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118 DERBY STREET - BUILDING JACKET rSuper iab. 90%Larger Label Mea • •�•^• /// SMEAD kw KEEPING YOU ORGANIZED olm io101 www•ry I/aft In YOA GET ORGAl1M AT SMEAD.COM WSPOSTWam rrttN�maaxaert Segaerrchitects, inc May 21, 2013 Michael Lutrzykowski Inspectional Services Department City of Salem 120 Washington Street,Salem,MA Re:Code review for Existing Restaurant Space Red Line Caf6-188 Essex Street-Salem,MA Ref:2009 International Existing Building Code w/MA State Amendments 8t'Edition Ref:2009 International Mechanical Code 301.1 Assembly Group A Existing Use Group-Assembly A-2. Proposed Use Group-Assembly A-2(no change of use). Occupancy: Chapter 9 Complies(No Change of Use) Alterations:Chapter 6. Level 1. Complies Means of Egress: Chapter 10-(2 existing means of egress)that fully comply. Accessibility: 521 CMR: Massachusetts Architectural Access Board-Complies. Sprinkler System:The existing building and restaurant space is fully-sprinklered. Floor Area: Existing Seating Area:900 SF Existing kitchen/Service/Storage Area:750 SF Total Retail Space 1,925 SF Scope of Work:The extent of work for the project is limited to interior finishes including new flooring, paint and the replacement of light fixtures.The new restaurant equipment is limited to new refrigerators,freezers,and an electric crepe maker and electric convention oven. Summary of Code Review:The existing restaurant and improvements to,fully complies with the 2009 IBC requirements for egress, life safety, occupant load, and accessibility requirements as further calculated below.The building is fully sprinkled. The allowable occupancy load for the restaurant table seating area is 60 persons and 4 persons at counter seating.The allowable occupancy load for the exterior seating area is 12 persons.The exterior seating will be seasonal.The tenant is to confirm with the landlord that the existing ventilation system meets the requirements for outdoor airflow rate (refer to below). 507.2.2 Type II hoods.Type II hoods shall be installed above dishwashers and light-duty appliances that produce heat or moisture and do not produce grease or smoke,except where the heat and moisture loads from such appliances are incorporated into the HVAC system design or into the design of a separate removal system.Type II hoods shall be installed above all light-duty appliances that produce products of combustion and do not produce grease or smoke.Spaces containing cooking appliances that do not require Type II hoods s. II be ventilated in accordance with Section 403.3. For the purpose of determining the floor area required to be ventilated,each individual appliance that is not required to be installed under a Type II hood shall be considered as occupying not less than 100 square feet(9.3 m''). 168 Essex Street-Page 1 of 3 f � Segaerrchitects, inc 403.3 Outdoor airflow rate.Ventilation systems shall be designed to have the capacity to supply the minimum outdoor airflow rate determined in accordance with this section.The occupant load utilized for design of the ventilation system shall not be less than the number determined from the estimated maximum occupant load rate indicated in Table 403.3.Ventilation rates for occupancies not represented in Table 403.3 shall be those for a listed occupancy classification that is most similar in terms of occupant density,activities and building construction; or shall be determined by an approved engineering analysis.The ventilation system shall be designed to supply the required rate of ventilation air continuously during the period the building is occupied,except as otherwise stated in other provisions of the code. Note:See below for requirements of posting of