385 ESSEX STREET - BUILDING JACKET 385 ESSEX STREET
Plans must be tiled and approved by the Inspector before a permit will be granted.
No.gy -9City of Salem Ward
X 11
IS PROPERTY LOCATED IN THE b -
HISTORIC DISTRICT? Yes No a
IF SIDING, HAS ELECTRICAL
PERMIT BEEN OBTAINED? Yes No Home Phone #
fk APPLICATION Bus. Phone #7u4 —279 6
FOR
q PERMIT TO R0eF,-R*R6eF O
Salem,Mass.,
TO THE INSPECTOR OF BUILDINGS:
The undersigned herebv ap�,lies fora permit to build according to the following specifications:
Owner's name and address p7 ✓�CC�`� C�- V I'�.0 /'t` I V� -S j'� �- \
Architect's name 1;� IJ YVl OL L
Mechanic's name and address
Location of building,No. 3 7 J. S S CSC S l^ S /} L C.-�"✓� YY✓/f�
What is the purpose of building? (ZC
Material of building? /3/C/C K Rt ST77ti V Asbestos? N -D
If a dwelling,for how many families?_
Will the building confonn to the requirements of the law?
Estimaied cost 6—bU ontractors Lic. No.
Signature of applicant
s�Q�Q
RE
GL—�Q Q
MARKS SIGNED UNDER THE
nyvv� L n� PENALTY OF PERJURY.
0 0 tiA� e/
P-
c�9
No. Ward 3
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location f� �c tCiii
PERMIT GRANTED
19 /
Appd
rov
Building/nspecto
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No. . City of Salem Ward
x
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APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, It, III, IV, and IX.
I. AT(LOCATION) a ,I — + /I J" ZONINC7 ��
LOCATION /_�/ I�"o.l ISREETI n,�
OF BETWEEN / �—r " T AND DNKN
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOTBLOCK SIZE
II. TYPE AND COST OF BUILDING -All applicants complete Parts A -D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION"USE MOST RECENT USE
1 ❑ New building Residential Nonresidential
2 ❑ Addition(I/residential,enter number of new 12 ❑ One family 18 ❑ Amusement,recreational
housing units added,i/any,in part D,13) 19 Chruch,other religious
13 ❑ Two or more family-Enter number
3 J9Alteration(See 2 above) of units ....................................................... 20 Industrial
21 ❑ Parking garage
4 ❑ Repair replacement 14 ❑ Transient hotel,motel,or dormitory-
22 Service station,repair garage
Enter number of units ...........................
❑
5 ❑ Wrecking(It multifamily residential,enter number 23 E] Hospital,institutional
of units in building in Part D,13) 15 ❑ Garage
24 ❑ Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
26 E] School,library,other educational
7 E] frountlation only 17 ❑ Other-Specity _
27 E] Stores,mercantile
B.OWNERSHIP 28 ❑ Tanks,towers
8 ❑ Private(individual,corporation,nonprofit
institution,etc.)
29 ❑ Other-Specify
9 ❑ Public(Federal,State,or local government
C.COST (Omit cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
machine shop,laundry building at hospital,elementary school,secondary school,college,
parochial school,parking garage for department store,rental office building,office building
10. Cost of improvement ......................................................... $ V cJ(,/ t� at industrial plant.If use of existing building is being changed,enter
P 9 9� 9 9 proposed use.
in be installed but not included � (�
in the above cast (.,AKGtX�F' d
a. Electrical................:..........................................
................
b. Plumbing.......................................................................... 'a/w�- -�'� /� n /' G�n{�,^1—e--Q— �✓t r
c. Heating,air conditioning.............................................
d. Other(elevator.etc.).....................................................
11. TOTAL COST OF IMPROVEMENT $,2 O
III. SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions, complete Parts E-L;demolition,
complete only Parts J& M, all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 ff Masonry(wall hearing) 35.F(�� Gas 40,t�r Public or private company Will there be central air
31 n Wood frame 36 Oil 41 ❑ Private(septic tank,etc.)
conditioning?
32 ❑ Structural steel 37 ❑ Electricity 44 ❑ Yes 45.15 No
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
I1�r�
34 ❑ Other-Specify 39 ❑ Other-Specify 42Z Public or private company 46 E] Yes47 y(I No
43 ❑ Private(well,cistern)
J.DIMENSIONS M. DEMOLITION OF STRUCTURES: III<S)'L(r -
48. Number of stones ............................................................
49. Total square feet of floor area,
all floors,based on exterior Has Approval from Historical Commission been received
dimensions ....-............................_.................................... for any structure over fifty(50)years? Yes_ No
50. Total land area,sq.R ............. Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed ......_....................... ......................
