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1 PARALLEL ST - BUILD SINGLE FAMILY HOME, BPA-2010-0543 The Cummonwealth of Massachuscus Board of Building Regulations and Standards Town of [t;Building � %(assachuseus State Budding Code, 780 CMR. T"edition Building Dept Permit Application To Construct. Repair, Renovate Or Demolish a twomwmm One- or Tiro-Faindi Duelling AMOK This Section For Official Use Only Building Permit Number: Date Applied: , l t7 Signature: 3 2, i D Budding CommlSila ted Inspata of BuJdmgs Date SECTION 1:SITE INFORMATION 1.1 PropeyY Address: 1.2 Assessors Map& Parcel Numbers ( VRvt AC.LCL $T 23 b11 1.1 a is this an accepted street'!yes no Map Number Parcel Number IJ Zoning Information: 1.4 Property Dlmemlom: ,� Z 2es�o«-tact 2t.,o�d 2 c1 S9 Zoning District Proposed Use Lot Arca(sq 0) Frontage(R) I.S Building Setbacks(R) Front Yard Side Yards Rem Yard Required Provided Required Provided Required Provided ( r la to r (po 1.6 Water Supply:(M.G.L c.40.154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public ft. Private O Zone: _ Outside Flood Zone? disposal system Check if Municipal tgOn site O SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: t 5-Er j2kw lame `"! �� mon l �Jt 5A`yri Name(Prin Address for Service: 8z� y Signature �' Telephone 611€-1417- SECTION): DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 19 Existing Building 0 Owner-Occupied O 1 Repairs(s) O Alterstion(s) O Addition J10 Demolition O Accessory Old#.0 Number of Units_ Other O Specify: Brief Description of Proposed Work': Waw JAJ-4e- SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials I. Budding f s Q0 p L Building City/Town Fee: f Indicate how fee is determined: O Standard CityrTown Application Fee 2 Electrical f 000 O Total Project Cost'(Item 6)a multiplier x I Plumbing f opo 2. Other Fees: f a. Mechanical (HVAC) f ^)006 List: S Nechanial (Fire f Su session Total All Fees: f Check No. _Check Amount: Cash Amount:_ h Total Project Coil: f lOZlOo U 0 paid in Full 0 Outstanding Balance Due: SECTION S: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) Lweme Number Espuurion Date N.4me of CSI.-Polder List CSL Type lice W,ow) Tvoc Description A,ldresl U Unrestricted(up to 13,000 Cu. Ft. R Restricted 1!2 Family Dwellin Signature M Masonry Only RC Residential Roolinst Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D I Residential Demolition 5.2 Registered Home Irnprovemcat Contractor(HIC) l 0 1 g 4 9 ;=70 cl HIC Company Name or HIC Registrant Name Registration Number ISU 2 Wuwut, "1t PeP.m any r+NA � I t) IZOIO Address Expiration Date Sigrtanue Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.I. e. 152.J 2SC(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. Signet A11fdavit Attached? Yea..........EF No...........0 SECTION Its:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, Sk-c P� 0 L-0-Jt U, , as Owner of the subject property hereby authorize WA sZ0.a- 0&1f,.s— PeA sow rs„�l k,,s to act on my behalf,in all mattm relative to work authorized by this building permit application. St nature of Owner Date SECTION 7b:OWNERr OR AUTHORIZED AGENT DECLARATION 1, S kp� 0 (mob te� 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. skep� (p U0,3'ekA Print Name Signature of Owner Authorized Agent Date Si tree under the ging and penalties ofperjury) 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 W have access to the arbitration program or guaranty fund under M.G.L. c. I42A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 790 CMR Regulations 110.R6 and 110.R5, respectively. 