13 THOMAS CIR - BUILDING INSPECTION :
' rK #� �s$ I !
The Cummonwcalth of Massachuscns
- � Board of Buddmg Regulauons rnd SlandarJs TO�
��� Nassachusrus Sta�e Bwlding Codt, 780 Ch1R..7'"ed�uon BwIJm� Dep�
Bwlding Pertnil Application To Cunstruct, Rrpau, Ren�vate Or Demolish a �
n O�ir• ur T��v-Fwrul�•On rlling
I„��" This Secuo r OfTcul Use nl
�
V
Buildin� Pertni� N mber: li :
Y
1 �
�� ,
0
s� ��N.�:
,, �
�
Bwldin�Commissi er/inspec�a of Bwldmw D��e
SECTION I: T IIVFORMATION
1.1 Proper�y Addreu: .2 A�seaon M�P 6 P�r�el Numben
^�r.oe+w! �:.. � '.� `�o4J
I.1 a Is Ihi�an acce led streel:'yes no Map Number Pucel Number
I.J Zonin�Inform�tlon: 1.� PropeAr Dtmenslons:
a-� g-a, s;r�� �,,...4 �.o,.` ;�.a�s 6�
2omno Dis�rie� Proposed Use La Are�(sq 0) FronuQe IR)
1.5 Bulldin�Selb�eks(R)
Front Yud Side rirdf Re�r Yud
Requucd P,ovided Required Provided Required Provided
�S l S �o io 3� Fo�_r
1.6 W�ter Supply:(M.G.L e.a0,s51) 1.7 Flood Zooe Informnloa: I.a Sew��e Dbpoial Sy�tem:
iona: _ Ouuide Flaod Zone7 Munieipd Ql On�i1e dispo�l sy�um �
hblia� Privarc O Check if �
SECTION 2: PROPERTY OWNERSHIP�
].1 Owner�of Reeord: a`Q6 b
N�� �i'�� 9 co:n..�� DA 5�,...,� n+�
Name ml Addrcss far Service:
/�,. c�, 't - a�a- sot3.°�.
Sipu�ure Telepha�e
SECTION l: DESCRIPTION OF PROPOSED WORK�(e6eek all that�pply)
New Conetruction m Existing Buildin�O Owner-Occupied O Repairs(s) O Alteration(s) O Addition O
Demolition O Accessory BIdQ. O Number of Units 1 Other O Speeiy:
8rief Dexription of Propoeed Workt: Rrs:�e al S� �� ��. o�'
SECTIOIV 4: ESTIMATED CONSTRUCTIOlV COSTS
E��ima�ed Costr. Oftlelal U�e Oolr
Item Labor and Matenal�
I. BwldmO f 1. Bwldin� Permi�Fee f (ndicate how he ia determined:
O Standud CiryiTown Application Fee
� 2 Elrancal s O Toul Project Cos��Utem 6)x multiplier a
� ) Plumbin� f 2. O�her Fea: f
� i. �lrchamcal IHVAC) f Lisl:
�3 D S bfechamcal 1Pire S Taul All Fees: S
/ Su .exsion — —
� Check No. �heck Amoune Cash Amoune
; A Toul Projecl CosL S q�� °O� O Pa�d m Full ❑Ouuundmg Balance Duc
/� 3�
�
i .
�
SECTION S: CONSTRUCTIOIV SERYICES
S.I LicemedComtructlon5upenisor�CSL) �S 6�'jOo3 h��S 9"�0
•• •���� �j-: r� Li..nae vumRr E.p�nuon D�ie
N.ypt ol CSl- HylJcr LiN CSL Typt lace Ifeluwl �"m
@l '�" �P� � ..S N�'{'
. AJJrcs�� G`qa� i� Oexn uon
U Unresinaed u to)3,000 Cu. F�.
