4 CURTIS STREET - BUILDING JACKET The Commonwealth of Massachusetts I ECEIVEO
Board of Building Regulations and Standards INSPEC1 ION TS ICES
b�! Massachusetts State Building Code,780 CMR SALEM
nn''hh ev ed Mar 2011
Building Permip Application To Construct,Repair,Renovate Or Dem'JIM Z U A,11: 5
One-or Two-Family Dwelling
This Section For Official Use Only
Building Pemri[Number: A lied: .
1� ao
Building,Official(Print Name) igna Da[e
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
- q,� C,0e n5 ST CA DNDD
1.1 a Is this an accepted street?yes_4ro1Z Map Number Parcel Number
13 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq 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:
Zone: _ Outside Flood Zone?
Public❑ Private❑ Check if yes[] Municipal❑ On site disposal system El
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:xti Iem D AV p- ,
1
Name(Print) City,State,P
o f oal S ST U 22 1 -1 -7 2— 11 4 3
Norman Street - Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED ORKZ(chec all that apply)
New Construction❑ Existing Building V1Owner-Occupied 10 Repairs(s) IV I Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units L O[ er El Specify:
{ Brief esFi of Pro e� o L
V [Wl VP
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
bor and Materials
1.Building $/ `),. 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ [I Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
�v7� [, Check No._Check Amount: Cash Amount:
6.Total Project Cost: $I p� �+7�/ . 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervi r License(CSL) • f oil IL 'I 11.
it
L-Nn'� 99 A Po 6'E License Number Expiration Date
Name of CSL Holder
Z— , 4- �• List CSL Type(see below)
No.and Street {r'�J„LTi 1_ vl 1 A r a Type Description
l�A /z- I l L N Ab m•A .V I 1yjUnrestricted(Buildings up to 35,000 cu.ft.
City/Town,State,ZIP R Restricted 1&2 FamilyDwelling
M Masonry
RC Rooting Covering
yt tQ La WS Window and Siding
SF Solid Fuel Burning Appliances
` t T1N YV d AV 'G I Insulation
Telephone Email address D Demolition
45,.�Regjc ryqd(1�pttte Jm rovement Contr„ai for TC) 't t I /
�1 �Y. G ,r f ut - HIC DRegistration Number Expiration Date
HIC Co any afire ar05Re reisGgnV`t Name eG ,1 )l�'-t o �/J A/UM.r�'7` ��r
.an 'O" G yCC Il '\ 1 O 7, •7 �. t� V't J' CEmail address
I
City/Town,' State,ZIP Telephone
SECTION 6: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 Is ce of the building permit.
Signed Affidavit Attached? Yes ..........W 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 LA AAV Q R AJA P0-L-6-
to act on my behalf,in all matters relative to work authorized by this building permit application.
STD��{aty/ l��lV/D '° /G 12,6 i
Print Owner's Name(Electronic Signature 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 accurate to the best of my knowledge and understanding.
Print Owner's or Authorized 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 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.eov/dys
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (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 half/baths
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"
_ > I'h¢Contmunsscahh ul b1;u,arhu ells
n ;� Iloard oflluilding Regulations and Standards CITY OF
IV, ll Nlassachusens State Building Codc, 780 CNIR S,\Lli�l
'L•,•. Ildrie�✓ 161r'll//
Building Permit Application 'ro Construct, Repair. Rcnovatc Or Demolish a
(hie-or Tuv-himili Du rllinXr
This Section Fur oil' ial Use Only
Building Permit Number. _ to applied: _
s�
liuildiny 011116al(Print Nmne) Signata Oulu
SECTION I:SITE INFORMATION
1'1 Pr9 party t d °ss / 1.2 lsses Alurs tap Parcel millers1.lei Is this ann accce led str-3eell?''es no Map,Nmnl+er Parcel Numlwr
1.3 Zoning Information: 1,� Property Dimensions:
Luring District Proposed use Lol Ann Isy It) Fmninge(11)
1.5 Building Setbacks(fl)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Reyuircd Provided
