96 SWAMPSCOTT RD - BUILDING INSPECTION (17) CITY O-'F-S-ALE
PUBLIC PROPERTY
DEPARTMENT
KIMBERLEY DRUCULL
MAYOR
1?0 WASHINGLON STREET•SALLN,\{A%ACHUS61T5 01970
Tri 978-745-959S ♦FAX;97&740-98"
APPLICATION FOR THE REPAIR, RENOVATION CONSTRUCTION
DEMOLITION, OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: SAl em COfiI/Y7,-ec= Building: 61jz-T A10. IO
Property Address: goo S„VA CCr7--7-
SAG,1=/n , /�hq ol990
Property is located in a; Conservation Area Y/N /V Historic District YIN /V
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: a L/YJe ��eiytAL �Pe?o f�
Address: /moo$ �,>✓odn �-r �
Telephone: 7`8! - SQ3 - OOs�
3.0 COMPLETE THIS SECTION FOR WORK IN EXICTrnrra BUILDINGS ONLY
Addition U
Renovation I/ Number of StoriesChange in Use Demolition 0 �/ `Approximate year of Area per floor (sn -�/-
construction or renovation
of existing building
Brief Description of Proposed Work:
FzT - O&P7- OF A=-7V
rro.�vcrro.� A2�,os j
Mail Permit to:
1
What is the current use of the Building? MAIO CCU 7s'Z-Z> I/A/—='T
Material of Building? 45�rEg4- if dwelling, how many units?
Will the Building Conform to Law?
s Asbestos?_VIA
Architect's Name
Address and Phone So GAA'A yr—Try
ro2SG�YH y!A O/95-0
Mechanic's Name
Address and Phone
Construction Supervisors License# O,�-0379 HIC Registration#
Estimated Cost of Project$ Z bOec Permit Fee Calculation
Permit Fee $Z_
9.00 Estimated Cost X$7/$1000 Residential
✓Estimated Cost X$111$1000 Commercial
/An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stat
specifications. Signed under penalty of perjury X
Date / O 9
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CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
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NAroa 130 WAMONGTOM ftna!•&UEK.VAaAG s =G1W4
712-97L74i9W•PAZ M740.964
Consimcdon Debris Disposal Affidavit
(required for all demliidon and rertovadon work)
in accordance with die aixt6 odidon of the State Huildin`Code,780 CUR section 111.5
Debris.and the provisions of MCii.a 40.9 ft
Buims Pwmk 0 is issued with dw condition that the debris r sultin3 floss
this wort shall be disposed of in a peopely licensed waste disposal lhcility as defined by MCM e
It 1.S 150A.
The debris will be transported by:
L-7g-nG — z � SFaSOL_
(rims a[hssbr)
The debris wiq be disposed of in
TA Ns
(name 0(facility)
'Z4S Corn�,s'�c�•o�. c�T/G��T
(addnts of facility)
sianasae permit aPe ' sot
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data
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WILLIAM A. YUHAS ARCC=(CT
TRANSMITTAL
DATE: 12.21.06
TO: Jonathan Gibbs, Groom Construction cc: Stacy Ames, Falmer
FROM: Bill Yuhas
RE: Falmer Thermal Spray
Attached are the following:
1. 3 stamped and signed sets on the Construction Drawings
2. Construction Control letters for Architecture, Structural and MEP
III as
rl Please Reply No Reply Necessary
80 Lafayette Street,Marblehead,MA 01945 (781)631-7039 wayarch@comeast.net '
Ile,
CITY OF SALEM, MASSACHUSETTS
10 PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RO FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 3a0
MAYOR FAX: 978-740-9846
CONSTRUCTION CONTROL AFFIDAVIT
Project Number. Date:
Project Title: �v- -ft�p-kn-' �-k--t
Project Location: UH IT # ID j q(p 2L VM- C6TT PtA-o 1 5600M 1 mok ,
Name of Building:
Scope of Project R T M-r or -r(15T. {
IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUIDING CODE, I
V�6wm N . . MASS. REGISTRATION NO. a BEING A REGISTERED
PROFESSIONAL ENGINEER HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY
SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS, AND
SPECIFICATIONS CONCERNING: /
Civil Architectural L 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
c onhact 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 specified in the accepted engineering practice standards listed in
Appendix 1.
