4-4A ROPES ST - BUILDING INSPECTION S
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APPLLCATIOY EOI2 PLAN EXAMINA'IYON AND 1301LlllNl, YGRMIT �
ALL STRUCTURF.S EYCEYT / AND 2 FAMILY DWEL/lNC,S
IMYOR7�:�N'1'.Applicanls must cnmplctc.JI i[cros un[hia p:igc � .
SI'1'E INFORM1TATION !J` �1 � �
l.ocation Name�p' /LuP�c� ST 6uilding_ � ���� 7 _ j
Property Address y y�%!Al��_—�� I .
Map# '
L�ated ii�: Conservation Arca Y Historic disaict Y �
Use Groups
(chcck one)
Residentia((3 or more Units) R2�
Type of improvement Residcntial (hotel/motel Rl
(check one) Assembly(churches) :�l .
Ncw E3uilding_ Assembly (nightclubs ete) �2
AJdition � . Assembiy(restam�emts, rcerca[ion) .43_
Altcration_� � 13usiness B_
Rcpnir/Replacement_ F,docatiomd E
Demolitiun_ Factory(muderate hazard) Ft
Move;Kelocate _ Factory Qo�v heznrcl) F2
' FounJation Only.__-- 1-ligh Hazard FI
� Aa;essury 13uilding_ Institutional (residential care) 17
� Olher(Ac�cribe) [nstitutional (incapacitntecl) 12
Institutional (restrainc�) 13
Mcrcantile M
. Storage(moderate huzard) S I
- Storuge(low harard) S2_
U�YNfIZ511JP LNPOItMA'IIOiV(Plense ty�x or I'rint<,:Icarly) �
Lt // p� /� ��j LLC`' G M G2�
OWNER Name 7"7/� /l_O�eR "/ �
Address �/3 GG K �ST ,c� l/P�'� . /f/t DoZI`�
Telephone 2 3Z�
�i�""1�,r��,,�i`�,,T c'�k��"��.,�� �nv^ ././ �1/ffC
iVcr.r� PU',f.i.,a..+F3i�v� �v � L , ��
n� n� f>-i 2 v/1
Ii57'IDIAI'I:U f.ONS"1'RUCI'ION CO57' �c,.7� J _ .
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� CON'fRACPOR[NFORMA'PION
Name SHEY�/��oiv f2E�'x-DLiClt �y2v.�G��D
Address �'� �U X �l�/�2 �f
Telephone %i�-590 - �'92�
Construction Supervisoi's Lic # P5__ 9Gv`�8J
Home ImprovemenC Contractor#
ARCIil7'ECT/ENGINEER INFORMATION
Name
Address
Telephone
Mass. ReQistration #
PEIiMIT FE�CALCULA7'ION
Residential est. cost x $7/$1,000 + $5.00 = �
Commercial est. cost x $11/$1,000 + $5.00= ��
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COMMF,NTS D�}Z� C.D'�l�U �/1//��CP �J/O,/ YD'�l^C� '� �I/l�
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Tlxe lertdersigned does hereby attest that all inforruation stated above is tnie tn the best
of my knowledge under the penallies of perjury
Signed
Date ' g
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-��" •� CITY OF SALLM
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�. �A�a'� PUBLIC PROPRERTY
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'A% �'�.�' DEP�R"I'?�1ENT
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�r,i:�.. r:ir�: �.i;,,, �..; i � -- �
�,i , „r, i�� �t'�;iun�..����r:<i:rr � ti.�in�. �t�.;�� :,. ; i .�_r� �
���Pi: ��78-?�;�1;�K � I�.�Y: 'i'8J3:�'��iit
Construction Uebris Disposal Aftidavit
(rri�uir��l li�r all dcmulitiun unJ r�no�'atiun wurk)
In accurdance ��itl� the sixth edition of the State BuiMing Code, 7S0 Ch9R scction I t l.�
Debris, and the provisiuns of'�1GL c 40, S 54;
Quilding Permit tk is issucd with the con�lition that the dcbris resultin� from
this wurk shall be disposed of in a pruperly liccnsed waste disposal facility as datined by MGL c
1 l 1. S I SOA.
