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90-92 CONGRESS STREET - BUILDING JACKET 90. 92 CONGRESS' STREET - Cite of harem, f aggarbugettq t Public Prmpertp Department AuiCDing department ®ne%alem Oreen (978) 745-9595 ext. 380 Peter Strout Director of Public Property Inspector of Buildings Zoning Enforcement Officer November 24 , 1998 Julio Baez 90 Congress Street Salem, Mass . 01970 RE : 90 Congress Street To Whom it May Concern : It has come to our attention that apartment 4F and 4R have more residents than the city zoning ordinance allows . This problem must be rectified immediately. Please contact this office as soon as possible. Thank you for your anticipated cooperation in this matter. S'-_n y, E' I •�n Peter Strout Zoning Enforcement Officer PS : scm Citp of Salem, 'ffla!5garbU5ett5 aPublic Propertp Mepartment �3uilbing Mepartment 'Y One&alem green (978) 745-9595 Ext. 380 Peter Strout Director of Public Property Inspector of Buildings Zoning Enforcement Officer November 24 , 1998 Lennin Realty Trust Barz Rubin Tr . 29 Perkins Street Salem, Mass . 01970 RE : 90 Congress Street To Whom it May Concern: It has come to our attention that apartment 4F and 4R have more residents than the city zoning ordinance allows . This problem must be rectified immediately. Please contact this office as soon as possible . Thank you for your anticipated cooperation in this matter . Sincerply, "Peter Stro t Zoning Enforcement Officer PS : scm Nov 9, 1998 Building Inspector Salem City Hall Washington Str. Salem, Mass. 01970 Sir: Would it be possible to check out a concern? There appears to be an inordinate number of individuals residing in two apartments in the building at 90-92 Congress Street. The apart- ments are listed specifically as 4R and 4F. The landlords name is Jose Baez. The concern is one involving safety and occupancy codes and wether either law is currently being violated. I know for a fact that in the case of two adults, neither has a key to the building, per se. Is it possible that the landlord is running a rooming house?In addition to the adults present, there is any number of children living there ranging in age from infant to middle school level.. The names listed on the mailboxes are as follows: 4F Jose Baez Ille Lisse Espiet Josa Montaz Abreu 4R Jose Delacruz Cruz Pena Ramon Pena Miguel R. Peon Please investigate as soon as possible! Thank You for your concern. roNolr�, CITY OF SALEM9 MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT v 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01970 Ttr?� TELEPHONE: 978-745-9595 EXT. 380 `��MIIv69 FAX 978-740-9846 KIMBERLEY DRISCOLL MAYOR February 20, 2007 Steve Chambers P.O. Box 605 Peabody, MA. 01960 RE: 90-92 Congress Street Dear Mr. Chambers: Due to multiple complaints, I have reinspected the condo units at 90-92 Congress Street and have found both crossed water lines and gas supply lines. Under the authority of Mass General Law 142, Section 13 & 21 and 243 CMR3.00, you are ordered to secure a plumbing and gas permit. You are further ordered to provide sufficient labor and conjunction with the Condo Associated, demonstrates correct water and gas piping to the individual units. Failure to comply will result in a complaint being filed to