19 WARREN ST - BUILDING INSPECTION (2) 0 The Commonwealth of Massochuseits rnwn of
Board of Building Regulations and Standards loomoww
Massachiaseu T
s State Building Cale, 780 ChIR. "edition Building Dept
Budding Permit Application To Construct. Repair. Renovate Or Demolish a f
One- or Tiro-Famrh Dmellmg
�1\/\� is Section For ORaal Use Only
/
_`' It i Budding Permit Number Date Applied: / • I O
—J Signature: + " I
Budding Co s spteiar of Buildings Dus
SECTION 1: SITE INFORMATION
1.t Property Addreu: 1.2 Assessors Map i Parcel Number
I c1 1nlc�rr{ S4 .Sreel,iLtA
M Number Parcel Number
1.I a Is this an acre led strcet?yes no >p
I.J Zoning Informetloa: 1.4 Property Dimensions:
Zoning Disinct Proposed Use Lot Area(sit R) Frontage IR)
IS Building Setbacks III)
Front Yard Side Yards Rem Yard
Required Provided Required I Provided Required Provided
1.6 Water Supply:(M.G.L c.40,154) 1.7 Flood Zone Information: 1.8 Sewage Dhoposal System:
Zone: _ Outside Flood Zorie7 Municipal O On site disposal system O
Public O Private O Check if veso
SECTION 2: PROPERTY OWNERSHIPt
2.l O aer'of Rtcprd: I of ��rY 1 SF SG I t4l &
rt c� Vie ONC
Nome l nt) Address for Service:
K 'rr4--A'�&q q -7b -141 48-70
Sigmture Telephone
SECTION 2: DESCRIPTION OF PROPOSED WORKS(cheek old that apply)
New Construction O Existing Building fY Owner-Occupied Repain(s) Altention(s) 61'� Addition O
Demolition Accessory Bldg. O Number of Units_ Other O Speeiry: 2
Brief Descrf ptign of Proposed Wo
r.
u r ICcbJ l t( S�N aA o on El sF
r —� bed A i2H 6
IL2.vw o�2 i �V 7"�/r�J by fjfr
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs: OMCIaI Use Only
Item Labor and Materials
1. Building f I. Building Permit Fee: S indicate how fee is determined:
undard CityrTown Application Fee
2 Electrical S O oval Project Cost'(Item 6)x multiplier x
) Plumbing S 2. Other Fed: f ,n (� yr
4. Mechanical (HVAC) S List: `:•1 AY:—
4/
s Nechamcal (Fire S Total All Fees. S
Su remon
Check No. _Check Arno no: Cash Amount:_
6 Total Project Cost S I I ❑ Paid in Full O Outstanding Balance Due
22.
7
I�
SECTION !: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor ICSL)
i.
• License Number Espuauon Date
N.yae of CSL-)!skier List CSL Type tscc trcluwl
v
AJJmsf i Description
U I Unrestricted(up to 13,000 Cu. Ft.
R I Restricted IA2 Farad 13*01in
Signature .N I Masonry Only
RC Residenti ofr al Ron Cover in
Telephone w'S Rrsidenual Window and Siding
SF I Residential Solid Fuel Burning Appliance Installation
D 1 Residential Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name Registration Number
Address
Expiration Date
Signature Telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.1..c. ISL I) 25C(6))
Workers Compensation Insurance affidavit 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.
Signed Affidavit Attached? Yes.......... O No...........O
SECTION 7o:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject property hereby
authorize to act on my behalf,in all matters
relative to work authorized by this building permit application.
Si alum of Owner Data
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
tJ0/vL ,as Owner or Authorized Agent hereby declare
that the statementa and information on the foregoing application are true and accurate, to the best of my knowledge and
beh
i V o.vc
Print,Nturr
( 1 I( 2a
Signature o(Owner or Authorized Agent ate
Si tied under the aim and penalties of r
NOTES:
I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program).will IM have access to the arbitration
program or guaranty fund under M.G.L. C. 142A. Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.R6 and 110.RJ, respeclively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq. Ft.) (including garage, finished basement/attics.decks or porch) ,
Gross living area ISq. F1.) Habitable room count
Number of fireplaces V umber of bedrooms
Number of bathrooms Number of half.baths
Type of heating system Number of decks porches
Ts re o(cooting system Enclosed Open
1 "Total Project Square Footage" may he.uhstimted for 'Total Project Cost"
r
,S CITY OF SALEM
a
PUBLIC PROPRERTY
$ps;
/ DEPARTMENT
:�iN$IBkI'T 0 S.\I 1'\I, \t.Ni.\t
l'F1:'178•.'i 'Ji'15 ♦t'.\x:'/78•NfY/9I6
Construction Debris Disposal Affidavit
(required 1'or all demolition and renovation work)
in accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit # _ . _ is issued with the condition that the debris resulting from
this work shall he disposed of in a property licensed waste disposal facility as defined by MGL c
