11 CEDARCREST ROAD - BUILDING JACKET 11 cK ►-1 , 3 $ z-7�
The Commonwealth of Massachusetts'tO�p F j , TY OF
ie Board of B!iilding Regulations and Standards SALEM
l Massachusetts State Building Code, 780 CWb AUG ( b A
qi�ed Mar 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One- or Two-Family Dwelling
/�( - This Section For Official Use Only
J Building Permit Number: 7FDate App ed:
I
'Building Official(Print Name) - _ - Signatures - - Date
j SECTION 1:SITE INFORMATION
CDCD
Ll Property Ad street'!{ress:////''' 1n/ � 1.2 Assessors Map&Parcel Numbers
1.1 a Isa Is this s an acc p d y*e_s no Map Number Parcel Number
1.3 Zoning nin Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
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:
Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Public❑ Private❑ Check if yes❑ p P y
SECTION 2: PROPERTY OWNERSHIP[
2.1 Owner of Record: /,�
Name(Print CiryState,�1Z�IP
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Addition ❑
Demolition ❑ 1 Accessory Bldg.❑ Number of Units_ Oth Speci
Brief Description of Proposed Work:
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
I.Building $ I. Building Permit Fee:$ Indicate how fee is determined:`
❑ Standard City/Town Application Fee
2. Electrical $
[3 Total Project Cast' (Item 6)x.mulhplier - x =.
3.Plumbing $ 2. 'OtherFees: $
4. Mechanical (HVAC) $ List;:..
5. Mechanical (Fire S Total All Fees:$
Suppression) -
Check No. Check Amount Cash Amount:
6. Total Project Cost: $ I ❑Paid'in Full ❑Outstanding Balance Due:
7
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
Lice' a Number Exp at n Date
Name of SL Holder . I
List CSL Type(see below)
N d Street Type Description
U Unrestricted(Buildings u to 35,000 cu.ft.)
R Restricted 1&2 FamilyDwelling
City/Town, tate, IP M Masonry
—9 I 1��r ,r6�GRC Roofing Covering
JjJ `T WS Window and Siding
Signature SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Regist ed ome Im ov .m nt Contractor(HIC) 1 �!� S
HIC Registration Number Qpi,*twate
HI e or HIC Registrar
M mg
N . et r Signature Email
Ci /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 Issuancof 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
1,as Owner of the subject property,hereby authorize Orl, 0,94
to act on my behalf, in all matters relative/to orkk}autho�d by this building permit application.
-Gv►I�iG�
Print Owner's Name 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 o y 1 wledge and understanding.
�Fi,e,
Print Owner's or Authorized Agent's Name Signa i g' Da
NOTES:
1. An Owner who obtains a buildi g permit to g his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement eontractor(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.roass.gov/oca Information on the Construction Supervisor License can be found at www.mass.Qov/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"
fL1tNSiNlf6i�E fiLeaAND APPROVED BY TfiE
A5pFDIDR PWQR TD A PEANUT BEING GRANTED
CITY OF SALEM
�!No. Date
� P7!/�j ';�
i _
Is Property Located In Location of
the Historic District? Yes No NdIdIng 11
Is Property Located In
the Conservation Area? Yes No_.
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, ool
Repair/Replace, Other: ►.s }z I
..
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS.
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name (Stem in J ov d 2 ►'t
Address & Phone II Cea2VCyeA- P-A . (W) f 9T-j6zr
Architect's Name
Address & Phone i )
Mechanics Name
Address & Phone
what Is the purpm of building? GYPi✓/� Al/c� —�
Material of WON? 4✓0&1� 0 a dwelling,for how many famines?
WW building cordorm to law? 4-5 Asbestos? N V
Estimated coat CRY License M N A State Llcerw
ZS °` thane Lwrovrsent
Lie. 0
Signature plicant
SIGNED UN
DER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
LOCATION.
PERMIT GRANTED
APPROVED
ECTOR OF UILDINGS
�_.MN_F T7. .Lid,
MAIN STREET USA
i
A
I 1
4 HOUSE i
j
i
i
?orc
20' Diamm
P00L
X FENCE
Scale 1"=20'
�n
1L
SURVEYOR'S STAMP
n U 7 lie Commonwealth of Massachusetts
hoard of tiALM
Building Regulations and Standards ('I'I'Y OF
s Massachusctis State Building Cute. 780 CbIR I.\I
I '�.�.. Ra•risavl llw'_'ill/
Building Permit Application 'ro Construct. Repair. Renovate Or Demolish a
(Arc- or Tmv-f•iuui.v DuaRin,\r
This Section For 011riciakGse Only
Building Permit Number: Date, p�pplli`e,.d:
Building OI)icial(Print Mum) Signature 61, /Date
SECTION I:SITE INFORDIATION
1.1 Pro PeTy Add tt'"W�.�re �I 1.2 Assessor Slap 1r Parcel Number
I.la Is this anaccepted street?yes no binp Number Purccl Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed thie Lot Amu(sq 11) Frontage(11)
1.11 Building Setbacks(R)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.I.c.40.§Sq) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: — Outside Flood"Luna?Check if ya❑ Municipal ❑ On site disposal sistem ❑
SECTION2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
CT Iehr, -f Qc lain 5tkkeYyr MA- 619-7D
Name(Print) City.State.ZIP
It ce&wu-e.�- d f-7r-74s--34U14
Nu.and Street Telephone Email Address
SECTION J: DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repa(rs(s) Alterations) ❑ Ad4onCO3
Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify:
Brief Description of Proposed Workfefyj� \
Fe LQ SFa` s pL
( ` 194elLQl
SECTION 4: ESTIMATED CONSTRUCTION COST
Items013
Costs: Ofllclal Use Only
(Labor ..\laterialsl Y
i. BuildingS I. Building Permit Fee: f Indicate how fee is determined:
2. Electrical ❑Standard City/Town Application Fee
❑Tulal Project CushI Item 6)x multiplier x
i. Plumbing1 Other Fecs: SJ, Mechanical IIList:
T11 .\IFces: SCheck No. Check:\nmunt: Car h Amount:
r. Total Project - — -- .
