17 NORTH ST - BUILDING INSPECTION (4) The Commonwealth of Massachusetts
Department uipublicSafety
Massachusetts titatc lluildin!;_Code(781)C\Ili)
Building Permit Application for any Building other than aOne-or Two- Dwelling
(This Section For Official Use Only)
Building Pennit Number: Date Applied: " Building Official: _
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
No.and Street City Town lip Code Name of Building;(if applicable)
SECTION 2:PROPOSED WORK
Edition of MA Stale Code used_ If New Construction check here❑or eteck all that apply in the thvo rows below
Existing Building Q/ Repair V1 Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change Of Occupanga ❑ Other ❑ Specify:
Are building plans and/or nnhstruction dhK'nlnentl being Supplied as part of this permit application? Yes ❑ No Is in Independent Structural Engineering Peer Review required? Yes ❑ No 0
Brief Description of Proposed Work:
.-7'jj LT tr
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 CRIR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of floors/Stories(include basement levels)& Area Per Floor(sq. ft.)
Tot:d Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-1 ❑ A-3❑ F B: Business ❑ E: Educational ❑
F: Factory F-I ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ 11-3 ❑ H-4❑ 1-1-3❑
1: Institutional I-1 ❑ 1-2❑ 1-3❑ 14 ❑ M: Mercantile❑ R: Residential R-113 R-2❑ R-3❑ R4 ❑
S: Storage SI ❑ S-_2❑ U: Utility❑ Special Use❑and please describe below:
Special Use
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
LA IB ❑ 1L\ 0 1160 IIL\ ❑ IIIB ❑ IV ❑ I VA V11 ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit: Ucbris Reuhnval:
Public❑ Check if outside Flood Zone❑ Indicate municipal ❑ A trench hvill not be Licensed Disposal Site❑
required ❑or trench or specify:
Private❑ or indentily Lune or on site system❑ permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: V \ I illh s .��.���.�, i a ., . .
Not Applicable❑ Is Structure within airport approach area? IS their rev iecv completed?
Or Consent to Build enclosed Cl 1 es❑ or.No❑ Yes❑ No ❑
SECTION 8:CON"I"EN'r OF CEI("1'IIIC,*%I E OF OCCUPANCY
I'.ditiun of Code: L'se Group(s): _ __ 1'%peot Construction. _ -_ Occupant I ood per 19ao r:
Does the building contain an Sprinkler SNstvm:': __._ _ —_Spec iol Stipulations:
t
SECTION 9: PROPP.R'rY OWNER AUTIIORIZA1ION
No.,lod Address of Pr pperly Ote ncr, —
Name(Print) i t� t.Snd Street City/Town Zip
Property Ort'ner Contact Inform,tion:
>76- ' f ?-�f1 �'� :'3o1 C//f Y/g- �.vr s� Corr
'I"itle Telephone No. (business) Telephone No. (cell) c-mail address
If,applicable, the property owner hereby authorizes y,�J �•
�.��ll'�
Name Street Address City/Town State Zip
to act on the ro er owner's behalf, in all matters relative to work authorized by this buildingpermit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) y
1f building is less than,15,0W cu.ft.of enclosed s•ace and/or not tinder Construction Control then check here O and ski Section 10.1 i
10.1 Registered Professional Responsible for Construction Control
Nance(Registrant) �.;Tclphone No. e-mail address Registration Number.
Street Address ,r City/Town State Zip Discipline Expiration Date
10.2 General Contractor
ZC c
C011112"Illy Nance
i
Name of Person Responsible for Construction License No. and Type if Applicable
>6C1
Street Address City/Town State Zip
" r 91ct� , 07 i ,t�
"role phone No. business Telephone No. cell a-mail ddress
SECTION 11:M INKI;I,", ( (WIN b.,N5A I ON V,1JKAN('I(Al_tO"Avl f 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 a lication? Yes❑ No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Ihm Estimated Costs: (Labor
and Materials) Total Construction Cost(from Item 6)=S_
I. Building $ SZ c1 Building Permit Fee=Total Construction Cost x (Insert here
2. Electrical S ' appropriate municipal factor)
t. Plumbing 5
a. Mechanical (HVAC) S Note: Minimum fee=$ (contact lilt]llicipa It tv
'
3. Mechanical Other S F.ncluse check payable to
h.Totdl Cost 5 �f;7 (contact municipality)and write check number here
SECTION IS:SIC NATURE OF BUILDING PERMIT APPLICANT
By entering Illy mince below, I hereby attest undor the paints and penalties of perjury that all of the information et wined ix t1tis
applicaation is true and accurate to the best of my knowledge and understanding.
