15 1-2 RIVER ST - BUILDING INSPECTION (3) ,a
/ The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Massachusetts State Building O Code, 780 CM R SALEM Revised Mar 2011
Building Permit Application ToConstrud, Repair, RenovateOr listta
One-or Two-Family Dwelling
This Section For Official,Use Only
Building Permit Number: D eApplied:
Building Official (Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 Property Address 1.2AssesmrsMap& Parcel Numbers
Rd`v-ef Sf
1.1aIsthisanacceptedstreet?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions
Zoning District Proposed Use Lot Area(sgft) Frontage(ft)
1.5 BuildingSetbacks(ft)
Front Yard S1deYards RearYard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L a 40,§54) 1.7 Flood Zone I nfor mat ion: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone — Outside Flood Zone? Municipal ❑ Onstedisposal system ❑
Check if yes❑
SECTION2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Name(Print) City,state,ZIP '
/S % A(y�e- .S><-- (zi3`�196-as9l
No.and Street Telephone Email Address
SECTI ON 3: DESCRI PTI ON OF PROPOSED WORK (check all that apply)
Neiv Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) X1 Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Sloecify:
Brief Description of Proposed Worik2: / e.c P /P r ;
r
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs Official Use Only
Labor and Materials
1. Building $ 1. Building Permit Fee $ Indicllehwv fee isdetermined:
2. Electric $ ❑ Standard Cityrrown Application Fee
❑TotalProjet Costs(item 6)x mul ti pl i er x
3. Plumbing $ 2. Other Fees $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire Suppression)
$ Total All Fees $
Check No. Cheek Amount: Cash Amount:
6. Total Project Cos: $ ��
0 Pad in Full 0 Outstanding Balance Due-
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
/1 I�r Y/ems Sr 1 List CSL Type(see below) LIP
No.and Street t L ( , Type Description
E6
/1 eytr )y / �/O l� U Unrestricted(Buildings u to 35,000 cu.ft.
c "l�`"C (! R Restricted 1&2 Family Dwelling
Cityaown,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) /6 1
Ut►ny AoeecsnPy4--/✓brp HIC Registration Number Expiration Date
HIC Company li&ne or C(t���t Name
P- t2- Ke 2 £�
No.and S t eil, &lqEmail address
Citygown,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 zr-e"4 41Le rna
to act on my behalf, in all matters relative to work authorized by this building permit application.
Print Owners 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.
e3te *tur�� it/��la
Print Owner's or Authorized Agent's Name(flectronic Signature) 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 MG.L. c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at mnNA sa eov/dam
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"maybe substituted for"Total Project Cost"
Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978)619-5685 FAX(978)740-0404
CERTIFICATE OF NON-APPLICABILITY
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
Reconstruction Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other Work
as described below does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District: McIntire
Address of Property: . 15 '/2 River St
Name of Record Owner: Peter G. and an hl Fschauzier
Description of Work Proposed:
Reconstruct an existing bulkhead stairs to meet building code and replace rotting wood doors with .similar
wood doors. Work that is an alteration from color, material, design or outward appearance is approved,
conditional that it is not visible from the public way.
Dated: Aueust 21, 2012 SALE ISSION
By.
The homeowner has the option not to commence the work (unless it relates to 1.resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals) prior to commencing work.
.�0 1
li'fll�rr���9�asvrlr�& 1'IOt-e, IC'-c�rla.
Cell: 978.578.0940
Office: 978.594.1138
Mailing Address: Offlee Address:
P.O. Box 8454 10 Rear .Jefferson #1
Salem, 1\7A 01.971 Salem, MA 01970
CONTRACTING AGREEMENT
Read this agreement and make sure you understand it before signing it.
This agreement has legal force and effect and binds those who sign it.
Notice: All home improvement contractors and subcontractors engaged in home
improvement contracting, unless specifically exempt from registration by provisions of
Chapter 142a of the general laws, must be registered with the Commonwealth of
Massachusetts. Inquiries about registration and status should be made to the Director of
Home Improvement Contract Registration, Office of Consumer Affairs and Business
Regulation, Ten Park Plaza, Suite 5170, Boston, MA 02116.
Designated Registrant's Name: Brendan Murray, President
Murray Masonry& More, Corporation
Registration Number: HIC License# 169898
This agreement is made on (date) between Murray Masonry& More. Coro.
hereinafter called"Contractor."
10 Rear Jefferson Ave. Suite 1
Salem, Massachusetts 01970
Telephone - (978) 594-1138
and Name: Peter Eschauzier
hereinafter called "Owner."
Address : 15 '/a River St. Salem, MA 01970
Street City, State Zip Code
Telephone: (239)290-0591
Email: pgeschauzier@me.com
I. DETAILED DESCRIPTION OF WORK TO BE PERFORMED
Rebuild bulkhead entrance
' 1.) Demolish existing bulkhead and excavate as necessary to extend bulkhead to +/-
80"x 68" foot print with height of+/- 64"
2.) Pour monolithic concrete slab at base, in two tiers approximately half of the total
length (40"). Height of tier will be approximately 24"
a. Slab is to be 6" in center and 1' x F around perimeter
b. Slab to be poured over 6" of/4" crushed stone compacted
3.) Side walls to be constructed of 8"CMU's with 1/2" rebar tied into slab in every
other core of CMU wall
a. Fill all cores with concrete after construction is complete
4.) Remove excess materials/debris and contractor tools upon completion
a. Repair brick patio as necessary and replace fence
All materials and installation procedures shall comply with all current local and
national building code requirements. All materials meet or exceed ASTM
standards/Code.
