12 ESSEX STREET - BUILDING JACKET 12 Essex Street
FIELD COPY
L' CITY OF SALEM BUILDING
SALEM, MASSACHUSETTS 01970 PERMIT'
.A ,. Y.L.ID.TION
I DATE Ian. 6, 19 93 PERMIT NLo. 4-93-
APPLICANT Stanley Kantorosinski ADDRESS DANVERS Owner
' IN0.1 ISrR[[il 'CONI R•y CV[NS[�
PERMIT TO RP.PATRG (_I STORY nL,rELTITW, NUMBER OF
DWELLING UNITS TWO
IivI[ 0• IUM Ov[M[Nil N0. LIR ORO)EO USE'
ATILO:PTIDNI 12 F.CCPX Ct TPP}' wArel IZONING
IN0.1 I)TR((TI . DISTRICT R-2
BETWEEN - AND
' u•os. Sr)LYiI Icnoss sr R[nl.
. - LOT
SUBDIVISION LOT BLOCK ".SIZE
BUILDING IS.TO BE FT. WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE 'USE GROUP BASEMENT WALLS OR FOUNDATION
3�/Y [TT)� yT�yiv •rM. ITIPE)
REMARKS: PdM LACE Tl11YI:E lel OF CHDIN Il
*��INSPBMON 745-9595
IOLUN�E ESTIMATED COST $_ 750.00 FEEMIT S 20.00
OWNER ZR Stanley Kantorosinski -
.,DRESS 13 Ipswich River, Danvers,MA. Leo E. Tremblay
INSPECTOR OF BUILDINGS
INSPECTION RECORD
DATE NOTE PROORESS CRITICISMS AND REMARKS INSPECTOR
_p16_ns must be filed and approved by the Inspector before a permit for ereethm will be grarued.
:T approved by the Inspector shall be kept at the building,
dupliof which when dttrMO
cates
the progress of the work.
City of Salem Waal
r TEL.# _77
STATE LIC. #
APPLICATION CITY OF SALEM LIC.#���_
FOR
PERMIT TO BUILD ADDITION OR MAKE ALTERATIONS
Salem.Mass.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a� peerrmiit to build according to the following speeirustiees:
Owner's name and .dares1 4d i—&Y pi v-oRgspd s�L ! 13 rPSNic>4};Rl il�Q
Architect's name
Mechanic's name and addrpqe Location of building. No. f 9C SIS
What is the purpose of building?
Material of building? j�O
If a dwelling, for how ,many families?—
Size
amilies?Sim of Addition: No. of feet front. ; No. of feet rear ; No. of feet deep.
No. of stories? `Wo
No. of feet from the level of the ground to the highest part of the roof?
How near line of the street?
How near line of the adjoining lot-
-
What will be the amass of access to the roof?
Size o(.floor.timbers. lst� ' ftd� ;
Span.. Distance on centers?
Size of carrying timbers?
Distance of supports on centers?
What kind of support?
Will the building be erected on solid or filled land?
What is the material of foundation?
Will the roof be flat. pitched. mansard or gambrel?
Material of roof covering?
Will the building be hated by steam or hot watw or hat air?
No. of brick walls? When located? Thickness?—
�j6
Will the building conform to the requirements of the bw1
�/a 6 • Fottmated Cost '
shpature of appiwnc
REMARKS PEjv%n OFDPE�JRY
j� �c ��oyc kap fl��°C�9c Ft e Gt eirtr�� -
p
wart-
APPLICATION FOR
PERMIT TO BUILD
ADDITION OR NUKE ALTERATIONS
Location C. Y��� /
PERMIT GRANTED ;
` 19
BaillwzI
U ..
SENDER:
• Complete items 1 and/or 2 for additional services. I also Wish to receive the
• Complete items 3,and 4a a b. following services (for an extra
• Print your name and address on the reverse of this form so that we can feel'
return this card to you.
• Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address
does not permit.
• Write"Return Receipt Requested"on the mailpiece below the article number. 2 ❑ Restricted Delivery
• The Return Receipt Fee will provide you the signature of the person delivers
to and the date of delivery. Consult postmaster for fee.
