6 WHITE ST - BPA-15-823 U 4 & 5 G� l ( lo7 `o2-S
The Commonwealth of Massachusetts INSPECTIONAL SERVICES
Board of Building Regulations and TWO S CITY OF
Massachusetts State Buildin ��aI�M�EaV10E t��S-p�y—���RM
► �i 1�15 AUG 12 �eWSedpMarzoil
Building Permit Application To Construct,Repair, Renovate pr`Vett3Slish a
One-or Two-Family, 1 12 A
n(\ This Section For O rcial Use Only
Building Permit Number: Date Ap ed: p jA
"., b /fC
Building Official(Print Name) Signature Dat
' SECTION 1: SITE INFORMATION
1.1 Property Address: Ll1.2 Assessors Map&Parcel Numbers
Lz, A1111r,& ST G1N/TS / OaBS-905
E la Is this an accepted street?yes ✓ no Map Number Parcel Number
u 13 Zoning Information: 1.4 Property Dimensions:
-Pl Idefi� /a6(0
I 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,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone?
Public Ild Private❑ _ Check if yes❑ Municipal On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
,SRNI>i/✓. lylA/CT/i✓ SAZL7/_" /I2/51 0/97 O
Name(Print) City,State,ZIP
sAst�/,r�martl��ret�a�/.
No.and Street Telephone mail Address
SECTION 3:DESCRIPTION OF PROPOSED WORK (check all that apply)
New Construction❑ 1 Existing Building R1
Owner-Occupied Repairs(s) 91 Alteration(s) Addition ❑
Demolition Pf Accessory Bldg. ❑ 1 Number of Units Other ❑ Specify:
Brief Description of Proposed Work :
sisp-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ Q�� "— 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
D oOD ❑Total Project Cost (Item 6)x multiplier x
3. Plumbing $ 00 _ 2. Other Fees: $ Lam_\
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 7S�OD ❑Paid in Full ❑Outstanding Balance Due:
1'nA1.�o 8�1�
V
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SECTION 5: CONSTRUCTION SERVICES
5.1 C �no�o rvisor Lie(CSL) CS— 0�+Od�V
ell License Number Expira
Name of CSL Holder
List CSL Type(see below)
YO erh Ave .
No.and Street Type Description
/��/� p U Unrestricted(Buildings u to 35,000 cu.ft.
/ r A �!l /p�9 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
INS Window and Siding
SF Solid Fuel Burning Appliances
nd I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HiCiR�egist�rattiion Number Expiration Date
HIC C
y�notp�JOf.[Y-/teY/legirlJ e ( t��z�Q✓h hl i .
No.and Street Email address
E' er MA bLc!a!3_ 929-Xg-MO
City/Town, State,ZIP Telephone
SECTION 6c 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 .......... M-' 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�Iincl Id lled
to act on my behalf—ult all matter eta 've to work authorized by this building permit application.
wne '� ne( ctro ignature) - Date
SECTION 7b: OWNER' 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=toof�myjalowled and understanding. ,
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.mass.gov/d s
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) 3Ag- (including garage,finished basement/a/tl s decks or porch)
Gross living area(sq.ft.) �J630 Habitable room count /�
Number of fireplaces 7 Number of bedrooms y
Number of bathrooms 91 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"
Work to be performed at #6 White St. Units 4 & 5
Basement:
- Cut&frame a 4'opening between the 2 basements
- Remove one stairway(unit#5)
- Install lights and outlets
1"Floor:
- Cut and frame a 4'opening between kitchens(combine into 1 kitchen)
- Cut and frame a 3'-6" opening between dining rooms
- Cut and frame a 4'opening between living rooms
- New hardwood floors in unit#5 to match unit#4
- New interior door and trim in unit#5 to match unit#4
- Remove% bath
2nd Floor:
- Renovate bathroom
- New interior door and trim in unit#5 to match unit#4
- New hardwood floors in unit#5 to match unit#4
3`d Floor:
- New hardwood floors in unit#5 to match unit#4
- Install recessed lighting
- New hardwood stair treads
- Remove exterior none support wall between decks
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CITY OF S.0 E'N1, NWSACHUSETTS
&1LDIING DEPARTNm\-r
• P• 120 WASHNGTON STREET,3" FLOOR
e� T EL (978) 745-9595
FAX(978) 740-9846
KINtBERLEY DRISCOLL
T
MAYOR 3tOb(AS ST.P[ERAfi
DIRECTOR OF PUBLIC PROPERTY/BUUM NG COJL%USSIONER
Construction Debris Disposal Affidavit
(required for all 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# 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:
(name oT hauler)
The debris will be disposed of in
(name a of facility)
Acz 14-aiA S/. GMIJOWn, /WA 01533
(address of facility)
\signature of permit applicant
—�
date
dcbriutld<x
-- 011ie•ul(ens a na i Ul Miles&.Rani ness Regulation License or registration valid for individul use only
!�;� iHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 135141 Type: Office of Consumer Affairs and Business Regulation
.E�' Expiration: V30I2016 Private Corporatior, 10 Park Plaza-Suite 5170
Boston,MA 02116
DAN REED. INC.
