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11 ESSEX STREET - BUILDING JACKET 11 ESSEX STREET 1 tMNS 6562 '1000 050E 2'101 r ` .y �'• U.S.POSTAGE)>PITNEY BOWES`°.5 CITY OF SALEM, MASSACHUSETTS 6 BUILDING INSPECTOR /�••� �� 120 WASHINGTON STREET, 3RD FLOOR ZIP 01970 O2 1W V$ 006.735 SALEM, MASSACHUSETTS 01970 11111111111 11111111111 . 000139292BSER 17. 2015. I I • I E995 6562 2000 050E 2'101 •UNCLAIMED loll Eileen riscoll 1stNOTIC 11 Es Street 2nd NRICE Unit NEiIINNED 5 Sa Ma. 01970 OCT OCT 2015 2015 A. I1Idlji1d1tl'111All Id,f 1tnRinl'luihu'�illi�l',"yilll SECTION . SENDER: COMPLETE THIS SECTION COMPLETE THIS ■ Complete items 1,2,and 3.Also complete a Signature ❑Agent item 4 if Restricted Delivery Is desired. X p Addressee ■ Print your name and address on the reverse so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below. ❑No =Insumd ('� +��b Priority Mall Express- E3 Return Receipt for Merchandise Coiled on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (transfer from service labeq Domestic Return Receipt ;i PS Form 3811,July 2013 - - CITY OF SALEM, MASSACHUSETTS INSPECTIONAL SERVICES DEPARTMENT 9 THOMAS ST.PIERRE INSPECTIONAL.SERVICES DIRECTOR /BUILDING COMMISSIONER KIMBERLEY DRISCOLL MAYOR 120 WASHINGTON STRFFT♦ SALEM,MASSACHUSETTS 01970 TEL:978-745-9595 FAx:978-740-9846 Date: September 17,2015 To: Eileen M.Driscoll Address: 11 Essex Street/Unit 1 City/State/Zip Salem MA 01970 i Re: k 11 Essex Street/Unit 1 Ms. Driscoll: The Building Department has received reports of construction/renovation work underway at your property at 11 Essex Street Unit 1.Recent observation of the property appears to support these reports. There is no current Building Permit on file for this address. A"Required Inspection"will be conducted on-site in order to determine whether or not a Building Permit, licensed contractor,or similar requisite is needed at this time. The Inspection is scheduled for Wednesday, September 23, 2015 at 10:00 AM. Please be present. If you are unable to meet at that time, contact me immediately. Failure to resolve the issues cited above will be construed as non-compliance and may result in the issue of municipal tickets and fines as well as further enforcement actions. If you feel you are aggrieved by this order, you have the right to appeal to the Massachusetts Board of Building Regulations and Standards(BBRS)at One Ashburton Place/Boston/MA. Thank-you, Harry Wagg Assistant Building Inspector 978-619-5643 - hwagg@salem.com cc Tom StTierre/Building Commissioner Scott Keaton/Unit 2,Unit 3 CITY OF SALEM, MASSACHUSETTS INSPECTIONAL SERVICES DEPARTMENT THOMAS ST.PIERRE KIMBERLEY DRISCOLL INSPECTIONAL SERVICES DIRECTOR /BUILDING COMMISSIONER MAYOR 120 WASHINGTON STREET♦ SALEM,MASSACHUSETTS 01970 TEL:978-745-9595 FAx:978-740-9846 Date: September 17,2015 To: Eileen M'Driscoll.. Address 11 Essex Street/Unit 1 City/State/Zip Salem,MA 01970' Re: 111:Essex Street./Unit 1 Ms. Driscoll: The Building Department has received reports of construction/renovation work underway at your property at 11 Essex Street Unit 1.Recent observation of the property appears to support these reports. There is no current Building Permit on file for this address. A"Required Inspection"will be conducted on-site in order to determine whether or not a Building Permit, licensed contractor, or similar requisite is needed at this time. The Inspection is scheduled for Wednesday, September 23,2015 at 10:00 AM. Please be present. If you are unable to meet at that time, contact me immediately. Failure to resolve the issues cited above will be construed as non-compliance and may result in the issue of municipal tickets and fines as well as further enforcement actions. If you feel you are aggrieved by this order, you have the right to appeal to the Massachusetts Board of Building Regulations and Standards(BBRS)at One Ashburton Place/Boston/MA. Thank-you, 1h( � 1 U� Harry Wagg Assistant Building Inspector 978-619-5643 - hwagg@salem.com cc Tom StTierre/Building Commissioner Scott Keaton/Unit 2,Unit 3 Certificate No: 591-2004 Building Permit No.: 591-2004 Commonwealth of