R Resincrcd IA2 Fomd DrelLn
Sirnamre H .Nawn Oel
io�'� - a1) "3O�,C�3 RC Residenual Noo�n Covenn
i.lephane K'S RssiJemul Window and Sidm
SF Residenusl Sohd Fuel Bumm A liance Insu11�1ion
D RevJenual Demolinon
S.] Rqi�tered Home Improvemmt Contr�elor(HIC)
HIC Comp�ny Name w HIC Re�{is�rw Name Reris�nuon Number
Addmf
Eapintion Dne
Si�nanue Tekphone �
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.I..e. 152.� 25C(6))
Workm Compensation Insurance andavit must be completed and submined wi�h this application. Failurc to provide
this andavit will reeult in the denial of the lesuance of tht building permit.
SigneJ AITiJavit AnacheJ? Yn.......... � No........... O
SECTION 7r.OWIVER AUTHORlZATION TO BE COMPLETED WHE1V
OWNCR'S ACENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I
�. , a�Owner of the subject prope�ty hercby
awlwrize to act on my behalf,in all mattrn
relauve to work authorized by�hia building permit application. '
Si mtwe of Owner Da�e
SECTION 7b:OWIVER�OR AUTHORIZED AGEfVT DECLARATION
t, {��� �\: rJ .aa Owner or Awhorized Agent hereby declare
tha��he sutementa and informalion on the foregoing application are true and xcunte, to the besl of my knowledge�nd
behrlf.
,/1..rk�+ . �-.r�
Prinl Name
���3o�oS
Signatwe of Owner Awhorizcd�Qent Date
Si ned under�he �in�and mhies of /
IYOTES:
1. An Owner who ob�ains a bwlding permi�to do his/her own work,or an owntt who hira an unregistered contrac�or
(no�rcgis�ered in �he Home Improvement Contruror 1 HIC)Prognm), will gg have xcess to ihe arbitra�ian
proQram or guaran�y fund under M.G.L. c. I J2A. O�her importan�information on�he HIC Program and
Consauc�ion Supervisor Licensing ICSLI wn be found in 780 CMR Regulation� I I O R6 and I I O RS. respec�ively.
- I. When subs�anual work is planned.provide �he mformauon below. .
� To�al Ooon area(Sq. FI.) Jboo'i' lincluding garoge, finished baxmenbaaics,decks or porch)
� Grose living are�(Sq. F�.1 �S��il'� Habiuble ioom coun� �7
Numberoffireplacef �� Yumbero(beJrooms 1.� � �
'. Vumber of bathrooms a Yi Vumber of half.batha t
�. Typeofheaung �ysam v'' i� F�1q Vumberofdeckyporches 1
Typeufcoohngcystem ee,�1<.1L Enclo.ed Open
1 ��Toul Pro�ect Sywre Foo�age"may he.uh�mwed (or-�Tuul Pro�ec�Cos�" �
' `'� CITY OF S.3LE.`i, �L�SS.�CHL;SETTS
, BI:RDLYG DEPA�TIE�iT
� • 1'_0 W.+��►GroN SntFE'r. 3'°FtooR
h�. (97� 7�5-9595
FAx(97� 7�0-98a6
KIJBF�t1EY DRISCOIl 'I410aW ST.P�Juts
HAYO�
DfiIECtOR OF PCBLIC PIlOPE1lTY/Sl'QDLVG CO�L�rtSSIONEI
Wu�kers' Compensatton (nsuranee AfTldavit: Duilder�/Contracton/Electrlclan�IPlumben
aunlleant Infarm�Hon Plerx Print Leaiblr
VaiTC Idusi�wL.OrymrarionlnJ.v�dwl): A^��� \ .��
Addresr. � �o: n�^+^"� D�
City/StatdZip: Sn��s /h� `utqob PhoneN: fot'�- ,�1a- �9�
,�re yo�r�empMrv'CsreY the appropriate poa: TYpr of proJeel(reqube�:
I.� I am a unployer wi�A �. 0 I�un a;cncnl conuaecot aad 1
�/�mployees(full and/or puhume).• hava hired the wbcw�tracmn 6. [�Naw conactuction
2.I� 1 am a wk propriemt nr partner- listed on �he aaached aheet : �. ❑ Remaklins
,hip anJ have fw employen T1uae subeontesetan h�w M. ❑ Ikmolition
warkin{ for me in�ny capociry. �*ns'comp.inaunnee. 9. � DuiWinj addi[ioa
(No warkm'comµ insurane� S. � We aro a eoeporsrion and iu
r��quireJ.)
