Loading...
0033 CEDARCREST AVENUE - BUILDING JACKET aooio P4 Certificate No: 700-06 Building Permit No.: 700-06 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0033 CEDARCREST AVENUE in the CITY OF SALEM Address TowrVCity Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY NEW SINGLE FAMILY HOME This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires - - unless sooner suspended or revoked. Expiration Date Issued On: Fri Nov 17,2006 GeoTMS®2006 Des Lauriers Municipal Solutions,Inc. """" """"""'-""""""'-------"""""""""'-"""""""" '9S�IQ . ,�,�,, �' �► � s W V + � .. ���C���s 0033 CEDARCREST AVENUE 700-06 166 s I COMMONWEALTH OF MASSACHUSETTS (Ma 21 Map: — — CITY OF SALEM Block: FLot (Category: 11101 New Single family re�n,lt# _- 70006 BUILDING PERMIT Project# JS-2006-1446 Est. Cost: 1$196,000.00 IFee Charged. $1,181.00 '(Balance Due: $.00 PERMISSION IS HEREBY GRANTF,D TO: c onst.Class: 6 l Cotitr¢ctor: License: AIse 61oup: _ PattiCasseli Lot Slze(sq. ftJ: 30492 ^ riomng R1R _ �Owiier LYMAN. ANDY r__ ___ .�._ _.,,,,_ _._._ A Ilicant _'aul C,ts. ;i -(hits Gained: App limit: Units Lost: _—{ -- Al": 0033 CEDARCREST AVENUE ISSUED ON: 02-Mur-2006 AMENDED ON_• EXPIRES ON: 02-Sep-2006 TO PERFORM THE (FOLLOWING WORK: 700-06 NEW SINGLE FAMILY 4OME PER'PI.,ANS SUBMITTED TJS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Cas Plumbing Build ne - Gadergruundr L.udern„on'td!-- ' - Service: Meter: r _ , Footings: Roughs Ay/QZ iw Roughs 1 L�"� "-oY lio;tvh�,y// X'/ reuudaiion: /A�y Final:1017114 � �Fin71: ` i�inal��,I y'U / HoughFrame: Up. // ! %._.ty�fY�J- _il+ircplace/Chi nc D.P.W. Fire IHeat h .. Meter: Insulation: Final: yy� l//i7/06 House p Smoker Water: Alarm: i Sewer: THIS PERMIT MAY BE REV—f_s--ICltill BY THE CITY OF SALEM 11PON OLATI€N OF ANY OF 11'� RULES AND REGULATIONS. Signature: '�•' ' Fee'rype: ,tteceipt-No: va(e Pldd: (Check No: Amount; BUILDING RFc-2006-002047 02-Maz-06 1411 $1,781.00 ' � 6 (- •� r 1 "��. P4���i�t...-� t' 3�£.: ft`s. R to ual O 3 , � +Y IIe� tor d . H IR r , • GeoTMS®2006 Des Laurier Municipal Solations,Inc. 't. V30VE AD CITY OF SALEM BUILDING PERMIT N�.-�Q� s ��,,,r$U City of Salem � :� � �' p..�- ��N�,.,� : : � � � t--�s . _ . ' ��,o� �� �y . k __. _ � ����2. � � : '` _ , EtPP1.l�►TION PERMIT T BU11 - ��� �. T1 R N NS O LD ADDfTtON, Mq�C :.A4TERA. ON3 O EW CO TRUCTI ;- di�OAT/IM�•Apip�Yeanf Eo'"` alpWn�N s�etlotn:4 K � N,and OL I _ . ... ....Ls:~. . . . �p� _ L . AT0.OGTIQN � � p161qCT LOCATION , , _: / pf =' - eE�w�p �"'.# �!/i. ' �;;�"�r-��' Np ��✓Gre� ��1 BUILDIPKi s��msowj /Yi�.�, �,rcT ���� �"�a'i�!, .� , �-- r. TYPE ANO COST OF 81lLDNQ-N aldqlk�s compNU Pi�As A-D A. T11P!OF Yi110VElIBf[. .. . .. ¢ pl10�.11lR�FOR"�EE11101J710fC U9E M08i.REC6if 1/9E' t�j w.r aydYy _ � .._ � _M�YrwF:�:_ . � _ � . �s�1� -. . ! ❑ AMMIse tli iwitl�4�nA►mn�Mrd n�r'. -� 12�i On�yII�M � t�Q M�L�7�r InYnPuqaOtl�LL/wlcnl�Q/�l ` . . - 1fQ.CMRRal1!A�MfDbn! a p M..�a..z.ea.r ,a 0 �.a.r�w•�rA.�e. �o Q ra.rr. , . o a.o..�,. ,, o ,�.,�.��a�. r a P..��..a., : �ir..e.aar� . _ n Q s.Msarr.a.a.� . s Q �vN��+riwdrrYl�nrreedr. . . . . .F,:; .. . 7t Q Ne�n�4lr!M!e!�!: du�wn.hrWiynM4 f�l.. . � .. �0 Q GrN�- � 2s Q Cwe�OiP�r 6 Q �VVgkA�7A>- ..� �- . . .. 16�'�CrYa�f. . . . 76 Q A�!Y�l .:;- . .. 7 ❑ PouiC�ImailY . . .. � r�. -._ . . .- ��❑ �am4f6Nryba�lyr�Clmllo�� . 