Mass,schusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0011 ESSEX STREET in the CITY OF SALEM ---------------- -- - - -- ------------------------- - -- --- ------ - - ----------------- - Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY RENOVATE 2ND. FLOOR AT 11 ESSEX STREET This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires ... .. .. . . .................. .. unless sooner suspended or revoked. Expiration Date --------- ._---------- -Issued On: Thu Oct 26,2006 - GeoTMS®2006 Des Lenders Municipal Solutions,Inc. ----------------------------------------___ ----------------------- _____ CITY OF SALEM BUILDING PERMIT 0011 ESSEX STREET 591-2004 GIS a =1696a COMMONWEALTH OF MASSACHUSETTS Map 41 CITY OF SALEM jBlock ILot 0177" !Category._ REPAIR/REPLACE , ermit# x` 591-2004, �� BUILDING PERMI,T Project# JS-2004-0930 ; lEst. Cost: > >_ $10,000.00:- Const. Class: PERMISSION IS HEREBY GRANTED TO: ,Use Group: Contractor: License: Lot Size(sq. ft.): 13200 'Roger Tremblay, Tremblay Construct ioGeneral Contractor- 043536 _1/0wner: KGATON SCOTT.R __. �Unrts Gamed: Applicant: KEATON SCOTT R Units Lost. _ - AT. 0011 ESSEX STREET f Dig Safe#: - ISSUED ON: 29-Jan-2004 AMENDED ON: EXPIRES ON: 29-Jul-2004 TO PERFORM THE FOLLOWING WORK: 591-2004 RENOVATE 2ND FLOOR TJS POST THIS CARD SO ITIS VISIBLE FROM THE STREET Electric Gas Plumbing Buildin Underground: Underground: Underground: Excavation: Service: Meter: -- Footings:— - Rough:.�� — D/yi%e Rough: Rouj,hd <y-a ` ,'. Foundation:. Final: /491/ 0 Final: Final�Q /9/;� ,.�ifiC� p Rough Frame:OW J` !/U� y/ Fireplace/Chimney:: )7 D.P.W. Fire Health /vP/0 Meter: Oil: _/ Insulati Cn: House d Smoke: K N /0,/Y-00 Final: � �//rQCO G�/LG // !! Trda urY' NNalel: ' - Al:uvmo t" Af1� — Sewer: Sprinklers: ��-- THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPPN V LATION OF ANY F'Iht RULES AND REGULATIONS. � ci Signature: Fee Type: Receipt No: Dale Paid: Check.No:,a ., Amount BUILDING REC-2004-000986 29-Jan-04 12993 $65.00 74,z L-) upon CC?I`CI(Drt,"S..e'°71 GeoTMS©2004 Das Lau viers Municipal Solutions,Ina - h �N O i YS�YYEQAO CITY OF SALEM � tJILIING PE�I�IVIIT--- � 4' `> (ditg of "intem, ttssttc�usetts .e� 4 P i`+'.J =y F Poxrb of Appeal I.. JAN 01 en d� � i DECISION ON THE-PETITION OF SCOTT KEATON FOR A VARIANCE CITY NFFICE FOR 11 SSEX STSALEM. MASS. 5" A hearing on this petition was held January 14, 1987 with the following Board Members present: James Hacker, Chairman; Messrs. , Bencal, Fleming, Luzinski and Strout. 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. c Petitioner, owner of the property, is .requesting a Variance to convert a two family dwelling into a three family dwelling in. this R-2 district _ . A petition to convert this property to 'a. three family dwelling was denied by the Board of Appeal on November 19,. 1986. 'The Board of Appeal, after hearing evidence regarding substantial change, said change being an acceptable parking plan, and M C�rv�Y after receiving' Consent from the .Salem.Planning Board, vdted unanimously that there 2 ` .. was substantial change in the petition and they would re-hear the case. ' The Variance which has been requested may be granted upon a finding of the Board i� that: a. special conditions and circumstances exist which especially affect the land, building or'structure involved and which are not generally' v � affecting other lands, buildings and structures in the same district; RU b. literal enforcement of the provisions of the Zoning Ordinance would involve substantial hardship, financial or otherwise, to the petitioner; and c. desirable relief may be granted without substantial detriment -to the. terns: public good and without nullifying or substantially derogating from the intent of the district or the purpose of the Ordinance. The Board of Appeal, after careful consideration of the evidence presented and after viewing the plans, makes the following findings of fact: 1 . There was major neighborhood support; 2. By allowing a three family dwelling it would enable the owner to substantially improve the building and' thereby improve the neighborhood. € On the basis of the above findings of fact, and on the evidence presented at the hearing, the Board of Appeal concludes as follows: ' 1 . Special conditions exist' which especially affect the subject property but do not affect,,the;.distryict generally;,,_ -"5c,. 