231 NORTH ST - BUILDING INSPECTION C_k Sol2s '°
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
t Massachusetts State Buildin ppCodR,EnMIQEa SALE�r�¢ Revised Mar2011
Building Permit Application To ConstrucW �t,�Itepair,'RR A' wl7eriiblish a
One-or Two-Famil Dwelling
This Section For c' se l
Building Petrnit Number: IV Ju—
Date App 'ed: to 8 D
Budding Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
L /� 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
U 1 a31 fYo(1 �n s-h-cep siw. MR a19�0 �-4- cd . {o
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(R)
[— - 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:
Public Ej Private❑ Zone: _ Outside Flood Zone?
Check if yes5r Municipal dOn site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ownert of RecoXd:
VOL Sa �_,UIG Sa.(ck MA- Olaf
Name(Print) City,State,ZIP
A31 nJ6(44 6n-a(3- YHO vakirs to dLA aQ q n1cj ry
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WOTW(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed World: vavt a sve
� 1Sit�r._I 1 ?J` AZE�
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materials Official Use Only
1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Su ression Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ tj 6o. ❑Paid in Full ❑Outstanding Balance Due:
SCAT bli 5 m N ,O .
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
R Restricted]&2 Family Dwelling
Cityfrown,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name i
No.and Street Email address
City/Town,State,ZIP 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 PERMI
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 Owner's Name(Electronic Signature) Date
SECTION 7b:OWNEW 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.
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. 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 can be found at
www.ntass.gov,'oca Information on the Construction Supervisor License can be found at w%vw.mass.aov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
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 Cost"
S( C 7S P\51U�
QTY OF SALEM, MASSACHUSETTS
,vb sj BUILDING DEPARTMENT
5aj• "m <frs 120 WASHINGTONSTREET 3"OFLOOR
TEL. (978)745-9595
FAX(978)740-9846
KINMERLEY DRISCOLL
MAYOR TrIOMAS STRERRE
DIRE CTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
Date b�aOlS- \
Job Location 23 t N06-k S-I t'Lfit , S��""rM'01JA I✓)A' D(a n
Home Owner Address o;M N01�}�1 *e eto SgjCgA fgft DIQ,O
Present Mailing Address a31 ND( 4 A1,C4 , S&I-Oh Mft 0Ig7t-D
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 that does not possess a
license, provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or
is intended to be, a one•or two-family dwelling, attached or detached structures 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 he/she 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 understand the City of Salem Building Department
minimum inspection procedures and requirements and that he/she will comply with such procedures
and requirements.
HOMEOWNER'SSIGNATUREq �
APPROVAL OF BUILDING INSPECTOR
y UNIT AREAS
+� 231 A 2318
1, jIRV 1IR F 619f5F 74*31,
iCIXiD R 514*SY FVaSF. A poy 6 a
` BA3 EtIT S553SF SUfit ,. 9r10Y UNIT S
TOTAL 1,688 F 1F 1,YB'1:SF: 2318
PETER & MARY SAL2NS om �
C GRANITE
PARCEL JD:II-D1313]-G UNIT
G=_, 31 CERTIFY THAT THIS PLAN
PREPARED :N CCMPLJhNCE' WITH THE THE
year LA
k RULES ANSI RCGLLATIDNS OF THE
ec REGISTERS OF DEEGS.
�r v
r= -
d
a 'T"R SECOND FLOOR;
�6,000±S.F
N f _
TOTAL a 0.41LNp0 & ALAIDE CORR`JA t .
233 N0Ii 5?.
PAR..EL 1Da7-]-Dt33-D ..
..*.. ,* UNYTSI 231�
y y
wil
Lt1 �..�^' ' �A _UNIT
LLJ 2318
I "
tW �
Yt, ni a3 �. d4YA , ,.:� r .•=:,I I UNIT rusty¢ :
It
Lo
r 2310 t52,
1 x
r �
1
t <
ukvx
W BASEMENT
, UNIT ` UNIT
231A �,.° 2378
GRAPFIIC. SCALE
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Y 196 p FYI xT'nNYCi 5 ilee6tR - .. .
