26 CLARK STREET - BUILDING JACKET T:3
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The Commonwealth of Massachusetts RECEIVED
Board of Building Regulations and Standards INSFtMIOEAL SERVICES
Massachusetts State Building Code, 780 CMR � SALEM
N Building Permit Application To Construct,Repair,Renovate Or Demolish a LU McU1 l ff l & 32
_ One-or Two-Family Dwelling
This Section For Official Use Only
Building Peanut Numbers Date pplied:
Ln
i Building Official(Pont Name) a Signature D
1 SECTION 1:SITE INFORMATION
I� 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
1 26 Clark St Salem MA 01970 03 03-0130-0
1.1 a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R1 Single Family
Zoning District Proposed Use Lot Area(art ft) 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 O On site disposal systm O
Check if yes13
-SECTION2: PROPERTY OWNERSHIP"
11 Ownerr of Record:
William Dunloo Salem, MA 01970
Name(Print) City,State,ZIP
26 Clark St 978-998-9355
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply)
New Construction❑ Existing Building If Owner-Occupied If Repmrs(s) Alteration(s) ❑ 1 Addition ❑
Demolition 0 Accessory Bldg.O Number of Units_ I Other If Specify:_Replacement
Brief Description of Proposed Work : Replacing 1 window, no structural change
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
Item (Labor and Materials Oflleial Use Only .:
1.Building $9,761.00 l i.Building Permit Fee:$ Indicate how fee is datennmed:,
2.Electrical $ O Standard CitylTown Application Fee
❑Total Project Costs(Item 6)x multiplier x
3.Pltmibing $ 2. Other Fees: $
4.Mechanical (HVAC) $ LisL
5.Mechanical (Fire $
S ion Total All Fees:$
Check No. =Check Amount: Cash Amount:
6.Total Project Cost: $9,761.00 p Paid m Full ❑Outstanding Balance Due:
M fa k L_k+--Q v U to
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 90125 10-6-16
Jaime Morin License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
86 Gardner St Type Description
No.and Street
U Unrestricted(Buildings up to 35,000 cu.ft.
Lynn, MA 01905 R Restricted 1&2 Family Dwelling
Cityfrown,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
508-351-2214 I Insulation
Telerihone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
170810 12-23-15
Renewal by Andersen RIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
30 Forbes Rd
No.and Sheet Email address
Northborouoh MA01532 508-351-2214
City/Town, State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 152.J 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.......... 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 Jaime Morin
to act on my behalf,in all matters relative to work authorized by this building permit application.
a'9 Z p 11 Q, /� / �' /5—
Print Owner's Name lectronic 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 a7!!!:=ofdge and understanding.
! e /Y f Ra-r�
Print Owner's or Authorized Agent's Nmne(EI Snature) 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 find under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mess.eov/dms
2. When substantial work is planned,provide the information below:
Total floor area(sq.IQ (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 haWbaths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
26 CLARK STREET
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Gi#g ofttlEm, � ttssttcllusE##s
BEjattrtment of Ilublir Works
PAUL S.NIMAN Y n�inEErin ctilision
CITY ENGINEER � /� �{� THOMAS E.BURKE
DIRECTOR OFPUBLICSERVICES One �ttlem IBregn 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: `
1. No curbing or sidewalks presently exist in the area.
2. Drainage will not be adversely affected.
Very truly yours,
(
; o
Paul S, Niman
PSN/cmc Director of Public Services
cc: Richard McIntosh, Building Inspector
Stephen Lovely, Ward 3 Councillor
Form #81(7/82) Fee Due $10. 00
Ree' d by: ,_�^.
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FIRE DEPARTMENT CERTIFICATE OF APPROVAL-FOR BUILDING'--PERal bgT
cm
To: Head of Fire Department Date. f7 19SZ1
Application for plan approval and Certificate
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.
(R(Ref. Section 113. 5, Mass. State Bldg. Code. )
Job Location: 2[11
Owner or
Occupant:
General /
Contractor: _ ;�nky7eo Address:-4,
Electrical
Contractor: . Address:
Fire Supreas'on
Contractor: w M P. Address:
Notice: Prior to starting work, sub-contractor shall file required form,
Final inspection is required, prior to issuance of Certificate
of Occupancy. Inspections are by appointment only.
Signature of
Applicant: Phone # 77V- `/9,cF
Address of City or ,
'Applicant: J1 - Town:
- -------------------------------------==—=—cccs===
Approval Date: Julv 20, 198tt
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
Occupant: Hewitt Const Co,.. Inc.
Project
Location: 26 Clark Street
Sign a e of Fire Official
This Certificate will a
expire on December 20. 1g81, ltie
Applicant shall submit this Certg.icate of Approval, to Bldg. Insp.
Form #81 (Rev. 7/82)
_
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* ` . City of Salem-
BUILDING DEPARTMENT
FIELD CORRECTION N'O`TICE
LOCATION ! �- ` ' PERMI`T 'NO.
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ISSUED TO
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PERMIT HOLDER AND/OR ALL RESPONSIBILE PARTIES. - -
NOTIGE DELIVERED TO
p nspection, violations of the '- J !-' Sec were in evidence.
The following orders are hereby issued for their correction:
_ PLEASE CAL°L FOR; INSP-ECTION .WHEN:..'CORR:ECTI,ONS HAVE; BEEN COMP,LETED,. ACCEP.TAN:CE .
AND APPROVAL BY AN -INSPECTOR OF THIS,DEp,ARTMENT,IS.REQUI;RED AND MUST BE CORRECT;E,D
.. 1`ON 0R. BEFOR Ell"
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Upon inspection, violation's Sec were in evidence.
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The following orders are hereby,issued for their correction,
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