24 CLARK STREET - BUILDING JACKET :) I'Ile C'ontnwmccalth of hfassarhuscus
hoard of fluilding Regulations ;mJ St;lndards CI I'Y OF
+I. biassarhusclts St;tte Building Cute, 790 C'AIR SALEM
L„
Building Permit ,lpplicatitsn TO Construct. Repair, Renovate Or Dcnn,lish a N,•ri,c,f Il,u
One. or flrn-f„noll. a+V,•141r1?
This Section For 0 rcial Lf Onl
Building Permit Number: Date.\ppl' J;
IludJing OIIhmI IPrint N;une) Signature
Dale
SECTION 1: SITE INFORAIATIO
L 1 -ffa
- 1.2 Assessor Ala dt Parcel Numbem
I.la Is this an acre led street? 'es no Ai-'p Nunsher Parcel Nuusher
1.3 Zoning Informatlenl 1.4 Property Dimension:
Luniny District I'ropnxeJ llsa Lol Area Is III V Frontage III)
1.5 BuIlJlns Setbacks(R)
From Yard Situ Yards Required Provided Required ProvidedRCyU1Rd Ruar Yard Provided
1.6 Water Supply:IM.G.I.e. 40, §14) l'? Flood Zone Information: 1-8 Sewage Disposal System:
Check
Ihtbllc O Pris ate O Zone: Outside Flood Long? Munici al O On site disposal s)slum C
k If es0 P
SECTION2. PROPERTY OWNERSHIP'
2.1 0 of Retor
eGN; su(Prnu
�y City.state,uP "
Nu..ud—'SIKCi felC
P one F.muil Address
SECTION J: DESCRIPTION OF PROPOSED WORK'(cheek all that apply)
New Construction l] Existing 8uilIII O Owner-Occupied ❑ Repairs(s) O Alteration(s) O Addition 0
Demolition O Accessary : Wit.O Number of Units_ Other O speedy:
Driaf Deseriplion of Proposed Work':
r
SEC ION 4: ESTIMATED CONSTRUCTION COSTS
Itenl Estimated Costs:
i Labur and.\h1crials) 0Mc1a1 Use Only
I. OuilJiny f I. Buildiny permit Fee: f Indicate how toe is determineJ:
'. FIvorical f O Standard CityTuon Application Fee
t I'lunihing S O Tutal Project COst'I Item 6)x multiplier
'. Other Fees:
I J. \ici h,miad ill\ W) S List:
\IcdI.11m.J i Fv¢ --
1 fotai \lt Fier: $
r. Total Prnjc'ct Cust S J _p CIT"k vu. _. .__ChccA AMMIuc
(� ❑ P lid in Full ❑Outstanding Ilal,utce Due:
SF.( I 10N .5: CONS URUC)'IOIN SFR%"(
5.1 C'u Ichars Su en usur If St.)
✓ !,2
V.0 to'If LIQL I ftIJVr 01 1'. N 1,4,!b6m)
F) Hesuiplion
pe
�K(:
S ... ... .id sidilill
SF soli)1.*Uk:l litiming
..................
—�l mail Ajmss
'Cl hone
r
overneril Contractor(IIIQ
1,1 Rtglslertd 110010 rail �i
lilt It4""'i'anp....
111CCoHIPM) Nan1e"I IIC NugistrwriName IM-31,—add—re—s �
No. wid Sued
Ci wn, state,ZIP role hone
i /Town Slate ZI
��WORKERS'C 0. 1 P
_:C� NCE AFFIDAVIT(M.G.L C. 153.1 25C(6))
SECTION 61 COMPENSATION INSURANCE
�vv*w_
N3U
I. _ witht"hisap lication.7Failure to provide
ed with this�appllcsft . Failure to provide
Workers Compensation Insurance affidavit must be completed:and submitted
this atYIdavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? yes .......... (3 NO...........C3
' TOBECOMPLETE WHEN
——————��.Ivlfipv 7s:OWNER AUTHORIZATION
OWNER'S AGENT OR
tACTOt APPLIES�FOR BUILDING PERRNIIT
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,
�Mtd
Print Otvncr'sNwiia(E 'tru"i
EC I 7b: OWNEWOR AU I tlunlZ --ENT DECLARATION
By cote ing i in below.. hereby attest under the pains and penalties Of perjury that all of the inrarmation
contain i his p i ation true and accurate to the best of my knowledge and understanding.
