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10 DEARBORN STREET - BUILDING JACKET 1 AR 10 DEARBORN STREET 1 e Certificate No: 814-09 Building Permit No.: 814-09 —I Commonwealth of Massachusetts j City of Salem Building Electrical Mechanical Pernuts This is to Certify that the RESIDENCE located at Dwelling Type 10 DEARBORN STREET in the CITY OF SALEM Address TowrVCity Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY UNIT 1 This permit is granted in confortnity with the Statutes and ordinances relating thereto,and expires unless sooner suspended or revoked. Expiration Date Issued On: Fri Sep 11, 2009 - ........... - -- --- GeoTMSO 2009 Des Lauriers Municipal Solutions,Inc. -'---- ------- -------- ---- ---- ---- - - ---- -- --'- __._ ---_. ..... ..... ... ...-. Certificate No: 814-09 _ Building Permit No.: 814-09 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type I 10 DEARBORN STREET in the CITY OF SALEM Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY I UNIT 2 This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires .........-___-_-_.,---------__ unless sooner suspended or revoked. Expiration Date ............ ... -. Issued On: Fri Sep 11, 2009 - - ._----- GeoTMS®2009 Des Lauriers Municipal Solutions,Inc. "--" ....' -- - ----- -- ------ --"'" - - - 10 DEARBORN .STREET 814-09 COMMONWEALTH OF MASSACHUSETTS Mapa 4 r r� Bioek rK : A<< - ~" CITY OF SALEM 0294 Categor, ;REPAIR/REPLACE4f',f r Permit#� $1411_09-�,i -�°��ta - BUILDING PERMIT `. Pr"eject# jJS-2009-001469T ;`;,f7r+; Est Cost '',+q'ir $34,000 00�" MAP 1„ Fee Ch'arged:k'rq' $243.00 prd r=*' Balance Due:'=;. $oo„1 iii,_ . - MR PERMISSION IS HEREBY GRANTED TO: Const. Class L , " Contractor: Ltcense: Exp{res—" Use Grou I"' 'a. _�1,E J �r ix +;, PuC Anthony J.Salalayko CONSTRUCTI,O•SUPERVISOR-44742 Lot Sizer fY)'2598.7896;yy - ,,. r Owner: James Vonteslinos Units Gamed: �, „ a. " " til Applicant: Anthony J. Salalayko Units Lost:r. .,„ jj" R AT: 10 DEARBORN STREET' Dig Safe ISSUED ON.- 02-Jun-2009 AMENDED ON: EXPIRES ON: 02-Nov-2009 TO PERFORM THE FOLLOWING WORK: REPAIR AND REMODEL INTERIOR REPLACE-OLD-WINDOWS AND REPAIR SIDING;KITCHEN.REMODELjhb POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Building ` "It Ne Underground: Underground: �, Underground: Excavation: �`' N Al Service: c , - v/�'✓ ,t, Footings RoughIought ���C't y/ Rou{,t `/Y_��,� pl ls� Foundation: L. Final: Final: Finalyry�' /_+ �t,l7 - Rough Frame: � '. . G _ • VJJ Fireplace/Chimney: D.P.W. Fi 'x,` Health Meter: Oil: Insulation: � House Smi ��/{�([{'e}t Final: 0K ,�rt/�, � )V/ r s -4 r — ' - C _. Wa[<r: Alarm:4�N f� � As:eSSOr Sewer: Sprinklers: Final: it v THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM U ON V�OLATIO/ OO/�F"ITS ' RULES AND REGULATIONS. 1 VIII" !. y�L Signature: Al Fee Type: Receipt No: s ' Date Paid: Check No.fs, ' Amount: BUILDING`. REC- ��1$ED 02Fun-09 1001 $243.00 IMPORTANT: An Inspection is_. Q0H _ , . upon completion of"riuork, please call ,y �� ',...,:, 978-619-5641- GeoTMS©2009 Des Lauriers Municipal Solutions,Ina y v w •. �.CONI�iT�' r r Y3DYE AD CIFY. OF _ .. � . r iJ._,..---�� Asx.:_ -�= � a..--• �I.�.-- y Cite of *aiem, fRa.5!5aCbU5Ctt5 1 Public Propertp Mrpartment jBuilbing ;Department One balem Oreen (978) 745-9595 (ext. 380 Peter Strout Director of Public Property Inspector of Buildings Zoning Enforcement Officer September 8, 2000 Mr. &Mrs. DeVoe 10 Dearborn Street Salem, Ma. 01970 Dear Mr. &Mrs. DeVoe: My opinion of this matter is that you legally obtained a permit when you installed the pool and that your intent for life safety was addressed i.e rails around pool and folding stairs. Although we would have different requirements today, we feel this issue is grandfathered. I would like to make a recommendation that you at least fence in the stair area with a self-closing and self—latching gate. 4S'Sincerelt Building Inspector SENDER: t I I I also wish to receive the • Complete items 1 and/or 2 for