12 CLARK AVENUE - BUILDING JACKET The Commonwealth of Massachusetts
�' Board of Building Regulations and Standards CITY
O; Massachusetts State Building Code,780 CMR Revisedilar 101/
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Buildin it mbe Ditt pplied:
B ding tcial Name) Signature Date
SECTION 1: SITE INFORMATI
I.1 Property Address: 1.2 Assessors Map At Parcel Numbers
l2 C1arK Five
I.1a Is this an accepted street?yes x no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq fl) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of Record:
oao 2eb o Salem MA ola-lo
N-me(Print) City,State,ZIP
12 ua-K Awe- g18 • 852-•+G`4 woomsn. Cow%
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply)
New Construction X I Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) ❑ 1 Addition ❑
Demolition ❑ 1 Accessory Bldg. ❑ 1 Number of Units Other ❑ Specify:
Brief Description of Proposed Work: S p p
PY\.O'}DV n l--GLI C. So l ctr SA S-}P.YYIS
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
1.Building $ I Z )-, 2- I. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical
27 LO�g ❑Standard City/Town Application Fee
$ ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:_
6.Total Project Cost: $ 'z�/��O 0 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
��y �/�p� �LI-5 25 I-1 � 28 19
�t_Y v tl_.J 2YYYL4Xl License Number Expr anon ale
Name of CSL Holder
I S_y_,�,^^1 List CSL Type(see below) U
No.and Street 1 t' �C' 1 Type Description
SCUD LLS Al A OI( l O Y U Unrest
ricted(Buildings u to 35,000 cu.ft.
CityTown/ R Re &2 Family Dwelling
M Masonry
RC Roofing Coverin
WS Windowand Sidin
SF Solid Fuel Burning Appliances
f`613 _ L6 VAO S AnL o VIUtt�ICCA r I Insulation
Telephone Email address Cprn D Demolition
5.2 Registered Home Improvement Contractor(HIC)
\/1 V i n+ So for neveloPeY L LC HIC Registration Number E pira[on Dale
HIC Com any Name or HIC Rgggistrant Name
o�3 t N Yv�A So IGL.r C�V IV I✓L-FSo r.
No.and Street Email address CsDn't
PrOYO L?'r $t}IPOt} '1$13o53o1Q5
City/Town, State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 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..........A No........... ❑
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 Vi y 1vtv Solar
to act on my behalf.in all matters relative to work authorized by this building permit application.
J oo.o 92bP.l o -See ak}GlCIAJ C xi p,� 51 22 113
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below;I hereby attest under the pains and penalties of perjury that all of the information
contained in th' p tion is true and accurate to the best of my knowledge and understanding.
v -t 0_X 5 22 13
Print Owr s r prized Agent's Name(Electronic Signature) Date
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 not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.uov/oca Information on the Construction Supervisor License can be found at www.mass eov/dns
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
WCONSULTING Wyssling Consulting
255 Reserve Street
Boonton, NJ 07005
Scott E. Wyssling, PE, PP, CME office (973) 601-3305
cell(201) 874-3483
wyssconsulting@aol.com
May 21, 2013
Mr. Dan Rock, Project Manager
Vivint Solar
24 Normac Road
Woburn MA 01801
Re: Structural Engineering Services
Rebelo Residence
12 Clark Avenue, Salem MA
AR#3015654
5.76 kW System
Dear Mr. Rock:
Pursuant to your request, we have reviewed the following information regarding solar panel installation on
the roof of the above referenced home:
1. Site Visit/Verification Form prepared by a Vivint Solar representative identifying specific site
information including size and spacing of rafters for the existing roof structure.
2. Design drawings of the proposed system including a site plan, roof plan and connection
details for the solar panels. This information was prepared by Vivint Solar and will be
utilized for approval and construction of the proposed system.
3. Photovoltaic Rooftop Solar System Permit Submittal prepared by Vivint Solar identifying
design parameters for the solar system.
4. Photographs of the interior and exterior of the roof system identifying existing structural
members and their conditions.
