10 FEDERAL STREET - BUILDING JACKET J14Omit)
UPC 10334
Broadfields Properties LLC and P-Mac LP
50 Broad Street
Salem, Ma 01970
978-744-2712
Building Inspector
City of Salem C
140 Washington Street
Salem, Ma 01970
Dear Sir,
This letter is to inform you that we intend to start work, with your permission, at Ten
Federal Street fourth floor for a tenant fit up for the Salem Social Security Office, while
waiting for issuance of a building permit. Stamped architectural plans and the
construction control form were submitted on April 27, 2007.
We understand that we undertake this work at our own risk, and any changes requested
by the Building Department to the submitted plans will be our responsibility. We also
understand that we will be responsible for any issues or liabilities arising from our work.
Thank you,
Peter C. Flomp,
Manager Ten Federal Street,
MA CS License 70702
1J`1��O�.JCt d-��SQF�'Sa�
,. UNITED STATES -Tk4. F;FY. ESSE.,
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MA
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• Sender: Please print your name, address, and ZIP+4 in this box
Ct o SA
S ^ I M
61170
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. X Agent
■ Print your name and address on the reverse ❑Addresses
so that we can return the card to you. IB. Receiv y(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 Rem 17 ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑No
P- MAL
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'SF I& Gpr�1I/o'Mrl/ t214t
(0 - '"_ e-%e)"g -S/-. 3. Service Type
❑Certified Mail ❑Express Mail
1. • 0 1 R 7o ❑ Registered ❑ Return Receipt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Ezra Fee) ❑Yes
2. Article Number
(transfer from sawke label)
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
Certificate No: 1070-07 Building Permit No.: 1070-07
Commonwealth of Massachusetts
City of Salem
Building Electrical Mechanical Permits
This is to Certify that the BUSINESS located at
Dwelling Type
0010 FEDERAL STREET in the CITY OF SALEM
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF
OCCUPANCY
TENANT FIT UP 4TH. FLOOR
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 Jul 19,2007
GeoTMS®2007 Des Lauriers Municipal Solutions,Inc. --------------------- _______ _ ------------___----------------- --
--
___---
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BUILDING PERMIT
0010 FEDERAL STREET 1070-07
GISGIS#- 10671 _ COMMONWEALTH OF MASSACHUSETTS
Map: 35
Block: CITY Oh' SALEM
Lot: 0192-0
Category: TENANT FIT OUT
Permit It 1070-07 B€TILDING PERMIT
Project# JS-2007-001724
Est. Cost: $240,000.00
Fee Charged: $2,645.00
Balance Due: $.00 PERMISSION IS HEREBY GRANTED TO:
Cons[ Class: Contractor. License: Expires
Use Group: P MAC LP General Contractor-CS 070702
Lot Size(sq.fl.): '
Owner: BROADFIELD PROPL'RTY LLC
Zoning:
Units Ciainedi Applicata: BROADFIELD PROPERTY LLC
Units Lost: AT: 0010 FEDERAL STREET
Dig Safe#:
ISSUED ON: 08-Jun-2007 AMENDED ON: EXPIRES ON. 07-Dec-2007
TO PERFORM THE FOLLOWING WORK.-
TENANT
ORK.TENANT FIT UP 4T I FLOOR J.B.
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Building
Underground: Underground: Underground: /1 Excavation: -
Service.-. _ Meter:
Rough:&112107 Rough: ,n /IV ,y/} Rough: �j N Foundation:
v �°I ,✓/t/ A I`
Final �/2,/0�� Final Final ^ � _ � ' Rorigh Franre' D� ��Q
't/ Firepl.nc uncy:
D.P.W. Fire ^] Iie:dth
Insula
Meter: Oil:
` Final: V ��
house# S
fi III/G
- - / Tr s ryo (Y
Water: n
Scwcr: - Sprinklers:
THIS PERMIT MAY BE REVOKED BY THE CITY OT SALEM UPON VIOLAT
RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: AuounC
BUILDING REC-2007-002108 08-Jun-07 1519 $2,645.00
Cali for Permit to OtCupy
GeoTMS®2007 Des Lauriers Municipal Solutions,Inc. a '
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nQVF AD
CITY OF SALEM
BUILDING PERMIT
Certificate No: 1070-07 Building Permit No.: 1070-07
Commonwealth of Massachusetts
City of Salem
Building Electrical Mechanical Permits
This is to Certify that the BUSINESS located at
Dwelling Type
0010 FEDERAL STREET in the CITY OF SALEM
Address Town/City Name
IS HEREBY GRANTED A TEMPORARY CERTIFICATE OF
OCCUPANCY
TENNANT FIT UP 4TH. FLOOR SOCIAL SECURITY OFFICE
This permit is granted in conformity with the Statutes and ordinances relating thereto,and
expires Wed_ne_sday Jul 25,2007 unless sooner suspended or revoked.
Expiration Date
--------------------- - -__
-----------------------
Issued On: Mon Jun 25,2007 ------------ - =
GeoTMS®2007 Des Lauriers Municipal Solutions,Inc. ---
CITY OF SALEM
BUILDING PERMIT
Certificate No: 73-06 Building Permit No.: 73-06,
Commonwealth of Massachusetts
City of Salem
Building Electrical Mechanical Permits
This is to Certify that the BUSINESS located at
Dwelling Type -
0010 FEDERAL STREET in the CITY OF SALEM
- - ----------- -- -- - - - - --------------Y-----------------------------------
Address Town/Cit Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF
OCCUPANCY
CERTIFICATE OF OCCUPANCY 10 FEDERAL 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:Mon May 15,2006 / -- - - - -- - -
.�D
GeoTMS®2006 Des Launers Municipal Solutions,Inc. ----------------------------------------------- -------------------------------
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`*CIVIT�
0010 FEDERAL STREET 73-06
GIS#: 10671 j COMMONWEALTH OF MASSACHUSETTS
Map: 35
Block: C — CITY OF SALEM
Lot: 10192-0
Category: 1437 Nonresidential:ad BUILDING PERMIT .