ot7lem Aava exeeeiaed their IO.Q Elxirical rep�in�addi�ioro
7.� 1 am a homeawner doins all work nghe of exemption per MGL 1 I.Q Plumbin�rcpain a rdditionf
myxlt.(\'o worken'comp. c. 132.�{I(4).amf we hsve no 12.0 Roof rep�in
insurance required.J t empbyees. (No warYen' 13.0 Otha
comµ inwnnce rsquircd.J
•nnr appliianl�Id chocY�Oaa sl muY alwr�q wM�M�u�ia Oelo��ooie�tAair Warltm'cwnpnaiG�n pulicy i�uimaba
'i 6wru.ma�.la.uhni�Tb aAl6va indiain�iAry an Jain�dl wat.vr Ma��in euaiJe eamnc�as muw suhmL�nw allJbva iedicri�y wd
<'.xnrayon�lul c6rek i�u Ea�inW anxAad a�sld�iuml Jrn�Iwrin�J��unv a!Iln w�►seM/sNn and�M4�orbn'caq.puliry iafamsua.
/u�w aw eu��p/oyn rA�t&prorid/n�woik�n'coaprntodow lnirrower jp nq tn�p/uyt�s. Sdow/i�At pelley oe/Ja�aldr
injormurioa
In.urance Company Vame:
Policy M ur Self-ina. Lie. p: Ecpirr�ion Date: �
Jub Sire AdJrcu: Ciry/State/Zip:
.�nacY�copy of tM worl�en'eomp�af�tlo�poltry daelanlla�pap(ahowtn�tw pollry aro�Mr ie��zpintlo�dah�
f ailure to x�:curc covewge a requircd unJer Section IJA of MGL a 132 can Itad to ih�imposition of criminal penaldp of•
fine up to S I.SU0.00 nm1/or one-year impri�onmenR a�wall os civil penrlties in�ha form of o STOP WORK ORDEA and�fiw
af up eo 5'_30.00+J�y�y�ins�ihe violatoc Ile aJvi.wxl�hut a c��py uf this a�atement may ba furw•urd�d to eha 011iae of
Im�.auga�iun�af U�e DIA for insuranca cov.�aga vuitic�liun.
/do/ier�by er��i�p m �h�pri und ytn u �r ary rhal+M inJawroNow p�ovided ubav�ia lrne rnd�unteL
�iuierure: I)uta� Y1�;3�� 1
Ph�ine a: 4, l l —�l a - �O cL}O .
I O/J7rra!we un/y. Do nof wiile in ihLt rrer, ro b�.u.np/ne/by riry or�oww,�/JJe•ivL �
i -- --_. __._ . - -- _ I
Ciry or 1'u��n: Ycrmit/I.Iteme M �
� I.suin�.\uihuri�rlcircleune): j
i
I. IfwrJ u!IIruI�A 7. Ruildln�D.par�men� ]. Cily/fown Clerlt J. flectric�l Imptttor 5. Plumbinq In�pecfor
� 6. l)�her __ _
lun�yel Pcnan: - . --. --- Pllone N•
.. :
-���_��� CITY OF SALEM
•. PUBLIC PROPRERTY
�,, ,�
�i
�; ��r',',,�% DEPARTMENT
�'.4��� . , .
� :.i\tl:� HItS '•Mlw �'ll. .
