Lot 735 THOMAS CIRCLE - BUILDING INSPECTION' No. �ity of Salem ��d ,
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F'� , -� APPLICATION �
�, . '. __.. FOR- -";
E' PERMIT TO BUILD ADDRION, MAKE ALTERATIONS OR NEW CONSTRUCTION .
�p ►MPORTANT AppUcaM ro complsts�aY Heme!n sectbns:� 14�►4 IV,and 1X.
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� 6 Aiaoc�iaH1 . � i3s 4,: -, � j�q^^�t-.3:YC,rt��2 zow R-1
'' . LOCATION „'°, ,:: �� :.:�: �r.,-�>
pp ' �ru��+ -. . �.��l��Z /1'� = � I.
� BUILDINf3 roasss+r�n �c�smffn ;
LOT
€,, _ .. -. SUgpry6qpN. - `1�M3 C:n<�C LOT::� i BLOCK SIZE �1. �b4 "�
6
� B. TYPE AND COST OF BUILDING-Ad appllcants'complete Parts A-D
A TYPE pF IMiPFtOVEMENT D PNOPOSED U8E-FOR 'DEM011710N"USE M04T RECENT USE
' � 1 [�INw buYdnO . � . ' M,IMnMY . . . . . .�broalda�tlY
: 0 �dano�romew�ae�.�a.n�maera�e»�. - iz �oror.�wi +e_�.an,.�.� .
Muslip uNfs etlded'A a�ry,M part O.73) . . . . 19 Q CMw34 oU�w�qbw .
13 Q 1Wo a mors lamiy'EnM mlmDer
3 Q Mer�im(See�2 aE0ve) - ot wufe�_._.�.__�:._ ZO Q IrduelrW . .
� E1 O Parkin09�7n .
< p a�� is ❑ ,�aromi�,«a��r- az p.s�.�.�o.:c�m.
�� -�-E�AerrwmOeiWunlls��
s ❑ w�ea�r+e m�n,�,ar�nrmt w,r,�me. ..._.._.__.— ri 0 �+oev�m.�
'��. . d unifa in buiMbp in Part Q 13) � .. 15 �•.(ieia0�.�,_ .. . _ . . . za Q 011b.benk.0�� .
c 8 Q Abwne(rebcaBan) " .. . . 25 Q.Pu6Ye W7Mr
18�❑ CaipoR•
. 7 Q Faurdetlm onAl . . . . . . . .. . . ZB Q.3e1nd.4ba�Y.olfw aducatlo�ul :.
r - 77 ❑ qlw•Spec7y
��, - 27 Q 317ieR�-
B.OW�IERSNIP . � Q T�,�s (
B � pMdMI6MiViCual,corpaahon.11IXlpofll 2H Q,OM!!•3GecW
inetilulion.e[c.l. .. .
9 Q Pudic(reae�a6 stete.a wed govammenc . .. �. , �
+
C.CQ$T - IQn#cend) NpvBeidmUel'DelCriD!in dBlei ProP�ues d WiIEriG�.a4.�W�0 G�. �
.�. � . mae�kralwqlauWrybuYOMp�1�mp�l,e�terymnoal.eecarderYxhoo�.�eolbps. i
ia coe�d�am�rn —�t 6�5��4—.---- s a�oa��ea�oa o�o��o.aooem��e mora�dros e��ar�o.anoe a,wma �
. . - , , - . . at:dwtrm�deM.n uw d exisliq EudElne is Eeino Ua�oM.enmr c�opoeeE uea
7oW�M�elkdDufnot(nelwletl _ � . .. . . . . . _ -
in fhs aEove casf
a EIBCUkeI�___....��OO"'___.......___.___
n. a��e:q ..---�����--�---�-----
a rleat:q,air corwnwnuq.3�d J_.._.� -
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a onw ce�sw.erc.l ----.__�__ (
17. TOTAL COST OF IMPROVEMEM
III. SELECTED CHARACTERISTICS OF BUILDING •For new buildings and additions, complete PaRs E�'L;demolition,
com te on Parls J&M afl others ski to IV
E PRINGPAL TYPE OF FAAME F. PRNCiAL TYPE OF HEATWfi FUEL (3. TYPE OF�SEWAC.E DlSVOSAL L TYPE OF MECHANICAL '9I
30 Maeorcy(wan bevin7) 35 Q Gas 40 j�Pudie a Wna6e oan�ny �a► i
31 � Nbod hams 38 �Oi 41� � Privab(xpie faNt ele.) � � ,/- 4S ❑ No i
32 Q Structulal ateM 37 ❑ Ele�riciN LSI^^� 7
K TYPE OF WATER�JP�Y �
. 33 Q Raink�cad mrcreEs � 38 Q Cod � Wi Mee by an ekvaEoll�
y1 ❑ W�a,Spech 99 Q �Uw.SOe�Jy 42��P�h6C ar Orirab comDenY � q8 Q yes , p �NO
� a?❑ Privms(wreu.ciafan) � �
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����0� M. DEMOLITION OF STRUCTURES: I
aa w�ros a sm�im ..._........_�.._.__.........._.._._...__ , , . ;, .
