2 MAPLE ST - BUILDING INSPECTION (2) K
C'onunomveailh of Massachusetts Cl rY OF I y, Board of Building Regulations and Standards
V
u t Massachusetts St Building Code. AO C NIR .�LI:,�I r
ate RV11 it I rnr'nil
Building Permit Application To Construct. Repair. Renovate Or Demolish a
One-nr Tern-Fumilr Jn cllin•q
This Section Fur(Iffici4i Use Only
Building Permit Number: ate Applied; _
Iludding Ullicial(Print Niune) Sipalure Wig
SECTION 1:SITE INFORMATION
I. Property Address: 1.2 Assessors, tap di Parcel Numbers
n1Af�jP
I.la Is this an acre ted street?yes no Nnp Vumher I'urcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Cursing District Proposed Usa Lot Area(sq 11) Froolage(11)
I.! Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Waterjorcl:
(M.G.I. 470.154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
lhlblie❑ e❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal s)slwn ❑
Check if cs❑
SECTION I. PROPERTY OWNERSHIP'
2. 0wne
ltree 0 _�. r/rLk
N;une(Print) Ugt Slate.ZIP
rNu.and Stm relephune Emnuil Address
SECTION J: DESCRIPTION OF PROPOSED WORKS(cheek all that apply)
New Construction Existing Building 1 Owner-Occupied Cl Repairs(s) ❑ Alteratlon(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg.❑ I.Number of Units Other (3 .Spccily:
Brief Description of Proposed Work':
'S42i0 CLvu( 9r1e 20o F
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Bent Estimated Costs: Olilclul Use Only
I labor and.\Materials) y
I. Building S 5 41. Building Permit Fee: S Indicate how lee is determined:
'. lilectrical S ❑Standard CitpTown Application Fee
❑Total Project C'ostl t Item 6)s multiplier
1. I'lumhing S '. Uthcr Fees: S h/
J, Mcch.ulicll ill\ %C1 S List:.— .----. ----N_ �a
9 \Ic0anic.0 iFue -=ff
�u ;ressiuni i ror11ANFees: S_ . ._ . .
n 1'ntul I'rnject Cost:
Check No. ( heck Anwunr. C.teh \m0nun:
i _. ---
600. OJ 0 Rdd in Full 0Oulstanding Bal.ulce Due:
SF.(*IIONt: CONSI'Rli('•rIONSERVICES
5.1 ConstructionSupenisorLiceuse(('St.) IOI O a_�O.aOty
I icome Numhar I vpmition Date
\;unc o(CSI. I hddcr I i'I(.St. I)pe(sec I+clots I.. s-
11 Pe Description
No. .wd Street
ll I hvcslricteJ IDuildin-i 0 10 15,111)0 cu. It
1U.,iricled 12•2 Famil INellin
Cigi own.Stale.Lll' Mf Mason
RC Rttttlin Cawrin
(4'S w'indmv and Sidin
— SF Sulid fuel Ilurning Applianecs
761 .275 tall 1 Insulation
1'eh• hunt Filth!adJresi D Demolition
t,2 Registered Ilome Improvement Contractor(HIC) j yl 77 a Sao/y
' r -+n "u f, t $I✓,f oa tlQoc'Ftus/ .1.N L I IIC Reglslration Numhcr F%pinlliou Date
I IIC'Company Milneor I IIC'Registrant Nome
a4 limo- n S-r
Nu.plsd Street O Finall address
— �J .rj�l �02
Ci / awn,Slate ZIP Tta hung
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 153.1 2SC(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...........0
SECTION 7s:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print O\Hlcf s Na111e(Eactrunic Signature) 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,
I'riul Owner's nr AtilhttriieJ rM6C111'tl Nallle(hl"trmw.Signature) Dult
NOTES:
I. An Owner who obtains a building permit to do his her own work,or an owner who hires an unregistered contractor
(nut regislercd in the Hums Improvement Contractor i H IC) Program).will no have access to the arbitration
program or guaranty fund under\I.G.L.'e. 1!?A.Other important information on the HIC Program can be liwmd at
„ttw mar•. t t I Inrornlation on the Construction Supervisor License can be round at w ww ma.: �; t -III,
I Wien substantial twrk is planned, provide(he information below:
rota111our aria I4 III - ____.._I including garagt, linishtd basement attics,decks or porehl
(lruii liv ing area 1 sy. 11.1 .,._.. Hobitable roust count
\unlher of'hcJroouts
\umher oI'll replaces \unlbcr of half hathi .. . . . .
\unlhtral'hodtrouini _ . . .