occupant load. 1004.3 Posting of occupant load.Every room or space that is an assembly occupancy shall have the occupant load of the room or space posted in a conspicuous place, near the main exit or exit access doorway from the room or space. Posted signs shall be of an approved legible permanent design and shall be maintained by the owner or authorized agent. The approximate occupant load for the potential floor layouts calculated in accordance with 780 CMR Table 1004.1.1 is as follows: TABLE 1004.1.1 MAXIMUM FLOOR AREA ALLOWANCES PER OCCUPANT Floor Floor Area Per Floor Area Area Occupant Occupant (ft2) (ftZ/occupant) Load 1st Restaurant Seating Area 900 15 net 60 Outdoor Seating Area 180 15 net 12 Counter Seating Area 30 7 net 4 Kitchen/Storage/Service 750 100 net 7 1st Total 1,925 Total for Floor= 83 Exit Capacity(780 CMR Table 1005.1)with sprinkler system Occupant Exit Total Exit Capacity Provided Floor Load Allowance Status (in/person) (Persons) Exterior Exit 34"door/0.15= 226 1 130 0.2 (Stair) Rated corridor 0.15(Door Exit 34"door/0.15= 226 Total Capacity=(226)per egress 168 Essex Street-Page 2 of 3 Se93rYchitects, inc The following analysis was completed using the expected population of the building based on the seats provided in the floor layouts. The expected population can be used to determine the required number of fixtures with approval of the Plumbing Inspector. Plumbing Fixture Water Closets Male Lavatories HC Service Requirements Female Male Urinals Each Sex Water Sinks Closet Assemble Use Group A-2 (Function Hall, Restaurant) 1 per 1 pern 120Total 30 60 50% 1 per 200 Occupants 60 F, 60 M Required Fixtures 1 1 1 0 1 2 1 Provided Fixtures 1 1 1 3 2 1 Total Fixtures 1 1 1 1 2 1 " Urinals may be substituted for toilets up to the percentage shown of the required number. Base on my site visit and code review for the proposed Red Line Cafe' and too the best of my knowledge, information and belief the project is in conformance with the provisions of the 2009 IEBC and 8th Edition of the Massachusetts State Building Code and all other pertinent laws and ordinances. 30105 \S itEDA,p0'y� ARCHITECT—MASS. REG. NO. Q4�' ZN A. SFc TFC F ' Seger Architects, Inc. 9 30105 y COMPANY CA BRIDGE, MA 10 Derby Square,Salem,MA q�TNGr�f,ASS�c ADDRESS S/til ?Pi�f 978-744-0208 `I PHONE 168 Essex Street-Page 3 of 3 Symbol Legend 'F:�7 EXIST.EMERGENCY EXISTING DIRECTIONAL Review of Existing Restaurant Space. LIGHTIN6 9 EXIT 5I6N Refer to Building Code Review F CP EXIST.FIRE ALARM HS EXIST.HORN STROBE Attachment CONTROL PANEL 5GOPE OF WORK: The extent of work for the project is SD EXIST.SMOKE DETECTOR PS EXIST.FULL STATION limited to Interior finishes Including new flooring,paint and the replacement of light fixtures. The new restaurant equipment Is Ilmlted to new refrigerators, CD EXISTING CO2 DETECTOR EX1571NO FIRE EXTINCU15HER freezers, and an electric crepe maker and electric convention oven. ® EXISTING EXIT 516N F� ADD FIRE EXTINGUISHER NOTE: THE EXISTING SPRINKLER AND FIRE PROTECTION 5Y5TEH 15 FILLY IN PLACE AND HILL NEED TO BE TESTED PRIOR TO OCCUPANCY. opsin % ............ I -I I )- SERVICEAREA so 9m l (refer 10 kitchen designer plan) ® --------- _--- 1 J � I 4 EXIST.COUNTER ��--- - ---� l KITCHEN ✓� ®(refer is ldishen designer plan) to ap SEATING 00UNISEX TOILETLLJ SF W STOCKI OFFICE ' ELECT,CLOSET UNISEX TOILET i' L uJ 41 LX i Lu //%O//,il/��/�OLvq/�mO:G%�i/�����%U//ii/��.9�OFL•0//////l/�.uG9d0///////LO/�iw�io%C%///O/////,'Uig/////�/�00//�LOnX/,%���///�/�/�///��������///�/�///�/�/////�//�//%���///��/�/�/%�/////�/�/��%/��/��////�� � i EXISTING TENANT SPACE I i i S 4 i i Life Safety Plan �N %ALE.I/a"= I'-0"WS ' NOTE: PLAN SHOWS ALL EXI5nN6 LIFE SAFETY EMlPt rENr IN PLACE i ® % PEII C 4 /i�omiviii-i iiiniiv ie .. HST 5' ENTRANCE TO MALL o 0.30106 CAMBRIDGE, in MA CZE pg47Ff OF MPSSP Z� RED LINE CAFE' - RESTAURANT IMPROVEMENTS sEGER ARCHITECTS,INC. Scale:as noted 188 ESSEX STREET, SALEM, MA 10 Derby Square Salem MA Date:5/20/2013 72SHW x 90 x 3..8'SH of eto�stltd Fn lri P, s - 13F�yl4nY,aBck C w.aC^CYrr. <8._E4Yz2001`._u 2z'SLY%2.qe 7xg�; 4(10.N ICE-L,*,ER - .2iW x 2 R)x2=H SEAR L27 `/3114•:' 41 . CCFE E. F I C04R TE GF Tutt ~ � Lfj t z .i-`,3x ns 59^h z9+?7G%18:£UH tx.3 / P2 -wlel sul!re 11838'• 2� 4 / n �^ "r2x'a X fi {/.