Please print ai, I .i;n lilt 11 l-itic Trlc hone 'o.
V- -
<treet Address icy/Town State /ip
i
Municipal Inspector to fill out this section upon application approval:
Name Date
' r
CITY OF SALEM
PUBLIC PROPRERTY
SD DEPARTMENT
.nn:.4:1 Y:Inl4 L•11
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11: \VAtlq.\GIU.\)IxCI.1' � $a1PN, M.11h,p.ln 4I nJPII,^,
Workers' Compensation Insurunce \tOduvit) Oullders/Contractors/tl ctrlclans/Plumbars
I )Ilcant In unnaflo
PI all Int le 'hl
V;I IT)a Illuwltctyl)raanlralinrvinJlrlduull; r /`�J
s
C1ly,Stare,Zip- S' .G I hunt ifi- �
I .\rv)nu ' 1,eirlploycr' Chuck the appropriate boo
1 :fin a cmpluyur with—_ 4. Q a ycncnl couoxlor and 1 lype trprn)uce(rullulrtd);
2.0en x(lull and/or part•tima).• huvv hired lhu.+uh.cum rjvOrS 4 New cunxtruenon
1.11111.solo propricrtx or partner• listed on the.ittachell.nccgc 1 �•�,Rmnabiins
vllip and hava no vmpluycc'x These subcontractors have "working l)rr Ine in any capacity, workers'comp, insurance. ❑Demalirion
I NO workers'sump. insurancd 3. ❑ Wean a cmporstion and its 9, ❑ 11uil4lin f JJdhiun
rvyuirud.J atttecn have evercircnl their 10.0 Electrical«psis or additions
7.❑ I ys l humv r workers'cul all work sighs of exemption per NIGL 11.0 Plumbinr repairs or additions
Inystlf, e rc ufed. comp, c. 132,¢1(4),anJ we hnva no
i,laurunca rcyuired.) l ctmpioyeux. (No workeq• 12.0 Ruul'npuirs
comp, in..urancurvyuind.J 1).0Other
\'O•i�plwYn gltx cheb has nl Must.t6u fill Intl Ihs webun LLIuw dwwu, I
t lurnwlwrwn who t.4m'il this Amdavil iAdi%atin I e U•i•u'whwl euntptnLWlw K Iuhrr
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tilyl,hall Burin IN runty t✓IM tae•eeMraCitYe and thsr uuAps'fO1M,Ixrl,cy ull,rlxsna�
/arm fin velployrr/haf Jr pruY!✓/nr lvurArq'rurnprrlmdos Lhmfnmee/sr/ny enp/Yprra BdwY/s Me plmy und/YI aif�
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Insurance C'un,pany.Vmnt:_iy�y .
14dicy 4 or SvlGins. LiC.rr: __•_
Enpirahon Dane:
lob Silo -\dJres.v: /7 i(�i/Z /f ��•
fJiV 11117, C•ny,�Ialeizip;
.vtacA a cnyy of tht workers' eompnsa[loe pulley Juulrrallun page hhowlnq rAe policy number and espirarlus ,
Pallury ill recurs cuv erup as rt:quired under Sccliun 231\ ul'.�IOC c. 132 wa lead to tht im
,6 all
fill it to sO 00..IM and/or una•year nnpri.vuumvnl, ax tYvll as civil pcnaltics in tht lunn Ora STOP 1VORK ORDER alnd a find
,,i up ra i'1n qn,l Jay I�uin.l the v,ol.lrar. Ile aJvl.tc•d lhut a copy urlhty .tulvmcnl may be IurwardeJ to the Ullict trf
bn an�awnta u(;he UL\ .or n,surltxe:nvcru,u ,ct riiulum.
