3A NIMITZ WAY - BUILDING INSPECTION (2) '191-- 3 q0�
pp - 2A S% -7
I'he Commonwealth of Massachusetts CITY OF II
1 Board of Building Regulations and Standards SALEM
Massachusetts State Building Code, 730 CMR Revised:Llur201/
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use only
Building Permit Number: Date Applied:
Building Otticiul(P ate
(Print Name).
Sign. e.
SECTION is SITE INFORNIATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
3 H N 1 —r
Nlap Number Parcel Number
I.I a Is this an accepted str:et?yes
IJ 'Zoning Information: 1.4 Property Dimensions: i
Zoning District Proposed Use
Lot Area(sq It) Frontuge(It)
i LS Building Setbacks(ft)
Front Yard
Side Yams Rear Yard
Require) Provide) Required ProvtJed Required Provide)
1.6\Vater Supply:(M.O.L c.40,§5q) 1.7 Flood Zone Information: LS Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Public❑ Private❑ Check if yesC
SECTION2: PROPERTY OWNERSHIP!
2.1 Ownert of Record: t?, l/i t *- C--2- '
k:�� �r`0A \ p City,State,ZIP
i Ire(Print) `yt
S S7a r✓ �Qi S' - _ j8�ephone
u. mid Street
Telephone Loin' r\ddress
N
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Buildings Owner-Occupied ❑ Repairs(s)� Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: �P2 h es
Ke >c� �xt5 S
Brief Description of Proposed\Narks:
�oCA
SECTION 4: ESThNATED CONSTRUCTION COSTS
Estimated Costs: Official Use Only
Item Labor and Materials)
I. Building
S 3 S moo, 1. Building Permit Fee:3 Indicate how rce is determined:
❑Standard City/Town Application Fee
2. Electrical S ❑Total Project Costs(Item 6)x multiplier x
J. Plumbing $ L OtherFers: S
1.Mechanical (HVAC) S List:
i. mcchanical (Fire rutal All Fees:S-
Suppressiun)
Check No._Check Amount: Cash Anunmt:_
C. Tntol Project Cost: S S • ❑Paid in Full ❑Olustanding Balance Due:_
\rM-PAt✓(FD 4 (Zs
f �151�14repe� /rg Y) fnr-K�
SECrION5: CONS'raucTIONSERVICES
5.1 Constructiou Supervisor Liecnse(CSL) O� Z -4_(6- Za( 6
�`�6cY'C57l�2 F O-Q-Z �0,.3'r� License Number Expiration Date
Name offCrSL Holder �/� List CSL Type(see below)
Type � Description
No. ;aid Street
�- D Unrestricted(Buildings u to 35,000 cu. Il.)
P2(J It Restricted 1&.2 R tinily Dwelling
Citylfewn,State,ZIP NI Masonry
RC pooling Covering
WS Window and Siding
A� SF Solid Fuel Burning Appliances
�7e(-L9K-6639 &,S Z� I Insulation
'rule hone Email address D I Demolition pp
5.2 Registered Home
11�limf� provement Contractor(111C) !0G / Q'� l-22-Zo(c(
Wit ,52e v\, rJi'-t^� �- � �� sO \U ��S� NIC Registraliort Nt:mber Expiration Date
I IIC Company Name or�jH�IC 11 gt�tmnt Name
ZS /yOe G ncY /� h�JP /M�• � k-krr M5A2-yroeQ
Ne. aid Street r6003 Email address
City/Town,State ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(NI.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 ..........tY No...........❑
SECTION 7a:OWNER AUTHORIZATIONTO BE COMPLETED WHEN.
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize �5 A- 1 V a''T� "'e- V" -y�Cs S p
t9 act on my behalf,in all matters relative to work authorized by this building permit application.
YKA R\c� 6- �Q(�o �Q�t ctL
c(-
Print Owner's Mane(Elilcumuc 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 a ur a to ee best o my kngwle a and understanding.