as. T«a w�e�d^o«�r Has Approyal from Histaicai Commission been received
,�noo�.oazm m e.re�o� a V to 4_ _._ fa arry shuchrre over fiftY(�)Years? Yes_ No_
��._.._...---._ ._.._.
-, F .: �:�. ..
sa rae�mna a�ea so-R--��•�.`'.4..---- D�9 Safe�Number
I
k��em oF o�srn�r runcu�c sa�cEs F�est Control: !
s�. eK,mea._._.____.`s�.._..---..__...-----.---
' ` " ',HI►VE THE FOklOWING UTILITIES BEEN DISCONNECTED? ;
sz anmom....----.._.._.._..---...----_....---- Yes No
��ooau�euawrws owr Water: . . , .
sa Ercwoee----._._.:.a-------- � � �' . . . . .
. C7882 :,,.� . .�... ._ �.. � ' .'.':" . .
Full__..�__"_ SEVYBI: . . . .. � - �
56' "�befa DOCUMENTATION FOR THE ABOVE MUST BE ATfACHED
batMoaro
�..—�----._...-...-.. BEFORE A PERMR CAN BE ISSUED.
J
N. COMPLETE THE FOLLOWING: a
i
Historic DistricCt� Yes_ No—� (if Yes,Pl�se encbse doCumentaGon from HisL Com.) _ _ . . _ �
. ,� , .:..:, .:.., .... I
. : .
Canservation Area7 ,Yea_ . No_ (ff Yes;please enGose Order of 1_ - 1
I
Has Fre Prevention aPProved and stamped plans a aPPI'uations? Yes_. No_
Is property bbatetl in the S.RA:'district? Yes_ No_
Compy with Zoning't Yes= No_ pf rro,encbse Bosrd of Appeal decision)
Is bt grand(athered? Yes_ No✓ (If yes,submit documentatlaol�f no,submit Board of Appeal decision)
If new constructlon,has ttie proper Routing Slip been enclosed7 Yea_ No_
Is Architectural Acxesa Board approval required? Yes_ No— pf yes,submit documentadon►
Massachusetts State Contracta License# E� `09 00 3 $�lem Lice�se#
Home Improvement Contractor# Homeowners Exempt form(if applicable) Yes_ No_
CONSTRUCTION TO BE COMMENCED WI7HIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMR
CONSTRUCTION IS TO BE COMPLETED BY: If an extension is necessary,please submH
ga�,y. �',�� in writing to the Inspector of Buildings.
V. IDENTIFlCATION• To be completed by all applicants
� Madiq addrem-Number,stieef,cAy,and skfe ➢P CoOe Tet No.
1. A.+�o�. �ro � �oi41NNN JQ ., .� � a1`tGb p�4o'v 6�'1 -
Ovmer or
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cmtrano` �ria Oe�1oo3
acnaeaor Nrv.l E"��i�7N� '�O Q«�aJ RoR�' � a4 C�•�3 -
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�q++e« %1.cr.� ��c (o�TaN`qU Z ; N- tl. 43�-��23�
I hereby certity that the pro woAc is autharized by the awr�er of record and that I have been authorized by the owner to make this application
as his authaized we a r to con all licable laws of this jurisd'�c4on.
Signature of applicaM \ � Address Ap icadon date
v � Co: q�.rNn fl S� 3��010�
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DO NOT WRITE BELOW THIS IINE
Vi. VALJDATION
BUfiding ' FOR DEPARTMENf USE OrLLY
i P�mit number
,�/ use c�w
P�mit��issued �J d nt e G,� � ?�"/ F.e c,r�no
Building t;ve taaevq
P'ermR Fee $
oawercv wad
Certificate of Occupar�cf� $ Apprwed y.
