32 SHORE AVE - BUILDING INSPECTION The Commonwealth of Massachusetts RECEIVEtDate
i Board of Building Regulations and Standa kPECTIONAL
Massachusetts State Building Code, 780 CR6
1 Building Permit Application To Construct, Repair, RenovalINSDN2,0 a
One-or Two-Farnily Dwelling
A� This Section For Official Use Only
Building Permit Number: Date pi ed.-
Building
Ci 1 Official(Print Name). Signature
SECTION 1.SITE INFORMATION
I.1 Property Addr ss: 1.2 Assessors Niap&Parcel Numbers
32 5kere V Aft 2
1.1 a Is this an accepted sti eet?yes no Map Number Parcel Number
1.3 'Lotting Information: 1.4 Property Dimensions:
R1
Zoning District Proposed Use Lot Area(sq 11) Frontage(11)
1.5 Building Setbacks(it)
Front Yard Side Yams Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.3 Sewage Disposal System:
Public 2( Private O Zone: _ Outside Flood Zone? Municipal CdrOn site disposal system O
Check if yesC3
SECTION2: PROPERTYOWNERSHIV!
2. Orvnert of Rccord:
Neu Ev PEIRC>: 064(.04� MA 0070
14tanc(Print) City,State,ZIP
32 SHORE Avi- APf. 2 -,g z I—460 31tc11eypelrcG A11.UM
No.and Street Telephone Email Ad ress
SECTION 3: DESCRI 1ON OF PROPOSED VORKA(check all that apply)
New Construction 14 Existing Building Owner-Occupied Repairs(s) ❑ I Alteration(s) 0 1 Addition ❑
Demolition Accessory Bldg.❑ Number of Un'ts_ Other ❑ Specify:
Brief Description of Proposed Work=: U
/ri rCHF
SECTION a:ESTIMATED CONSTRUCTION COSTS
Item (Labor
Costs: Official Use Only
Labor and Materials
I. Building S so0 I. Building Permit Fee:S Indicate how fee is determined:
2. Electrical S ❑Standard City/Town Application Fee
8 so ❑Total Project Costs(item 6)x multiplier x
3. Plumbing S ' 3 pd !?,Qther Fees: S
d.Mechanical (HVAC) $ List:
5. Mechanical (Fire S
Suppression) Total All Fees:S
Check No._Check Amount: Cash Amount:_
6.Total Project Cust: S /0/00 b Cl Paid in Full ❑Outstanding Balance Due:
C4�3 t✓I_ : C1-7 8— 8 2, 1
c-late t ��4
SECTION 5: CONSTRUCTION SERVICES 4
5.1 Cunstructiou Supervisor License(CSL) C5 -0/3075 (012al5
CVJVJ5'(pFHFR A MOAGO License Number Exoiratioh Date
Name of CS L,,IIulJer List CSL Type(see below)
3 F L M PLACE LACC Type Description
No.and Street
M G RGLOEA D M A Kl 15 U Unrestricted 1 2 Family
s u el ing cu. Il.
R Restricted !&2 Fannil Dwelling
Cityfrown,State,ZIP M masonry
RC Roofin Coverin
WS Window and Sidin
SF Solid Fuel Burning Appliances
I Insulation
Tele hone Enmil address D Demolition
5.2 Registered Home Improvement Contractor(HIC) /I0/—fr7 /a 9 /&/
/Q G D SoHd 5�)AI HIC Registration Number Espir tion Dale
IIIC Cum_p+a�yName or HIC Registrant Name
bLP7Email address
No.and Street
04f&411UP IAA 0194 5
City/Town,State ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§2500)),
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Isluance of the building permit.
Signed Affidavit Attached? Yes ..........O 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 /V
t9 act on my behalf,in all matters relative to work authorized by this building permit application.
-;2 3yfccF� pr llZcr< 2D lao ,
Print Owner's Name(Electronic Signature) Date
/ SECTION 7b:OWNEW ORAUTHORIZED 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 Ziand accurate to the best of my knowledge and understanding.
X !r'fufy PEIRCE ad l5
tint Ow is or Ruth eJ i gent's Name(Electronic Signature) Date
_i NOTES:
I. 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 I.G.L.c. I42A.Other important information on the HIC Program can be found at
+aw+v.mass.,,ov+'oca Information on the Construction Supervisor License can be found at ww�'dus--------------
.
2. When substantial work is pl.mned,provide-the below:
rotal fluor area(sq. ft.) (including garage,finished basemenNattics,decks or porch)
Gross living area(sq. It.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
'rype of heating system Number of decks/porches
rype ofcooling system Enclosed Open_
1. ,I't)til Projcct Square Footage"nmy be;ubstitutctl for"Total llroject Cost"
1 .
III
I
I 1 :tic 0 . .sil pc I,kw
CS-013075
CWUSTOPHER A MONACO -
i - 3ELMPLACE -
t MARBLEHEAD MA 01945
i
10t26/2015
� 049U!?2042.t,UP.CY� 014Q IJICXCkloelz
-' Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 110147
- - Type: Partnership
Expiration: 1 0/912 0 1 6 Tr# 259046
MONACO JOHNSON GROUP
CHRISTOPHER MONACO - -
3 ELM PL
MARBLEHEAD, MA 01945 _-
Update Address and return card.Mark reasoV for change.
Address ] Renewal Employment �J:I Lost Card
1 $CA 1 C.• 20WOW11
n%/rrv,ruunynorvr�/�n C.��r:mr�u.le/b
office of Consumer Affairs&Business Regulation License or registration valid for indiv'd iul use only
before the expiration date. if found return to: s
-;OME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation
F' egistmtiore 110147 Type:
Partnership10 Pflrk Plaza-Suite 5170
Expiration: 10/9/2016 Boston,MA 02116 i
MONACO JOHNSON GROUP • '
CHRISTOPHER MONACO-
• 3 ELM PL
MARBLEHEAD,MA 01945 Undersecretary Not valid without signature ,
QTY OF SALEM, MASSACHUSETTS
e�
Ali BUILDING DEPARTMENT
120 WASHNGTON STREET,3"D FLOOR
TEL. (978) 745-9595
FAx(978) 740-9846
KINIBERLEY DRISCOLL
MAYOR THOMAS STTIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
}
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
Date Z 1`j 14 \
Job Location 32 Shari Ave. APT 2
Home Owner Address 3L Shore Acme- APT 2
Present Mailing Address .3Z Skcrr i Ave. APT. `L
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 that does not possess a
license, provided that the owner acts as supervisor.
DEFINITION 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 "homeowner" certifies that he/she understand the City of Salem Building Department
minimum inspection procedures and requirements and that he/she will comply with such procedures
and requirements.
HOMEOWNER'SSIGNATU �4 Eec
68EIZFY / e
/
APPROVAL OF BUILDING INS CTO
QTY OF S CHUSE M
x ALEM, MASSA
y i BUILDING DEPARTMENT
120 WASIENGTON STREET,3ADFWoR
nL.(978)745-9595
K1WERLEYDRISCOLL FAX(978)740-9846
MAYOR T Homm ST PIERRE
DIRECTOR OF PUBLICPROPERTY/BUIIAING OCAAHSSIONER
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 c40, S 54; Building Permit#f is with the
condition that the debris resulting from this work shall be disposed of in a properly licensed
waste deposit facility as defined by MGL c 111, S 150A.
The debris will be transported by:
A4
(name of hauler) -V
The debris will be disposed of in:
(name of facility)
1Z S�Il>BN;(071 ED. SAi 9f MA
(address of facility)
S' nature of applicant
7/4
Date