35 NORMAN ST - BUILDING INSPECTION -
The Commonwealth of Massachusetts
Department of Public Safety
Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(Phis Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
vS 35 Norman St. Salem, MA 01945 Verizon Corporate Offic
No.and Street City/Town Zip Code Name of Building(if applicable)
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Budding Repair❑ Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ 1Change of Occupancy ❑ OtherX❑ Specify: HVAC Upgrades
Are building plans and/or construction documents being supplied as part of this permit application? Yes N No ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No t
Brief Description of Proposed Work: Reconfigure ductwork, add AHU.
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): IProposed Use Group(s):
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 applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F. Facto F-1 ❑ F2❑ 1 H: High Hazard H-1❑ H-2❑ H-3 ❑- H-4❑ H-5❑
1: Institutional I-1 ❑ I-2❑ 1-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑
S: Storage Sl❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ IIA ❑ IIB ❑ ILIA ❑ IIIB ❑ 1 IV ❑ 1 VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Trench Permit: Debris Removal:Flood Zone Information: Sewage Disposal: Licensed Disposal Site❑
Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be P
Private❑ or indentify Zone: or on site system❑ required ❑or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ 1 Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
v SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Timothy McGonigle Verizon 11-13 Pleasant St. Taunton, MA 02780
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Senior Analyst 508-823-0784 508 - 269 1108 timothy.i.mcgoniqle@veriz,)n.com
Title Telephone No.(business) Telephone No. (cefl) e-mail address
If applicable,the property owner hereby authorizes
Steve Benecke, R. C. Griffin, Inc. 49 Central St. Peabody, MA 01960
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.h.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control
Peter Dussault 617-443-4050 45628
Name(Registrant) Telephone No. e-mail address Registration Number
263 Summer Street _Boston MA 02210 PE
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
R. C. Griffin, Inc.
Company Name
Claude Dwan CS078163
Name of Person Responsible for Construction License No. and Type if Applicable
49 Central Street Peabody MA 01960
Street Address City/Town State Zip
978-977-3339 508 954 5711 cdwan@rcgriffin.com
Telephone No.(business) Telephone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152.§ 25C 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 ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor 185,210.00
and Materials) Total Construction Cost(from Item 6)=$
1.Building $48,160.00 Building Permit Fee=Total Construction Cost x 11 (Insert here
2.Electrical $21,2 0.0G appropriate municipal factor)=$
3.Plumbing $
4.Mechanical (HVAC) $115,800.00 Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $ Enclose check payable to City of Salem, MA
6.Total Cost $185,210.00 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering y na below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
applicatio u d accu ate to the best of my knowledge and understanding.
Steve enecY.e, R.. C. Griffin, Inc. Project Manager 7788 -977 -3339 10/17/11
Please print and sign name Title a el)one No. Date
49 Central Street Peabody, 0 960
Street Address City/Town tate r
Municipal Inspector to fill out this section upon application approval:
Name Date
L -
i CITY OF iti'WSACHUSETTS
BUILDING DEPARTMENT
• N 120 WASHINGTON STREET, 3"FLOOR
TEL (978) 745-9595
F Ax(978) 740-9846
KI\jBFRT FY DRISCOLL
vfAYOR THObLiS ST.PtERR&
DIRECTOR OF PUBLIC PROPERTY/BUILDING CONWMSSIONER
CONSTRUCTION CONTROL DOCUMENT
Project Title: S<k!% {' IJA C Llpy .A Date: 00/01 /
Project Location: �,35 NO�»t1►n "ST y SG�N+ � MA
Scope of Project: _/ I,tit[1! o'..s re iou hRo61 I'VRC dSV1CCws.
In accordance with SECTION 116.0-116.4.2 of the 6th edition of the Massachusetts State Building Code :
1,__?C.1tf/ DwS5oLV& Mass. Registration Number 1514 Z8
being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans,computations and specifications concerning:
[ J Entire Project ( ] Architectural [ ] Structural Mechanical
[ ] Fire Protection ,�1Q Electrical [ ] Other(specify)
for the above named project and that to the best of my knowledge,such plans, computations and specifications meet
the applicable provisions of the'Massachusetts State Building Code,all acceptable engineering practices and all
applicable laws for the proposed project.
Furthermore,I understand and AGREE that I shall perform the necessary professional services and be present on
the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the
documents approved by the building permit and shall be responsible for the following as specified in section
116.2.2:
1. Review of shop drawings,samples and other submittals of the contractor as required by the construction
contract documents as submitted for the building permit,and approval for the conformance to the design
concept.
2. Review and approval of the quality control procedures for all code-required controlled materials.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine, in general, if the work is being performed in
a manner consistent with the construction documents.