The dehris ���ill be transporteJ by:
��� �����
� Inamc o[haulerl
I he dcbris will be disposed uf'in :
�� _--�-_- lrt��_
(mm�e ul Ihcihty)
/ '�(f�=� � ✓�� ���L�'�" ' � /� '/
�;iddress ul'I�acililyl .
yignaturc of prrmit applic�nt
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;: � �� CITY OF SALEM
' ,��` PUBLIC PROPRERTY
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�'?`��-r� DEPARTMENT
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I.I\II1:'fti lfl':JRF1(:��l.l.
>�t�n�H 12�W A1HI\i{7UN S'1 XECI' �Snu:�4.M.�iti.ua u�ir:i�i�GI�i70
.. 'lla.:978-.'-fi9i9i � P:�s:97N-?iC�78iG
Workers' Cumpensation Insurunce :V'Gdavit: L3uilders/Contracturs/Electriciens/Plumbers
� > >I�c�nt Infurmation
Plca�e Print Leeiblv
�ErvsTo�v r e�n✓,�u��
V8171t; 113usincss�Orp,anizatioNlndivmlu�ll:
:,���i���,�: �'p �ox yvi2 �9
City;Scacc:z�n� S��^��"2�%�G�' I'hone M:
6���,�9� - B'.�2�
:�rc you •rn cmploycr"Chrck the appropriate bux: '1'ype of prnject(rcyuireJ):
I �,� 1 am a cmploycr with 4. 0 I am a gcncral coutr�cwr and I �� � ��N,����,truction
have hircd the ;uh-cuntructors � �j aemodeling
employces(Cull an�Lbr part-tintt).' li,ezd on rhe attachcd,heet. � .
2.Q 1 ;mi a sole proprictor or partner- Thzse sub-contractors have 8. Q'Demolirion
ship and havc no cmpluyccs ���orkzr�' com insuranca.
working ti�r mc in any capacity. p. 9. ❑ Quilding addition
(Ko workcrs'cump. iiuurance 5. 0 W����'<<i co�porrtion and its 10.�Electrical rtpairs ur additions
rcquircJ.] ufticcrs havc cscrciscd thcir
1 l.(� Plumbing rcpairs or udditions
3.� I am a homcowner duing�ll work righe of exemption per MGL 1u
myselE �Ko ��prkcrs' a»np. c. 152, j l(4),and we have no 12.0 2uuFrepairs
1 empluycrs. �No workers' 13. Otl�cr
inwrancu rcyuired.J � . ���np. in,urancc rcc�uirod.J �
•.qny:,,plicau��hut chccks box r11 mus�alsu lill um ihc xction Lsluw showiny�h�ir x�orkux'cumpenwlion pulicy inlirtmativa � �
' I lomeuwn:n whu su�mit Ihis a�davit indica�ing Ihcy are duing ull�wrk mul tl�cn hire outsiJe cumm<�on musi eubmii a new alfAavn indiu�ing.amh.
:(' � �i �d i ch.ck�his box muu�anxh�d on audi�ion�l sh• �,h�wing tho namc of tlm sub<ontranors and�hcir�vurkcrs'cump.pulicy informariun.
1 am wi ¢�nplay¢r druf is proniding svurkers'canpensr+rinn insurnuce jor u�y employres. Belrnv rs�he puliey und%ob site - .
injannutiun.
In.uranccCnmpany Vame: Z�Y L -�` %�-S(//�NC
Tl �' C s_ �-_
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CS - .�G�g3 ...._ Expirmion D;ite: ��/�6 2c'7/�
Pulicv�t ur SelGins. Lia r: .-.--. . .. - .
� y_ y� �Zp�'�S $% Ci�yiStatd"Lip: -S�LT"Ai(
JUb tiitc Adtlross: -
�etrch a cupy nf Il�e worken'cumpens�tiun pulicy dedar•rlion pa�e(showin�Uic policy number•rnd espiration d•rte).