Print Owner's or Authorized Agent's Name(Electronic SignatureW Date
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 Flonte Improvement Contractor(111C) 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
wcvw.ntnss.eo;' htrormation on the Construction Supervisor License can be found at wtvw.ntass.eov'JL
�. Whcn substantial work is planned,provide the information below:
Total floor area(sal. I1.) (including garage, finished basemendattics,decks or porch)
Gross living area(sal. It.) Habitable room count
Number of fireplaces. Number of bedrooms
Number or bathrooms Number of half/baths
Type of heating system Number of decks/porches
I'ypeofcoolingSysletn Enclosed Open
i. "I'otal Project Square Footage"may be substituted for"Ful:d Project Cost"
CITY OF S,1U_EIM, NL-1SSACHL'SETTS
/ BUILDING DEPARTNLE.NT
120 WASHLNGTON STREET, 3co FLOOR
-ML (978) 745-9595
F.sx(978) 740-9846
KI\BERLFY DRISCOLL
�NLAYOR - THO\IAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING CO\WI5SIONER
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
A r tlicant Information Q Please Print Legibly
Name tilusiness Organlzatiorvindividu,J); I S t��a o—n C ,
Address: 2 S /J et-' k u S T 2
City/State/Zip: (L>i e.,,� f dv�'Q� `j2 t S Phone #: r7$ tt— 2
Are you an employer? Cticck'fbe appropriate box: Type of project(required):
1.Flrl am a employer with L-- 4• ❑ i am a general contractor and 1 6. ❑New construction
employees(full and/or part-time)." have hired the sub-contractors
2.❑ I atn a sole proprietor or punnet•
listed on the attached sheet.t 7. Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity,
workers'comp. insurance. 9. ❑ Building addition
(No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their
10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL I I.❑ Plumbing repairs or additions
myself. [No workers'comp. C. 152, §1(4),and we have no 12.❑ Roof repairs /J
insurance required.1 t empluyms. [No workers' 13.Ri Other
comp,insurance required.]
•Any appina,ro our chucks box#1 most also fill out Ibe sccl.un below showing their workers'compensation policy inllurnatiun.
'I tomeowncn who submit this at ctrwit indicating they arc doing all work and then hire outride contractors must submit a new a(fdavit indicating such.
$\numuon that check this box must anached an additiurul sheet showing the mmro of the sub<omracton and their wurken'comp.policy information.
I ant an employer that is providing workers'conspetseltlan insurance for my eurplayees. Below Is die policy and fob site
injorurutian. /]
Insurance Company Name: fto 1ja..rX ee .
o I r)
Policy #or Self-ins, Lic.#: W L Expiration Date:
Job Site Address: 3 A Ou c vv.�\"T_ 3- cxJ S
City/State/Zip: ar-�-Q-�-'�
,Mach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of vvIGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a line
of uii to 5250.00 a Jay5gainst The violator. lie advised that a copy of this statement may be forwarded to the Office of
lmvsligwions of the DIA for insurance coverage verification.
I do hereby cent under liite�lights and penalties of perjury Iha!the infmvnaUun provided above is true and correct
Si..o.lturc V �K'E/`'S-D Date:
p,�c ---
Official use only. Do not write in this urea,to be completed by city or lonus officiuL
City or fawn: .__ Permit/Llcense#
Issuing Aut horky(circle one): — - 7filipector
1. Buurd of Ilealth 2. Building Department .1.Citylrown Clerk 4. Electrical fnspector 5. Plum6.Other
ContactI'crson: Phone
I [
l
CITY OF SM-EM, A-1SSACH US ETTS
ilu=LNG DEPAMILFUNT
l30 CV.ISHLNGTON STREET, 3'0 FLOOR
TIL (978) 745--9595
F-JaX(978) 7-W-9843
KIN IBEI2L.frY D2ISCOI.L
INLAYOIL I7(osL3.s ST.Pmus
DIRECTOR OF PI;BLIC PROPERTY/BCILDLNr,COMMISSION EX
COnstruction Debris Disposal affidavit
(required for all demolition and renovation work)
in accordance with the sixth edition of the State Building Code, 730 CMR section Debris and die l l I.5
revisions o
p f MGL c 40, S 54•
8uil 'ding Permit q is issued with the condition that the debris resulting From
this work shall be disposed of in a properly licensed waste disposal facility as defined by NMI.. c
l 11. S 150A.
The debris will be transported by:
y
(name ofhaulcr)
The debris will ba-disposed of in
(name of Facility) —
PtisZ� � v��p/�•-
(address of taeili(y)
I � l
S lSnaturc Utp"ma-1,1Irallt —
1
Jude David
From: David Cody)<DCody@Salem.com>
Sent: "�TH—U'r*sday, arch 201412:11 PM
To: Michael Lutrtykowski
Cc: om
Subject FW:Occupancy limits Salem Willow Seafood Festival
Attachments: Beverage Tent Layout.pdf
Mike, Can you help her on this please?Jude, Mike works as a building inspector here in Salem, he can set the number
you need.
