73 PIERPONT ST - BUILDING INSPECTION Tr,�)- IIA - 1 -12 y� 0%o clot %19
The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Massachusetts State Building Code, 780 CMR MUNICIPALITY
USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date�xi!ied:
4"'. �.
_ Building Official(Print Name) Signature Date
(� SECTION 1: SITE INFORMATION
Ql� 1.1 Proe���eyy Address: 1.2 Assessors Map& Parcel Numbers
! ! L la Is this an accepted street? yes y no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
so rn
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) t„► — ;v'
1.5 Building Setbacks(ft) Z�rt
Front Yard Side Yards Rear Yaq r rn
Required Provided Required Provided Required Provi
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage D'sposal S em: N
/' O Zone: _ Outside Flood Zone? M//
Public$l Private❑ Check if yes❑ Municipal On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
J.s(j?wner'of$eF�d.
Name(Pr'p� City,State,ZIP
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) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Worltz:
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
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
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $G BOO. ❑ Paid in Full ❑ Outstanding Balance Due:
u /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 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
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: 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
contained in this application is true and accurate to the best of my knowledge and understanding.
Print Owner 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.eov/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"
10/3d/2014 Unofficial Property Record Card
Unofficial Property Record Card - Salem, MA
General Property Data
Parcel ID 10-0077.0 Account Number
Prior Parcel ID 41 —
Property Owner GARD GLEN P Property Location 73 PIERPONT STREET
GARD CHERYL ANN Property Use One Family
Mailing Address 73 PIERPONT STREET Most Recent Sale Date 4/28/1995
Legal Reference 13001-39
City SALEM Grantor SWINIUCH MARGARETTE A
Mailing State MA Zip 01970 Sale Price 135,500
ParcelZoning R1 Land Area 0.125 acres
Current Property Assessment
Card 1 Value Building Value 167,100 Xtra Features 5,000 Land Value 97,100 Total Value 269,200
Value
Building Description
Building Style Old Style Foundation Type Brick/Stone Flooring Type Hardwood
#of Living Units 1 Frame Type Wood Basement Floor Concrete
Year Built 1905 Roof Structure Gable Heating Type Forced H/W
Building Grade Average Roof Cover Asphalt Shgl Heating Fuel Gas
Building Condition Good Siding Vinyl Air Conditioning 0%
Finished Area(SF)1702 Interior Walls Plaster #of Bsmt Garages 0
Number Rooms 6 #of Bedrooms 3 #of Full Baths 1
#of 314 Baths 0 #of 1/2 Baths 0 #of Other Fixtures 0
Legal Description
Narrative Description of Property
This property contains 0.125 acres of land mainly classified as One Family with a(n)Old Style style building,bulk about 1905,having Vinyl
exterior and Asphalt Shgl roof cover,with 1 unit ),6 room ),3 beciroom(s),1 bath(s),0 half bath(s).
Property Images
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Disclaimer:This information is believed to be correct but is subject to change and is not warranteed.
hfp://salem.patriotproperties.mm/RecordCard.asp 1/1
' QTY OF SALEM MASSAC:HUSETTS
BUILDING DEPARTMENT
120 WASFUNGTON STREET 31D FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KINIBERLEY DRISCOLL
MAYOR Tf io&As ST.PIE RRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT: /
Date /e -,-76 -1-7`
Job LocationOI�G/eZ� Q�
Home Owner Address ✓ C� ✓
Present Mailing Address a� I�
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 SIGNATU
APPROVAL OF BUILDING INSPECTOR "