11 WILLIAMS ST - BUILDING INSPECTION (2) PUBLIC PROPERTY
DEPARMAYORT>tiIF��JT
ju.
SnYsy MAiSAQ/l:shll3 01970
nt L-979-745.959S•Fex:973.740.98"
APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION,
DEtitOLITION. OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTLNG
STRUCTURE OR BUILDING
1A SITE INFORMATION
Location Name: Building:
--- Property Address:— 11 ..
II VV1� t4 S JI
Property Is located In a; Conservation Area M Historic District Y
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land S'kLAVjyjoA
Name:
Address: ,
c5'a A -0
Telephone: !
3.0 COMPLETE THIS SECTION FOR WORK IN EXRXING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation ! F'oo
of existing building I I New
Brief Description of Proposed Work: /
c
"IG /S X fw/,q, a —�,r\/ , /deck- LIVA S Vvuc
Off (eolr of F.eS(�C� / Von I,,, wcs
groAJ(d o ki g-ola(� 3' �� Sfde yid
---Mail Permit to: -----
What is the current use of the Building? �c AA r F 2-
Material of Building? 2)onl If dwelling, how many units?
Will the Building Conform to Law?
Asbestos? AJ•
Architect's Name
Address and Phone j
Mechanic's Name
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost of Project
U60 J Permit Fee Calculation
Permit Fee SC' Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/1111000 Commerc"I
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build t the above stated
specifications. Signed under penally of perjury X
Date
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1 � W
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96
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CrrY OF SALm&
PUBLIC PROPE M
DEPArnAENr
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The ddwls will be dimpow d of in: 1
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due
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
xntasttsav scou
WYM 120 WAtratWrW SUM•
Sa[rss.IdwWgittstiTIS 01970
Its:M745-"" a FAX:M740.n%
Workers' Compensation Insurance Affidavit: Bnilders/ContractoraMectridans/pinmbers
Applicant Information an Print/ .gi .ti.
Name( "):_&,b a 0 s �c• �cl i`��/ i�
Address: Q� a e lz -7
City/Statel2ip:_ /l e//i 12 Ire' IU i`7 Phone# 6� 3 33-- b�%s
Are you as employer?Check the appropriate boss Type of 1.❑ I am a employer with 4. ❑ I am a genes]contractor and I i�1 ( :
employees(!all and/or part-time).• have hired the tub conaacoon 6. ❑New caasauction
2.❑ 1 am a sole proprietor or partner. listed on the attached sheaf.t 7. ❑Remodeling
ship and have no employees These have 8. ❑Demolition
working for me in any capacity. workers'comp,insurance.
[No worker'comp. insurance 5. ❑ We am a corporation and its 9. ❑Building addition
1equired-1 officers have exercised their 10.13 Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MOL 11.[]Plumbing repair or additions
myself.[No workers'comp, a 152.j 1(4),and we have no 12, Roofrepair/
insurance required.]t employees.[No workers' 13;�Other_ air P G f comp.insurance required]
;Any sPP�err curb Non[e1 mint WIND all out the armor hdow showing a k wakwa -
Hamaowh ess who nhhmit thk ah d"mNama amf'on&dog ch weds and sue him DDW&om multi�pew INlltaplt
tCoawnemm do cheek shin ism mina aaeehed as a i t pod short showing am mine otsM 'eft
momemoommo� sod their woskma'camp pay Wfm=adm
am an rrrINpfoya tlYas/s provldLrs worbn'ln cowpewsadow lasarmrcejo�try raeployrea Below 4 Nb pn!!ry ow/Jof Me
Insurance Company Name:
Policy N or Self-ins.Lie,N Expiration Date:
Job Site Address: Citylsttte/Lip:
Attacb a Copy of the workers'compettsadon policy declaration page(sho
wWg tM podgy number and explratloa dap).
Failure to secure covergo as requited under Section 25A of MGL c. 152 can lead to the
fine up to S 1,500.00 and/or one-year imprisonmenR as well as civil penalties in the form of imposition TOP WORRK OR EAR and es Ora
f fine
of up to 5250.00 a day against the violator, Be advised that a copy of this statement may be forwarded to the OfiSce of
Investigations of the DIA for in nuance coverage verification.
