3 ESSEX STREET - BUILDING JACKET IM
OPendaffor
orsse/te
74520 MOR
aCITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380
MAYOR FAX: 978-740-9846
August 10, 2005
To Whom it May Concern
RE: 3 Essex Street
According to our records, it has been determined that the building located at 3 Essex
Street is a legal grandfathered non -conforming 3 family dwelling.
This is to determine use only and in no way is meant to confirm or deny whether said
property is in compliance with all building, plumbing, gas, electric, fire or health codes
Sincerely,
Thomas St. Pierre
Zoning Enforcement Officer
filld161A116T�EfNA6400 APPROVED BY T44E
JW&PJ:CYOB PRIOR TOA.PEAWT JWMQ GRANTED
CITY OF SALEM
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BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whictwvor apply) Roof, ROW, lnsW S , Construct Dock, Shed. Pool,
Ropawasplace. Oter ahno VwTe- /-0
PLEASE FILL OUT LEGIBLY a COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undaragneddt/ttereby applies for a/permit to build according to the following
Owners Nwne
:
Address a Phone 3 FSSex ST
Architect's Name
Address a Phone ( i
Mechanics Name rPa r9 e �y NUJ
AddressaPhone 22 (9yigis"- y87I
Naut Is to prpoee it b? (2 , lL
Mao d p ~ N a dwMtl e.for taw many Ismon?
we bAd%cwkm to low? J ? m ry 2
Edmmod Not Of QW Uane e N A awe Uosrw o O Z 2 Y
fYSignighui of Applicant
v SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
r '
r7ov/yT/oil g.� S /-- lJn ,
MAIL PER TO: T PERMIT TO: ��
No. 23 - 6
APPLICATION FOR
PEMW TO
LOCATION
PERMIT GRANTED
5/3 o Za
FD _
INSPEGT OF BUILDINGS
The Commonwealth of Massachusetts
Board o Building Regulations and Standards CITY
f
Massachusetts State Building Code, 780 CMR, T°edition OF SALEM
r Revised Jumstirr
Building Permit Application To Construct, Repair, Renovate Or Demolish a 1. ?orlx
(� One-or Two-Fumi1v Dwelling
- This Section For Official Use Only
PO Building Permit Number: Date Applied: 5 2 U
Signature: �27�G0
Building Commissioner/Inspector of Buildings [Pate
SECTION 1:SITE INFORMATION
1.1 Property Address:S,.T. 1.2 Assessors Map& Parcel Numbers
SSse c�
I.I a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: IA Property Dimensions:
Zoning District Proposed Use Lot Area(sq R) Frontage(11)
1.5 Building Setbacks(R)
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? Municipal❑ On site disposal system ❑
Public❑ Private❑ Check if es❑ P Po y
SECTION 2: PROPERTY OWNERSHIP'
2.1 Awner I of Record:
EA - I �l N�j S CSse 51 y�77
Name(Printy AcIdress Servtcy5 e:
��I - Z 2 47
UUUUUU 7 0
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORW(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied O 1 Repairs(s) ❑ Alteration(s) O Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other 13--Speciy: F.'/'t
Brief Description of Proposed Work':���'P 7FRi°e2 .. Cr?a1E'�"r r Ac-
TP-r -j
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:
❑Standard City/Town Application Fee
2.Electrical S ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: S
4. Mechanical (HVAC) S List:
5. Mechanical (Fire S Total All Fees: S-
Su ression
Check No. Check mount: Cash Amount:
6.Total Protect Cast: S 0 Paid in Full 0 Outstanding Balance Due:
' r
SECTIONS: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) ' 3/ 3 r)
License Number fix imlion Date
C.�.- EJ�� O env\no 1� p
Name of CS .-I folder
9S (T r,Cef'\ (0 JSh List CSL Type(see below)
Address T 17exri Lion
(�G�- I'f'� U Unrestricted u to 35,000 Cu.Ft.
®RC
Restricted 1&2 FamilyDwelling
Signalu Mason Only
Residential Roolin Coverintelephon ,J Residential Window and Sidin� �� ` l5 Residential Solid Fuel Bumin A fiance Installation
Residential Demolition
5.2 Re btered Home Improvement Contractor(HIC) �/�(
l/h/9 4n!/L,7n ?%/tC Sar✓.`CCS (� -f % [
111C Company Name or I C Re ismint Name Registration Number
AddssAddress z
me ��5 ,�� 3Zia//z�'✓f P_ � C,f�c/yl — Expiration Date
Signature Telephone
SEC ION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 2SC(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...........0
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 to act on my behalf, in all matters
relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 71b:OWNEW OR AUTHORIZED AGENT DECLARATION
1. 5 15 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 O or uthorized Agent Date
-Lsixncd under 1 ains and penalties of 'u
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 gj have access to the arbitration
program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I I O.R6 and 1 IO.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 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"
III