32 PUTNAM ST - BUILDING INSPECTION (2) c;r. 5769 z- 4 7 80O
ILK The Commonwealth of Massachusetts RECEJVE13
Board of Building Regulations and StanfAW ECTIONAE SER ICESALEM
Massachusetts State Building Code,780 CMR g led Mar 2011
Building Permit Application To Construct,Repair,Renov4V bAar citlslfa
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
g (�
Building Official(Print Name) Signature Date
V J SECTION 1:SITE INFORMATION
1.1 Property,{1ddress: 1.2 Assessors Map&Parcel Numbers
ST
L 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 ft) Frontage(it)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required I 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 L9' Private El — Municipal C9�On site disposal system ❑
Check if yesCiY
SECTION 2: PROPERTY OWNERSHIP'
2.1 OwPr'C/lR *
City,State,ZIP
�26Z �Sk
No.and Street Te ephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORle(check all that apply)
New Construction Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) Addition ❑
Demolition ❑ 1 Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work : /D c C✓ NeLJ
ao 1 D 04f 6AJ 160ail' + Q Sth �AtfS
O J lS4- F/wtr uec
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials
1.Building / D �! $ 1. Building Permit Fee:$ Indicate how fee is determined:
❑Standard CityfFown Application Fee
2.Electrical $ ❑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: $ S OG ❑Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) (SM8Mr7 q /0 16
License Number Expfratugh Date
Name of CSL Hot U
Lis[CSL Type(see below)
No.and Street J 1 T Description
L p ^. /� y� 1r,� U Unrestricted(Buildings u to 35,000 cu.ft.)
C- �J�-/s /�'� V J R Restricted M2 Family Dwelling
City/Town,State,XT M Masonry
RC Roofing Covering
WS Window and Siding
Xtl-3{t/—/lgll Pau Jk(nccgne ® ec)^c,% Ae--c- SF Solid Fuel Burning Appliances
I Insulation
Tel Email address D Demolition
5.2 Registered Home Improvemle t Contractor(HIC) 'u,aa Lf �� 7
�N7 fO` C� -- `� HIC R_[egistration Number ion Date
HICC�o� 16 A)J STgistrmt Name (/ h(( �� ��IG. bcu,UJe U F*Kca'1'
No. meet Email address
- �PJk MA-U 1�a g DUX-36y-//�/y
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6))
Workers Compensation Insurance affidavit most 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..........l3' 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 / & �U/? �l
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Ownersc 'c Si ) 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
contain i this applicatto it true and accurate to the best of my knowledge and understanding.
Print Owner' or A d Agent's Name(Electronic Signature) I 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. ov@ /oca Information on the Construction Supervisor License can be found at MMMM ss.gov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.fL) (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"
The Commonwealth ofMassach.usetts
Department oflndustrial Accidents
Ogice oflnvesagations.
600 Washington Street
Boston,MA 02111
www.massgov/die
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ,
A bca it Information M I I Please Print Leeibly
Name(Business/Orgm&260nQndual)s
Address --
City/Statelzip: CSS D1�� Phone.#:
Are you an employer?Check the appropriate box Type of project(required):. .
1.❑ I am a employer with 4. ❑ I am a general contractor and I .6. ANew construction
employees(full and(or part-time). have hired the sub-contractors
2 I am a.sole proprietor or perfect- listed on the'attsched sheet. 7• ®Remodeling
These sub-contractors have 8. ❑Demolition
ship and have no employee
working forme in ffiY capacity. loyees and have workers'capacity. suuance= 9. ❑Building addition
comp.in
[No workers'comp.insurance5. ❑ We are a corporation and its 10.0Electrical repairs or additions
requite&] officers have exercised their 11.❑Plumbing repairs or additions
3.01 am a homeowner doing all work right 6f exemption per MGL
myself.[No wormers'gip, 12.❑Roofrepaint
insurance required•)t c•152,51(4),and we have no 13.00 uter
caployees.[No workers'
comp.insurance required.]
. *My appliceatdutcbwb box#1emst also SD out theseeden below showbrg their wodan'wmpaWdoo Policy httmmados. .
t nomeoweeu wfiosubmt JIM affidavit tadirating they see dobgg all work and dten hue outsWecontractors must subrdtamew adiidawtsoMm es suet.
j 1Cmbecmu that dteek des box moat atteched®additional shed Awwtng the berm Ofdtesub"eongacrou aed.fete wbcdw or sot those euddes have
employees. rftsubeoabacmnhaveemOoyees.dMmtgstpwn&dmworbu'eomppobcya®bw -
_Tam
am an employerdwisproviding workers'compenration basurancefor my employees Below rs thepolicy andlob aue
Information
insurance Company Name: ✓ —
Policy#or Seh ins.Lie.# ✓& Bspiration Date: "
Job Site Address: GSty/State/Ztp
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date}
Faihne.to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of tamtinal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a Sue
of up to$250.00 a day against the violator. Be advised that a eopyof this statement maybe forwarded to the Office of
hweatisations of the DIA for insurance coverage verification
I do hereby ce under the paths and penaties ofperjury riot the lnfornurtion provided above is, and correct
Si e: ate
Phone#. 5-o 3 ����y
O rcial use only. Do not write in this area,tb a comp red by coy or town offwIaC
City or.Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk.4.Electrical Inspector 5.Plumr� ector
6.Other
Contact Person: Phone
3 .
