23 WARREN ST - BUILDING INSPECTION (4) IF i
V
/I The Commonwealth of MassachusettsTa *kvmmw�
f
Board of Building Regulations and Standards ~
Massachusetts Slate Building Code, 7g0 ChIR, 7'"editionept
Building Permit Application To Construct, Repair, Renovate Or Demo
O • ur Ttto•Funuls''Durllreg
is Section F Official Use Only
Budding Permit Number Date Applied: U
Signature:
gull g Co tsstoned Inspec Bug mgs Date
S TI N 1:SITE INFORMATION
I.1 Property Address: 1.2 Assessors Map At Parcel Numbers
a3 wr t=� s
I.la Is this an acc ted street?yea no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq to Frontsge(A)
1.5 Building Setbacks(It)
Front Yard Side Yards River Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.e0,1 Sa) 1.7 Flood Zone Information: 1.11 Selvage Disposal System:
Public O Private O Zone: _ Outside Flood Zone? Municipal O On site disposal system O
Cheek ifyesu _
SECTION 2: PROPERTY OWNERSHIP'
2.1 waer'of Record:
4 WPwRErJ '5k S�( Er+��ytlw
Name(Print) Address for Service:
08-11N- a?sS
Signature Telephone
SECTION J: DESCRIPT1 N OF PROPOSED WORK'(eheck 50 that apply)
New Construction O rExistinj Building el Owner-Occupied O 1 Repairs(s) el Alteration(s) O Addition O
Demolition (3 AeeessoryBtdg.O I NumberofUnita_ I Other O Specily-
Brief Description of Proposed Work': JMtO RroF SM IA&C6S )5torn /2crrfS n/iAu s2 L p,E.W-1 S
AT f1JMO./JAIL LoGSt c F `ar¢OS 3 A( /LIE Pay
Q/[.l 1tULi 6L+lSH/We5 sir vac � "r n ri7 G t �. aOs
N r
SECTION d:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Budding I. Building Permit Fee: f Indicate how fee is determined:
O Standard City/Town Application Fee
2 Elecincal f O Total Project Cost'(Item 6)a multiplier x
J Plumbing f 2. Other Fees: S
a. Mechanical IHVAC) S List: ply
s Mechanical tFire S Total All Fees. S
Su esmon
Check No. _Check Amount: Cash Amount:_
6 Total Project Cost S GD r� 0 Paid in Full 0 Oumandmg Balance Due:
I
SECTIONS: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor ICSL)
f�11G1 � b z
r,��h1AcI�tJZI� Lacn.e Number Espu ion aro
N.yat tit CSL Hylder 12l Ltsr CSL Type IrY h,luw)
• I�.UUTII� �. �
Addtrs Tvat Description
GC U Unrestricted to 37,000 Cu. Ft
tA
R R Family IS2 Fa D%ellin
Sianamre M Masonry Only
19?¢� RC Residential RoofingCoverm
Telephone wS Residential Window and Sidm
SF I Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
S.2 Istered Home I Contractor(HIC)
�wlut& r!rw /mprovement or�7ac��3 /66,77�
HIC Company Name or WIC Repstrant Name Regtsnat umber
Addraa Q, (WilLix ;7 6
'Yl I , Exoirsn6n Date
Signature Telephone i I
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. IS2.1 25C(6))
Worker Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this sRdavit will result in the denial of the Issuance of the building penniL
Signed AffidavitAttachar Yes.......... No...........a
SECTION 7a: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 arum of Owner Date
L SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
1. „r �� r� ,as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application arc true and accurate,to the best of my knowledge and
Ixhalf.
EA) M146- za4.
Print Name
Gc 3 N io
Signanue of ner ar Authoriz A rat Dale
Si un the aim and penalties of
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 rgg have access to the arbitration
program or guaranty fund under M.G.L. c. 1 a2A. Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110 R6 and 110.RS,respectively.
2. When substantial work is planned,provide the reformation below:
Total floors area(Sq. Ft.) (including garage, finished basemenoattics•decks or porch)
Gross living area(Sq. Fl.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half.baths
Type of heating system Number of decks/porches
Tvpeof cooling system Enclosed Open
1 "Total Project Square Fuotage"may he.uhslituted for-'Total Project Cost"
FB0 L( lU UZ:3Up r-0105 rlpan
e. S
Salem Historical Commission
120 WASHINGTON STREET,SALEM, MASSACHUSETTS 0197C
(979)745-9595 EXT 311 FAX(9781 7c0-0404
CERTIFICATE OF NON-APPLICABILITY
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
! Reconstruction ❑ Alteration
b Demolition ❑ Painting
❑ Signage ❑ Other Work
as described below does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District: McIntire
Address ofPropeny: n3 Warren Street
Name of Record Owner: Nicholas t t Pwde
Description of Work Proposed:
Replacement of wood gutter on.southeast side of house to replicate woodgutter on northeast side of house.
Replacement of roof on side porch of southwest rear of house to replicate existing. Replacement of roof of main
section oj'house to replicate existing (black or charcoal grey, 3 tab. asphalt). No changes in color, material,
design, location or outward appearance. Non-applicable due to being in kind maintenance.
Dated: September 15. 2008 SALEM H>TPRI L COMMISSION
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.
near 111 lu ui:utp roies Hpan
Wort'fit_
From: "Jane Guy'clGuy@Salem.conu
,'SLtbect: RE:certifies%of non-applicabi8ty ,\
Date: March 1,2010 9:03:19 AM EST
To: "KellyTyler-Lewis"<ktyledewis@comcast.net>
I think it Is okay for you io proceed and I win request an extension of
your certificate for you at this week's meeting How'brig do you
` the extension for? -
i
Jane A. Guy
Assistant Community Devebpnrent Director
City of Salem
Department of Planning&Community Development
12o Washington SL, 3rd Floor
Salem,Mk 01970
978.619-SM5
(F)978-740-0404
jguy@salem.00m
www.salemcom
---original Message--
From:Kelly Tyler-Lewis[maiftoMylerlewis@oomeast.nell
Sent:Saturday,February 27,201012:27 PM
To:Jane Guy
Subjecl:certificate of non-applicability
Hello Jane,
We applied for a certificate of non-applicability due to in kind
maintenance for our roof and northeast gutter in Sept.2008. It was
issued Sept. 15,2008. Unfortunately,we werent able to complete the
repairs in the required year interval.We have a contractor available
who could start this week and would like to request a renewed
certificate.(Irs no cpbcidence that I'm writing you two days after
the storm—the 60mph winds started the shingle-stripping job already and
the attic is leakingl)AN the application information remains the same.
Do you need a new application from us?
Thanks so much for your help. I'll have 10� �e�garden finished
fence and gate projw SHC approved.last
A up in December and think it looks great!
Kelly and Nick Lewis