The URL can be used to link to this page

19 SABLE RD WEST - BUILDING INSPECTION The Commonwealth of Massachusetts t\ 130did of 13ulliliug Regulations and Standards y \II'Nlt ll'.\I.I I 1 � t NQassaehusettS St:ue Btildln' Code. 780 CMR, 7"' edition I 'SI_ {, i.,.% Building Permit ,Application To Construct. Repair. Rcnoxate Or I)enutlislt a t,rn rJ.htnmu t One- m Tu o4amilv Du c1ling 'oral' This Section For Official Use Onlv Building Permit Nun ee _ Date Apphcd: r Si_naturc: _ BwIJi g ColnmjN1IoIIeI/ Inspcentr of BUtdmgs Dale\ SECTION 1: SITE INFOR:MA PION 1.1 Property \ddress: 1.2 Assessors Map & Parcel Numbers fF n-✓ ...5! '7— Ca_'-©/3 t7-(-1.la Is this an accepted street? Yes lo_ Map Munber I'ur:cl ,N'umhcr 1.3 Zoni Information: 1.4 Property Dimensions: a5,. o /XWO /0z Zoning District Proposed Use I..ut Arca(sy it) Frontage (it) 1.5 Building Setbacks (ft) Front Yard Side Yards Rem Yard Required Provided Required Provided Required PruudcJ 1.6 Water Supply: (M.G.L c. 40. §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: ,--,/ Zone: _ Outside Flood Zone" Municipal Ll-On site disposal syaetu ElPuhlic y- Pris'ate❑ Check if yes&' SECTION 2: PROPERTY OWNERSHIP' 2 winert offAeetcord: �5alyY Ili Vat Address for Service: . tgnamre Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Additi:m ❑ Demolition ❑ Accessory Bldg. ❑ 1 Number of Units_ I Other a Specify: Brief Description of Proposed Work': /!nf i K. 9Grvo own Pry SECTION a: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Official Use Only Item (Labor and Materials) 1. Building S 3 QG, O"C7 L Building Per mit Fee: $ Indicate llosr ice is dr m eteined: ❑ Standard City/Town Application Fee 2. Electrical S ❑Total Project Cost lltem 6) x multiplier x i 3. Plumbing 'S 2. Other Fees: $ 4. ,Vlerhanir.J (fIVAC) S List: 5. Mechanical (Fire ti -- Su>>ressiun) Cotul All Fees: S 6ZJ Check No�QI JO Cheek AnwunC fj3 (;toll Amount ----- � j b. Tolal Project Cost: S U Paid in Full ❑ Outstanding B;t:mce I I SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSI.) I_Ieense Number E\1111auon Date -- Name of('SL- I folder List CSI_l'cpc isce brlowl 'I've Dascri shun Wdress C Cnn•soiarJ W to iS,IA)0 Cu. Pt.I R Restricted 1 fit' F:uwls Dsr clime Slgtla Wrd \t �lasonn Unla RC Remdenual ko"ttire Co\er IIIL l'elephone N'S RC Hrle nual \V nJrIrr end SiJin_ SF Rcsidcmi:t Solid Purl Bununc Applrmiy ImLlle D ReaJenti:l Ucuwlition 5.2 Registered [ionic Itnprorentent Contractor (HIC) HIC Company Name or HIC Registrant Name RCgbtlatl II :Number Address Espuadwn Date Signature Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152. § 2506)) Workers Compensation Insurance affidavit must be completed and submitted with this application. F Ilurc 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 - to act on my behalf, in all matters relative to work authorized by this building permit application. l Signature ot'Owner - Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION 1, , as Owner or Authorized Agent herchy declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and behalf. k�-t'rL Name Signature of Owner or Authorized :gent Date dunderthe ❑ins and enalties of .erjur ) NOTES: n Owner who obtains a building permit to do his/her own \work. or an owner who hires an uIIIC�istered 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 inhumation on the HIC program and Construction Supervisor Licensing (CSI-) can be found in 780 C'MR Regulations I I0.R6 :nd 1 10 R5 respectively. When subsiantr al work is planned, provide the information below: Trial floors :area (Sq. Ft.) (including garage, finished basement/anics, decks or porch) Gross living area ISq. Ft.) Hahituble room count _ Number of fireplaces Number M hednunns Number of bathrooms Number of half/bath: _ -- fvpe of heating system Number ordecks/ pruchcs Type of cooling system Enclosed Open __-- _ 3 "rot:d Project Square Footage' in ay be substituted for "Total Project Cost' _J CITY OF S.0 E.M PUBLIC PROPERTY DEPARTMENT MAVOI 130 WASONCT'0N 9MERT•SAIFx MASSAfM'StT[S 01970 TEL 970-74S-9S"* FAX;978-740-96" HOMEOWNER LICENSE EXE.MMON Please Print Date f///6) Job Locations fz P Home Owner Address f�3.4-m IF— Home Owner Telephone Present Mailing Address a11= The current exemption of"Homeowners"was extended to include owner-occupied dwellings of two Units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFDUION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two 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 "homeowner"shall submit to the Building Official, on a form acceptable to the Building Official, that he/she 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 "homeownee'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 BUILDING NNSPECTOR See other side for state code Salem Web GIS - Map Page Page 1 of 1 „ �d Property Viewer � Wetmtue#o'fhe"f.Yfi"o SnTeuit h2aasachrt New Property Search Property Record Card QHELP � 62 feet '1,111€ "11$Eh I s � �l�j 281 09 014 ----- 70D Property ID 09 0139_0 Address 19 SABLE ROAD WEST 17 l Land Use 101 �"""-�-- Book and Page 22720-261 Lot Size(Acres) 0.44 t Assessed Value $423,100.00 ' SgS.'i: ' �.'i'f - I` e m .... - M 0132 Q3 0142 ,� de + Choose a printable map from the drepdown list m 48k" �0 (Select Printable Map) T 11�� • .= Fy-1 ❑+ °I y0 �� J G� Ri ® Scale i"= I62 R El Show Aerial Photo Salem City Hall 93 Washington Street,Salem,MA 01970 Phone:978-745-9595 City Hall Hours of Operation:Monday,Tuesday&Wednesday 8AM-4PM Thursday SAM-7PM Friday aAM-12PM Site Jesgned by AppGeo. http://host.appgeo.com/salemma/Default.aspx 4/25/2008