12 CHANDLER ROAD - BUILDING JACKET The Commonwealth of Massachusetts
' Board of Building Regulations and Standards CITY
Massachusetts State Building Code, 780 CMR, 7"' edition OF SALEM
11 Revised January
Building Permit Applicatio Construct, Repair, Reno fe Or Demolish a I, 2008
O e-or o-Family Dwellin
(I This Sektion For Offici se Only
"1 Building Permit N ber: I Da Applied:
Signature:
Building Commissi r/Inspec o mgs Date
SE ON 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
l2 Ch�rtdler �2G�•
1.1 a 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 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:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP[
2.1 Owner tof,l,2ecord: `2 Gh"�r
Name t Address for Service: J!(J
Q 7R —74 5-5—W—
Si tore Telephone
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) Alteration(s) ❑ Addition ❑
Demolition ❑ 1 Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work': r0Mo&o01fVA6tce
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Building $ 1 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) S / List: ( ' '�,(t /'� �) (,✓L.J
5.Mechanical (Fire $ i
Su ression Total All Fees: $
6. Total Project Cost: $ �l Lq�. Check No. Check Amount: Cash Amount:
❑Paid in Full ❑ Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 'Licensers Construction Supervisor(CSL) 71 't s 7 $ 11 k
&YUL{ (f f(y6 11n License Number Expiration Date
Name of HP�d�er 11 '' �,q AA
17-CT
C�a'S �'• p9LlFl/ /(1• 61140List CSL Type(see below)
Address —f I TYpe Description
U Unrestricted(up to 35,000 Cu.Ft.
Signature - R Restricted 1&2 FamilyDwelling
y29-532-63V M Mason Only
7 RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Re istered Home Imprgqv@ment Contractor(HIC) 3 3`{/y
Wo rbA54fi. tan
HIC Company Name or HIC istr t1jame Registration Number
A es/�s" " � � I 6/?.71(4
ge J/y-GiZ�,� Q Expiration Date
Signature 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 Issuan a 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, 61 P• f4�V S1 as Owner of the subject property hereby
authorize �py �krr Itn to act on my behalf,in all matters
relative work autlrori by this building permit application.
2 �,�/���
Si au�' rear're of Ow ' Date
SECTION` 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
I, �• �(` 1,Vodnitn ,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. y7 1J
htM,(I � ldnt��
Print Name
Ar
Signature of Owner or Authorized Agent Dates
(Signed under the pains and penalties of perjury)
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 and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and I IO.RS,respectively.
2. When substantial work is planned,provide the information below:
Total floors 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"
r
The Commonwealth of Massachusetts
r °4 Board of Building Regulations and Standards CITY OF
Massachusetts State BuildingCode 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 Penn it Number: Date plied:
� 7
1131u, ding Officia (Print Name Signature Date
SECTION 1: SITE INFORMATION
1.1 Propertyddress: a�Pr A 1.2 Assessors Map& Parcel Numbers
l��� Q�
1.1 a 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 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:
Public ❑ Private❑ Zone: _ Outside Flood Zone?Check if yes❑ Municipal ❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner' fS( 70 o - ��em t m(�
Name(Print) City,State,ZIP
Q 1:1- T73''bz3$
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) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ SpcciA
Brief Description of Proposed Work':
r c
SECTION 4: ESTIMATED CONSTRUCTION COSId
Item Estimated Costs:
(Labor and Materials) Official Use Only
I. Building $ I 9 S 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 $ 01' 2. Other Fees: $ ��
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) / Total All Fees: $
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ I q��j ❑ Paid in Full ❑ Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 CoAn�trrulction Supervisor y�FFense(CSL)
/'I/(:�G�� Q �lyIP 2193 3
License Number Ex va ion Date
Name of CSL Holder
/ I..ist CSL Type(see below)
fl Sib '
No.and Street
Type Description
b em ,M p 0IQ V U Unrestricted(Buildings u to 35,000 cu. ft.)
