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Citp of Salem, :fljaS2;atbUs;Ptts
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GTED
Building Permit Application For: Tondos of Building I1 U
'(Circle whichever applies) Roof, Reroof• Install Siding Consuuet Dock, Shed, pool
Addition, Alteration, RepaidReplaM Foundation Only, Wrecking
Otber.
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inspector uif Buildings: '
The mull 4"d hereby applies for a permit to build"rdisg to the following specifiations
Owners Name: t"YiPI Cost r.
sneetllC_b t s ("I�( clty a street cfty
Sian ` CL Pbone (QTa')�C►S q I(Q , state ( )
Architect: City of Salem Lk
Strut Ciq State L HIP#
State phone ( ) Homeowners Exempt Form —JW
Structure: (please dwie.) a Famil • Multi Family N
Estimated Coot of job S ` J
Will building confirm to law! }
..des no
Asbestw! yp_�so
Deseriptias of work to be done:-
Drawings Submitted: no Mail Permit to: .
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71�� l�'�t•y
SipaWre of Application,$ GNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION T B MP
+ OLETED WITHIN SIX MONT=OF PERMIT ISSUED DATE
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D%mun at use only: Penngw# � g
Permit fee S
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The Commonwealth of Massachusetts
� CITY OF
d Board of Building Regulations and Standards SALEM
Massachusetts State Building Code, 780 CMR Revised Mar 2011
rl �� Building Permit Application To Construct, Repair, Renovate Or Demolish a
One or Two-Family Dwelling
'This Section For Official ITsc Only p
r -
Building Pe r mi ert Numb ate F pphed
Butldmg Official(Print Name) ,•L Signature w;
e,
SECTION L' SITE INFORMATI
1.1 ropprty Addrgss 1 1.2 Assessors Map&Parcel Numbers
'I. Is this an accepted street?yes Ma_ no_ P 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:
Zone: _ Outside Flood Zone?
Public Private❑ Check if yes❑ Municipal On site disposal system ❑
,'SECTION 2,.PROP ETtTl'O _NE
RSHIPi
1�1n Owners of ecord:
GlyeiCSto, , re"
Name(Print) City,State,ZIP
a �4 R Q. 1?J 4S- 9/6t
No. and Street Telephone Email Address
SECTION 3i DESCRIPTION OF PROPOSED;WORKZ.(check all that apply)
New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work': = o
SECTION 4:ESTIMATED.CONSTRUcTION COSTS
Estimated Costs: f„ =
Item Offictal`ilse Only_
Labor and Materials
1. Building $ 'l Building Permit Fee $ Indicate how fee is determined:
❑Standard CitylTovyn Apphcation Fee
2.Electrical $ ❑TotalPiolect Cost' (Item 6)x ihultiplier�- x `
3. Plumbing $ 2 Other Fees• $
4. Mechanical (IIVAC) $ List "
5. Mechanical (Fire $
Su ression Total All Fees $ -
Check No. Check Amount; � Cash Amount,
6. Total Project Cost: S ❑paid in Full . ❑ Outs(anding Balance Due'
f,_
SECTION 5:' CONSTRUCTIONS SERVICES'
5.1 Construction Supervisor License(CSL)
License Number Expiration Dale
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 Dwellin
City/Town,State,ZIP M Masonr
RC Roofin Coverin
WS Window and Sidin
SF Solid Fuel Burning Appliances
I Insulation
Tele hone Email address D Demolition
5el Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
Ci /Town, State,ZIP Telephone
SECTION6: 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 Zn 6n �1A.A4 r
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: 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.
Print Owner's or Authorized Agent's Name(Electronic Signature) t Date
NOTES:
L 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 tinder M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.marss.yov'oca Information on the Construction Supervisor License can be found at www.nlass.uod/dns
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"
CITY OF S.UXENf
PUBLIC PROPERTY
DEPAM LENT
wvae t b v�wrw,oM sraaa•suaa�MNuoRs�rn Onf-s
na.9,1045.9s"•K.a.9'1.7447W
HOMEOWNER LICENSE EXEMMON
plow "I
Date 1/ lZ
!ob L«adon l O` D. S DLQ
Home Owmsr Addrese o
Home Owner Telephone S 441
Pressm Mailing Address 14er So fvt o e
The current exemption of"Homeowners"was extended to include owner-occupied
dw@Hinge ohwro Unib or leas and to allow such homeowners to engage an individual for
hire who does oat possess a licensed provided that the owner acts as supervisor.
DEFINMON OF HOMEOWNER
Person(s) who owns a pared of land on which he/she redder or intends to reside.on
which there is, or is intended to be,a one or taro 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
"homeownee shall submit to the Building Oi icial,on a fort acceptable to the Building
Oilicial, that hdshe 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 understands the City of Salem
Building Department minimum inspection procedures and requirements and that he/she
Will comply with said procedures and requirements.
