16 PEARL ST - BUILDING INSPECTION '-f 2 �� CK LN 9
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Ulf Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct,Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Dat Applied:
as
Building Official(Print Name) Signature Dat
1 SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
16 Pearl Street 34135-106 36-0507-802
\\\ 1.1 a Is this an accepted street?yes / no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R2 Condo 0.380 acres
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?
PublicfcY Private❑ Check if yes Municipal)�J On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Rebecca Jablonowski Salem,MA 01970
Name(Print) City, State,ZIP
16 Pearl Street (781)799-6998 ludlow07lO@gmail.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK=(check all that apply)
New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s)fd' Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work: Basement refinishing When house was purchased the basement had studs,
insulation,poly and electrical(power and lighting)in place. I'm looking to install a couple extra outlets,recessed can
lighting then board up the walls. Basement does not have direct access to the back yard and we're looking to install a
sliding door on the back of the house near the patio stairs. Photos and sketches attached.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Costs:
Item Labor and Materials Official Use Only
1.Building $ 5,000 1. Building Permit Fee: $ 42.00 Indicate how fee is determined:
2.Electrical $ 950 ❑ Standard City/Town Application Fee
)Z''I'otal Project Cost (Item 6)x multiplier 5,950 x .007
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Su ression Total All Fees: $ 42.00
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ 5,950 ❑Paid in Full 13 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES 1
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 1&2 Family Dwelling
City/Town,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
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
1, as Owner of the subject property,hereby authorize 4/. k"-s
to act on my behalf,in
�t/in all matters relative to
work authorized by this building permit application.
/GiR20CCI .7. f/YlOZU�B'� LO G�Lo
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.
•Y1 0n2 J, �at���acrGu�Sk� 4e1201ice
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.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) .3 2-/O (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) ,?� u�' /O Habitable room count [p
Number of fireplaces / Number of bedrooms
Number of bathrooms Number of half/baths O
Type of heating system rc� Number of decks/porches /
Type of cooling system N14 Enclosed Open ✓
3. "Total Project Square Footage"may be substituted for"Total Project Cost" -
DA
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aetion 16 PEARL STREET Pro Account Number 0 Parcel In Md50]
Old Pesal 10 Zt-
Current Pro ManI.9 Addrwa
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Stern W
Address 16 PEARL ST UNIT 16 Zip w910
ZOeb RZ
Cwmnt Pr Sales lnlermeUon
Sale Oats 6/152w5 Le6al Rebrence 3635106
Sale Price a25900 Gmn Selbr BROWNPNYLLIS BREWER
Cwrant Pro a Awaawnnt
Card Value
Year 2016 Building Value 351,90D
%de FeeNres Value 0
Lead Area OXO scree Lead Val-Y
True l Value 3A,900
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CITY OF S.U-EN1, 11WSACHUSETTS
BUILDING DEPARTmExT
• 120 WASHLI:GTON STREET,3� FLOOR
TVL. (978) 745-9595
FAX(978) 740-9846
KINMERL.EY DRISCOLL
MAYOR Tkows ST.PtERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
(NOTICE SHALL BE GIVEN 48 HOURS IN ADVANCE)
It shall be the responsibility of the permit holder(owner or contractor) to contact the inspector
when the work has progressed to the point of needing an inspection.
0 Excavation: inspector to observe soil types: groundwater elevation, temporary shoring, site
safety.
0 Foundation: inspector to observe location, size&shape, width, reinforcing, height of
unbalanced fill, fireplace jog,ventilation, damp-proofing/waterproofing, foundation drainage,
and either first floor framing in place or proper bracing before backfill
0 Frame: call after all framing is in place and the sub-trades have finished all cutting, drilling
and notching. inspector to observe species& grade, spans, connections, cutting & notching;
and fire-stopping( after inspection and sign off from sub-trade inspectors)
0 Sub-trade Inspections: call appropriate inspector for individual inspections including, but
not limited to: Plumbing, Gas, Electric:}]; Oil Burner
0 Fireplace/chimney: call following completion of firebox , throat and first flue set
0 Insulation: after insulation is in place: inspector to observe insulation type, vapor barrier,
and R-values
0 Mechanical: inspection of duct installation (for type and fastening), furnace plenum,
hydronic piping, wood &pellet stoves, dryer vents,bath exhaust,fans, heat pumps, etc.
