27 DUNLAP STREET - BUILDING JACKET .27 DUNLAP STREET
f
Certificate Number: B-15-384 Permit Number: B-15-384
Commonwealth of Massachusetts
City of Salem
This is to Certify that the .......................................................... Multifamily 3+ Building............................... located at
Building Type
27 DUNLAP STREET in the Ci o Salem
................................................................................................................
...................................................................................................
Address ............................................. .................................................
Town/City Name
IS HEREBY GRANTEE) A PERMANENT CERTIFICATE OF OCCUPANCY
C/o unit # 1
CANDICE REALTY TRUST
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires ................................Not Applicable unless sooner suspended or revoked.
Expiration Date
Issued On: Thursday, February 18, 2016
Certificate Number: B-15-384 Permit Number: B-15-384
Commonwealth of Massachusetts
City ®f Salem
This is to Certify that the
....................................................................Multifarn.Zy 3+ Building located at
Building Type
27 DUNLAP STREET in the Ci
..............................................................................................................................................................................................I.................... ............................................ty o f . . . ..Salem
...............................................
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY
c/o unit#2
CANDICE REALTY TRUST
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires Not Applicable unless sooner suspended or revoked.
Expiration Date
Issued On: Thursday, February 18, 2016
Certificate Number: B-15-384 Permit Number: B-15-384
Commonwealth of Massachusetts
City of Salem
This is to Certify that the Multifamily 3+ Building located at
...............................................................I...... ..... .............................................................................................
Building Type
.......................................--.............................27 DUNLAP STREET in the .....................................City_of Salem
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY
C/O unit #3
CANDICE REALTY TRUST
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires ...............................NotAPPAi 9 ... unless sooner suspended or revoked.
Expiration Date
Issued On: Thursday, February 18, 2016
CITY OF SALEM
PUBLIC PROPERTY
a DEPARTMENT
KIMIIERLEY DRISCOLL
MAYOR 120 WASHINGTON STREET♦ SALEM,MASSACHUSETTS 01970
TSL:978-745-9595 ♦ FAX:978-740-9846
REQUIRED INSPECTION
27 Dunlap Street
December 13, 2013
Thomas P. Michaud
27 Dunlap Street—Unit 1
Salem,Massachusetts 01970
The above referenced property has come to the attention of this department for the following
reason(s):
As discussed at our meeting on Thursday, December 12, 2013 at your property at 27 Dunlap Street,
along with Elizabeth Gagakis of the Salem Health Department. Access to your basement and first
floor apartment is required to follow up on complaints made to our Department. Additionally life
safety and egress stairway violations have been noted at the property,for these reasons an
inspection must be conducted by our inspection team to assure compliance with the code and city
ordinances.
Under the provisions of 780 CMR, Section 115.6,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 shall be conducted on Wednesday, December 18, 2013 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)-745-9595, extension 5648.
Respectfully,
Michael Lutrzykowski
Assistant Building Inspector
rr �y
�"� `, � a +20 Washington St 3rd Floor Salem,IvL4 01970(978)745-9595 x5641
� n
Return card to Building Division for Certificate of Occupancy
L
Structure CITY OF. SALEM BUILDING PERMIT
Excavation PERMIT TO BE POSTED IN THE WINDOW
Footing INSPECTION RECORD
Foundation
i
Framing r
Mechanical 4 F,
Insulation INSPECTION: BY DATE
Chimney/Smoke Chamber
Final PAI
Plu bing/Gas
Rough:Plumbing,
Rough:Gas
Final 1�
UElectrical
Service e
Rough
Final r
izsr1
Fire Department
Preliminary
Final
Health Department
Preliminary
Final
°"°`T• Commonwealth of Massachusetts
City of Salem
. a
120 Washington St,3rd Floor Salem,MA 01975(978)745-9595 x5841
Return card to Building Division for Certificate of Occupancy
Permit B-15-384 PERMIT T O BUILD
FEE PAID:: $1$1,001.00 J
DATE ISSUED: 5/22/2015
This certifies that CANDACE REALTY TRUST VITAS CHARRISSA TR
has permission to erect, alter, or demolish a building _ -..27._DUNLAP STREET Map/Lot: 260145-0
as follows: Renovation REMODEL THREE (3) EXISTING KITCHENS & BATHS. REFINISH FLOORS,
REPLACE THREE (3) EXISTING DECKS
Contractor Name: JOHN C HARVEY {•-- -- ---
DBA: JOHN C HARVEY , ,t F g
Contractor License No: 093706
'/lam v 5/22/2015
Building Official Date
This permit shall be deemed abandoned and invalid unless the work authorized by this�permit is commenced within six months after issuance.The Building Official
may grant one or more extensions not to exceed sixmonths each upon written request. '
t
All work authorized by this permit shall conform to the approved application and the approved coristiuction documents for which this permit has been granted.