HOMEOWNERS SIGNATL
.APPROVAL OF SUILDENG DiSPECTOR
Sce other side for state code
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CITY OF SALEM, MASSACHUSETTS
BUILDING DEPARTMENT
120 WASHINGTON STREET,3"D FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
;V"L1YOR THO\LIiS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
June 4, 2010
Aleksandor and
17 Chandler Road colp
Salem Ma 01970
Dear Owners,
Last year I spoke with your son regarding the inground swimming pool in your back yard. I
informed your son that the pool had to be maintained. The State building code 780 C.M.R
section 103 requires the owner of a structure to maintain and to keep all systems in a safe and
operable manner. In this case, an inground pool cannot remain empty. The walls of an inground
pool are not desiged to hold back the unbalanced load imposed by the surrounding soil.The
empty pool also creates a serious fall hazard. The pool needs to placed back into and maintained
in an operable condition. The other choice is to remove the pool. You are directed to begin
repairs or to begin to remove the pool within 5 days of this notice. Failure to comply will
constitute a violation of the Building Code and can result in daily fines and further enforcement
actions. If you feel you are aggrieved by this order, your Appeal is to the Board of
Buildings,Regulations and Standards in Boston.If you have any questions,please contact me
directly.
Tho s t.Pierr
7ti,
Building Commissioner/Director of Inspectional Services
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
Item 4 if Restricted Delivery is desired. ❑Agent
■ Print your name and address on the reverse X F ❑Addressee
so that we can return the Card to you. B. Received by(Printed Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits. _
D. Is de' doss different from hem 17 ❑Yes
1. Article Addressed to: 1 3@peAa
ry address below; ❑ No
JUN 0 8 2010
3. Service Type
❑Certified Mail rens M I
RO
d ❑Return Receipt for Merchandise
❑Ins at ❑C.O.O.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(71ansfer from service tabe9
PS Form 3811,February 2004 Domestic Return Receipt 10259542-bi-1540
i �J�
UNITED Sr '�n .r � �. qtr 3Ki'MID e9vt
R,
• Sender: Please print your name, address, and ZIP+4 in this box
HIM 111IIIIIIA IIIiii„ii,iiiiiiiiiilitilifillifiIIl„IJ
,
MORTGAGE INSPECTION TO EASTERN BANK,
ITS SUCCESSORS AND/OR ASSIGNS
PLAN IN AS THEIR INTEREST MAY APPEAR.
SALEM MASS. I CERTIFY THAT THE DWELLING IS LOCATED
AS SHOWN AND CONFORMED TO THE ZONING
f SET BACK REQUIREMENTS OF THE CITY OF
REID LAND SURVEYORS SALEM WHEN CONSTRUCTED, OR IS
• EXEMPT FROM VIOLATION ENFORCEMENT
365 CHATHAM ST., LYNN, MASS. UNDER M.G.L. TITLE VII CH. 40A SEC. 7.
N/F
N/F B&N REATLY TRUST N/F
DORON HARRINGTON
55' r�T pyy Ml AAIB
SHED ►/ iiti a=M, !<�
LOT 18 IN—GROUND RALPH
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6723± S.F. POOL P
No.L;422 ►
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17 CHANDLER STREET
"I, HEREBY, CERTIFY TO THE BEST OF MY KNOWLEDGE NOTE: THIS PLAN WAS PREPARED FROM A
THAT THE PREMISES SHOWN ON THIS PLAN ARE NOT LOCAT— TAPE SURVEY AND IS INTENDED FOR
ED WITHIN A SPECIAL FLOOD HAZARD AREA AS DELINEATED MORTGAGE PURPOSES ONLY. OFFSETS SHOWN
ON THE MAP OF COMMUNITY #250102—B PREPARED BY THE ON TG SCALED FROM THIS PLAN, ARE
FEDERAL EMERGENCY MANAGI=MENT AGENCY OR IT'S
SUCCESSORS DATED 8/5/85, PANEL 5 , ZONE C ." APPROXIMATE ONLY AND SHOULD NOT BE
I FURTHER CERTIFY THAT 1NIS INSPECTION WAS PER— USED TO DETERMINE PROPERTY LINES.
FORMED IN ACCORDANCE WITIi THE "TECHNICAL STAND— SCALE: 1" = 30' DATE: FEB. 23, 2004
ARCS FOR MORTGAGE LOAN INSPECTIONS" AS ADOPTED
BY THE MASSACHUSETTS AS'.00IATION OF LAND SURVEYORS BOOK: 16605 PAGE: 475 CERT.#
AND CIVIL ENGINEERS.
THIS CERTIFICATION DOES NOT INCLUDE SHRUBS, WALLS, CONTROL #: PO4-0110 BLB
FENCES OR DRIVEWAYS AS THEY DO NOT ALWAYS INDICATE
PROPERTY LINES. I DLO