2. Literal enforcement of,„,the provisions of the Ordinance would involve substantialhardship to the' petitioner; 3. The relief requested can 'be granted without substantial detriment to the puglic good and without nullifying or substantially derogating from the . intent of the district. or the purpose of the Ordinance " knF 3f°iWZ' t u : r DECISION ON THE PETITION OF SCOTT KEATON FOR A Rks VARIANCE FOR 11 ESSEX ST. , SALEM=r° page two. - A Therefore, the Zoning Board of Appeal voted unanimously, 5-0, to grant the i Variance requested and allow property to be converted to' a three family dwelling, subject to the following conditions: 1 . Property must be owner occupied; 2. Parking plan be designed so that cars will park at an angle away t from Essex Street, 3. Property meet all regulations of the Salem Fire Department relative to the installation of smoke detectors and fire alarm configuration; . AWA 'N 4. . A building permit be obtained for all'construction, x j W&fid+» 5. A Certificate of*Occup'az4cy-be obtained prior to proposed unit u �, dG-1 4W 'TM- ,IYS y+„ N eR vf^ 64+ being occupied. : . VARIANCE GRANTED' "{�f�.Zy. Y#X _ ' ^5^1*Y 1`N' b • /SOY ` y' ' ames B. Hacker Chairman,( &t 3°`4. ( TO A .COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD_ AND THE CITY CLERK .. - .. Tm. C_.13i .,iF ,!. °n._L 9E-•`.'F. _ Fu4SO:. T� :_,. !0 11 `F ih: 4 :. z ..� �� r; CD ?C t � F.riT r c'.,E r, -� _..� .._ .v..•. Dc_S !14 THE ..FT�CE =CF Tht CITt CIER ..8-1 .:L I, -E. Ems. L L_ F_CC- 1 _ .r•- i S._.r ESSE> REM tt LF �.+J is:U ._. .— ----- ,-..-.:-' OF REC RD OR I. RcCJRDED OV.NER'S CERT Fl ..L-OF,.TITLE. ,..�.., . BOARD OF APPEAL _ . 3 - a F iv �y,X+^�m=ssa+ca. _ .w.iFrw _ .a-nn«r F.a -vrc�rrzwa+�ar<9<n .ia� nm c^amm�vs w 2A1 k. w xix.ff b Y-X43 as r 'r r $>:. s v `.,Ti cn.• (t m.tY��-'' s$ ' ffi2d5LT 10y �Y+i3,' '#n'"r-Y.eP�.Sx'^itrrcT, rec by a.o np�. — ° APPLICATION FOR PERMIT TO ERECT A SIGN NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED Location, Ownership and Detail Must Be Correct, Complete, and Legible Salem, Massachusetts Date To the Building Inspector: The undersigned hereby applies for permit to ❑ Erect, Alter, ❑Repair a sign on the fallowing described buildings: DistrictStreet Address Zoning 1 3 ESf{� S fV t t (' �,S ❑ Urban Renewal Area a Entrance Corridor ❑ Historic District 0None FTelephone fSf-e,)' srr-c<fi Reg /ty TuLSj— Buildingphone �81- 71 S'_ Ol7s A40rh Va. j -11 1' floor STOk"l- n V4N 1 2 flOOrdress 131 Fs F< STrttT 3 floor «rfm f wt 7 �1_ 71Z _ o17s 4 Floor E-mail M 0lr/f V 4h cl<11 A VQ 400. con, How many businesses are in the building? L_/ -If a corporate body, name; of responsible officer 1411 (n.(f a S al Building r7' 6" linear feet Construction Sup's License No Applicant's Space(if multi-tenant) I ' linear feet Address 7 S (_o L.,11 Sf Pe,6,d{ Property C 7 ' S " linear feet Telephone q7S- S?I— 7100 Mail Sign Permit to E-mail Q 11 IG c[j of Sryal Ya 400, cow, Sign Owner o Sign Erector ❑Other: Proposed Signs (If more than three signs are proposed, additional Si n 1 MKTI Sign 2 Sign 3 71 - Fea— e tySurface "urface Sale• Ti' _ /t•.c,N0 [I Surface ❑ Right Angle to Building ❑ Right Angle to Building ❑ Right Angle to Building • Free Standing ❑ Free Standing ❑ Free Standing ❑Awning ❑Awning ❑Awning ❑ Portable(A-Frame) ❑ Portable(A-Frame) M Portable (A-Frame) ❑Other(specify) ❑ Other(specify) ❑ Other(specify) Sign Materials 66arl.i d- Sign Materials Sign Materials Plyw...l ♦'rinw, d' ��71•r•e>o1 /-��vw,�wow, Sign Dimensions „ , Sign Dimensions Sign Dimensions 9 8 wr.f��'13iTMu � � 2' U x y T44 Sign Area (fi $7s Sign Area 1 Sign Area s ft I s ft sq ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) y, Estimated Cost of Net Work $ 2v00- GO Existing Signs T ppe Sign Area To BF�Removed? Sign Owner� m,Surface 19,2l sq ft eyes ❑ no g ❑ Right Angle to Building sq It ❑yes ❑ no Free Standing 8 sq ft ages ❑ no Sign Owner's Authorized Representative ❑Awning sq ft ❑yes ❑no ❑Other(specify) sq ft ❑ yes ❑ no Property Owner Internal Review 1 FA'nn i n 4 g& n diDevelopment 060artment Historical Commission Approval B'�+o Building Inspddtor 0824110 rev �j e Commonwealth of Massachusetts t RECE Th bED °ksx Board of BuildingRegulations and Standards a S'q �S . 