additional services. • Complete items 3, and 4a & b. following services (for an extra • Print your name and address on the reverse of this form so feel: that we can return this card to you. • Attach this form to the front of the mailpiece, or on the 1. ❑ Addressee's Address back if space does not permit. • Write "Return Receipt Requested" on the mailpiece next to 2. ❑ Restricted Delivery the article number. Consult postmaster for fee. 3. Article Addressed to: 4a. Articlle7 Number `�aF"�'ee 4b. Service Type �9 ❑ Registered ❑ Insured "Certified ❑ COD ❑ Express'Mail ❑ Return Receipt for Merchandise 7. Date of Delivery G-/0-97 5. Signature (Addressee) S. Addressee's Address(Only if requested and fee is paid) Snature (Age h Y`� PS-Po 3811, October 1990 *U.S.GPO:1990-213881 DOMESTIC RETURN RECEIPT United States Postal Service Official Business PENALTY FOR PRIVATE USE, $300 Print your name, address and ZIP Code here Titig of alem, Massar4uattts publir Frnpertg Bepartment Nuilbing i9epartment (One Saltm (green 598-745-9595 Ext. 380 William H. Munroe Director of Public Property Inspector of Buildings Zoning Enforcement Officer 6/9/92 Mr . James Sagris 10 Dearborn St . Salem Ma . Re : 10 Dearborn St. Dear Sir : On June 9 , 1992 a site visit was made at the above mentioned address .Upon inspection it was noted that construction was proceeding without the benefit of a building permit. Please be advised that a stop work order has been issued. You are in violation of the Massachusetts State Building Code section 113 . 0 (no permit on record) . Contact this office within seven ( 7 ) days of receipt of this notice. Failure to do so shall result in further action. Sj' erely i� nc9/� David J . Harris Assistant Building Inspector cc: Ward Councillor City Solicitor (fit" of -"-5ttlem, ��ttssttehusetts � F' �nttra of peal DECISION ON_THE PETITION OF GAIL AND JAMES SAGRIS FOR A SPECIAL PERMIT A7410 DEARBORN ST.- (R`-;2) A hearing on this petition was held September 30, 1992 and continued until October 21, 1992, the following Board Members were present: Richard Bencal, Chairman; Richard Febonio, Vice Chairman; Francis X. Grealish, Jr. , Secretary and Stephen C. Touchette. Notice of the hearing was sent to abutters and others and notices of the hearing were properly published in the Salem Evening News . Petitioners, owners of the property, are requesting a Special Permit to extend side and rear setbacks to allow construction of a second story deck. The property is located in an R-2 district (residential two family) Before hearing the merits of this petition, the Board of Appeal must decide whether or not there is substantial and material change from a previous petition which was denied by this Board on July 22, 1992. Said previous petition was for a Special Permit to extend nonconforming rear and side setbacks to allow construction of a second story deck. Consent from the City of Salem Planning Board was received and placed on record. The Board of Appeal, after hearing the evidence presented and after viewing the plan submitted voted one ( 1) in favor of hearing this repetitive petition, three (3) opposed. The motion to hear the petition failed to garner the required four (4 ) affirmative votes needed to pass and therefore does not carry, the motion is denied. The Board concludes there is not substantial or material change and the petition will not be heard. REQUEST TO HEAR REPETITIVE PETITION DENIED October 21, 1992 Francis X. Grealish Jr. , Secretary Board of Appeal o r me CZ*j T �l) T O W DECISION ON THE PETITION OF GAIL AND JAMES SAGRIS FOR A SPECIAL PERMIT AT 10 DEARBORN ST. , SALEM page two 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 MGL Chapter 40A, and shall be filed within 20 days after the date of filing of this decision in the office of the City Clerk. Pursuant to MGL Chapter 40A. , Section 11, the Variance/Special Permit granted herein shall not take effect until a copy of the decision