12 DANIELS STREET - BUILDING JACKET INPendafivC
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The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct, Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Offic' Use Only
Building Permit Number: Date/Applied:
—.. jq
Building Official(Print Name) Signature to
SECTION 1:SITE INFORMATION
1.1
aop�rty Addr ss: l 1.2 Assessors Map&Parcel Numbers
Pa
Uar,�0 J 57 �gIYrn
].la 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 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?
`v Check if yes❑ Municipal Vol site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record•
jjrtp>, Q0�l,Ps I 1�ez7,z1 a y�j
Name(Print) City,State,ZIP
10) k-Mw 4 zy96-/) r/ r 'A(A'0 I ow)
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply)
New Construction❑ Existing Building Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition 0 Accessory Bldg.❑ Number of Units Other ❑ Specify:
Brief De cription of Proposed Work: w7o de 1 Yvt t w 4 W I e `
2 i ofil,5 e rs R L4Jm < CAdekil w s IrJ plaE J\
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ Do 00 Q 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
2 ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ �3 QQ� ❑Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction S pervisor License(CSL) _Olt SS7�a r�G» C✓1�-� _l 23 L
License Number Ex D Name of CSL Holder
19 //. z—m List CSL Type(see below)
No.and S ` 1 �� / Type Description
,mlu i S U Unrestricted Buildin s u to 15.0 .cu.ft.
R Restricted 1&2 Family Dwellin
Cny/fown,State,ZIP M Maso
RC Roofin Coverin
WS Window and Sidin
SF Solid Fuel Bunting Appliances
L J I Insulation
Tele hone Email address D Demolition
Yisteredm Hom provemegt Contractor(HIC) b��s ZZ 15
(7 c .JS
HIC Registration Number E irat on Date
HIC Company Name or HIC Registrant Name l
No.ands 0� n t7r)Cu0b0C1)e5 e5rne)]' �o
Email addresg
City/Town,State,ZIP Tele hone
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 Issuance of the building permit.
Signed Affidavit Attached? Yes .......... ❑ No...........❑
SECTION 7a:OWNER AUTHORIZATION WTO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,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.
Q Gngn 90(kQ� wly)A v) ly
Print Owner's Name(Electronic Signature) I J Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATIO7bate
By entering my name below,I hereby attest under the pains and penalties of perjury that all of th
contained in this application is true and accura o the best of my kn ledge and understanding.
Print Owner's or Authorized Agent's Name(Electronic Signature)
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 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.gov/dps
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 hanaths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
I
Certificate Number: B-14-1432
Permit Number: B-14-1432
Commonwealth of Massachusetts
Permit Number B,14-1432
City of Salem
This is to Certify that the
.......... Building
Buiid�in6 f�;p a .......... ....... ... located at
........................................... .12. . . .:NNIELS STREET
0
Address in the / f�Salem
Town/City
,
..�ilY_Qf Salem
�Io ''7' ' ' "
Town/CitY Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY
12 DANIELS STREET
BRIANBOCHES
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires ........... _Not.4p
Applicable
Expiration Date... unless sooner suspended or revoked.
Issued On: Thursday, May 28, 2015
.om onwialth of IVlassachus tts
• � -of�Salem ,
.• x
a 120 Washington St floor Item,MA 01970(978)745 9595 x5641 •{ _
FFF111occupancy
b N
Retum card t 'Bu',Ing Div'pS�'on for Certificate of Occ}panty -
`>.rmit No.,
o a-14-1432
-14,. -1432
1FEE PAID $924.00 PERMIT Tt�
j BUILD '
DATE ISSUE 9/41201
,j
17
L This certifies that BOCHES BRIAN
x
has permission to erect,•alter or demolishla buifding �Z DANIE_LS STREET �` «v ' Map/Lot 350357-0 4
x W
as follows =Renovation REMODEL EXISTING SINGLE FAMILY�WIT ( 1A1 IT HEN, 2112*'BATHS,
` e
SOME SIDING REPAIRS;FLOOR & WALL WORK (*ADDING 1 BATHROOM) �
_ Contractor Name: BRIAN BOCHES, y '
.DBA: COASTLINE CONSTRUCTION
Contractor
License No =1A6095 �.
4 a v 9/4/2014
[. e
1 Buifding Official W
Date
This
. c grant shall be reemd abandoned and invalid edsix
urrless the work authorized b this permit
" r-
�i may grant one or more ex ensions not to exceed six months each upon written request�c mit Is commenced within six after issuance:The Building Official,
All work authorized b this
Y pe tnitshaVonform to the a.Wroved application and the approved construction d u men fo whichlhhis permittes been granted N
a All construction,'afterations andchang�es of use of any building and struct res shall be incompliance with the local zoning bylaws and c�+od s.
This perms shall be displayed m a�ccahon clearly visible hom access street or road-and,shall be maintained open for:publ* tris tion fo7the entire duration of the .
i ..
�, i-w
I " work until the compretion of the same.' g,
l . The Certificate of O}cupancy will notbe issued until all applicable signatures by the Buildi.ng and Fire fficials are _
provldett on this permit
} b
HIC#"x106095 at ^Persons contracting with unreglstered contra tor'c s�do not have access td the ouafa^ry tend (as set forth m MGLc.i42q) ,-, a
Restrictionns "'`` -
11 lit '
.F" lans'are*o Buildin
9 p yo available on.sits
All Perlriit Cards the property of the '�PERsY; �•r ``
E ,ah t PWNER.r_
rr
i
Commorwealth of Massachusetts
Citv,of Saler
" ' 3
'120 Washington Sl,3rd Fir "Salem,MA 01970(978)745-9595 x5641 -
Return card to Building&1slon for Certificate of Occupancy
Structure CITY OF SALEM BUILDING PERMIT � s
.Excavation PERMIT TO BE POSTED IN THE WINDOW 's
Footing INSPECTION RECORD
Foundation
w K�
Framing+ .a 1 A , �, •,
-Mechanical
INSPECTION:
By DATE
Chimney/SmokeChamber ., , . - , •++ ..
g
Final /L'
Plumbing/Gas"
Rough;Plumb(ngC7l/`l q' '/' f -- -.
r Rough:Gas �- l w
Final
Electrical t A
J '
Service _��0,.^.�
Rough
c .