r
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained opens for public inspection for the entire duration of the
work until the completion of the same.
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
HIC#: "Persons contracting with unregistered contractors do not have access to the guaranty fund"(asset forth in MGL c.142A).
Restrictions:
I
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
APRIL 9, 1989
TO WHOM IT MAY CONCERN, V m
v c'a o
r
m
cn Cx>
(n co
PLEASE BE ADVISED THAT FOR a'THE� PAST�7L"YEARS:� I HAVE RESIDED
AT 31 DUNLAP STREET, SALEM, AND _DURING THAT TIME , FOR THE PAST
40 YEARS THE PROPERTY` AT 27-DUNLAP STREET: SALEM HAS BEEN USED
AS A 3 FAMILY HOME ., # '}c
PREVIOUS TO THIS IT.HAD ,ALWAYS BEEN USED AS - A MULTI FAMILY HOME ,
I ` " ' fib« 1 -.'+ J t I P ,' ) Y
THE PROPERTY IN QUESTION (27 DUNLAP) IS LOCATED ON THE SAME SIDE
OF THE STREET, 1 HOUSE TOWARDS MASON STREET .
WILLIAM P . MANNING
APR.IL 9, 1989
TO WHOM IT MAY CONCERN,
PLEASE BE ADVISED THAT I HAVE RESIDED AT 31? DUNLAP STREET,
SALEM FOR THE PAST FORTY YEARS . .THE PROPERTY AT. ' 27,:DUNLAP
'STREET, SALEM HAS BEEN USED AS .A THREE FAMILY HOME .
PRIOR TO MY MOVING TO #31 DUNLAP STREET, MY AUNT, UNCLE ,AND
COUSINS RESIDED THERE SINCE 1912 WHEN THE HOUSE WAS BUILT.
I AM VERY KNOWLEDGEABLE WITH BOTH #27 AND #31 SINCE I SPENT
MOST OF MY CHILDHOOD AT 31 DUNLAP STREET WITH MY COUSINS,
THE 11ANNING FAMILY . AT THAT TIME, 1912-1913 THE HOUSE AT
27 DUNLAP STREET HAD THREE FAMILIES OCCUPYING THE FIRST,
SECOND, AND THIRD FLOOR APARTMENTS ,
THE PROPERTY IN QUESTION (27 DUNLAP) IS LOCATED ON THE SAME ,
SIDE OF THE STREET, ONE HOUSE TOWARDS MASON STREET.
"` MARY RUANE
fL�M61Ai1St9E f NID APPAOVEO 8Y T44E
AL9j T„I B PWR TO A.PEW JWM0 GRANTED
CITY OF_SALEM
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BUILDING PERWT APPLICATION FOR:
Pwmk to:
(Circle whichever apply) Roof, Reroof. Instal CorMnict Deck, Shed. Pool.