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1 Ill,,u'd I(Ilealth 1. Ilwldln. Ihpar hllYtll I. l:ill.'fgwn C'Icrk J. l'Ivetririll lot rLr lur i,
6. l)Uter I Plumbing Insyeclor
i
it1' 'I.IL'l I'trwu:
information and Instructions
ll employers to provide
workers' compensation tot ill,:'(
i2 eyuueY a
cutployees.
r+ service on to the e of another under Illy cuntnet of hire.
\I.u;.I.hu:eus GCnenl Laws chayttr I I
I•ur.u.un to Ilya.utula, an rmylusae is defined at". every Pc
;.press or unphcJ. oral or wruten." oration ur other legal enrity,or any two or more
artner"It aYYOCta11Ua,Corporation lu yr or the
to ,•,nplupar is defined as"an Individual, p tom vroplo)CCo. However'hit
t the Gutggmli engaged m a)omt enterprise.
ind isoetayoa or other legal analy`ompotya Ceased employer.
I¢Cmver or trustee
ul.tit indicr that
aing p
employment be deemed to be an employer.'•
r+ono w Jo maintenance,eumuuetion or repair work on such Jwellina huuae
owner of a dwelling{house having{not mere Ihta Three apartments and who resides therein,or tht acupanl o
.Iwelling huutt of another who employ" f
,,r on the grounds or building appurtenant Thereto shall not because of such emp oY
�IGL chapter 132. y25C(6) also $tates th°t''tvary staff or local buildings llo
18 the shag withhold the Issuance for
reneltel Ur a license 'if Permit to operate a busintac e. to tie\11 umaiN w1te thesinsuranct ovtrageiregor any
VP rodu eed a cceptablee*vId* her the ommonwualrh not any of its political subdivisions+hail
r lleunt nbs has not p
1ddiUunally, �IGL chapter I S_, i-3 I
enmr into any euntract Ior the pereom+an1 d Vf pUbh.�work tt`N„u„�Jh�hadtyviJance°fcumVli+nce with the insurance
requirements of this Chapter haw bean p'
Applicants checking tht hoxcs the apply to yutu situation and,if
ensnion atlldavit em )aladlphona number(s)along with their eartiJleale(t)of
Pge;�sa gill out the workers' comp with no employee ether Than the
necessary,supply Yub-contructor(s) name").addreea(nr)and p have
worktrs' compensatio submitted sur ce t if so
the LLCf)epa at LLP
a e�Industrial
Inswvnce• limited Liability Companies(LLC)or Limited Liability PaMtnhips lLL
Inenrben or purtners, are not required to carry
employees,a policy is required Be advised that this atlldavit'naydavit should of
lie cads Aticin far the pannit or license is being requested,not the DtD
reeidents Ior confirmation of inauraneo coverage All*be sure to slga sad Jute the an d to obtain atpantr workers'
f
he Icutmed to ilia city or town that the rpp uestioas regarding the law or if you an required
You have any q epics should ems thew
I ndustriul l,on pelie should
s"call the Deparanent at the number listed below. Self-insured pomp
compensation policy, V
stir-insurance License number on the a ro riots line.
City,or Town OMeiale
please be surf that the affidavit is complete Al printed Iof Inv. The Department has provided u space
h the liCaft t
of rho uifidavit fur YOU to gill out in the event the C hi� of investigations has to contact nut you ren addition,
the applicant.