Permit# 73-06
Project# JS-2006-0068
Est.Cost: $4,711,000.0
Fee $47,115.00-
Const.,
47,115;00Cost Class:'' . PERMISSION IS HEREBY GRANTED TO:
Use Group: ,I Contractor: License:
Lot S1ze(sq, ft.): -3 DeIulis Brothers Construction STATE-040461
Zoning: Owner: P MAC LP
Units Gained:! �Appiieant: DEIULIS BROS CONST CO INC
Units Lost:
Dig Safe#: jAT. 0010 FEDERAL STREET
ISSUED ON: 21-Jul-2005 JAMENDED ON: EXPIRES ON. 21-Jan-2006
TO PERFORM THE FOLLOWING WORK.-
73-06
ORK.73-06 ADDITION 3 STORY FOR OFFICE SPACE TJS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbin¢ Building
Underground: Underground: Underground: Excavation:
Service: Meter: - - — -- - -Footings;- _///. ttTT--
Rough: - Rough: Rough: Foundation: / Dl
d P/oS U 41
Final: Final: Final: Rough Frame: 9
Fireplace/Chimney: -
D.P.W. Fire Health
Insulation:
Meter: Oil: Final:Ok F/,o 0 r n
V �
House# Smoke:
Treasury:
Water: Alarm:
Sewer: Sprinklers: /P'
�� /A �— �nr OtfrC d
THIS PERMIT MAY BE REVOKED BY THE CITY OF SA M ON VIO ATIO ANY OF ITS a/Q(
RULES AND REGULATIONS. irx.q y/�
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
BUILDING RFC-2006-000093 21-Jul-05 6737 $47,115.00
Lail-for Permit to Occupy
GeoTMS®2005 Des Lauriers Municipal Solutions,Inc.
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' YV
YSQYE Ap
CITY OF SALEM
BUILDING PERMIT
,, CONSTRUCTION CONTROL
Ii//
PROJECT: w01c )ts.L
PROJECT OWNER: Vjoe, 1.4w.
PROJECT LOCATION —10 h�l�Y7�{�L ��jfrirf' cfa� t M
ARCHITECT/ENGINEER: (jrf j jjj?=�
IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUILDING
CODE, I_f j*tj . IG �Ah tZlpd'if REGISTRATION NO. `{JZP,?
BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECT HEREBY CERTIFY THAT 1
14A VE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS,
COMPUTATIONS AND SPECIFICATION CONCERNING:
ENTIRE PROJECT_ARCHITECTURAL X_STRUCTURAL_MECHANICAL_
FIRE PROTECTION—ELECTRICAL_OTHER(Specify)
FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE,SUCH
PLANS,COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF
THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING
PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND
OCCUPANCY.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL
SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND
PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE
WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE
RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.2.2:
I. Review of shop drawings,samples and other submittals of the contractor as required
by the construction contract documents as submitted for building permit,and approval
for conformance to the design concept.
2. Review and approval of the quality control procedure for all code required controlled
materials.
3. Special architectural or engineering professional inspection of critical construction
components requiring controlled materials or construction specified in the accepted
engineering practice standard listed.in Appendix B. .
PURSUANT TO SECTION 116.2.3,1 SHALL SUBMIT PERIODICALLY A PROGRESS REPORT TOGETHER WITH
PERTINENT COMMENTS TO THEA BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I
SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE
PROJECT FOR OCCUPANCY.
VATI
SIBSCRiRF.D ND SWORN TO BF,F F.ME THIS 3 DAY OF a ��. 200
'i
NO ARY PUBLIC ; MY COMMISSION EXPIRES
CITY OF SALEM, MASSACHUSETTS
a.
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3R0 FLOOR
SALEM, MASSACHUSETTS 01970 ^®�
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380 V
MAYOR FAX: 978-740-9846
April 14, 2005
Dellulis Brothers Construction, Inc.
RE: Special Work Permit
10 Federal Street
Dear Sirs:
This will acknowledge your request for a Special Permit to allow work to be conducted
before the required hours under Chapter 22-2 (5) of the City of Salem Code of
Ordinances.
Your request is granted and a Special Permit is herewith issued to allow work to begin
7:00 a.m. Monday thru Friday If work is done on Saturdays the 800 start time will apply
The Salem Police Department will be notified on this permit.
Sincerely,
Thomas St. Pierre
Building Commissioner
cc: Mayor Usovicz
Chief St. Pierre
0
CITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
d
AwAIN6 120 WASHINGTON STREET, 3RD FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. LISOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380
MAYOR FAX: 978-740-9846
February 22, 2005
DeIulis Brothers Construction Co., Inc.
31 Collins Street copy
Lynn, Ma. 01922-2295
Attn: Tony Pacitti-Vice President
RE: 10 Federal Street Project
Dear Tony:
This letter is to confirm our conversation earlier this week. I will issue an initial permit
for the erection of the steel frame only.
Prior to further work, an evaluation of the existing structure is required as well as an
independent peer review of the structural design,that was done by the structural Engineer
of Record.
Also,the permit application should include the schedule of required testing and
inspection as required by the Structural Engineer of Record and the State Building Code.
I would like to meet with the building owner and/or representative,yourself, as the
General Contractor and the Architect. We will have representatives from Electrical, Fire
and Plumbing present.
We have found these pre-construction meetings useful to establish lines of
communication and to define the code requirements of each department.
We look forward to working with you on this project. If you have any questions,please
contact us.
Sin ly,
Thomas St. Pierre
Building Commissioner
cc: Kate Sullivan,Mayors Office
►- . - -
► L
DelULIS BROTHERS
i CONSTRUCTION CO., INC.
