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6 TRADERS WAY - BUILDING INSPECTION (2) H `-EO Lt; tzFs3 The Commonwealth of Massachusetts Department of Public Safety -- (,v Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) ;;k .' t.. (t Building Permit Number: Date Applied: Building Official: "-1," SECTION SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) 1 & Ta-ADP-0-4Wf--( s 011Zo eAsTr-" e, ,-Ak— No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK ':, J" Y Edition of MA State Coda uszd. If New Construction check here❑or check all that apply in the two rows below 1V Existing Building❑ Repair❑ Alteration Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use Cl Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes Ed No Is an Independent Structural Engineering Peer Review required? Yes ❑ No Q Brief Description of Proposed Work: DgAko Et-tST"Ir DR+JPLTH1111 KoW" WtrIIBOW % 4our4T*45 tr4STA,- that NFLU-Wog-l— '� ITA, ^ACULAC- SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY ., Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): - Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND.AREA " Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A.-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1 ❑ Y-2❑ I-3❑ I4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ T Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ - IB ❑ IIA ❑ IIB ElIIIA ❑ IIIB ❑ IV ❑ VA ❑ VB ❑ -- SECTION 7:SITE!NFORMATION(refer to 780 CMR 111.0 for details on each item) _: Trench Permit: Debris Removal: Water Supp y: Flood tone Information: Sewage Disposal: Licensed Disposal Site Public Check if outside Flood Zone❑ j Indicate municipal❑ A trench will not be P required❑or trench or specify: Private❑ or indentify Zone: __- or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Stt:uctu_re caithin azrport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: — Use Group(s): —_ Type of Construction: Occupant Load per Floor: Does the building contain art Spiinkler System?:- Special Stipulations: ------- Massachusetts Department df Public Safety Board of Building Regulations and Standards License:"CS-075407j Construction Supervisor ° J TGDD M GAINEY r 41 OAK'ST PLYMPTON MA j236 - �/(� Expiration: Commissioner 06/20/2017 i CITY OF SM.&M 2IASSACHUSETTS • BUILDLNG DEPARTNE&NT 130 WASHINGTON STREET,3a FLOOR o TEL. (978) 745-9595 PAX(978) 740-9846 KINIBFRr F.Y DRISCOLL MAYORT�tObtAs ST.PIERRS DtaECTOR Ok N BLIC PROPERTY/BUILDING CONMMIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) 1n accordance with the sixth editie--n o=the date Building Code, 780 CN4R section 111.5 Debris, and the provisions of MGL e 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: W h"ST� ll/lP-N,k-�t EM 4iJ 7 (name of hauler) The debris will be disposed of in WAT° U-44AS4" ^t T (name of facility) 11 o e— 5-r. TvJA wianl Ab- (address of facility) signature of permit applicant U • I (. date debriviLduc SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner EAS ftE;t� rl &&-4.- 17s MA-M-£T 51-• LYrit-j , Nl Name(Print) No.and Street City/Town Zip Property Owner Contact Information: V.4 VLA94?. 1$I _49L- 72'�-9 - - IQ•.RLr�EN-Q�AST�.Rntl l�.� Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes J�;ag 4-A-vr4 EY °A-l<- ST. "[n L) Namel toTALL 6441LD"S Street Address City/Town State Zip to act on the ro 2r owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) ,., If buildingis less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑and slu Section 10.1 10.1 Registered Professional Responsible for Construction Co�nttr�o�lt� "'' ` "` V ` cS co TT Yowga - BI-. &2- Iri �aR.ta,&m4Arr Eli luft Name(Registrant) Telephone No. e-mail address Re is tion Number t'° P�oX BS-o�2- piRAi TR MP cuib Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor IJoT U I L1�£IZS l ry.c- Company Name T oon S�T/rtrl `P O754u7 fi N me of Person Responsible for Construction License No. and Type if Applicable •TI oP-�L 5� hLxlu-bZc� 67-3b7 Street Address C.iTown State Zip 7 t�k AriAs '4o"h tUL • GAw- Tele hone No. business Telephone No. cell e- i]address SECTION_11:IVORK_ERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152.