II. PRICE
Contractor agrees to do all work described in Section I for the total price of
$6500
Note: Price does not include engineer's fee nor the permit fee. Those fees will be
billed directly to owner.
III. PAYMENT
Payment will be made as follows:
Due at contract signing = $1000
1/3 of remaining balance due when demolition is complete = $1800
'/z of remaining balance due when job is approximately half completed = $1800
Final balance due upon completion of work outlined above = $1900
Terms: Service charge of 1.5%per month on past due accounts.
Returned checks: A new check must be sent and a service charge of$15.00
must be added to balance.
Notice: No agreement for home improvement contracting work shall require
a down payment(advanced deposit) of more than one-third of the total
contract price or the total amount of all deposits or payments which the
contractor must make, in advance, to order and/or otherwise obtain delivery
of special order materials and equipment, whichever amount is greater.
J1
OWNER:
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES OR
F, YOU HAVE NOT RECEIVED TWO COPIES OF THE NOTICE OF
CANCELLATION.
— et��i�—
OWNER'S SIGNA DATE SIGNED
OWNER'S SIGNATURE DATE SIGNED
MURRAYMASONRY&MORE, Corp.
BY: 1. - r��
BRENDAN MURRAV,President DATE SIGNED
CITY OF S. .FNl, N'L-kSS.ICHusETTS
BUnDLNG DEPARTMENT
f 130 WASHLNGTON STREET, 300 FLOOR
b TEL. (978) 745-9595
FAX(978) 740-9846
KINIBFRi FY DRISCOLL
MAYOR THOatAs ST.PtERRE
DIRECTOR OF PUBLIC PROPERTY/BUUMIIVG CMMUSSIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit# is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
Nc t P� htcgA?
(name f hauler)
The debris will be disposed of in :
�BpG< I-KC 4 en _
(name of facility)-
AW . �Pa d•�
(address of facility)
signature of pertn�pplicant
date
dot (>rtr.a�
i CITY OF SALE:, A)SSACHUSEITS
• MULDL\G DEPART1fEZ-iT
' 120 WASHINGTON STREET, 3so FLOOR
T1EL_ (978)745-9595
FAx(978) 740-9846
KI\(BERLEY DRISCOLL
MAYOR T HoMAs ST.PmRRB
DIRECTOR OF PUBLIC PROPERTY/Bt:13.DLNG CO\t\QSSIONER
`Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
.Armlicant Information L - Please Print Legibly
Nance(Business,Organization/Individunall)):
Address: 10
City/State/Zip: Sd 66?1 bvt4 Dlg76) Phone #:
Are you an employer?Cheek the appropriate box: Type of project(required):
I)FE 1 am a employer with'_ 4. 0 I am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.0 1 am a sole proprietor or partner- listed on the attached sheet.: 7• f] Remodeling
ship and have rm employees These subcontractors have ll. 0 Demolition
working for me in any capacity. workers'comp.insurance.
9. 0 Building addition j
workers'comp. insurance S. ❑ We are a corporation and its
required.)
10.0 Electrical repairs or additions
required.) officers have exercised their
3.0 1 am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions
myself[No workers'comp. C. 152, §I(4),and we have no 12.0 Roof repairs insurance required.)t employees. [No workers' 13,0 Other -&'`Gtg
/l,6501
comp.insurance required.]
'Any applicant that chocks fox o t most also fill out the sectim below showing their workraa'comprnsaion policy inronnalion.
I Imteowtten who submit this affidavit indicating they ate doing all work and the,hire outride c,ntr,m,,mtet submit a new affidavit indicting such.
:Contructon that cheek this box must attached an additional short showing the name or rho eub-eontraam and their worker'comp,policy info m,im.
1 am an employer that Is providing workers'compeasarlon Insurance far my employees. Below is the pollty attd fob site
insuranc i C new t�
Insurance Company Name, �1p-�(t
Policy 4 or ScIf-ins. Lie.#: `3 d83 3/ Expiration Date:---7' 1 !.
Job Site Address: /s5 / f�/'-Pr- J"� City/State/Zip: �i4 (2/''( _ `�l/•� Q/
Attach a copy of the workers'compensation policy declaration page(showing the policy 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 of a
fine up to S 1,500.I10 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
do hereby cerrJLfy under the ppuins and penalties of perjury that the information provided above is true and correct
Si¢nature:_ !3 '•d�"7� Date lr/a C�iOL
t
Phone X:
Official use only. Do not write in this area,to be cumplered by city or town offlc&L
City or Town: Permit/l.icense# _
Issuing Authority(circle one):
1. Board of health 2.Building Department 3.City/town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other .
Contact Person: _ Phone M