4 EAST COLLINS STREET - BUILDING JACKET CU
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CITY OF SALEM, MASSACHUSETTS
r �s BUILDING DEPARTMENT
120 WASHINGTON STREET,3" FLOOR
TEL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR THOMAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
September 28, 2017
Scott Truhart
4 East Collins Street
Salem Ma. 01970
Re: inspection/complaint
Mr. Truhart,
As you are already aware, this Department received a complaint from Mr. Meyers alleging that
you had done a kitchen over without permits. My Assistant Building Inspector,Stephen
Cummings ,received the complaint and came to your property to check on the complaint. After
he spoke with you, you allowed Mr. Cummings inside to confirm that only a countertop had been
changed. No violation existed and Mr. Cummings left the property. Thank you for your
cooperation with my Inspector.
Thogra� St.Pien•,e(.
/,��
The Commonwealth of Massachusetts
Board of Building Regulations and.StandAt CITY OF
Massachusetts State Buil`ding°Code;1780�-CMR' ICES Reviseed dMar Mar 2011
Building Permit Application To Constructs 1 eltoipe I r�molish a
One-or Two ingllJJ
This Section For Official Use Only
Building Permit Number: Date Applied:
0
Building Official(Print Name) Signature Date
'n SECTION 1:SITE INFORMATION
1.1 Prope Address: 1.2 Assessors Map& Parcel Numbers
Ma
l.la Is this an accepted street.9 yes no_ _ P Number Parcel Number
1.3 Zoning Information: `` 1.4 Property Dimensions:
sfl�.a� �1rJ1
Zoning District Proposed se Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside.Flood Zone?
Public❑ Private❑ Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 OwJnerr of Recr 1 ( A
Name(Print) City,State,ZIP'
1-1 Eo151 9-'-6-99Ss-9goL1
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) la I Alteration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Workz: S}r+p .S i t Al rt-5 7o x-
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 3 %()() 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 $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ / 7j� �(� ❑Paid in Full ❑Outstanding Balance Due:
�'IPiu fib �r3
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) V 16
wa rmf) peer 1)(d License Number Expitatioft Date
Name of CSL Holder
Lis[CSL Type(see below) LI
1 S0 r= W rvonr." S�
No.and Street M� Type Description
la ' �+ ' U i /D q/� Unrestricted(Buildings u to 35,000 cu.ft.
PPA�jnd
R Restricted 1&2 Family Dwelling
Cityrrown,St le,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
qn-7�� Zy3� I I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Exf,mtion Date
HIC Comp Name or HIany C Registrant Name
No.and Street
ISo � GJi iyoN'ov Sr
Pam,,bc,�n , MA is19 66 q�Sr_75 fr-11 W Email address
City/I owr, 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 ...........F No...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR"PLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize I/ A went i PiwTGo
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this applic `on is true and accurate to the best f my knowledge and understanding.
7,1
4-iint Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass. og v/oca Information on the Construction Supervisor License can be found at www.mass.gov/di)s
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basementlattics,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"
The Commonwealth of Massachusetts
J l OF
Board of Building Regulations and Standards CITY SALEM
Massachusetts ReviseddMar
�f Mhtts State Building Code, 780 CMR
.Nur 201
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Fancily Dwelling
This Section For Official Use Only
Building Permit Number: Da .Applicd. Z
u J 3o1/
Building Official(Print Name). - Signature, Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors blip&Parcel Numbers
� Lulf- e'd///nn sf
I.I 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 11) Frontage(it)
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❑
SECTION2: PROPERTY OWNERSHIP'
2.1 0" ertof Record:
7y TT ti level Al ft 6 l q7a
�m Print) City S�tattee,ZIP
q
�r,5}- <b ll,n L � ` s, MY
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply)
New Construction❑ Existing Buildi Owner-Occupied Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed\York'-: X''eSio/( �iP-P//ef-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials)
I Building S I. Building Permit Fee:S indicate how fee is determined:
�. Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost(Item 6).e multiplier x
3. Plumbing S 2. Other Fees: S
4. Mechanical (FIVAC) S List:
5. Mechanical (Fire S
Su ression) Total All Fees:S
Check No._Check Amount: Cash Amount:_
6. Total Project Cost: S ❑ Paid in Full ❑Outstanding Balance Due:
'i'�1wtiT
M�iti,- owN -
�k.A'
SECTIONS: CONSTRUCTION SERVICES
5.1 Constructio»Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type.: Description
U Unrestricted(Buildings tip to 35,000 cu. ft.)
R Restricted 1&2 Family Dwelling
CityfNwn,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
1 insulation
'relc hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
IIIC Registration Number Expiration Date
IIIC Cumpany Name or HIC Registrant Name
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'CONIPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 15Z.$ 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 TO BE COMPLETED WHEN:
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING.PERMIT
I,as Owner of the subject property,hereby authorize
tq act on my behalf,in all matters relative to work authorized by this building permit application.
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.
�ca`tr —Fri�,i V IL 2 Ld/ 3
Print Owner's or Authorized Agent's Name(Electronic Signaure) Date
NOTES:
I. .An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC) Program),will not have access to the arbitration
program or guaranty fund under NI.G.L.c. 142A.Other important information on the HIC Program can be found at
www.n1ass.1 ov'oca Information on the Construction Supervisor License can be found at ww%v.nass,eov'dps
�. 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. It.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type orhenting system Number of decks/porches
Type of cooling system Enclosed Open
3. Total Project Square Footage"may be substituted for"Total Project Cost"
I