48 NORTHEY ST - BUILDING INSPECTION r }
"ll The Commonwealth of Massachusetts
fy� Board of Building Regulations and Standards Town of
/VIA
Massachusetts State Building Code, 780 CMR, 7ib edition
w Building Dept
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or rtro-Fumilp Duelling
This Section For Official Use Only
Building Permit Numbe . Date Applied: �7 . J
F
e: { V
Bwldi C issioner/Inspector of Buildings Date —�
SECTION 1: SITE INFORMATION
pert
Addre s: �- 1.2 Assessors Ma & Parcel Number
��A� S/� Pis an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq R) Frontage(it)
1.5 Building Setbacks(ft)
From Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40.154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check it yesC3
SECTION 2: PROPERTY OWNERSHIP'
2.1 �Iof Record/' W X f
%7� fY• 1Cej/ /0 �o rFy
Name ring Address for
Service:
Signature Telephone
61, SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ sting Buildin Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Addition ❑
Exi
Demolition ❑ Accessory Bldg. ❑ Number of.Units 2. Other ❑ Specify:
Brief Description of Proposed Work=: — )
-7-tVe ocr %i1�Rti
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: ORlclal Use Only
Labor and Materials
I. Building E Z VJ 1. Building Permit Fee: S Indicate how fee is determined:
❑Standard City/Town Application Fee
2. Electrical S 300 ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S 2 2. Other Fees: S
4. Mechanical (HVAC) S List:
raI
S. .Mechanical (Fire S
Su ression Total All Fees: S g2o
Check No. _Check Amount: Cash Amount:
b. Total Project Cost: S •�Z(1�) ❑ Paid in Full ❑Outstanding Balance Due:
5
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor iCSSLI) Y ? !v L 2��0
Licrnsc Number E. tmuon Date
Ngmc of CS Hylder f List CSL Type(>ce below) (�
T Descn uon
AJ�I •ss
U Unresuicud u to 33,000 Cu. Ft.)
- R Restricted ' Famd Dwcllm
Signature - .M .Mason Onl
9')$- RC Residential Roofin Coverin
Telephone WS Residential Window and Sidin
SF Residential Solid Fuel Rumin A fiance Installation
D Residential Demolition
5.2 Registered ed(\A Le m— .k-em�t Contractor(HIC) ��3
HIC Company NXme or HIC Register I Name Registration Number
J u ay�e.3to� st Ua�r , 2 /Z7led//
979_77!7_Y3-17. Expfri—ion Date
Signature Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 152.J 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
(, 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.
signature of Owner Date
SECTION 7b:OWNE`W OR AUTHORIZED AGENT DECLARATION
' \ 1, ,A r'b" l!:I,--'M kcl `-tf(— __, 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.
X Print Name
gAn
Signature of Owner or Authorized Agent Date
(Signed under the pains and penalties of peru
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�I 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 I I O.R6 and 110.115,respectively.
2. When substantial work is planned, provide the information below:
Total floors 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"
CITY OF S.UlaNis AxSSACHL;SETTS
BL'IIDING DEPARTJIENT
120 WASHIINGTON STREET, )'a FLOOR
TEL (978) 745-9595
FAX(978) 740-9&M
Kl,fgEjtIEY DRISCOLL
MAYOR THOmitS ST.P1FM
DIRECTOR OF PLBLIC PROPERTY/BCQ.DLNG CO%L%llSsl0%'ER
Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectriciansiPlumbers
AnDlicant Information ( _ jPlease Print Letibly
Nalne (Businevorganniizatiamindsvtd"):J r��� \t✓ � �1�
Address: 0 21 e_�
City/State/Zip: V�lay_L),O S ! VVr Phone A: g7`25 -777`/3�iL,
Are you as employer?Check the appropriate box: Type of project(required):
I.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction
9tri
ployees(full and/or part-time).* have hired the sub-contractors
2. am a sole proprietor or partner- listed on the attached sheet ?• ❑ Remodeling
I g
ship and have no employees These sub-contractors have S. ❑ Demolition
working for me in any capacity. workers'comp.insurance. 9. ❑ Building addition
I No workers'comp. insurance 5. ❑ We are a corporation and its MCI Electrical repairs or additions
required.) officers have exercised thew
3.❑ 1 am a homeowner doing all work right of exemption per MOL 11.❑ Plumbing repairs or additions
myself.(No workers'comp. C. 152,§1(4),and we have no 12•0 Roof repairs
insurance required.) t employees. (No workers' 13.❑Other.
comp. insurance required.]
-Any applicant this chats boa sl must atw rill out the satiao blow showing their woke,'conpr sok.policy inforssuak n.
'I Lmuns,am a who submit this aHldsvil indicting they are doing all work alit then hire oulside controcu"nxW submit a new,aTdavil indicting suck
T.mnn cton that cheek this box mug attached an 3d itiunel+Met showing tho no,ee of tha Nh4Vntnean and their wortms'tatmp.policy infomouoe.
I um an employer that Is providing workers'rompetssadon Insurance jar my employees, Below is the pulley ond/ob rite
information.