Drain Tile � �
Plan Review Fee $ �� S , /[�. .�/S �
TTTLE
NOTES AND Data• (Fa department use)
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C� S
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PERMIT TO BE MAILED T0:
DATE MAILED:
ConsUuction to be started by. Completed by.
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� zoNwc � exaMiN�s ao�s _
DISTRICT . . � � . .. - - . .. ... - - �. _ ...
USE __ ,_ .
FRONTYARD
SIDE YARD SIDE YARD
REAR YARD
NOTES � 1
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SRE OR PLOT PLAN-For Applkant Use
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ON
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/�°: �, ' CITY OF SALEM
%y .�. �\`
;a 1�«�i PUBLIC PROPRERTY
l�,Y�
\�4,�� � DEPARTMENT
xnme.ni.r,v peiscc�i.c.
:�4.;vor. 120 W:�sri��c;i'oNSrteEe'r� S.�u�_ti.MnssnCiiusc.i'rs0197C �
Trt..:978-745-9595 �1�.�'t:978-7aCr98a6
� Construction Debris �Disposal Affidavit '
(reqttired tbr all demulition and renovation work)
In accordancc with the sixth edition of thc State Buildina Code, 7S0 CMR section l 11.5
Debris, and the provisions of MGL c 40, S 54;
Building Yermit# ____, is issued with the condition that tlie dcb:ris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
11 l, S 150A.
The debris will be hansported Uy:
__ i�� ��2�,
� (uame of hauler)
"Cl�e dcbr�is will be dis��osed of in :
_I�_'�-���� _�A'���.-
(n�une of facility)�--���—
__ �'w�Pxa� 1��
(uddress i�f faciliryj
signatur of nit applicant
�� ����
date
- debri:a(f.doc
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' � c� � 1 - a � a -� o�30
CITY OF SALEM - �
D � 3'� g� ROUTING SLIP ��_ 96. m�
� NEW CON5TRUCTION �
CERTIFICATE OE'OCCUPANCY
LOCATION• � 3 J �"�^^'�:� C :a.�t DATE .3I �yl� '1
APPLICANT• /}'��'" �R�'
ASSFSSORS
FRANK KULIK DATE: lJ �
(93 Washington S t)
crrtircLExic 3 /9 O �
CHERYL LAPOINI'E DATE:
(93 Washington Street)
PUBLICE SERVICFS Jf�
BRUCE THIBODEAU DATE: � ��v�
, I20 Washington Street)4ih oor
(
1 9
� 6
WATER
�./ �
DOTTIE THIBODEAU LL%� DATE: � 02 X � 7 CL��/ f�Sd 2_
(l20 Washington Street)4ih
CROSS CONNECT SUPE � �� � f ��J
BRIAN THIBODEAU ' �
(5 Jefferson Avenue)
� ��� PLANIYING /�/A, ��Y / �O4 3�a8� ,2
� ��r x ��'� DATE:
(120 Washington Street) 3`d f7oor
CONSERVATION COMM[ N �`� � �'�` ��'ti• �I
AtO.r.f n..P/�� DATE: t°J 0
C'��'`� (l2p Washington Street) 3'd Floor
,
ELECTRICAL /
JOHNGIARDI + DATE: °� /� , I
(48 i.afayette S t) � �
FIREPREV ION ', , �— fI 1 �� ' y
ERIN GRIFFIN i ^;' li,i, � _DATE: -�_� � r ( U 1
, i t �
(?9 Fort Avenue) �'� � �
;_;� i2, i-„ �j� ,��'^�' �
HEALTH i �. ��� . �� 7
JOANNE SCOTT � 'i--�-�.'-., . ':_/` _DATE:
(l20 W�shington Strer�g 4i6 Floor
BUILDING n� -
THOMAS ST. PIERRE �`°"� DATE: �
(l20 Washington Sveet) 3`d Floor
_ _
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TES GRAPHIC SCALE /
US IS SHOW�'r � SALEM ASSESSORS MAP 8, IOTS 20, 21 AND 22 xo 0 10 20 �/// \ r
/�/ �
, gTREET ADDRESS IS WRRENTLY LIST AS 7-17 THOMAS qRCLE.
;US IS SHOWN ON LAND COURT PLAN �11802-58 AS LOT 735. LOCUS �,.