��,,,,,, i�e�'.�illl\��:Ou5lNCl'T 1 J.0 f�t. `1.\+i.\t Ilt a r,..r,:��
rri:v-a.-�;:r��s . r:�s:v�aa�a��a��
Construction Debris Disposal Aftidavit
(r�yuired lur ail dcmulition wiJ r�nuvatiun work)
►n accurdmue with the sixtB edition of the State Building CoJe, 780 CMR scction I i I.5
Debris, and die provisions uf MGL c 40, S 54;
Duilding Permit E� _ is issued �vith the condition that the debris resulting from
this work shall be disposcd of in a properly licensed waste Jisposal facility as dztined by MGL c
t l l. S 150A.
The debris will be trunsportcd by:
�VDin"\ S�J� ��� "� .
lname o[haultrl .0 � .
I'he dcbris will be disposed of'in :
— ---- . __
__ ,
(n,une uf(aci ity) �
�'w�P��-�- �- ����^
� . laddrcss uf��cilily) � . �
. - � . �ignamrc uf�xnnit applicant
1 � l 3�o�
dace
.�.an i.,t f,:,,e
.., i�r� � �b� /6 �
CITY OF SALEM
ROUTING SLIP
New Construction �
Certificate of'Occupancy
L�T " � 32
LOCATION �� ��"'"*s �: «\� DATE '
`� �`� ASSESSORS �"`�' s llATE �/ �3 6
"'�� 93 �Vashington St.
Sb��
CITY CLERK � ai DATE �� -2 3 09.
93 Washington
PUBLIC SERVICES f V�ATE �'L�K�a 1 m��,�-
120 Washington St. S �`�f Y�
WATER C� l,U�i�G�-- DATE t� O / �Id1° ' ��. ��/3�/��.
120 Washington St. � � �� �`�
CROSS CONNECTION ��DATE U / W"'� �(1 � �
S��t�er-s-on-�ve
PLANNING���rDATE�I_I���9
120 Washington St.
,
CONSERVATION DATE �) 1 0
120 Washington St
S�� ELECTRICAL �DATE� �
?,, ,- 48 Lafayett t.
w3.�., _ ��Co .� be ih3`�(.e�/
FIRE PRE NTION � DATE � 0
�~ j 29 Fort Avenu � �C
-�4�. , r (.OG�p .
��� �
HEALTH DATE � � ^ 2� - dS
�� � � � 120 Washington St.
l'I + -
� guo
[3UILDING INSPECTOR DATE
120 �Yashington St.
DRIP EDGE
P GABLE ENDS �
� 6" RAKE JETS � � � �
� � � � � � � � � � � �
�
� � � � � � � � �
VINYL CORNERS
� � � �
� � � � � � � � � � a �
0 �
� � � � � � � �
D � � C�1
GRADE I
_ STEPS AND STOOP ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ,
� BY BUILDER �
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
. ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ .
❑ ❑ ❑ ❑ � ❑ ❑ ❑
� NOTE: ANY & ALL Material shipped loose for the site compietion of the manufactured product is ULi1MATELY the SOLE RESPONSIBNTY OF THE BUILDER LISTED BELOW to install and fnish.
Standard FRONT ELEVATION NeW NEIN ENGLAND HOMES INC. �A� PRc oA� o,-z�-os N.E.H. 101
England �,��„ � �^� O
Sheffield �!-lomes o�� �� �/4"=,'-o" Standard
, �o,_o„ "
� 10 _ ��� II'-I���" 8'-q" 6i_3n
i 2�_3��
_ 0 3� � � ' 20�_����� ���_��� 6�_g�� .
T
� 40�_p„ ���_ � �3'-ti 4 26 10�/�" _
I244 2830 244 2830 I 244DN 2/304q I WRD 6066R I
f ' �� -.1 J 3�/ J___ �____ I oo '-'-A-_I____W�___FI �
I 6 � W33 i
Q J
—a� BATH 3 , �P ow sa� eziR�sr �
� � 3� �' m'" 3'-4/2" Q iF 20,_d�4„
I �� _ + �° x '� -
, , � LL KITGNEN m � NDOK
m �- �m I w/14" SOFFITS
i z-y � FAMILY ROOM
— i Oo I�o _dj1 \ry
�`"I i MUD ROOM �' ��' 3�
� � I =� '� o m
� - � m 1 _
m I a
— m PB3-VENEER
�m _ (ZM � OGM � .