the Plumbing & Gas Board. Sincerely, Dennis Ross Plumbing/Gas Inspector0 cc: Jason Silva, Mayors Office 90-92 Congress Street, Condo Associates Suzanne Harvey , Unit 4R CITY OF SALEM9 MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR • 'tpo SALEM, MAO 1970 `d° TEL. (978)745-9595 EXT. 380 FAX (978) 740-9846 STANLEY J. USOVICZ, JR. MAYOR s September 27, 2002 William A. Sherman 21 Pinehurst Drive Boxford, Ma. 01921 RE: 90-92 Congress Street Dear Mr. Sherman: At the suggestion of Mr. Mc Swiggin and per your request, I met with you to inspect the condition of the side porches at the above-mentioned property. I agree with Mr. McSwiggin that the porches are in serious disrepair and need to be repaired or replaced immediately. If the porches are not a required means of egress, they also could probably be removed. Please contact this office within ten days upon receipt of this letter to inform us of your course of action. Sincerely, Thomas St. Pierre Acting Building Commissioner cc: Mayors Office Tom Phillbin Councillor Chuber Fire Prevention Chris Hatch, Trustee Salem Point Child Care Center got fgumuwnwraltr at d CITY OF SALEM y In accordance with the Massachusetts State Building Code, Section 108. 15, this V e� CERTIFICATE OF INSPECTION is issued to SAI....EIV S POINT CHILD CARE 1 Ylpii�ly that 1 have inspected the premises known as SAL_E11' Si PnINT CHILD CARE. located at 005311 - 19;2 CONLaRF_SS STREET in the city of Salem County of Essex Commonwealth of Massachusetts. The means of egress are sufficient for the following number of persons: BYSTORY Story Cape'e'' ' % 'r� t'� '7'�' Capacity Story Caai"i. �"` 'b Capacity BY PLACE OF ASSEMBLY OR STRUCTURE Place of Assembly Place of Assembly or Structure Capacity Location or Structure Capacity Location Z..- 50 IST FLOOR 9?tis ID 1.i/ 1998 4/ 7.5! :L'.)99 Certificate Number Date Certificate Issued Date Certificate Expires i ding O(fi to The building official shall be notified within ( 10) days of any changes in the above information. COK-!ONNF.ALIE OF ?L�ISSACHIISTS CITT OF SALEM APPLIC.,TION FOR CERTIFICATE OF INSPECTION Date /!�/9�%7 Fee Required S 11d," ( ) No Fee Reouired Ia accordance with the provisions of the Massachusetts State Building Code. Sect: 108, 15. I herehv apply for a Certificate of Inspection for the below-named premises located at the followin g address: ,s Street S Number- 0 1 (ao-y'J.7" �Hamrvpf Premises �S �-4� � .Z- 4 _ Q o&e for which Premises is used Child Care Uj'-'--:'(I 4ietsS e(s) or Permits) required for the premises by other Governmental Agencies: U� License or Permit Agencv W LL Ja:(:D 200853 Office of Child Care Services Certificate to he issued to: Salem's Point Child CAre Address: 90-92 Congress ST. P.O. Box 8 Salem MA 01970 Owner of Record of Building: Salem's Point Child Care Address: P.O. Box 8 Salem MA 01970 Hale of Present Holder of Certificate: Salem's point Child Care Name o�(f�/, Agent. if any.. . Executive Director Signature °or Person to whom Cerr_ficace TITLE is issued or his/her authorized agent 12/24/97 Date IN=UCTIONS: Day time phone I 978-744-3479 I. Make checi payable to: The City, of Salem 2. Return this applicarion with your -check to: Inspector of Buildings. City of Salem Building Department. One Salami Green. Salem. MA. 01970. PLEASE NOTE: I. Application form with required fee must be submitted for each building or structure of part thereof to be certified. 