17 plll•SpN► . �.OWNE�FIIl. . . . u ,;i: �f .l9na�M. '... .. .. . . . . . ]�� 1YiM.brw B�PrfY�letlMiO�LOo�pv�OCR�oip�i/�, - �ap� � . r�W1oDr�MU . , - . . . . 9 ❑ PuMe�FAr�9Yh a nal�rnl, � . C COST . . �Q71kM11111 Noiww7FM�f-Gw7ib w a��Y P�Me 1r d A�IOiIy��4.�Oimr�90�M. : ' � -- .. . . -- nrohYr rod rndr�q r na�o�a�rew+r'r�oee�re�a�►mrw. t0. CalaleYaiwtiM � f . � O�aeI��CIMC60�YP�id4v1NM�M0�RwnYlObhri4A0�brlY9 rns�rrarr.ru.sn.ra ar4o�o.naaqoawoeww��s �' my�ait�ot•w�!ir. p � /'� . .�� ' �/�iUW ��/r�.(' NB:c,✓ ���S �P T�^��, d ww�e.y �lJi� �lo � �n� L_ ' �C� ���.-- 5 � �a..�o ��� -�� .51- �i�1t�.i,/II a OwrM��er.rnl . z _ . ti. OfIUi110bB�EN� L / � . rL SELECTFD CFIARACTERIBTICB OR BULDprG•fa nsw builWnpt and addltlaa,complelr Pm�r E-L:drn�4 c on Perta J 6 A�a/Whs�s ' b N • ! PIrIC�AL TY�!0I Fi1AIN! R Fl1UClNL f1'R OI IfAiNO nll8 �L 1'YR Of LlMIAO[DIYoiAL L ?1i/[Of 11lC11�I���It 30QMrd�ffr/�Yp J6�Oo . �0�►�tlC4rPr�Conp�M. ���Y �� Mb104rA J/ Q O� N Q RMwp�0�0rnICrC.1 37 Q 9YlOr�1�I�1 37 Q E1�14Y M�N/ M Q tfa u Q R�i4a�aCao� 3r Q Co�l IL TYr[0/1NATE11fl�/lY YY�MM���.R �4 Q Orl�•8o011' 7� a pr►-fO�eA' ��N�16v0�Y�0aoAorN� p Q-� _ q�SI !b tl Q hA�YOwlrJrr111 � . .. /__' i orcwbw �. WL DEMOLRION OF SiRUCTURES: +! rw�r o mr�_�—� ' . +v. ran ar...d eee.,n. , � `�t �i.AOp��� Yee_ �'�0_ � ' �.-��uw�a m�ss „�.�,�ry S�tICh110 OYlf fillY(50)Y6B1S? , D �� =: ,�;>. ' � s�-� Sd,Nin�her SQ TOaIIIMiR6t .� .,.t'-�. L IRM�Of OR-iilllET IM�IN9 fMCB , �, �.' _ s 5f 6rJor0 � .. ' :-r�� ��f�,�$�N��� , y5 g'�e Qm� 4�3} 1„ -'.. � � � g�..e^P . k �. : d..!, 5 y-..:�.�' .— , �..� . �.. • ... ,. . ^ 'l�6-- � ..' . V ,r .. . .. , . L�'� .. tis.. ..,z.�....� •y: -�.�...�v.^ ��1� `� 4+h". .; ���i - . r .y... .wi. A.... ... -t� �_�..:. .. �. .eM_ • ". a'�� ..�/�..P� � . ., yy...�.._r..... �l . . � ���. _.. .. . . ... . . ...__ . ,... .,. �. . . . . . . .. . ' � . . .._.. - � : _ . _ _�, a _ g,w.�---- : sa w.r� _ ,� pQC{�NTAl10N FOR TFE ABdVE MUST BE ATTA�D. , _.__ °n'°°'i � �wnw�— , �- � B�IE.P6iMf CAN 8E -� -' _. _ ___ 1S91�. � �:,...- - - .. , - . - ,.. .. i�L TG�!T��C �� t/- �._ �—r��F"'R 'Y +�;y�y�f1f�W�'F"-.�--r�yR .rny,��-�,4, _ .' .Y..v ...,... , - _ _.� � ���� ,.... ►��* , ` � � � ,w��tcm..�� �.,,: , s:�,4?^�'tl3'�k.�:#^x3y ,ca�i:r' ', . . � NQ� (�Ye4 O�M��t��Or COfldftloM� i > x., . ... Y9e �WF ���11rMw�� �5�� �I�y . "y ' v, n . ' . I Hes F{n!ProrlMpn end stamPed Dlero a�Ip�M�w�r ��f4�� ` . a .. • � w..� s:va.a. ._ . � .. -, �, ' � . .. .,,, �s,. e . �;,c. . .. IS P�oP�b�YI 1ht.5AA 6eYSCl4 Yee�_ ,,;_ a rv.�. � � r.t,4..,r�n+d+ .; . _. yy � . . �.._X.3:'h1:��4 wp�. � .e �- y� - �� , � � � ��OIM1�OfiY����1 c�"�� � , � Y ..... t pc .�, ��. -��._ :_Ee d �� ,�"-'° ��' ,' �p,� (M yes,subrtdt��R��Boerd d ApPer dechionl Is b!¢sid�;Med�l� ,YpR — � ,. . a g6p Deen ec�lOeed�:-.1� ��� ,a-. �. 'Mo�_ .,� ,camru_c�n,�.tlM a►ca��!+�o._..__.. � _ ._,�....._ - �_ . _ .�.r,-,� . ,.._._.._ . __ ,_ . _. la Archifec9irat�`Aocesa ea�!�eDO��� Yee_ (B Y'e�,aubnit.dOcume�etlon) �� ,. _ ,.. - - z"C� Soleln LiCMiN-� �� �S�b Cantraelor licenee s�.� � ,.._e .__ Y I�b �al�e` ,x.,�,�g r���'�"„"� , tlom0ow�ier°FxemP�torm lif appicabbl ae_ � � ._ "�. , .�.u- sesss?ai,».:,:^�',�. ,a��a@.•.�k„� .:�a,��.t�..Fy.x��-sy:.e�aryca.�rp�'�'�',,'.: � Q/���.e����y'.�/��1W��/y , . .du"" '`�, I sTQOG.��tl�_�^�V11�IW�I�M�,�Kwi�i�Nrw/G,V��M.V1Ti�:.�.� , ; .»,.� .+.