��� LarJe aa_r 2 cel f x'.?.^•x A '} aed- vE3aT FREE'EA 28138° »..ecria tf r Y e 3� 5212' �,x NY 9'1 t3 i�ha Erz Ct3UNZ TEF J ^a8 G x x_2?t n As•' -alow 72,ldw R21?7%?3'.= ar'— 'i 451 12" or 1 • 194 t!4" F � { 1 f ci118 V2' /ZEA UVF CfE�E.' e 4�L 4 eft• 6� #� _ vi afL 13c { i 5 � Y 1 Y � 1l SIC *S ZL rte€4 4[ 4 X4 .: — Z'i- l ,d C5} tA3 17 3 3 -w i.P 1911 241 1 30'0 6,1 " 49@1 J 77118 �1 ♦ e p w C GQ rCh tl r' Q F �... .. u - 4 Q tL __, fid 13t apt til t L t 6 Of Sa .. c f 117112" e. { 44 UT t. �--� Segaerrchitects, inc May 21, 2013 Michael Lutrzykowski Inspectional Services Department City of Salem 120 Washington Street,Salem, MA Re: Code review for Existing Restaurant Space Red Line Cafe-188 Essex Street-Salem,MA Ref:2009 International Existing Building Code w/MA State Amendments 8th Edition Ref: 2009 International Mechanical Code 301.1 Assembly Group A Existing Use Group-Assembly A-2. Proposed Use Group-Assembly A-2(no change of use). Occupancy: Chapter 9 Complies(No Change of Use) Alterations:Chapter 6. Level 1. Complies Means of Egress: Chapter 10-(2 existing means of egress)that fully comply. Accessibility:521 CMR: Massachusetts Architectural Access Board-Complies. Sprinkler System:The existing building and restaurant space is fully-sprinklered. Floor Area: Existing Seating Area:900 SF Existing kitchen/Service/Storage Area:750 SF Total Retail Space 1,925 SF Scope of Work:The extent of work for the project is limited to interior finishes including new flooring, paint and the replacement of light fixtures.The new restaurant equipment is limited to new refrigerators,freezers,and an electric crepe maker and electric convention oven. Summary of Code Review:The existing restaurant and improvements to,fully complies with the 2009 IBC requirements for egress, life safety,occupant load, and accessibility requirements as further calculated below.The building is fully sprinkled. The allowable occupancy load for the restaurant table seating area is 60 persons and 4 persons at counter seating.The allowable occupancy load for the exterior seating area is 12 persons.The exterior seating will be seasonal.The tenant is to confirm with the landlord that the existing ventilation system meets the requirements for outdoor airflow rate(refer to below). 507.2.2 Type II hoods.Type II hoods shall be installed above dishwashers and light-duty appliances that produce heat or moisture and do not produce grease or smoke,except where the heat and moisture loads from such appliances are incorporated into the HVAC system design or into the design of a separate removal system.Type II hoods shall be installed above all light-duty appliances that produce products of combustion and do not produce grease or smoke.Spaces containing cooking appliances that do not require Type II hoods shall be ventilated in accordance with Section 403.3. For the purpose of determining the floor area required to be ventilated,each individual appliance that is not required to be installed under a Type II hood shall be considered as occupying not less than 100 square feet(9.3 m'). v 168 Essex Street-Page 1 of 3 4 Segaerrchitects, inc 403.3 Outdoor airflow rate.Ventilation systems shall be