2. Application 6 fee musr be received before the certificate will be issued. 3. The building official shall be notified within cen (10) days of any change in the above information. CERTIFICATE I [ - �( ESPIRATION DATE: 0 !S 9 r (�l�P �AlriritArilttPMl#� Af �tt,��rl�t$Pi#s t F CITY OF SALEM In accordance it,iiIt the Ma s s a c It it s e i is State Building Code, Section 108, 15, iItis wy see�• CERTIFICATE OF INSPECTION is issued to SAI—EM' S PO:CN"1- CHILI:) CARE. 7 Ttrtifg that I have inspected the premises known as SA[...EMI cH FUINT CI"IIL_Ii ERRE located tit 0090 —;fi_ CC:)NGRE::SS SFRE[*:T in the city of Salem County of Essex Commonwealth of Massachusetts. The tit eaits of egress are sufficient for the following number of persons: BYSTORY Story Cat � NYSa�y{yx Capacity Story Caaf � ) { j ¢f Capacity 56ffi!67G567G7ii'SGYL7LYG7S757GiGV54>S6'/n '/r",G:d+' S576Y�5f.5.5t'%°�.7y'A9G`Y�76!G BY PLACE OF ASSEMBLY OR STRUCTURE Place of Assembly Place of Assembly or Structure Capacity Location or Structure Capacity Location I 50 EST FLOOR Ai zi /ih I /1 99 13 Oi 4/ 15/ 1 S39'=) Certificate Number Date Certificate Issued Date Certificate Expires Building ficial The building official shall be notified within (10) days of any changes in the above information. 11 PERIOD�IC ORSURVEYINSPECTION REPORT . .� !'// a 7 11 Date 7/0//q � .3 INSPECTOR Location S 9- 7-, Responsible Parties---/- 1. Owner �c ✓/ (�k ) �' �!'ri/� �U _ Telephone Address 2. Ownerrs Agent Telephone Address 3. Tenant Telephone Address 4. Contact Telephone Address TYPE OF INSPECTION / Periodical Survey Speci al C""7/Q5i> T ZONING STATUS 11 Conforming Nom Conforming Map District Use Use BUILDING CODE STATUS Before After Fire Coda Code Type Class Stories Limits Legal Use or Occupancy Actual Use or Occupancy Fee Class Fee Invoice No. To No. Notify No. Compliance Date Notice No. Checked by Violations of SUPERVISOR I have made an inspection at the premises described above and hereby submit my report and recommendations: GENERAL OBSERVATIONS Yard Sanitation Exits Building Exterior Exit Signs Accessory Buildings Fire Doors Accessory Structures Sprinkler System Parking Facilities Storage Space Loading Facilities Heating Apparatus Fences Flammable Liquids v- Interior Sanitation Incinerators v Signs Air Conditioning & Refrigeration Elevators & Escalators Electrical Wiring Plumbing (,/-Df�'h ��+c�.(_1—rF✓l� T • v. • r v� v.• v v�� rv• .. vv• �..• r �••�.. .. .�...XVII •� e.V, . uVV • ./lu .a. Vy• ,rVVG. f r , ' COMMON-,'7EALTH OF RASSACHUSETTS OFFICE FOR CHILDREN DAY .dARE SERVICES . . FI-R-.-INSPECTION REPORT This is to certify that Salem Point Child Care A2 Name of Facility located at 90=92""'C'onares''s'`St Salem Mass 0100 Address was inspected on 8-30-83 by Raymond -T Dansreau. Date Name of inspector Report of Inspection: Conditions satisfactory at time: of inspection*. 6[- Fire Chief Nam_ and Title Please return this report: Office for Children CC: Salem Bldg. Insp. Day Care Services Salem Health Dept. % 83 Pine Street Occupant Peabody, Mass . 