111. S 150A.
The debris will be transported by:
(name of Miller)
'I'Ine debris will be disposed of in
To
(tarn of aci Ity) -
pnddrcss ul'facility)
+ignature of permit applicant
I� IlI2Aj1Q
date
l
Y
CITY OF SMJE.Ni
PUBLIC PROPERTY
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DEPARTMENT
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raL rS.745.9S"•F..a 97L74a964
HOMEOWNER LIMNSE EXEMPTION
Please "I
Data ( 11 Z010
Wcxo. � sf saFeM Mq a1q7�
Job Location 1 � �
Home Owner Address 15 Wa vru- C V Sc-O-e L- AJ A 019 -70
Home Owner Telephone -7v
Presaot Mailing Addreas 19 Lt S r MA 0147 D
The current exemption of"Homeowners"was extended to include owner-0ceupied
dwellings of two Units or lea and to allow such homeowners to engage an individual for
hire who.does not posses a licenser provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
person(s) who owns a pace)of land ou which he/she resides or intends to reside, on
which there is, or is intended to be, a one or two family dwelling. attached or detached
structures accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
homeowner"shall submit to the Building Official.on a forth acceptable to the Building
Oflticial, that he/she be responsible for all such work performed under the Building
Permit
The undersigned "homeowner"assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations
The undersigned "homeowner"certifies that he/she undentands the City of Salem
Building Department minimum inspection procedures and requirements and that he/she
will comply with said procedures and requirements.
HOMEOWNERS SIGNATURE I
,- PPROVAL OF BUILDING INSPECTOR
See other side for state code
January 11, 2010
Requesting Building Permit for:
19 Warren Street
Salem, MA 01970
Summary:
1. Repair/Rebuild Existing Back Sun Rooms on First and Second Floor
2. Remodel Second Floor Rear Bedroom and Adjoining Hallway
3. Install Master Bathroom.
Detail:
• Repair, reframe and rebuild as necessary two story enclosed sunrooms to replace existing rooms
located in the rear of the property.
• Replace roof to match existing roof line of remainder of house.
• Remove interior walls on first and second floor to expose sunrooms to kitchen and bedroom.
• Replace all windows in first and second floor sunroom with six over six double hung windows to
match existing windows in the house.
• Install four new matching six over six double hung windows on first and second floor next to
existing windows.
• Relocate side entry door.
• Remove chimney.
• Remodel second floor rear bedroom and hallway area. Incorporate floor space of reframed
enclosed sunroom areas.
• Install new master bathroom. Install shower,vanity and toilet.
• Relocate doorway to sitting room adjacent to the new master bathroom.
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Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978) 745-9595 EXT. 311 FAX (978) 740-0404
CERTIFICATE OF APPROPRIATENESS
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction 12�, Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: McIntire
Address of Property- 19 Warren Street
Name of Record Owner: Karen Vitone
Description of Work Proposed:
Per presentation materials dated 211110, rebuild and alter first and second floor sunrooms in rear of building
and faVade changes to rear ell, including window replacement, installation of 5 new windows, relocation of
door, removal of casement window, removal of chimney and changing roof line from flat to gable. All windows
to be Brosco, wood, single glaze, true divided lite windows to match rest of house. Roof shingles to be 3-tab
and match color of'main roof. Install antique leaded glass window in new gable.
Removal of vinyl siding on rear additions and repair/replace clapboards underneath. Reapply wood trim
around windows similar to 21 Warren Street. Paint clapboards white and trim black. Option to remove vinyl
siding on main portion of house when financially feasible.
Dated: February 4, 2010 SALEM HISTORICAL CCOMMISSION
By:
The homeowner has the option not to commence the work (unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals) prior to commencing work.
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