5 NAPLES RD - BUILDING INSPECTION i
g� The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
�I Massachusetts State Building Code,780 CMR,7"edition ReOvF SALEM
dJamary
Building Permit Application To Construct,Repair,Renovate Or Demolish a 1,2008
One-or Two-Family Dwelling
This Section For Official Use Only
Buil ' Permit Numbs Date Applied: • 1 S• l (�
Signature: l • I I O
Building ommissioner/Inspector of Buildings Date
SECTION l:SITE INFORMATION
1.1 1'jyp'fzrty Address: 1.2 Assessors Map&Parcel Numbers
0'b-(1u
L l a Is this an accepted street?yes 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(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:
Zone: Outside Flood Zone?
Publi Private❑ Check if yes0 Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
`21�Owner�lof RR�ecord:
J/w'u:C`/ l�{p0✓I(dc,� AX�}��Q/3- S�-�(J\^\ f�'7"
e(P nt) Address fo Service: r
T
NA 1J% '04- 05-14
'fzVlur - Telephone
SECTION RIPTION OF PROPOSED WORW(check all that apply)
New Construction❑ Existing Buildin Owner-Occupied Repairs(,) ❑ 1 Altemtion(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ 1 Number of Units Other ❑ Specify:
Brief Description of Proposed/IWorkk/2:�
4 CoMd U l_.P W\� fX�.1S w r�C.J a tc NW— V(O dw�
SECTION 4:ESTIMATED CONSTRUCTIONCOSTS
Estimated Costs:
Item Labor and Materials Official Use Only
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ Otter Fees: $L � n'�_1
4.Mechanical (HVAC) $ List: L ��JII-
5.Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ �1 (M) 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES f
5.1 Licensed Construction Supervisor(CSL)
License Number Expiration Date
Name of CSL`Holder
List CSL Type(see below)
Address Type Description
U Unrestricted to 35,000 Cu.Ft.
R Restricted 1&2 Family Dwelling
Signature M Masonry Only
RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name Registration Number
Address
Expiration Date
Signature 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
1, , 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.
Si nature of Owner Date
SECTION 7b:OWNER[OR AUTHORIZED AGENT DECLARATION
I, ,as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and
behalf.
Print Name
Signature of Owner or Authorized Agent Date
(Signed under the pains and penalties of e
NOTES:
I. 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 and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.R6 and 110.R5,respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq.Ft.) (including garage,finished basementlattics,decks or porch)
Gross living area(Sq. Ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halFbaths
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 Cosf'
HARVEY VINYL WINDOW 5A HEAD
I. BUILDING PRODUCTS
harveybp.com3800-9HARVEY REPLACEMENT INSTALLATION INSTRUCTIONS
These Parting
Stops Must Be Iaside�
1)Remove inside trim/stops at sides and top.The top trim 8)Tilt window into opening.Center the window and push it Removed Before Trim
may need to be cut down when replacing.Care in removing tightly against the blindstops. window Is
the trim may allow you to reuse it.(Refer to either Figure 5A or 5B) Installed
9)Square windows in opening by installing wood shims where
a)Cut pulley cords and remove lower sash. necessary.Placing a carpenters square on the master frame and sill 0 FOR
Adjustable
b) Remove parting beads at sides and top. corners will aid in the process.On double hung and rolling units, Sill Expander DOUBLE
c) Cut pulley cards and remove top sash. slightly opening the sashes will give a sight line to help square the HUNG
d)Remove pulleys,weight cavity covers,and the window.On other products,verify that the margin between sash and WINDOWS
weights.Fill this top to bottom cavity with fiberglass master frame perimeters is equal on all 4 sides.
insulation.If desired,replace covers or cover holes IMPORTANT:Vinyl Double Hungs only-Tilt in both sash and remove
with wood. balance covers. Turn adjustment screws located in side jambs R
NOTE:If original windows have vinyl or aluminum jamb clockwise until they are firmly seated against opening.This will help
liners,use a flat pry bar to remove liners. ensure frame members remain parallel and plumb.CASEMENTS: SILL Stool
2)Jamb depth of vinyl replacement elfin stop Crank open sash to seat adjustment screws in each side jamb.