� . ..:a-�.:,. r,..�. -.. • . . p �,y��� /� �y��p� . . `' p� . , � N�RYl�lil�!�• ,�'�1!!ww^"^ GONSTRU�TIQN IS TO BE COAAP�E(ED SY:. C Cw I - h b tlis MroDeclpr d Btildin9a. . , . _ _..._. V. IDEN�F1CA710N• To bs aomokted bY aM aGO�►� �� _ _ �__ _.. . . ,_ . . . _ rr w � wrq,qa..•w.mw.o.a Wc+uerr. � .. - � � �7 /J , ' ,_ .. �7YJ t. 1 0��77(� _ _ .�. ..., . .:.,,.: . o..o�� _.. ,_� ..w._ ._ ;,_. ., ,5'�.ir�-� r94 Dls7v - 0. r- �� �163/ �... �-��/C�; r�� : U , s1.: _ � . : - � .�.� ��l ; - caa:as .;; ?�;;,�(a� ,�{"4 ''°e�i�n' 63!' �a -r�A �_ -Po9 3- �:� K : 03d3/., e �33� �•• . _ I hseby oertly Cqt t�e DroDowd wqk it autlio�d bY tlM awrrr d recad and tlal I IiM beM�itlior¢ed DY CN anMt p m�rit�PD�� � a6 hie iltl101Re0 a0M1 ws b Op1�0�m b 2M a00MClbk 12�w{af tlli!urlldlCtldl - � j siywe,ro d aoo� /J �,( / ,�vhj /j'{QOl51d AppYiO°�aaa �� 3l/�1�-5 Y'TT5 _ _ . ._ .� DO NOT WRITE BELOW THIS IINE VL VAL�ATION ' . FOR oEPM11iY6d�USE ONIY � PermR rwmber ��yp�p �� 19 Fn Rrnetip g�q liN la�0iq Permil Fes S Qaasr■.v I�e Certlfleate d O�p�eY � ADO�aved W Drain TYs � �'�� plen Revisw Fes t� ' a/�e,�� p"7«,y.2.��� 7fllE , NQTE$AND Diq•ffOl d�►u�l . - � � �. � � PERMR TO BE MAILED TO: DATE MAILED: C,orrotnieban to be star0ed DY Carn0leled by. � i � a I , �. � � 1 N O . asn w�W�•nrw ioia ao�s � � _ 0!!tlA tlY3tl _. ._ OtltlA 3QS OtlVA 301S _ • ' 0!!VA 1NOHd .. ,, : - 3�1 $ ' � i . 1�Ik!lS10 � S310N Stl3M11tlX3 NYId!1MN02 IA . � � LOT #3 w o N 2a0 532ACRES Q'i � C���� � � c.�.�s� � No. 35 �,����� �� . j�� �NUL�' 1 S�03•38 F 8 � L=31.91' �,73.p0, R=22.00' R,53• ti �`9• 6'S �'o ;,� \'�s• A. , g"E "� �° `S�� N�2 3ti 3,, �2g a 38' N PROPOSED 24' DWLG. N 62, N S� � �XA, �' 10.9' R \9��'k LOT J/2 q� r� �A 20073.6 SQ. F"f. ry ,ry`� �a, 0.46 ACRES ry .p`a THE VIL/LAGE AT � ��� zzsz4°4 ss. �r. PROPOSED PLOT PLAN VINNIN SQUARE CONDOMINIUM 'LAR. 0.53 ACRES 33 CEDAR�REST AVENUE `�'s�� SALEM, MA ) LAMD OF >>o�'��, ANDREW & CHRISTINE xEr�t�rrcEs: 'A�. LYMAN LOCUS DEED: BK. 25168 PG. 495 LOCUS PLAN: PL. BK. 389 PL. 18 ''��M�,�'`"' •,'aE>�'" °` ';< "�- KANE LAND SURVEYORS NOTES: ,� � �o�� ?�T� ', ' 72 HAMILTOIV AVENUE PROPOSED DWELLING DATA FROM PLANS R2. � �E SOUTH HAMILTON, MA SUPPLIED BY CASSELL CONSTftUCTION. S�, 'O� K � o�. � �°�°> �,SCALE: 1"=30' FEBRUAftY 14, 2006 j_ ��4� F95��_ '� 7� - ��� - ��f�' X 3� rr��,�, �1 �� ��< �� � s� CITY OF SALEM ROUTING SLIP NEW CONSTRUCTION� CERTIFICATE OF OCCUPANCY LOCATION:3� C e�ln,.�cf es�� ��C. DATE APPLICANT: U"�W I �SS-[i�I ��1'll�.,�/Ytr� ASSESSORS n � � �_ ' ,. FRANK KULIK V�.��-�-�.�` DATE:�) ' � C'� (93 Washington Street) CITY CLERK �/ CHERYL LAPOINTE �!�' �Y - _ DATE:�-�6 (93 Washington Street) 'S� ^BRUCE TH BODEAU /��" DATE: �rI 6 -�6 (120 Washington Stree[)4 oor WATER A�.,,�^.— DOTTIE THIBODEAU � DATE: 02 6 G ���u- (I20 Washingron Street)4t°F7p r CROSS CONNECT SUPERVISOR • // n (�_ '�'BRIAN THIBODEAU ��� /'r� DATE: �v�" , (5 Jefferson Avenue) "� VALERIEGINGRICH �� ����FISV�h DATE: � /�` _ �� (120 Washington Sveet)3`"F7oor CONSERVAT[ON COMMISSI 2 �b �/ � FRANK TAORMINA �--J DATE: � Q20 Washington SVeet)3"'Floor ELECTRICAL �/�/�/ II��c� JOHN GIARDI DATE:a!y`-`-`5�F> (48 Lafayene Svee b'-` �t�� FIRE PREVENT O�!