2. When substantial work is planned,provide the information below Total Goon area(Sq. Ft.) l')0 o (including garage, finished basement/attics.decks or porch) Gross living area(Sq. Ft.) 1')v o Habitable room count Number of fireplaces U Number of bedrooms 3 Number of bathrooms 2 Number of halfbaths s Type of hating system QA S Number of decks/porches L Ty pe of cooling system 454 Enclo.ed Open 2. 1 "Tool Project Square Footage'may he.uh.trmled for"Total Project Cost" r�53� .p - � I a„n�"X"?.?+ '_ ��' . �- + .., .'fit �' •i• �?.^ ° +7"... . �T PEARSON BUILDERS " ,< WarrenA°Peaison �� ♦ � a w— �✓ l 3 7 t �� " - �.'Y tN.- - Y x _ �.♦ ,ten,,.,, _ �� £, ,� Y r0 160 fi Wt�iwne St + Phone&Fax 978535 6b6b , ,- ,.::W Peabo�iy.MA019eo' Cell' 978-759-2838 Massachusetts 'Departgreut of Public Safety k B oa d of 8w[dm`gRlatiOAS aad Stawbu Js Supervisor License.: 6 '010M :GS i �a- .. � 4YL.nyu...'...aM .. .�\yyb..4 F>i<a`+. ..a. � .N •YY _ _ r „WARR } P u � •V ExplraWn: 4112=11 Co - Trs: 13734 - - e: r ° a t Fyc t w tipy.Y }t g�y.yya^rxrii--%J o� Y` I. a l d S 0f Isdidine(Rwuegula(/1tlQ0!Ynd SfaOdat.'�"a* °° " 1 t 3' °i t,i HOME IMPROVEtAENT 6 ONTFiAC(0 ' 'a3 m- .4 ^a \ 107999 n N Tr6 a '�_ �• � i . •�.` y�•,a� k ., .. i �'.••#* � :fix WARREN Yk P 1 1508 YY(sz�.pa St AL0z1y ;�, t ,:a ,, .. .t � t ° ..< �w �"ap ala'tti. _ °' r 'zvE,,F� #4 �• x �. 10 14 i. 10 ,'t t '1; £ : : d.. • e ' S a _'4 •�.1``. 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F ti� Y + 1 y'p� g Ik. ,•, _ PhaneN l. * ti 'Y X54 '4 70" L: ';r• '::rf-s z «� ... titw•sYm ae• r z �'x < e -' -,4. ,�' > .r �\ CITY UFYSALEMI` ` i PUBLIC PROPRERTY „ R, F _ PEP ENT s � , k� '' ^::\I t.�N, b r i .;, •-+aN 1'O:� VIII\I_ iiy�lNL[i•i�-\I1,?Il�t\+t 11111 d la� 1'l .' t _w. "A �° . IEt:'liw;•1{:)3'/S?::ts\:(ivlr:z4a')r46 y�x y - .» "t+r, a ;f "t � °•'!k5'' r 7'Yt, Mi .k � v'4 + Aq � „+„ski^ .r+4. . } � *Yr'vx rd�'r-,! A•� 't-1 k+x^ _.� r J s•w- + s y.a '�`' " .r`6 w a .-6 i 4+k:.. [� 4i: +S,r garx4 i r7i# +Gt. 4 t «..� .' d 'T ar•„ at"iix '. -a 2z N x f n% rre • ! 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Cv�oss �-e%�.� �� / 2�`��/'rt'f L � Tl�cv �/J�„y,f��`1�_7 �f�y�� 0 � r�zn� �'� ��„ �� y _ fI�jCri V��nl { Sri"r7"5 f j 2X/0 OL ---------.____ --�o- ..----------- ------ ,� ,��G � -- S�—v�. _'—'' S �r� i G ' oT'� mr �� ►"� �� S � Z3 - oo --7- CITY OF SALEM ROUTING SLIP New Construction Certificate of Occupancy LOCATION / t4r-,e[&//J�^ � DATE ASSESSORS �lG�t'�-f;Gf - DATE /6 v 93 Washington St. CITY CLERK DATE 10 9 D 93 Washington St. PUBLIC SERVIC DATE dA 120 Washington St./ / / dv— WATER �/G��L DATE b 0` 120 Washington St. CROSS CONNECTION DATE 5 Jefferson Ave PLANNING ,Q,,,, o Dj DATE L 120 Washington St. CONSERVATION DATE Z l( 120 Washington St. ELECTRICAL DATE O _ 48 Lafayette S . FIRE PREVENTIONQ DATEG G 29 Fort Avenue HEALTH DATE 120 Washington St. BUILDING INSPECTOR DATE 120 Washington St.