April 26, 2005
r
Mr. Thomas St. Pierre, Director
► City of Salem Building Department
► 120 Washington Street
Salem, Massachusetts 01970
Building RE; 10 Federal Street—Request for Waiver
excellence From Cio Ordinance For Construction Start Times
since 1958
i Dear Mr. St. Pierre:
We request permission to start construction activities at 7:00 A.M.,'Monday,through Friday, at
the above project. We understand that this is earlier than what is stipulated in the City
► Ordinances; however, we believe an earlier start would actually lessen the impact of
construction on the surrounding district. Given its central location, adjacent to municipal
j. parking and courts, starting work before those activitiescommence and ending workbefore
j . they conclude would ease congestion and be less intrusive than would otherwise be the case.
We realize the project is adjacent to two elderly housing projects and will do our best to insure
that any impact to the residents is minimized.
Thank you for considering this request: Please inform us as soon as possible as to your
decision.
► Very truly yours;
Frank DeIulis,President
j`
j
►- ♦ 31 Collins Street Terrace,Lynn, MA 01902-2205 � 781-595-8671 FAX 787-593-7890
jGeneral Construction • Construction Management• Member A.G.C. .
Civil Engineers *Land Surveyors
Land Use Planners •Environmental Consultants
CHERENZIA Raymond F.Cherenzia, P.E., L.S., President
& ASSOCIATES, LTD.
July 19, 2005
Commissioner Thomas St. Pierre .
City of Salem, Massachusetts
Building Department
120 Washington Street
Salem, MA' 01970
Re: Independent Structural Engineering Review
10 Federal Street Project
Dear Mr. St. Pierre:
This letter.reports our independent structural engineering review of the,primary
structure of the project including the existing structure to be added to.
The primary structure includes the three-level structural frame, the load
supporting parts of floors, roofs, and walls,.which will be built on an existing two-
story, building and its foundations. Cladding, cladding framing, stairs, equipment
supports, ceiling supports, non-load bearing partitions, and railings are excluded
from our review.
Our review was based upon structural drawings S1 through S4, dated December
13, 2004, prepared by Architectural Renovations, and the original structural
drawings,'F1 through F10, and architectural drawings 1 through 13, both dated
during 1956 and prepared by Cram & Ferguson Architects & Engineers of Boston
for New England Telephone and Telegraph, Company. The original. drawings
contain 5 boring logs with soil descriptions, blow counts, water tables, the design
allowable soil bearing pressure and .the building design live loads. The building is
about 130' by 202' in plan. It is.a cast-in-place concrete 9" flat-slab, with 3" drop
panel frame, with concrete basement walls and spread footings. The first and '
second floors and present roof were designed for a 125-psf live load. The
structure was designed to accommodate future third and fourth floors of similar
construction and live load.
P.O. Box 513 • 25 Ledward Ave. Westerly, RI 02891 • Tel (401) 596-7747 • Fax (401) 596-3610
500 Bridge St. • Groton, CT 06340 • Tel (860)405-1900 • Fax (860)405-1990
The three-level addition is a steel frame supporfing a 5 '/4" lightweight-concrete
composite deck. It is laterally supported. by Eccentrically Braced Frames (EBF's)
in both directions. r
We also discussed certain aspects of the design with the Engineer-of-Record
(EOR) related to the EBF's and his assessment and modeling of the existing
structure under lateral loading.'
Inacccrdance with,780 CMR,,Appendix I, we report as follows:
1. The design loads meet the requirements of 780 CMR. The design criteria
of 125 psf exceeds the minimum requirements of 50 psf office + 20 psf
partition = 70 psf or 80 psf corridors;
2. The EOR modeled the existing flat-slab as a flat-plate frame using the
technique of Fraser, "Elastic 'Analysis of, Laterally Loaded Frames",
Journal of Structural Engineering, August 1983. We believe this technique
is appropriate and accepted;
3. We agreed with the EOR that, in accordance with 780 CMR, sec.1805.3,
the soil at site is not susceptible to liquefaction;
4. We consider the organization of the structural systems, both the existing
and the addition to be straightforward;
5.. We preformed independent calculations of the typical beams, girders, and`
columns and their connections, which are repeated throughout the
structure. We checked the strength and ductility,of the shear.link$ of the
EBF's; which are critical, as well as the sway and stresses of the existing
structure:
We conclude that the structural,design shown on the drawings conforms to 780
CMR.
We . believe. this independent structural engineering review meets . the
requirements of 780 CMR sec.:110.11`and hope it is satisfactory to you.;Please .
call)f any further input is required.
Verytrulyyours;
Ch nzia & Associates, Ltd.
OF MgS
YM ND
000 mond F. Cherenzia, PE, PLS
President"
Ss104r.�E� -
0
0
CITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
o'
120 WASHINGTON STREET, 3RD FLOOR
��C�MMe SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380 1J
MAYOR FAX: 978-740-9846 no j
April 14, 2005
Dellulis Brothers Construction, Inc.
RE: Special Work Permit
10 Federal Street
Dear Sirs:
This will acknowledge your request for a Special Permit to allow work to be conducted
before the required hours under Chapter 22-2 (5) of the City of Salem Code of
Ordinances.
Your request is granted and a Special Permit is herewith issued to allow work to begin
7:00 a.m. Monday thru Friday If work is done on Saturdays the 800 start time will apply
The Salem Police Department will be notified on this permit.
Sincerely,
Thomas St. Pierre J
Building Commissioner
cc: Mayor Usovicz
Chief St. Pierre
City of Salem ward
.. 9
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE-ALTERATIONS OR NEW CONSTRUCTION
- IMPORTANT.Applicant to complete att Noma in sections:{ Ib NL IV,and IX.
L AT ILOCATK M IO FeO e+ i S> 2
LOCATION ab1
OF. BETWEEN AND
BUILDING 1N0°"'"IZn is M37f en
LOT..