I.ti Water supply (M.G.1.c.40.§!a) 1.7 Flood Zone Inrormallons 1.3 Sewage Disposal System:
Public 0 Pris use❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal s)item ❑
Check it cs❑
SECTION2. PROPERTY OWNERSHIP'
7.1 Ownirl o -cor :
�� crag
Nan (Prin _ _ City.Slaw,ZIP 'C
`77¢?�7
No.:w Street relephona Er a' Address
SECTION,!: DESCRIPTION OF PROPOSED WORKs(check all that pply)
New Construction O Exist nil Building❑ Osvner•Occupied ❑ Repairsls) ❑ Alleration(s) O Addition ❑
Demulition ❑ accessory Bldg. ❑ Number or Units_ Olher ❑ .spcvity:
Brief Description of Propo ed Work':
�- S 4• /Zvu - .0 � c��.-r
SECTION 4: ESTI,M.ATED CONSTRUCTION COSTS
I ens Estimated Costs:
ILabor and Malerials) Official Use Only
I. Building S C->CxJ.0e I. Building Permit Fee: S Indicate how tee is delermined:
v'. Vl irical S ❑Standard Ciry'Tussn Application Fee
O Tulal Project Cosl'l liens 6)s multiplier
_. Usher Fees: S
------41-4. \1"11.mic.d ill\ \('1 S Lisl:
j \ledunic•il iFtrc '— - --- ------- - -
1�u„reeswni S r,rtal .\IlFces: S _ — —
o Final Project Cosl: j-S��p rJ• l hr.A Vu. _. .__(heck:\nnnun: _ _. __._l',uh \m,nuI
❑P.lid in Full Cl Ouislviding 11.11mcc Due:
r ,
Sh:('Ilt)V S: ('ON,S I'RUc I—ION SFRVI('FS
t.1 /('VnslrurtiunSupenis iceusr(�'SL) d89��Y G-13 C
� �y�x Air I le�n...\'unlh�.r / ' I ,pl 11 I7u¢
.N.11119e ui l'SI I LoLler/� I lst l'SL I)pe l\ee belual
.J -y��_-S -__. . - _._. 1 7 P`' Dcrcripliun
NNI'. .."Iirce �F I I InrntrideJ IIhulJin r li 10 1y.000.a Il.l
He+tricled NU I.Imil Doalin
l'igi tooul.State,LII'
\I NHm,ory
RC' Ro+t+tin l'n\crin
_ µ'g µ'indow.wJ Sidinit
SF Solid Fuel lluming:Appliances
hlsulatiun
Pmail aJJn,es U Don
lilion
'etc bona �j
4.2 Registered Monte Imp men(Contractor(HIC) ,9C�J �i
���.w/J/C�� ,�/1�'/d✓� I—IIC itcli6t—ration Number lispiruliuu Ual¢
/ I. C'Compin) Nintc or I IIC' I(egistrwtl Nil lc
No. wt g t _ Email uJJnvi
City/Town. State ZIP T¢le hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.C. 152. 1 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 Aflldavit Attached? yes ..........13 No...........C3
SECTION 7s: OWNER AUTHORIZATION TO BE COI►IPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Date
Print U\aler's Nwne(Electronic Signature)
SECTION 7b:OWNERt OR AUTHORIZED AGENT DECLARATION
By entering my name below, I hereby attest der the pains and penalties of perjury that all of the information
contained in this appli 1 n is true and ac �ur Ate the best my knowledge and understanding,
Trills 11\wer's ar \utlulrireJ agent's Ndn Il:kctruoie Siguaulnl
VOTES:
I. .\n O\sner %%hu obtains a building permit to do his her o\vn I1 rk,cr an owner who hires an unregistered contraetur
(nut registered in the Hanle Improvement Cmumctur IHIC) Program), will rru have access to the arbitration
program ur guaranty tund under\1 G.L.c. 142A.Uthcr nnpuriant infurmation on the HIC Program can be Ibund at
,,,,,+ n Imo•
hlfannatiun un the Construction Supenisor License can be found a++++" I11•+•' ""` 'h"
\1-hen substantial`lurk is planned, prtn iJe the in(ur n....-n below:
2. hour area I nt Il.l _ ____.._1 including garage. Imishcd basement allies, decks or porch I
rotai Its r a c.1 i t. 1 1).7 _.._ l :Ibil.Ihle rourn countCros _ _, ... . ..
\umbI,%ingrcplaces -... _._ . \lunhero(hedroomi
\umber o,l halhnwnls -- \timber ui half'hulls
\umherol'decks porches
1\pe of he.1604 i\\ICI❑ (7peII
I\pc „I'croling \)\I¢m
i "I oi,d 'roic,l Square I'thgJ ga"111.1\ he NIh,tItIIIc,l hr"I ot.d 11rojc%;1 Cost"
:.CURTIS 3 STREET;
r
i- >, n�= tzblir ru Pxf P �rfinenf
John P. Pnfurrs
5 Prom 9fre2i
745-17213
March 13, 1980 -
Mr. James Bailey
271 Essex Street
Beverly, MA 01915 RE: 4 Curtis St. , Salem
Dear Mr. Bailey:
It has been 18 days since the fire which occurred at
the referenced premises. To date no building permit has
been taken out for fire damage repairs. I made an external
inspection of the building on this date.
