87 WASHINGTON ST - BUILDING INSPECTION (6) The Commonwealth of Massachusetts
Il ,' Department of Public Safety
V➢U Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One- r Tw -Family Pwel '
(This.Section:For Official Use Only) /
Building Permit Number: Date Applied: Building O al:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for w c street ad re o available)
8ZWA5,qi,,:aro6i 5r :5� 0/9-70
No.and Street City/Town Zip Code Name of Building(if applicable)
SECTION 2:PROPOSED WORK
Edition of MA State Code used$_ If NewConstruction check here❑or check all that apply in the two rows below
r Existing BuildingaN Repair❑ 1 Alteration>I Addition❑ 1 Demolition ❑ (Please fill out and subnut Appendix 1)
Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes X No ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No Q
Brief Description of Proposed Work: �,&A2 E9rh r
;4c��rK oi� z1 R-E--i---AiAPA 1'r/3AIZ //=nAU An A) c5r A lF a srAiR3 7-0 P10Tr
R.�rli n rr /e/n�C�i e7� /.i o-- A i.C7L7-jcAL //9FT ( �77Y�C.7�'•O M�1.�,'P.c
_AP'PFat -D yARiAn/cf"),_` �oA7i<IljuaAT�o�V D1-- iY/OU s'JST i�1s ArJ'P snn4
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): _ I Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
L
Existing Proposed/xrfr OF- a�-K oA/ v
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 2 't-ZS2`/5- 2 +/_3 245
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2,V Nightclub ❑ A-3 ❑ A-4❑ A-5 ❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ I H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H4 ❑ H-5 ❑
I: Institutional I-1 ❑ I-2❑ I-3❑ I-4.❑ M: Mercantile ❑ R: Residential R-1❑ R-2❑ R-3❑ R-4❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use ❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ _ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB .Q IV ❑ VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Debris Removal:i Permit:Water Supply: Flood Zone Information: Sewage Disposal: TrenchLicensed Disposal Site❑
Public Check if outside Flood Zone X Indicate municipalA A trench will not be P
Private❑ or indentify Zone: or on site system❑ required❑or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure witlin airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No D.fl 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 an Sprinkler System?: Special Stipulations:
1
SECTION.9:-PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
,FjgRr'/ oodE k)A5MlAApk7
:5r �gc. LL/ 7 Ra,,r- Lx 5r.
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
6N/A)5FF -014LiAN cj4wD K 978- 22- 0369
Title Telephone No. (business) Telephone No. (cell) e-mail resssc"W"
If applicable, the property owner hereby authorizes
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building ernut application.
SECTION 10:CONSTRUCTION.CONTROL(Please fill out Appendix 2)
(If building is less than M,000 cu.ft of enclosed space and/or not under Construction Control then check here❑and skip Section 10.1)
10.1 Re 'stered Professional Responsible for Construction Control
�a ���taw ? -L$2 tg�,3a14G4QCaK 'Le3S
Nazne Registrant) Telephone No. e-mail address Registration Number
S9S3 GSS�slr.�tt� x M.4 oRso ,AHr�T Lol
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
__ D-aNlet of-P-46N 2 _
Company Name
'TN i E L No o 01 "S 60 Name of Person Responsible for Construction License No. and Typi if Applicable
S 056> I 2D 6&eKt'!7 A16- o<'�-7/5
Street Address City/Town State Zip
Telephone No. (business) Telephone No. cell e-mail address
SECTION 11:WORKERS'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 f uance of the building permit.
Is a signed Affidavit submitted with this application? Yes the
❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs: (Labor G�
Item and Materials) Total Construction Cost(from Item 6)
1.Building $
Building Permit Fee=Total Construction Cost _o (Insert here
2.Electrical $ appropriate municipal factor)
1 Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=.$_ (contact municipality)
5. Mechanical Other $ Enclose check payable to "C Z.0 S,0 0
6.Total Cost $ NO (contact municipality)and write check number here
SECTION 1 :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 the b�s"y of y know e ge and understanding.
O)ONiCL NO(WMP 12 SDI - - 6 (� zv�z,
Please print and sign name Title Telephone No. Date
O(iC1Q rn
Street Address City/Town - State Zip
.Municipal Inspector to fill out this section upon application approval: _
. Name - Date
1
Appendix 1
For the demolition of structures the building permit applicant shall attest that utility and other
service connections are properly addressed to ensure for public safety.
Please fill in the information below and submit this appendix with the building permit
application. The building permit applicant attests under the pains and penalties of perjury that
the following is true and accurate.