Puilurc w sccure coverage as required under Scuiun 25A ul�IGL a 152 can lead to the imposicion of criminal penalties of a
tina up eo S1.SOOAQ anJ/or une-year imprisnnmcnt, �s �vcll az civil penullics in ihe 1'urm of a STOP �VURK ORDER and a fine
nf up«i 72i0.00 �i day aguinst the violam�. 13e advixcd�hut a copy uf this stutcment may be lurwardcd io thc 017ice of
Im�r��igaiiuiu�f thc [)1.\ for in�ur:u:te co�cragc��u'ificar,un.
/Ju herehy crr(ijV����i� d n�na'a pnud(ics uf prrjiiry thaf Ibe iujunnulion pruvideJ aGoti�e is trtte and coirucl.
s��:,,������
f��,�:����z'� ���«. rJ6/��v/�a'
rhi�rc r:
�/� 5.9�- �9G �
U/'Jiciuf i�st o�ely. Do not n•ritr irr d�is areu.m ha co�upleled by city or to�vn oJJiciul.
YcrmiUl.iccnse�--- .-.. .. _ .. . _ . - -
Citv or�fii�rn: --_- . - " � .
Ixsuing:\ulhurily' (circic onc):
I. ISuard uf 1(e:dd� 2. liuildiny Dcparnncut 3.(:ily/1'o��u Clerk �. L'lecfrical Inspecfor i. plmnbin� Inspector
G.Olher ----- -
Cout�cl Pcrsou: ---- _ ._ ---- Phonc S:
t
Information and Instructions
.� . . :
;\1av:�chu;etts General Laws thap[ar 1�2 reyuirrs all einployers to provide wurkers' compensation tix their employees. �
Pur,u:uu tu Niis,iawia, an rmp(q�•r� is dcfined.�s"...evzry pci;son in thz scrvice uf aiw�her under any conn�oct of hire,
- rzpress or implicd, oral or wricten..•
:\n cmp/n��cr is dcfincd as"an individual, partnenhip,association, wrporation or ather legal cntity, or�ny two or more
of the Forogoing angaged in ajoint eniarprise, and including the fegal rzpresrutatives oPa deceased employcr,ur che
rccaie�er or trusiec u(:u� individual,pa3mership,associatioo or other legal enqty,omploying emplo}•ees. Nowcvcr the
owner of a dwelling huuse having not more than three apartments and who resides therein, or the occupant of the
� dwclling huiisz of ano�hzr who employs persons tu do maineenunce,constzuction or rzpair work un such dwelling house
or on rhe orounds or building appurten:uu thereto shall noc because of such emplaymcnt be deemed w be an rmpluyer." �
`SGL chaptar 152, §35C(6) also staczs chae "every state or locai licensing aRency shall withhold the issuance ar
renewal of a license or permit tu uper�te a Ausiness or to coostruct buildings in [he cummonwealth (or airy �
:ipplican[ wLo has not prnduced •acceptable evidence uf cumpliance with the insurance coverage required:'
Additiunalty, biGL chxp[er 1 i?, S25C(7) st:rtes"Neither the connnonwcaleh nor any of its political subdivisions shall.
encer into�ny contract for the perY'orniance uf'public .vork until acceptable evidence uCco�upliance wich thz insurance
reyuirzments of this chap�er havz heen presented to the contracting authoriry." .
Applicants
Ple:ise fill out the workers' cumpeivation at7idavit completely,by checking die boxes that apply to yuur siluaiion and,if
necessary, supply sub-contractor(s) nsme(s), address(es) and phona number(s)along with�their certificate(s)of
� insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP) with no employees uther than[he
�nembers or partners, �re not required ro carry workers' compznsation i�uurance. if an LLC or LLP does have . �
employees,a policy is raquired. Be advised that this aftidavit may be submitwd to the Depurtment of Industrial
.4ccidents for contirniation of insurance eqverage. Alsa be sure lu sign und date Ihe �Ctidavit. The�a(tidavit.hould
bc rciumed tu die city or town that the application for the permit or license is bcing requzsted, not the Uepartment of -
. InJustrial Accident�. Should you have any yuastions rtgarding the law or if yu�i �re reyuirzd to obtain a workers'
cumpen,ation policy,please call the Dep:utment at ehe number listed�below. Self-insureJ coinpanies should znter their �
sclf-insurance license number on the appropriate line. -
City or'Cown OfOcials - .