Buildine Permit Application Routine and Approval Form
Name of Applicant: V 1�I(l�iP
Property Address: I t I+A) j^ J �
Map 61 Lot:)
Name of Agent/Builder: C66 -y-,
License Number:
The original ApPlication was received for processing by the Building Inspector
ector on:
The Application requires review by the following departments as indicated by the Building Inspector:
Department Not Applicable Approved Denied Initials
Board of Health
Water/Wastewater
Department of Public Works
Conservation Commission
Fire Department
Historical Commission
Planning Board
Approved/Signed by the Building Inspector one
Conditions:
4 .
�e (pamnemuno¢�N o�C�/f�at9rz<�aeeCLy�:
_ .OIBee orCoosomer Affairs&Business Regulation License or registration valid for individul use only
✓S OME IMPROVEMENT CONTRACTOR before the expiration date. tf found return to:
egistra0on r'1.47Y14 Type Office of Consumer Affairs and Business Regulation
- ExpiraUon -6lZi�`i2612 pgA 10 Park Plaza-Suite 5170 _
O'CONNELL CONST i �. � - Boston,MA 02116
�Y
PHILIP O'CONNELL -
. 63 POND ST. r - -
ESSEC,AAA 01929 - Undersecretary
No valid without igoature -
Massachusetts-Department of Public Safety
Board Of Building Regulations and Standards
Construction Supen-isor
License: CS4)WSJ7
PffiI OCONNEfi`
63 POND ST
ES SEX NIA 01929
Expiration
Commissioner 09110=16
Salem Web GIS -Map Page Page 1 of 1
. Property Viewer
�Welapine.fo the_cty o;','"`Sale n?✓Mauod�esetts
^�— me i^6iucuiL »nio.
New Property Search Property Record Card ()HELP
'Meet N
j' 15_0295 n
1 N
Property lO 15_0281_0
15 150294 15 0293 Addreas 32 PIfTNAM STREET
Lena use 101
> Book and Page P3474-55
Lot Size(Acres) 0.08
Assessed Value $254,500.00
is 0?51
((JJ a
>d, Choose a printable map from the dropdown list.
15 0276
l� l
(Select Printable Map)
ozm
I 1 y�mlno.aaaaaannuu,,
v Q •• Fy ❑+ tlsv+oaar� O n tP it ® Swle 1'= 30 it ❑Show Aerial Photo
Salem City Hall 93 Washington Street,Salem,MA 01970
Phone:978-745-9595
City Hall Hours of Operation:Monday,Tuesday a Wednesday S M-4P14 Thursday aAM-7PM Friday 8AM-12PM
Site dmiexal M APPeen.
http://host.appgeo.com/salemma/default.aspx 8/13/2015
o Q �
\� 7f�rvOJ-\�
uj 4ril
�So9Xy � l - _I- ��
t1f f w��J aIx@ OF
tQ� / 5J,1�1S/
Mh
o/X61TR-
M� ol
M
Mein a��S
rauSis+'�
{ I
cot
floor P I1�-,jS rrAo-c
4o�b�r KM
a x ro PT
NA�6GRS
f.,1.SQ�
� 9Xh
i
I I _
�O
1 ,
Page 1 of 1
Card 1 of 1
oeatlon 32 PUTNAM STREET Properly Aceount Number 0 Parcel ID 15-0281-
Old Parcel ID 42 —
Current Property Mailing Address
Owner SZYMANSKI RICHARD J City SALEM
State MA
Address 32 PUTNAM STREET Zip 01970
Zoning R2
Current Prope Sales Information
FF Sale Date 1/1/1960 Legal Reference P3474-55
11 Sale Price 44,000 Grantor Seller
Current Property Assessment
Card 1 Value
Year 2015 Building Value 139,300
Xtra Features Value 0
Land Area 0.080 acres Land Value 98,200
Total Value 237,500
Narrative Description
his property contains 0.080 acres of land mainly classified as One Family with a(n) Old Style style
uilding, built about 1850 , having Aluminum exterior and Asphalt Shgl roof cover,with 1 unit(s), 7
4 1 rooms ,4 total bedrooms , 2 total baths , 0 total half baths , 0 total 314 baths .
Legal Description
Property Images
>.
ifL 10 11
t0 BYi ,
1
art w —
elm
f ZI i 9 .p Z 11 l�0
W1
http://salem-patriotproperties.com/summary-bottom.asp 8/13/2015