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTE
52. Outdoors........................................-................................... Yes NO
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed............................................................................. Electric:
Gas:
Full ................ Sewer:
54. Number of
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial.-----........................... BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes No (If yes, please enclose documentation from Hist. Cam.)
Conservation Area? Yes_ Nci`—�Q (If yes,please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No
Is property located in the S.R.A. district? Yes_ No_
Comply with Zoning? Yes---J No (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No (if yes,submit documentation/if no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ No
_Is Architectural Access Board approval required? Yes_ Non (If yes,submit documentation)
Massachusetts State Contractor License # Salem License#
Home Improvement Contractor # Homeowners Exempt form (if applicable) Yes_ No_
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6) MONTHS OF ISSUANCE OF BUILDING PERMIT
If an extension is necessary, please submit
CONSTRUCTION IS TO BE COMPLETED BY: / 9J in writing to the Inspector of Buildings.
V. IDENTIFICATION - To be completed by all applicants
Name Mailing address-Number,street,city,and state ZIP Code Tel.No.
1. Q�9 eco C Rc "3 �'�r' �s S i' o ti �u
Owner or /
Leasee
2. s �/
Contractor
Builder's
License No.
3.
Arohitect or
Engineer -
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant - Address 3 L J6S� ' Application date
r 0 9/C.��/1M
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building 9 FOR DEPARTMENT USE ONLY
Permit number H
Building l / /fit use Group
Permit issued -7 19 jJ
Building
Fire Grading
(�
Permit Fee $ ' Z�• �. Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ ' qn
TITLE
NOTES AND Data • (For department use)
/k a,I ( Ev
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4
PERMIT TO BE MAILED TO: S' F CS b
DATE MAILED:
Construction to be started by: Completed by:
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD 4
REAR YARD
NOTES
SITE OR PLOT PLAN -For Applicant Use
O N
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20 Hillcrest Cir
SwampscodMA 019071721
Job No. By T,_` Date \ ' Sheet
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STRUCTURALn
No.33719
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Edward Moll - Project
20li lloest Cir
SwampsconMA 019074721
Job No. By Date " Sheet
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2, No.33710
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: GORDON Page3
Paye z HOW TO SELECT: GORDON HOW TO SELECT
"CELLADOOR" REPLACEMENT DOORS
MODEL - CD MODEL RD
FOR EXISTING FLAT FOUNDATIONS FOR
AND NEW CONSTRUCTION RAISED FOUNDATIONS
l K
i�
A 8 Height A 'g �� \
Length\
V I� �C� Length Width \ c0 �dtb
1 Measure dimensions A, B, C, & D
1 Measure dimensions A, B. C, D &K 2 A&B Select length at least 2'r longer than "A" and within 2"
ti 2 A& B Select length at least 2" longer than "A" and at least 2" of •'Br
N shorter than "B" 3 C & D Select width at least 4" wider than '•C" and at least 2"
3 C& D Select width at least 4" wider than "C" and at least 2" narrower than '•D•'
V. narrower than •'D".
4 Check to make sure the height of the model selected is
greater than ••K". The "K" dimension is the distance from
the top of foundation tot p of basement door opening.
CD-3 WITH CX EXTENSIONS WITH 6" WITH—Ir WITH ta"
MODEL CD SL � � MODEL WIDTH LENGTH EXTENSION EXTENSION EXTENSION
_E8!Z ,¢6,t,! X6" C%4 V CX IV CX.24'• IF LONGER LENGTHS
62'" 67"-69'" 73"'-75" NA ARE REQUIRED.ORDER
LENGTH 42X•' 57" AD-1 44 h" iuTSTEELFROM
ED.O
63" 71' 77" 83"' 89•• g5••
RO-2 1 4,. E6'%i' • 6"s"-71" 75"-77" NA RLANT.
DTH 49" 45" 49"
WI53" 1 53" 53" 53" �••
AD-3 5215" 731h" 78"-80" 84"-86" 90"-92"
EX TENSION HEADERS ARE NOT INCLUDED IN 000R-
HEIGHT Sl" 24%" 22" 19X'" 21" 22X" 24" 26X" - STANDARD DIMENSI DNS ORDER SEPARAtELT.