Based on the above information we have evaluated the structural capacity of the existing roof system to
support the additional loads imposed by the solar panels and have the following comments related to our
review and evaluation:
Description of Residence:
The existing residence is typical wood framing construction with the roof system consisting of 2 x 8
dimensional lumber at 16" on center with 1 x 8 collar ties every 32". The attic space is unfinished and
photos indicate that there was free access to visually inspect the size and condition of the roof rafters. All
wood material utilized for the roof system is assumed to be Spruce-Pine-Fir #2 or better with standard
construction components. Our review of the photos of the exterior roof does not indicate any signs of
settlement or misalignment caused by overstressed underlying members.
Stability Evaluation:
A. Wind Uplift Loading
1. Refer to attached ZEP calculations sheet for ASCE/SEI 7-05 Minimum Design Loads for Buildings
and other Structures, wind speed of 100 mph based on Exposure Category "B" and 30 degree roof
slopes on the dwelling areas. Ground snow load is 40 PSF for Exposure "B", Zone 2 per(ASCE/SEI
7-05).
2. Total area subject to wind uplift is calculated for the Interior, Edge and Corner Zones of the dwelling.
Page 2 of 2
B. Loading Criteria
10 PSF = Dead Load roofing/framing 40 PSF = Live Load (ground snow load)
• 5 PSF= Dead Load solar panels/mounting hardware
Total Dead Load=15 PSF
The above values are within acceptable limits of recognized industry standards for similar
structures. Analysis performed of the existing roof structure utilizing the above loading criteria
indicates that the existing rafters will support the additional panel loading without damage, if
installed correctly.
C. Roof Structure Capacity
1. The photographs provided of the attic space and roof rafters show that the framing is in good
condition with no visible signs of damage caused by prior overstressing.
2. The dwelling owners shall be made aware that long term build-up of heavy snow conditions may
produce deflections in the roof. If any deflection is noticed, then it is recommended that the solar
panels be cleared of accumulated snow more than one (1) foot deep over a period of one week. If
no deflections are visible under any snow loading over a period of time, then there is no need to
clear the solar panels.
D. Solar Panel Anchorage
1. The solar panels shall be mounted in accordance with the most recent "ZEP Code Compliant
Installation Manual", which can be found on the ZEP website (zepsolar.com). If during solar panel
installation, the roof framing members appear unstable, deteriorated, structurally compromised or
deflect non-uniformly, our office should be notified before proceeding with the installation.
2. Maximum allowable pullout per lag screw is 235 Ibs/inch of penetration as identified in the National
Design Standards (NDS) of timber construction specifications for Hem-Fir(North Lumber) assumed.
Based on our evaluation, the pullout value, utilizing a penetration depth of 2 ''/i', is less than what is
allowable per connection and therefore is adequate. Based on the variable factors for the existing
roof framing and installation tolerances, using a thread depth of 2 '/" with a minimum size of 5/16"
lag screw per attachment point for panel anchor mounts should be adequate with a sufficient factor
of safety.
3. Considering the roof slopes, the size, spacing, condition of roof, the panel supports shall be placed
at and attached to no greater than every fourth roof rafter as panels are installed perpendicular
across rafters and no greater than the panel length when installed parallel to the rafters (portrait).
No panel supports spacing shall be greater than four(4) rafter spaces or 64" o/c, whichever is less.
4. Panel supports connections shall be staggered to distribute load to adjacent rafters.
Based on the above evaluation, it is the opinion of this office that with appropriate panel anchors being utilized
the roof system will adequately support the additional loading imposed by the solar panels. This evaluation is
based on information supplied to us at the time of this report and current industry standards and practices.
Should you have any questions regarding the above or if,you require further information do not hesitate to
contact me.