Please hc sure tha[the affidavit is complete xnd printed Icgibly. The Deparhnent Nas provided u space ut the bo[[om
oC the aFtidavit for you to till out in the event the Ot2icz of lnvestigations has to conWc[you regarding the applican[. .
Pleasc be surc w till in�he pcnniblicense number which will be uszd as a retercncc �wmber. (n addition,an applicant
ihat must submit multiple permiUliceivse applications in any given year,need only submit one.�ffidavi[indicating current
policy information�if necessary) :uid undzr'7ob Site Address"the xpplicant shouid writc"all lucations in (city ur
town)." A cupy of the aftidavit�hat has bten officially stampcd or marked by[hz ciry or to�m may bc provided to [he
appiicant as proof diat a valid affidavit is on file for future permits or licenses. A new affidavit nw,t be tilled out each
year. Whare a home owner or citizen is obtuining a licenst or permit not related to any business ur commercial venture
(i.e. a dog license or permit[ti burn Itaves ztc.)said persai is VOT required ro complete this affidavit.
l�hc OIIICI' OI II1Y25U�3I1Of15 \4'OUI(I IIiCB IU [I7811IC �'OU 111 J(IV.IIII'C IOC yUll!COOP0��40f1 81](I tiIIOUI(I}'Ull I7llYC 1[ly(�LLCJIlOIli�
� plea�z Ju na hesicate [o give us a call.
Thc D.parnnent',address, telephone and fax numbzr. �
The Commonwealth of Massuchusetts
DepaRment of Industrial Accidents
Ottice of InvesUgaUons
600 Washington Street
Boston, MA 0211 l
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax #617-727-7749
iLc��iscJ i��G-OS �
www.mass.gov/dia
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� UNIT #2 Al�TD UNIT #4
' 4-4A ROPES STREET
SALEM, MASSACHUSETTS 01970
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1 . GENERAL NOTE q_1 O o
2. UNIT 4 FIRST FLOOR PLAN A-2 . . � �
3. UNIT 4 SECOND FLOOR P�AN A-3 ��w
4. UNIT 4 BASEMENT AND REINFORCEMENT PLAN A-4 ' �'-�N
5. SECTION 7 S-1 z�=
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GENERAL NOTES: �_ € _ � �
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1. HE CONTRACTOR OR OWNER IS RESPONSIBLE FOR OBTAINING AND PAYING FOR ALL PERMITS REQUIRED FOR THIS PROJECT. .
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2. ALL WORK SHALL BE PERFORMED IN ACCORDANCE WITH THE COMMONWEALTH OF i.URRENT MASSACHUSETTS STATE BUILDING CODE (780 CMR) �
AND OTHER APPLICABLE CODES. �",�«��'��'��„ � �O
� � lTiAF1 Y"'y�, � � 10 i
3. THE CONTRACTOR IS SOLELY RESPONSIBLE FOR MEANS, METHODS, TECHNIQUES, SEQUENCING, SCHEDULING AND SAFETY FOR THIS PROJECT. � �� �-i — m z
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4. DIMENSIONS ARE NOT GUARANTEE, THE CONTRACTOR SHOULD VERIFI' ALL DRAWP�V„ DIMFNSIONS BEFORE PERFORM WORK. �� r ''fn �o :
5. THE CONTRACTOR SHALL WARRANTEE HIS WORK FOR A PERIOD OF ONE YEAR FRC:M THE DATE OF FINAL COMPLETION. VI � �
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6. THE CONTRACTOR SHALL REPORT ANY DISCREPANCIES BE7WEEN DRAWINGS SPECIFICATIONS OR FIELD CONDITIONS TO T DESIGN IMMEDIATELY. > �
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7. CONCRETE AND REBARS STRENGTH SHALL HAVE MINIMUM OF 3000 PSI AND 60,OU0 PSI RESPECTIVELY. c ~
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SALEM, MASSACHUSETTS 01970
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2. UNIT 4 FIRST FLOOR PLAN A-2 �` �
3. UNIT 4 SECOND FLOOR PLAN A-3 �_w
4. UNIT 4 BASEMENT AND REINFORCEMENT PLAN A-4 wN
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GENERAL NOTES: W � e � ,� ',
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1 . HE CONTRACTOR OR OWNER IS RESPONSIBLE FOR OBTAINING AND PAYING FOR ALL PERMITS REQUIRED FOR THIS PROJECT.