�/�p"
PLEASE FILL OUT LEGIBLY i COMPLETELY TO AVOID DELAYS W PROCESS"
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owners Name 7HOM'is P_ 19;cNA v D
Address & Phone a? aLJNL/gp S T (,?,M 7y/ -3a33
Architects Name 4/0YV
Address d Phone !! I 1 Mechanics Name t t J ,
Address A Phone 2,3 9 J—em Con (91A 7 U / — 4®[(,R-
wnu is ow Puryaa GI bWidMp7
WINNOW Of buYdMp? Woo b I a dmov.for now away taaYlMa4��
wo b AWQ eaacam to law?_T S A.baaos7 A!a
EOMM aoa CRY UMM• N A am r►
ao.a Lipso�t� x
Lit. e� f i TiZie of Applicant
G/1016`7 SW = UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
11;A)V1, SJh iNG
MAIL PERMIT TO. hO A
No. _e
APPLICATION FOR
PERMIT TO
LOCATION
PERM GRANTED
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APPF
INSPECTOR OF 13UILDINGS
cr- 12(7
The Commonwealth of Massachusetts
Department of Public Safety
W
Massachusetts State Building Code(780 CNIR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number. Date Applied: IBuilding Official: n+ ✓r
( SECTION 1:LOCATION(Please indicate Block k and Lot k for locations for which a street address is natsw4ilab
No.and Street City/Town Zip Code Name of Building(if applicable) Zrn
SECTION 2:PROPOSED WORK r{
1{. Edition of MA State Code used If New Construction check here❑or check all that apply in the two Pvs be6F
IExisting Building Repair❑ 1 Alteration ❑ 1 Addition❑ 1 W—niolition ❑ (Please fill out and submit A fflradix
Charge of Use ❑ 1 Change of Occupancy ❑ Other Cl Specify: S;
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ .�
Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑
Brief Description of Proposed Work:.
�I /G D OPi
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 CNIR 34) ❑
Existing UseGroup(s): Proposer( UseGroup(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-I Cl A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ 1 H: High Hazard H-1❑ H-2❑ H-3 ❑ H--1 Cl H-5❑
h Institutional 1-1❑ I-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as a licable)
iA ❑ IB ❑ IIA ❑ 11813 IIIA ❑ IIIB ❑ 1 IV ❑ 1 VA VB ❑
SECTION 7.SITE INFORMATION(refer to 780 CZAR 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: %I\I lki a C mnnii,,i o ko, e,r 1'r,r<c
Not Applicable❑ Is Stnrcture within airport approach area? Is their review completed?
or Consent to Build enclosed El Yes El or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Qnle: Use Gnmp(s):. Type of Construction:. Occupant Load per Floor: _
Does the building contain an Sprinkler System?: _ Special Stipu let ions __._
i
SECTIONS: PROPERTYOWNERAUTHORIZATiON
Name and Address of Property Owner
�A&jc .e� �c°wrl P2 �Jc �f l�d¢77/opvq M►4- r
Name(Print) No.and Street - .City/Town Zip
Property Owner Contact Information: p '
Title Telephone No.(business) Telephone No. (cell) a-mail address
If applicable,the property
/�owner hereby authorizes
__ "
go
Name Street Address City/Town State Zip
to act on the property owner's behalf, in all matters relative to work authorized by this budding 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 ski Section 10.1
10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. a-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
�o�fK 1�64-veY 1-6 C.
Com any Name
T6�i4 Rn,<-V-o, 6
Name of Person Responsible for Construction License No. and Type if Applicable
'3014 6-tzp e-- S ' '5-/57Ae&� );,W ell/%) o
Street Address City/Town State Zip
7y-y�zo 61/Y C
Telephone No. business Telephone No. cell e-mail address
SECTION 11:IVORFEIS'COMPENSAIION INSURANCE AFFIDAV!"I 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❑ No ❑
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) 'total Construction Cost(from them 6)_$
1. Budding $ - 000 Building Permit Fee-Total Construction Cost x_(Insert here
2. Electrical $ appropriate municipal factor)=5
3. Plumbing $
d. Mlechanical (FIVAC) $ Note:Minimum fee=S (contact municipality)
5. Mechanical Other $ Enclose check payable able to
6.Total Cost $ (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 th o n knowledge and understanding.