Final
Fire Departme t
Preliminary
Final - . 1. . . ,,•, „ '
Lot. Health Departm nt T
y .
Preliminary
Final ..- ,+ ,rn
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,''and 3.Also complete A. Signature
;
item 4 if Re^ ted�elivery is desired. X ❑Agent
■ Print your name and address on the reverse ❑Addressee
so that we can return the card to you. & Received by(Panted Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from Item 17 ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑No
L:Y Ac- l 6 C'A
V yl` �G O�cJ /V 3. Service Type
�J ❑Certified Mail ❑Express Mall
❑ Registered ❑Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Exam Fee) ❑yes
2. Article Number-
(Transfer from service label)
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fee's Paid
ASPS '
Permit NJ.G-10
• Sender: Please print your name, address, and ZIP+4 in this box
City Of Salem
Building Department
120 Washington Street
Salem, MA 01979
A�.
CITY OF SALEM, MASSACHUSET'T'S
BUILDING DEPARTMENT
fisc tl 120 WASHINGTON STREET,3'FLOOR
TEL: 978-745-9595
FAY: 978-740-9846
KIMBERLEY DRISCOLL
MAYOR
THOMAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTIES/BUILDING COMMISSIONER
August 8,2014
Ingersoll Trust
C/O Linda Locke
1 Pickering Street' - ---
Salem, Massachusetts 01970
RE: 12 Daniels Street
Ms. Locke,
Our office received a complaint regarding your property located at 12 Daniels Street. The complaints
were investigated on Thursday, August 7, 2014 along with Ms. Elizabeth Gagakis and David Greenbaum
of the Salem Health Department, Lt. Peter Schaeublin of Salem Fire Prevention and me. Said property
was found to be in violation of Massachusetts State Building Code requirements.
The most concerning off these violations that has been received and noted during the inspections are the possible life
safety and egress stairway violations have been noted at the property. Additionally the remaining frame work of a stair
platform and stairway on the rear of house is also is in need of repair as it poses a risk to Public Safety. This stair is a part
or the required second means of egress out or the dwelling and is a requirement of the Massachusetts State Building
Code thus; IMMEDIATE REPAIR, CORRECTIONS OR REPLACEMENT IS REQUIRED. For these reasons an
inspection must be conducted by our inspection team to assure compliance with the Massachusetts Building Code and
city ordinances. '
Under the provisions of 780 CMR, Section 115.6—Right of Entry, of the State Building Code, access to this property
must be granted for the purposes of this inspection. Please call this office upon receipt of this letter to schedule this
required inspection. If this property has rental units, these tenants must be notified in advance of this inspection, so that
access to these spaces may also be accomplished.
This inspection is scheduled for Wednesday, August 13, 2014 at 10:00 a.m.; failure to respond to this notification will
be construed as non- compliance, and as such an Administrative Search Warrant will be sought, so as to allow the lawful
inspection of this property.
If you have any further questions regarding this th/is letter,please call this office at(978) 619- 5648.
Michael E.Lutrzykowski
Assistant Building Inspector cc: file, Health Dept., Fire Prevention
CITY OF SALEM, MASSACHUSET'T'S
BUILDING DEPARTMENT
.gip c 120 WASHINGTON STREET,3RDFLOOR
TSL: 978-745-9595
KMERLEY DRISCOLL FAX: 978-740-9846
MAYOR
THOMAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTIES/BUILDING COMMISSIONER
August 8, 2014
Ingersoll Trust
C/O Linda Locke
1 Pickering Street
Salem,Massachusetts 01970
RE:12 Daniels Street
Ms. Locke,
Our office received a complaint regarding your property located at 12 Daniels Street. The complaints
were investigated on Thursday,August 7,2014 along with Ms. Elizabeth Gagakis and David Greenbaum
of the Salem Health Department, Lt. Peter Schaeublin of Salem Fire Prevention and me. Said property
was found to be in violation of Massachusetts State Building Code requirements.
The most concerning off these violations that has been received and noted during the inspections are the possible life
safety and egress stairway violations have been noted at the property. Additionally the remaining frame work of a stair
platform and stairway on the rear of house is also is in need of repair as it poses a risk to Public Safety. This stair is a part
or the required second means of egress out or the dwelling and is a requirement of the Massachusetts State Building
Code thus;IMMEDIATE REPAIR, CORRECTIONS OR REPLACEMENT IS REQUIRED.For these reasons an
inspection must be conducted by our inspection team to assure compliance with the Massachusetts Building Code and
city ordinances.
Under the provisions of 780 CMR, Section 115.6—Right of Entry, of the State Building Code, access to this property
must be granted for the purposes of this inspection. Please call this office upon receipt of this letter to schedule this
required inspection. If this property has rental units, these tenants must be notified in advance of this inspection, so that
access to these spaces may also be accomplished.
This inspection is scheduled for Wednesday,August 13,2014 at 10:00 a.m.; failure to respond to this notification will
be construed as non- compliance, and as such an Administrative Search Warrant will be sought, so as to allow the lawful
inspection of this property.
If you have any further questions regarding this letter,please call this office at(978) 619- 5648.
Michael E. Lutrzykowski
Assistant Building Inspector cc: file, Health Dept.,Fire Prevention