2. ALL WORK SHALL BE PERFORMED IN ACCORDANCE WITH THE COMMONWEALTH OF CURRENT MASSACHUSETTS STATE BUILDING CODE (780 CMR) L - ° I
AND OTHER APPLICABLE CODES. ' , ` ��
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3. THE CONTRACTOR IS SOLELY RESPONSIBLE FOR MEANS, METHODS, TECHNIQUES, SEQUENCING, SCHEDULING AND SAFETY FOR THIS PROJECT. m �
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4. DIMENSIONS ARE NOT GUARANTEE, THE CONTRACTOR SHOULD VERIFY ALL DRAWING DIMENSIONS BEFORE PERFORM WORK. �'�'������ 'n r �
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5. THE CONTRACTOR SHALL WARRANTEE HIS WORK FOR A PERIOD OF ONE YEAR FROM fHE DATE OF FINAL COMPLETION. � ��' ��� �
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6. THE CON7RACTOR �HALL REPORT ANY DISCREPANCIES BETWEEN DRAWINGS SPECIFICATIONS OR FIELD CONDITIONS TO T DESIGN IMMEDIATELY. /,� � Q °
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Inspectors Test
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� Bedroom#1 Bedroom#2
i I ���� % ^ � Open�'overed Porch Bedroom#1 Bedroom#2 Open Covered Porch
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, Im , / ' 113 I No fire sprinkler protection � Kitchen No fire sprinkler protection 206 itchen ,,✓''
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� / — — — � 'i � ''�/n I � '��'� Unit#4 /
� / Unit#1 Bath i Unit#2 Unit#3 Bath lo � �
�q I , I I„ U � Q 1" Up & Down 1„ LTp_.__ &Dawn� r I„ Down 1„ D� I I !-y / / i
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M3 � � �n,� I f � Living Room � � Dining Room Mec . L� iving Room � ��� Dining Room
�(U .� � � ; 1� � �
, � � ` �,- II Room II % /
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Hall ��� �
2 i� �,
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Hall
r Design Area
\z �iz" F.v.c.
I 2 Heads �
Desig;n Area 4" fire service main (by others) I
.15 / 90(0 electric bell
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Basement � Second rloor ',
3/16�° = i' � F1CSl� FIOOP 3/16°° = i° '
ZO-Upright Heads _ _ — — — — — 3/16" = P ' 12- Sidewall Heads _
2- Sidewall Heads �' Y 12- Sidewall Heads
\ 6" Circulating street main
._���m.._. .�:�T..`.� I
GY�. Board �
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2nd n.
Gyp. Board � j
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ELEcrRlr gEu � �
(OUISI�E BI�G.�,,,0 [CPVC PIPE STRqP � -� ^^l�� � �,
� TO SYSTEM �C�PPER SPLIT RMG / - � ., lsf Il.
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HEX HEA➢ SELF
HIDRAWC DATA PLAIE �/--y_ TAPPING SCREW ' �
�� . [—SELF-TAPPING WOOD SCREW I � 4 '�''� ���� Ed�OSC(I WOO(I /
vnNe-rrFe �.ow senrai-\ � SINGLE FASTENER
�� � ' General Notes ''6"
ZyL 6-HEAO CABINET W1hl COPPER "BELL" HANGER STAND—OffF - Basement
saneE sFaiNr:�es CPVC PIPE STRAP -� • All workmanship, materials and design shall confor:,�to NFPA 13R 2002
eREssuRE cnuce Q F , edition, the Mass State building code and all local codes.