I)Ile of heaving is'l nl \'unlbcr of decks porches
1\pe of PW lmlg it atoll
I?ucloscd Olsen
Project Syunrc Paol,lcc,ni;l) ht.uhNiouwd Ibr"Total Project 01 1l
artment of Public Safety .
t fAassachusetts -"P ulations and Standards
OF Board of Building Re r Sperialtc '.
Construction Suf` 101220
L-
License:CSS ..�S
TRAIIANT"R
W ILLIAM R S
21s VERONASTRF'$T'
LYNN MA 0)904it`
t Expiration
.f. itt+tt�a 0y1012014
Commissioner
... *"..."w"�*"�'*""�. •r
Otfice 6t L�odSQfI Rghe5k fh1�5
HOME IMPROVEMENT CONTRACTOR Type:
Registration: 141778 _
Expiration 2/5/2014 Private Corporatic.
M TRAHANT`"JR COPSTRUC,TION INC.
1-1 I i4
e � \,
WILLIAM TRAHANT7,��
215 VERONA -6---
��
LYNN,MA 01904 .;;;`4 si-,,;• Undersecretary
CITY OF S.u.E,tif, AISS,kcHuSETTS
JL'tLOtNG OEPAMLI N-r
110 W-UNLNGTON 5rXW, Jw 6ZOCR
` RL �97� 14l.9J9!
K11C3ERL.BY ORLSCOLL P,Vt(973) 74&994
0IR8CTCR OP PL SLIC PRCIPER7Y/3L:MDLN43 C01QIt33rO,VER
Con9tructio n Debris Dfaposal At'tTdavit
(required tot aU demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 730 CMR section
Debris, and the provisions of MGL o 40, 3 34g
Building Permit ,*11, S I JOA. is issued with the condition that the debris resulting from
l I I
1 work shell be disposed of in a properly licensed waste disposal facility as defined by&ICE c
The debris will be transported by:
(mace arhauler)
Tho debris will be disposed of in :
SQrhMcaCia-l—�112 f`�'R��,
(name or facility)
�Ornn.e2Gr�L s'1- ��N�
I,ddra,ar n,+I,+y)
+yn�nus ofrerm+f +pph.rnt
Q-1-Y OF S:Ulm, NWs.il,CH[:SETTS
s
t3L:I DING DEPARTMEINT
120 WASHLNGTON STREET, 3ma FLOOR
TEL (978) 145.9595
Rita(978) 710.9844
tl�(BE.'iLFY DMCOL
�,UYO Z THoatAs ST.PtaaRs
DIRECTOR OF PUBLIC PROPERTY/Ot:11DNG COALsIMIONER
Workers' Compensation (nsurance Affidavit: guilders/Contractorv/ElectrlcianslPlumbers
tiiollcant Inrormatiren Please Print Learihl�
V;1111C lllusitss Urg,lnuatior lmlividu•dl: Ls-)M -At'1 T(LAI-1 R,r.aT�2 Cc�NS'f2uCt10n ..LN(✓.
Address: )-1S V EP cx,-�P S f
CityiSlawitZip: LWA) I to a9QY Phone N: ?ot J,7 40 it'
Are yt as employer!Check the appropriate ban Type of project(required):
1 I am a employer with ) cf 4. C1 I am a goncrai contmclor and 1 6. Q Now construction
ealployces(Nil and/or part-lima).• have hired the sub•contnctars
2.❑ lain a sold proprietor or partner• lived on the attachcei sheee.t 7. Q Remodeling
ship and have no employees These sub-eonlraetars have O. Q Demolition
working for me in any capacity. Workers'comp.insurance. t). Q Building addition
(No workers',comp,insurance 5. Q We are a corporation and its
ruyuircd.j
officers have dxercised their 10.❑ Electrical repairs or additions
).Q I am a homeowner doing all work right of exemption per MGL I t.Q Plumbing repuirs or additions
myself.(No workers'cump. c. I52,11(4),and we have no 12. aof repairs
insurance required.j t employees. (No workers'
cump. insurance rcquimd.1 13.0 Other
•.vny applh:ud dot aluckr hod rl mime also all um the wceiue below showing(hair tvatren'eamprnudun policy inntnm llon,
'I hvnouwm"who.uhmil this adiMvil Initialing thty are doing all work and tha hire outlide centnerale mime auhmk am"a0tdavil indiaina such.
:P„ntnrlons that chc<k this box insist nuhud in addilluwl short showing the name or the oubaunlrKWn and Ihalr workers'write.pulley Inttxrwdon,
fain an employer that It providing workers'romprnstulun besurancefor my errrptuyeka Below b du policy and Job site
infaanatlon.
