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13 PICKMAN RD - BUILDING INSPECTION ��f The Commonwealth of Massachusetts Qk Board of Building Regulations and Standards Town of Massachusetts State Building Code, 780 CMR, T"edition Building Dept Building Permit Application To Construct, Repair, Renovate Or Demolish a tbkvom dkva One- or Tito-Fontih•Di elli dons& This Section For Ofli Use.Onlyl Building Permit Number W, ate pit Signature: Budding Commissioner/Inspector of uddin at SECTION I: ATION LI Pro ert Address: n 1.2 Assessors Map dt Parcel Numbers 1.la 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(sq n) Frontage(fl) 1.5 Building Setbacks(B) Front 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 O Private O Zone: _ Outside Flood Zone? Municipal O On site disposal system O Check if es0 tJ SECTION 2: PROPERTY OWNERSHIP' / 2.1 wnAlk l 'RfRecort . ��`�f(Qr^ �� / �r=K{nG .') Na (Print ����WW Vl Address for Service: 97l--Z � /ate Signature I I ITelephone SECTION 3: DESCRIPTION OF PROPOSED�!ORW(checkjelll that apply) New Construction O Existing Building Ef Owner-Occupied Repairs(s) Alteration(s) Addition Demolition ef I Accessory Bldg. O 1 Number of Units Other O Specify: Brief Description of Proposed Work':1 f ,�,r / t1 l -c- J�. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Offlcial Use Only Labor and Materials I. Building f I. Building Permit Fee: fan Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical f ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing f 2. Other Fees: f 4. .Mechanical (HVAC) f List: 5 Mechanical iFire f Su ression Total All Fees: f 'L.� Check No. _Check Amount:,�9 Cash Amount:_ 6. Total Project Cost: f (�� O C7 ❑Paid in Full O Outstanding Balance Due: (y /zr ©moo hei,j -to F/9� � y t SECTIONS: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor tCSL) ;L.1cnc 5- j5 3 92 1 (0 Number Espuu ion Date N;)me of CSL- H [der T=�a L N ti n'11V 03ype(wc below) Descrri tion Address Unrestricted u to 35,000 Cu. Ft.) Restricted l&2 Faml Dwelhn-,"nature .Mason Only /g(- 2-5 RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Summit Appitance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) w6 3 g y HIC any Name or HI Registrant N e Registration Number �PA L111 drt /1/f� 03 07-) 1-2 -,009 Address 71? Z5`( 226V Expi lion Date Signature Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 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. Signed Affidavit Attached? Yes.......... 0 No...........0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I Ntu£J A4• as Owner of the subject property hereby authorize to act on my behalf,in all matters relaIt t it a thorized b this building permit application. 7/Z Zc Si nature of Owner Date I SECTION 7bb:�OWN�ERt OR AUTHORIZED AGENT DECLARATION t,(/'t as Owner o uth�rizcd hemby declare that the statements and information on the foregoing application are true and accuraf my knowledge and behalf. !}— I,ovn I l �ry Print Name J q Signature of Owner or Authorized Agent Date Si ned under the ains 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 Pd have access to the arbitration program or guaranty fund under M.G.L. c. 1 J2A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I I0.R6 and I IO.RS, respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq. Ft.) (including garage, finished basemenuattics, decks or porch) Gross living area(Sq. Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halfbaths Type of heating system Number of decksi porches Ty pe of cooling system Enclosed Open 3. "Total Pro)ecl Square Footage" may he substituted for"Total Project Cost" , r . CITY OF SALEM PLlBL1C. PRc)PRERTY ' DEPARTMENT >�y V III ' 7 '7; 'i',V V: lib. Construction Debris Disposal Aflidav it (icyuired lbr all demolition and renovation work) In accurdance 11 itIi the sixth edition of the State Building Code, 7S0 CAIR seCtiun 1 1 1 5 Debris, and the provisions of MGL c 40, S 54; Building Permit It is issued with the condition that the dcbris resulting from this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c I 11. S 150A. The debris will be transported by: �1 10'lc�t �1SI�'lavl�l ✓� l name of hauler) I he debris will be disposed of in (IWlne tit laclltty) t.IJdres. of Inc Jilyl .I�ndlwe dpi lout apphranl CITY OF S.\I_EM, A—kss kcHL;SETTS BI:IIDLNG DEPARTMENT 120 WASHINGTON STREET, )ta FLooA T L (979) 745-9595 FAX(978) 740-98" ICI\[BERIEY DRISCOLL 'I wnu ST.P[Exim MAYOA DIRECTOR OF PL BLIC PROPERTY/BUDDING CO%L\rtSSIO\EA Workers' Compensation Insurance AITIdavit: builders/Contractors/Electricians/Plumbers A t licant Information Please PrintLegibly Nalne (Busirwv.Organizationlndavedual): � 1_I e- `N Address: G/ T bA L N 91kil l o n rat/ Itle 3a ?7 City/State/Zip: Phone * %�re ti an employer'Cheek to appropriate box: Type of project(required): t.(y l am a employer with 4. ❑ I am a general contractor and I ctnployeas(full and/or part-time).* have hired the sub-conuacmn 6. ❑,/New construction 2-❑ 1 am a sale proprietor or partner- listed on the attached sheet 2 7 L`7 RfIn ing ,hip and have no employees These sub-contractors have S. rkmolition workingfor me in an capacity. worker'comp.insurance Y P tY• 9. D aiding addition INo workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 1 O.J2 Electrical repair or additions J.❑ 1 am a homeowner doing all work right of exemption per MGL I(.Plumbing repairs or additions myself. [No workers'comp. c. 152.$1(4),and we have no 12. aof repairs insurance required.] t employees. [No workers' 13 ❑Offer comp. insurance required.] 'Any applicant slur ducks boa el must a1N fill wl the miles below showing their worken'cerp",wkae policy infurmation. 'I heneuwnaa who subake this aMdsvk indicating they ars doing all wort and this him ounide eantneres,meat submit a new anTjsvta indice".li wek !r,newton ehst cheek this has must attached an adtkrnual sh we showing the cane of ray subeo ureekes and eheir worker'comp.policy information. I not an employer that ir provid/nx workers'tomparmadow Insurance for my employees Brow/s rbe psNgr otrd Job rip informal" Insurance Company Name: Policy M or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: ,mach a copy of the workers'compensation policy declaration page(showing the polity 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 are fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Ik advmcd that a copy of this statement may be forwarded to the Office of 1nVCatlSatiurtn ol'thc DIA for Insurance Coverage vcrihCalWn. l do hereby terrify rder rake pelafti i nd enaldrs of perfary that the informadon provided above is true and rarreet ienalure: ^7/�iln r�j,/l I)ute: Z v O Phone a: < D /_Zsy— 9 3 0 0 iDflitiel sae only. Da not write in thij area, to be runty/Ned by city or town off/tial City or fawn: --- Pcrmit/LlccnseN__, Issuing Aulhurily (circle une): 1. Ituard of Ilvallh 2. Building Department J. City/town Clerk 4. Electrical linpector 5. Plumbing Inspector 6. Other C,uttxct Person: _ _ ._, _.. Phone s• DiPietro Contracting Renovation - Remodeling - New Construction k P.O.Box 162Y Swampscott,MA 01907 i J 6 THOMAS DIPIETRO 781.254.9300 General Contractor 781.820.9439 appts. Fully Licensed&Insured dipietrocontracting@comcast.net .., ^� ` _ , �� +� ; . i ', ; a ��� �� r�,x \� �� L�� �,''P�'� �- . ;, �-�t � `� '�� � � i a �. �-� _� g s U s� I C� os E7 I 13 Z° g �I1 � ? ' 19 ` 3DiPietro Contracting f Renovation - Remodeling - New Construction P.O.Box 162l Swampscott,MA 01907 N THOMAS DIPIETRO 781.254.9300 General Contractor 781.820.9439 appts. b Fully Licensed&Insured dipietrocontracting@comcast.net i rD v-w �Lr i I g�J I OL- 