I do hereby cerdA rn r Pahn�mrd pew�,of PJ4 rhat fibre j nwadowprovided about 4 arse and corrrd
Phone#: 00 ? ) 2 3 5'
DJkW use ox4t Do not write In this area,to be cossiokW by aV or town Ohlc a(
City or Town: PermittLieense N
Issuing Authority(circle one):
1. Board of Health 2.Building Department 3.Cltylrown Clerk 4. Electrical Inspector 5.Plumb(as Inspects
6.Other
Contact Person: Phone 0:
Information and Instructions
«s General Laws chapter 152 requires all employers to provide workers' compensation for their employees-
pursuant to this statue,an ewp(oyee is defined as"...every person in the service of another under any conmacj of hire.
r
express of implied.oral or written"
association,won deceased
other legal entity,or any two or mom
An earp(oyer is defined as"an individual,panaenh* legal representatives of a deceased employer.or the
of the foregoing engaged in a joins entapdse.and including receiver at trustee of an individual,pummsbW, enuty.emploYloa�►oYep However the
association a orbs legal
0e and who resides therein.or the otx rich
d
owner of a dwelling house 1havingthan am R
threewelling house
of the
dwelling house of another who employs persons to do ma nteasnea,consmrcton or Must degmed to bsan employer."
a on the grounds building appurtenant thereto shag not because of such employment
that"every state or local Heneft agency shag withbotd the W=m Or
MGL chapter 132.$2SQ6)also MOM rK to eoastrod bntldlsgs is the eommemwealH(or any
teaewal t a license hasor permit to operate acceptable businessnapbstaft with tW learomnee coverage required,"
a�coal has not per 152ed5Q7) toevidence of a common
appal MGL chapter 132,$23C(�state+"Neither the commonwealth not any of its pow sv>tb the��
subdividow shall,
A di� � cmtrad for the paformaoce of public wah until acceptable evidence of comp
requirements
an of this chapter have him presented to the Contracting authosity."
Appneuts
compensation affidavit completely.by checking the boxes that apply toyour situation and,if
Please fill out the workers'
-tods name(s),address(es)and Phone number(s)along with their catifiata(s)of than the
necessary.supplyr ; Liability Companies(I LG7 or Limited Liability Partnerships(ice with no employee
insurance. es carry wakes•compensation insurance- if an LLC a LLP does have
members or parmae.are am required Be d that this atBdaviYinay he submitted to the Department of Industrial
employees,a policy is Hof iaserance coverage. Abe be a=*to sigh and date the amdaviL The affidavit should
Accidents t the city nos application for the permit a license is being requested.not the Department
be tetutned to the city or town that the the law a if you as required to obtain a workers'
lodustzial Accidents. Should Yet have enY number
Salt-insured should eater thait
compensation Policy.plan call the Deparmoeat at do
tmmbambec bated below.
self insuenee unseen number on the
City or Town Offload
and rimed legibly. The Department has provided a space at the bottom
Please be sera that the affidavit is complete P
of the affidavit for you to
fill out is the evens the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the perroWliceme number which will be used as a reference Wombat. In addition,as applicant
that must submit multiple permitAlceaaa apPl °OOi to any liven year,need only submit one affidavitindicati
ng Correa
nary)and under"Job Site Addrem"the applicant should write"all locations in--to the or
policy information(if twees marked by the city or town may be provided
town)."A copy of the affidavit_ Itt. been officially stamped or or licenses. A caw aM&vk must be filled out each
applicant as proof that a valid affidavit is on Elite f permit not related to to any business or commercial venture
year.Where a home owner a citizen is obtaining a license a to lets this affidavit
(i.e. a dog license a permit to bum lava etc.)said person is NOT required complete
ou in advance for your cooperation and should you have any questions.
The Office of investigations would like to drank y
please do not hesitate to give us a call.