sl�a� L N r C d-,-IL -e
P ease print and sign name Title Telephone No. Date
�O v4 y,19 rie S S>Y if - .1" O
Street Address City/Town 'late Zip
Municipal Inspector to fill out this section upon application approval: ksvro t V-oi 3 a0
Name Date
$1001 • Gi<, lye
RECEIVED
The Commonwealth of Massac usetts
Department of Public Safety
r ry4YtJ Massachusetts State Building Code(780 C�1L) �AY 1 A 11- �JS
Building Permit Application far any Building other than a One-or TWo-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
S
ECTION I:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
e /h e1s�
reet 10 City/Town Zip Code Name of Building(if applicable)
SECTION T PROPOSED WORK
MA State Code used If New Construction check here❑or check all that apply in the two rows below
gilding Er I Repair ETI Alteration ❑ 1 Addition❑ 7 Demolition ❑ (Please fill out and submit Appendix t)
^ Change of Use ❑ 1 Change of Occupancy ❑ 1 Other ❑ Specify:
( J Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ •No
1 Is an Independent Structural Engfneertng Peer Revt r aired? Yes ❑ No
Brief Description of Proposed Work " r rF
O
l�
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANCE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CNIR 31) ❑
Existing UseGroup(s): I Proposed UseGroup(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 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ II: Hi h Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional 1-I❑ 1-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-113 R-2 O R-3❑ R4❑
S: Storage S•1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as a licable)
IA ❑ IB ❑ '11A Cl 118 ❑ IIIA ❑ IIIB ❑ IV ❑ 1 VA ❑ VB ❑
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: Ilazards to Air Navigation: \l,A I list".i, 1 w.,. .:
Not Applicable❑ Is Structure withinairport 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 St ipu lal ions:
1A A\S DtWb
� ( ZI
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner.
Name(Print) No.and Street City/Town Zip
i
Property Owner Contact Information: -
Title Telephone No.(business) Telephone No. (cell) e-mail address
If a livable,th}e�Property owner hereby authorizes
Al "we
Name Street Address City/Town State Zip
to act on the property owners behalf, in all matters relative to work authorized by this budding permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)"
If building is less than 35,600 cu.ft.of enclosed space and or not under Construction Control then check here O and ski 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
10.2 General Contractor
-SoPIt" , [41-1-vf-y GLe
Company Name
Tohw P*4ve y CS-09 ??06
Name of Person Responsible for Construction License No. and Type if Applicable
20 A LIA-/C6 V-e- ..3 /'z S/OL/C--/PL ,&P^
Street Address City/Town State Zip
",.37-CAr eeLe@ Ys4Nao . rosYl
Telephone No. business Telephone No. cell mail address
SECTION 11:WORKERS'COAIPENSii'1ION WtiUlt:\NCE:11'EIUr\b'IT 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 0 No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) 'focal Construction Cost(from Item 6)_$
1. Budding 5 Building Permit Fee=Total Construction Cost x_(Insert here
2. Electrical $ / wo appropriate municipal factor)=S
3, Plumbing $ Q 0
d.Mechanical (HVAC) $ / 000 Note:Minimum fee (contact municipality)
5. Nlechanical Other $
o Enclose check payable to
6.Total Cost $ 000 (contact municipality)and write check number here
SECTION 3: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 knowledge and understanding.