V truly yours,
Scott E. Wyss g,uPE'
NJ LiceriiuN . 41
TEMPORARYPERMIT MASSAG,NUSSETTS 2013-048-PE
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"Board of Buildin!_ Regm1a[ions and Standards
Construction Supervisor License
License: CS 100434 -
R
PHILIP BRIENZE`' r i
57 MURRAY STREET APT 2
LYNN, MA 01905
Expiration: II/1112013
C'ununicsinuei . ` Tr#: 7260
Office�on�mer av`s"Ni BR ness egu HOME IMPROVEMENT IMPROVEMENT CONTRACTOR Type:
Registration ,158909
Expiration: 3014 DBA
P. ALTY MGM —Y T�
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PHILIP BRIENZE
57 MURRAY ST APT,#2-1_•��y
LYNN, MA 01905 �` Undersecretary
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Y 1�
'tOt CERTIFICATE ISSUED
DATE August 5, 1993
CITY OF SALEM
M SALEM, MASSACHUSETTS 01970 BUILDING PERMIT
a4LBm,( CERTIFICATE OF OCCUPANCY
_ DATE Jan. L[ I@ 13 RM IT NO. .�_93
APPLICANT Uulld A3XAI:StY(311CJ ADDRESS szew[�i U1975
SS qq Ty INO.I ISTII[LTI IC4rI P•5 IICCNS[I
;![jy+ y+Sy+ i� ! NUMBER OF 4
PERMIT TO I=1 STORY OWELLING UNITS
11.1E o[ Iwaov(uENn .a. IPROPOSED USE)
AT (LOCATION) r 12 ClaErlk AV&iR 'wiard 3 ZONING 1_1
END.) (STREET, DISTRICT_
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT, INIOE P.• FT. LONG BV FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
lTT[EI
m" ; ANiL'1 'i;JO f,�� ay '.:.•:�iFSd,ilG
REMARKS'. Lam A a
>u XR Pllt�1IT 10 OCCUPY 745—::595
�9m11 �IAA01
AREA OR In INN W.—ti
VOLUME
MIR
OWNER +'t.l112iSfit.a"CiRQ Ibrns�+Ier[!s�IbT+rv..�barlbci)vc[I �EbrElvwTbrn s�.rsvly
TO BE POSTED ON PREMISES
ADDRESS ( l°tanstaeil PkwV,:,dlem.L'L; SEE REVjamix BaCrMftloieioms OF CERTIFICATE
I w
' BUILDING '
PERMIT
(a JOB WEATHER CARO
.^ �AAgmas� DATE jail. IB 93, MIT NO. 8_'V.i
APPLICANT �N ttaq ADDRESS lams, - -
INO.) ISTREETI ICONt R•S LICL MS61
igg FRARAEAa= NUMBER OF �
PERMIT TO r•R OI IM ('��l IMPROVEMENT)1L'h._ ( No I �r ORY AIIPROPOSED USE) DWELLING UNITS
♦T (LOCATION) 12 " A` r� 3 ZONING �[R • '.
(NO.) ISt REEL DISTRICT
Ile
BETWEEN AND
ICROL STREET) (CROSS ST P[[TI
LOT
SUBDIVISION -LOT-BLOCK SIZE
n
BUILDING IS i0 BE FT, WIDE dY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROU4 BASEMENT WALLS OR FOUNDATION
ITVPEI
���
mwr A fiY 1PIdf i "4 '9mn �Rad.IE�6
REMARKS:
CAYL om obbor 20 Q=�w(yf�{f(y�(7�45�-iV589 t�Q /�/{
I�REA OR +.. QE•. `i1/Al'fl USES Do
40LUME C ESTIMATED COST p INSZ�JI TiiVEdA�-FEEMIT 5
COAIC•SQUARE FEETI
OWNER �PEE��^A�"SS��wE�I�.
.
ADDRESS � rrtv,=/�lEit�Q a91i 8U'L01Nla TW iPMW
.
INSPECTOR OF BU .DINGS
THIS PERMIT' CQNVEY,4',NORIGHT TO OCCUPY ANY STREET, ALLEY OV SIDEWALK OR ANY PART THEREOF, EITHER TEM►O AIRILY.OIR W
PERMANENTLY. ENIC RO'A CMMEN T.S ON PUBLIC PROPERTY. NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, UST BE AP-
ED BY THEI �1F[ISDICTION,: STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF.PUBLIC SEWERS MAY DB OBTAINED
FROM THE DEPART ENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM TMERIONOITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CAI( APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APDL CABLE' SE
PA
INSPECTIONS REQUIRED F.OR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PF RMI rS ARE REOUIREO-
PFOB
ALL CONSTRUCTION WORN: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE. MECMANICAL INSTALLATIONS.