3. Article Addressed to: 4a. Article Number
Zbigniew Kantorosinski P 009 226 025
13 Ipswich River Road 4b. Service Type
Danvers, MA 01923
11 Registered El Insured
❑ Certified ❑ COD
❑ Express Mail ❑ Return Receipt for
RE: 12 Essex St. Mer Rcl
7. Date of Delivery
5. Sig a I ddressee) /� Addressee's Address(Only if requested
and fee is paid)
6. SIVrkt Agent) -�
DOMESTIC RETURN RECEIPT
PS Form $ 71�Novem�ber 1990 *U.s.OPo:1991-2s7aee
UNITED STATES POSTAL SERVICE I II II
12/15/9'2 1pm
PENALTY FOR PRIVATE
USE, $300
Print your name, address and ZIP Code here
• Leo E. Tremblay, Inspector of Buildings
One Salem Green
Salem, MA 01970
P 009 226 0125
Receipt for
Certified Mail
No Insurance Coverage Provided
,® Do not use for International Mail
(See Reverse)
ItTgniew Kantorosinski
Street and No.
r P.O.,State and ZIP Code
r A 01923
Postage ..'^.,m...,. . $ .
2.9
Certified Fee
1 00
ecial Delivery Fee Q
%Sestrlctad,Deli¢ery ee
_
®®
Return ReceiP[Sh'wJJng 1
pt';3L„_Whom.&Date .'a red
m Return ReceipfShto Whom,f �.
C Date,and Addresse€s`>{ddress
TOTAL Postage Q 29
C '
&Fees -.�_" Y�
Postmark or Date
M
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LL
N
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r
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES lase front).
1. If you want this receipt postmarked,stick the Bummed stub to the right of the return address
leaving the receipt attached and present the article at a post office service window or hand it to j
your rural carrier Ino extra charge). K
2. If you do not went this receipt postmarked,stick the gummed stub to the right of the return
address of the article,date,detach and retain the receipt,and mail the article. m
3. If you went a return receipt,write the certified mail member and your name and address on a c
return receipt card,Farm 3811,and attach it to the front of the article by means of the gummed
ends ff space permits.Otherwise,affix to beck of article.Endorse front of article RETURN RECEIPT
REQUESTED adjacent to the number. 0
00
4. If you went delivery restricted to the addressee,or to an authorized agent of the addressee, M
endorse RESTRICTED DELIVERY on the front of the article. E
0
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.if LL
return receipt is requested,check the applicable blocks in item 1 of Form 3811. i
6. Save this receipt and present It 6 you make inquiry. 105603-92-B-0954
tai � ttiem, �H � sttriuP�
�t� p
t Ste\
publir Prupertu Department
Nuilbina Department
0)ne o-alem l6rren
308-i.15-9595 tixt. 380
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer
December 8, 1992
Zbigniew Kantorosinski
13 Ipswich River Road
Danvers, MA 01923
RE: 12 Essex St. , Salem (R-2)
Dear Mr. Kantorosinski :
This office has received a complaint regarding mortar falling off the
chimney at the above referenced property. This is a hazardous condition
and a constitutes a danger to the public safety.
Please contact this office within seven (7) days of receipt of this
notice in order to obtain the permits necessary to correct this condition.
Sincerely,
Leo E. Tremblay
Inspector of Buildings
LET:bms
cc: Councillor Harvey, Ward 2
Sylvia Dee, 10 Essex St.
Certified Mail #009 226 025
iviarzi it iu.via U Izut34ZZ"IZl p.t
82.'72
The Commonwealth of Massachusetts ' " - •1
Board of Building Regulations and Standards CITY OF '
' Massachusetts State Building Cade,780 CMR ZQ�7 BAR z SALEM
mL, -2"
CrJ" Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Fa mfly Dwelling
This Section For Official Use Only
Building Permit Number. Date App ed:
l
n Sutldtng Official(Print Name) Signature
Date
SECTION 1:SITE INFORMATION
1.1 Property Address: '\:) �_z5-'It 1.2 Assessors Map&Parcel Numbers
1.1 n is this an accepted street?yes 'no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoaing District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Budding Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M,G.L c.40,§ 44) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone?
