348 ESSEX STREET - BUILDING JACKET 4d
UPC 10330 y
m 153E ala
HASTINGS, UN
348 ESSEX STREET G-155-09
COMMONWEALTH OF MASSACHUSETTS
CITY OF SALEM
GIS#. . R 13809
Map: 26 --
Bock:
Lot g 0524 802 , GAS PERMIT
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Permit i .Gas
Category: GAS t
Permit# s G-155-09 ,a
ProtectJs-2009-00062l !. ': PERMISSION IS HEREBY GRANTED TO:
Est. Cost: $0.00 , „ . Contractor: License: Expires:
Fee Charged:$80.00 s ''' 'j Paul Flores
Balance Due:$.00.� - .t,� ` ' Owner: SKERRY JON T, SKERRY REBECCA S
#of Fixtures: j ,:€Applicant: Paul Flores
AT: 348 ESSEX STREET
ISSUED ON: 05-Nov-2008 AMENDED ON: EXPIRES ON: 05-Dec-2008
TO PERFORM THE FOLLOWING WORK:
(2)HEATING BOILERS jhb
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF
ITS RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount.
GAS REC-2009-000728 05-Nov-08 285 $80.00
GcoTMS®2014 Des Lauriers Municipal Solutions,Inc.
Q The Commonwealth of Massachusctts Town of
Board of Building Regulations and Standards 102011111111100
Massachusetts State Building Code, 780 CMR, 7'"editi:Demolish
Building Dept
Building Permit Application To Construct. Repair, Renovate Or ja
One- or Tsto-Fumilc Dwelling
This Section For Official Use Only
Building Permit Num Date Applied: G
>� Signature:
Building Commissioner/f6spector of Buildings Date
SECTION I:SITE INFORMATION
1.1 Property Address: �y 1.2 Assessors Map At Parcel Numbers
I.1 a Is this an accepted street:'yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning Distnct Proposed Use Lot Area(sq n) Frontage(n)
1.5 Building Setbacks(R)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.I,c.40,l54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if es❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of Record:
�7o 3W u sew
Name(Print) Address for Service:
Signature Telephone
SECTION J: DESCRIPTION OF PROPOSED WORKS(check If that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Additiod13
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief De pt on of Pro sed �
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
I. Budding S o (00,0, 1. 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
J. Plumbing S 2. Other Fees: S
4. .Mechanical (HVAC) S List:
5 Mechanical (Fire S
Total All Fees: S
Su ression
Check No. _Check Amount: Cash Amount:_
6. To(aI Project Cost: S /Q 0O 0 0 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor iCSL)
E•n ��2to v ;.M
NumRr Espuauon Date
N,poe of(-SI. Helder L Type 6ce heluw)
Descri tion
Address
Unrestricted u to 33.000 Cu. Fc)
Restricted I&Z Pored Dwelhn
5tgnamrc Masonry Only
RC ResidentialFlooriin Covering
Telephone WS - Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
Sy eglstered Home Improvement Contactor(HIC) /—S�b 15�O —A-
6/r/= (gnu✓T'
HIC Company Name or HIC Registrant Na�{ie r Registration Number
T _ J4/
Address _ aD i ti - D t .���-��t3 j J' D l j`
Sig Telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 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 .......... O No........... O
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.
Si nature of Owner Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
I. ^—_ � �� LQ (%(- 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
beha
Print Name
Signatuhrisro*nerW Muthorizeu 4gent Date
Si ned under the ains and penalties of perjury
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 W have access to the arbitration
program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and I I O.RS,respectively.
2. When substantial work is planned,provide the information below:
Total floors 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 halfbaths
Type of heating system Number of decks/ porches
Typeof cooling system Enclosed Open
3. "Total Project Square Footage" may he substituted for 'Total Project Cost"
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PUBLIC PROPERTY
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APPLCATI IN FOR TIC RE UM n12NOVATION CONDUCTION
DEMOLMON,OR(�Gz OF USE on
332U(n"1t OR
1.0 S M INFORMATION 14 ✓G
Loca*M NWW 1119
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Property Is boded In a:Cordervadon Ana Y/N HkWft Oehbt YIN
2.4 OWNERSHIP INFORMATION
2.i Owner of Land
Narrw. t C�
Addrsew
e >
Telphane:
3.0 COMPLETE THIS SECTION FOR WORK IN EXl3TIM BUILDINOs ONLY
Addidon Existing
Renovation Number of Stories Renovated
Change 1n Use New
Demolition
Existing
Approximate year of Ares per floor(af) Renovated
construction or renovation
of existing building New
Wd Description of Proposed Work:
Ve, lJ y! ir5 d-1
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matte of Bulow? Asbestos?
Wlr the Bu§*V Cadbrm to Law?
ArcAilOds Name �)
Address and Phom A7S3
tAael+s�'a 'y
Name �l
9uPervhots Lwenae 0�q L2 HiC Reghtralbn•
Estlrnsted Coat of PrOl" Pe d Fee CaWft 000 Reside "
x »�
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Estimated
Fee S --- ._...
F�tfnY - - Estlrrmtsd Coat X S41/Si000 Conrnarda4
-- An AddNlWW S&OO Is added as an
Admin*kadvo churge.
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MaM dare that all ROWS are property and ably written to avoid delays in proesednliL
TM undersigned does hereby apply for a Building PR to e
species Signed under penalty of PwIUrY
Date
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