�
� \v 6�_5�2�, �, g�_2�� 36" TOP �
'
`O F3 @I 5/8° '
r � � -li----„— � � 5 SNELVES '\�o`r 28�_6 /4�, 2a II �3��� 1 IB�_03��" , 12�_0��
-�' F3�PI 5/8 p � ,
D W I 3 , ��
i - o � i I 2x6 WALL � 6 CO 2_6 XXX �II� _3=0I CO_ ---6—�I��---- `
a � � I
a
—
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' n 3/2z POST � 3C'-�� " ----DN---- �-� /2x PCS"
EACN SIDE XXXi 4 -----"----- .
r-- AC�I 51 D�
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____________
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--�_��-- 2� ��� f��_6�� � �I
DINING -____-_ j � i ii LIVING m
o _
i � �o = \`ti
� \� --------- I lo c� _I
� I I� r m
m II
— II
� -------- I I .
--------- I I �
-------- o 0
� � �
i b C��EN 70 AS VE � ^
v FOYE
i i� � 16�_0��
13�_y�� ,�r, - IO'-q
i'
� i �
1 1 2g -��
� 244DN 3049 244DH 3049 26,_q�, 3-Oxb- A60 w/2-SL 244 H 3049 244�7N 3049
. 40�_p�� � 35�_3�� I 22'-0" �y�_p,� II'-2" � 4�_q��
� 6�_��� 4,_q��
10'-IO"
4�-9'� � 6,_5�� 6 _�p^ .
NOTE: ANY & ALL Aiaterial shi ed loose for the site completion of the manufactured roduct is ULiIMATELY the SOLE RESPONSIBILITY OF iHE BUILDER LISTED BELOW to install and finish.
Standard 1st FLOOR PLAN NeW NEW ENGLAND HOMES INC� ORANN PR� oa� o�-z�-os N.E.H. Ol�o�
England �°°�""�"° REV DAiE �
Sheffield �Homes o�N"� � �/4°=r-o° Standard
.. � � 4C�_��� � I '
� 19'-6�� 8�_q�� 6�_3��
��_6 �
4G�_��� � �,��_6�, 2?'-I03/�" 24�_�3�a�� ���_��� , 10�_��� I 6�_3�� .
I 244DH 2830 , 22�-%�� 244DFI 3049 I
I 244DN 3049
--�— i i= � i � ' �
� � �
iG'-��d�� � � I 5,_5. 2'''1��2 � � �� �6�a I
; ; _ I
`,,I�.- � I �`r
^ _ m
i �N i
� � i O N
BATN #2� � � � j N BEDROOM sR4 =� BEDROOM #3
o a � I � _
� 3 ,�_.... � �v ,
u = �
— OPEN � �-�.���;ATH 7s3 � � -= �n
�� \� 'i p_ _ BELOW r _ I0�_7n _ .
i_ �2n � � �Y n't
� � �i .s w � —
i �
m � � w �
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� � ', OPEN � �
�
; m , m I BELOW 2_6 2-6
I m � � �- --, 1 �_�� u 7 � n
o � ' .I.006 '/ I -y� I 2 2
I ' 2 /.____...SRM�O �14T2/�t 2/2-6
, , , � 22" x31"
a
�, I ��„ "' �, �,� `n 2�_q��� =Q. _
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I� 2-6 0 � 21'-qli � I6 - �m � \
r � �
_ � .a.,,_„ ----- -------i-I--
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i rc'
k_ �, NOLD B'A�C'K WAL�L � 6 42 vJAtL w/pINE�CAP �' �
� — O�K;NO CcaL1N� � „ , , � 2_b � . �
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. �,; ' ; :� �� CFILkNG
n 34 -11�2 �---DN—`- ol ROCK TNIS AR"tA_. / a�-
5 SH L�YES -m I
--
--�,—_8,� — �'_7f,"i� �i_6n I
`����"���'S PED WALL '
''�,�;i; � .