1 c� os er I e�LD r1 J Cn CO N 9 ; — �'ril � C M 3 N cs 1 �o � tr7 G .) Sod old • � � SDL( � l( o i 6 i i - 71 i r7 +_ s wr IS �r ,` UX=' TIOA-) E ti I1 71D„J - I Uy ;a 1.Sv 1 � iIG 1 � � � i I � I ► I � I I I ► Illf _ i � ' I , 1 Ln3wLly � ganu �ay � SI 3 � IF, iJJ _ H 5 � II III 'I III, a ��I i. 11 III III III SIG , I � � i � I i ,I it i i 'I 'I ,i i � � I � l I I , � � � I i I I I' I � I I i � i � � I 'i � ! I I i � I i i � I � I � i i i I � i i I I � � f � � i t � � I , f l I I � ! I I i I i I i � ' I I I � I I � ; I i I I I i t I � � a i t � � � i I ( � ' I i i � � � � I � � , ICI � � � ' � I i I i l � I � j � i i + If 1 ' ! � I i I I I i � � I � i � � � I �' I ; � I ; , i 'I I ; , ; i I , i i j � I 'ill i � i � � ! � � � i ! ! � � i � � I i i II � I ( III l I, f I f I� I � i i � �'� '� �� ��� � � � � � � � , i � l � � � I � it I i� I j I � � I � � i �. � i I i i I I I / I i I � I � I ! � I � � I I I i I I I � � I � � � I t � I � � I i � I I i I � � � � � i� i � I � I � { � ; � ' I i i 11 I, i t II i I I I � I � I I � I i I � � � i I � � i � I I � ! I I � I � i � � � I i ill � Ilij I ! i � � , � il � i , � � I � I I I I !I i � I i I i I � i � i i � I �� � I I � i � � � I i j i i i � l � � I i I , i Ba$E Double 1-3/4- x 11 7/8" VERSA-LAND 2.0 3100 SP Roof Beam1RBO3 BC CALC®2.0 Design Report-US :.'. splints{ No-cantilevers 10112 slope Tuesday,July 07, 2009 11:56 Build 284 File Name: BC CALC Project Job Name: I Description: SS03 Address: Specifier: City, State. Zip: Salem, Me Designer: Customer: Company: Code reports: ESR-1040 Misc: 12 l�l�lllT-1I cL 14-0P00 1 L 1Gt 14.00-00 60 ( B1 V 82 uL 026 Ns t -t DL 3,0921bs OL 928 lbs SL 2,69E$ \ V SL 7.7001bs SL 2,695 lbs t , T, al of Horizontal Design Spans=28-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Rot. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf. Area(psf) Left 00.00-00 28-00-00 15 40 11-00-00 Controls Summary Value %Allow;. .ile Duration case Span Disclosure Pos. Moment 10,640 ft-lbs 43-5°/ 115% 193 1 - Internal Completeness and accuracy of input must Neg. Moment -1 S.109 ft-lbs 61.8% 115% 3 1 - Right be verified by anyone who would rely on End Shear 2,967 lips 32.70/c 115% 193 1 - Left output as evidence of suitability for Cont. Shear 4,696 Ibs 51.7% 1150/0 3 1 - Right particular application.output here based Total Load Qefl, U497(0.338") 36.2! on building Code-accepted design. 194 2 properties and analysis methods. Live Load Defl. U616(0.273") 39.0°/: 194 2 Installation of BOISE engineered wood Total Neg. Defl. -0,074" 9.8 h: 194 1 products must be In accordance with Max Defl. 0.338" 33.80/c. 194 2 current installation Guide and applicable Span/Depth 14.1 n/a 1 building codes.To obtain Installation Guide or ask questions,please call Cautions (800)232-0788 before installation. For roof members with slope(1/4)/12 or less final de ilgn must ensure that ponding instability 8C CALC40, BC FRAMER®,AJ81-, will not occur, ALLJOIST(II),BC RIM BOARD?-,B0I0, For root members with slope (1/2)/12 or less final dr iign must account for Rain-on-Snow BOISEGLULAMTm SIMPLE FRAMING Surcharge load. SYSTEM®,VERSA-LAM®,VERSA-RIM PLUSm,VERSA•R1MO, VERSA-STRANDO.VERSA-STUD®are Notes trademarks of Bclse Wood Products, Design meats Code minimum (U180)Total load def'.`:.ction criteria. L.L.C. Design meets Code minimum (U240) Live load deflo:tion criteria. Design meets arbitrary(1") Maximum load deflectiol Criteria. Minimum bearing length for Bo is 1-1/2". Minimum bearing length for B1 is 4.1/8 Minimum bearing length for 62 is 1-1/2". Entered/Displayed Horizontal Span Length(s) =Cler.: Span+ 1/2 min, end bearing+ 112 intermediate bearing Connection Diagram �J 1`1 b d .t L_ a minimum =2" c= 7-718" b minimum =4" d _24" a minimum= 1" Member has no side loads. Connectors are: FMTSL338 Page 1 of 1 741�lf