k
SALEM, MASSACHUSEIIS
FIRST FLOOR SITE & MASTER FLOOR PLANS
4R' 231 NORTH STREET
as \UYI{231A ti HERBY CERTIFY,.cuNrn A
LINES
r- SHOWNEON THIS PLAN AARFHTHER'UNES CINDING CONDOMINIUM
�+-*_=----¢..-NORTH 4STR STREET ''_. EXISTING OWNERSHIPS, AND 1H JNES OF THE
_ ___
5TPUBU AND OR WAYS SHOWN ARE R WA OF PARCEL ID: 17-0738 0
Ij REAOY ES PRIVATE STR ETS T WAYS RED �D SURVEYORS
ALREPUY ESABLISHED. AtJD THAT 40 NEW ft
ONES FOR DIVISION OF EXISTING OW'NERSH'P 36G CHATHAM STREET
LYN.N, MASSACHUSFITS S^'
RECORD OWNER A/K/A ROUTE 114 OR FOR NEW WAYS ARE SHOWN.' PHONE R781 592-2880
USED REIF32,GE 5: RI LTS SD DATE: AUGUST' 4, 2014 SCALE 1"=10'
is
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THC Com as Name or IIIC Re suaut Name + a a ^ +"'
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SECTION 6 WORICER$'GOhHtES(SATJON IN ItRdt CL AFFIIIAV f ChY G Lµ cc.J$ § qfi F
r Insne-Aid a_ ,. a ` ' 2WorkersCom ensatiunuracaavrtmustbe eanPleiedand subruttdwrtb this
thisafIIdavitwdlresultmthedenraloftireIssuanceofthe'bmldingpennit t,�;� `Nr ;> , '° n „_ ),�
Ma1.Wr ad -
M YtG,h u S1gRed AffidaVlf Attaohed�s YeB: .,. °�#NO L „P.t �r "'! a+ „ 4t n tr i€y' + 3 ua i'
.Y.F x ti''2g � -t"SECTJON7etOWNERAUTHORIZAI'IBNTO'IIECOhJPI.ETEDWHEN ,� ""'{, F �.s '
' x ¢aT R rF k A� DINNER 5 AGENT bR CONTRACTOR AFPLIFS FOA BUILDENG pERItIIT }, n t6RIM
n #it'k^A,M,re$Mp Aar ka 's a'.T F6pna'N ds Ei6 i xarfl<FM'i"'P
ruse € n� a :v p,v a f` ,v5 i w '
n iaF q-„ i s SH, an t"-
t - + ;: 1 as Owner afthe subject property,hereby authorize :HIM aA+-
�..
to act Un my behalf in,alI matters r 11 elaOii to work authorized bytltis bwidmg permit apphceuon a it v m-' ' aM x;l;xi"'
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y. tl4 F{ tY lily $9CTION 76f OWNEW'OR, ),}�FYiV 1A ' GGIYd r �Ma� � I f
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} to 6"3 By entering my name below,I hereby attest under the pains and penathes of pequry that all of the utfovnatton, `t r . °, ' !
e. - ties an m a r a,* z,,,c n x . i ki. r m+,
3 contained m this application is true and accurate to the best of my knowledge and uuderstandmg �r n -mac ,r ' �� ,
a x iP,ri;' },v as
sl. �tM '3Vet'.r ary
}i ..I
oriel k #- YeY`
, _..'} e $r i e15, `kl frs#6#.auh;xiPNlYdatv,r` ailw--sir NOTESrxarutbgars,'' ryf`l hRd' ' ' a, +! ..`m"` `I9s x !.$
t =�" r x,ka'{not registered m t6e Home Jmprovemeni t,ontractor(HIC)Program) wnll not hhaveH actsess to the arbitrda contractor
tra"ctor
t_ 1 1
'
x� 1S
,;ry a nprogiam or gua�snty fund under M C L�a 142A Other impoRant information on tlse HIC Program can be found at '
, Fx`t r, a wwty"mass idv/oca InfonnaLan Du the Constiuctton Supervisor Ltconse can kle fouPd'at wu'w mass ovldns a r , 'f"t"- " '
" 2'„x,Wherisubstanllalwortttsplanned,prowdetheutfotmauonbelow sr +` . gi ' t'all�fiEl�-ta "'rea"''-r«,.n,, r ''
€ a' Total flooi area {in{sq R ,rr + " `'`"x r t'"� cluding garage,finished basemenUattres r decks o porch)
Yarve K ` Gross hvhi areas ff , , '"a l '�;ix * �' , r`�"" ' i' Habitable loom count " " , ; r �' 'f
tpf r,za" Numbcroffueplaces )�"' �:.+r t �: a 6+ `l alas Number ofbedr 0-MS,HHNiPPRi+ %� =� ,. I f j
fi vt Ego a fr i Mgr tIA�M
Number o[batbrooms �"x' ��`l r'x it r t "� r Number oPhalf/batits'a � a .
rs:; zi mg4. isl"x4 p is Rs a a As € r
"' ,..�� a� Typo of heating system: ur g .-.a*-l.+a, a�. x!L kv ss " t la Number of decks/porches d, a a P r ,
s #,, ram` ErTYpeofc_oolmgsysiem;,,,,,,z`°: "` hrs � `T,� , Encloscd{fFu'"r+ ut rKllreun rs
4
a , l :s 3 ,Total Protect Square Footage maybe substituted for,Total Proloct Cost'd4
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