designed to have the capacity to supply the minimum outdoor airflow rate determined in accordance with this section.The occupant load utilized for design of the ventilation system shall not be less than the number determined from the estimated maximum occupant load rate indicated in Table 403.3.Ventilation rates for occupancies not represented in Table 403.3 shall be those for a listed occupancy classification that is most similar in terms of occupant density,activities and building construction; or shall be determined by an approved engineering analysis.The ventilation system shall be designed to supply the required rate of ventilation air continuously during the period the building is occupied,except as otherwise stated in other provisions of the code. Note:See below for requirements of posting of occupant load. 1004.3 Posting of occupant load. Every room or space that is an assembly occupancy shall have the occupant load of the room or space posted in a conspicuous place, near the main exit or exit access doorway from the room or space. Posted signs shall be of an approved legible permanent design and shall be maintained by the owner or authorized agent. The approximate occupant load for the potential floor layouts calculated in accordance with 780 CMR Table 1004.1.1 is as follows: TABLE 1004.1.1 MAXIMUM FLOOR AREA ALLOWANCES PER OCCUPANT Floor Floor Area Per Occupant Floor Area Area Occupant (ft') (ftZ/occupant) Load 1st Restaurant Seating Area 900 15 net 60 Outdoor Seating Area 180 15 net 12 Counter Seating Area 30 7 net 4 Kitchen/Storage/Service 750 100 net 7 1st Total 1,925 Total for Floor= 83 Exit Capacity(780 CMR Table 1005.1)with sprinkler system Occupant Exit Total Exit Capacity Provided Floor Allowance Status Load (in/person) (Persons) Exterior Exit 34"door/0.15= 226 1 130 0.2(Stair) Rated corridor 0.15(Door Exit 34"door/0.15= 226 Total Capacity=(226)per egress 168 Essex Street-Page 2 of 3 Segaerrchitects, inc The following analysis was completed using the expected population of the building based on the seats provided in the floor layouts. The expected population can be used to determine the required number of fixtures with approval of the Plumbing Inspector. Plumbing Fixture Water Closets Male Lavatories HC Service Requirements Female Male Urinals Each Sex Water Sinks Closet Assemble Use Group A-2 (Function Hall, Restaurant) 1 per 1 pern 120Total 30 60 50% 1 per Z00 Occupants 60 F, 60M Required Fixtures 1 1 0 1 2 1 Provided Fixtures 1 1 1 3 2 1 Total Fixtures 1 1 1 1 2 1 " Urinals may be substituted for toilets up to the percentage shown of the required number. Base on my site visit and code review for the proposed Red Line Cafe' and too the best of my knowledge, information and belief the project is in conformance with the provisions of the 2009 IEBC and 8th Edition of the Massachusetts State Building Code and all other pertinent laws and ordinances. 30105 \S FED ARCy� ARCHITECT—MASS. REG. NO. A. SFe rFn� Fp Seger Architects,Inc. o 30105 r, COMPANY 10 Derby Square,Salem.MA ADDRESS 978a44-0208 PHONE 168 Essex Street-Page 3 of 3 Symbol Legend EXIST.EMERGENCY Ex15TIN6 DIRECTIONAL Review of Existing Restaurant Space. L16HTIN6 e EXIT SIGN Refer to Building Code Review CP EXIST.FIRE ALARM RS EXIST.HORN STROBE Attachment. F CONTROL PANEL 5OOPE OF WORK: The extent of work for the project 15 $D EXIST.SMOKE DETECTOR © EXIST.PULL STATION limited to Interior finishes Including new flooring,paint and the replacement of light fixtures. The new restaurant equipment 15 limited to new refrigerators, CD EXI5TIN6 CO2 DETECTOR EXI5TIN6 FIRE EXTINGU15HER freezem,and an electric crepe maker and electric convention oven. ® EXI5iIN6 EXIT SIGN ® ADD FIRE EXTINC05HER NOTE: THE EXI5TIN6 SPRINKLER AND FIRE PROTECTION SYSTEM 15 FULLY IN PLACE AND WILL NEED TO BE TESTED PRIOR TO OCCUPANCY. so i ® G ! 