39 WALTER ST - BUILDING INSPECTION (2) 4031A l p�
TPA- 1 kI - Z 30
The Commonwealth of MVIGES
Department of PAW1
N1assadmeetts Slate Building Code(78�0p�C�N��
Building Permit Application for any Building other p >l vo-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: IBuilding Official:
SECTION 1: LOCATION(Please indicate Block#and Lot#for locations for which a street ac ress is not available)
?A wh' R %- Akth ✓mw) UNPY'ik2
No.and Street City/Town Zip Code Name of Building(if applicable)
SECTION2:PROPOSED WORK
Edition of NIA State Code used' If New Construction check here❑or check all that apply in the two rows below
Existing Building 16 Repair❑ 1 Alteration ❑ 1 Addition f9 I Demolition ❑ (Please fill out and submit Appendix I)
Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Specify: NA 6" W~Ai'3"EL&R
Are building plans and/or construction documents being Supplied as part of this permit application? Yes 15 No ❑
Is an hldependent Structural Engineering Peer Review reyuired? Yes ❑ No E7
Brief Description of Proposed Workt_6WOSWJ5'7�X10` �' 3/q, 6M�h' AT 3pqfterg
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): '1'YrlcMnV 07t b Proposed Use Grou p(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 ❑ A4❑ A-5❑ B: Business ❑ E: Educational Cl
F: Facto F-1 ❑ F2 Cl H: Hi h Hazard H-1❑ H-2 ElH-3 ❑ FI-4❑ H-5❑
1: Institutional 1-1❑ 1-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R-2 III R-3❑ R4❑
S: Storage S-I ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:.
SECTION 6:CONSTRUCTION TYPE(Check as a licable)
fA ❑ IB ❑ ILA ❑ 1113 ❑ [HA ❑ [[Ill ❑ 1 IV ❑ I VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal:
l JJ tor trench or specify:
Pi{
Public® Check if outside Flood"Lune❑ Indicate municipal m A trench ill not be Licensed Disposal Site
y reuired 1
Private❑ or indentify Zone: or on site system❑ permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: Vr\Ili t ii_C wnu s nI .i•.. I �, _, :
Not Applicable GQ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed ❑ Yes❑ or No 06 1 Yes❑ No M'
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:.__ Occupant Load per Floor:
Dues the building contain an Sprinkler System?: .rJo Special Stipulations_
'})I>
z 1 G.ckZ�e .. �, -Y
SECTION 9: PROPERTY OWNER AUTIIORIZA,rION
Name and Address of Property Owner
;!2, � ��o: 3t« :),VCJZ ; tgoo
Name(Print) - ' ',"KNZ�Jlll&5tn2et City/Town Zip
eH.
Property Owner OrithetlInformation:
Title Telephone`No.(business) relephone No. (cell) e-mail addr ss
Ind If applicable, the property owner hereby authorizes
U Name Street Address City/Town State Zip
to act on the property owner's behalf, in all matters relative to work authorized bX this building ermit ap2lication.
SECTION 10;CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here Il end skip Section 10.1
10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
VoWfM4 COWAVA[+1')6!J
Company Name
Name of Person Responsible for Construction License No. and Type if Applicable
Street Address City/Town State Zip
'TIE.)CV-1074O R`t'a 'Y(k- itZ�j AAMD(, NVVMC$uILycp�eY .CaM
Telephone No. business Telephone No. cell e-mail address
SECTION 11:1V'0RI<HIL9 C0N1[111: 1Sn I IONINSUNANCT AFFIDAVn' M.G.L.c.152.§25C 6
A Workers'Compensation Insurance Affidavit from the NIA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes 1 ' No ❑
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs: (Labor
and Materials) Total Construction Cost(from Item 6)_$
1. Building $ 74Z- Building Permit Fee-Total Construction Cost x_(Insert here
2. Electrical $ �j4w, appropriate municipal factor)_$
3. Plumbing $ vim,
4. Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5. Mechanical Other $ Enclose check a able to
payable
6.Total Cost $ I (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and accurate to a est of my knowledge and understanding.
Please print and sign name "title Telephone No. Date
Street Address City/'town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Date
CITY OF S,1LEm, AASSACHUSETTS
B(aLONG DEPARTMENT
1e Y e. 120 W-UHLYGTON STREET 3w FLOOR
T aL (973) 745-9595
;<!\tDERL^cY DRISCOLL FAA(973) 740-93M
%,LAYO;`L
R-to�c�s Sr.Ft��
D17ELTOR OF PLoUC PROPERTY/3LIL0LNG CO\L\fts�tO� EA
Construction Debris Disposal At-f7davit
(required for all demolition and renovation work)
In accordance with the sixdt edition of the State Building Code, 730 QMR section 111.5
Dcbris, and the provisions of rb(GL c 40, S 54;
Building Permit N is issued with the condition that the debris resulting from
this work shall be disposed of- a properly licensed waste disposal racility as defined by %IGL c
l 11, S ISQA.