applications in any given year, need only submit one atlldavit indicating current ar
I'I:ase be sure to RII in the petmiNicmtl* nwnbar which will Ix used as a reference number. In addition,an uPP
hat must submit multiple pennitJliearsa app cd h marked 1t die city write
town ,nay be provided to the
policy i,,Iormation(if necessary)and under•'Job Site Itaripe the applicants lid city
write"all ),nay b p o Y
town)•"A copy of the ullidavit that has been officially sump'
applicant as proof that a valid affidavit is on rite Yor tLttsn permits of licenses. t new atusines muss be Ailed out each
y eor. Where a home owner or eitiaen is obtaining a IicenYe or Penn" not related to any business id eomnwreial venture
a Juge lieenst or permit w burn loaves tie.)said person is NOT required to complete this affida a haw•ny yuesueus,
I hC t)u1Ce it lorerrigatiuns wuuld het to thank you in advance fur your Cooptntion and should y
plea.e Ju nut hesitate to give us a Call.
fhe U:parnncnt's address, telephone and fax numbtr.
The COMM nweaM of Massachusetts
Department of Industrial Accidents
Olflee of Invest[gpdons
600 wustinston Street
Boston, MA 02111
fei. N 617.727f 6l1 7
00 Catt 02 of1d9"-MASSAFE
n. I s www.man-gov/dia
.A,
CITY OF S,V-&Nfj ,. USACHUSET-rS
BLtLOLVG DEP.1RTlF.\T
120 W.liHLVGTON STAEST, }a FLOOR
T-EL (978) 745-9595
KIS03ERLBY ORMOLL RVt(978) 740.9846
MAYOR TRo.►W ST.PtERRtt
DIRECTOR OP pL aLlC PR0PERTV/8L:MDLYG C0-%0i1SS10V ER
Construction Debris Disposal Atttdavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.1
Debris, and the provisions of MGL a 40, S 54;
Building Permit M is issued with the condition that the debris resulting from
this I
I I. S 1 SOA.
work shall be disposed of in a properly licensed waste disposal facility as defined by hIGL c
The debris will be transported by:
%� /%h �rS c7A i, j
(name ofhaular)
The debris will be disposed of in :
. (name orfagdily). _
(JJdR1J O' �Nllly)
z ayn�mra oof,/er .otipphunr.
L/
,nn vA b.
Wednesday, November 2, 2011 9:36 PM
Subject:Minutes for Condo Meeting on Oct 23,2011 (chaine@hainews.com)
Date: Monday, October 31,2011 9:35 AM
From:evelynsmdtay@gmail.com
To:Charles Heine chaine@hainews.com
Cc:bobdawnl@gmaii.com,kate.a.soto@gmail.com,chdstina.ssekandi@mrc.state.ma.us,
orlando.soto.2@gmail.com,carolinesvoox@gmail.com, ianjoox@gmail.com,Ssekandi,Christina
cssekandi@yahoo.com
Conversation:Minutes for Condo Meeting on Oct 23,2011 (chaine@hainews.00m)
®� I've shared Minutes for Condo Meeting on Oct 23 2011
Click to open: _
Minutes for Condo Meeting on Oct 23,2011 -
Agenda for Fall Condo Meeting /Minutes from meeting added in blue.
Attendees: Bob& Dawn(hosts),Connie,Caroline,Christina,Kate&Orlando,Evelyn
(recording minutes)
Confirm minutes for 7/11/2011 meeting. CONFIRMED by all.
Ongoing Old Business:
*Budget update
Kate reported that so far in 2011,we have received fee income of about$12,000 and have
spent about$11,000 in expenses,which is on track with the most recent version of the budget.
At the January meeting,Kate will report on 2011,and propose the 2012 budget.
Bank charge
Kate reported that Salem 5 is now charging us$12 per month for our checking account.
ACTION: Kate agreed to call Salem Five to ask questions about getting the fee withdrawn,
and also to call other Eastern Bank to see what their fees are for the same services.
VOTE:We voted not to open up a credit card account for the Condo.
*Common area punch list
Based on the letter sent in February,the remaining items on the common area punch list
are:
>>Replace the existing sump pump with a new,larger one.
>>Paint and finish the external basement door.
(Any actions on this?)
*Fire Inspection update for annual certificate
We need to know who initiates the fees for and the timing of the fire inspections.With that
knowledge we can question the timing and perhaps avoid the large fee we had to pay this past
year.We can also consider alternative providers at that time.