Oale
o4o'rES:
stcred conwwor
uran o%vner shave
an unrelit
ho obtains a building licrinit to do hishe bitration
Cr\� I ptovelligniCutitrnt;tur(HIC) Flragrant),�villdtahavgac�csslolhtar
(Ilut registtred in the Hu'lle 11 on the HIC Prograin can be found at
pragriol or guarant) Nod UnderM.G.L. c. 14-I.A. Other illipurtant information
t 111rormation on the Construction Supervisor License cin be round at,�
U, P the i1trurinatiun below: decks or ror0i I
2 11 en substantial i%ork is Piall— including garage, Ililished bascinvilt 311i",
rota) ti%iovirci 1'4. Hobilable WWI' eOtlllt
Groii lit 1119 Ife't 154- 11 of bedrooms
\111111,Vr of lirvi'lacei \tJJ11hQr of liall hailli
Ntlolhvr'10allirt,01111 \11,11heroid"Its 110rdics
I livot livMilig '),M11 Flljo,cd
I I,Q of 01"11114 i.%ovill l'o,
11roi,:0 c,luAN ):Ool"tc 111,1.\
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(� P( p,,24'5:wnr)g4Z�rnJ ��TDOM3_
the Commonwealth of Massachusetts
�Board of Building-Regulations and Standards CITY
Massachusetts State Building Code, 780 CMR, 7ih edition`. OF 3ALEM
t Revised✓mtuury
Building Permit Application To Construct, Repair, Renovate Or Demolish a 1. =0014
One-or Ttvo-Family Dwelling
This Section For Use Only -
Building Permit Number: zDate Appli
Signature: _
13ui1 ing Comimssio er/I ec o w dings Date
01, SECTION Q SITE INFORMATION
Ll Property A 1.2 Assessors,Map& Parcel Numbers
I.Ia Is this an accepted street?yes_ no Mao Number Parcel Number
1.3 Zoning Information: -1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(11)
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,§34) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone'?
Public❑ Private❑ Check ifyes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 OwnertU
Name(Prim AJdre r Service:rq n -
Signature ` Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check a tat apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) &I Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other P Specify:
Brief Description of Proposed Work'-:
SECTION 4: ES IMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials
I. Building $ I. Building Permit Fee: $ 19JieatePow fee is determined:
❑Standard City/Town Applicat on Fee
2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (FIVAC) $ List:
5. Mechanical (Fire $ Total All Fees:$
Su ression
Check No. _Check Amount: Cash Amount:
6.Total Project Cost: $ l 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 License nstruction ' ervisor(CSL)
L.iccnsl Nu�r I cpir tiu Ual
Nam- 'G'l. IIoJ
List CSL Type tsce below)
:\ ressr" Description
lJ Unrestricted a to 35,000 Cu.Pt.
R Restricted 1&2 FamilyDwelling
aloe n` M Mason Only
D � -- RC Residential Rooting Covering
I'clephone _ _ _ WS Residential Window and.Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition 5.2 Registered Hom-c.la la em n C n(_ - pi ' '
li piny i ne IC a� am RI na uber
L
A r ss
Expiration ate
re 'telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 25C(6))
Workers Compensation Insurance affidavit must be co pleted and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuan the building permit.
Signed Affidavit Attached? Yes .......... Qf 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 to act on my behalf, in all matters
relative to work authorized by this building permit application. -
Signature of Owner Date
SIECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
I, as Owner or Authorized Agent hereby declare
that the statements a formation on the foregoing app!cation are true and accurate,to the best of my knowledge and
behalf.
Print Name /
Signatures n orNothorizedfAierft Date
Si meJ under the airs and penalties orperjury)
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 W 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 I IO.R6 and 11025, respectively.
27 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(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"
24 '-CLARK STREET
� t
U..IA
CERTIFICATE OF OCC. ANI,,
CITY OF SALEM Issuedc29'/ Permit#: I
Dept Dept.
SALEM, MASSACHUSETTS 01970 City of Salem Building
DATE19 PERMIT No.
ADDRESS
'4r9EEIF (CCINTR S LICENSE)
APPLICANT (No
CITY STATE -ZIP CODE TEL.NO.