��) 1-� ERIN GRIFFIN �� l,/[/:r - DATE: a / 8 C (29 Fort Avenue) JOANNE SCOTT DATE: v-/�P � �y (120 Washington Str 4'"Floor BUILD[NG �'"6� THOMAS ST.PIERRE DATE: (120 Washington Sveet)3`d Floor � , � _ , � CITY OF SALEM, MASSACNUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASMINGTON STREET, 3RD FLOOR SALEM, MASSACMUSETTg p�g7O STANLtY J. UlOVICZ, Jp, TE�EPNONH: 978-743-9593 E%T. 380 MAYOII F�lt: 978-740-9846 � Salem Buildine Deuartment Debris I);soosa! Form In accordance with the provisions of MGL c40 S 54, a condition of your Building permit is that the debris resuldng from this work shall be disposed of in a properl licensed s ' Y olid waste dis posal facility as defined by MGL Chapter III, S 150 A. The debris will be disposed of in: �6�I'`� �'',��, �0 (LocationofFacility) �_O, —=_._ e`� Signahue of Applicant _ �Y /( Date I � FEB-21-2006 09 :59 AM ROLRNDBERUBE 9787445052 P. 02 � . 7Tit Connno�wealtA ojM�achaaeae Deportn+eat ojlndwaMd AecWe�b • o,�e ojr»►�ea�lons 600 Wa�JYfnjtan Sa�t Baetoir,MA 0211X x�►��oasaad�to Worken'Compqwtlau Ineur�na A�davlC BaNdeNContrncton/EledNdaaa�IPlamben A Name !�, ' Addresa' �� 'L1G �_t � /a.c-� , ._. City/3tateJZip: ✓�I wb 'Q�9 Phane A� � � - ,_, �/ G 3.i ��G .�roa..e�yerr c�rar .ua.eau : . 1.❑ 1�a �� 1 '4'�dproJeet he9�re�: �PbYa wiA► �� 4. [�'1 un��1 a�dor aud i amployea(�11 ond/or D�pt^tNm�e}� h�vE hbed me�p�Ctraap�r `•,�lY�ex�m�as 2.�,T ua a wle propiiaoo�ar pumm� lieted�1�e�tta�ad�hoet.3 �. ���i ahip and Lave m emPipyep Thpt�b-coatrac6orl have B. [�Denlolidou wo�9p'me m�.e�y�cfly. wtuke�'oomp.�, 9 �g�addidon [No aorke�'conap.iwpnaoe 0. �Wo afe�amporeddn'�d�• . � rcqaired.j � �,. ol�cete hsy,e exesdeed�elr lo.[]Ekcelcal tepeie�ot adQidamt 3:� IameL�meowmt.doinsalla�a� �eote�am��er�cr.� a.Q�,�,c�aaa�o,r uryeel��rro amrke�s�o� . . a ts�,il(��;a�aaelh.neao t2.p Ttaorrepan, 1°�p���f• �DbY�L1V0 Moiloetil' , �.��� 13.0 Olhei '�r wvliom�rhu oheot�bme r1 m�t.bo�aus+4}waian 6e1nw,�owhy+5.tr wtl�a�m�n wHor ioamze�ioor t Hm�row�ur.wdo mt�t4d.d�Wt�a,y,n aoio�.n«oh md tiNa ea:aq�ooq�db.dmn w�.ar a�drWt�oef�woh. � �Co�'�oeon�at��eekld�EOa"r�ts6�6ed�e�dlAoaldreldoaA�qPo�nsinebftbq�me�pp����otl•�o'mnq,Pod�Y�'+�lam. �•n�Ple�r�A.r bvrov�s wnrbp�eanpau.rf�l�umorJ�+Rr�I�Is�eat 8etow v d1.pallr,y autJoa ada. 1�►� . ��N�: �, ✓��,'f�� G�✓Ga3 •�36 -ai �oucy a m sa�i�.i.�c,�: wG,27is 3 y�;° n�e• c� JobSioeAddrep: . � Gty/st�/zip: Sr� �is-t�.�',��� 7v Attac6 a cop�ot140 wart�r�oop�pmatloa Pode9 dtduetloa p�,e(�ho+rini t6e podcy qamber�ud eiplratlao d�te� F�ue to ia�re co�'m�e�reqmlrod nadar 9ectlon 23A of MbL a 152 c�lad m fhe impwiefon mferimioel nenaltke oss Y.u��ey aa$i,S3fl.G"v�ar amo-Y��yOnm�pt,u weA ur civil p�e in @le fbtm of�STOP WORiC ORDER aud a 8ne of up m E2Jo.W a dry egpiwt We vfolelor. Be edwlloA th�t a copy of t�etr0emau may be�maad eo me Ot�ce of Invaidptt�of tLo DIA fiu ma�mce mveeege veri$md� �a ee.�y r�. .�wire�e�or►i�y arm a�a{/«+�roaa�r �aw..�w�+�e 1 ^�� oW � — �a-0 � S .5a-$ o.,�lew,w ar,�, D.Nar wn�r qi h16.rr.,ro e,r�dy�b�+y�r.,�Jrrd Clq�or 7or►�t Pa'm1U[Jaew�Y Is�ala`Authorit�(clyda ope)c 1.Bla�rd of�eakh t.Bulldlnq D�u�t�ust 3•CHy/fowu Ckrk 0.1Electrtt�!