s
DONALD REED - J
Q SOUTHERN d-VE. /...!—
I4idersecretary of valid without signature
I 'Aassar,husetts - Department of Public Safety
Hoard of Building Regulations and Standards
moruction Supen'isor
License: CS-060080
DONALD REED 4.� ' _
40 SOUTHERN AVE z
ESSEX MA. 01929 I
-r
Expiration
Commisswner 0 410 9/2 0 1 6
i CITY OF S. I. A1, NAXSSACHUSETTS
• BtiILDLNG DEPART%IENT
• p 120 WASHINGTON STREET, P FLOOR
dj TEL (978) 74S-9595
FAX(978) 740-91M
1C1JffiFRi FY DRISCOIL
THOMAs ST.PI£RR&
MAYOR
DIRECTOR OF puBLIC PROPERTY/BI a=NG C01%MSSIONER
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business:OrWizationAndividu/al):
Address: zo
City/State/Zip:/ES_ RA OL922 Phone #: '775? - 76S?- 68/0
Are y an employer?Cheek the appropriate box: Type of project(required):
1.01 am a employer with 4. ❑ I am a general contractor and 1 6. ❑N construction
employees(full and/or part-time)."' have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner- listed on the attached sheeL t 7. Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working forme in any capacity, workers'comp. insurance. 9. C] Building addition
[No workers comp. insurance 5. ElWe are a corporation and its IO.Uv Electrical repairs or additions
required.] officers have exercised their
3.❑ 1 am 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.❑Roof repairs
insurance required.]t employees.[No workers' 13.❑Other
comp. insurance required.]
•Any applicant that citecits box M I must also fill out the section below showing their workers'compensation policy infurmation.
'I trxrteowner who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating such
:Contractots that check this bolt most atmchcd an additiorul sheet showing the name of the sub-contractors and their worker'comp,policy ioformattoa.
I am an employer that is providing workers'compensation insurance for my employees. Below Is the policy and Job site
fnformmion. 1
Insurance Company Name: C Cf/Q t, .ems CO
Policy 4 or Self ins. Lic.#7: pp IVC_V 0 00 G721zi Expiration Date: a
Job Site Address: 6 Ltlt ,I S • City/StatetZip: 019 70
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 132 can lead to the imposition of criminal penalties of a
fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
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 or the DIA for insurance coverage verification.
I do hereby c rider the pains and penaid jperya that the information provided ab ve/i3,true and correct
Signature: —cota� Date:
Phone#:
Official use oily. Do not write in this area,to be completed by city or town ayftciaL
City or Town: PermidUcense#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.Cily/town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
- 15- $ �3 (o Si
Units 4 and 5 Construction Proposal
Carol Naranjo and Sandy Martin hereby present to Nathaniel's Landing Condominium Association owners and Trustees
this proposal to combine the two units 4 and 5, both owned by Carol Naranjo and Sandy Martin.
The proposal includes all of the plans submitted in the architectural rendering drawn up, certified and dated by Ed
Nilsson of Nilsson and Siden Associates, a professional architectural firm based in Salem, MA and licensed by the state of
Massachusetts.
This proposal includes a breakthrough passageway in the basement adjoining the units;a walkthrough passageway on
either side of the fireplaces adjoining the two units on the Vt floor; eliminating the half bathroom in Unit 4 on the 1'`
floor, and extending the kitchen area into Unit 5 on the 1"floor. There will be no breakthrough on the 2nd floor. The
deck divider will be removed on the 3'd floor, conjoining the two and making the 3rd floor deck into one.
All work will be done in a professional manner, using high quality materials, high quality workmanship, and will follow
any and all pertaining construction laws and regulations, including obtaining any pertinent and required construction
permits from the Building Department of the City of Salem.
Please sign and date:
Date: a ��
Denise McCauley, rustee; 9w1 Unit 1
0, Date:
Jame alfitano,Trustee;owner Unit 2
�, �r' Date: �sl
Vahessa Ma fit o,owner Unit 2
r Date:
)Jn Bur ,own nit 3
t fC� Date: rJ
die Burke,owner Unit 3
0000/
Date:_4 /1
Carol Naranjo,Trustee, owner U t 4,5 �--
Date:
Sandy er Unit 4,5