It I
o�
Diag.01 Diag.02 Diag.03
Nhen using a CD door for remodel. K Dimension Is the The metal door in the above
ng, K dimension is not the height dimension illus. illustration is not as high -
d your wooden door. The door in trated in diag #2 clearance to tr.e Gass--ent has
.ran.». YI � ....r....� ..... '
i t
Saiem Historicai commission
ONE SALEM GREEN.SALEM, MASSACHUSETTS 01970
508) 745-9595. EXT. 311
APPLICATION FOR CERTIFICATE OF NON-APPLICABILITY
Pursuant to the Historic District's Act (General Laws , Ch. 40 C) and the
Salem Historical Commission Ordinance, application is hereby made for issuance of
a Certificate of Non-Applicability for:
construction [ ]; reconstruction [ ]; demolition [ ]; moving [ ]; alteration [ ];
painting [ ]; sign or other appurtenant fixture [ ] work as described below in the
Historic District.
5;
(NAME OF HIS URIC DISTRICT)
Address of Property: �S-f L4 ET—
Name
lName of Record Owner: 1:;�;Q6ccs�- C I-j-t)taC 9 N
Date building erected and architect, if known:
DESCRIPTION OF WORK PROPOSED: L%�2
A.
Name of S -1 Signature of
Owner: -1 f� Owner:
(PLEASE PRINT OR TYPE)
Address of S Tel . No. 7 �`�^27/�o Date
Owner:
SPACE BELOW LINE FOR OFFICIAL USE ONLY. FOR INSTRUCTIONS SEE OTHER SIDE.
Date received: Date of hearing:
-A. Number of Certificate:
iALEM HISTORICAL COMMISSION
P o d s for Fil Lne A221icacions
A. There is no tee to come before the Commission.
B. Be prepared to apply for approva Ls well in advance of commencing any exterior work. Before making anvv changes to the
exterior of a propercv in an historic district, the owner should call or visit the Commission representative at the Salem
Planning Department co discuss proposed alterations and; to determine the category of the application (Appropriateness,
Von-Applicability or Hardship).
C. The Commission norma Liv meets on the first and third Wednesdays of each month and notices are posted at City Hall. The
meetings are held at Une Salem Green. 2nd floor, and begin at 7:30 p.m. All meetings of the Commission are open to the
public and any person is entitled to appear and be heard on any matter before the Commission before it reaches a decision.
U. An application car a Certificate of Appropriateness or Hardship must be received by 3:00 p.m. on the Monday L6 days before
the meeting to order to make the following agenda. An.application for a Certificate of Non-App Licabtlity may normally be
added to the agenda up to the day of the meeting.
h:. All appi icac tons for Ce re it icate of Appropriateness or Hardship require a pub I is hearing. Notice of the hearing must be
posted with the Citv Clerk 14 days before the hearing and abutters must be nocitied in writing. Commission staff will
hanule mese procedures. i public hearing is not required for a Certificate of Non-Applicability.
. . Anp..CatlonS inns[ or Supmltted by the owner nl the property. In case of a tenant, a waiver of the owner's appearance may
'.ee granted at a+d discretion at the Commission it Ic is requested by the owner.
An application wiLI not be considered complete unless all work items are thoroughly'described on scaled drawinas and
include specifications regarding dimensions. materials. and any ocher information needed for the Commission to visualize
the changes to order to make a determination. :tppiications for paint colors should include a paint chip or chart.
Applications tot changes ocher than paint colors must be accompanied by scale drawings chat adequately illustrate all
proposed changes. The following items should be included in your drawings as applicable:
1. Site plan showing location of improvements;
? Elevation drawings of the spec Ltic improvements;
1. Ueca;is/prot ties ( i.e. moldings; fence caps, cornices. etc.);
4. Materials ( i.e. wood, brick. ere.);
5. ❑imensions ( i.e. .tae of trim); and
n. Transtormers, heat pump and condenser locations, electrical entries and meters, lamp posts. stove pipes.
I. At their convenience. .t representative of che,Commtssion will cake pictures at clic property from clic public way for
presentation ac the meeting. It is not necessary that the applicant be home or be present.