In,umaca Company Noire: C9Az+tS
Policy d or Selr-iro. Lic.d: 5l7 5��� Expiration Date: 7 -j 3 aU I
Jub Sitd Address:o2 (0 4pleST- Cilyistuttizip: Sajei» y/h/}
Atlacb a copy of Ihs worker'compensatlaa pulley doclarallan paµe(showing the policy number and expiration data).
V iduru w wcurc cuvemga as required under Suction 3JA ut',MU c. 152 an lead to the imposition orcriminal penalties of a
tine up to 51,500.00 undlur one-year imprivnnmenes as well as civil penalties in the form ot'a STOP WORK ORDER and a line
of up to S_M.00 a Jay against flit violarnr. Ile advised that_a copy of this.statement may be furwardcd to the Oitica of
Inve,tigations,d the OIA for insurance coverage verilicaliun.
i'do hereby certify wider die pains�Q that the infunnuNon pruvidad abuvd is frue vld corrvee
; .:r.it1Jre---4) ua: 5'r-'oZ0/ z
r
1z----
Oljhiul toe wily. 17,a net Ivrtte hr driv area,to hr e'utapleterd by city at tuwriidl
(:itynrl'mvn:. PermitA.lccmeI
hsaio-At lvirily (circle one): —_. ...__ .. .
1. hoard ul Ileullh !. Iluilding Ueparlmem 1. ('ilyi Town Clerk I. b:Iuetric.11 (it,peclor i, Phlmhinq laspaetor
6. Other -- -- ..
Page No. of - Pages
' �aoft�g �rnp�s�tl
WM. TRAHANT JR. CONSTRUCTION, INC.
4TH GENERATION ROOFING
215 Verona Street
LYNN, MASSACHUSETTS 01904
(781) 599-1211 •,(781) 844-4551 • FAX! (781) 581-0855 H.I. LIC. #141778
PROPOSAL SUBMITTED TO PHONE DATE II
IJ
JOB NAME
STREET � f _�
CITY,STATE and ZIP CODES JOB LOCATION
h l.) 1P
.hereby submit specifications and estimates for: We hereby submit specifications and.estimates for:
SHINGLE ROOF FLAT/RUBBER ROOF
Strip-entire roof ❑ Sweep entire roof clean
[We
"Replace any bad boards up to 100 linear feet ❑ Strip entire roof
Install ice and water barrier first tree fee up roof ❑ Mechanically fasten down ISO board insulation
-- -- -- — — — — — —
❑ Install-ice and water barrier in all valleys and along dormers ❑ Install 060 Rubber Roofingon entire roof"
----------------------------------
O Inst II 151b felt paper on"remainder of roof — ❑ Install metal flashing around perimeter of budding
Install eight Inch drip edge ❑ Flash chimney(s) pipe(s) and wall(s)
-,—�� �.i��
VIlnstall ridge vent ElEdge caulk all seams
— — - - -- — — -------
Ka/Flash orreflash chimney(s) :�5t, 1I It LPL ❑ Install new copper center"drain
—
Install new pipe flanges ❑ Other
(WrnnstalF�O-year shingle ❑-other err r C7 Clean up all debris
" ❑ Install gutters and downspouts ❑ Labor and materials guaranteed 100% for five years
❑ Install trim coil
❑ Install new fascia boards o
❑ Install new rake boards
❑ Install sky light(s)
/ r -
❑ Other: --J t �( 1 -
[Z Glean up all debris _
C] La or and materials guaranteed 100%for five years /
p _ _ - - - r %� � __ ._ --- — --
1' P/AII shingle roofs are nailed by hand. _ �----
" material and labor = complete in accordance with above specifications, for the sum of:
�illle PrOpOse hereby to furnish
li Total Price($ `� ��x>•_,r� 1..
'CIF YOU ARE HAVING YOUR ROOF STRIPPED, PLEASE COVER ALL VALUABLES IN ATTIC, AS
WE HAVE NO CONTROL OVER DEBRIS THAT MAY FALL THROUGH ROOF BOARDS."
All material is guaranteed to be as specified. All work to be completed in a workmanlike Authorized"
manner according to costs
standard practices. Any only
upon ri deviation from above specifics Si nature
I [ions involving extra costs will be executed onl upon written orders, and will become an g.
! extra charge over and above the estimate. All agreements contingent upon strikes, /
accidents or delays beyond our control.owner to carry fire,tornado.and other necessary
{ insurance.Our workers are fully covered by Workman's Compensation Insurance.
I �
tarice of Vropilsal—The above prices, specifications
CCB�1
rdo
conditions are satisfactory and are hereby accepted.You are authorized to Signatur2—
he work as specified.Payment will be made as outlined above.e of Acceptance: Signature
e moll yellmv c°Pr to above nddr°as.