13 CLARK STREET - BUILDING JACKET The Commonwealth of Massachusetts
WBoard of Building Regulations and Standards CITY OF
Massachusetts State Building Code,780 CMR SALEM
Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011
1 One-or Two-Family Dwelling
fYJ', This Section For Official Use Only
Building Permit Number: Date Applied:
wilding Official(Print Name) S *Signatur a Da
SECTION 1: SITE INFORMAITON
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
31 C:lorf� 57 Salem 11A 0070
Lia Is this an accepted street?yes z no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(Il)
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?Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP
2.1 Owner'of Record:
Cd%,.or(( ZI P-4 -'nleim ✓`1A olg7o
Name(Print) City,State,ZIP
31 C,(0 S.}.
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 01 Existing Building❑ Owner-Occupied ❑ Repairs(s) d I Alteration(s) ❑ 1 Addition ❑
Demolition ❑ 1 Accessory Bldg. ❑ Number of Units_ I Other ❑ Specify:
Brief Description of Propos d Work': oce- r-ocxf e
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ ig C)o 6,q 5 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑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: $ 1Q7 SO6.95 ❑Pail in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
� I p (� S 6 9`7 ti
i nel I—�^ IN wf—o License Number Dafe
Name of CSL Holder
SqU S �.
List CSL Type(see below)
In/�5k;ao� oy
No.and Street q Type Description
�P vn 6/ O I P_ rI fi o a 3 5 9 Unrestricted(Buildings u to 35,000 cu.ft.
Restricted 1&2 FamilyDwelling
Cityfrown,State,ZIP M Masonry
RC Roofffig Covering
WS Window and Siding
G SF Solid Fuel Burning Appliances
7� `'Sj fjl7� I 1Insulation
Tel hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 6 6
S y"60?V Q he 544+i0 b1S 1 A6.HIC ompan me or HIC Registrant Name HIC Region Number Ekpifation Date
5 ci o Wd54,ne4-on 5 +
r No.and Street — Email address
PP'j" k,-oke, 11A b2=55 7a -453-66.�3
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 Issuan a of the building permit.
Signed Affidavit Attached? Yes .......... No........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,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.
C0k1 4-rbCf" A++*r_LeGY
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 this application is true and accurate to the best of my knowledge and understanding.
I /I ;G1ineI T- Rufy
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. 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.gov/oca Information on the Construction Supervisor License can be found at www.rnass. oQ v/rips
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"
1�
A olnislon or:
li! RGVONE'
N6NIAIGLAN4 BUILD Bk 60-00E , DUO IONS...
His,Water&b m Damaga ftalrs Our Synergy is Your Solution
Authorization toPerform Repair and Other Restoration Services
� TO jl herein referred to as the "Customer",
authorizes New England Build & Restore ("NEBR"), a division of SynergyOne Solutions, Inc., to
perform any and all necessary repair, mitigation and/or cleaning services on Customer's
property located at:
31 rbi,-� S r 1Pm /�v -,
and with respect to any items that need to be cleaned at a remote location, to remove and clean
such items as necessary.
Direction to Pay: The Customer authorizes COMMGI•Ge-., Insurance
Company (the "Insurance Company") to pay NEBR solely and directly.
If for any reason a check should come to or be made payable to the Customer from the
Insurance Company, the customer agrees to pay NEBR immediately upon receipt of the check
from the Insurance Company. The Customer agrees to pay the Customer's deductible (in the
amount of$ 1 that applies to this claim and also if the loss is not covered by
insurance, the Customer agrees to pay the total amount for services rendered to NEBR
immediately upon receipt of the Invoice Amount.
IT IS FULLY UNDERSTOOD THAT THE CUSTOMER AND ITS AGENTS, SUCCESSORS,
ASSIGNS AND HEIRS ARE PERSONALLY RESPONSIBLE TO PAY ANY AND ALL COSTS
NOT COVERED BY INSURANCE INCLUDING ANY DEDUCTIBLES OR AMOUNTS NOT
COVERED FOR DEPRECIATION WHICH COSTS ARE TO BE PAID TO.NEBR
IMMEDIATELY UPON THE COMPLETION OF THE WORK.
The liability of NEBR is expressly limited to the total amount of services authorized herein. The
Customer further agrees to pay one and one half(1-1/2%) percent per month on any
outstanding balance not paid when due, and will pay for all collection expenses including
reasonable attorneys' fees.
The Customer understands and agrees that NEBR is working for the Customer and not
the Insurance Company or its agent/adjuster.
NEBR Job Claim #: )on k T �
Customer Signature: --- Date: 149 ?e f/;a —
Print Name: EJlu.!&(! 1;21J14kL Z
New England Build&Restore,a division of SynergyOne Solutions,Inc.