8 1, SERVICE AREA % (refer to kitchen designer plan) -------------------- -- '/ J S EXIST.COUNTER jj//%%%%%/%///,ij////��®(refer to MKITC designer plan) 1/ 7 7Z �� _ ,iiouiiovivv...zvo...�< I � ivao..opiiivoivv i -voiiunioiu ioiuvr i- ..iwm voi. SEATING UNISEX TOILET i Lu 900 SFILL! MIMMIMM111111ell CL STOCK/OFFICE ELECT,CLOSET i so N.LC. r L $ UNISEX TOILET i 2 W 5 f rn W ._._._._ _ _____.___________._.�z i TRIM 4-41 W ///iiviivd////%fl//i/ivm i EXISTING TENANT SPACE i II Life Safety Plan SCALE: Ile,"= I,-0„ EM P tiaED AIfCyA NOTE: PLAN 51-10106 ALL EXI5TIN6 LIFE 5AFETY EGUIPIIENT IN PLACE. ® % �,� 30105 ENTRANCE TO MALL AFd RIDGE, y ASA �J ' �A{l},CFMPSSP RED LINE CAFE' - RESTAURANT IMPROVEMENTS SEGER ARCHITECTS,INC. Scale:as noted A-1 188 ESSEX STREET, SALEM, MA 10 Derby square Salem MA Date:5/20/2013 i CITY OF SALEM, NIASSACHUSETTS BOARD OF APPEAL 120 WKHINC'I'ON SI RET *$AI Y\I,\[.\SSACLWSI'!'rIS 01970 �MINBD FFLE:978-619-5685 ♦ FAX:978-740-0404 KINIBR.RI.GY DRISCO11 MAYOR CM) October 3, 2012 r o aT Decision �m w m City of Salem Zoning Board of Appeals N i w N 00Petition of CHRISTINE BURKINSHAW requesting a Variance from side yard setbdft and a Special Permit to extend a nonconforming structure, in order to construct an addition to the second floor unit located on 118 DERBY ST(BS Zoning District). A public hearing on the above Petition was opened on September 19, 2012 pursuant to Mass General Law Ch. 40A, § 11. The hearing was closed on September 19, 2012 with the following Zoning Board of Appeals members present: Rebecca Curran (Chair), Michael Duffy, Jimmy Tsitsinos, Annie Harris and Richard Dionne. Petitioner seeks a Special Permit pursuant to Section 3.3.3 and a Variance pursuant to Section 4.1 of the City of Salem Zoning Ordinances. Statements of fact: 1. In a petition date-stamped July 24, 2012, petitioner requested a Variance and a Special Permit to construct a second-floor addition on the property located at 118 Derby St. 2. In the course of reviewing the application, the Building Commissioner determined that only a Special Permit would be required to construct the addition, and not a Variance, as requested. 3. At the hearing, Paul Lessard, the petitioner's architect, presented the petition. Owners Robert and Christine Burkinshaw were also present. 4. At the hearing, Mr. Lessard stated that the addition would provide a better egress for the upstairs apartment, and that the lower level would be storage for Ye Olde Pepper Company, the adjacent candy store, which the petitioner also owns. S. At the hearing, no member of the public spoke in favor of or against the project. I The Board of Appeals, after careful consideration of the evidence presented at the public hearing, and after thorough review of the plans and petition submitted, makes the following findings: 1. Desirable relief may be granted without detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the zoning ordinance. The proposed addition would improve the building and the property, and provide a better second-story egress. While the building would increase in square footage, the addition is small. The project does not present any problems with regard to parking. 2. In permitting such change, the Board of Appeals requires certain appropriate conditions and safeguards as noted below. On the basis of the above findings of fact and all evidence presented at the public hearing including, but not limited to, the Plans, Documents and testimony, the Zoning Board of Appeals voted five (5) in favor (Curran, Dionne, Tsitsinos, Harris and Duffy) and none (0) opposed, to grant the requested Special Permit. A Special Permit under Section 3.3.3 is granted to allow for the proposed addition as shown on the submitted plans. The Board of Appeals voted to grant petitioner's request for a Special Permit subject to the following terms, conditions, and safeguards: 1. Petitioner shall comply with all city and state statutes, ordinances, codes and regulations. 