§25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the' suance of the building permit. Is a signed Affidavit submitted with this application? Yes 0 No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE " Estimated Costs:(Labor Item and Materials) Total Construction Cost(from Item 6)_$ ° Ste' 1.Building $ _1) °° Building Permit Fee=Total Construction Cost x 11 i(Insert here 2.Electrical $ 'S-o° appropriate municipal factor)_$ 3.Plumbingj�S^ 4.Mechanical (HV AC)____ _ f S 1 Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ Lf o ,5C"v (contact municipality)and write check number here . . ' SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below T h reby attest under the pains and penalties of perjury that all of the information contained in this application is true and accu a c the best of my knowledge and.understanding. 7tl _1V4_ g417 l+•Im ease print and sign nam. Title Telephone No. Date ql 6Al+- S-C kLyf-=Vto.l _ 4274.'7 Street Address I C'ity/iown State Zip Municipal Inspector to fill out this section upon application approval. dtft^' . Name :Date - (DEastern Bank April 5, 2016 Town of Salem, MA 93 Washington Street Salem, MA 01970 Re: Eastern Bank Branch 6 Traders Way To whom it may concern: This letter represents authorization for Pivotal Builders, Inc.to perform modifications to ITM and related work at Eastern Bank Branch at 6 Traders Way in Salem, MA. Sincerely, It Ronald P. Richer Vice President- Real Estate Operations 195 Market Street • Lynn, MA 01 901-1 508 • 1-800-EASTERN (327-8376) •www.easternbank.com Initial Construction Control Document Ito To be submitted with the building permit application by a Registered Design Professional for work per the a edition of the Massachusetts State Building Code,780 CMR,Section 107.6.2 Project Title: �'z t >t � >L Date: s I 1 Property Address: -AZA-fe Project: Check one or both as applicable:O New construction/ isting Construction Project description: �l�l�j' `Ai _ it,/eW AfL LAG ISE �'2l ✓� yP Lr/ i N' n�i uJ I SWTT P_, Id r c_/N41� MA Registration Number. 9 1(U Expiration date am a - registered design professional,and hereby certify that I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: [ ] Entire Project Architectural_ [ ] Structural [ ] Mechanical [ ] Fire Protection ] Electrical [ l Other for the above named project and that such plans;computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2_ Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become.generally familiar with the progress and quality of the work and to determine if the-work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final-Construction Control Document'. Enter in the space to the right a"wet'or �`O�t R. r electronic signature and seal: . 9168 M i BOSTON, Phone number. !/I MA Z 4QCA-1 Y5 T h1OFMF^T' Building Official Use Only Building Official Name: Permit No.: Date: Trial Version 10 09 2012 CITY OF S��1I.Ei�i, �r'L�SS<�CHLTSETTS a BUI DIINGDEPAR-r.%cL1T 120 WASHINGTON STREET,3sa FLOOR TEL (978)745-9595 FAX(978)740-9846 KINIBERLEY DRISCOLL i4fAYOR TIiOMAS ST.POERRE DIRECTOR OF PLaUC PROPERTY/SUMDL*tG CO.NLNQSSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name(Busitxss:Organizatioivindividual): f!IV LgUtLoslt-5 [14c_ Address: 61 bW✓s. City/StateiZip:6vJ.-t*Scer 'T AAA os 7 _ Phone N: 7s" ry+- f- C e Are an employer?Cheek the approprlate box: Type of project(require*: I. 1 am a employer with,_ 5'— 4. ❑ I am a general contractor and 1 6. Q New construction employees(full and/or part-time).* have hired the subcontractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.t 7• ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. Building addition (No workers'comp. insurance 5. 