1 Massachusetts State Building Code,780 CMR INSPECT1014f ( EM Revised Mar 2011 Building Permit Application To Construct,Repair,Renovate Or%17 U�1 A 5 q r One-or Two-Family Dwelling 1] Ul.l Q This Section For Official Use Only Building Permit Number: Date pplied: Building Official(Print Name) Signature Date iSECTION 1:SITE INFORMATION _^ 1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers 1 Lla 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 OWNERS IHP' 2.1 of e E 19noa_ 414 Name(Print) City P r r/ � s, VAJI. I 7sl- Ll3I-o7� s -�IemC�vF�a .� No.and Street Tclepbone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) - - New Construction❑ Existing Building 0 1 Owner-Occupied ❑ 1 Repairs(,) Of Alteration(,) ❑ 1 Addition ❑ Demolition 06 Accessory Bldg.❑ 1 Number of Units I Other ❑ Specify: /0^ srvW-Z4 Brief Description of Proposed Work: ' `s /J - 2t=Y)tr tl AI C-� tr.Q cN SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only abor and Materials 1.Building 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ 0�+9 ❑Standard City/Town Application Fee ❑Total Project Costs(Item 6)x multiplier x 3.Plumbing $ zoe r6, B 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ - Suppression) Total All Fees:$ 6.Total Project Cost: $ ,��. '' Check No. Check Amount: Cash Amount: /� eC r ❑Paid in Full 0 Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 4 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street �V Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Faintly Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Dale ogi pan y�,Iame or egistrant Name _ ,9 No.and Street Em Ci /Town,— t-tez P �w Telephone - SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.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..........❑ 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 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: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 applicatio .is and accurate to the best of my knowledge and understanding. Print Owner's or Authorized getft's ame(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 land under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.sov/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" SCOTT R. KEATON 3 Nicole Avenue Beverly, Massachusetts 01915 September 18, 2015 City of Salem Inspectional Services 120 Washington Street, 3`d FI Salem, Massachusetts 01970 To Whom It May Concern: As a trustee of the 11 Essex Street Condominium Trust located at 11 Essex Street, Salem, Massachusetts, 01970, I am writing to verify that I am aware of and support the updating of the Unit 1 Condominium. Should you require any further information, I may be reached at 978- 922-1474. Thank you for your assistance in this matter. Sincerely, �l Scott R. Keaton — ° APPLICATION FOR PERMIT TO ERECT A SIGN NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED Location, Ownership and Detail Must Be Correct, Complete, and Legible Salem, Massachusetts Date To the Building Inspector: The undersigned hereby applies for permit to ❑ Erect, Alter, ❑Repair a sign on the fallowing described buildings: DistrictStreet Address Zoning 1 3 ESf{� S fV t t (' �,S ❑ Urban Renewal Area a Entrance Corridor ❑ Historic District 0None FTelephone fSf-e,)' srr-c<fi Reg /ty TuLSj— Buildingphone �81- 71 S'_ Ol7s A40rh Va. j -11 1' floor STOk"l- n V4N 1 2 flOOrdress 131 Fs F< STrttT 3 floor «rfm f wt 7 �1_ 71Z _ o17s 4 Floor E-mail M 0lr/f V 4h cl<11 A VQ 400. con, How many businesses are in the building? L_/ -If a corporate body, name; of responsible officer 1411 (n.