Check ifyes0 Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner t of Record:
_NNN SN" �sg,Sc,V C-)
Name(Print) City,State,ZIP
No_and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied D Repairs(s)�Ailteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units Other fy; ��5�\ ti 4
Brief Description of Propose
SECTION
SECTION 4:ESTUAATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materials) Official Use Only
1.Building $ O`���3` ,` 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard CiVFown Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) S List: 7�L
5.Mechanical (Fire
S ression $ Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due:
6at 46
r /Ge
krn-,�,ILcp
iviarzi ii iv-.uua V Izu/agF ZIzI p.o
a
SECTION S; CONSTRUCTION SERVICES
S.1 Construction Supervisor License(CSL)
StNICNIN
Name of CSL Holder 5 Lrcetue Number Expiration Date
List CSL Type(see below)
No.and Sheet � Type Description
t1 Unrestricted(Buildin to 3�000 cu tt
City/fown,State, tl' R Restricted 1&2 Famil D�vetli
M M
RC Rco6nCovvn
WS Window and Sidi
SF Solid Fuel Burring Appliances
nf" Insulation
Email adSZ Redstered Honte Improvement Cantractor(HID J.Demolition
H1C Com any Name or HIC strarstName + �--t r MC Registration Number Expiration Date
\� �La.��i
No et and Stre4•
-Email address
ultyf to— ate,ZW
Telephone
SECTION 6:WORKERS•COMPENSATION INSURANCE AFFIDAVIT(XG,L,c.152,6 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 PERNUT
I,as Owner of the subject property,hereby authorize_
to act on my behalf,in alftrratters relative to work authorized by this building �~ � \
permit application.
�► ► !"IP.7�rQj��
nt ti . . s. Mect vmc signature)
Date
SECTION 7b:OWNER`OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perj ury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
3
Print O«ner's or Autlarized Agent's ane(Electronic �gna un; �
Date
NOTES:
1. An Owner who obtains a building permit to do hisiher own work,or an owner who lures an unregistered contractor
(not registered in the Home Improvement ContractorIII
( C)Program),will xot have access to the arbitration
program or guaranty fund under NLG.L.c.142A.Other important information on the HIC Program can be found at
ova ti .mass.uoivoca Information on the Construction Supervisor License can be found at wivw.mass.�ov;ars
2. When substantial work is planned,provide the information below:
Total floor area(sq..f
Gross living area(sq.ft.) (including garage,finished basementlattics,decks or porch)
Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halt7baths
Type of heating system Number of decks( orches
Type of cooling system Enclosed p
Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
7 --- I he C'omm11omce;dlh of Massachusetts
AD y; , I1nard of Building Regulations and Standards CI IN OF
+).; Massachusetts Statc Building Cudc. 738 C NIR SALEM
ra•t;.,e�/ (i„r_all
Building Pennil Application To Construct. Rcpair, Renovate Or Demolish u
One- or rwo4luni(r Dive/how
This Section For 011icial Use Only
Building Permit Number: Date Applicd
�r t
td w rs-s2Z-Y L'e�. —--
holing 011icial(Print N;une) Sigtlature Date
SECTION I: SITE INFORIII N
1.1 Property Address: 1.2 Assessurs Nlap dr P ceI Numbers
I a .ESSEK- -S-r _
1.la Is this an acre ted streel? es no 11%fals Numlter Purcel Numhcr
1.3 Zoning Information: 1.4 Property Dimenslons:
Zoning District Proposed Use Lot Arco 04 11) Frontage(Ill
I.! Building Setbacks(R)
Front Yard Side Yank Ruar Yard
Required Provided Rt:q,rcd Provided Required Provided
1.6 Water Supply.(M.G.I.c.40.§JJ) 1.7 Flood Zone Information: 1.8 Sawaga Disposal System:
Zone: _ Outside Flood Zone?Public❑ Private❑ Check if �cs❑ Municipal❑ On site disposal s).rtmn ❑
SECTION2: PROPERTY OWNERSHIP'
p�r1 evord:
IICIJ cS1iAL50 Stetk2r✓I M/-1
Mbno(Print) N City.Slate.ZIP
No.and Street relephune Email Address
SECTION J: DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied O Repairs(s) Zrj Alleration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ .Speciry:
Brief Description of Proposed Work": -IM rY P �ie.E ju`zxl 1Qq0.iC
SECTION 4: ESTLMATED CONSTRUCTION COSTS
Item Estimated Costs: OMCIIIl Use Only
il.aborand \laterials)
1. Building S I. Building Permit Fee: S Indicate how lee is determined:
2. lilectrical S ❑Standard Citffossn Application Fee
❑Tuml Project Cush I Item 6)s multiplier _ s
1. I'lunihing S v. Other Fees: S_ --
� J. \Icclt.ulical ill\
5 \lcchaniad Wiry S --- — — — -
`11 t t/C5tl Il1n1 rtltll \Ii F1'llf S_..
op ('heck No. ( heck:\nunun: C,tuh \ounmt:
n 1'utal I'rajectCot S -- -- _.-.._..