window is 3-1/4 If the opening jamb IMPORTANT:ROLLING ONLY-The sill must be supported in a flat
Must haaT
depth is greater,nail furring strips to inside 31/4"here and level position along its entire length to ensure alignment of HEAD aside
of blind stops.If opening jamb depth is less sash locks and keepers and proper operation. C Trim
than 3-1/4",trim back the stool cap. Interior trim 10)Complete fastening the unit by screwing frame to opening J
3)Completely clean opening and proceed with installation through prepunched holes at top and bottom of both sides of These Parting /
master frame,using screws provided.Do not over tighten. Stops Must Be
4)Check the prime sill for level.Compensate for out of level Removed Before
conditions by installing wood shims tightly against outside NOTE:Casement/Awning units need 1/8" holes drilled in Window Is
edge of stool cap. each jamb at latch and hinge locations.Shim behind these Installed
5a)Sill Expander:Measure the distance between the blind locations and secure using screws provided.These holes should o FOR
stops at the sill and cut the sill extender to fit.Return extender be located along groove on inside frame. ALL
to proper position in the window unit.See detail drawing 5A 11)Insulate between window frame and rough opening on. OTHER
Sill Angle VINYL
5b)Sill Angle:Install sill angle with long leg up,1/8"back from all sides.Be careful not to overpack and bow jambs. to be mounted WINDOWS*
before window
inside edge of blind stop using three 14'screws provided.Caulk 12)Verify window is plumb,level and square.Check operation is installed
along entire length for weathertight seal.See detail drawing 5B- of unit and make necessary adjustments.
IMPORTANT:If this is a flat sill installation,the sill 13)Tap head expander up to head and fasten with self tapping
extender or angle should be removed and discarded. screws provided or use white pop rivets. SILL stool
6)Run a heavy bead of caulk along the inside of the blind 14)Tap down sill expander and caulk along entire length(when
stops at the jambs and head. ' using a double hung window). NOTE:Screens are intended to provide reasonable insect
7)Fill space under head expander with insulation.Also lay 15)Replace wood interior Vim.- control and are not intended to provided security or '
insulation along sill of opening and staple in place. the retention of persons or objects ' interior.
Failure to follow these instructions may result in this window unit
'It Is recommended that the hardware on casements&awning windows be
not performing Up t0 Harvey's specifications for its Intended use.
08-26311/08 lubricated twice a year or as needed with a light oil for years of trouble-free
All warranties may also be voided. operation.
CITY OF SMENI
PUBLIC PROPERTY
DEPARTMENT
KIfOYi�iY D4i1'•v L
Vnvoa 13S WAourrTCN s79FiT•Surx%&UAoR,Qrrs 01970
71:1.97L7454S" • F.ut 9711.740.994
HOMEOWNER LICENSE EXEMPTION
Please t
pare S
Job Locatim 0 � C
Home owner Address
Home Owner Telephone
Present Mailing;Address O
The current exemption of"Homeowners"was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who does not possess a license4 provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Persons) who owns a parcel of land on which he/sbe resides or intends to reside, on
which there is. or is intended to be.a one or two family dwelling, attached or detached
strucnua accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official,on a form acceptable to the Building
Official, that hdshe be responsible for all such work performed under the Building
Permit.
The undersigned "homeowner"assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations.
The undersigned "homeowner"certifies that he/she understands the City of Salem
Building Department minimum i on roc9durcs and requirements and that he/she
will comply with said procedures req it is.
HOMEOWNERS SIGNATLRE U
,APPROVAL OF BUILDING NI SPECTOR
See other side for state code
,\ CITY OF SALEM
• PUBLIC PROPRERTY
� Joe
DEPARTMENT
\I .1„µ I_'G W.%+III\I.:JV 5rN LET 0 S•tl I'f1, NIA S"'
I'Ft:97g-7� 9595 1°.�s:979.743-9946
Construction Debris Disposal Affidavit
(required fur all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 730 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building 11crmit N _ _ is issued with the condition that the debris resulting from
this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c
111. S 150A.
The debris will be transported by:
'�
( 1 me of hauler)
The debris will be disposed of in
I,
(nameu acl Ity)
taddrcss d larlluy)
+igna ure of(wnnit applica t
f I I�I ►0
�,latr