SUBDM.9ION LOT_BLOCK SIZE
I. TYPE AND COST OF BUILDING.All apptEants complete Parts A-D
A. TYPE OF IMPROVEMENT D. PROPOSED USE•FOR"DEMOLITION"USE MOST RECENT USE i
_. t�14weeg ReaOarWl NOereetlerrtlal i
2 Q Aaatlon Ia TaaNneW.enM nunderd new 12 Q One career, 18 Q AraawrwL reereabaw i
hWSWq unua aoasa.0 airy.n prf0.131- - 19 Q C1wum aarr-urian
1313 Tv or repre tw*-Enter number
3 Q Aeeraaon Sw 2 aboral Of rales 200 l^*A&W
21 Q Pereeq garage
0 Q A We replacemsnl 14 Q Tranwn h0Kn - ordarmrwy- 2213 Seneca ateabn.repw Wragg
S Q Wrseltng ler naalwray resdandd errw namOer - EnYremWaiauaR
2313 Noap1Y,eplNtAarY
of umW n belong in An D.131 18 Q Garage 2ejEr0IBp,bane.Wlraoaonll
B ❑ tnloraeorrl 16 Q Carpo„ 25 Q P18ae uMv
7 Q Fdadatdn orw 17 Q OUw-Spell 2e Q SeAapl,hWary.a - eanpbar
27 Q swab.voce
0.WW RSNIP 28 Q Twft owwe {
B PnwWlaWMdLA.mrparataln nawaa 2913 Cow Speryy
�nsitho ,em)
1
9 Q Public(Federal.SWM a cul 9wwrmwa
C.COST - forrut ON= Nvaa ftral-Dpaee in oeWi propowc uw a buamlga,eq.bw aaaauq Alam
mW ere drab W1nary buiaeq at hospdL mom wWy ecrrml,aeoualary aellpor,maaW.
10. coat a Imao`wmm - S S 2 !! Q t>atw3lw soma 0"Ing 9arege lar agowwom etpre.nnm aece buo ng.0.111011 buealrq 3{
at eraUYt aent g"a eaaft buitleq a Warp elwrpea error peerage sae,
ro be yellow but W1 nMa"
m an abuse mer
a EYetraal
b. PYwbng ^•S� -09 ' - ✓roof .j r`-o. cSY qF'C-H
Q Knew w mrlaNlateq j d c� c o o
d Ogrrlwaeaa.Mt:l -
11. TOTAL COST OF g,PROVEMENT * 73h O 0"
IL SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additlons, complete Parts E-L:denwhWon.
compiefe only Parts J 8 M.aH others skip to IV
E. PR*1CIPAL TYPE OF FRAME F. PRNCPAL TYPE OF NEWWO REL G. TYPE
yOFSEWAGE DISPOSAL L TYPE OF MECHANCAL
3013 Magary leeabwatp) 3*81w , nTalIIaAle aomprry WN owe be aartaat Sir
313' Q Acv w S am 37 Q ENoicity e1 Q PrNele luplle wad atl M� 45 Q w
3313 Reemana• mmem, 38 Q CaY K TYPE OF WATERSWPLT yyg,9byaaaWNaaY
3e Q COW-Use* 3913 Ogrr-Spn:A e2 Q Ppbge a Myla cmwry
a640:;W 47 Q No
43 Q PrNa1a feet eslrm
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
48 Nummr O<SlOrlm...__._..._......................._..—_..
49. TOW aeon Nen a Rom area _ Has Approval from Historical Commission been received
a:aooi Dam en 0 w
aun.ncaa _--_---.—.--._......__ 7?aw 5) - r for any structure over fift(50)yam? Yes_ No_
50. TOW ulw area as R.__---- _ Dig Safe Number
K NUMBER OF OFF-STREET PAMUNG SPACES _ PestControl:
51 Ercima
r. HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
52. Ouuhoon... ° Yes No
L REEMOrn&sueolk"Color, ' . ` ' k3; W "�•A ti�xt y ,a,
53.
Ful _ Sewer
se: Numm al" -062110011111 DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Pa" BEFORE A PERMIT CAN BE ISSUED.
N. COMPLETE THE FOLLOWING:
Historic District? Yes_ No_ (H yes,please:enclose documentation from Hist.Com.) _
Conservation Area? Yes_ No_ (If yes,please enclose Order of Conditions)
Has Fre Prevention approved and Stamped plans or applications? Yee_ No_
Is property located in the S.RA district? Yes_- No '
Comply with Zoning? yes_ .No (if no.endow Board of Appeal decision)
Is i6it'grandfathered? Yes_ No_ (It yes,submit documentabonfd 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_ No_ (If yes,submit"documenWon)
Massachusetts State Contractor License# rti d 4-6 i Salem License#
Home Improvement Contractor# Homeowners Exempt form(if applicable) Yes_ No
CONSTRUCTION TO BE COMMENCED WITHIN SIX(B)MONTHS OF ISSUANCE OF BUILDING PERMIT
CONSTRUCTION IS TO BE COMPLETED BY: If an extenaon is Y,please submit
5 U J z in writing to the Inspector of BuAdmgs.
V. IDENTIFICATION- To be completed by all applicants
_ NMr Makv aOmm•Nuftff Lnet my.rk SM ➢P Com Tel Na
of 9 w 97r-err_
LAMS. z Phft `
dro r4 Ilcanw C &
00g16�
2 6fu tom✓ _ g,
coeaame. Cc)>/5'fl� �..�• L 7�✓✓ '`7/d e)t 7 V Z wa: I �L
SON& RF�rJJvgno .J LyaJ./ A El 1 4-65?
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 the apptieation
as his atmtonzed aormt anti we agree to co to all aDolicade laws of this iunsdiclbn.
Signature of applicant AddressL ✓✓ /7R Application daze
7-
oj5-0 Z
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building .. FON DEPARTMEHr USE OND'
Permit number
Building- use Group
Permit issued 19_ Fie Gra M
Building - w_ _ _ Live,
Permit Fee $
Certificate of Occupancy s D�rwri v iced
Approved by.