a Finish: call after sub-trade inspectors have signed for final approvals and building, or parts
there of, are ready for occupancy and/or use
Contact Telephone Numbers
Inspection Service Inspectors Name Contact Telephone Number
Building Inspection:
Electrical Inspection:
Gas Inspection:
Plumbing Inspection:
Oil Burner Inspection:
Bd. of Health Inspection:
Fire Department Inspection:
Conservation Commission
Dig Safe
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Unofficial Property Record Card - Salem, MA
NONE
General Property Data
Parcel ID 36-0507-802 Account Number 0
Prior Parcel ID 21 --
Property Owner BROWN PHYLLIS BREWER Property Location 16 PEARL STREET
BROWN FRANK H Property Use Condo
Mailing Address 16 PEARL ST UNIT 16 Most Recent Sale Date 7f7I2006
Legal Reference 26865-57
City SALEM Grantor NADEAU,KEITH A
Mailing State MA Zip 01970 Sale Price 375,000
ParcolZoning R2 Land Area 0.380 acres
Current Property Assessment
Card 1 Value Building Value 319,500 Xtra Features o Land Value 0 Total Value 319,500
Value
Building Description
Building Style Condo TnHs. Foundation Type Concrete Flooring Type Hardwood
#of Living Units 1 Frame Type Wood Basement Floor Concrete
Year Built 2004 Roof Structure Gable Heating Type FardW414k 6a e-60
Building Grade Average Roof Cover Asphalt Shgl Heating Fuel Gas
Building Condition Average Siding Vinyl Air Conditioning.441111,
Finished Area(SF) 1886 Interior Wells Drywall #of Bsmt Garages,* 1
Number Rooms 7 #of Bedrooms 3 #of Full Baths4 '','
#of 3/4 Baths 0 #of 112 Baths-Or #of Other Fixtures 0
Legal Description
Narrative Description of Property
This property contains 0.380 acres of land mainly classified as Condo with a(n)Condo TnHs.style building,built about 2004 ,having Vinyl
exterior and Asphalt Shal roof cover,with 1 unit(s),7 room(s).3 bedroom(s),2 bath(s), 1 half beth(s).
Property Images
F.,
Disclaimer: This information is believed to be correct but is subject to change and is not warranteed.
1 8
Tache Real Estate
tsar rosy
208 DERBY STREET SALEM,MA 01970
OFFICE:(978)745-2004 • FAX:(978)745-0450
Listing Broker
- Office Phone#
_ - Home Phone#
8 8 ® �-
Address 14,Pearl Street, Salem Price 479,000
Directions off Bride Street
Style Colby Cape Ld Area common House Sz 28x40
AM NEW Rooms 7 Liv Area 2260+ Color
Stories 2 Bdrms 3 Mbrm Size 17x20 Fence
FLOOR PLAN B 1 2 3 Foundation concrete Roof asphalt
Livin Room t5xl4 X S.Pump no Basement full
Dining Room 20x14 X Exterior vinyl Insulation yes
Kitchen 12x14 X Stm Wad Floors wd/tile/carpet
Family Room 15x14 X Dom HW yes Own/Rent oo
Bedrooms 3 Heat FHW Fuel gas
Bathrooms X 2 Cost est Gallons
Shower X 2 Wiring CB Plumbing mixed
Porch/Deck X Gas yes Water city
Fireplace Pool no Sewer city
Garage 1 car Driveway es
POSS. I I Zoning res
Stove yes Fan ycs W/D no Hk U yes Book
Ref. yes D/W yes Dis yes A/C Page
Assessment TBD Taxes r TBD
Remarks:
New construction with waterviews. 3 bedrooms,3 baths, 1 car garage under. Central air and fireplace are
optional.
CONSUMER INFORMATION:
Massachusetts Board of Registration of Real Estate Brokers and Salespersons requires Mandatory Agency Disclosure/Agency
Relationship. Whether you are the buyer or the seller you can choose to have the advise,assistance and representation of your
own agent. Do not assume that a broker is acting on your behalf unless you have contracted with that broker to represent you
prior to viewing any property.Types of Agency Representation Include Seller's Agent,Buyer's Agent and Disclosed Dual Agent.
Except as may be otherwise noted,specifications with regard to the property described above were provided solely by the seller(s)without verification thereof by
broker(s)and,therefore,broker(s)accepts no responsibility for the accuracy thereof.Offering is subject to prior sale,price change,or withdrawal without notice.
Note:Foreclosure Properties Only:The Seller,their agents and sub-agents,assume no liability for errors or omissions in this property listing or advertising or promo-
tional statements and materials.Although information has been obtained from sources deemed reliable,the Seller,their agents and sub-agents,make no guarantee Lipp
as to the accuracy of the information herein contained or in any other listing or advertising material.The property is to be sold`as is'-'where is'.
T
f The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
16 Pearl Street 34135-106 36-0507-802
Lla Is this an accepted street?yes / no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R2 Condo 0.380 acres
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?
Public Private ❑ Check ifyes(� Municipally On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Rebecca Jablonowski Salem,MA 01970
Name(Print) City,State,ZIP
16 Pearl Street (781) 799-6998 lud1ow0710(aiemaiLcom
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s)jd' Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work 2: Basement refinishing When house was purchased the basement had studs
insulation,poly and electrical(power and lighting)in place. I'm looking to install couple extra outlets,recessed can ,
lighting then board up the walls. Basement does not have direct access to the back yard and we're looking to install a
sliding door on the back of the house near the patio stairs. Photos and sketches attached.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 5,000 1. Building Permit Fee: $ 42.00 Indicate how fee is determined:
2.Electrical $ 950 ❑ Standard City/Town Application Fee
fd"Total Project Cost (Item 6)x multiplier 5,950 x .007
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $ 42.00
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 5,950 13 Paid in Full 0 Outstanding Balance Due:
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 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D I Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC 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.