Q� ❑ P,IiJ in Full ❑Outst:uWing Buhmcc Due:
tit:("PION t: CONSI-R111criON SERVICES
i.l C'unstructimt Supers isor Lirnse I�SI•) ��� 3 cj 3 _. 3^ I_- 13
I iccnsc Nunlhcr rvpiralian D;11c
C.SI, I kidder 1 1st l'SI. I\Pe hcc h6m f
'06-
25
_.. .CI , _.._._..__.___ I•)p�, U¢scriPliun -
N„ and Slrcct
11 I41restricmJ IlfuilJin s Lin to 34,IIIItl cu. IL1
(�� It Rc IricicJ F-18 Dwcllin
t iI%,'o1111,SI;IK,LII' �I \la.un
RC Raclin C11%crin
\45 N'induw.uid.4idin
SF Solid Fuel Ilurning Appliances
1 Insulation
-I'eic bona I`ma11-'d -ss D 1)"11 iliun
S,2 Registered flume Improvement Contractor(HIC) /iTrt R 53 -a
M91: Dm . 0,.Sr,9rri_ ;pAJ Lt_C: IIICI(cgistnaionNuinlicr F%piraliunDula
I lI(*C'onlpan) Name or I IIC I(496trant Name
AJ f AJ G-5 L 7 CZ
N 1J StrcM Email address
Pi f9 C zla L o�lI
CityfTown.State.ZIP relc one
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,e. I52.1 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 Aflldavit Attached? Yes .......... O No...........Cl
SECTION 7s: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 Novae(Elcclrunic Signature) Date
SECTION 7b:OWNERt 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.
Prim Owner'+ur:\ulhorircJ.\�cnt'.+Nuuw IOccuonic Sigmuure) Data
NOTES:
I. .\n Ovvner who obtains a building permit to do his.her own work,or an owner who hires an unregistered cuntractur
Ulot registered in the Hume Improvement Conlfactur(HICl Program),will nu have access to the arbitration
program or guaranty fund under M.G.L. c. 142A. Othcr important information on the HIC Program can be found at
t,t„% m.rv. t 0% 1 Information on the Construction Supervisor License can be found at „r" n .1 ; �:" 1111,
2. \\lien substantial lwrk is planned,provide the hiformadon below:
row flour area(14, 11.1 - 1 including garage. finished basement allies,decks or porch)
Gross living area 1 sy. 11.1 Habitable roust count
Nunlbenll'tirrplaces .. _ --- Gunheroflicdrooms
Numherol'hathroolns . . _ Numlicrol'hall halhs
I%Pe of hcanng s)stela Numher of decks porches
I'\pe oI'aa4ntg <.%aem I'nclo,cJ .,
t. "l'ot,d Probe! Square F„ot,tgc-111a) he s,,K tinncJ liv"f.ael I'mjccl Cost—
a
PI�NSIMATOEfRAWO 0 APPROVED BY THE
JMPJ:C MR PNOR W A PERMIT REM GRANTED
CITY OF_SALEM
Dft
\ WW
• Z0nWq ObMd
Is Propwiv LWOW In Location of
the skim Obbld? Yes No rma
Ie P OPWIV LOCONd In
ra C mmodon Men? YsM No
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Remot, Install Sidh% Construct Deck, Shed, Pool,
RspaidReplace, Other
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '•
The undersigned hereby applies for a permit to build aocorcLig.to the following
spedfica ona:
Owner's Name T o A� Tams y=
Address A Phase ess x cr-. L97k 1 I I - 03q 1�
Architect's Name
Address d Phone ( 1
Mechanics Name 4L�(zrve t*rjatPav5)
Address 6 Phone i'Ignoc\IL -2 LY��)Fiel o Erna. OR40 (76I l j;y —hn63
Whet b the pupose it b N*W
AA�IMw a bulatq? n.dw.wq.for how mmy lawAn?
Wo ool nn to tow? Mibe"?
Edkr W cod Carr U=ft r srw Uc«e>.r
15-30 SWature of icant
SKiNED UNDER THE PENALTY,
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
STP-)f kJh ai:P &—r yv) Agj g)l -Ij4 At 41T.- E0ir,16L9S
fztRnd=
MAIL PERMIT TO:
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