ACTION: Christina to call(or was someone else going to do this?)
*Quarterly dates for condo meetings
The following dates are to be reserved for the next four condo association meetings:Jan 15@
unit 3;April 15 @ unit 6;July 15 @ unit 4;October 2b,@ unit 1
*Ongoing projects
Weeding
Connie and Dawn have put in many hours each weeding the front garden and generally
making the area more attractive. Connie and Dawn are planning to plant hydrangeas this
spring and also to lay down more mulch. if we know the date/time ahead of the next round of
yard clean up,more people may be able to join in.
VOTE: We unanimously agreed to Dawn's suggested budget of—$50 to buy the plantings.
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Watering system
Orlando reported that the watering system is now installed and working well.Some hostas
that look dried out will be checked in spring and either replaced or pulled,or the watering
system adjusted,if needed.
ACTION: Orlando will purge the water from the two outdoor spigots within the next week or
two.The water will need to be turned on again come spring.
Fall clean-up
Connie offered paper yard bags to anyone helping to keep the key areas on our lot clear of
leaves.
ACTION: Orlando will call John to ask him to pay particular attention to the leaves along
the edges of the house,and also the leaves that get trapped under the plantings in front of the
house.
Building maintenance
VOTE: We all agreed to Christina's suggestion to place a sign-up sheet beyond the entrance
area& to ask John to sign and date the form each time he cleans.Orlando will call John and
to let him know about the sign-up sheet and to confirm that John comes to clean about every two weeks.
Window cleaning
Connie proposed that we have the outside of the windows cleaned professionally; however,
everyone agreed to wash their own windows. Bob offered a tall ladder that others could use.
Others offered advice on how to tackle the higher portion of the windows. We all agreed to
try to clean the outside of our windows before the January meeting so that we can see then if
we need to do anything additionally.
*Parking concerns
After much ado,we agreed that tolerance and respect would go a long way to defusing this
hot button,providing that people ask ahead of time if it's okay to use a space/area that
compromises an owner's ability,to park temporarily.
New Business:
*Church construction
There's nothing to be done but live through the construction.It will likely be over soon.
*Eaton Place private vrs.city governed
Connie will give a brief summery of Oct 12 City Hall meeting
Kate will relate her findings on legality
We need a consensus of our next action
Several people shared their knowledge about this.In 1996,the City of Salem intended to take
over Eaton Place from Mr.Sevicky,the owner.Apparently,the City's process was flawed and
in fact ownership was never changed.Nonetheless, Mr Sevicky is asking for his ownership to
be clarified and confirmed.We have a legal easement to use his property.Kate has since
forwarded the easement to everyone in email.We have no reason to believe that Mr Sevicky
will not continue to abide by the easement. The next meeting on the property ownership will
be about three months after the last one,sometime in late December or January. We'll need
one person to represent the condo association at the next meeting&their role will be to
confirm that the condo association has no.problem with the ownership"change".
*October rain problems
Dehumidifier
New findings
Solutions
Where to begin?! Connie and Chuck are having several contractors working to repair the
damage to their unit caused by the extremely heavy rains and the possibly faulty sump pump,
and/or problems with the water system for the whole house.
ACTION: Connie agreed to ask the contractors for their professional opinions on:
• The sump pump configuration
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• The drainage and water management system for the whole house
• Whether and how we could install a water sensor
• How best to dehumidify the basement
NOTE THAT we may need to hold another meeting prior to January to discuss any actions
based on these opinions.Or,if things appear to be straightforward,we could take next steps
by email.
VOTE: The majority(units 1,3,4,5,and 6)agreed that Connie and Chuck could proceed -�
with installing a fire-proof door so that they have access to the basement area.
*North St.door refinishing
The front doors have dried out as they were not sealed.The door should be sealed before
winter starts.
VOTE: We agreed that the condo should proceed to get a quote for this work.
ACTION: Connie to get a quote from her contractor.(We'll vote by email once we know the
quote.)
Lastly,apparently the owner of the red house next door has asked that we do NOT hang
anything over the fence between his house and ours.
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