BP & TEMP C/O ST. NICHOLAS RUSSIAN ORTHODOX GREEK CHURCH Certificate Number: B-18-619 Permit Number: B-18-619
Commonwealth of Massachusetts
City of Salem
This is to Certify that the Building located at
Building
Type
64.66 FORRESTER STREET in the City o,f Salem
Address Town/City Name
IS HEREBY GRANTED A TEMPORARY CERTIFICATE OF OCCUPANCY
Lower Level Only -
ST. NICHOLAS RUSSIAN ORTHODOX GREEK CHURCH
This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and
expires __Wednesday, November 28{2018 unless sooner suspended or revoked.
Expiration Date
Issued On: Monday, October 29, 2018
Final Construction Control Document
With Request for Temporary Certificate of Occupancy
x b To be submitted at completion of construction by a
a Registered Design Professional
for work per the ninth edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Renovations Date: 10-15-2018 Permit No.
Property Address: Saint Nicholas Orthodox Church 66-64 Forrester Street Salem, MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description: Accessibility Renovations to building including new wheelchair lift, accessibility modifications to
existing side entry, new single user accessible toilet room, new single user mens and womens toilet rooms, new stairs,
new side entryway, and other minor improvements as shown on drawings. Note: This is an affidavit to certify that the
project qualifies for a temporary occupany permit,because the level of completion provides finished access to two
means of egress from both building levels,access to toilets,and functioning alarm systems and emergency lighting.
I , Richard Griffin, MA Registration Number: 7814 Expiration date: 8-31-2019, am a registered design
professional, and I have prepared or directly supervised the preparation of all design plans,computations and
specifications concerning:
X Architectural Structural Mechanical
Fire Protection Electrical Other:Describe
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
with the construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisi ris QL 80 CMR 107.
SSE,ED ARC1,1
Enter in the space to the right a"wet" or
electronic signature and seal:
CO) No. 7814 rn
SALEM,
�p MA J�
2 .Z.
q J F P
Phone number: 978-740-9979 Email: richard@derbysq.com C— j
G
Building Official Use Only
Building Official Name: Permit No.: Date:
Version 01 01 1-20 19
.. ,.,tr i lunwealti. -*. ev,cA,,),ct%.,r ..��►
uc*j City of Salem
120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641
Return card to Building Division for Certificate of Occupancy
Permit No. B-18-619
FEE PAID: $2,068.00
PERMIT TO BUILD
DATE ISSUED: 6/25/2018
This certifies that ST NICHOLAS RUSSIAN ORTHODOX GREEK CATHOLIC
has permission to erect, alter, or demolish a building 64-66 FORRESTER STREET Map/Lot: 410219-0
as follows: Other Building Permit MINOR INTERIOR UPGRADES TO EXISTING BATHROOM FACILITIES.
RELOCATE STAIRCASE TO ACCOMODATE NEW ADA LIFT. ADDED EGRESS DOOR. INTERIOR
TRIM &VCT IMPROVEMENTS.
Contractor Name: CLAUDE DWAN
DBA: R C GRIFFIN INC
Contractor License No: CS-078163
!� 6/25/2018
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.
H I C#: "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.
Commonwealth of Massachusetts f16\J
Citv of Salem
120 Washington S r Floor Salem,MA 0197 978 745-9 5 x5841
St, S e 0( ) 59
Return card to Building Division for Certificate of Occupancy
NV Structure CITY OF SALEM BUILDING PERMIT
Excavation PERMIT TO BE POSTED IN THE WINDOW
Footing INSPECTION RECORD
Foundation
Framing 5-_
ig
Mechanical
Insulation INSPECTION: BY DATE
Chimney/Smoke Chamber
Final I-ft yt' L 46,V , YZ'y)ri C& $ h —07-4'A?
.;A Plumbing/Gas
Rough:Plumbing
Rough:Gas
Final
1 Electrica
Service 114
Rough
Final 8 1141tV
Fir Department v "'�J✓�-
Preliminary
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Health Department
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