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96 SWAMPSCOTT RD - BUILDING INSPECTION (13) f1lMS1A1lSZ�EfiLfGq p y►pPROVlEO BY TW JdSP.JPL"�Oq pol R To A.PERW BE GRANTED CITY OF SALEM Data No. Am is jrC Loestlon of Is Propahy t omm in ant l d nv 9�¢ #*Hdoft Me&? yes,No Is pmp@rW LacmW In C4twvall0n Am? Ya No BUILDING PERMIT APPLICATION FOR: Permit to: Construct (Circle whichever apply) Roof, Reroof, Install Siding, � � -Cl ZicS Repatr/Ropiace, er• PLEASE ALL OUT LEGIBLY fA COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owners Name Address & Phone Architect's Name NAu t iM Bt 5 Address & Phone 16�_Mechanics Name ' r t Address & Phone "u� Pei WhM Is us purpose of hwav? tJtEaccuvt�`P Matwtai d twndlrq? s�� � n.dwWwtp,ror how�� � WW hikkV co +� -�---- rM omt to law? Asortatw? t2alknatad owl ,7. �i(? Cuy Um"s L N A r 3 pto.a..nt x • W e of Gott SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OP WORK TO BE DONE �.�rt,�TW3C-ct�� � C��•�®-mil 1 y. MAIL PERMIT TO: t A No. , APPLICATION FOR PERMIT TO LOCATION PERMIT GRANTED APPROVED TOR Or BUILDINCaS CONSTRUCTION CONTROL AFFIDAVIT Project Number. Date: Project Title: TITf©r!'5 Project Location: 91P Slur l`( Z6 f6 O Name of Building: fV% Scope of Project: fi�Em-n'bti5 j U N IT (� IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUIDING CODE, I \f I I Lt.lArWy Pc MASS. REGISTRATION NO. (e BEING A REGISTERED P OFESSIONAL EN42INEER HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS, AND SPECIFICATIONS CONCERNING:_ . . _ _... _ _ Civil Architectural Structural Mechanical Electrical Fire Protection Other(specify) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS, AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND ALL APPLICABLE LAWS FOR THE PROPOSED PROJECT. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2. 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required control materials. 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specked in the accepted engineering practice standards listed in Appendix I. PURSUANT TO SECTION 116.4, 1 SHALL SUBMIT PERIODICALLY, A MHFAn TOGETHER WITH PERTINENT COMMENTS TO THE BUILDIN I SPEYZ R OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS T SA AND READINESS OF THE PROJECT FOR OCCUPANCY. Signature °y� SS. ," SUBSCRIBED AND SWORN TO BEFORE ME THIS AY OF'"r OF 054'�04 My commission Expires: Notary Public STRUCTURAL ENGINEER'S CONSTRUCTION PHASE AFFADAVIT PROJECT NUMBER PROJECT TITLE: 96 Swampscott Road,Unit 6 PROJECT LOCATION: 96 Swampscott Road,Swampscott,MA NAME OF BUILDING: 96 Swampscott Road SCOPE OF PROJECT: Unit Fire Separation Partitions In accordance with Section 116.0 of the Massachusetts State Building Code Sixth Edition, I, Edward Moll Mass.Registration No.33718 being a registered professional engineer hereby certify that I,or a duly registered staff person,have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: _ENTIRE PROJECT ARCHITECTURAL X STRUCTURAL __MECHANICAL _FIRE PROTECTION _ELECTRICAL _OTHER(specify) for the above named project,and to the best of my knowledge,such plans,computations and specifications meet the provisions of the Massachusetts State Building Code applicable to the mechanical,electrical and fire protection systems design,acceptable engineering practices and laws applicable to the engineering design for the proposed project. I further certify that I,or my authorized staff,shall perform the necessary engineering professional services and be present at the construction site on a periodic basis to determine that,generally,the work is proceeding in accordance with the engineering documents approved for the building permit and shall be responsible for the following as specified in Section 116.2: 1. Review of engineering shop drawings,samples and other submittals of the contractor as required by the engineering construction contract documents submitted for the building permit,including critical construction components requiring controlled materials specified in the accepted engineering practice standards. Pursuant to Section 116.2,my authorized staff shall submit periodically,a progress report together with pertinent comments to the building official. Upon completion of the 1from ort shall be submitted as to the satisfactory completion and readiness of the engineering poect for occupancy(excepting any items not endangering such occupancy and listing pertinent deviatproved building r documents). SM OF e(QS \ �o EDWARD FdARMENING i�` NamC-( , M�• Date•1'rJ� MOLL,11 STRUCTURAL No.33718 3?).711 b Engineer's Registration Number Ffsro HG�N .�NAE_E SEAL CITY OR $ALiM9 MASSACHUSiTT! PIJSUC PROPCRTV DtPARTMKf4T 120 WASN'NSTON STRUT, 2R0 FLOOR SALEM, MASSACNySSTM 01970 TSLtPMONti S79.71S'S596 MM. 300 FAXI 978-740.9"g Salem Bvit�t••�....._.__. Debris Dlsuffid p••-m In accordance with the provisions of MGL c4O 314, a condition of your Building Permit is that the debris m Wdng from this work shall be disposed Of in a propedy licensed solid wsstel&posd facility as defined by MGL Chapter IIL S 150 A. The debris will be disposed of in: (Location of Facility)M T2avSi/` 7v� Jgllature of pli ant S /dv Dare