I. At the hearing. the Commission will discuss the application with the applicant or his representative, hear the abutters and
take a Nate. 'wners havtna professional consultants such as architects or contractors are urged to have thea be present at
the hearing. :I the application is approved a Certificate will be issued. mailed to the applicant and copies will be sent
:.p the City ;.lark and Building lnspeccor. I'leasenote: that the application can be continued until the neat Marine if the
Commission deems necessary ( i.e. tot reasons of incomplete dravtnase to perform a site visit. etc.). In any use, the
Commission must make a determination within 00 days frow the date the application is received.
J. A propertv owner or a contractor cannot receive a building permit unless a Certificate has been issued or the applicant has
a Letter tram the Commission stating that the change involved is not subject to the Commission's Jurisdiction.
K. The City of Salem reserves the right to inspect the project to determine compliance with the conditions set forth in the
Certificate of Appropriateness.
Violations
A person commencing or completing work to Elie exterior of a building in an historic district without the necessary approval of
the Commission is subject to fines of up to $500 per day from the dace of the violation. The City of Salem is not responsible
for an owner's negiect to inquire about necessary City permits and approvals.
All records are public and we will be happy to confidentially assist.you if you are concerned that someone in your
neighborhood is in violation.
Assistance
Copies of Commtsston guidelines are available at the Salem Planning Department. The guidelines provide examples of what is
historically appropriate (and inappropriate) for Salem's neighborhoods including trim9 siding, doors. doorways* porticos,
steps, fences, masonry, paint colors, parking so Lutions. roofing, and windows. These guidelines will help you understand wha
changes are likely or unlikely to be approved. The Commission supports your efforts co improve your property and can guide
you on historical appropriateness. various books and City-wide architectural inventories are avaiLabla to help you identify
the style and age of your home. Also available are rehabilitation guidelines. mist. legislation. pictures. books, and other
historical data and research materials. For further information contact the Commission's staff representative,Jana Guy
(Salem Planning De t.. One Salem Green. Salem, MA 01970. 508-745-9595. ext. 311).
JHisCom7/Suanis ry
£msec rrr.
07.77
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I - .s_ GRACE CM1./RG}y
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1 PLAN CFL-ND OF•GRA .E CMU tr_"
SALEM. MASS. - - - --
CITY OF SALEM
PUBLIC PROPERTY
a DEPARTMENT
KIMBERLEY DRISCOLL
MAYOR
120 WhSHINGTON S'rnEE'i'# SALEM,MASSACHUSETTS 01970
TEL:978-745-9595 FAX:978-740-9846
E
Gov�
May 17, 2007
Dr. Stephen Hayes
387 Essex Street
Salem,MA 01970
Dear Mr. Hayes:
This office has determined that the legal use for this property located at
387 Essex Street is 3 dwelling units, with an allowance for one of these units to contain a
Professional Office. A recent inspection by my assistant confirms that this is also the
current configuration and use of this property.
If you have any further questions regarding this issue please feel free to call this
office at (978) 745 -9595, ext. 5641.
Sin ly, /
Thomas J. St. Pierre
Building Commissioner/Zoning Enforcement Officer
CC: file
CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
KIMBERLEY DRISCOLL
MAYOR 120 WASHINGTON STREET♦SALEM,MASSACHUSETTS 01970
TEL 978-745-9595 FAx:978-740-9846
May 9, 2007
Tom Umbrianna
22 Bow Street
Carver,MA 02330
Dear Mr. Umbrianna;
The enclosed application has been returned to you,having been rejected by this
office. The issue being that you by virtue of the permit application paperwork submitted
you are illegally dumping building materials in Town of Jefferson, New Hampshire. A
call from this office to the Town offices in Jefferson causes me to conclude that this is an
illegal practice. As such this rejection of this permit application package is based on
fraudulent claims made by the contractor within this application.
Please be advised that this practice has been made known to both the property
owner and the State Building Inspector. I will be requesting that the Town of Jefferson,
N.H. send me an email as to their records regarding the nature of the dumping that has
been going on at this location. I am also sending a copy of this letter to the Town of
Jefferson for their files. Any further information that this correspondence generates will
be shared with the State of Massachusetts Board of Building Regulations and Standards.
If you feel aggrieved by this action, you may contact the BBRS at 1 Ashburton
Place, Boston, MA, Room 1301, as any appeal of this action would be through them.
If you have further questions regarding this issue, you may call this office at(978)
745 —9595, ext. 5643.