Drain Tile _ S �( a
Plan Review Fee $
NOTES AND Data•(For department use)
i
I
i
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by. Completed by: °
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD 1
REAR YARD
NOTES j
j
SITE OR PLOT PLAN •For Applicant Use
ON
i
What is the current use of the Building? how many unita7�
Cs..m L r� _ If dwelling,
Material of Building? Asbestos?
Will the Building Conform to Law? IES-.
Archited's Name
PFTC./l Crl-C✓L J.A2T / �1rzC41-c Tc � 2c.J a�/�-c�.aS
Address and Phone—• s` t-� ( 1
Mechanic's Name
Address and Phone
Construction Supervisors License S z HIC Registration 0
Estimated Cost of Project Permit Fee C trWw
Estimated Cost X 171$1000 Residential
Permit Fes
Estimated Cost X S71/$1000 Commarc al-----An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are property 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
Date
-U
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V
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EITy`OF�XLE�
PUBLIC PROPERTY
DEPARTN ENT
KIND ev DlwX L
�rAYO{ Y
t30 W' S11tFb'r•juu'j4. AMCKLSk-1-M 01970
TEL-978-745-MS•FAX:978.740.M6
APPLICATION FOR THE REPAIR RENOVATION CONSTRUCTION
DEMOLITION OR CAANGE OF USE OR OCCUPAN FOR ANY MSTIN
STRUCTURE OR BUILDIN[�
1.0 SITE INFORMATION
Location Name: i o G Fo,,4` Building:
Property is located in a:Conservation Aro&Y/N Historic Oistrkd YM
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address:
S4LI.A
Telephone: ci-76 ,4y - -2-7 1 Z
3.0 COMPLETE THIS SECTION FOR WORK IN EXISIINJ31 BUILDINGS ONLY
Addition Existing 6
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
�Socsp
Approximate year of 195b Area per floor NO Renovated
construction or renovation
of existing building °" ' New
I
Brief Description of Proposed Work:
?Eagan Ft— uP G�� Sorra SEc z:r 0
K�oa -leao Sean:�c �Ja��S Sv v l0 4 C,- ~�zac-
1
------_--_Mail Permit to: ---
1
City of Salem Ward
a
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all Items in sections:b ll, lll, IV,and IX.
I. AT(LOCATIOM IO FED En L JT - 2 p {'
LOCATION ux" 6s1aPn
OF BETWEEN AND
BUILDING (CROSSsmtEn cross LOT n
SUBDMSION LOT_BLOCK SIZE
11. TYPE AND COST OF BUILDING-All applicants complete Parts A -D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOUTION"USE MOST RECENT USE
1 New budding Raaldenosl NelYeatlentlY
2 ❑ AddM W fa wdwlW.enw numprOt n 12 ❑ one 1sfltey 18 O AnapenW1L lecreabo W
hw&ng unns added.d arty•m parr D.731 -13 ❑ T 19 Q CaneR Other relgcus
wo or mps tamd•Enw number 20 Q Iraasb*
3 Q Aberalcn f5ee 2 abosel Of fares—_
21 ❑ Penang garage
s Q Repw replacemwe to Q TraneieW MM,fnorol,or donMary• 22 ❑ sefldp ataaon,repMr oer.g.
EnMrMmbMdunds____—_ ❑ .
5 ❑ wfepa.r9(e mufrdanar reederMet amr dumber 23 tdppiml,nstdworo
of unds m bwdit m Pan D. 13) 15 0 Garage 24,R Office.baWL professor0d
8 Q MwM trelocaoorfl - 18 ❑ Carport 25 0 P ubby
7 O Founwononty 26 0 SdWW.hbnly.QVw WUQWwW
17 ❑ Other-Speed 27 ❑ Sfpee.nemermle
B.OWNERSHIP 28 0 TaWfa,towara
8�P.W I.dnAdu1L corpo.OM rMn0MM 29 O Odw•Speedy
9 ❑ Public(Fed".Stats.or local 9wanmrnt
C.COST IOrrld oentat Norcasnemwl-DeepOa m detad prbposea use W euadal vk e.0.loon orupeaslg PMM
S TTW V!`rlt•�'L flwJfifM argil,18undry budding at hOSPML elemamary Stood.SemnderypWnW.Coaage,
10. Cost W impryveflMm .._ 5 ''EL S 8 U UG PVOWrI aW1OW.prbm9 9ara9e for deparerMm etas,renttl oace budding,Wap brWdar9
at afdubol Plant Ifuse d eSLtnrrg btoldbnJ M being Cnenge0.enter proposed US&
To a ersralled bur nor mmuWd
in Me soon toss 3 57X)A-7 V eA l L"R-1_
a Elocom _— -
b. Pbaneatg /1b V)Tt-I F0w G rF l c er
Q a koft ,w mMitlaslg ✓y e
d. Othw teWmw.Mel �q
11. TOTAL COST OF IMPROVEMENT t 6 / U U d
IIL SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions, complete Parts E-L:demobdon,
complete only Parts J 8 M,all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRNCIM TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL 1. TYPE OF MECHANICAL
30 Q MMpfey peas bwtrlgl 355Go 40ErPublie orPmele oWnPany Wa1 �al air
31 Q Wood home 38 Q Od 41 0 PrWM Isaplc tvk atcl
32jS'Sbucbaal Ma 37 ❑ Elecbcey 44 Idea 45 0 No
33 OR , - conoer 38 0 COW H. TYPE OF WATER SUPPLY wo pyre by in aM.elorr
34 p olhw-Spoil 39 p COW•Sppd 42 ❑ Pubic or pre OonMwW 46®rYes 47 p No
43 0 PrNele twed coftn t
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
48 Numoer or stones ............._..__.._....................
.._..._.
39. Tcw sm,are rem or floor area 76 ODD sit Has Approval from Historical Commission been received
a..Boors.oases w ff r - .-
a:menstons ............__.....__....- _:....................---. ';, " _ - for any structure over fifty(50)Years? Yes_ No-
0 00
o_000 N jF-�, k 3 r-L-o
50, Toni lana area W.it........__.__----_.__..._.__._._ Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51 Encblmx;-_.__...._.___.._..__.._..-._._..._.__.__-.. ..