I shall submit periodically, in a form acceptable to the building official,a progress report together with pertinent
comments. Upon completion of the work, I shall submit to the buildin ial a final report as to the
satisfactory completion and readiness of the project for occupancytN OF Mgssgcy
G
Signature and Seal of registered professional: PETER J.DllssAu
MECHANICA
A 9 No.4
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FSS/ONAL
i CITY OF SALE.N,1, LASSACHusETTS
BUILDING DEPART!,MNT
• p• 120 W.16HINGTON STREET, 3' FLOOR
TEL. (978) 745-9595
FAx(978) 740-9W
KINtBFRI EY DRISCOLL
MAYOR THOblAS ST.PIF4RR
DIRECTOR OF PUBLIC PROPERTY/BUILDING CO%L%IISSIONER
CONSTRUCTION CONTROL DOCUMENT
Project Title: V Z - Se-14.4. R VA C Jp 4 r.,k Date: LV 01 `
Project Location: 3 Noem&n SF r Se lem MA
Scope of Project: _L!11_eieU_As[tva roiey&4 oni {la I+VAG Syaks-4s,
In accordance with SECTION�116.0-116.4.2 of the 6th edition of the Massachusetts State Building Code :
1,�G / V&*xJgV/,� Mass. Registration Number —1�&Z8
being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans,computations and specifications concerning:
( ) Entire Project [ ] Architectural [ ] Structural X Mechanical
[ ] Fire Protection ,1►Q Electrical ( ] Other(specify)
for the above named project and that to the best of my knowledge,such plans,computations and specifications meet
the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all
applicable laws for the proposed project.
Furthermore,I understand and AGREE that I shall perform the necessary professional services and be present on
the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the
documents approved by the building permit and shall be responsible for the following as specified in section
116.2.2:
I. Review of shop drawings,samples and other submittals of the contractor as required by the construction
contract documents as submitted for the building permit,and approval for the conformance to the design
concept.
2. Review and approval of the quality control procedures for all code-required controlled materials.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine, in general, if the work is being performed in
a manner consistent with the construction documents.
I shall submit periodically, in a form acceptable to the building official,a progress report together with pertinent
comments. Upon completion of the work, I shall submit to the buildin ial a final report as to the
satisfactory completion and readiness of the project for occupancy 'oT\OF AI'18 �
Signature and Seal of registered professional: PETER J. cm
DUSSAUL
MECHANICA
No.4
9�FF
SS/ON A L
_ CITY OF SALEM, MASSACHUSETI'S
WILDLNG DEPARTNtENT
• 120 WASHINGTON STREET, 3tO FLOOR
TEL (978) 745-9595
FAx(978) 740-9846
KI\LBERI EY DRISCOLL
MAYORTHOb(AS ST.PtFRRF
DIRECTOR OF PUBLIC PROPERTY/BUILDL\G COJLMISSIONER
' CONSTRUCTION CONTROL DOCUMENT
`�f Project Title: Z — Sale- M R VA Date: dBh l /
Project Location: _35 N#"M&n SE y 54 IM O MA _
Scope of Project: __11J_ert //.Asta�tl rerte.,sa}io11 It, VRC STekwtt.
In accordance with SECTION 116.0-116.4.2 of the 6th edition of the Massachusetts State Building Code :
I, PVSJpV_L_ Mass. Registration Number 1stI ZA
being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans, computations and specifications concerning:
[ ] Entire Project [ ] Architectural ( ] Structural Mechanical
[ ] Fire Protection ,�IQ Electrical ( ] Other(specify)
for the above named project and that to the best of my knowledge,such plans,computations and specifications meet
the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all
applicable laws for the proposed project.
Furthermore,I understand and AGREE that I shall perform the necessary professional services and be present on
the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the
documents approved by the building permit and shall be responsible for the following as specified in section
116.2.2:
1. Review of shop drawings,samples and other submittals of the contractor as required by the construction
contract documents as submitted for the building permit,and approval for the conformance to the design
concept.
2. Review and approval of the quality control procedures for all code-required controlled materials.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with
Elie progress and quality of the work and to determine, in general, if the work is being performed in
a manner consistent with the construction documents.
I shall submit periodically, in a form acceptable to the building official, a progress report together with pertinent
comments. Upon completion of the work, 1 shall submit to the buildin ial a final report as to the
satisfactory completion and readiness of the project for occupancy0"OF M,g8'9
Signature and Seal of registered professional: z� pUSS PETER J. m+
o MECHANICA
-0 9 No.4 2 v
FG/g
FSS/ONAL