Property Location (Please indicate Block # and Lot # for locations for which a street address is not
available)
No. and Street City /Town Zip Name of Building (if applicable)
For the above described property the following action was taken:
Water Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑
Gas Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑
Electricity Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑
Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑
Other (if applicable)
Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑
Other (if applicable)
CITY OF Smy"NIV IN'IASSACHUSETTS
• BCD.DING DEPARTNMNT
' 120 WASHINGTON STREET,3w FLOOR
4j TE1- (978)745-9595
FAX(978)740-9846
KIMBERLEY OPISCOLL
MAYOR DIRECTOR
ST.Pt>`ttR6
DIRECTOR OF PCBLIc PROPERTY/BL'R.DING CO',L%MIONER
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information y� Please Print Leeibly
Name(9usim-saorganintiorvindividual): LCOX YL9<g-7 o
Address:
City/State/Zip: 6ae] C-!J i✓1/7 0I-'IIS Phone#: S-5`3 c)3 4 y
Are you an amployerY Check theappropriate box: Type of project(required):
1.ER I am a employer with_� 4. ❑ 1 am a general contractor and 1 6. ❑New construction
employees(full and/or part-tithe).' have hired the sub-contractors
2.❑ I am a sole proprietor nr partner. listed on the attached sheet.: 7• ® Remodeling
ship and have no employees These sub-contractors have S. ❑ Demolition
workingfor me in an capacity. workers'comp.insurance.
Y P tY• 9. ❑Building addition
(No workers'comp.insurance 5. ❑ We ate a corporation and its
required.] officers have exercised their I0.❑Electrical repairs or additions
3.❑ 1 anti a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself.[No workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs
insurance required.]t employees. [No workers' 13.❑Other
comp. insurance required.]
"Any applicant that checks box#1 must also till out the section below slowing then workers'compensation policy information.
t 1 kotteowrw•es who submit this affidavit indicating they are doing all work and then him outside commetors most submit a new affidavit indicating such:
{ontratwn that cheek this box miry anachod an o witional sheet showing the name of ft subcontractors and their wodu ss'comp.policy infinoaion.
I am an employer that Is providing workers'compensation lnsuranee for my employees. Below is the policy and Jab site
information. n�/�//� e��/ //
Insurance Company Name: �- l Vllf°IC V �Iv -NU&RA _ i WS• c
Policy#or Self-ins.Lic.#: 1,n U(� - J &, Expiration Date: c ZY 1
Job Site Address: ki W 5T City/State/Zip: S19CV" en 9'__
Attach a copy of the workers'compensation policy declaration page(showing the policy number and eirplration date}
Failure to secure coverage as required under Section 25A of MOIL c. 152 can lead to the imposition of criminal penalties of a
fine up to S 1,500.00 and/or one-year imprisonment.as wall as civil penalties in the form of a STOP WORK ORDER and a tine
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 .
Investigations of the DIA for insurance coverage verification.
I do hereby certify a the p Ins and pens of perjury that the faformadon provided above Is true and correct
Sinnature: Date:
r #' Sod �3
OJJlcial use only. Do not write in this area,to be completed by city or town o0wird
City or Town: PermitiLleense#
Issuing Authority(circle one):
I.Board of Heailh 2.Building Department 3.Cilyffown Clerk 4.Electrical inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Appendix 2
Construction Documents are required for structures that must comply with 780 CMR 107. The
checklist below is a compilation of the documents that may be required for this. The applicant
shall fill out the checklist and provide the contact information of the registered professionals
responsible for the documents. This appendix is to be submitted with the building permit
application.
Checklist for Construction Documents*
Mark"x"where applicable
No. Item Submitted Incomplete Not Required
1 Architectural -FR/a i 51,c -r T X
2 Foundation X
3 Structural
4 Fire Suppression
5 Fire Alain(may require repeaters)
6 HVAC
7 Electrical X
8 Plumbing include local connections) X
9 Gas Natural,Pro p ane,Medical or other)
10 Surveyed Site Plan (Utilities,Wetland,etc.) )(
11 Specifications X
12 Structural Peer Review
13 Structural Tests&Inspections Program
14 Fire Protection Narrative Report
15 Existing Building Survey/Investigation
16 Energy Conservation Report
17 Architectural Access Review 521 CMR
18 Workers Compensation Insurance
19 Hazardous Material Mitigation Documentation
20 Other(Specify)
21 Other(Specify)
22 Other(Specify)
'Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work
so identified must not be commenced until this application has been amended and the proposed construction document amendment
has been approved by the authority having jurisdiction.Work started prior to approval may be subjected to triple the original permit
fee.