Yt t 1J R Restricted 1&2 Family Dwelling
Citv/To% . tale ZIP M Masonry
RC Roofing Covering
WS Window and Siding
_�3p-7(7C1 SF Solid Fuel Burning Appliances
7 I Insulation
Tele hone Email address D Demolition
5.2 'Registered Home Imp(ro'v�eymeentt/CContractor(HIC) wk
Lave e " HIC Registration Number rpiration Date
HIC Company Name HIC e istrant Name
I ?� .Tu�nDl
ra+ 0177d— 417_96q-09 [6 En-Nit address
City/Town,State,ZIV Telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152. 5 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 y S/ �
FOR BUILDING PERMIT
I, as Owner of the subject property, hereby authorize t?I �-Z4rJ Alopy
to act on my behalf, in all matters relative to work authorized by this building permit application.
ac,{ " �favK.t3' � KIyG �c— � ISI!3
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 i__n''this
//application
��ilIs true and accurate to the best o(/ff my knowledge and understanding.
�(Vf1W� l.il'1lA.6�I�— Y AA�I 11 �SIt7,
Print Owner's or Authorized Agent's Name(Electrons a u e) 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
wwvv.mass.2ov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps
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"
.�••�r, 12 CHANDLER ROAD •,
4 •
/, �. -�� -J,1��
O SENDER:Complete items 1,2,3,and 4.
Add your address in the"RETURN TO"space
!n on reverse.
(CONSULT POSTMASTER FOR FEES)
1.The following service is requested(check one).
® Show to whom and date delivered.................... 606
❑ Show to whom,date,and address of delivery.. _0
z.❑ RESTRICTED DELIVERY _C
(TSe restricted deliveryfee is charged in addition to
the return receipt fee.)
TOTAL $
-�3.ARTICLE ADDRESSED TO:
Norman Tache
12 Chandler Rd.
a Salem, MA 01970
z
a a. TYPE OF SERVICE: ARTICLE NUMBER
m ❑REGISTERED ❑INSURED P474
El CERTIFIED [:1 COD 720 624
❑EXPRESS MAIL
In (Always obtain signature I addressee or agent)
w I have received the article described above.
H
M SIGNATURE ❑ Addressee ❑ Authorized agent
In
Z 6.
C D DELIVERYr• RWFWA-RK
= 6.ADDRESSEES ADDRESS(Only I ragaeued)
O
O
M
a
H
r 7.UNABLE TO DELIVER BECAUSE 7a.EMPLOYEES
m INITIALS
D
>C
D
r
UNITED STATES POSTAL SERVICE
OFFICIAL BUSINESS
PENALTY FOR PRIVATE
SENDER INSTRUCTIONS USE TO AVOID PAYMENT
Print your name,address,and IIP Code in the space below. of POSTAGE,S300
• Complete Items f,;3,ad d on the reverse. U.SNUIIL
• Attach to VOM of article it space permits, �®
otherwise affix to back of article.
• Endorse aNcle"Rehan Receipt Requested"
adjacent to number.
RETURN
TO
Inspector of Buildings
L — _
(Name of Sender)
One Salem Green
(Street or P.O. Box)
Salem, MA 01970
(Cfty, State, and ZIP Code)
P 474 720 624
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED—
NOT FOR INTERNATIONAL MAIL
(See Reverse)
Sentto
Norman Tache
Street and No.
12 Chandler Rd.
P.O.,State and ZIP Code
Salem
Postage $
C titled Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt ShowingI
to whom and Date Delivered
Return Receipt Showing to whom,
N Date,and Address of Delivery
m
�. TOTAL Postage and Fees E 1.55
F
Postmark or Date
w
5/5/83
m
E
`o
w
Go
O.
STICK POSTAGE STAMPS TO ARTICLE TO COYER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CNAAGES FOR ANYEELECTED OPTIONAL SERVICES:(uPoep
1.If youwentthtsreceiptpostmarksdrsthkiwh Wnnmel5tubontheleftportion oftheaddressslds
of the article leaving the recelptattached and present the article at a post office service windowor
hand R to your rural carrier.(no extra charge) -
-2.If you do not want this receipt postmarked,stick the gummed stub on the left portion of the
address sideofthe article,date,detach and retaln the receipt,and mall the arYcTe.
3.If you want-a return receipt,write-the car i �ednait number andyour name arra address on a
return racoiptcard;Form 3811,2rid attach it tothe front-of the artcle by means ofthegummederia
N spacapernifts.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT
REQUESTED adjacent to the number.