E. PRIOR TO COVERING STRUCTURAL 0UIRED,SUCH BUILDING SHALLNOTSE OCCUPIED UNTIL
ME MORRIS I READY TO LATHI.CTION BEFORE
S. FINAL INSPEFINAL INSPECTION HAS BEEN MADE. '+
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSSP-ECC��TIOON APPROVALS ELECTRICAL INSPECTION AP► VVA S
2
2 �� � ��a.e
4�- Q�
3
POA RD IF HEALTH 7 GAS INSPECTION APPROVALS FIR DEPT, I 5 E TING APPR "
.!1✓� r( I
OTHER CITY ENGINEER 2 � ply __ � Z
/
WORK SHALL NOT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD
INSPE] JR NAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY T€LEPPONE
STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION.
-9j
LAND COURT NO "SPECIAL FLOOD HAZARD" AREA INVOLVED
LOT 71 COMMUNITY #250102 0005 B 8/5/85
LAND COURT 96
LOT 72
.o�
[i
q ` r
LOTS 139 & 140
29, 650 +- S . F _
LAND COURT LAND COURT TO: GEORGE PEABODY CO-OPERATIVE BANK
LOT 141 LOT 138 " I CERTIFY THAT THE FOUNDATION
z
m IS LOCATED AS SHOWN AND CONFORMS TO
N THE ZONING LAWS OF THE CITY OF SALEM . "
A,3P �J
RALPH W . REID P . L . S .
cn
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i ro / \
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F /
100 ' BUFFER
ZONE
i
1 INCH = 30 FEET
30 0 30 60
26 9' •67•--i
-- 35,33'
----_ NI
NEW o
FOUNDATION
SALEM, MASS
N NEW FOUNDATION
100.00'
S 33'-29'-00" E PREPARED FOR: JULIA ARMSTRONG
LEGEND C L A R K A V E N U E REID LAND SURVEYORS
100 . BUFFER LINE
- _ - WATER
-�- SILTATION FENCE 365 CHATHAM ST . , LYNN, MA
® EXISTING WATER VAL VE
EXIST
0 IMG MANHOLER9243A SCALE 1 =30 ' JANUARY 20, 1993
_
X ELEVATION POINT 91-1
1
LAND COURT NO "SPECIAL FLOOD HAZARD" AREA INVOLVED
LOT 71 COMMUNITY x=250102 0005 B 8/5/85
LAND COURT
0
LOT 72 '
< w
y
LOTS 139 & 140
29, 650 +- S. F _
LAND COURT LAND COURT
LOT 141 Z LOT 138
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0
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100 ' BUFFER
ZONE
1 INCH = 30 FEET
-------- -------i 30 0 30 60
35.33' 24.67' �� I
--- REVIEWED-OK
PROPOSED G i D -�2,3sZ
FOUNDATION-. 24 DO_ 7oyt 7
-�--
CITY ELECTRICIAN
SALEM, MASS .
I
N I
UI I
1
PROPOSED FOUNDATION
1100.00'
S 33'-29'-0V E PREPARED FOR: JULIA ARMSTRONG
LEGFND C L A R K A V E N U E REID LAND SURVEYORS
100 ' BUFF,-P. L NE
h14TF,9
-�--' SILTATION FENCE 365 CHATHAM ST . , LYNN, MA
® EXISTING MA TEA VAL VF
EE
Q 75XJS AX7M04F " SCALE 1 -30 DECEMBER 15, 1992
A
X ELEVATION P0,71T 91_1
r f�.