�o�peetp� !.Plumbin4Iutpector 6.Oth� Co�aet Pvwa: ry���: FEB-21-2006 09 :59 AM ROLRNDBERUBE 9787445052 P_ 03 Information ana �����1 u��=�ua Ms�e�nusa�G�r�wr ch�er�sZ requae�an emn1��P��'�G0"pon�r��� ffi w dafined at"...aery Da�on in tho oavice�f aoother ander m►Y puYeuant m th�etetu�, � �or�1ied,onl or writ0en." i�de6ned ar"m�P����0°���°�otha legat eqritY,a a�Y tavo or m�s ����ed'in A,f o�t�'P�;�imctndini 1���'a o€�decasad�pbY'�r+ar tbe uwdauon a�o�er iega►antib'�e�►1aYm�emPbYet�. Howava dro rx.aEv�or trneroe o��i�����d Wbo realdet the[e�0.ot the oanpmt ot�',� ovvner of o daeiliu� m do maut�e,comGucdon or tepair wotk at a+ch dwell�boute dwalliai houee ot�o�cr who emploYa Pwsom be deemed m be�e�►loY�.» or on 9�e�orbu�7d'n►i��°�D ebeu mt becnwe of ench anPbY� MOi.cbap4er ts2,4ZSC(�atro rtaa thwt~eveq fM1�te or loeat ueeoda��cy rh��vlthedd the i�rr�e or reoe�l o!�Bean�e�'p�t0���bndem or to tomdrnet b�t�t6e wmmooweati ta�a�' aPPUAddmon�'�MC�.�e uV�ateA� wNta��el�'�he ao����Y D��dal�sLall em�inoo amy coauact�br I�e P��otpubNo wo�uaUl raxPubk evidea►co of co�Neace wi9t dro insarmue . raq�ts of�sha!►tnr�eve6an p�m�d so me Coqa�w9�X" � ��� ' ofBAevit cornVleoelYr bY����li�a boxee thet app1Y t�►Y����� Pta�e�11� �e wo=ken w�tdo° with ffiait ce�Ei&aEe(i)oP neoawYY��AP1Y eo���e)n�pc(e�addreeKae)md 1�m�(�)�D8 with no emA1a'Y�ather th�tha �, I,{m�I.teb�Y�mP��or Limi�od Liab�Wv Pu�(� memban or permae,am fat nqulrod oo cr�'�wfl��c�adon im�aanoe. If au LLC ot 1.iX Eoee bave employees,o Po1�Y�raN� &aQvlia9 9iat dlb e�vit msY���to�e Dpta�of IednetrL►1 Aa�dt�t R�r�on$�of ineu�wce�vae�e. AW b��r�e to a�Y�aud d�te the�davlG 1Le aHlAavh ehonid be mau�d m 9�e ahY ot�own�at tLe applk;etion��p�t m dceme�ba�a6 reqnaied.uat the Depa�mt of If�mtrial Accldem�. 9bou1�Y'���°�1'4°�0D°�°6�e laar m if yon aro ra9u�aD obuia a Worlcon' �Po�P�aall 8m D�uae��the�1is�ed below. Selghwted oc►mpaaiee ehonld eatta��eir sdgim�amanca tic�we�an 9ro ' llaa qq or Tmn Ol�dt� Pleaw be aue mat d�e a�d�v&�«�P�md 1�utea le�l►ri. 'i'be DeP�mment uae P�ed a evace at�e boaom or the aPfidavh�r yon m flll out in�e evtpt�e Of9ce of Imeedg�ru Lae m coutact yon re�atdio�ihe spP�� Please be s�ue m SIf m gte P�0°��whidl a�71 be uead�a referma m�mber. In additioa,an a�pPlic�t �Lat mu�t sub�t maldPle P��6�P�Iane in anY�'W Y����Y submit ane affidwit auticadn6 auravt Po�'�II(��',p�¢�')�nnder"7ob 9he Addr�"tbe aPVHceut abould wtioe"pli bcatlocu m (cllY m' �ow�n�^A oopy oi�e affiE�vit 8u�t 1w be�o�iq��or nmked bY the citY or town�Y be Vrohded to 4ue �pplie�ne a�p�ooftlue�valid r4�vlt n�me�t Na�o Pe�mia aa lica�ta. A aow a�dev�ma�tbe dlled o�each yz�.9J�er s ffi�x o�x'^s'dt��a��qat�flcoetue�pprodt not tdnoad.�D eRY budne�or aoam�rcial vmmie (ta a do`�a pemdt to b�un ibvee as.)aald p�on u IVO i[e4�m�l�e tH�e�7dwic '1'he Offfcc ofIaveedgado�wonld Hko bo 8�ant y�m advaoce&u Yau aoopaalioa md e�nld Yon Lm a�'4aadon�, q1EefC d4 not haim0e 91�ive 0t i Ca11 The popar�enY�ad�,tel�pLone�d�mm�ba: The Cammonwe�lth of Massachusetts Depa�ndrt of Iadiretrial Accide�ts ' Omce ot inve�t�adoar 600 Wa�hicgta�Stcat BpsEom,MA 02111 Tol.i�b17-727-4900 ext 406 or 1-879-MASSAFE F�#617-727-7749 Rcvisca 5-26-os www.mase.gm/d'u ��Ll� �i �� —S�G� /1 The Commonwealth of Massachusetts IIIVIUUrc Board of Building Regulations and Standards CITY OF Massachusetts State Building.Code,780 CMR SALEM '�g5s Remised Mar 2011 Building Permit Application To Construct, Repair, Renovate Or D polish One- or Two-Family Dwelling This Section For Pfficial Use Only Building Permit Number: "ate A^_p�plied: p! .Building Official(Print Name) Signant �Date SECTION 1:SITE INFORMATION 1.1 Prop�{ty Address: - 1.2 Assessors Map&Parcel Numbers 1.1 