y Registered Professional Contact Information
Mt-,//gVr icWqu1A,C,'+l 203S/
�Name(Registrant) Telephone No. e-mail address Registration Number
4m , Fr 24iAF Az&&r��
Street Address City/Town State Zip Discipline Expiration Date
�.lo .l CJ�o i5 7$/-729- 4644- )acgeooefhIo-&o; Gam 30774
Name(Registrant) ,Tel�ephone No. e-mail address
Registration Number
9 -r F-r -DRIVE W/AJ4�F2 T a/ 90 JcvrzAr (3 /14
Street Address City/Town State Zip Discipline Expiration Date
Name(Registrant) Telephone No. e-mail address Registration Number
Discipline Expiration Date
Street Address City/Town State Zi
CITY OF S.kLE11, N-LksSACHUSETTS
BUILDING DEPART%MNT
e 120 WASHINGTON STREET, 3' FLOOR
TLi. (978) 745-9595
F.*.r(978) 740-9846
IU%.IBEFJ RY DRISCOLL
1b1,AYOR Tt-tOh4As ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUU.DR9G CO`•(! IISSI0NER
CONSTRUCTION CONTROL DOCUMENT
Project"rifle: �g P/J� / Date: / � /2 _
Project Location: O7 WASI�Jn��9r�Q1 _�_
Scope of Project: Lo_.1� ._..� zT� d �/R37 �Loe� TFg7Ll01/ U2&)
In accordance with SECTION 116.0-116.4.2 of the 6th edition of the Massachusetts State Building Code
Mass. Registration Number
being a registered professional Engineer/Architect hereby CERTIFY that I have prepared or directly supervised
the preparation of all design plans,computations and specifications conceming:
( ] Entire Project pQ Architectural [ ] Structural [ ] Mechanical
( ] Fire Protection [ ] Electrical [ ] Other(specify)
for the above named project and that to the best of my knowledge,such plans, computations and specifications meet
the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all
applicable laws for the proposed project.
Furthermore, I understand and AGREE that I shall perform the necessary professional services and be present on
the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the
documents approved by the building permit and shall be responsible for the following as specified in section
1 16.2.2:
1. Review of shop drawings,samples and other submittals of the contractor as required by the construction
contract documents as submitted for the building permit, and approval for the conformance to the design
concept.
2. Review and approval of the quality control procedures for all code-required controlled materials.
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, in general, if the work is being performed in
a manner consistent with the construction documents.
I shall submit periodically, in a form acceptable to the building official,a progress report together with pertinent
comments. Upon completion of the work, I shall submit to the building official a final report as to the
satisfactory completion and readiness of the project for occygd 4444
®�ESet)ARCyies;
Signature and Seal of registered professional: �v �Af`�
C �.
4 Q¢ c0 No
o.-20 3A5S1 r
&LEST /!
J
'aX
(b OFM
�
l
APPPPP�
R.W. Sullivan Engineering
HVAC . Electrical . Plumbing . Fire Protection . Code
November 26, 2012
Poore & Co.
315 Washington St.
Gloucester, MA, 01930
Attn: Tim Curtis
Re: Opus Restaurant
87 Washington Street
Salem, MA 01970
Dear Tim:
This letter is regarding the renovations to the Lower Level and First Floor of 87
Washington Street in Salem and our review of the progress documents dated
November 16 and 26, 2012. The project is required to comply with
Massachusetts State Building Code, 8th Edition (780 CMR) which adopts the
2009 International Building Code (IBC) and 2009 International Existing Building
Code (IEBC) with amendments. Since the renovation does not result in a
change of use, tho work is classified as Level 2 alterations, which includes the
reconfiguration of spaces, the addition or elimination of doors and windows, the
reconfiguration or extension of systems, and/or the installation of additional
equipment in less than 50% of the aggregate area of the building. Therefore, the
work must comply with IEBC Chapters 6 and 7.
The altered portions of the floors as shown on the architectural design
documents meet the code for new construction as required by IEBC 701.3.
Since the work area includes the entire floor, the remainder of the requirement of
IEBC Chapters 6 and 7 are also satisfied since the work area includes a
complete new fit-out. The renovation also complies with IEBC MA Amendment
Section 102.2.2.1 since the floors will have sufficient exit capacity for the number
of occupants. Since the floors are being completely renovated, it is assumed
they will also be provided with updated exit signs, emergency lighting, and fire
protection systems to protect the new floor layout.
If you have any questions please do not hesitate to contact us.
Very truly yours,
SULLIVAN CODE GROUP
i
DON E. CONTOIS, P.E.
010 Sc IMM i;enler.529 Main Sirea*1,Suite 203,Boeicn. MA 02129-1107.617.523.8227(p) 617,5218016 if). www.rwau0hdansom
r
Deval L.Patrick "" '' '""'""'""'"""""""" b aolnp- exp.