ONLI{•_ - FIELD COPY
H CITY OF SALEM BUILDING
SALEM, MASSACHUSETTS 01970 PERMIT
Julie Armstrong DATE Jan. 2, a$ 93y�19PgRMIT No 2-93 ,�n7
APPLICANT ADORES _
EPI= {T{.)D.F{ANTE. IrvO.1 ISiFE(11 tC O V 5 L C E N3(1
Ta•
'a ��(�N 2 � NUMBER OF
PERMIT TU (_ DWELLING UNITS) STORY
• IT,nL 01 1NRROv[uE rvTl rvO. IV9OPO3{D USE) �—
AT ILOCATICNI 12 Clark AVen Ward j ZONING �+
DISTRICT_
Irvo.l )STREET)
BET WEE'. ._. AND
CnO3a STa(ETI (CROSS STREET)
LT
SUBDIVISION LOT LOCH 502E
BUILDING IS 70 BE fi, wlpE Nr FT, BV FT, IN HEIGHT AND SHALL CONFORM IN CONSTPUCT ION
TO TYPE _ USE GROUP BASEMENT WALLS OR FOUNGAT ION
EPI= A ONE FAMILY RSVl7 D6VELLING PE1
REMARKS:
CALL FOR PERMIT TO OCCUPY 745-9595
/DO,DO �r
AREA OR /�.ppopnp�/p�(y1
VOLUME ESTIMATED COiTS__' PEq MIT C 618.0
ATE.((ccuubic SOUARE •Feil FEE
OWNER 4ulie rmstrong
ADDRESS 7 Manswell PkW,SWemAMk leo E. 'Premblay
INSPECTOR OF BUILDINGS
UTY OPSALEM
WATER DEPART/7,,.
II
Assistant
•/��� cif '�0/1�
Director •i . Services
x -COMMONWEALTH OF MASSACHUSETTS
='
R cf
^ k DEFAXrMENTOFINDUSTRIAL ACCIDENTS
600 WASHINGTON STREET
aures Gamooec BOSTON, MASSACHUSETTS 02111
�om��ss�one WORKERS' COMPENSATION INSURANCE AFFIDAVIT
(licensee/perminee)
with a principal place of business/residence at:
(City/State/Zip)
do hereby certify, under the pains and penalties of perjury, that:
[ J I am an employer providing the following workers' compensation coverage for my employees working on this
job.
US F9
Insurance Company Policy Number
[ J 1 am a sole proprietor and have no one working for me.
[ ] I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below
who have the following workers' compensation insurance policies:
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
[] I am a homeowner performing all the work myself.
NOTE: Please he aware that while bomeownen who employ persons to do maintenance,construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto arc not generally
considered to be employers under the Workers' Compensation Act(GL C. 152,sect. 1(5)),application by a homeowner for a license
or permit mays evid:nce the legal:tarns of an employer under the Workeri Compensation Act
1 understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' Office of insurance for coverage
verification and that failure to secure coverage as required under Section 25A of MGL 152 cart lead to the imposition of criminal penalties
consisting of a fine of up to $1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 5100.00 a day against me.
Signed t 's day of L1/2-1 19
Licensee/Permittee Licensor/Permittor
r
N Chi of �nlem, ��assachuspaffs
ALL DF,%=Pl-TS OF SLK (0) OR MOF.E. RESIDENTIAL DWELTSPIG
UNITS OR 10,000 SQUARE = OF COI^�4CTAL SPACE
(ROUTING SLIP
REVIEW AND PASS ON AS INDICATED
LOCATION: ( .Ld M" dlUlt LYiLPD�12ti.,
D�AT"E"
APPLICANT. apcur?/�
,UK �L INSERT DATE WHEN PASING ON
AssFssoRs Date
CONTACT PERS • PCARON L 2 2� q Z
OFPARTMFNT. CITY PLANNER � /'2-Z%
r 7JbS
�T a-d��a„cA-Oa( 4,L
3DEPARTMENT' FIRE DFPP.RTDtFTTP � ,
OR
rnNTACT n COPT. TUIIN�..;P�.r!TCR lLAPO'D77, 7 ,
DEPARTMENT: DEPARTtfr CF PUBLIC SEPV.T.CES ^
4 ' .G
CONTACT PERSON: DIRECTOR
S wA'!Tr, nFpmTr�T-w
NARGAREC HA=TY OR
HE?F'N JIAr)OSZ
6 PARTMENT: ELECTRICAL j� r -9Ji
CONTACT PERSON: PAUL TUTTLE
7 DEPARTMENT:
8 DEPARTMENT:
CONTACT PERSON:
RETURN TO
BULTZIFC, DFPART.m-r-%'I'
` CITY OF SALEM, MASSACHUSETTS
PLANNING DEPARTMENT
G-P"10 l:AVAI;AUGN �. h� ONE SALEM GREEN
5'� 01970
LIiY PLANNER (6171744-4580
TO: All developers of six (6) or more residential dwelling units or
10,000 square feet of commercial space
FROM: Salem Planning Department/Building Department
RE: Salem Area Residents Construction Employment Ordinance
-------------------------------------------------
The Salem City Council recently passed the attached ordinance which
requires that all developers of six (6) or more residential dwelling
units or 10,000 square feet of commercial space hire specific
percentages of Salem and Salem area employees for their construction
work.
e
The purpose of the ordinance is to ensure that Salem and Salem Area
residents receive the maximum benefits from the growing construction
ecomcny of the City of Salem.