�y� pp� pLANNING BOARD APPROVED PLAN AS LOT 4. � � �� ) �
1 inch = 20 !t �� ' 1e342 _ , I
" ZONING DISTRICT LINE SEPARAi1NG B-2 FROM R-1 WAS INiERPRElED NEW SMH/k5—•� �
IE BUILDING INSPECTOR IN A MEETING WIlH PLDE ON AUGUST 9. 1999• RIM=161.8 ` kZ`�� ' ,
^ \ I
INVn=156A �B S)�� N6$. .�619`�
ppQtTY IJNE �7D TOPOGRAPHY PER AClUAL FlELD SURVEY . IfJVout=155.4
HE-GRWND BY NOR1H SHORE SURVEY CORPORAl10N. REFERENCES FOR .i\
72TY UNE INC�UDE IAND COURT PLAN M1�802-E• }
_...- ,; . .
=VATIONS SHOWN ON THIS PLAN ARE BASED ON CITY OF SALEM (MEAN �_; I / � .�Q� �� �
FVEI.) DAlUM. hIE CITY BENCHMARK USED WAS A DUPLEX HEAD NAII � SEwER WYE-�\ � �\ �� � �
11JTY POLE 78/1557 JUST SOUlH OF SWAMPSCOTT ROAD BETWEEM TONY CONNECTION I�$5 �" �M� ' /
'S AND MOOSELOD(� ON THE EAST SIDE OF T11E NORiH80UND HIGHIJ�ND g"x 6"x 8' �' ` � � � �� � � � /
UE (ROU'tE 107). ELEVAlION=132.79 (qTY OF SALEM MSL DATUM). � INV 154.68 \ � � � N j c'� � � / \
.
ORARY BENCHMARKS HAVE BEEN SURVEYED ON THE LAND AS FOLLOWS: � � $•�� 30% SEME S �\' �
.�. � /• i
2• ECEVAilON=133.88 TACK IIN SENlOOD STAKE ENT '� ��'�'_,Z�R'I� �� ` �i � �2��5�Ei �P � ��BP�� ' � �`�c�` \ \ � o2'O �
3: ELEVATION=135.07 DRILL HOLE SET IN LEDGE �' i YnC / 5 � �h. �3'a, % Z l
+ :*" Pg� i
i .
4: EI,EVATION=158.64 TACK IN WOOD STAKE �" '�-- TeMs \w � �
`o i,2 � �PR�( i �!„� / -,
5: ELEVATION=158.35 PK NAIL SET IN iREE S'R1MP \ /3o0,E �,/ � �a. � 0� R / \ � �p/ '
6: ELEVAiION=158.43 TACK IN WOOD STAKE "/ � ` F� �
7: ELEVAiION=162.40 DRILL HOLE SET IN LEDGE `I'3 -%� _, i � � � N 30 i '9`S+�`d,� �
!�'�i_yr:::a� ` $g� � �S�$ �
8; ELEVATION=167.93 PK NAIL SET IN PAVEMENT Y \ a,��� � � y�� �a
9: ELEVATION=187.45 PK NAII SET IN PAVEMENT �� �129 ' i �' � �
t0: ELEVATION=t49.96 PK NAIL SET IN PAVEMENT / � W m � S.INVout=155.0 �/ % y
11: ELEVAT10N�743.21 PK NAIL �T IN PAVEMENT � 4, / \ 1 O/ t'�i
Iq N `� 50' _ / v T NrJ I
iE LOCATIONS OF EXISlING UNDERGROUND UTILJiIES SHOWN ON iHIS PLAN : I
APPROXIMAlE BA�D 0�'� �1'�E BEST AVAILABLE INFORMATION AT iHE i1ME Y � ^q ' �� � ///�P.� � � Z
>REPARA110N OF 7�'��S PLAN. iHE CONTRACTOR SHALL VERIFY ALL � � � � � W � � ^/ �i �
\1I0N5 AND ELEVATIONS OF ALL EXISIING UTIUTY LINES PRIOR TO ANY � U � � ' �� � I
' \VATION NIORK. ADJUSTMENlS IN 11iIS PLAN AND SUBSEQUENT PLANS (IF � Q v� � � �, O�
1�REp) SHALL BE iHE RE�ONSIBILITY OF h1E SITE CONiF2ACTOR BASm ON � � �- '1� 133 SF / �q (�,