PURSUANT TO SECTION 116.4, 1 SHALL SUBMIT PERIODICALLY, A PR
TOGETHER WITH PERTINENT COMMENTS TO THE BUILDI G I PECTO F=T
OF THE WORK I SHALL SUBMIT A FINAL REPORT AS T SATIS C L
AND READINESS OF THE PROJECT FOR OCCUPANCY. ae h
/ M
Signature
SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF 4
My commission Expires:
Notary Public
STRUCTURAL ENGINEER'S CONSTRUCTION PHASE AFFADAVIT
PROJECT NUMBER:
PROJECT TITLE: 96 Swampscott Road,Fahner Thermal Spray
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:
L 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 work,a final report shall be submitted as to the
satisfactory completion and readiness of the engineering portions of the project for occupancy(excepting any items
not endangering such c and listing pertinent deviations fr e approved bbu' ing permit documents).
N OFRs� l `T
Signature
Name Date
a3 18
gf�fSTEgF� 4 M/k 3 3�-1 ab
�F�YONAL fN Engineer's Registration Number
SEAL
ISO AF 1
AFFIDAVIT
MECHANICAL DESIGN
Permit No.
To the Commissioner,Inspectional Services Department:
I certify that to the best of my knowledge,information and belief,the plans and computations accompanying the attached
application concerning the locus at
sj%t.C'M , ?A Ar Ward SAZVV% are in accordance
with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances.
William J. Scanlon-45449
oa�E' tl Y,ss' 6 ENGINEER-MASS. REG. NO.
m BLW Engineers Inc
W ]AM J. COMPANY
r
ENGINEER 311 Great Road, Post Office Box 1551,Littleton, MA 01460
N . 45449 ADDRESS
�Ap ISTU @
f`aSIOMAL RMo 978.486.4301
PHONE
Commonwealth of Massachusetts
County of Middlesex
On this 1415+L day of 2006,before me,the undersigned notary public,personally appeared
William J. Scanlon ,proved to me through satisfactory evidence of identification,which were
Personal Knowledge , to be the person who signed the preceding or attached document in my
presence, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of
his/her knowledge and belief.
Bef�orc,
LDUISJ.LSERNARDJ0. W
MOWy Pak
t CaMMI adndNsudwwtu
►g Cmm�lsaon E`pMa Feb 1 IOta My Commission expires
t:i-Q,2uATLY 76
Mechanical Design Affidavit Bill Scanlon.cim
AFFIDAVIT
ELECTRICAL DESIGN
Permit No.
To the Building Commissioner:
I certify that to the best of my knowledge,information and belief,the plans and computations accompanying the attached
application concerning the locus at:
FA4lwtom. —t w2m" 9A94q, Ito Sis Pic tila'C 'R-�,
S4.4'a V#-1 VA At Ward SR LE VA *� are in accordance
with the requirements of the Massachusetts State Building Code and all other pertinent laws and ordinances.
Stephen J. Sullivan -27913
�SNOFytgs ENGINEER-MASS. REG. NO.
�.21 sq i
cep Stephen J. BLW Engineers, Inc.
SUIIiV n COMPANY
Ele i 1
NO 2 311 Great Road, Post Office Box 1551, Littleton, MA 01460
9 ADDRESS
0 LEN�� 978.486.4301
PHONE
Commonwealth of Massachusetts
County of Middlesex
On this I S{l day of 33f Imo, 2006, before me, the undersigned notary public, personally appeared
Stephen J. Sullivan proved to me through satisfactory evidence of identification, which were
Personal Knowledge to be the person who signed the preceding or attached document in my
presence, and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of
his/her knowledge and belief.
Bef me,
leas J.L BERNARD JR.
NdMMy Commission expires pd�
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Electrical Desgin Affidavit S.Sullivan.doc