wooc doist—�� � SCHEDULE 10/40 . 1�`& 2"d floor piping shall be P' Bazemaster CPVC. 3asement mains will be
cn� vn�v� � � �SAMMY SCREW STEEL PIPE 2 '/z" schedule 10 steel pipe with grooved fittings an�9 1" schedule 40 steel
HANGEP, APPLICAilON �CFPVC PIPE STRAP 4111�ry
�1Ckflow � / HANGER SPACING pipe with threaded fittings. Other sizes where noted. r,� � ��)
,,,, TAMPER SNITCH 6fAIN DRAIN VhIVE RESTRAINE\ APPLICATION A - NOMiNa� Mnx . All heads used are manufactured b TYCO. Livin area heads aze model LFII �� �, ��
2 1�2 E�MES CO�Y#CLOO .
�- - SizE SP�CI�IG Y g � Typical Sectioh -1�`
double check backflow sn�sMv scaEw—�'" -�3/8" Roo '/z" 4.2 K 155F degree quick response sidewalls. Ba�ement heads are model � ' `' '� i1,
�" iz'—o" TY-FRB '/z" 5.6K ISSF uickres onseu ri hts. N.T.S. �
TAAiPFR SWITCH� � CPVC P[PE � � g THREADED ROD�� • .� 1—I/4' 12'-0" . This is a wet system and building owner isresponsible to provide sufficient Fq; , ` �-���� � - -,=T�
p HEX HEAD SEIF CPVC PIPE FIEX HEPD SELF �IG. 200 �-� Z 1S�-O��
� Iy TAPPING SCREW TAPPING SCREW //{'/7�/��, ADJUSTABLE RIIJG / heat to prevent pipes from freezing. � � . _
::AIF VAL�E GROOVED CFIECK VALVE 1 ��/ LODP HANGER � �j� HANGER 2 15�-0�� .� All hangers used to be spaced and installed as per listing. r�' � ,: ��-
.. 6
� � � � 2-1 2� 15'-0° r{
e � ��' • Wiring of alarm devices by others. r � �
W/ AUTOAIA7IC DRIP �� P \ VA � f F ' ,.__. r -� `
3" t 5'-0" « Installation, flushing and testing of fire service main by others. F ,
,. ,
_
��� 15'-0" . nc �. i�r .:.. __. _�.��_� ��
Fisuce 90�—� SINGLE FASTENER DOUBLE FA;STENER � w Water supply info: 76 PSI static, 75 PSI residual cil 840 GPM. Flow test taken
CPVC PIPE STRAP CPVC PIPE STRAP on 7/28/08 at 10:0oPM by APEXFire Protection Inc. and Salem Water
o �'v G�`� Department. 4 �O p8S StPBEt I
y D.I.C.L WA*ER RJTRAFICE- i Han�er Detail •� .The basement remote area is hydraulically calculate:i and requires 317.26 Unit #2 & #4
(9Y OiF1F.R5) � �� GPM at 60.51 PSI
. Zt" (�U�G. MAXIMUM DISTANCE BERNEEIJ HANGERS N.T.S. Salem,MA.
. . NOMINAL PIPE 3/A' 1' I-7IF" 1-1/2" 2' 2-II2" �' J-1/2" 4" 5' e' B' i
� PIPE STAND � sizE (�^.) � .
COPPE2 lU9E 6-0 8-0 10-0 10-0 1Y-0 12-0 1Z-0 IS-0 15-0 115-0 15-0 15-0
`-� � ' � � " � CONCREiE ROOR n ' � ���
� � � � + p � � p � �9 �� CFVC 5-6 6-0 8-8 ]-0 6-0 9-0 12-0 N/A N/A IN/A N/4 N/A , __� '
�,,. AP�X Fire Protection Inc. �
M Sa� 39 Salem Street
�vstem Riser Detail Han�er Detail s LAWRE E v y`� Swampscott,Ma oi9o� �
�
N.T.S. N.T.S.
� fia�P TECT�oN 7g1-595-7234 MA LIC.#SC 131938
aseti3 a cc
.0 9 i 7 �,
. �. "flp SiEP G�e�4' . ,..
IONA�E�� Date: July 30, 2008 Sheet: 1 of 1
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