JAL FlELD LOCAiIONS OF UTILITIES. PLDE ASSUMES NO RESPONS�BILJTY � �w a ' � FFE=169.0. � �P I, ��
ANY BROKEN (OR DAMAGED) UTIL1iY LINES DURING SITE EXCAVAiION ' � o GF=768A 1n
/OR CONSiRUCTION WORK. ' � _ ro.s• � BASEMENT FFE.=158A '� �� �,^'� / �SEWER ST118 �
ti MARKED WIiH PRESSURE
1NAL REOUI�ENTS FOR PAVING WAIER lF2ENCH MALL BE MADE AT i1ME �w - , // �p� TtzEA7ED 2x4
coHsntucnoH. � � � � ! i � � �o iNv=�ss.sz(a's) �
:ONSIRUCTION OF iHE UTILJTIES MUST BE DONE KEEPING THE ROAD OPEN '' �' I /' N/F SUSAN M. HOWLAND
)RDER TO PROVIDE EMERGENCY SERVICES AND ACCESS FOR ABUTTING LAND � a /' �� � � ��
f i' ' ��r — EXiEND 8"WATER MAIN ,NAP 8. LOT 23 & 24
IERS � � � � i ' � TO PROPERTY LJNE
-�� � �i � / i� � INSTALL CAP AND 5 THOMAS CIRCLE
)OWN TIME WHILE CONNECTING EXISTING HOMES TO NEW WAiER SERVICE � ' � � �' BLOW-OFf VALVE L.C.C. 6653>/3z>
�LL BE COORDINATED YA'IH INDIVIDUAL HOMEOWNERS AND SHALL BE KEPT i � _ - � - -M- _
A MINIMUM. _�ia�- ' � G� FRJ:VTS' , Oi � �/ ,
ALL UTIUTY L1NES SHALL BE UNDERGROUND. Ul1lJTY INSTAWTION SN�I.I- � ER� ' qRD S '
REVIEWED AND APPROVED BY iHE CITY ENGINEER. 5 f7g � %
,'�, . V1P'�� �� �CK � ' ���
THE APPLICANT SHALL COMPLY WI7H ALL REQUIREMENTS OF THE SALEM ' , �' � R `48 56' / / �LO T P LA N
<^;_„DEPARiMENT AND BUILDING INSPECTOR. � - -_ ,v--.--_- 49�j, �. � '�' cnance
,��. �� ���-� _ � O�
wNG C�PISTRUC?ION WORK SHALL COMMENCE BEFORE�SAM ON N'EEKDAYS \, �� ��%' � -INSTAL� NEW -.� /��' �`' f0�
' a SAIURDAYS• NO WORK SHALL CONl1NUE BEYOND 5PM. lHERE SHALL BE j . -
CONS1ftUCTiON WORK CONDUCTED ON SUNDAYS OR HOLIDAYS. / HYD VALYE \ � � 3 5 �
��`� �F �i � �� � � / / LO
A L L R E A S O N A B L E A C i I O N S H A LL B E T A K E N T O M I N I M I Z E l H E NEGATIVE � P� 'p a
� "-
�ECTS OF CONSTRUCTION ON ABUTTERS. ADVANCE NOl10E SHALL BE i "
OVIDED TO ALL ABUTfERS IN WRIi1NG AT LEAST 72 HOURS PRIOR TO THE ,-� �N � ! p9`ro PAVID ARFA
MMENCEAIEP�T OF CONSTRUCiION. �6LP�' O �------'-'_ -''� (Formally Lot 4�
ALL CONSTRUCTION (MATERIALS AND METHODS FOR INSTALLATION) �ALL ' \�" �
CARRIED WT IN ACCORDANCE 'MTH THE RULES AND REGULATIONS OF THE � Thomas C irc le
� TEMB
LEM PLANNING BOARD, AND SHALL COMPLY NAiH ALL RULES, REGULATIONS, � �P�� 1- �
ECIFlCATIONS a'!D ORDINANCES OF THE CITY OF SALEM AND MASS BUILDING O� (t = 99� \ ``�o� i
�DES. �� �N� � �o� .;��s �,� ' r� 1p �iassachusetts ;
_......�� _..... ,,...�,.��..t ��nrrr ewreoiur_ nN h10MAS CIRCLE. AS � _+ �� i � _ _� �.,; , S i.11'C.i ��
-- - ;`