4.if you:ward-delivery restricted to the addresses,or to on authorized agent of the addressee.
endorse RETiTRTCTED DELIVERY on the front of the article.
6.Enter fees for the services requested in the appropriate spaces on the front of this receipt If
return recelpt Is requested,check the appficable blocks In Item 1 of Form 3811,
t
6.Save this receipt and present it If you make mqulry.
a Salle tt9 An5ar4us2fivi
�, r,��:. ,;a?� �uhlit �SII3JErt�J �E�"iFlrtYttPnt
?Ruilbiq PEpttrtrtPnrt
Richard T. McIntosh
One Salem Green
745-0213
May 5, 1983
Norman Tache
12 Chandler Road
Salem, Massachusetts 01970
RE: Trailers
R-1 Zone
Dear Mr. Tache:
Apparently you have ignored my letter to you dated June 29, 1981
regarding parking of trailers in an R-1 Zoned District. You are there-
fore required to remove the illegally parked trailer immediately.
Section VII .3.B of the City of Salem Zoning Ordinance states,
"Trailers shall not be stored in any front yard, the trailer shall not
be placed closer than 10 feet from any lot line or within 5 feet of
any building on an adjacent lot."
Failure to comply with any of the above will result in this matter
being brought to the Courts for their determination.
Very truly yours,
Richard T. McIntosh
Zoning Enforcement Officer
RTM:bms
f cc: Frank Beauregard, 10 Chandler Road
Councillor John Nutting J / f
�I 3 -7Y1-C f �/ lam, 7_&c,L h, A
- . ,,,
T
y o1it oftt1em, Cmc ttsttr usz#try
M,
Richard
p
Richard T,
McIntosh
I Salem Green
Salem,Ma 01970 June 29,1981
Norman Tache
12 Chandler Road
Salem,Ma 01970 Re: Trucks
Dear Mr, Tache:
Please be advised that
you cannot park trailers or trailer truck
cabs in a residential zoned district,
Chandler Road is in a R-I District, which provides for single
family residence only.
Please take the action that is necessary to comply with the above.
Very truly Yours,
Richard T- McIntosh
Zoning Enforcement Officer
RTM:mo a
cc: Frank Beauregard
�w.cw my
y ?11P11t
t
Richard T.
McIntosh
4-
Salem
Salem Green
Salem,Ma 01970 June 29,1981
i
Norman Tache
12 Chandi,:!r goad
Salem,Ma 01970 Re: Trucks
Dear Mr, Tache:
Please be advised that you cannot park trailers or trailer truck
cabs in a residential zoned district.
Chandler Road is in a R-I District, which provides for single
family residence only.
Please take the action that is necessary to comply P y with the above.
Very truly. yours,
Richard T. McIntosh
1 zoning Enforcement Officer
RTM:mo's
cc: Frank Beauregard
SUPPLEMEOTARi ' REGULATIONS / SECTION VII
Of
A. Trailers kk��
No person shall paArrT,,1%to" V A9r'OJccupy a trailer for
living or business pur ops �s.Otvithin 'the City of Salem
except - �xTF.$ALEM4EQq ,
1. The owner of residential premises may permit occupancy
of such premises by non-paying guests using a trailer
for a period not to exceed twenty days. A Special Per-
mit for this purpose must be obtained from the Inspector
of Buildings before the land can be so occupied. No
more than one ..trailer is permitted with any one residence
or lot.
2. A temporary office incidental to construction on or
development of the premises on which the trailer is
located shall be permitted.
In neither case shall the trailer' be connected to public
water or 'sewer facilities. ' Trailers used as temporary
construction offices may be connected to telephone and
and electric facilities.
3. Dead storage and/or parking of trailers will be permitted
in accordance with the following provisions -
a. Such stored trailers shall not be used for living
occupancy, except as stipulated in Subparagraph 1
hereinbefore.
b. Trailers shall not be stored in anyfront yard. If
stored in any .side or rear yard, the trailer shall
-not be placed closer than ten feet from any lot line
or within five. feet of any building on an adjacent
lot.
4