Hie debris will be transported by;
y
1 Mt D tA+i CmMpr.
(name ut'hautcr)
The debris will be disposed of in
vo-- o 6p'
blllncu S�ELi� Nfq
(aJiress of'raeiliry)
iyuarure u(Ixrrtnt appliauit
CITY OF S:'ll-EM, tiL1SSACHUSE-17S
. 4
BUILDING DEPAIATMEINT
120 WASHIINGTON STREET, 31'FLOOR
� �nc TEL (978) 745-9595
F cal:(978) 740-9846
ICI\iBERLF-Y DRISCOLL
1L�kYOR THomsST.PIFR E
DIRECTOR OF PUBLIC PROPERTY/BCILDf\G CONNISSIONER
Workers' Compensation insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Informatinn ,, n,,,,���,,,L,,..�� Pleaa.gerrPri-nntt rl ceifbly
Natnc tHusinessOrganiralion'Imlividwd): 1-VtS�+i'� 1.1 "or`+T{'I�w'v�+ I r *I "� 1 "v""r Kilt
Address: —
Cily/State/Zip: ' ( / Phone lt:
A,r�c yy�nu an employer:'Check the•appropriate bust: F, .
e of project(required):
I.LI I am a employer with 2 4. ❑ 1 am a general contractor and I IN consWetion
entpinyees(full and/or part-time).• have hired the eels-
contractors
2.❑ f ana a sole proprietor or partner- listed on the attached vhect. t Remodeling
ship and have no employees These sub-contractors have C] Demolitionworking frs me in any capacity. workers'comp. insurance. ❑ Building addition(No workers•'comp. insurance 5. ❑ We are a corporation and its
required.) officers have exercised their 10.❑ lectrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions
myself. (No workers'cutup. c. 152, §1(4),and we have no 12.❑ Roof repairs
' insurance required.) t employees. )\'o work cn' 13.`[�]OtherA9m P.Ytitif-
cunip.insurance required.)
,env applirmn nor checks but rt mot also ft11 tm1 the sec Lion below showing their workers'compensation put icy inllrrmalton,
;A.
I L+mouwtwn who wluuit this atndnvit indicating they art doing all work and then hire outside contractors mtat svhmit a new Aredav{t indicating such
:(."0L cton thof chick this box mutt mgchar an additiuml.hoct showing 1114 mine of the subwuntnctun and Iheir workers'sump.pulley information.
I am can employer that is providing workers'compenradon insurance for my employees. Below is Nha policy and fob.vita
information.
Insurance Company Name:
....---
Policy 4 or ScIf-its. Liu. H:: '�i?SLt9�9 Expiration Date: LOI�Ee1.1+
_
Job Site Address: 3q W&'rf`{z !�V' klwrr-2
City/State/Zip:_ Mdx'C1'Ztf
Attach a copy of the workers'cornpensud011 policy declaration 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
line up to 51,500.00 undlor one-year impri.cnnnicn4 as well as civil penalties in the form of a STOP WORK ORDER and a find
of till to S25oAo a day against the violator. Ile advised that a copy of this statement may be furvvarded to the Oilice of
Invc,lig;uions uflhc MA for insurance coverage verificatiun.
/do hereby certify rut 1 pains and penalties of perjury Mat the infornatlou provided above is true and correct
ii•m t rc' .ten�yy Date:
Phone t ���� s'"'✓•"rSU -----
OJ/iciul use only. Oo our write in/his area, to be completed by city ur town of)lc'iuC
City nr'fusrn: 1'crnsi(hl.Icensc 4
hoeing ,\car hurily (circle rate): -- ---- ---
I. L'uord of licallh 2.Ouiidinq Departole"( I.Cilyfrnwn Clerk 1. F.Icctrical 6tspec(or 5. Plumbing Inspector
6. Qthcr
( onlael Person: ,
-
` I
I i
:
i t }
s
t ,
t
I
- {- �IERIDIAN , - -
i —t - —
cons El ucfron
- --t j2JAMOWSTREEF--gEyERLY, ---
i
'� 1 i (978)927-0740 --- ---- -- ------- - ----
CLOSET EgXM51V2 UES a
LAST
FP. F7ICW21E USE
h UNIT 1 UNIT 2 .