NUMBER OF
PERMIT TO STORY DWELLING UNITS
(110PIS61 USE) ZONING
AT(LOCATION)
DISTRICT—
BETWEEN AND
(GROSS STREETI. (GROSS STREETI
LOT
-
SUBDIVISION LOT BLOCK—
SIZE
BUILDING IS TO BEFT.WIDE BY FT.LONG BY FT.IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP— BASEMENT WALLS OR FOUNDATION (TYPE)
51
7
REMARKS: if'
PERMIT
AREA OR ESTIMATED COST$ FEE $ L7
VOLUME
(cublubuuARE'EE')
OWNERL'z7IJ:�:=, -i BUILDING DEPT.
ADDRESS ,L,-7
k, I ,=
�—7 BY
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY ENCROACHMENTS
Form #81( 7/82) Fee Due $10. 0 0 �~
Recd bys v.>,
Ck# Cash �C
A. C�t#V of "Salem, tt tt c rix e
'f4 kl��Map1 Aire Pepurtmeut Peabquarteln ry -
Taman 48 T�dgLtte ',iitreet
GIl�ief \\ nO Sa6n, Au. II137A D s" z
FIRE DEPARTMENT CERTIFICATE OF APPROVAL-FOR BUILDING�?ER�
Tot Head of Fire Department Date: L19
Application for plan approval and Certificate a c—
In accordance with the provisions of the Mass. State Building Code and
Salem Fire Code, application is hereby made for approval of plans and
issuance of a certificate of approval for a building permit, by the
Salem Fire Department. (Ref. Section 113. 5, Mass. State Bldg. Code. )
Job Locations Ic
Owner or
Occupant: ,
General
Contractors Address: r o.
Electrical
Contractorsc —Address: , h
Fire Supres ion,
Contractors coAddress:
Notices Prior to starting work, sub-contractor shall file required form
Final inspection is required, prior to issuance of Certificate
of Occupancy. Insp ctions are by appointment only.
Signatureof I
Applicants Phone # Z� y�%� n
Address of City or
Applicant: Towns
e------------
Approval Dates July 20, lsBL
Certificate of Approval is hereby granted, on approved plans or sub-
mittal of project details, by the Salem Fire Department.
All plans" are approved solely for identification of type and location
of fire protection devices and equipment. All plans are subject to
approval of any other. authority having jurisdiction. Upon completion
the applicant or installers shall request a test or inspection, and
the installer shall file a Certificate of Completion, if required.
Owner or
Occupants Hewitt Consst Coo, Ince
Project
Locations 24 Clark Street
igna le of Fire Official
This Certificate will
expire ort Deoamber 20, 1981T_ Titie
Applicant shall submit this Certificate of Approval, to Bldg. Insp.
T,_ Form_#8l_(Rev. 7/82)
��.
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.,,.. ,
�I r r,
Gitg of "qttlem, lylassarljuset#�
Brpartmertt of Public Works
PAUL S.NIMANyjjjTePrjjt$ �jljjsjIIYl
CITY ENGINEER /gyp D {�' THOMAS E.BURKE
One ne ' jalrm (Seu
rrt ASSISTANT DIRECTOR OF PUBLIC SERVICES
January 23, 1985
Mr. Harry Hewitt
Hewitt Construction Co. , Inc.
18 Verdon Street
Salem, MA. 01970
RE: Sidewalks - Waiver
Dear Mr. Hewitt:
I have reviewed your request for a waiver of curbing and sidewalks for lots 24, 26,
and 28 on Clark Street. Additionally, I have discussed the waiver with Ward 3 Councillor,
Stephen Lovely.
In accordance with Chapter 26, Section 105 of the Salem Code of Ordinances, I
hereby grant your request for a waiver of both curbing and sidewalks based on the
following:
9
1 . No curbing or sidewalks presently exist in the area.
2. Drainage will not be adversely affected.
Very truly yours,
Paul S, Niman
PSN/cmc Director of Public Services
cc: Richard McIntosh, Building Inspector
Stephen Lovely; Ward 3 Councillor
.� �
IS VEROON STREET - SALEM, MASS.
® BUILDERS ® CUSTOM HOMES COMMERCIAL BUILDING
® Financing Arranged
k
January 14, 1985
Mr. Paul Niman
Director of Public Services
Salem, Mass.
Dear Sir:
I wish you would consider my request for relief from the city
ordinance requiring curb stone at lots 24, 26, and 28 Clark Street.
The area is one where sidewalks, grass plots and curbing do not
currently exist. The location and width of the road also create a
problem. I have discussed this problem with you before.
Thank you.
Very t my your ,
itt
Hew-tt Construction Co., Inc.