590 Washington Street"Pembroke,MA 02359"Toll free 800-649-3293"Office 781-826-7212'Fax 781-826-0240
® www.Synerev0neSolutions.com -
www.neAbr.com
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NOTES
ELEVA TIONS ARE ON THE SALEM CITY BASE. SAL Em. /Y/i`'1
EX/ST/NG CONTOURS ARE SOL/D L/NES / CERT/FY THAT THIS PLAN CONFORMS TO THE OI MED BY
RULES AND REGULAT/ONS OF THE REGISTRY
THIS PROPERTY LIES OUTS/DE THE OF DEEDS
FL 000 HAZARD DIS TRIC T. 6/ O pEp J
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TI/ IAN
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ZON/NG O/STR/CT- R - / SAO�7CHILDS ST.
LYNN MA
SETBACKREOU/REMENTS:
FRONT- /5 <'j SCALE: /" = 20' MAY/990
SIDE- /O'
REAR - 30.
r 4,
L ANDMARK ENG/NEER/NG
NOTE'LOT 8 MUST HAVE 490' OF FRONTAGE ON AN -
1MPROvEO ROAD 8EFow ams Rm T oN B SURVEYING, INC.
L YNN, MA
O 20 40 60
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DECISION ON THE PETITION OF ROBERT J. STILIAN ECR VARIANCES AT 13TCL
S:., 26 BARNES CIRCLE, 30 BARNES CIRCLE and 34 BARNES CIRCLE, hS RS MAP 3
LOTS 81, 82, 85 & 86 BARNES CIRCLE/CLARK SI'REEI' (R-1 )
A hearing on this petition was held August 16, 1989 with the following Board
Members present: James Fleming, Chairman; Messrs. , Febonio, Luzinski, Nutting
and Labrecque. Notice of the hearing was sent to abutters and others and notices
of the hearing were properly published in the Salem Evening News in accordance
with Massachusetts General Laws Chapter 40A.
The petitioner, represented by Attorney Robert Ledoux, is seeking variances for
three of four lots on a proposed subdivision which do not meet the required area
and for one lot .which does not meet frontage requirements. The lots are also
identified on Assessors Mao 3 as lots 81 , 82, 95 and 86. The locus of the
property is in an R-1 district.
The variances which have been requested may be granted upon a finding of the
Board that:
a. special conditions and circumstances exist which especially affect the land.
building or structure involved and which are not generally affecting other
lands, buildings and structures in the same district;
b. literal enforcement of the provisions of the Zoning Ordinance would involve
substantial hardship, financial or otherwise, to the petitioner;
c. desirable relief may be granted without substantial detriment to the public
good and without nullifying or substantially derogating from the intent oi'
the district or the purpose of the Ordinance.
The Board of Appeal, after careful consideration of the evidence presented. and
after viewing the plans, makes the following findings of fact:
1 . Several abutters, as well as other residents of the immediate area, spoke in
opposition to the petition, citing the addition of traffic to heavil;
:raveled adjacent streets, blasing problems, and changes in the drainage
patterns in the area.
The locus could be developed by the petition if the lots were joined.
On the basis of the above findings of fact, and on the evidence presented, the
Board of Appeal concludes as follows:
1 . Special conditions do not exist which especially affect the subject property
and not the district generally;
2. Literal enforcement of the provisions of the Zoning Ordinance would not
involve substantial hardship to the petitioner;
The relief requested cannot be granted without substantial detriment to the
public good or without nullifying and substantially derogating from the intent
of the district or the purpose of the Ordinance.
DECISION ON THE PETITION OF ROBERT STILIAN FOR VARIANCES FOR 13 CLARK ST. .
26, 30 and 34 BARNES CIRCLE, SALEM
page two
Therefore, after a motion to grant the requested variances, with conditions,
was made and duly seconded, the Zoning Board of Appeal vote 0-5 against granting
the requested variances. The petitioner failed to receive four (4) affirmative
votes and, therefore, the variances are denied.
VARIANCES DENIED
James M. Fleming, Esq.
Chairman, Board of Appeal
A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CIT CLERK
dece:nn. if -ny, ein:' ha mide ou,,onnt b ;esticn I' of
Lmws, Ch.;oter :SCS, and sh^H h_ ..._d }.'!'in 20 '_d'Is
.,.onion .n file cCi7e CT the C;/ C:nrk.
a' '
of . CC—t 0 c :r:.e
I' been, r rt a=ue,i t^c L_eo
t - tes, J. ms_ed c ru d i; r cordal in fne £»th Essex
F,; stry or U. ds and indexed under the name or the oiiner of record or
is iecoraed and noted on the owner's Cortificate of Title.
BOARD OF APPEAL'
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FORM A - DECISION
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Ms. Josephine Fusco N
N
City Clerk
City Hall
Salem, MA 01970 o
Dear Ms. Fusco:
At a regularly scheduled meeting of t}:e Sale-. Planning Board held
on June 7, 1990 it was voted to endorse "Approval Under Sub-
division Control Law Not Required" on the following described plan:
1. Applicant:
Robert Stillian
50 S. Common Street
Union 510
Lynn, MA 01902
2. Location and Description -
13=15 Clark Street, Salem
Deed of property records in Essex South District Registry.
Sin/ceer�ellyy�6
Walter Power IIIj
Chairman
WP/sm