsesea However the
Of receiver of uurase of as atdavrdud.parmasbtp�amaetatsaa or other lap(entity.aaP� °m
house baying set sets ern nonce speraasaw and wbs residers tbesei. or rko on
dwelling
in
owner dvse bst�{ oflsoatae another Who employs Persons to do maintenance.cuabauctim of repair work oe such dwellisag house
ce as rllte poaot or btha w aPpueteoaat tbsred shah net bmmM of tttsab asplaymcm be doomed 1D be sn employer-"
do al"widateld an
:.tGL chapter 152.125C(6)also MM dirt""vary sea"bbed y 1i es r Nanoee M
ere operant a btsttbtw with the lamas"eoverap req**W
renewal of•lieeset or/arteflt avid""b[ampttisnoa
applies"wM W net predtsnd ado nor of im poUdW=bdivi&w shall
Aa4lisianally.MOL chapter 152.;25C(1)salsa nce of public work until acceptable evuisaeo ofcomplisnea with rho inwrance
entermw f �is err p haw ftr the�P to the cartractittp autbarlty
requirements of thin abopttr
ApplHeasp to our situation"if
Please till out dye srofkers'compensation af(Wavit eamPbad p by eheokias the boxy roar apply Y
at
necessary.supply sub-cownscaar(a)Daa*&N o�a1 dad ab000 nuanbefa , LLL.ng P with no�glacir �a)�than the
;raprrstsee limited Liability Companies R�or t imlted tlabdttY Pamtsrabipa l
member pattterr,an not es 0D a workew earrtPOnation bmu*oce• (tan LLC or LLP don have
of way be submitted to the Dqmunmu of Wdustrilil
amployea.•polity is tequued Be advised dun rst&this wore to sign and date the je The&ITW&vit should
Accidents for conAratetian of insurance co%`
be returned to do
city or town that the application far the permit or license f being requested, net the Department of
Industrial A",ddsw Sbould you have any questions regarding the law or if you are required w obtain a worker'
compensation policy.plena call the Dapar®ros a dw Dumber listed below. Self_mc arad compeam should sniff theit
litre.
self-irtfurarteo Hearn number on the
City err?own OQlelab a dw.boaat► ._
x __a,...._4. . . .. k i The Deperimant has provided, spec+
ptcace bar sure that rho affidavit is complete and pnnrcd f bly: the lictim
of the affidavit for you to felt out in the event the Ot7lee of Investigatirws hers to contact you regarding DPP applicant
1'l,ase be sure to till is the permitllicense numberwhich�any givill be en err.need only submied an a reference t one ePPdovittiindicating cureas
that must submit multiple peraait/licattso applicationsapplicant should write"all locations is h 'x
polity information l if necessary)and under"lob Site Address tad by the city or town may be provided te the
town A copy of the sffldavit that has boat officially ut a peril Or
applicant>r proof the a valid affidavit is on fib for Ii+tun permits or licenses. A nowv ^ ommerc"iaout
vaenmw
year. Whet a home owner a citilea is obtaining a license or permit no related to any
business or(i.e.a dog license or permit to burn laves ate.)said Person is NOT required TO complete this affidavit.
as would line to thank you in adv nce for your cooperation and should you have any questions.
I'hc Oi ti.e of(nvesti tiu
ieaae jo nut hesitate to give us a call.
The pcparment's addresk telephone and fax numbsc
The COMM11wealth Of Masaaclnlsetls
DeparMKat Of IsldlHsteial A=identg
OAUS St(nveedge(la"
we waaeitl8ow Saeet
Bow MA 021 It
TeL 0 617-7274900 ext 406 Or 1-877-MASSAFE
Fax 0 617-727-7749
acviacd 5-26-05 www.num.gov/dia
CITY OF SALEM
- - PUBLIC PROPRERTY --- --
DEPARTMEM
,um'mt all-AM- IL
al.+�w l'1'f.�iLw':Je+f 7ra4�3Atcfe.>uv►�t»w.t�'t►::�
T11t a17WK��91!{w tuC 97iJ�6liM
Construcdos_.Debrb Disposa(AMdsivit
(reg0tw far an asinaudon and movad"west)
In ac cone with the six&edition of du Sets liiuildiM Cade.7SO C'&Ut section It t.5
tkbri&and dw provisions of M- CL a 44 S A
13WIMBI per"* _ _ is iswted with dw condition drat the dews cradling loom
this week shall be disposed orin s properly licensed warm disposal facility as defined by MOL a
111.S INA.
rho debris will be transported by:
tnotw of OautM
rhedcbris wilt be disposed grin :
1112Il
Professional Roofing Contractors, Inc.
James W. Shea,President
P.O. BOX 262 45 DEARBORN STREET
SALEM,MASSACHUSETTS 01970
PHONE(978) 744-6888 FAX(978) 744-8814
PROPOSAL
September 26, 2007
Mr. John Bertini
5 Wilson Street
Salem, MA. 01970
RE: Eastern Bank Building, Salem, MA.
To re-roof ehtire main bank building with the following steps:
1. Remove loose gravel from roof.
2. Install 2" wood nailers to roof edge.
3. Apply 2 " polyiso roof insulation to entire roof.
4. Apply Carlisle 060 fully adhered design "A" roof system.
5. Re-flash all penetration per Carlisle details.
6. Install 040 Mill finish roof edge flashing.
7. Repair one hole in roof by replacing rotten, roof board and framing.
Repairs to facia and soffit boards by others.
8. Clean up and remove all roofing materials.
Options:
A. Provide Carlisle 10 year labor and 20 year material warranty.
Cost........................................................$800.00
B. Replace any rotten roof boards at an additional cost of
$8.00 per sq. ft.
s
TOTAL COST:........................... .... .... ...... ..... 6,W0 00
ACCEPTANCE OF PROPOSAL:
TERMS OF PAYMENT:
JWStlbp