1468# S.F. 11478 t S.F.
�m USE I RON I01 PANTRY I Wmq NOON PANTRY
1 F EVNIM IW.1• MNM SOON LIVING R0001
qqOOEB 10. ELEVATION a IVW A .COMMON
7p,
E:N�CITNZ K USE -
R
MAIN gTL11FN BAN MTCKN
22.rPUy��y�y� Q17RAHOE � ENTRANCE
TROT 2
1& CWiMO{/ UNIT 2
MIT 211E USE AREA = NIR1G ROOM
BEDROOM BATH �'IT E smom TIE10oM 1075 # S.F.
b ROOM BEDROOM
a IF
COMMON BATHROOM SADNOON
Q - IflI q,pyE{ CLOSET
CtteAGT �—
EUUAggCL9IE BEDROOMBFDROCM BEDROOMWATT 6FJNODid BEDROOM BEDROOM
SASEMFJET ELEVATION = 98.0' FIRST FLOOR ELEVATION m107.S SECOND FLOOR ELEVATION = 118.4' THIRD FLOOR ELEVATION= 125.4'
FIRST FLOOR SECOND FLOOR THIRD FLOOR TOTAL AREA
UNIT 1 1488 t S.F. 1468 t S.F.
UNIT 2 1478 ± S.F. 1075 t S.F. 2553 t S.F.
I CERTIFY THAT THIS PLAN CONVEYED AND THE IMMEDIATE SHOWS UNIT UNITS AF`t"°`N4ssq�y FLOOR PLANS
AND THAT IT FULLY AND ACCURATELY DEPICTS o GAIL G"m FOR
THE LAYOUT, LOCATION, DIMENSIONS, APPROXIMATE L.ITH 39 WALTER STREET CONDOMINIUM
AREA, MAIN ENTRANCE AND THE IMMEDIATE COMMON NSM35043
AREA TO WHICH IT HAS ACCESS, AS BUILT. T ° xi SALEM
cISTE AUGUST 11, 2004
vS I 1 O �� `r1 Nn1 1 u4 S,
DATE REG. PROFESSIONAL LAND SURVEYOR NORTH SHORE SURVEY CORPORATION
47 LINDEN STREET — SAtEM MA i 'Yz
- I
Mug
UNIT
s
THIRD _
11-942649772 . ' 3
'"..�,.
pox WAna s s This carU acknowledges that the n;cspima rids successfully coinnpletetl a
�. a..oarricrwsaa*:mr :{ f?. 104mur Occupational Safely and Headh Tminirg Course m,
�atrwnYAstl►alal►t�e z Construction Safety.and Health .
.,... PAUL FUNARI I
a> y
ARMANDO GAITAN 6/7/11
---- — -
:;" — ^g— tionorz (Tiaamr netne-trim or type) (Cawse ene Bate)
— .
�/, 1 Q�
l2Pi VJ�/I9?//49iQ/19iLlleCGLtJ2 r2��[' Cl.i,iC/C'�/I�GI�;
- Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 162124
Type: DBA
Expiration: 1/20/2015 Tr8 235930
MERIDIAN CONSTRUCTION
PAUL FURNARI
12 JACKSON ST
BEVERLY, MA 01915
Update Address and return card.Mark reason for change.
l i Address j Renewal ❑ Employment ❑ Lost Card
SCA 1 0 20M-05111
eorauroxroerd!/o�'G'/lauac/rueCl License or registration valid for individul use only
Office of Consumer Affairs&Business Regulation before the expiration date. If found return to:
ME IMPROVEMENT CONTRACTOR Office
on 1202015 DBA of Consumer Affairs and Business Regulation
gtstrabon 162124 Tye' 10 Park Plaza
Neoxpirati
-Suite 5170
Boston,MA 02116 _
MERIDIAN CONSTRUCTION.,-'`'._;
PAUL FURNARI
12 JACKSON ST -
BEVERLY.MA 01915 Undersecretary Not valid without signature
Massachusetts -Department of Public Safety
- Board of'Building Regulations and Standards.
Construction Super isnr I S ?Family
License: CSFA-045871
PAUL FURNARI
12 JACKSON ST
Beverly MA 01913
Expiration
Commissioner -
39 Walter Street
Unit # 1
Salem, MA 01970
July 17, 2014
To whom it may concern:
This letter is to confirm that the undersigned, owners of Unit # 1, do not object to
the Ringers, owners of Unit # 2, constructing a bathroom on the third floor of 39
Walter Street.
Sincerely,
CL
.zz