Insurance Company Name:
Policy N or Self-ins. Lic.p: Expiration Date,
Job Sire Address: IN City/Star_ Zip:
,%ttacb a copy of the workers'compensat policy dec rs age(showing the policy number and expiration hate),
Failure to secure coverage as required under c lion 5A 'M c 152 can lead to the imposition of criminal penalties of a
fine up to S 1,500.00 and/or one-year impriso me well c it penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 u day against the violator. I advised that co y of this statement may be forwarded to the Office of
I nvesi t gat ions of the DIA for insurance coverage vent'catio
I do hereby certify under the pains and penalties of perjury that the information provided above is true and carnet
'lure: Bute:
Phone A:
iOfrial use only. Do not write in shin area, to be curnpleted by city or town o/)Iciat
City or Town: __ __ Prrmit/Llccme M__._. ._.._
Issuing Aulhonly (circle one):
I. Board of llealth 2. Buildlnu Department 3. Cityfrown Clerk 4. Electrical Intpedor 5. Plumbing Inspector
6. Other
C,nuact Person: _. _, ___ __ Phone#'
TONY MICHALEK c.s. #042415 Estimate
30 Preston St
Danvers , Ma 01923 Number: E110
Date: May 11, 2009
Bill To: Ship To:
c/o George Tully
Northey St
Salenn, MA
Terms terms
50% down 50% upon completion
Description Amount
REMOVE PARTITION BETWEEN LAUNDRY ROOM AND BATH TO ENLARGE BATH
REMOVE SHEETROCK IN TUB AND REPLACE WITH DURA ROCK OR EQUAL AREA TO
ACCEPT TILE
TAKE UP EXISTING FLOORING AND INSTALL NEW SUB FLOOR TO ACCEPT TILE
TILE TUB AREA AND FLOOR
ALL MATERIALS SUPPLIED BY HOMEOWNER
PRICE ONLY FOR WORK LISTED ABOVE
ANY UNFORSEEN PROBLEMS SUCH AS ELECTRIC, FLOOR LEVELING,DUMPING DEBRIS
WILL HAVE TO BE BILLED AS NEEDED
LABOR 2,150.00
Total $2,150.00
Your Buisness Is Appreciated
ARCHICAD EDUCATIONAL VERSION
GRAPHISOFT.
V rtua Bu d ng So ut ons
o
�C DO
�1
O�
BEDROOM m BEDROOM
DN DN
E 8A
BEDROOMI,' ','BEDROOM
6 -
72-0' Q LAUNDR 9T-10"
UNIT 50 UNIT 48
1 1009 SF± 1009 SF* o
V-1 7T-.r 17•-5"
CLOSET CLOSET'[
D
I I I 1
MASTER a m MASTER
PAL 7814 BEDROOM< r BEDROOM NORM
on
THIRD FLOOR PLAN UNIT NO. 48DRAWING NO. 3 OF 3
0 5' 10' 20' DATE. 7/02/03
SCALE. 3/32s=1,_0" NOTE: ALL
DIMENSIONS ARE t 1 "
CONDOMINIUM PLANS FOR: RESERVED FOR REGISTRY USE
46— 2 NO T-nEY STREET 9ALEM, MASSACPUSETTS
Drawn By: RICHARD W. GRIFFIN, ARCHITECT
37 TURNER STREET SALEM MASSAC14USETTS
I CERTIFY THAT THESE PLANS SHOW THE UNIT BEING CONVEYED. AND THAT THEY FULLY
AMP ACCURATELY DEPICT THE LAYOUT OF THE UNIT, ITS LOCATION. MHENSIOAIS,
APPROVMATE AREA, MAIN EtlFRiuv.ES, AND flh&EDIATE COMMON AREA TO WHICH IT HAS
ACCESS AS BUILT.
I CEITTIFJ THAT THIS PLAN HAS VEEN PREPARED IN CQMFORMIiY TO THE RULES AND
RE N 0 TH REG OF DEEDS OF THE COMPAONWEALTH OF L4ASSAC9U.'SETTS.
C
r
REGISTERED ARCHITECT DATE
1
J & M Plumbing & Heating
203 Andover Street
Andover, MA 01810
617-794-7322
To:
Job location:
Salem Ma.
Description of Work
-demo existing plumbing fixtures for bathroom renovation
-remove washing machine hookup permanently
-relocate water lines and drain for new sink
-relocate water lines and drain for new bathtub (Jacuzzi style)
-install new bathtub(Jacuzzi style)
-install new shower valve
-install new sink and faucet
-intall new toilet
Comments:
*estimate is only a rough estimate based on all walls and flooring still existing.
*All fixtures to be supplied by homeowner
Total cost for labor and material =$2750.00
Michael Delellis
Ma. Plumbing license#
31533
J & M Plumbing & Heating
203 Andover Street
Andover, MA 01810
617-794-7322
To:
Job location:
Salem Ma.
Description of Work
-demo existing plumbing factures for bathroom renovation
-remove washing machine hookup permanently
-relocate water lines and drain for new sink
-relocate water lines and drain for new bathtub(Jacuzzi style)
-install new bathtub(Jacuzzi style)
-install new shower valve
-install new sink and faucet
-intall new toilet
Comments:
*estimate is only a rough estimate based on all walls and flooring still existing.
*All fixtures to be supplied by homeowner
Total cost for labor and material =$2750.00
Michael Delellis
Ma. Plumbing license#
31533