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
52. omdoore..._.____..---------_-...— Yes No
L RESIDENTIAL BUILDINGS ONLY Water. _
53. Enloe___ Electric:
Gas:
Full_—_ Sewer.
54. Number of
oadsoom5 DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Parma------ BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No f Qf yes,please enclose documentation from Hist Com.)
Conservation Area? Yes_ No`/ (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_ No_ (if no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No_ (If yes,submit documentationld no,submit Board of Appeal decision)
E
If new construction,has the proper Routing Slip been enclosed? Yes_ No {
Is Architectural Access Board approval required? Yes_ No_/ (If yes,submit documentation) !1J
Massachusetts State Contractor License# O 4 4 e / Salem License# I
Home Improvement Contractor# `— Homeowners Exempt torn(if applicable) Yes_ No_ f
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMIT
CONSTRUCTION IS TO BE COMPLETED BY: If an extension is necessary,please submit
SP i2D A/< "o v in writing to the Inspector of Buildings.
V. IDENTIFICATION- To be completed by all applicants
Nero Mohn adWese-Number mraat city,ew sate LP Coos Td Na
Ornrer or r''t c L//h l Sit B ILJ/d-0 U n'7
uaee owe !' 8ro . L( e Le-r- " o67j
z. e wl �oS 3/ "111n) 5T 0-AWL 0'far04 / 70 " s9s
Contractor MWS I
C-6 'j Lb /✓L. L/ NN /j 0)5Y 2 Low=No. ;
3. d83 Y78 7yy 1
Erpirber ��5b�
I hereby certify that the proDosed work is authorized by the owner of record and that I have been authorized by the owner to make this applipGon
as his authorized aaent ano we agree to conform to all aoolicable laws of this jurisdiction.
Signature of applicant Address Application date j
+ I Ce�%ol 5r �u & ,f,✓ siFet -p�
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit Issued 19 Fire Grading
tB Building
j� Permit Fee $ Live Loading
F Certificate of Occupancy $ goad
Approved by
Drain Tile $
Plan Review Fee $ /7�ti c rt�s7l
TITLE
NOTES AND Data •(For department use)
41- 477
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by. Completed by.
VI ZONING PLAN EXAMINERS NOTES
DISTRICT '
I
USE.
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
SRE OR PLOT PLAN •For Applicant Use
O N
1
A.
i1
CITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR KATNIEIAtmiotR
SALEM, MASSACHUSETTS 01970 (' Pa1UC
a
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380 A�rGX1Y1VlfI01IE�QY!/,WII,tO••
MAYOR FAX: 978-740-9846
CONSTRUCTION CONTROL AFFIDAVIT
Project Number. Date:
Project Title:
Project Location: o fed er o / J t. Ja /e M
Name of Building:
Scope of Project: Ad d: f,oeve/,r >O eX/Sf%n9 1 Jfery
IN ACCORDANCE WITH SECTION 116.0 OF THE MASSACHUSETTS STATE BUIDING CODE, I
Aed. r 0. De Fg/rD . MASS. REGISTRATION NO.L0/89 BEING A REGISTERED
PROFESSIONAL ENGINEER HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY
SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS, AND
SPECIFICATIONS CONCERNING:
Civil Architectural Structural ✓ Mechanical
Electrical Fire Protection Other(specify)
FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH
PLANS, COMPUTATIONS, AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE
MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES AND
ALL APPLICABLE LAWS FOR THE PROPOSED PROJECT.
I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES
AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO
DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS
APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING
AS SPECIFIED IN SECTION 116.2.2.
1. Review of shop drawings, samples and other submittals of the contractor as required by the construction
contract documents as submitted for building permit, and approval for conformance to the design concept.
2. Review and approval of the quality control procedures for all code required control materials.
3. Special architectural or engineering professional inspection of critical construction components requiring
controlled materials or construction specified in the accepted engineering practice standards listed in
Appendix 1.
PURSUANT TO SECTION 116.4, 1 SHALL SUBMIT PERIODICALLY, A PROGRESS REPORT
TOGETHER WITH PERTINENT COMMENTS TO THE BUILDING INSPECTOR. UPON COMPLETION
OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION
AND READINESS OF THE PROJECT FOR OCCUPANCY. a���k D z� o
Signature
S BS IBED AN�DjSWO TO BEF RE ME THIS c�9 3"f DAY OF C004
My commission Expires: O G�
Notary Public
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�, PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
LocationotBuilding /O FEDEien� ST
�Ee�ildeog Permit ppplicatioo For:
'(Circle whichever appGes) Roof, Reroof, Ins�ali Siding,Conswct Deck, Shed, Pool
Additioq Alteration, Repau/Replaa,Foundation Only, Wrxking i
O�her. �'caaa� F�s n�� '•� �
PLEASE FILL OUT LEGIBLY & COMYLETELY TO AV.OID DELAYS IN PROCESSIIYG
To the Inspector of Bui�dings: ' ' I �
The undersigned hercby applies for a pertni�to build according to U►e following specifcations: "
OwnerdName: P- MAC LP Contnctor• t`�- �t� C. ��o,,,,.P '
Strat_ _So 3nora0 s� Cit�• Srt� Svat 3S cJr�•na�„J S�� Ciry ��r�.
State I�IA P6one (Q�s) -)y4 2'L � 2 State� << A Phone(9��) '7 K� i �13 0
Architect: 1-�e-r� ('r�Ali F�A�-� CIIy 0�SYIlm LIC�
Strat E�c�+a,3 G� C� . Cit}• L�a,J State Lic#� O't o�0 2�#
G�
Sta:e_ vLIR Phone ( )� Homeowoero E:empt Form_yes no
Shveture: (please circle) Single Family, Multi Family# Other �o..�,nr.e.�z.t� e,Fe�cc
Eatimated Cost of job S /o p . c�o r�
Will building confirm to IaN2,�yes no .