❑Paid in Full Cl Outstanding Balmier Due:
SE("PION 5: CONSM C'TION SERVICES
5.1 C'onstructioliSupcnisorl.iceuse(C'SI.) qq 170 1Z I�7�fZ
I�
P------m I);;ila
icense Nunthcr �pv;ui
N;une ill Csl. I kidder
I ist CSI. I\pe Isee
__� ybrrh-G '-- - --- - --- - -- r\pe Description
No. and street
log 11 1Inresireted(l)uildin-ts 010 i5.001)"1 fl.l
m/3 a{ —'— R Rnlricted IR? Tamil M%ellin
C'iP/I'oen, 'uae, .II' SI %lasoitry
RC' Rix)11,19 Oncrin
W'S W'inJuw said Sidi❑
7p '' SF Solid FuclllurningAppliances
Ol7 z 3-3 1 Insulation
I'cle hone I'.mail address D I)cniolition
S, Registered Home Improvement Contractor(HIC) (4 fP6p (d is
Qu+�J lwm" s c✓y'Un" I I ' Re straliu unther Fspiruiun Dutc
LJo.
'C'o t a Nuntc or IIIC'Rc t unt Namuit I
�mid cl T - "3�c/�gcL6 a drewor " A177-/Town,State,ZIP Tale hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 152.1 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...........O
SECTION 7s: 01*VNE§k AUTHORIZATION TO BE COINPLETED 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.
Q��'CAVS. JOr'(IJr yN 4a
Print Owner's Nwne(Fleclriall Signature) Date
SECTION 7b: OWNERI 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 tru and ccurate o the b t o my knowledge and understanding.
G (;L 1;L—
I'ritit Osuter's ur:\uthoriieJ.\gene's au a Ililectrunic. ' nature) Dutc
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 rro have access to the arbitration
program or guaranty fund under I.G.L.c. Ia?A. Other Important information on the HIC Program can be found at
www n .n. t;ot ok i Information on the Construction Supervisor License can be found at It)s,s !;k -Ip,
2. When substantial tvork is planned, provide the information below:
rota) floor area(sq. fl.) _ ____-,_1 including garage. linished basement attics,daks or porch)
Gross It%ingarea(sy. fl.) ---- habitable room count __. ..... . ..
Number of tireplaces - Number dl hcdrounis . .- .. .. .. . .
Numher of bathrooms -" — - - — Number of half hall's -
I\pc of heating S%stem . . _ . . Numher of decks, porches
. .. . -
i
I\J'V of oling systei❑ I"nclascJ Open
_ -.
t "foul Prjvcl Square lomuge' nta\ be ubstmiwd Ihr"roml Project Cost"
UPC 10333
No. 153L-3
HASTINGS.@1N
0011 CEDARCREST ROAD 297-2000
cIs#: 3041 COMMONWEALTH OF MASSACHUSETTS
Map: 21 CITY OF SALEM
Block:
Lot: 0055 O
Permit: Building
Category: 434 Residential:addti BUILDING PERMIT
Permit# 297-2000
Project# JS-2001.-0712
Est. Cost: $4,200.00
Fee: $29.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Colonial Remodeling Corp General Contractor-Salem#1800
Lot Size(sq. ft.): 14184 '` Owner. JORDAN GLENN E
Zoning: - Rl
' Applicant: Colonial Remodeling Corp
Units Gained:
Units Lost: A T:Y0011 CEDARCREST ROAD
ISSUED ON. 31-Oct-2000 EXPIRES ON: 30-Nov-2000
TO PERFORM THE FOLLOWING WORK:
Remodel kitchen,repair front porch stairs.F.R.D.
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter: Footings:
Rough: Rough: House# Foundation:
Final: Final: Rough Frame:
Fireplace/Chimney:
Gas Fire Department Board of Health
Insulation:
Rough: Oil:
Final:
Final: Smoke:
Treasury:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF
ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
BUILDING REC-2001-000840 31-Oct-00 01 $29.00
GeoTMS®1998 Des Lauriers&Associates,Inc.
0011 CEDARCREST AVENUE 297-2000
GIS#: 8542 :;, COMMONWEALTH OF MASSACHUSETTS
Map: 21
Block: CITY OF SALEM
Lot: 0031:
Permit: Building
Category. SIGN BUILDING PERMIT
Permit It 297-2000 l ^^
Project# JS-2001-0562 ndOv
Est. Cost: $4,200.00
Fee: $29.00- PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ! Colonial Remodeling Corp General Contractor- Salem#1800
Loc Size(sq.ft.): 110028 Owner: DALLAIRE LILLIAN M
Zoning: Rl
` Applicant: Colonial Remodeling Corp
Units Gained:
Units Lost: AT: 0011 CEDARCREST AVENUE '
ISSUED ON: 31-Oct-2000 APIRES ON. 30-Apr-2001
TO PERFORM THE FOLLOWING WORK. `-t
Remodel kitchen,repair front porch stairs.F.R.D. l U��
W � CORP )A)
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter: Footings:
Rough: Rough: House# Foundation:
Final: Final: Rough Frame:
Fireplace/Chimney:
Gas Fire Department Board of Health
Insulation:
Rough: Oil:
Final:
Final: Smoke:
Treasury:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF
ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
BUILDING REC-2001-000689 13-Oct-00 3999 $29.00
GeoTMS®1998 Des Lauriers&Associates,Inc.