Governor - �/ ry�Q�n ThomaC mm ssisiioner P E
Timothy P.Murray
Lieutenant Governor �,%2p- � ���Qp�j� Thomas P.Hopkins
Director
Mary Elizabeth Heffernan /
Secretary Uss'a`Lfi`'.sltlLdtltf
TO: Local Building Inspector Docket Number V 12 266
Local Disability Commission
Independent Living Center
FROM: ARCHITECTURAL ACCESS BOARD
RE: Opus Restaurant
87 Washington Street
Salem
Date: 11/6/2012
Enclosed please find the following material regarding the,-above location:
Application for VarianceDecision of the Board
Notice of Hearing _Correspondence
Letter.of Meeting
The purpose of this memo is to advise you of action taken or to be taken by
this Board. If you have any information which.may assist the Board in reaching
a decision in this case, you may call this office or you may submit comments in
writing.
n
, d
Deval L.Patrick '
Governor 'A y yo Thomas G.Gatzunis,P.E.
c/ ��/-/G����� Commissioner
Timothy P:Murray - (��' �y y y �+�+
Lieutenant Governor 5%� 4j/,-- -OWef - Thomas P.Hopkins
Director
Mary Elizabeth Heffeman
secretary eVtU"'��'«'� / Docket Number V 12 266
NOTICE OF ACTI
RE: Opus Restaurant, 87 Washington Street Salem
1. A request for a variance was filed with the Board by Mark McDonough (Applicant) on October 12, 2012
The applicant has requested variances from the following sections of the 06 Rules and Regulations of the Board:
Section: Description:
28.12.1 Petitioner seeks a variance to allow the installation of a vertical wheelchair lift to serve the first floor and lower
level of a proposes restaurant. The petitioner does not meet any of the"By Right" allwances of 521 CMR
Section 28.12.1 a thru e. The vertical wheelchair lift will meet the requirerments of 521 CMR Section 28.12.2
2. The application was heard by the Board as an incoming case on Friday, November 2, 2012
3. After reviewing all materials submitted to the Board, the Board,voted as follows:
GRANT: the variance to Section 28.12.1 as proposed for the reason that impracticability(see definitions of
impracticability in Section 5 of 521 CMR) has been proven in this case and on the condition that the vertical wheelchair
lift is permited and inspected by the Commowealths Elevator Division, and a copy of the inspection certificate is
provided to the Board upon completion of the work.
_PLEASE NOTE:All documentation(written and visual) verifying that the conditions of the variance
have been met must be submitted to the AAB Office as soon as the required work is completed. .
Any person aggrieved by the above decision may request an adjudicatory hearing before the Board within 30 days of
receipt of this decision by filing the attached request for an adjudicatory hearing. If after 30 days, a request for an
adjudicatory hearing is not received, the above decision becomes a final decision and the appeal process is.through
Superior Court.
Date: November 6, 2012
,. '�
cc: . Local Disability Commission Chairperson
Local Building Inspector ARCHITECTURAL ACCESS BOARD
Independent Living Center
CITY OF SM.&M, TN'LA SSACHUSETTS
BUILDING DEPARI"NEENT
• 130 WASHNGTON STREET, 3' FLOOR
a . 'ILL (978) 745-9595
FAX(978) 740-9846
[U-,{gFRt FY DRISCOLL
MAYOR T�-IoNw ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BI;ILDL*IG CONLMSSIONER
Construction Debris Disposal Affidavit
(required for Tall 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 At 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:
P14L
(name of hauler)
The debris will be disposed of in :
BFI
(name of facility)
Fo/1e5T Jr. P&,V1360-7
(address of facility)
a/;
sr re of permit appli ant
A / / z
to
JebriutTJcx
The Commonwealth of Massachusetts
Department of Public Safety
�i. Massachusetts State Building Code (780 CMR)
Building Permit Application to Construct, Repair, Renovate or Demolish any
V4ssbw �„'QC4'
Building other than a One- or Two-Family Dwelling
f
Code and Other Requirements for Building Permits
The Department of Public Safety has issued these building permit application forms so that municipalities
across the state can move toward use of a single permit form and consistent permit application process.
The MA State Building Code specifies the requirements of building permits and the applicant is advised to
review and be familiar with these requirements in order to avoid some of the common permit application
problems. Likewise the applicant should be aware that some municipalities require that the owner confirm,
even prior to acceptance of the building permit application, that no outstanding property taxes, water fees,
etc. exist.
Filing Instructions
1.Please contact the city or town where the work will be done to ensure that the city or town will accept
this application form and if any additional information is required, and obtain the correct mailing
address. After doing so, print the application, fill in completely and then submit to the local city or
town where the work will be done.
2.All applications shall be considered complete and will be reviewed if construction documents,
specifications, fee, and other materials that may be required as indicated in the Building Permit
Application are included with the application.
3.Please include a check for the Building Permit fee. The fee may be calculated using the information to
be supplied in section 12 of the Building Permit Application. The check is to be made payable to the
local city or town where the work will be done.