5 COLLINS STREET - BUILDING JACKET BE n
CES
the Commonwealth of Massachusetts INSPECTIONAL ER CI OF
Board of Building Regulations and Standards rITY
Massachusetts State Building Code, 780 CIVIR 2014 DEC -2 evlseSO.Ck r'2011
Building Permit Application To Construct, Repair, Renovate Or Demolish a
I One-or Two-Fnrrtlly Dwelling
This Section For Official Use Only
Building Permit Number: D e Applied:
t
Building Oi icial(Print N.une). Signature- Date
SECTION l:SITE INFORMATION`
I.1 Property Addresr. 1.2 Assessors[Slap&Parcel Numbers
Cr
X 5 Of j i /G S 1'
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 'Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq It) Frontage(It)
1.5 Building Setbacks(it)
Front Yard Side Yards Rear Ymd
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§Sd) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone? Municipal❑ On site disposal system ❑
Public❑ Private❑ — Check if es❑
SECTION 2: PROPERTY OWNERSHIP!`
2.1 Ownernof Record:
mg_ LIC
�me(Print) City,State,ZIP
,:;"- gotlrrrvs s— 778 S3G 2 �l�sl�� t✓rst�a'-r
No. and Street Telephone Email Addres
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Altemtion(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work-:
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Itcin Estimated Costs: Official Use Only
Labor and Materiels
I. Building S Q(90.0 d 1. Building Permit Fee:S Indicate how fee is determined:
Cl Standard City/Town Application Fee
2. Electrical S ❑Total Project Cose(item 6)x multiplier x
3. Plumbing S 'PaQtherFees: S 2
4. Mechanical (11VAC) S List:
5. Mechanical (Fire S fatal All Fees:S
Su ression)
Check No. Check Amount: Cash Amount:
G. Total Project Cost:Ty006. 00 ❑Paid in Full ❑Outstanding Balance Due:
00 97(P- M_(993t)
c=> LA,IE�:o 12, 1S /Sefjr IZIS VIA Lt
'SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expim[iun Date
y Name of CSL Holder List CSL'rype(see below)
Type - Description
No. and Street
U Unrestricted Buildin s tip to 35,000 cu. 11.)
R Restricted l&2 F:unil Dwellin
City/Town,Stale,ZIP Ni Mason
RC Rooting Covering
WS Window and Siding
SF Solid Fuel Bruning Appliances
I Insulation
'rule hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
I IIC Company Name or HIC Registrant Name
No. and Street Email address
City/Town,State ZIP Tcle hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.C4 c. 152.$ 2$C(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'
1, as Owner of the subject property,hereby authorize
t9 act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below, 1 hereby attest under the pains and penalties of perjury that all of the information
col in 'n this application is true and. urate to the best of my knowledge and understanding.
' nt + ter's \uthorized Agent's Name(Electronic Signature) Date
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 got have access to the arbitration
program or guaranty, fund under M.G.L.c. 1 J2A. Other important information on the HIC Program cart be found at
1�w%v.mass cov oLa Information on the Construction Supervisor License can be found at w�ov:'dps
2. When substantial work is planned,provide the information below:
Total floor area(sq. 11.) .(including garage, finished basementlattics,decks or porch)
Gross living area(sq. ttJ Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
'l'ypeofcoolingsystem Enclosed Open_
1. Total Project Square Footage"may be substiuted fur"Total Project Cost"
l
1 5 COLS.INB ST
I
f�
C/
June 21, 1993
John A. Herzog
5 Collins Street
Salem, MA 01970
Dear Mr. Tremblay,
In response to your letter concerning illegal use of the garages at the
5 Collins Street address, I am unaware of any such activity. I can only assume
that the individual that made the complaint was misinformed, Also, as of June 2,
1993 I am no longer the owner of this property, . The property has, been sold to
Kevin J. Byrne and I am now a resident of Stoneham, Thank you for your attention
to this matter,
Sincere
J hn A. Herzog
n
Public 11ropertp Department
0
` �nrraPj
iguilding Department
(One Ealem Green
511-745-9595 Ext. 3141
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer
June 10, 1993
John Herzog
5 Collins Street
Salem, MA 01970
RE: 5 Collins Street
Dear Mr. Herzog,
This office has received a complaintof illegal use of garages at the
rear of the above referenced property. It was stated that automobile
repairs were being performed at said location.
Said property at 5 Collins Street is located in an R-1 zoning area,
which is a single family zone. It is illegal to conduct any type
of business in this area without a Special Permit from the Zoning
Board of Appeals.
Please contact this office within five days upon receipt of this letter
to let us know what course of action you will be taken to rectify this
problem.
Sincerely
;
Leo E. Tremblay
Zoning Enforcement Officer
LET/eaf
cc: Ward Councillor
•SENDER: 1.
I also wish to receive the
Complete items 1 and/or 2 for additional se4eices.
• Complete items 3,and 4a a b. following services (for an extra
• Print your name and address on the reverse of this form so that we can fee):
return this card to you.
• Attach this form to the front of the mailplace,or on the back if space 1. ❑ Addressee's Address
does not permit.
• Write"Return Receipt Requested"on the mailpiece below the article number. 2. ❑ Restricted Delivery
• The Return Receipt Fee will provide you the signature of the person delivere
to and the date of delivery. Consult postmaster for fee.
3. Article Addressed to: 4a. A icle Nu ¢er
G a� 9/ 7�
4b. Service Type
❑ Registered 1:1 Insured
Certified
( f1 7 Express M ' Aetur e,Se for
7 h` s
� 7. Date of A4 r [A1.
Q , J
5. Sigpature (Addressa 1 9. Addressge"§ ddres n ' r quested
and fee i pa �� •a
6. Si nature (Agen
PS Form 3811, November 1990 *U.S.GP0:1ea1—zs7-0es DOMESTIC RETURN RECEIPT
UNITED STATES POSTAL SERVICE
Official Business
I II I
PENALTY FOR PRIVATE
,^ ( USE, 9300
Print your name, address and ZIP Code here
Chita of li�alcm, Massar4usetts
publir propertg i9epartment
Suilbing Department
(One ftlem (6reen
500-745-9595 Ext. 300
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer
June 10, 1993
John Herzog
5 Collins Street
Salem, MA 01970
RE: 5 Collins Street
Dear Mr. Herzog,
This office has received a complaint of illegal use of garages at the
rear of the above referenced property. It was stated that automobile
repairs were being performed at said location.
Said property at 5 Collins Street is located in an R-1 zoning area,
which is a single family zone. It is illegal to conduct any type
of business in this area without a Special Permit from the Zoning
Board of Appeals.
Please contact this office within five days upon receipt of this letter
to let us know what course of action you will be taken to rectify this
problem.
Sincerely,
� flay
Leo E.
r' Zoning Enforcement Officer
LET/eaf
cc: Ward Councillor
�ys•.p�6� � 9i - 76