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(sit ft) Frontage(ft) 1.5 Building Setbacks(ft) front Yard Side Yards liear Yard Required Provided liquired Provided Required Provided 1.6 Water Supply: (M.C.L a 40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: "Lone: _ Outside Flood Zone? Public. Private El Zone: if yes[] Munieipall On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of R corp I LG an Jal n19:) Name(Print) City,State,ZIP g,3 —Ce J- exr G R It, 9-4 7y V031 4A) s Ms ) (0C^ No.and Street Telephone 1Jgn.D= SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction ❑ Existing Building -1 Owner-Occupied '0 Repairs(s) ❑ 1 Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: . Brief Description of Proposed Work': �S 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 I Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List:_ 5.Mechanical (Fire $ Suppression) ICE Total All Fees:$ Check No, Check Amount: Cash Amount: 6. Total Project Cost: $ �j/�( ❑Paid in Full ❑Outstanding Balance Due: y?, 0 41 �0" � 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 LIP to 35.000 cu. ft.) R Restricted 1&2 Family Dwellin. City/hown,Stale,ZIP M Masoin RC Roofing Covetin, WS Window and Sidin SF Solid Fuel Burning Appliances 1 Insulation Telephone Email address D Demolition 5.2 Registered Homc Improvement Contractor(HIC) h11C Registration Number Expiration Date HIC Company Name or hIIC Registrant Name 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 PERMIT 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) DaLe 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 containeo in thisiapplication is true and accurate to the best of my knowledge and understanding. o - m A XVI'1(yu ,? 3 Print Owner's or Authorized Agent's Na e Electronic Signature) 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 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.mass.2ov/oca Information on the Construction Supervisor License can be found at www.mass.Pov/dps 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 halflbaths 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.U.EM PUBLIC PROPERTY DEPARTMENT Klla�atar N,YIY l MA1Oe 130 Wumpac,nm ftm•sLw MAUMO&MM of r-o HOMEOWNER LICLNSB EXE.N 10IV Pleaw Frl�t Dw a l a Job Location Home Owner Adder Home Owner Telephone Q T R— 79 .5--A R 3 1 Presort Mailing Addrass The current exemption otf"Homeowners"was extended to include owner-occupied dweUings ottwo Units or leas and to allow such homeowners to engage an individual for hire who.does not possess a licens4 provided that the owner acts M superviaor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of lmW 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 uss and/or farm structures. A pawn who constructs more than one home in a two year period shag not be considered a homeowner. Such "homeowner'shall submit to the Building Ofllcial,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 bylaws and regulations. The undenigned "homeowner"certiRa that he/she understands the City of Salem Building Department minimum inspection procedures and requirements and that he/she ill comply with said procedures and requirements. HOMEOWNERS SIGNATLRE APPROVAL OF BUILDING INSPECTOR See other side for state code CITY OF S,VZN[, A1ss.1CHC'SETTS i31.'amow omij n—j7r 120 %V..UNLNGTON STXMM, }iO