(f a S al Building r7' 6" linear feet Construction Sup's License No Applicant's Space(if multi-tenant) I ' linear feet Address 7 S (_o L.,11 Sf Pe,6,d{ Property C 7 ' S " linear feet Telephone q7S- S?I— 7100 Mail Sign Permit to E-mail Q 11 IG c[j of Sryal Ya 400, cow, Sign Owner o Sign Erector ❑Other: Proposed Signs (If more than three signs are proposed, additional Si n 1 MKTI Sign 2 Sign 3 71 - Fea— e tySurface "urface Sale• Ti' _ /t•.c,N0 [I Surface ❑ Right Angle to Building ❑ Right Angle to Building ❑ Right Angle to Building • Free Standing ❑ Free Standing ❑ Free Standing ❑Awning ❑Awning ❑Awning ❑ Portable(A-Frame) ❑ Portable(A-Frame) M Portable (A-Frame) ❑Other(specify) ❑ Other(specify) ❑ Other(specify) Sign Materials 66arl.i d- Sign Materials Sign Materials Plyw...l ♦'rinw, d' ��71•r•e>o1 /-��vw,�wow, Sign Dimensions „ , Sign Dimensions Sign Dimensions 9 8 wr.f��'13iTMu � � 2' U x y T44 Sign Area (fi $7s Sign Area 1 Sign Area s ft I s ft sq ft Sign Height(if free standing) Sign Height(if free standing) Sign Height(if free standing) y, Estimated Cost of Net Work $ 2v00- GO Existing Signs T ppe Sign Area To BF�Removed? Sign Owner� m,Surface 19,2l sq ft eyes ❑ no g ❑ Right Angle to Building sq It ❑yes ❑ no Free Standing 8 sq ft ages ❑ no Sign Owner's Authorized Representative ❑Awning sq ft ❑yes ❑no ❑Other(specify) sq ft ❑ yes ❑ no Property Owner Internal Review 1 FA'nn i n 4 g& n diDevelopment 060artment Historical Commission Approval B'�+o Building Inspddtor 0824110 rev �j e Commonwealth of Massachusetts t RECE Th bED °ksx Board of BuildingRegulations and Standards a S'q �S . 1 Massachusetts State Building Code,780 CMR INSPECT1014f ( EM Revised Mar 2011 Building Permit Application To Construct,Repair,Renovate Or%17 U�1 A 5 q r One-or Two-Family Dwelling 1] Ul.l Q This Section For Official Use Only Building Permit Number: Date pplied: Building Official(Print Name) Signature Date iSECTION 1:SITE INFORMATION _^ 1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers 1 Lla 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 OWNERS IHP' 2.1 of e E 19noa_ 414 Name(Print) City P r r/ � s, VAJI. I 7sl- Ll3I-o7� s -�IemC�vF�a .� No.and Street Tclepbone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) - - New Construction❑ Existing Building 0 1 Owner-Occupied ❑ 1 Repairs(,) Of Alteration(,) ❑ 1 Addition ❑ Demolition 06 Accessory Bldg.❑ 1 Number of Units I Other ❑ Specify: /0^ srvW-Z4 Brief Description of Proposed Work: ' `s /J - 2t=Y)tr tl AI C-� tr.Q cN SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only abor and Materials 1.Building 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ 0�+9 ❑Standard City/Town Application Fee ❑Total Project Costs(Item 6)x multiplier x 3.Plumbing $ zoe r6, B 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ - Suppression) Total All Fees:$ 6.Total Project Cost: $ ,��. '' Check No. Check Amount: Cash Amount: /� eC r ❑Paid in Full 0 Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 4 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street �V Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Faintly Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Dale ogi pan y�,Iame or egistrant Name _ ,9 No.and Street Em Ci /Town,— t-tez P �w Telephone - SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.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..........❑ 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 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: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 applicatio .is and accurate to the best of my knowledge and understanding. Print Owner's or Authorized getft's ame(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 land under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.sov/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" SCOTT R. KEATON 3 Nicole Avenue Beverly, Massachusetts 01915 September 18, 2015 City of Salem Inspectional Services 120 Washington Street, 3`d FI Salem, Massachusetts 01970 To Whom It May Concern: As a trustee of the 11 Essex Street Condominium Trust located at 11 Essex Street, Salem, Massachusetts, 01970, I am writing to verify that I am aware of and support the updating of the Unit 1 Condominium. Should you require any further information, I may be reached at 978- 922-1474. Thank you for your assistance in this matter. Sincerely, �l Scott R. Keaton