01960 File SFPB Form 41 (Rev. 1/82) 10/21/2008 13:21 19787448298 SALEM FIRE DISPATCH PAGE 02106 CITY OF SALEM, MASSACHUSETTS ELECTRICAL DEP,RTMENT 44 LAFAYETTE STREET TEL(978)745-6300 ICIMBERLEY DRISCOLL FAx (978) 745-4638 MAYOR MARK ROCHON WIRE INSPECTOR TO: JOSE AND JUANA ALIX October 21,2008 UNIT 2 F 90 CONGRESS ST. SALEM,MA.. 01970 SUBJECT: 90 CONGRESS ROOF WATERLEAK LEFT STAIR WELL,4'FLOOR SMOKE DETECTOR DAMAGED "ALL OWNERS NOTIFIED" DEAR OWNER, THE SALEM FIRE DEPARTMENT AND MARK ROCHON CITY OF SALEM WERE INSPECTOR RESPONDED TO A WATER LEAK SEPTEMBER 26,2008 WITH THE FIRE ALARM IN "ALARM". THE 4"ff FLOOR SMOKE DETECTOR WAS REMOVED TO LET TIM WATER DRAIN FROM THE ROOF LEAK AND THE WIRES WHERE WIRE NUTTED,THE FIRE ALARM ANNUCIATOR CONTROL PANEL WAS TAGGED REQUESTING REPAIR AND AN ELECTRICAL INSPECTION. THIS OFFICE HAS NOT RECEIVED AN ELECTRICAL PERMIT FOR THESE REPAIRS. PLEASE TAKE THE NECESSARY STEPS TO REPAIR THESE ELECTRICAL HAZARDS. THIS WORK SHALL BE DONE BY A LICENCED ELECTRICIAN WITH A PERMIT FROM TATS OFFICE, IF YOU HAVE ANY QU STIONS,PLEASE CONTACT ME AT MY OFFICE. SINCERELY, MARK ROCHON WIRE INSPECTOR CC: FIRE PREVENTION FAX: 402 BUILDING DEPARTMENT FAX: 846 HEALTH DEPARTMENT FAX: 343 1012112008 13:21 19787448298 SALEM FIRE DISPATCH PAGE 03/06 CITY OF SALEM, MASSACHUSETTS ELECTRICAL DBPART'MENT 44 LAFAYETTE STREET TEL(978)745-6300 KIMBERLEY DRISCOLL FAX(978) 745.4638 MAYOR MARl<ROCHON WIRE INSPECTOR TO: WILLIAM SFIEMtMAN THE THIRD October 21,2008 2 PINE HURST DRIVE BOXFORD,MA.41921 SUBJECT:90 CONGRESS OWNER ROOF WATERLEAK UNIT 2R AND 3R LEFT STAIR WELL 4TH FLOOR SMOKE DETECTOR DAMAGED ,ALL OWNERS NOT'IF'IED" DEAR OWNER, THE SALEM FIRE DEPARTMENT AND MARK ROCHON CITY OF SALEM WIRE INSPECTOR RESPON35ED TO'A WATER LEAK SEPTEMBER 26,2008 WITH THE FIRE ALARM IN "ALARM". THE 4T"FLOOR SMOKE DE'T'ECTOR WAS REMOVED TO TET THE WATER DRAIN FROM THE ROOF LEAK AND THE WIRES WHERE WIRE NUTTED.THE FIRE ALARM ANNUCIATOR CONTROL PANEL WAS TAGGED REQUESTING REPAIR AND AN ELECTRICAL INSPECTION, THIS OFFICE HAS NOT RECEIVED AN ELECTRICAL PERMIT FOR THESE REPAIRS. PLEASE TAKE TIME NECESSARY STEPS TO REPAIR THESE ELECTRICAL HAZARDS. THIS WORK SHALL BE DONE BY A LICENCED ELECTRICIAN WITH A PERMIT FROM THIS OFFICE. IF YOU HAVE ANY QUESTIONS,PLEASE CONTACT ME AT MY OFFICE, SINCERELY, MARK ROCHON WIRE INSPECTOR CC: FIRE PREVEN'T'ION FAX: 402 BUILDING DEPARTMENT FAX: 846 HEALTH DEPARTMENT FAX: 343 10/21/2008 13:21 19787448298 SALEM FIRE DISPATCH PAGE 04/06 CITY OF SALEM, MASSACHUSETTS '.ELECTRICAL DEPARTMENT 44 LAFAYETI'E STREET TEL(978) 745-6300 IC1NMERLEY DRJSCOLL FAX(978) 745-4638 MAYOR MARK ROCHON WIRE INSPECTOR TO: INEX N. GOMEX October 21,2008 UNIT 3 F 90 CONGRESS ST. SALEM,MA. 01970 SUBJECT: 90 CONGRESS ROOF WATERLEAK LEFT STAIR WELL 4T"FLOOR SMOKE DETECTOR DAMAGED "ALL OWNERS NOTIFIED" .DEAR OWNER, THE SALEM FIRE DEPARTMENT AND MARK ROCHON CITY OF SALEM WIRE INSPECTOR RESPONDED TO A WATER LEAK SEPTEMBER 26, 2008 WITH THE FIRE ALARM IN "ALARM". THE 4TH FLOOR SMOKE DETECTOR WAS REMOVED TO LET THE WATER DRAIN FROM THE ROOF LEAK AND THE WIRES WHERE WIRE NUTTED.THE FIRE ALARM ANNUCIATOR CONTROL PANEL WAS TAGGED REQUESTING REPAIR AND AN ELECTRICAL INSPECTION. THIS OFFICE HAS NOT RECEIVED AN ELECTRICAL PERMIT FOR THESE REPAIRS. PLEASE TAKE THE NECESSARY STEPS TO REP`A.IR THESE ELECTRICAL HAZARDS. THIS WORK SHALL BE DONE BY A LICENCED ELECTRICIAN WITH A PERMIT FROM THIS OFFICE. IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT ME AT MY OFFICE. SINCERELY, M<R:20Z-J0N WIRE INSPECTOR CC: FIRE PREVENTION FAX 402 BUILDING DEPARTMENT FAX: 846 HEALTH DEPARTMENT FAX: 343 10/21/2008 13:21 19787448298 SALEM FIRE DISPATCH PAGE 05/06 • CITY OF SALEM, MASSACHUSETTS ELECTRICAL DEPARTMENT .. 