Si erely,
),/ J seph E. Barbeau,Jr,
Local Inspector(Assistant Building Inspector
City of Salem
CC: file, State Inspector Wakem, Town of Jefferson, BBRS
What is the current use of the Building?
Material of Building?"d-S�OvN A If dwelling, how many units?�
Will the Building Conform to Law? Asbestos?
Architect's Name
Address and Phone ( )
Mechanic's Name
Address and Phone
License# HIC Registration#
Construction Supervisors c g �
Estimated Cost of Project$�T Permit Fee Calculation
Permit Fee$ Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of perjury W-�
Date�JA�F- ZS U�
o
9
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CrrY OF SAmm
' PUBLIC PROPERTY
DEPARTMENT
�„�• t2e�wm�or stseR•s.urtixs.roawee,sotsis
11`M?4& Sae•PAZSM74&"
Constmdam Debsls DjsImd Aflldavlt
(required 8ttt an demadon std rmovades woo
to mordamm with the sitcth WWom nabs Shoe BWWb*Code.780 CMR section 111.5
Debris,and the povisions a(U(N.o A S 34
gym pUNIN N to bm d with ds eosdides that the darts cauidss 0me
this war!she0 be disposed obis a peop b 8aeosed waste disposal Atcift s 4e ined by MM o
t t 1.S 1S0A.
The dells will b.Uumpoeted by:
��. nsms a[>tselsrl
The debris will be disposed of In:
(aa®e oy(�I,Se9ti�Mpj�
(oJdnar of Iheility)
Lsoasee o(ptm�ir rpptkaat
�rb-6
dw
►�260
S - S
The Commonwealth of MassffV'Igt(AL SERVICES
® Department of Public Safety�y�,
Massachusetts State Building Code(780'�1 SEP 8
Building Permit Application for any Building other than a One-or Two-Family Dc eAng
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
3'K EsSex St, So e", Vv A o 19`7) o Gro..cc
No.and Street City/Town Zip Code Name of Building(if applicable)
SECTION 2 PROPOSED WORK
Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below
Existing Building❑ Repair p4, I Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ft
Is an Independent Structural Engineering Peer R1eview required? Yes ❑ o 1
Brief Description nFf'Propos �y�eork: �c1—a P b 0 ti� r: D�&,C e yr e� •� O
0T1rv�t'�\
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A. Assembly A-1❑ A-2❑ Nightclub ❑ A�3 ❑ A-4❑ A-5❑ B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ I H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional I-1❑ I-2❑ I-3❑ I4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑
S: Storage S-1❑ S-2❑ U:.Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IHB ❑ I IV ❑ 1 VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal:
Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑
Private❑ or indentify Zone: or on site system❑ required❑or trench or specify:
permit is enclosed❑
Railroad right-of-way- Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
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SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property fik e C at-e }_o.X cti
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Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Cna- . 93Sd
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0 and skip Section 10.1
.10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2General Contractor
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Company Name
Steve. L. Qjw-*,y CS 05 3LFb 3-1Z-2o16
Name of Person Responsible for Construction License No. and Type if Applicable
3`? 3 F_Ss._,c S+• Sa\cam-. 1 'M . oil-w
Street Address City/Town State Zip
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Telephone No.(business) Telephone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT .G.L.c.152.§25C 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes❑ No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ q- ppo
Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)_$
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $
Enclose check payable to
6.Total Cost $ It',0 0(5 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
applicca_tion is true and accurate to the best of my knowledge and understanding. (07I tt f
PN00 -V� ri �QVK � �NQ �r . �YGO�SWMG°^ C4/d _7T C!
Please rint arld, sign E name Title Telephone No. Date
. S C, S Ste\ cv� o p`t?o
Street Address City/Town .// State Zip
Municipal Inspector to fill out this section Jun application approval: nD
Name te
I
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s,
Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978)619-5685 FAX(978)740-0404
CERTIFICATE OF NON-APPLICABILITY
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
El Reconstruction ❑ Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other Work
as described below does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District: McIntire
Address of Property: 385 Essex Street
Name of Record Owner: Grace Church in Salem
Description of Work Proposed:
Repair and replace in-kind wood windows.
Replace clapboards in-kind. Repaint to match the existing colors.
Install n�w storm windows in'a.e color black
There will be no change to the design, material, or color of any replaced materials.
Dated: August 7,2014 SALEM HISTORICAL COMMISSION
The homeowner has the option not to commence the work(unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
THIS
(or any other necessary permits or approvals)prior to commencing work.