A preconstruction conference will be scheduled by the Planning
Department to discuss and explain the developer' s requirements as
outlined in the City of Salem Ordinance. The following information
shall be furnished by the developer to ensure compliance with this
ordinance:
Upon issuance of a Building Permit, the developer shall submit to the
ales Planning Department the following requested information:
a. scope of construction;
b. construction time schedule;
c. projected number of employees and man-hours;
d. types of trades to be hired; and
e. names, addresses, and principals of contractors and
sub-contractors being hired.
Upon initiation of construction, all developers shall submit weekly
workforce reports listing the following:
a. names of employees;
b. residential address of each employee;
C. craft of each employee;
d. job category of each employee;
e. hours worked of each employee;
f. hourly wage of each employee; and
g. company which each employee is employed by.
L'.45)
y 'Poo -2,
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APPLICATION FOR
PLAN EXAMINATION AND
092 C �J BUILDING PERMIT
IMPORT -,.Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
AN
fir( �•/�� ///
[BUILDING
AT (LOCATION) 1 // Y G� /Q ZONINGDISTRICT
ATION ////{/� /(na.) (STREET)
BETWEENICi?MA/t fnartccai . IS Mra,/9 2;y Are,
ICRaSS STfl ESTI )CROSS STREET)
LOT ry
SUBDIVISION LOT/ �BLOCK SIZE Jf
Ln
p II. TYPE AND COST OF BUILDING — Ali applicants complete Parts A — D
z
k A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
1 Naw building Reside of Nonresidential
2 [_] Addiiion(if residential, enter number 12 One family 18 ❑ Amusement, recreational
o/new housing units added, if any,
in Part D, 13) 13 ❑ Two or more family - Enter 19 ❑ Church, other religious
number of units- - - - y
3 ❑ Alteration (See 2 above) 20 Industrial
14 ❑ Transient hotel, motel, ❑
4 ❑ Repair, replacement 21 or dormitory - Enter number ❑ Parking garage
5 ❑ units ------- 22 Service station, repair garage
Wracking (!f multifamily residential, / - i- ❑ P 9 9
enter number of units in building in 15 ®Garage 23 ❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation)
17❑ Other - Specify 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNFx RSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, w
`�// 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other - Specify.
9 Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
processing plant, mac.rine shop, laundry building at hospital, elementary
10. Cost of improvement................ school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost 00
a. Electrical....................... 60,
b. Plumbing ! �
y
c. Heating, air conditioning......... `
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT
III. SELECTED CHARACTERISTICS OF BUIL ING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 E Masonry (wall bearing) 40 48. Number of stories.............
Public or private company
31 VWood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, t ,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPEOF WATER SUPPLY
. �y
34 ❑ Other - Speci/y 42 P 50. Total land area, Sq. It. ...........
ublic or private company �(!
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES n
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... X•
35 ,L. )(Gas Will there be control air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Speci/y Will there be an elevotor? Full..........
54. Number of
46 ❑ Yes 47 both rooms
Partial........
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, ane!State ZIP code Tel. No.
owner ar —/ se( y P( ��, k/k� r/ aiy�� /fry(-�s�d
Lessee /di Rra-f/- s . /us���iZ
2. 0 � /J' s Clef Po✓a /ryyrLicenser Na.
Contractor AL
(' 1i&(Y1P /b' N7 n 9°l3
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date PlansB Date Plans B Notes
Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Checkate Dot.
ObDtained Number By Permit or Approval Check obtained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
VIII. ZONING PLAN EXAMINERS NO'fFS
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN For Applicant Use
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