TBA B-17-77 WINDOWS N ��D L Cti i� o LTA
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
1 / Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct,Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date App '
E Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property dres > 1.2 Assessors Map&Parcel Numbers
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner' Record�` Q A �^ --fir
Name(Print City,State,ZIP
No.and Street Te phone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK (check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work 2:
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 1. Building Permit Fee: Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees: $
Suppression)
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
. - 5.1 Construction Supervisor License(CSL)
Is.A,, G\4= �
f )� License Number Ex 'r do ate
Name of CSL Holder S
List CSL Type(see below) ui
112 uIA 6S 1 r ,10— e
No.and t et r Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
City/Town,State, PW ` R Restricted 1&2 FamilyDwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Ho Im ement Contractor(HIC)
12/.6.63
HIC— Mgi tion umber E it ion ate
HIC Coma am or tra Name
No. Street Email address
D
city/Town,SZItate, 'p'� Tele hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6))
Workers Compensation Insurance affidavit must be co leted and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuanc 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 PERMIT
I,as Owner of the subject property,hereby authorize (76 4ra-L l
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) 17 Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
con ed in this application is true and accurate to the best of my knowledge and understanding.
Pnn Owner s or Authorized Agent's Name(Electronic Signature) Date
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 not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mLss.gov/oca Information on the Construction Supervisor License can be found at www.mass. og v/dns
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
Sanctuary Condominium Trust
c% Crowninshield Management Corp.
18 Crowninshield Street
Peabody, MA 01960
(978)532-4800
February 7, 2017
Ms. Beth DeVirgilio
1 Grand Turk Way
Salem, MA 01970
RE: Replacement Windows—Sanctuary Condominiums
Dear Ms. DiVirgilio:
Thank you for your inquiry regarding window replacements at your unit. Please be
advised that the Board of Trustees for the Sanctuary Condominiums does not object to
the replacement of these windows so long as they match in appearance (no crank outs,
etc.) from the existing, they must fit in the existing opening,molding size and glass size
must remain the same and they will not allow grids.
We also require the permits be pulled in advance, and that a copy of the final approved
permit once completed is also submitted to our office. We also require that you hire only
a licensed contractor, with adequate insurance.
You will most likely need to show a copy of this letter to the Building Department in
order to obtain your permit.
Should you have any questions or require additional information, please feel free to call
me directly at(978)532-4800 ext#232.
Sincerely,
JJ Jama
Jill Fama, CMCA
Regional Property Manager
Crowninshield Management Corp.
Managing Agent for the Sanctuary Condominiums
cc: File