�122C� �.b�dnauAyc._� �O�Zo�(Lv
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.
ea .Jab/dnatczsl� !a 120114,
Print Owner's or Authorized Agent's Name(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.eov/oca Information on the Construction Supervisor License can be found at www.mass._gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) _ 3 at/6 (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) .? 816 Habitable room count
Number of fireplaces / Number of bedrooms 3
Number of bathrooms Number of half/baths U
Type of heating system 2 t�� Number of decks/porches /
Type of cooling system Enclosed Open /C
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
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oadon 16 PEARL STREET Propum,AccountRumber 0 Parnl l0 96AgOZ80
Old Peroel 10 21-
Cunant Pannam Mallinq Ammw
Owner JAHLONIMSM REBECCA City SALEM
sham
Addren 16 PEARL ST UNIT 16 Zip 01970
Zanln RZ
Cunene Pro Sales lnfmmatlon
Selo Oem VIYt015 Legal Ratomneo M","d
SalafMca A95900 Gran Selbr&9OWR,PHYLLIS OREYIER
Cumnl Punaaw Aaseoament
C2rd1 Value
Year M16 Building Value 3MA00
Xtro FeeNree Value 0
Land Aree 0MIT ecru Lend Value 0
Tagil Value TKIN 0
Rartnlhe Da.fi lion
bb popery CAmelda 0m eam of land nualat,clmlflad as Cantle wlN nContlo TnHs.sryb buiMM1l0.bulk, Z006 M1evl Wellbe satt SM11 _ aar ll i4a6el a Otdel Llb aMA tob
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i CITY OF Sm-Em. M.kSSACHUSETTS
BUMDNG DEPARV*IENT
a• 120 WASHINGTON STREET,3w FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KI\t$ERLEY DRISCOLL
NMAYOR T1:Iows ST.PmRim
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
(NOTICE SHALL BE GIVEN 48 HOURS IN ADVANCE)
It shall be the responsibility of the permit holder(owner or contractor) to contact the inspector
when the work has progressed to the point of needing an inspection.
0 Excavation: inspector to observe soil types: groundwater elevation, temporary shoring, site
safety.
0 Foundation: inspector to observe location, size& shape, width, reinforcing, height of
unbalanced fill, fireplace jog, ventilation, damp-proofmg/waterproofing, foundation drainage,
and either first floor framing in place or proper bracing before backfill
0 Frame: call after all framing is in place and the sub-trades have finished all cutting, drilling
and notching. inspector to observe species & grade, spans, connections, cutting & notching;
and fire-stopping ( after inspection and sign off from sub-trade inspectors)
0 Sub-trade Inspections: call appropriate inspector for individual inspections including, but
not limited to: Plumbing, Gas, Electrical; Oil Burner
0 Fireplace/chimney: call following completion of firebox , throat and first flue set
0 Insulation: after insulation is in place: inspector to observe insulation type, vapor barrier,
and R-values
0 Mechanical: inspection of duct installation(for type and fastening), furnace plenum,
h dronic piping, wood & pellet stoves dryer vents y p p g, p , dry ,bath exhaust fans, heat etc.
pumps,
0 Finish: call after sub-trade inspectors have signed for final approvals and building, or parts
there of, are ready for occupancy and/or use
Contact Telephone Numbers
Inspection Service Inspectors Name Contact Telephone Number
Building Inspection:
Electrical Inspection:
Gas Inspection:
Plumbing Inspection:
Oil Bumer Inspection:
Bd. of Health Inspection:
Fire Department Inspection:
Conservation Commission
Dig Safe
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C n Y OF SALEM, AWSACHLBEM
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120 WA9WWX aSMW,3IDFioast
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Construction Debris Disposa/Afdavit
(required for all demolition and,.renovation work)'
in accordance with the sixth edition of the State Building Code, 780 CMR, Secdon 111.S Debris,
and the provisions of MGL c40, S 54; Building Permit 8 is issued with the
condition that the debris resulting from this work shall be disposed of in,a properly licensed
waste deposit facility as defined by MGL c 111,S 150A.
The debris will be transported by:
4e, u,6/,'c Se+ V 1.ees
(name of hauler)
The debris will be disposed of in:
41)Jkll
(name of facility) /
(address of facility)
Signature of applicant
Date
!e ° CITY OF SALEM, MASSAC USETTS
BUILDING DEPARTMENT
120 WASHiNGTON STREET,3" FLOOR
TEL. (978)745-9595
KIMBERLBY DRISCOLL FAX(978)740-9846
MAYOR THOMAS STTIERRE
DIRECTOR OF PUBLICPROPERTY/BUILDING COMMISSIONER
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT.
Date17
Job Location /b f earl _31,_ce� , JQ lem HAQ 6/9'79
Home Owner Address lb AQLa l c34ree 4 ((Sae(,-, M/-1 6/97G7
Present Mailing Address lb lai4 0/270
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'S SIGNATURE
APPROVAL OF BUILDING INSPECTOR