Asbeitos?_�a o0
Daeriptioa of work be doar.—F2r JP "TI�w�Yi SPA� � �„� �� PE,zT�y.� S
. ��'P�AC-6 CPc'�n1C��'C�tS : l'f�c rr � fQ CJ�1A.1�
Drawioga Submitted:�yes no Mail Permit to:
% P MA� CP So 32aao ST
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Sigoaturc of Applicatioa,S[GNED UNDER THE PENALI'Y OF PERJURY
CG�"?S'�'g�!!CTl�►N TO B ��QIN?BLETEQ�L'!'9II�SdX(s�h101YT�dS OF�EiiME'1'ISSUEID DA1'E
t a: `�
Depariment use onty: Permi�N �: `�Oning Map/Lot
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Permitfa S
COl4�ENTS: .
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TEMPOR�ARY SPACE - SCHE��IATIC SPACE PLAN 3,335 SQ. FT. USABLE AREA PETER K. GEARHART
SECOIWD FLOOR PLARI - OFFICE OF THE EASTERN D�STRICT ATTORNEY - 10 FEDERAL ST., SALEMi, MA. i �s��-1 � -o�� MAY 2005 �HEET 3 OF 3
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; : The Commonwealth of Massachusetts
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Alt Department of Public Safety
Massachusetts tilate Budding Code 1780 CMR)Seventh Edition
\`^ City of Salem
(�`l)
Building Permit Application for any Building other than a 1- or2-Famil Dwellin
v\ (This Section For Official Use Onlv)
J Building Permit Number. Date Applied: Building Insp
_J
SECTION 1: LOCATION (Please indicate Block N and Lot N for locations for whic '
a street ad es s t available)
I! rAFQ,k A-_ S: A LF_M n to O I T)U
..\'o. and Street City /Town Zip Code Name of Budding(if applicable)
SECTION 2:PROPOSED WORK
If New Construction check here❑or check all that apply in the two rows below
Existing Building Repair❑ Alteration ❑ 1 Addition ❑ 1 Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other 'R Specify: DIS 40re ALGJ,Jr C•ac� lry�� . •
Are building plans and/or construction documents being supplied as part of this permit application? Yes P( No Cl
Is an Independent Structural EngineerinPeer Review required? Yes 13 No ja
Brief Description of Proposed Work: in
LA seZA ,Qoclj •1h €r-•s—r l6 T>-.A,
i s ,,A ATc�.i i=xes—r\ t.I�ae 5 �.7r L cJA�I
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Evaluation is enclosed(See 780 CMR 3402.0) ❑ -
Existing Use Group(s): Proposed Use Group(s): r
Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34:
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-2r O A-2nc❑ A-3 O A4❑ T-5❑ B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ H: ligh Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
1: Institutional f-1 ❑ 1-2 ❑ 1-3❑ 1-4❑ 1 M: Mercantile❑ R: Residential R-1❑ R-2 ❑ R-3❑ R4❑
S: Storage S1 ❑ S-20 U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as a licable)
IA 111 IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ 1 IV ❑ 1 VA C) VII
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 outstdr Floud Zone Indiarte municipal A trenchw ll not be Licensed Disposal Site 13Private❑ or ndentif\ Zone:_ or on site system ❑ requiredWor trench or specify:
permit is cndusrd ❑
Railroad right-of-way: Hazards to Air Navigation: \I:\ I lists grit( •nnmi.,im IL•�ir„ I'n
\nt :\pl,lir,d,liTB I,Struiture,\nhut airport approach arra.' In their rev irm completed'
u'( nment to Budd enclosed ❑ Ye,❑ or No W' Yes❑ \I. ' Co
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
-If usun ui CI'III': _ Lsr F. �c nl Comtructnrn: )
. ) C ccupanl Load per I looe
I)i 1r. the buddm};contain an Sprinkler Sl,trm': 5par1a1 Stipulations:
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SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner C 147CS
.b /AAAA L So 136 r kn S,f Jk.tA
Name(Print) No.and Street Citv/Town Zip
Property Owner Contact Information:
6�rc�c.1 c- F>_ouP `7200- -211
Title NA/ad A k,> ^_ Telephone No. (business) Telephone No. (cell) e-mailaddress
If applicable, the properly owner herebv authorizes
Name Street Address City/Town State Zip
to act on the *no perty owner's behalf, in.ill matters relative to work authorized by this building permit a p plication.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
(If buildin•is Icss than 35,000cu. ft.of enclosed s ace and/or not under ComMru.tion Control then check here O and skip Section 10.0
10.1 Registered Professional Responsible for Construction Control
Name(Registrant) Telephone No. e-mailaddress Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
CuQ�pany Name-
1154Z
ame:
1 54Z�c C FI OMP CS '70-7Q'Z
Name of Person Responsible for Construction License No. and Type if Applicable
?,at LJ AAA" s T CAL EM M M&- n IR 20
Street Address City/Town State Zip
%V by • 27 t'2_ _
Telephone No. (business) Telephone No. (cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152. 25C(6))
A Workers'Compensation In 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 O
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item j-)
d Costs: (Labor Total Construction Cost(from Item 6) _$
Materials)
1. Building 0 ,O v Building Permit Fee=Total Construction Cost x_(Insert here
2. Electrical appropriate municipal factor)3. Plumbing 4. Mechanical (HVAC) Note: Minimum fee=$ contact mgnicipality)
5. Mechanical (Other) Enclose check payable to C'/�\�
6.Total Cost S (contact munici alit )and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below, I herebv 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.
pe—mA, .0 P-t_c e.-Ap "A4 G t� 4,7✓;' 7Y`( - 7-7j-z- i7
Please print and sign name Title Telephone.No, Date
-?S "J �i*k,, .i "Ar- CC) )4-7C)
Street Address Cit.'/Town State Zip
Municipal Inspector to fill out this section upon application approval:
Name Date
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CITY OF SALEM
ir��
No. :> /
� "v �\ Date
Ward
NE�°�n Zoning District
Is Property Located in Location of
the Historic District? Yes_No Building /o Ee i ew7f. 5 T
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, InstalSiding, Construct Deck, Shed, Pool,
Repair/Replace, e
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name SPI g-05 FLO "'r
.Sa B Abf" s v-
Address & Phone S / L L-l+ —;-A d 19 -D 0-w 7YY— L 7/ 2
Architect's Name {e T 4 g-&R/wriT
$S EA41169 /te Sr
Address & Phone L,7^J J nA • U /`i d/ ((0/7 ) 9 Y 3- COs /
Mechanics Name des camas �P ;✓�
3 / '� Sst 7EV"
Address & Phone 4,y,,jd .-, A 0) 9 u z Hyl ) S56 e(. 7 ?