----------- :j=-PLANT�w INE CAP I
___ �!SHEL��� �
_ BEDROOM #I ;;% �/,� �- I BEDROOM #2 =n
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1 H
OPEN 70 SELOW j �
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�
� 2'� �2" 13�_��2u
. 13'-3° �0 -4 I � i I
� —
I 244DH 3049 244QH 3049 � 244DH 3049 � 244DH 3049 244DN 3049
40�_��� 3��_3�� � 28'-10' 26�_�,� 22�_��� 16�_��, il'-2° 4�_0��
q�_o„ � 6�_5�� E'-IO" 10'-���� y'_5" a�_o��
NOTE: ANY k ALL Material shipped loose for the si�e completion of the manufoctured product is ULTIMATELY the SOLE RESPONSIBILITY OF THE BUILDER USTED BELOW to install and finish. �
Standard 2nd FLOOR PLAN NeW NEW ENGLAND HOMES INC. �A� PRc oA� 01-27-06 N.E.H. Ol�o
England T'°°�""�"° � �^� L
Sheffield �Homes o°'�� x� �/4°=��-o�� Standard
34'-11"
�
i
L — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — II
- �
1 � - - - - - - - - - - - - - - - - - - - i �
� - - - - - - - - - - - - - - - �
i �
i � � �
I � FOUND,^�TION NOTES: I �
I I) LALLY GOLUMN SPAQNG �IS SUBJEGT TO CHANGE UNTIL FINAL A?PROVAL
I I 2) SOGALTAND/OR STATE GODES NOT BYTIN E.HER SITE GONDITIONS AND I I
3) BULKNEAD AND SUMP,SIZE AND LOGATION PER SITE GONDITIONS NOT BY N.E.NI I
\n I � � 4) TNE BUI:DER SNALL SUPPLY C INSTALL TO THE FRAME DIfIEN510N5 OF TNE H� 5 ' �
7 I � ALL S�TE SILLS 8 SILL SEALER SQUARE AND LEVEL BEFORE TNE ARRIVAL
^� I � OF THc MODULAR AND PANELIZED PORTIO�S FOR SET BY NEH. (SEE SRM I I
I I � DETAIL REFERENCED BELOW) I I
II II SRM�8.004 i � �
� � o � 5 5 E, d��„ �2'_����Bn ���_�7�8" �
� I
= I I ��� �I� I � — — — — ���I — — — �
�' � � � � � ----- � � �I ( I .
I 6" DROP TOP OF FND. I I
I 3 V2"� CONC."rILLED WALL TO TOP OF FIN. SLAB .
I STEEL COLUf1N5 ————— I
I 24°X24"XI2" CONC.FTG. ----- �
�
�
� ''']]]���''' ---- GARAGE I
_ I � i / ____= UNEXCAVATED I I
� PIT�FICTOLDOORS -- I
�� / WALL TO TOP OOPFOF SLAB ----- r---------------� r-------- � I I
� I
`O I I B" CONC. WALL ----- I I 1 I I I
ib"x8° CONC. FOOTING ----- I � � � I
I 4°CONC.SLAB _____ I I I I I
� WALL d FOOTING DIMENSIONS � I I I I
� I I �S BUiLDING G DE R OU�I EIMENTS j I I I �
/ I I I I � I
I I � � I I I I I � I
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- Standard FOUNDATION PLAN �1eW NEIAI ENGLAND HOMES INC. oRA� PRc oA� 0�-2�-os N.E.H. � �
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Sheffield �Homes o�� � �/4"=�'-o" Standard
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Standard 1st FLOOR PLAN NeW NEW ENGLAND HOMES INC. oRA� PRc oAh o�-2�-os N•�� OA01
England �°°�""'°0A"° � �A� j
Sheffield �Hormes o�""� 5�� �/a°=r-o° Standard
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� Standard 2nd FLOOR PLAN NeW �� �GLAND HOMES INC. �A� PRc pA� 0�-2�-os N•E•H. 020
England �00�""�°"° � �^�
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