44 LAFAYETTE STREET TEL(978) 745-6300 KIMBERLEY DRISCOLL FAx(978) 745-4638 MAYOR MARK ROCHON WIRE INSPECTOR TO: SARA SANTAYE October 21, 2008 UNIT 4 F 90 CONGRESS ST, SALEM,MA. 01970 SUBJECT: 90 CONGRESS ROOF WATERLEAK LEFT STAIR WELL 4n'FLOOR SMOKE DETECTOR DAMAGED "ALL OWNERS NOTIFIED" DEAR OWNER, THE SALEM FIRE DEPARTMENT AND MARK ROCHON CITY OF SALEM WIRE INSPECTOR RESPONDE'I7 TO A WATER LEAK SEPTEMBER 26,2008 WITH THE FIRE ALARM IN "ALARM". THE 47"FLOOR SMOKE DETECTOR WAS REMOVED TO LET THE WATER DRAIN FROM THE ROOF LEAK AND THE WIRES WHERE WIRE NCTTTED.THE FIRE ALARM ANNUCIATOR CONTROL PANEL WAS TAGGED REQUESTING REPAIR AND AN ELECTRICAL INSPECTION. THIS OFFICE HAS NOT RECEIVED AN ELECTRICAL PERMIT FOR THESE REPAIRS. PLEASE TAKE THE NECESSARY STEPS TO REPAIR THESE ELECTRICAL HAZARDS. THIS WORK SHALL BE DONE BY A LICENCED ELECTRICIAN WITH A PERMIT FROM THIS OFFICE. IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT ME AT MY OFFICE. SINCERELY, MARK ROCHON WIRE INSPECTOR CC: FIRE PREVENTION FAX: 402 BUILDING DEPARTMENT FAX: 846 HEALTH DEPARTMENT FAX: 343 10/21/2008 13:21 19787448298 SALEM FIRE DISPATCH PAGE 06106 a CITy VF' S n EM5 MASSACHUSETTS ELECTRICAL DEPARTMENT 44 LAFAYETTE STREET TEL(978) 745-6300 1UNMERLEY DRISCOLL FAx(978) 745-4638 MAYOR MARK ROCHON WARE INSPECTOR TO' STACEY L.BELARO October 21,2008 UNIT 4 R 90 CONGRESS ST. SALEM,MA.01970 SUBJECT: 90 CONGRESS ROOF WATERLEAK LEFT STAIR WELL 4TH FLOOR SMOKE DETECTOR DAMAGED "ALL OWNERS NOTIFIED" DEAR OWNER, THE SALEM FIRE DEPARTMENT AND MARK ROCHON CI'T'Y OF SALEM WALE INSPECTOR RESPONDED TO A WATER LEAK SEPTEMBER 26,2008 WITH TIM FIRE ALARM IN "ALARM", THE 4Tx FLOOR SMOKE DETECTOR WAS REMOVED TO LET THE WATER, DRAIN FROM THE ROOF LEAK AND THE WIRES WHERE WALE NUTTED.THE FIRE ALARM ANNUCIATOR CONTROL PANEL WAS TAGGED REQUESTING REPAIR AND AN ELECTRICAL INSPECTION. THIS OFFICE HAS NOT RECEIVED AN ELECTRICAL PERMIT FOR THESE REPAIRS. PLEASE TAKE THE NECESSARY STEPS TO REPAIR THESE ELECTRICAL HAZARDS. THIS WORK, SHALL BE DONE BY A LICENCED ELECTRICIAN WITH A PERMIT FROM THIS OFFICE. IF YOU HAVE ANY QUESTIONS,PLEASE CONTACT ME AT MY OFFICE. SINCERELY, MARK ROCHON WIRE INSPECTOR CC: FIRE PREVENTION FARC: 402 BUILDING DEPARTMENT FAX: 846 HEALTH DEPARTMENT FAX: 343 10/21/2008 13:21 19787448298 SALEM FIRE DISPATCH PAGE 01/06 CITY OF SALEM, MASSACHUSETTS ELECTRICAL DEPARTMENT 44 LAFAYETTE STREET TEL(978) 745-6300 KIMSERLEY DRISCOLL FAX(978) 745-4638 MAYOR MARK ROCHON WIRE INSPECTOR TO: SALEM POINT CHILD CARE October 21,2008 UNIT 1 90 CONGRESS ST. SALEM,MA. 01970 SUBJECT: 90 CONGRESS ROOF WATERLEAK LEFT STAIR WELL 4m FLOOR SMOKE DETECTOR DAMAGED "ALL OWNERS NOTIFIED„ DEAR OWNER, . THE SALEM FIRE DEPARTMENT AND MARK ROCHON CITY OF SALEM WIRE INSPECTOR RESPONDED TO A WATER LEAK SEPTEMBER 26,2008 WITH THE FIRE ALARM IN "ALARM". THE 4T"FLOOR SMOKE DETECTOR