Dave
From: Jude David fmailto:iudeCalfesteventsne com]
Sent: Wednesday, March 26, 2014 9:55 AM
To: Peter Schaeublin; David Cody
Subject: Occupancy limits Salem Willow Seafood Festival
Good morning Gentlemen,
I'm in the process of completing the application for the Licensing Board and it requires that I enter an Occupancy/
Capacity for the beverage tent. I have attached a layout for your review. Can you please advise as to occupancy
number?
Thank You & Best Regards,
JUz1�DCWi&C.E.0 1 -�
FestEvents
603.918.3385 cell
603.474.5495 fax
www.fc,steventsne.com
t
1
� � 1
Domenic Giglio
From: Jennifer Pappas Upappas@aptfin.coml
Sent: Monday, April 07, 2014 2:02 PM
To: Domenic Giglio
Subject: RE: Send data from MFP07326553 04/04/2014 08:12
Attachments: Nimitz 3A-deck approval 040714.doc; Nimitz 3A-slider approval.doc
Hi Domenic -
Attached are the letters giving you permission for your deck and slider.
We are aware that they new sliders are slightly smaller.
Thanks!
Jen
Jennifer Pappas,
Senior Property Manager
American Properties Team, Inc.
Direct Fax: (781) 569-2657
-----Original Message-----
From: Michael Mahoney
Sent: Friday, April 04, 2014 10:23 AM
To: Jennifer Pappas
Subject: FW: Send data from MFP07326553 04/04/2014 08:12
Jenn,
This seems like this should've been sent to you. . .
Michael Mahoney
Service Coordinator
American Properties Team, Inc.
500 West Cummings Park, Suite 6050
Woburn, MA 01801
Direct Line: (781)569-2647
Fax: (781)569-2617
-----Original Message-----
From: Domenic Giglio [mailto:DGiglio(@mfa ore]
Sent: Friday, April 04, 2014 9:26 AM
To: Michael Mahoney
Subject: FW: Send data from MFP07326553 04/04/2014 08:12
Mr Mahoney,
Attached is a picture of the slider and a sample of the composite floor that I am planning to
replace at 3A Nimitz. The color of the floor is coastal cedar and it is very close to the
existing color. The slider is smaller than the one that is there now because they no longer
make that large size. The contractor will need to build a frame around the door. You may
contact him directly, his name is Sal and his number is 781-284-6633. You can also call me
anytime at 781-640-2389.
1
r
American Properties Team, Inc. /\
TO: 3A Nimitz Way
FROM: Jennifer Pappas, Property Manager
RE: Slider Replacement
DATE: March 3, 2014
Please be advised that the Board of Trustees for Pickman Park has approved a replacement slider
for the above referenced unit. This approval is contingent upon it matching the existing slider,
fitting in the existing opening and being the same in appearance from the exterior. The Board
will not allow grids, etc. unless they are removable. You should also be aware that your
contractor is responsible for painting any new trim/clapboards as a result of the installation.
Should your contractor find any rot or damage during the slider installation, it should be reported
to my office immediately.
We also require that permits be pulled in advance (regardless of what your contractor may tell
you), and then a copy of the final approved permit once completed must be sent to APT for the
unit file as well. fn addition, we recommend that owners obtain a certificate of insurance from
the licensed contractor.
You will need to bring a copy of this letter to the Salem Building Department in order to receive
your permit.
Should you have any questions or require additional information, please feel free to call me
directly at (781) 569-2675.
cc: Unit File
500 WEST CUMMINGS PARK-SUITE 6050. WOBURN -MA -01801-781-932-9229 -FAX 781-935-4289
1
American Properties Team, Inc.
TO: 3A Nimitz Way
FROM: Jennifer Pappas, Property Manager
RE: Deck Replacement
DATE: April 7, 2014
�r*rs***+rt�***r+*+►s�+s+**�r**�**r�++r:*��*sre+�+r**+:a�**r*r****•+r*+�
Please be advised that the Board of Trustees for Pickman Park has approved the replacement of
your deck at the above referenced unit. This approval is contingent upon it matching the existing
deck (composite materials can be used). The Board will not allow any design alterations.
We also require that permits be pulled in advance (regardless of what your contractor may tell
you), and then a copy of the final approved permit once completed must be sent to APT for the
unit file as well.
You will need to bring a copy of this letter to the Salem Building Department in order to receive
your permit.
Should you have any questions or require additional information, please feel free to call me
directly at (781)932-9229.
cc: Unit File
I
500 WEST CUMMINGS PARK SUITE 6050. WOBURN MA -01801.781-932-9229 FAX 781-935-4289