What is the purpose of building? a f-r- c>
Material of building? /`9FI3o„/ry If a dwelling, for how many families?
Will building conform to law? Y 4;$ Asbestos?
Estimated cost /wn City License# State License # 04 Of /
Home ImprovementQom_
Lic. 1 w
Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
F_ V^-a d 4=6-2 RS 4or
MAIL PERMIT TO: Pe'17v vs :ARos G�jsr ) i✓4.
S/ CnI Si /reyv-
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No.
APPLICATION FOR
PERMIT TO /
LOCATION
PERMIT GRANTED
19
AP�'FtOVD
INSPECTOR OF BUILDINGS
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JdSPFCS�F1,P9mR TD A PEAAUT BEWG GRANT�D
CITY OF SALEM
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BWLDII�Ki PERMfT APPUCATION FOR:
Permit to:
(CUcle whichever aPPh�I �. R�roof, IneWl Sidinp� Constnkt Dsck, Shsd, Pool,
R�pai�/Rlplsl�. OthN: 'T�►�J c 3.�r.�o o.; �
PI.EASE RLL OtR LE(�IBLY i COYPLETELY TO AVOID DELAY8 M PROCESg�p
TO THE INSPECTOR OF BUILDIN(iS: ' I
Ths und�roiqnsd hereby epplbe for a psrtnit to build 8xordGig,to ths followirp
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Ownera Neme �- MA` ��c � I
AddfeBs b PhOf1s .Soi'xzaan .cT ��FM nao (9�Fs 1 -J�-i`(• z7i i I
Arohiteot's Neme f ATTtAScnS ��;c��
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Mschanics Neme t�-r�ti �' ��Q�..P ,
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DESCRIP'T10N OF WORK TO BE DONE
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Certificate Number: B-19-140 Permit Number: B-19-140
Commonwealth of Massachusetts
City of Salem
This is to Certify that the Gen Office Building located at
-
------------------------------
Building
Type
------------—--------
-- -----
IOFEDERALST_R__E_ET-------- ------------------ in the -------------- -ityofSalem
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires ........_..-Not Applicable unless sooner suspended or revoked.
Expiration Date
Issued On: Friday, June 28, 2019
Commonwealth of Massachusetts
� 9 City of Salem
A'D•p x- 120 Washington St 3rd Floor Salem,MA 01970(978)745-9595 x5641
Return card to Building Division for Certificate of Occupancy
Structure CITY OF SALEM BUILDING PERMIT
Y
xcavation
PERMIT TO BE POSTED IN THE WINDOW A
noting INSPECTION RECORD
oundation
raming 'ZC
'"I
lechanical
[Sulation INSPECTION: BY DATE
hlmney/Smoke Chamber
Inal�'�`. Gr � 11" �
Plumbing/GaS
y f
ough:Plumbing 3 a* ®A
ough:Gas A
i
inal
Electrical
ervice
wgh
ial f
e� Fire Department
eliminary
nal eC
�I Health Department /
eliminary
gal
Commonwealth of Massachusetts
:I, q City of Salem IRS
' i120 Washington St,3rd Floor Salem,MA01970(978)745-9595 x5641Return card to Building Division for Certificate of Occupancy
E PAID:
N$4 B-19-140 PERMIT TO BUILD
E PAID: $4,103.00 ii
TE ISSUED: 2/7/2019
This certifies that BROADFIELD PROP LLC/P-MAC
has permission to erect, alter, or demolish a building 10 FEDERAL STREET Map/Lot: 350192-0
as follows: Other Building Permit FRAME OUT PARTITION WALLS FOR AN OFFICE. ADD HVAC
THROUGHOUT SPACE, KITCHEN & NEW LIGHTING.
Contractor Name: JOHN CHEW
DBA:
Contractor License No: CS-109169
2/7/2019
Building Official Date
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official
may grant one or more extensions not to exceed six months each upon written request.
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public Inspection for the entire duration of the
work until the completion of the same.
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
HIC #: 184358 "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
-
Final Construction Control Document
UTTo be submitted at completion of construction by a
*
Registered Design Professional
for work per the 8th edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: 2**McS Date: (2ro4LJ.19 Permit No.
Property Address: 10 �� �T. S('S(JQ,( A AMA
Project: Check one or both
'as applicable: ❑ New construction )4xisting Construction
b
Project description: IvVJW n
l71� � l�UCP/� Pi \NL} T
I IN \W p'Qj MA Registration Number: `1 O 8"I Expiration date: ,am a
registered design •oressionat. and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
AArchitectural [ ] Structural [ J Mechanical
Fire Protection [ J Electrical [ ] Other:
for the above named project. I, or my designee,have performed the necessary professional services and was present at the
construction site on a regular and periodic basis. To the best of my knowledge,information,and belief the work
proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building
permit and that I or my designee:
1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals
by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the
progress and quality of the work and to determine if the work was performed in a manner consistent <r
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR C
Enter in the space to the right a"wet"or
electronic signature and seal: fl
Phone number: 151. (o31 .71440 Email: WAd1(' &MZA I10Wt • ( W
Building Official Use Only
Building Official Name: PennitNo.: Date:
Version 06 11 2013