The Departmenes address,telephone and fax number:
TM `OOpwedth Of Manwhusetts
DVUUMW of ln&uMd Awdt its
OtIIa of 1Javesdpdons
600 washmgm Street
Boston,MA 02111
Tel. it 617-727-4900 Old 406 or 1-877-MASSAFE
Fax 0 617-727-7749
Revised 5-26-05 www.mass pv/dia
. ON01T CITY OF SALEM, MASSACHUSETTS
BOARD OF APPEAL
120 WASHINGTON STREET. 3Ro FLOOR ,
SALEM. MASSACHUSETTS 01970
TELEPHONE: 978-745-9595
FAX' 978-740-9846
KIMBERLEY DRISCOLL
MAYOR
�n -
J
January 10, 2007 -
Decision
Petition of Shannon Engelhardt requesting a Variance
for the property at 11 Williams Street
City of Salem Zoning Board of Appeals
A public hearing on the above petition was opened on December 20, 2006 pursuant to
Massachusetts General Law Ch. 40A, Sec. 11. The following Zoning Board members
were present: Nina Cohen, Bonnie Belair, Steven Pinto, Elizabeth Debski and Robin
Stein.
The petitioner, Shannon Engelhardt, sought a Variance to the side setback requirement of
ten (10) feet to three and one-half(3 'h) feet to allow construction of a two (2) story deck
for the property located at 11 Williams Street, Salem, in the Two-Family Residential
District (R-2) zoning district.
The Board of Appeals, after careful consideration of the evidence presented at the public
hearing, and after thorough review of the Petition submitted, makes the following
findings of fact:
1. The property at 11 Williams Street is within the R-2 zoning district.
2. The petitioner is requesting a variance to the side setback requirement ten (10)
feet to three and one-half(3 '/2) feet to allow construction of a two (2) story
deck.
3. The proposed deck will be a ten (10) by fifteen (15) foot deck with stairway.
4. One member of the public spoke opposed to the petition due to the petitioner's
contractor having to access the site via her property.
On the basis of the above findings of fact, including all evidence presented at the public
hearing, including, but not limited to, the Petition the Zoning Board of Appeals concludes
as follows:
1. The petitioner's request to for a Variance does not constitute substantial
detriment to the public good as the use of the deck will not cause a substantial
impact on the neighborhood.
2. The requested relief does not nullify or substantially derogate from the intent
or purpose of the zoning ordinance as deck structures are frequently attached
to residential structures in the R-2 District.
3. A literal enforcement of the zoning ordinance would create a substantial
hardship to the petitioner by unfairly restricting the usage of their property.
4. In permitting such change, the Board of Appeals requires certain appropriate
conditions and safeguards as noted below.
In consideration of the above, the Salem Board of Appeals voted, five (5) in favor
(Cohen, Pinto, Debski, Stein, Belair) and none (0) opposed, to grant the request for a
variance, subject to the following terms, conditions, and safeguards:
1. Petitioner shall comply with all city and state statutes, ordinances, codes and
regulations.
2. All construction shall be done as per the plans and dimensions submitted to and
approved by the Building Commissioner.
3. All requirements of the Salem Fire Department relative to smoke and fire safety
shall be strictly adhered to.
4. Petitioner shall obtain a building permit prior to beginning any construction.
5. Exterior finishes of the new construction shall be in harmony with the existing
structure.
6. A Certificate of Inspection is to be obtained.
7. Petitioner is to obtain approval from any other City Boar
d or Commission having
jurisdiction including, but not limited to, the Planning Board.
8. Unless this decision expressly provides otherwise, any zoning relief granted does
not empower or authorize Petitioner to demolish or reconstruct the structures(s)
located on the subject property to an extent of more than fifty percent (50%) of its
floor area or more than fifty percent (50%) of its replacement cost at the time of
destruction. If the structure is demolished by any means to an extent of more than
fifty percent (50%) of its replacement cost or more than fifty percent (50%) of its
floor area at the time of destruction, it shall not be reconstructed except in
conformity with the provisions of the Ordinance.
9. The petitioner shall supply insurance certificates to the Building Inspector and to
their abutters prior to the issuance of a Building Permit.
1�
Eliza eth Debski
Salem Zoning Board of Appeals
A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY
CLERK
Appeal from this decision, if any,shall be made pursuant to Section 17 of the Massachusetts General Laws
Chapter 40A, and shall be filed within 20 days of filing of this decision in the office of the City Clerk.
Pursuant to the Massachusetts General Laws Chapter 40A, Section 11,the Variance or Special Permit
granted herein shall not take effect until a copy of the decision bearing the certificate of the City clerk that
20 days have elapsed and no appeal has been filed,or that, if such appeal has been filed,that it has been
dismissed or denied and is recorded in the South Essex Registry of Deeds and indexed under the name of
the owner of record or is recorded and noted on the owner's Certificate of Title.