Ftcolt rM (973) 745.9595 YW13FRLBY ORMOLL FAX(978) 740.9t14d .MAYOR IHa+w ST.PMXAS 0IRFCTO4 OP PL 8LIC PROPEATY/at:Mn c4G CawlISSIO V ER Construction Debris Disposal AftIdavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 730 CMR section 111.1 Debris, and the provisions of MOL o 40, S 34; Building Permit M is issued with the condition that the debris resulting from 11 work shall be 1 11, S I JOA. disposed of in properly licemed waste disposal racility as defined by NIGL c The debris will be transported by: (name 00441tlr) The debris will be disposed orin : (name of fauiljly) Iiddreas of rj,d„y) vyn�nrre 6tpermu rpphun :JItl 9 The Commonwealth of Massachusetts m 's• r Board of Building Regulations and S CEIVEO CITY OF C �NAL SERVICE SALEM 1 ! Massachusetts State Building Codcl, Revised blur 2011 Building Permit Application To Construct, Repair, �yoyyQOp�errli @15 One-or Two-Family Dwellin ,199 AN [L This Section For Official U e Only Building Permit Number: Date App e : Z� Building Official(Print Name) Sign Da e SECTION 1:SITE INF MATION L1 Property AJ ress: T 1.2 Assessors Map& Parcel Numbers 1.1 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(sy R) Frontage(It) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Wa er Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewag Disposal System: Lone: _ Outside Flood Zone'? Public Private❑ Check if ycs❑ Municipal On site disposat system ❑ SECTION 2: PROPERTYGON ERSHIPt 2."roN I City,State,LIP No.and Street 'telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction ❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) I Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: _ Brief Description of Proposed Work': SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and blaterials Official Use Only 1. Building 1. Building Permit Fee:S Indicate how fee is determined: $ 1 ��� ❑ Standard City/Town Application Fee 2. Electrical ❑"Total Project Cost'(Item 6)s multiplier x 3. Plumbing 2. Other Fees: $ Lt. Mechanical (IIVAC) S List: 5. Mechanical (Fire S Suppression) Total All Fees: $ �( Check No.__Check Amount: Cash Amount 6. Total Project Cost: S t �b� ❑ Paid in Full ❑Outstanding Balance Due: Mt�Lc TC> SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supe or.License( 'SL) ` � �� - r,. -� cgb , License Number Expiration Date ' Name of CSI•Holder List CSL Type(see below) No.and Street \ rype Description U Unrestricted(Buildings up to 35,000 cu. tt. R Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding <=kJ%k) SF Solid Fuel Burning Appliances l Insulation Telephone Email address D Demolition 5.2 Registered Ho Improve ent Contractor(IIIC) �Ds , IiIC Registration Number Expiration Date N L meor IC I gistr tNamev�,�` ol6 n c�.�f� `�t . I 21n Email address City/Town,State,ZIP �-i' \ 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 pe it. Signed Affidavit Attached? Yes .......... ❑ No........... SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,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 a-pyplica 'on is true anddccurate to the best of my knowledge and understannddin . Print Owner's or Authorized Agent's Name(Electronic Signature) I 3atc 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 Horne 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.,ov/oc❑ Information on the Construction Supervisor