WAS REMOVED TO LET THE WATER DRAIN FROM THE ROOF LEAK AND THE WIRES WHERE WIRE NUTTED.THE FIRE ALARM ANNUCIATOR CONTROL PANEL WAS TAGGED REQUESTING REPAIR AND AN ELECTRICAL INSPECTION. THIS OFFICE HAS NOT RECEIVED AN ELECTRICAL PERMIT FOR THESE REPAIRS. PLEASE TAKE THE NECESSARY STEPS TO REPAIR THESE ELECTRICAL HAZARDS. THIS WORK SHALL BE DONE BY A LICENCED ELECTRICIAN WITH A PERMIT FROM THIS OFFICE. IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT ME AT MY OFFICE. SINCERELY, MARK ROCHON WIRE INSPECTOR CC: FIRE PREVENTION FAX: 402 BUILDING DEPARTMENT FAX: 846 HEALTH DEPARTMENT FAX: 343 hl'I31 .IC PROPI ."Wl'1' I_'ll\\ \�I II\ .Ii".?IItII 1 ♦ �'.Li '.I.\I'�: \slit �I a 'll'1-il I I .'I_Y --7i '1 i7i 0 I \\ 9-8---111 11X-10 \ (1 APPLICATION FOR PLAN EXAMINATION AND �VJ BUILDING PERMIT ALL BUILDINGS EXCEPT ONE AND 2 FAMILY DWELLINGS IMPORTAN'r: A , licants must Complete all items mn this page SITE INFORMATION p p Location Name -ler+�(�p�"+vHg �.�1��Gt UU'� Building IN, Property Address Located in: Conservation Area Y/t Historic district APPLICATION DATE g 0 1 Use Groups (check one) Group Homes R3 —`124_ Residential (3 or more Units) R2_ Type of improvement Residential (hotel/motel) RI _ (check one) Assembly (Theaters) All — New Building_ Assembly(restaurants & clubs) A2r_A2nc_ Addition Assembly (churches) Al Alteration_� Business B Rcpair/ Replacement_� Educational E Demolition '10 Factory(moderate hazard) 171 _ Move/Relocate Factory(low hazard) F2_ Foundation Only High Hazard H_ Accessory Building Institutional (residential care) 11 _ Institutional (incapacitated) 12_ Institutional (restrained) 13 Mercantile NI Storlee Sl _Moder:uc 1-laza1 d Storage S2_Low I laz:ud ON'NI•:RSIIIP INFORMATION(Please or Print Clear / OWNER NameC�� C) •^ �� 1@C� Address Telephone Sionalure DESCRIPTION OF %%ORK TO RE PERFORMED ( Es I IMA I'El)CONSTRUCTION COST :;�O-D-, 60 1 G� r � CoN'rRAC'I'OR INFORMATION Name U0.1 Address qs( Zj, �kIa a h-, -•p-h /-(Aat��3 Telephone 9�st S 4r� OrnB`I Construction Supervisor's Lic # rt 5t7788 Home Improvement Contractor # /53295 .\RCI11"1'EC'I'/I-'NIiINEISR INFORMATION Name Address Telephone Mass. Registration # _ ________ PEIti IUF FEE CALCULATION Estimated Cost x $1151,000 + $5.00=13 3s 62 CONINIENTS The undersigned applicant does hereby attest that all information stated above is trite to the best of my knoivledge under the penalties of perja Signed (owner) (aeent) APPROVED BY : tx DATE' APPROVED: /� 3� /O �, PUBLIC PROPERTY DEPr1RTMENT u.SESLIV ORNWAR NArae 130 WAtattN=M MEM•sMMKyAMAua;sr-r,:01970 APPLICATION FOR THE REPAIR. RENOVATION_ CONSTRUCTION, DEMOLITION. OR CHANGE OF USR OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUILDING 1.0 SITE INFORMATION Location Name: +f e1 Building: ----- - Property Address:-�l�'EtZ Crr�'s off-_S~t�. Property fs located N s;Coraervatlon Aroa YM Hkdork OhOrid YM 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land . Name: N f} 5 S2 Address: 90 r-1Z CaNS;lftf -ft ICOVM �-k� Telephone: 478 7`l 0 3.0 COMPLETE THIS SECTION FOR WORK IN E7(1STIJ+<lp BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use Now Demolition Existing Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New add Description of Proposed Work: Uc� Svcs Mail Permit to: 