The premises is open to the weather. Therefore I am
ordering the property be made safe and in the interest of
public safety I am ordering the chimneys be removed down
to the roof line.
In accordance with Section 123.0 of the Building Code,
you are given until twelve o'clock noon of the day following
receipt of this letter to commence work on the orders
contained herein.
Very truly yours,
Daniel F. Mansur
Assistant Building Inspector
DFM:tc
cc: Board of Health
Licensing Board
EU1LDiH�G DEPT. '.
Cpl a 03 p�i '99
RECEIVED
CITY OF SALEM
i
8/25/88 I ! #311-1 Drew Hingson 4 Curtis Street k_
J; STRUCTURE MATERIAL DIMENSIONS No. OF STORIES No.OF FAMILIES WARD COST
Dwelling Wood 3 Z 1 $ 8,000.
BUILDER
Owner
CNew asphalt roof,repair rafters,insulate and sheetrock�
3/25/83 #109 (Owner-Helen Phaneauf_ Install woodburning stove. (1) stove,top floor
bedroom-right only
+' 1/3/84 del Install (2) woodsburning stoves _
11/3/87 # 1210 add exterior door & stairs , nostructural changes , repair foundation
interior doors, windows & paint est . cost $ 10,000. fee $65.00 (Owner - Clifford T. Hughes)
CMTIFICATF OF OCCUPANCY ISSUED 3/7/88
tia
Form of 'Notice of Casualty Loss to Building
Under Mass.Gen.Laws, Ch, 139 Scc,113B if,
IO n5
I
o
37 TO: Building Commissioner or BoardOblF Health or
I�n�sspector of Buildings Board of Selectmen
a ) ( I
addresses
k.q. RE:.. Insured: �^ k Tiu�-6 N �.Tce
Property address
�1
v` Policy No. _ L-BlI Z SG 0.
, Loss of
File or Claim No. S— U 3 �
Claim has been made involving loss, damage or destruction:...
of the above-captioned property; which may either exceed
$1, 000 . 00 or cause Mass.Gen.Laws, Chapter 193 , Section 6 to;
a be applicable. If any notice under Mass.Gen.Laws, ,h l39,
Sec. 3B is appropriate please direct it to the .attenti.on of
{ the writer and include a reference to the captioned"insured,
, ,.
location, policy number, date of loss and claim or fihetriumbern '
� .. :*.ate
T-it 15
On this date, I caused copies of this notice to be
sent to the persons named above at the addresses indicated .
above by first class mail. ,
:
a � � ignatu , and date
.m,
Form of Notice of Casualty Loss to Building'
Under Mass.Gen.Laws, Ch, 139 Seq„����{� gF;'sT
l.. ww.C.� Ll 2i'
�• y nRFcc¢
TO: Building Commissioner or Board Cap Heajlth orSS.
Inspector of Buildings Board of Selectmen
kill
�j �n� ) addresses
s:
RE:. Insured:
lits
_ Property address c ktd#r t la ak
I � M ! +
tt Nd
Policy No. C-QAt
Loss of 19 $G
a; File or Claim,No. S� , o 3 (o
c Claim has been made involving loss, damage or destructions I ..,
of the above-captioned property which may either exceed„
$1, 000 . 00 or cause Mass.Gen.Laws, Cha ter 193, Section 6, to, ��p�„'�
be applicable. If any notice under Mass.Gen.Laws, h.,l'39,
Sec. 3Bis appropriate please direct it to theatfention'ofl,
The writer and include a reference to the captioned a'insured f?,4"'i"'
location, .policy number, date of loss and claim. .or, fil' �numbez { �
a `..
x
. YN�.'a, .. m IAM'. r,s •Y»:.wrn ,
11�N Alt ��5�Y/AJ. h
On this date, I caused copies of this notice' to be
sent to:.the persons named above at the addresses indicated
above by first class mail.
a �
r
gnatu and date -
I
CONI
ofIEm, �ttclub##
CMInT�
Juhn �6. �'3ofners
s �3rotta �freet
7454213
March 13, 1980-
Mr. James Bailey
271 Essex Street
Beverly, MA 01915 RE: 4 Curtis St. , Salem
Dear Mr. Bailey:
It has been 18 days since the fire which occurred at
the referenced premises. To date no building permit has
been taken out for fire damage repairs. I made an external
inspection of the building on this date.
The premises is open to the weather. Therefore I am
ordering the property be made safe and in the interest of
public safety I am ordering the chimneys be removed down
to the roof line.
In accordance with Section 123.0 of the Building Code,
you are given until twelve o'clock noon of the day following
receipt of this letter to commence work on the orders
contained herein.
Very truly yours,
Daniel F. Mansur
Assistant Building Inspector
DFM:tc
cc: Board of Health
Licensing Board