License can be found at www.ntass.,ov/dus 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" CITY UE 5:10E1 f, ;tiL1SS:1C HUSE17S l} .' ©UWINGD EPA RTN0NT 130 WASHNGTON STRPBT, SRO FLOOR " n T EL (973) 745-9595 lug®t=lu y oRIscoLt FAX(978) 740.984d &L-ma Tltostas Sr.Ft^�xns DIRECTOR OF PUBLIC P[tOPE1tTY/9UIL0LNG CONNISSIONER Construction Debris Disposal Aftldavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 730 CMR section l 11.5 Debris, mid the provisions of�,IQL c 40, S 54; Building Permit this work shall be is issued with the condition that the debris resulting from l l 1, S I SOA. disposed of in a properly licensed waste disposal facility as defined by rNIGL c The debris will be transp rtcd by: (name ot'haulcr) The debris will be disposed of in ; (name of t]edily) -vim- (7ddrCss of l*a'Il Ity) signs reufpermitapplicant J.uc DigCIZ�C OF S.1LEl1 ..L- sSACHUSET rS BCI[D[NG DEPART\IE.\T 120 WASHINGTON STREET, 3"a FLOOR. TEL (978) 745-9595 F.ur(978) 740-9846 KI\BERLFY DRISCOLL ,U-kyOR THOMAS ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BCILDNG COJLMISSIONER Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers At rlicant Information Please Print Legibly Name(Business Organ izatinmlndividual): � Address� �\,/�f�, n City/State/Zip: nk � lit nk Phone N:Gm �� U Arc you on employer? Check the appropriate box: Type of project(required): I. I am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑Ncw construction employees(full and/or part have hired the subcontractors 2. 1 ani a soie proprietor or partner- listed on the attached sheet.I 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 worker•'comp. insurance 5. ❑ We are a corporation mid 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' cutup, C. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.) t employees. [No workers' i},❑ Other cutup. insurance required.) -Any applicant nut checks bus at must aisu fill out the wcti,n below showing their wofkcn'compenuilun puliry inll,.ation. 'I r, neowners who subntil this aflidivit indicating nhcy are doing all work and then hire outside contractor most s0nnit anew arfdavil indicating such. C,uumcton shut check this box must anach al an additional Am,-bowing the name of the sub-contractors,and their workers'comp.policy infonsation. f aat un eaployer rliat ix providing workers'c•onipeasatlon iururancefor my employees. Beloly Is the policy and fob site iujormation. Insurance Company Policy 4 or Self-ins. Lic.d: Expiration Date: Job Site Address: - City/State/Zip: Attach 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 MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1, \0.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and aline nFup cc)$250.0 U d' against the violator. Be advised that a copy of this statement may be furwarded to the Offilce,of Investigations ul \\te A for' a coverage verification. f do hereby certify titer to wins and renalties ojperjury that the informutfoa provided have t. true\and correct. S',•no I rc; _Date: Phunc,1: ZJ `TV� � OJJicial use only. Do not write itt this area,to be completed by city or town ofjiviuL City nr'I'nwn: _..._„ . .__ Permit/Llcensc t; Issuing Authority(circle one): I. Board of health Z. Building Department 3.Citylrown Clerk 4. Electrical !inspector 5. Plumbing Inspector 6.Other Contact Person: __ _.. __ Phone