2. All construction shall be done as per the plans and dimensions submitted to and approved by the Building Commissioner. 3. All requirements of the Salem Fire Department relative to smoke and fire safety shall be strictly adhered to. 4. Petitioner shall obtain a building permit prior to beginning any construction. 5. Exterior finishes of the new construction shall be in harmony with the existing structure. 6. A Certificate of Occupancy is to be obtained. 7. A Certificate of Inspection is to be obtained. 8. Petitioner is to obtain approval from any City Board or Commission having jurisdiction including, but not limited to, the Planning Board. 9. Unless this Decision expressly provides otherwise, any zoning relief granted does not empower or authorize the Petitioner to demolish or reconstruct the structure(s) located on the subject property to an extent of more than fifty percent (50%) of its floor area or more than fifty percent (50%) of its replacement cost at the time of destruction. If the structure is demolished by any means to an extent of more than fifty percent (50%) of its replacement cost or more than fifty percent (50%) of its floor area at the time of destruction, it shall not be reconstructed except in conformity with the provisions of the Ordinance. Rebecca Curran, Chair Salem Board of Appeals 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 the Massachusetts General Laws Chapter 40A, and shall be filed within 20 days of filing of this decision in the office of the City Clerk. Pursuant to the Massachusetts General Laws Chapter 40A, Section 11, the Variance or Special Permit granted herein shall not take effect until a copy of the decision bearing the certificate of the City Clerk has been filed with the Essex South Registry of Deeds. 3 � � �1�. ., r e ' ; N �. .� rl�... p. . �,rr � �' The Commonwealth of Massachusetts I�� f� q 1, Boazd of Building Regulatioris and Standards CITY OF Massachusetts State Building Code,780 CMR SALEM �� V� Revised Mar 20I1 Building Permit Application To Construct,Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: � if1��� Building Official(Prin[Name) - Signa e i Date SECTION 1: SITE TNFORMA ION 1.t Property Address: 1.2 Assessors Map&Parcel Numbers /�8 i �rl�• 5-f✓u� 1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number 13 �oning Information: 1.4 groperly Dimensions: Zoning District - �Proposed Use � Lot Area(sq 8) Frontage(ft) � 1.5 Building Setbacks(ft) Front Yard Side Yards . Reaz Yazd Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c:4Q§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Zone: _ Outside Flood Zone? Munici al�n site dis osal stem ❑ C� Private❑ Check if yesO P P � SECTION 2: PROPERTY OWNERSHIP' 2.1rf�wner'of Record• 'n �Gc�/Zrf L� �rz i'r 5hfl�n r 1 /o���1 19viC�C�(,+-Gk /YI/�'j � 18L1S � Nam�n[) City,State,ZIP 11�✓-fr�yh A-�i� C�17�) c�$S -d �{ ��.Q.F�r�Rh�nshAcU �r� v�r��aoh No.and Street Telephone Email Address �/I e'r � SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building C3� Owner-Occupied ❑ Repairs(s) GY Alteration(s) ❑ Addition E� Demolition Accessory Bldg.❑ Number of Uniu� Othet ❑ Specify: Brief Description of Proposed Worl�: o po, q � v� � .,...� v�[C � .p' ,�y O T SECTION 4: ESTID7ATED CONSTRUCTION COSTS Item Estimated Costs: Of5cial Use Only Labor and Materials 1. Building $ `-3O o� . o" I. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ �� .� � Standard City/Town Application Fee O Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ ' 2. Other Fees: $ 4.Mechanical (HVAC) $ � �'�� 5.Mechat�ical (Fire $ Total All Fees: $ Su ression Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 0��, ❑p�d in Full ❑Outstanding Balance Due: . � � conm�r � ^ �.�`"�' ''��'�5�, _ � ; - �a '�� . ,. �,�T .. �ainm�aW�' Salem HistoYical Commission 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 07970 (978)619-5665 FAX(978)740-0404 _ CERTIFICATE OF APPROPRIATENESS It is hereby certified that the Salem Historical Commission has determined that the proposed: O Construction ❑ Moving ❑ Pronstruction ❑ Alteration ,��:_ ❑ l�i�;�tolition ❑ Painting �' ," ;signage ` ❑ Other work ; as dis:Y;,�ibed below will be appropriate to the preservation of said Historic District;as per the requirements set fort� in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: Derb}�Street Address of Property' 1 1 R nerh�,4treet Name of Record Owner: Robert Burkinshaw Description of Work Proposed: Add roof�ri�Jge vent to house, as detailed in plans dated 6/9/13. A soffit vent wzll be located under the ridge vent. :> A.sc;..;tti;aitional window to the previously approved addition, as detailed in plans dated 6/9/13. >.,,.. Dated: June 27, 2013 SALEIVI HISTORICAL COMNIISSION By'�CLi�"�i%�tti�h� The homeowner has the option.not to commence the work(unless it relates to resolving an outstanding violationl,,;;A11 work commenced must be completed within one yeaz from this date unless otherwise indicated. T;�[w t "!(�T A BUII,DING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Bui c'� ;s (or any other necessary permits or approvals)prior to commencing work. I - - , . . �. . � � • � SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor Liceose(CSL) ��R � �N 13 �S w L � �� g' �,�,r� License Number Expiration a[e Name of CSL Holder r ` � Lis[CSL Type(see below) (�) ].N 1� �10 r�h v�f-Ce � TYPe Description No.and Stree[ � O �G�� U Unrestricted uildin s u to 35,000 cu.ft. � -A�e�_� i'Y)✓-i� i R Restricted 1&2 Famil Dwellin Ciry/I'own,State,ZIP � M Maso RC Roofin Coverin � WS WindowandSidin SF Solid Fuel Buming Appliances ct7$ gO8 �(�6 � ,� �y�,�-10 ( I Insula[ion Tele hone /}% Email address G �H�i . D Demolition 5.2 Registered Home Improvement Contractor(I-IIC7 �� / /��_�'S ?� I O lA , -� � > >�97,� �C11 I-IIC Registra[ion Number E pi 'on Date HIC Company Name or HIC Regishant N te / - r ���J QJaV-��(�_ 5"r✓-CsC `� �y✓le/7 fohs�l��L('��oh , il^ No.andStreet - ' Emailaddress ym�.�'� , a� SA(er.vi YVIi4 CJ )q-�o Ci /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..........L9� . No...........❑ SECTION 7a: OWIYER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUQ.DING PERMIT I;as Owner oFthe subject pmperty,hereby authorize IitJ ' eY` to act y ehalf 'rall matters relative to work authorized by this building ermit application. � � 7• /7• /�_— � Owner's Name( ectronic Signature) ' Date SECTION 76: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the informa6on contained in this application is hue and accurate to the best of my F�owledge and understanding. � � ��• I� Print Owner's or Authonzed Ag Ys Name(Electronic Signa[ure) � at�— 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 infotmation on the HIC Prograu�can be found at www.mass. o� v/oca Information on the Construction Supervisor License can be found at www.mass. o� v/dos 2. When substantial work is planned,provide the infortnation below: Total floor area(sq.ft.) (including garege,finished basemenUattics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of Sreplaces 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. 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