0t�a `What is the curent use of the Bui6 ing? oS Material d Building? vC �5 o rnr 79 dwelling,how many units? - Will the Binding Conform to Law? Asbestos? Architects Name Address and Phone l ) lytechanies Name lAo N e Address and Phone 1 `� Cepbt o i? S 7 Construes Supervisors Licensee �� HIC Registration S SS-8 Estimated Costs—� Permit Fee Calculation Permit Fees Estimated Cost X$71$1000 Residential Estimated Cost X$41/51003 C01mmercia4--------- -An Additional Sa.00 is added as an Administrable charge. Make sure that all fields are properly and legibly written to avoid delays in Proceeaing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of perjury Date o� 0 o N � yy N A `d Ct. Cl< 22t b r55 AFUIVED The Commonwealth qA99Ea9ffiMtftSy Department of Public Safety A �1 Massachusetts State Building��jjpp ��C A 1 Building Permit Application for any Building othet n a Ones or Two-Family Dwelling (This Section For Official Use Only) Building Permit Number: Date Applied: Building Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) C(o y al2 D 504ewt Cik') Ca"'- No.and Street City Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ Alteration M/' I Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are budding plans and/or construction documents being supplied as part of this permit application? Yes ❑ No Er Is an Independent Structural Engineering Peer Review require Y ❑ 0No - Brief Description of Proposed Work: &'5110.11 o-r�. -/�``�Ol a 4el"P I-( 'p-o -✓ 12o✓ SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) O Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1 ❑ I-2❑ 1-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑ S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA O IB O IIA O IIB 0 IIIA ❑ IIIB O 1 IV 0 1 VA 17 VB O SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit. Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑required❑ or trench or specify: Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: / aEE1,,7- Tn P4 wl)a SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner I_e5te�/ iUlavla4c �FHB-8aac9S�lQ M,t,-blehAac( A Name(�) -�� No.and Street City/Town Zip Property Owner Contact Information: C'h✓ist4v _+yakh 9?Vjff-3�79 317 -d� 9-70-7 Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes Cln ; !:!2K I l 6- NLY-t`h s4-. 5.der� MA- 019 70 Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2General Contractor nn Company Name t�t 1- (,n✓',-.0 {--Olr'1-� D S`1� 1 33 CO✓�S 1 V KG'I-i 0.2Sti(�.e/-✓,-s Name of Person Responsib for Construction License No. and Type if Applicable 1�- I I S /Vo✓iti. 54-- �CkUe� 1M:t - 619T0 Street Address City/Town State Zip qq I11l qk Telephone No. (business) Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152.§ 25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes O No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ - Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)_$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ Lq C(Q O. (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 accurate to the best of my kn wledge and understanding. Ur,,-; z Qr<_s , �— 978"-`74(- 0�( a- Please print and sign nart r Title Telephone No. Date 5 lyozfk <�,a Lzw, Im ik 01 C170 Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date