bearing the certification 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 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. Board of Appeal � co n < N W - O c� �� Ncn Tit" of �ittlem, 'Ifassaidlimetts Bons of Aupettl _ <r� m o w 7�m r o m o DECISION ON THE PETITION OF GAIL AND JAMES SAGRIS s FOR A SPECIAL PERMIT AT- 10 DEARBORN"ST —(R?2) m - n LCS � N A hearing on this petition was held. July 22, 1992 with the following Board Members present: Richard Bencal, Chairman; Richard Febonio, Francis Grealish, Jr. , Stephen Touchette and Associate Member Arthur Labrecque. Notice of the hearing was sent to abutters and others and notices of the hearing were properly published in the Salem Evening News in accordance with Massachusetts General Laws Chapter 40A. Petitioners, owners of the property, are requesting a Special Permit to extend nonconforming rear and side setback to allow construction of a deck. The property is located in an R-2 district. The provision of the Salem Zoning Ordinance which is applicable to this request for a Special Permit is Section 5-3(j ) , which provides as follows: Notwithstanding anything to the contrary appearing in this Ordinance, the Board of Appeal may, in accordance with the procedure and conditions set forth in Sections 8-6 and 9-4, grant Special Permits for alterations and reconstruction of nonconforming structures, and for changes, enlargement, extension or expansion of nonconforming lots, land, structures, and uses, provided, however, that such change, extension, enlargement or expansion shall not be substantially more detrimental than the existing nonconforming use to the neighborhood. In more general terms, this Board is, when reviewing Special Permit requests, guided by the rule that a Special Permit request may be granted upon a finding by the Board that the grant of the Special Permit will promote the public health, safety, convenience and welfare of the City's inhabitants. The Board of Appaal, after careful consideration of the evidence presented at the hearing and after viewing the plans. makes the following findings of fact: 1. The immediate Ebutter was in opposition. 2. The Special Permit requested cannot be granted without substantial detriment to the public good or without nullifying and substantially derogating from the intent of the district or the purpose of the Ordinance. DECISION ON THE PETITION OF GAIL AND JAMES SAGRIS FOR A SPECIAL PERMIT AT 10 DEARBORN ST. , SALEM page two On the basis of the above findings of fact, and on the evidence presented, the Board of Appeal concludes as follows: 1 . The Special Permit requested cannot be granted without substantial detriment to the public good or without nullifying and substantially derogating from the intent of the district or the purpose of the ordinance. 2. The granting of the Special Permit requested will not be in harmony with the neighborhood and will not promote the public health, safety, convenience or welfare of the City' s inhabitants. Therefore, the Zoning Board of Appeal voted two (2) in favor (Touchette and Labrecque) three (3) against (Bencal, Febonio and Grealish) the granting of the Special Permit requested. Having failed to garner the four affirmative votes required to pass, the motion to grant fails and the petition for a Special Permit is denied. Special Permit Denied July 22, 1992 Stephen Touchette, Member Board of Appeal 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 MGL Chapter 40A and shall be filed within 20 days after the date of filing of this decision in the office of the City Clerk. Pursuant to MGL Chapter 40A, Section 11, the Variance or Special Permit granted herein shall not take effect until a copy of the decision, bearing the certification 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 is recorded in the South Essex Registry or Deeds and indexed under the name of the owner of record or is recorded and noted on the owner's Certificate of Title. Board of Appeal n Is 3� rt MC) Cis 31 T �Cn r om C T i O mn � cc .H 6%s-9-1. h Public PrnpertU Bepnrtment \fnNEr% Nuilbing Department (One #alem Green 500-745-9595 Ext. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer February 8, 1993 James & Gail Sagris 10 Deafborn St. Salem] MA 01970 RE: 10 Dearborn St. (R-2) Dear Mr. & Mrs. Sagris: On January 15, 1993 I sent a letter to you regarding the demolition of the deck at the above referenced property. While I did not set a time limit on your contacting this office, I did expect to hear from you by now. The building permit was obtained December 15, 1992 and I do think there has been sufficient time, weather conditions notwithstanding, to have accomplished this demolition. You are hereby notified to contact this office within seven (7) days of receipt of this notice so we can get this matter resolved in a timely fashion. Sincerely, Leo E. Tremblay Zoning Enforcement Officer LET:bms cc: City Solicitor Councillor Hayes Councillor O'Leary Certified Mail QIP 009 226 193 ,J March 2, 1995 Mr . Leo Tremblay Building Inspector City of Salem One Salem Green Salem, MA 01970 Dear Mr . Tremblay: I am writing to youln follow up of a telephone conversation we had in early February. As I agreed, the illegally constructed deck: on my property at 10 Dearborn Street must be removed. Toward the accomplishment of said task, I obtained the required demolition permit , a r=opy of which is enclosed. I understand you may have rec=eived calls from certain individuals inquiring as to when I will be accomplishing the removal of the deco. It is my assurance that this removal will be effected no later than May 31 , 1553. I will call your office for a final inspection to approve all finished work. Sincerely, a es H. Sagri lu l7EAKi362N ST, SALEM , mA• b19'}U R = APPLICANT COPY CITY OF SALEM - BUILDING =[ SALEM MASSACHUSETTS 01970 PERMIT FA r ' '.;,• .'t. i a,'i;. VA,LIOATION r a4COUNT Pe, ,, _DATE - 6cC 15• 19 92PEf(MIT No 2 APPLICANT ... James �SagriB 'r-t'.. .ADDRESS 1O'De61 WTSI Ot, 4 Okmer , Ir. 6 IND 1 IS TAt[tl "- ICO I [ ![ f(I PERMrT TO TIIwnliafi ;(_I TORY' TX` T.IAY�� - NUMBEP• OF T - - -u DWELLING LNITS nr.( o• w.Aort M[xi(y xo. v.o.osEn usu + AT ILOCA:,ONI 10 Dps rfnrri C;frnFsf W;4r(i 6 - ;:o'DISTRICT CT" R-2 (STIIE(TI .. BETWEEN -'� AND . ICIIDf> fTllE[tl , ICMDSS'ET1((il ,LOT _ SUBDIVISION LOT BLOCK 512E _ BUILDING IS tTO BE FT WIDE.Brt FT; LONG BY F.T. N HE�IGNT AMD SHALL CONFORM IM y:,:� .COM STBUCTION� [�ryBy ddNN,, J! tv 2 ,� •e.:,. .a. .;I. If'� t f 1 TO TYPEUSE GROUP - BASEMENT WALLS OR FOUNDATION §- ' - + Ir r[! REM.RK5 Oemlish illegally constructed deck 1 TA CALL FM INSPk=ION 745-9595 AREA OR (A PER MIT C ._-ZO.OO VOLUME 4 ESTIMATED F -COST $ — J csc uER AW NER James,Sagr - - - -o.F<5 1 rn St.;- Salem,MA P�ttriceM. M@maneau INSPECTOR :OF BULLDINGS sl LL L C/YY� '-/�.� ', �a�s��� G�-� �� �ete.J ���,��,��. � /�s/�.� SENDER: • Complete items 1 and/or 2 for additional services. I also Wish to receive the • Complete items 3,and 4a&b. ' following services (for an extra • Print your name and address on the reverse of this form so that we can fee): return thiscard to you. • Attach this form to the front of the mailpiece,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. ElRestricted Delivery • The Return Receipt Fee will provide you the signature of the person delivers to and the date of delivery. Consult postmaster for fee. 3. Article Addressed to: 4a. Article Number James & Gail Sagris P 009226193 10 dearborn St. 41b. Service Type Salem, MA 01970 ❑ Registered ❑ Insur.;d Certified ElCOD ❑ Express MailFt_eturn Receipt for `-Ivlerchan 7. Date fFli leC've,1t 5. Signat re (Addressee) 6. Addressee's Address(Only if requested and fee is paid) 6. Signature (Agent) PS Form 3811, November 1990 *U.S.cpo:lael-2a7-ose DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERVICE Official Business i. PENALTY FOR PRIVATE USE, $300 Print your name, address and ZIP Code here •Leo E. Tremblay Zoning Enforcement Officer One Salem Green Salem, MA 01970 e CfttU of �*atrM, .4ftaSSar4uSEttjj Public Prnpertp Department Nuilbing 19epartment (One Salem Green 5Q8-745-9595 Ext. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer February 8, 1993 James & Gail Sagris 10 Dearborn St. Salem, MA 01970 RE: 10 Dearborn St. (R-2) Dear Mr. & Mrs. Sagris: On January 15, 1993 I sent a letter to you regarding the demolition of the deck at the above referenced property. While I did not set a time limit on your contacting this office, I did expect to hear from you by now. The building permit was obtained December 15, 1992 and I do think there has been sufficient time, weather conditions notwithstanding, to have accomplished this demolition. You are hereby notified to contact this office within seven (7) days of receipt of this notice so we can get this matter resolved in a timely fashion. Sincerely, Leo E. Tremblay Zoning Enforcement Officer LET:bms cc: City Solicitor Councillor Hayes Councillor O'Leary Certified Mail #P 009 226 193 Pubtir Propertg Department Nuilhing Repartment (One 6nlem (Sheen 508-745-9595 Ext. 380 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer January 15, 1993 James & Gail Sagris 10 Dearborn St. Salem, MA 01970 RE: IO Dearborn St. (R-2) Dear Mr. & Mrs . Sagris: On December 15, 1992 you pulled a building permit to demolish an illegal deck at the above referenced site as per the denial of the Board of Appeal . As to date, this deck as not been removed. I realize that the weather at this time is not conducive to this type of outside work but I would appreciate your removing said deck as soon as possible. Please contact this office upon completion of the demolition. Sincerely, Leo E. Tremblay Inspector of Buildings Zoning Enforcement Officer LET:bms cc: Councillor O'Leary li 1�alrm, Aussachu effil Publir Propertg Department Nuilding Department lone l9nlem Green 500-745-9595 Ext. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer January 15, 1993 James & Gail Sagris 10 Dearborn St. Salem, MA 01970 RE: 10 Dearborn St. (R-2) Dear Mr. & Mrs. Sagris: On December 15, 1992 you pulled a building permit to demolish an illegal deck at the above referenced site as per the denial of the Board of Appeal . As to date, this deck as not been removed. I realize that the weather at this time is not conducive to this type of outside work but I would appreciate your removing said deck as soon as possible. Please contact this office upon completion of the demolition. Sincerely, - 1 Leo E. Tremblay Inspector of Buildings Zoning Enforcement Officer LET:bms cc: Councillor O'Leary C � SENDER: • Complete items 1 and/or 2 for additional services. I also Wish to receive the • Complete items 3,and 4a&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 mailpiece,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. Article Number James & Gail Sagris P 009 225 548 10 Dearborn S'L. 4b. Service Type Salem, MA 01970 ❑1 Registered ❑ Insured Certified ❑ COD ❑ Express Mail ,Z Return Receipt for Merchandise livery 7. Date of el r J t 5. Signature (Addressee) ✓' B. Addressee's Address (Only if requested and fee is paid) 6. Signature (Agent) PS Form 3811, November 1990 *U.S.GPO:1991-287-w6 DOMESTIC RETURN RECEIPT UNITED STATES POSTAL SERVWE� ESSF , Sp+ash Official Business o LO cvi OC a. 13 DEC } of Fun I ✓ �: 2 Colfe: c St= i PENALTY FOR PRIVATE USE, 3300 Print your name, address and ZIP Code here Leo E. Tremblay, Insp. of Buildings One Salem Green Salem, MA 01970 lit,::iii1161iiis i111,itillil1 (situ of .. alcm, fassar4usetts T Vubtic Vrnpertp i3epnrtment +'Sudbing Department (One 6atem 16reen 500-745-9995 Ext. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer December 11, 1992 James & Gail Sagris 10 Dearborn St. Salem, MA 01970 RE: 10 Dearborn St. (R-2) Dear Mr. & Mrs. Sagris: The City of Salem Zoning Board of Appeal denied you petition for a deck at the above referenced property on July 22, 1992. On September 30, 1992 you repetitioned the Board and the Board voted there was no substantial or material change. The twenty (20) day appeal period has elapsed and no appeal was filed, therefore you are hereby notified to contact this office within seven (7) days of receipt of this notice in order to apply for a permit to demolish said deck. Failure to comply with this notice will result in this office taking the appropriate legal action. Sincerely, Leo E. Tremblay Zoning Enforcement Officer LET:bms cc: City Solicitor Councillor Hayes Councillor O'Leary Certified Mail # 009 226 548 December 11, 1992 James & Gail Sagris 10 Dearborn St. Salem, MA 01970 RE: 10 Dearborn St. (R-2) Dear Mr. & Mrs. Sagris: The City of Salem Zoning Board of Appeal denied you petition for a deck at the above referenced property on July 22, 1992. On September 30, 1992 you repetitioned the Board and the Board voted there was no substantial or material change. The twenty (20) day appeal period has elapsed and no appeal was filed, therefore you are hereby notified to contact this office within seven (7) days of receipt of this notice in order to apply for a permit to demolish said deck. Failure to comply with this notice will result in this office taking the appropriate legal action. Sincerely, Leo E. Tremblay Zoning Enforcement Officer LET:bms cc: City Solicitor Councillor Hayes Councillor O'Leary L abed 9860Z9L8L6 9S:Ll OZ-SO-60OZ i The Commonwealth Of Massachusetts Town of Board of Building Regulations and Standards a� Massachusetts State Building Code. 780 CMR, 7'a edition Building Dept Building Permit Ap ton o notruct, Repair, Renovate Or Demolish a � One-or Tit, -Family Dwelling Se tion For Official Use Only !SignaWrurc; i Date Applied: t ' 7 •uildings DareION 1:SITE INFORMATION 1.1 Pro�pertyY��Address: 1.2 Assessors Map& Parcel Numbers /�. Ma Number Parcel Number 1.1 a Is this an accepted street!yes no P IJ Zoning Information: 1.4 Property Dimensions; Zoning District Proposed Use Lot Area(sq R) Frontage(II) 1,5 Building Setback$(R) Front Yard Side Yards Rear Yard Required Provided RcgoiredProvided Required Prav(dad 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone fntormatlon: 1.8 Sewage Disposal System- Zone!/ Zone: _ Outside Flood Zone? Municipal O On site disposal system O Public p' Private❑ Check if esO SECTION 2: PROPERTY OWNERSHIP' 2.1 weler'of Re or rn I rn r— \ 10 O _ �N INe (Pring Addres forServiee: i unTelephone SECTION 3: DEION OF PROPOSED WORK'(check a6 that apply) New Coostruction EI C'xisting Building 4wnar-(,lrcupied O Repairs(s) Alleratiort(s) O Addition p Demolition O Accessory Bldg.D Number of Uhtta—go vusot u sywuy. Brief Description of Proposed WorV: SECTION a:ESTIMATED CONSTRUCTION COSTS I Estimated Costs: OfRclal Use Only Item Labor and Materials $ 1. Building Pctmit Fee: S Indicate how fee is determined: I. Building ❑Standard City/Town Application Fee 2. Electrical S 13 Total Project Cosh(Item 6)x multiplier x ). Plumbing $ 2. Other Fees: S 4. Mechanical (HVAC) E List' w 5. Mechanical (Fire 5 Total All Fees: S -.. w. . Su ression Check No._check Amount: Cash Amount:- 6. Total Project Cost: S O Paid in Full. ❑Outstanding Balance Due: ,+Adair: 7W /o 60/10 39Vd 3-1aVI-138 8860Z9LBL6 90:91 60OZ/TZ/90 SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) e "Z— Z�I V Liccnsc Num er Expiration Dace Ngmc C�SL�HnplJer C 1 List CSL Type(see below) AJJr}ss .1-•/�- s` 4 / T Descn tion �G r✓r _� ���... Unrestricted fura to 35,000 Cu. Ft.) Restricted 1&2 FamilyDwellin Signal ire / M Mason Only 5'E L� RC I Residential Roofin Covering WS I Residential Window and Siding `eP SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Registered Holm.I . 