13 We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.0 1 am a homeowner doing a9 work right of exemption per MGL I LEl Plumbing repairs or additions myself(No workers'comp. c. 152,41(4),and we have no 12.❑Roof repairs insurance required.)t employees. [No workers' 13.❑Other, comp. insurance required.] Any applicom than chtxxs box fl i must also fill out the section below al owing their workers'componwion policy infmmmiom t I hmseowmcts who submit this affidavit indicating they ate doing all comic and then hire outside cmtmcmm must submit a new affidavit indicating such. =Contmsets that chick this tax must ariached an additional sheet showing me none of the sub-comrocmrs and their workers,comp,policy information. ass . I an an employer that is providdng workers'cmxperesrtinn ittut ante far my employees. Below Is the pollfy sad fob slue information. Insurance Company Name; SeL -rti0 Policy Nor Self-ins.I.ic.M We— Tziti ' Sb�O9.`� __ 2.�I Expiration Date: 8 /1" Job Site Address: _.71e k9 zrz S (v. �% _ ..._-------------- City/State/Zip:J4L�___, wo Attach a copy of tba workers'com,penaatioo policy declarailon page(showing the policy number and expiration date). Failure to secure coverage as required under Suction 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 anti/or one-year imprisonn ei:,as woii as civii penalties in the form of a STOP WORK ORDER and a Hite of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Invrsligaiions of the MA for insurance coverage verification. I do hereby tort y der the pains and penalties of perjury that the iteformadon provided above is true and correct sit! all � Date: Phoned: 751, S34- �Szv 0fitial use only. iyn oaf it d!e to this mmn; f;,,)e r.+JrJetee°by CIO,of town officiaL City or Town: Permit/License N Issuing Aulhoriiy(t:ircie erne): 1. Board of health t.Building Department 3.Cityifown Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: _ Phone M Unofficial Property Record Card http://salem.patriotproperties.conVRecordCard.asp Unofficial Property Record Card - Salem, MA General Property Data Parcel ID 08-0129.0 Account Number Prior ParcellD -- Property Owner HIGHLANDER PLAZA REALTY TRUST Property Location 210 TRADERS WAY CIO JAGER MANAGEMENT INC Prope Mailing Address 261 OLD YORK RD STE 814 Most Recent Sale Date 1 2124/1 9 9 2 Legal Reference 11672-92 City JENKINTOWN Grantor HIGHLANDER PLAZA REALTY TRUST, Mailing State PA ZIP 19046 Sale Price 11,378,860 ParcelZoning B2 Land Area 4.100 acres Current Property Assessment Xtra Features Card 1 Value Building Value 590,400 Value 32,500 Land Value 2,652,200 Total Value 3,275,100 Total Parcel Xtra Features Value Building Value 2,593,200 Value 51,600 Land Value 2,652,200 Total Value 5,297,000 Building Description Building Style Restaurant Foundation Type Slab Flooring Type Softwood #of Living Units 1 Frame Type Wood Basement Floor NIA Year Built 1989 Roof Structure Gable Heating Type Forced HIAir Building Grade Good Roof Cover Asphalt Shgl Heating Fuel Gas Building Condition Average Siding Clapboard Air Conditioning 100% Finished Area(SF)8797 Interior Walls Drywall #of Bsmt Garages 0 Number Rooms 0 #of Bedrooms 0 #of Full Baths 0 #of 314 Baths 0 #of 112 Baths 0 #of Other Fixtures 10 I of 2 4/7/2016 3:50 PM Unofficial Property Record Card http://salem.patriotproperties.com/RecordCard.asp Legal Description Narrative Description of Property This property contains 4.100 acres of land mainly classified as Shop Center with a(n)Restaurant style building,built about 1989,having Clapboard exterior and Asphalt Shgl roof cover,with 1 unit(s),0 room(s),0 bedroom(s),0 bath(s),0 half bath(s). Property Images .x .. .r Disclaimer:This information is believed to be correct but is subject to change and is not warranteed. 2 of 2 4/7/2016 3:50 PM