Please print and sign name Title Telephone No. Date
Street Address City/Town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Date
ZS 0: mil; I Lfo
The Commonwealth of Massachusetts
1 Board of Building Regulations and StandardsRFTF
\W Massachusetts State Building Code, 780 CMR SALEM
�p�rgtj se ar2011
Building Permit Application To Construct,Repair, Renovate O �'�. ��
N One- or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applie
Building Official(Print Name) Signature VDate
SECTION 1:SITE INFORMATION
1(� 1.1 Property JAddress: 1.2 Assessors Map&Parcel Numbers
27 Dunlap St Unit 2
l.l a 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? Municipal❑ On site disposal system ❑
Check if yes[]
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of Record:
Godfrey Chua Salem,Ma 01970
Name(Print) City,State,ZIP
27 Dunlap St Unit 2 617-388-4800 gchua70@yahoo.com
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building M Owner-Occupied M Repairs(s) ❑ 1 Alteration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units 3 Other ® Specify: Insulation
Brief Description of Proposed Work': Insulate vinyl sided wall with 4"dense packed cellulose.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 3,078.20 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Su ression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: S 3,078.20 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
CS-052576 1 0/03/2017
James Fortin License Number Expiration Date
Name of CSL Holder U
50 Rundlett Way List CSL Type(see below)
No.and Street Type Description
Middleton,MA 01949 U Unrestricted(Buildings up to 35,000 cu.ft.)
City/Towq State,ZIP R Restricted 1&2 FamilyDwelling
M Masonry
RC Roofing Covering
WS Window and Siding
978-998-4684 phil@air-tightweatherization.com SF Solid Fuel Burning AppliancesI Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 165640 3/15/2018
Air-Tight Weatherization,LLC James Fortin HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
50 Rundlett Way phil@air-tightweatherization.com
No.and Street Email address
Middleton, MA 01949 978-998-4684
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 Issuance of the building permit.
Signed Affidavit Attached? Yes .......... IX No........... ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize James Fortin
to act on my behalf, in all matters relative to work authorized by this building permit application.
Godfrey Chua . C1t1_1 Dec 12, 2016
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNEW 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.
James Fortin 6
12/12/16
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
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.,ov/dos
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"may be substituted for"Total Project Cost"
b6
The Commonwealth of Massachusetts
ml Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code, 780 CMR SALEM
M Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2Q11
One-or Two-Family Dwelling
a
c� This Section For Official Use Only
—� Building Permit Number: Date Ap ied:
y 1 70
1a
Building Official(Print Name) Signature c is�
i�
(� SECTION 1: SITE INFORMATION
(U i 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 01
— 27 Dunlap St Unit 1
1.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?Check if yes❑ Municipal ❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Julia Monaghan Salem,Ma 01970
Name(Print) City,State,ZIP
27 Dunlap St Unit 1 401-263-3266 Monagham.julia@mac.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building M Owner-Occupied IS I Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_3 Other ® Specify: Insulation
Brief Description of Proposed Work': Insulate vinyl sided wall with 4" dense packed cellulose.
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materials Official Use Only
1.Building $ 3,078.20 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
76Total
ession) Total All Fees: $
Check No. Check Amount: Cash Amount:
Project Cost: $ 3,078.20 0 Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
_ CS-052576 10/03/2017
James Fortin License Number Expiration Date
Name of CSL Holder U
50 Rundlett Way List CSL Type(see below)
No.and Street Type Description
Middleton,MA 01949 U Unrestricted(Buildin s up to 35,000 cu. ft.)
City/fown, State,ZIP R Restricted 1&2 FamilyDwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
978-998-4684 phil@air-tightweatherization.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 165640 3/15/2018
Air-Tight Weatherization,LLC James Fortin HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
50 Rundlett Way phi]@air-tightweatherization.com
No.and Street Email address
Middleton, MA 01949 978-998-4684
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 Issuance of the building permit.
Signed Affidavit Attached? Yes .......... EX 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 James Fortin
to act on my behalf, in all matters relative to work authorized by this building permit application.
iL& - �^ Dec 14, 2016
Julia Monaghan ulia Monaghan(D ia,zois�
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNEW 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.
James Fortin ( " s 7'
12/12/16
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
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.aov/oca Information on the Construction Supervisor License can be found at www.mass.�ov/dos
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"