7rgm�Contractor(HIC) HIC Com y N eo HIC Re / ant Naw Registration Number Address , 2 3 /-13 // � Expiration Date Signature Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.; 25C(6)) Workers Compensation Insurance affidavit must be comOeted and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance 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, <<S O- r2-e as Owner of the subject property hereby authorize c to act on my behalf,in all matters 'veto work authorized y this building pem5it application. Tbehalf� ature of Owner Date SECTIO b: OWNER'OR AUTHORIZED AGENT DECLARATION as Owner or Authorized Agent hereby declare the statements and information on the foregoing application are true and accurate, to the best of my knowledge and Print e PIA Cr ! / _ Sign of Owner or Authorized Agen _Date S' ne44nder the pains and penalties ofperjury) 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.116 and I I O.RS, respectively. 2. When substantial work is planned,provide the information below: Total floors 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 halfibaths 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" U' The Commonwealth of Massachusetts Z), Town of Board of Building Regulations and Standards Massachusetts State Building Code, 780 CMR, T"edition Budding Dept Building Permit Application To Construct, Re Renovate Or Demolish a ! One- or Tu'o-F r ) Dn'elii g This tion F r tial se my Building Permit Nu er: D e d: q� Signature: �O'T�i t v Building Commissioner nspect rof Build s Date CTI 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers J \,ec, J ✓ t rnn -S i I.I a Is this an accepted street?yes__,Z no. Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq R) Frontage(R) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.O.L C.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Municipal 0_`6n site disposal system ❑ Public G� Private❑ Check if yesO SECTION 2: PROPERTY OWNERSHIP' 2.1wner'of Recod: I !]f'c �^e(Print) Address for Service: \ I7 T 2 S n3a— �ign ure Telephone SECTI J: DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction O Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ I Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work: ✓ cra SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Official Use Only Item Labor and Materials I. Building b `LY B� c•' I. Building Permit Fee: E Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ' cicla. ❑Total Project Cost'(Item 6)x multiplier - 3. Plumbing S y UOr) 2. Other Fees: S 4. Mechanical (HVAC) S List: a 5. Mechanical (Fire S Total All Fees: S Su ression �LJ �7 Check No. _Check Amount: Cash Amount: J 6. Total Project Cost: s V-00d ❑ Paid in Full ❑Outstanding Balance Due: v0.17�a11'66'.5 3 ' A/ H �ti�vP,-s Mtiaiq �3 )I SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) q Y '' q Z 2— "Deserintion License Number EsN,gmc ofCSL-Holderet , riNV_w \r_/ { P� List CSL Type(see below)Jress lel���eee:::.. b �=l MD11tesidential Unrestnctrd u to 35Restricted 1&2 FamJ'Signature �sMason Onl _ $ 0Q/ 3Z.0 ff (2— Residential Roofing Covering Telephone Residential Window and Siding Residential Solid Fuel Burning Appliance Installation Demolition 5.2 egistered Home Improvement Cgntra for( C) yt .0 v 2w i) -4g '✓L I o (l Mc Com an Name or H C Re istrant Name Re istration Nu ber ddrc t/ H ZO (J Expirationuatle nature 1 �— Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.4 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 7s: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, P O as Owner of the subject property hereby authorize - V �t u �tio to act on my behalf,in all matters relative to work authorized by this building pe it application. / �J Si g'atumprowner Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and behalf. Print Name Signature of Owner or Authorized Agent Date Si ned under the pains and penalties ofperjury) 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I I O.R6 and I 10.115, respectively. 2. When substantial work is planned, provide the information below: Total floors 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 hal6baths 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"