REJECTED BLD PERMIT B-19-102CITY OF SALEM, MASSACHUSETTS
BUILDING DEPARTMENT
120 WASHINGTON STREET,3'D FLOOR
TEL: 978-745-9595
KIMBERLEY DRISCOLL
FAX: 978-740-9846
MAYOR
THOMAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTIES/BUILDING COMMISSIONER
6 Lemon Street
February 4, 2019
Charles Fusi
6 Lemon Street
Salem Ma, 01970
Dear Owner,
This letter is to inform you that I am rejecting the permit application that you have
recently submitted to build a new 8 foot by 12 foot deck with stairs to the second floor
for the following reasons.
First the deck was built prior to filling a building permit
Second there are many Building code violations that pertain to the new deck.
Third the new deck does not conform to Salem Zoning requirements and
is in the allowed set backs encroaching the neighboring abutter.
If you feel aggrieved by the Building code section of this letter your appeal
is to the Board of Buildings, Regulations and Standards In Boston.
If you feel aggrieved by the Zoning section of this letter your appeal is to
The Salem Zoning Board of Appeals.
Stephen Cummings
Local Building Inspector
ZH c-K
The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR
MUNICIPALITY
USE
Building Permit Application To Construct,Repair,Renovate Or a wised Alar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building Official(Print Name) IN,,Signature Date
SECTIO TE INRMATION
1.1 Pro rty dress:1.2 ssessors Map&Parcel Numbers
2yvty1,
74-
1.la Is this an accepted street?yes no Map ber Parcel Number
1.3 Zoning Information: 1 P e Dimensions:
Zoning District Proposed Pse Lot Ar (sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Providedaired Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Infor 1.
ewrE030n
osal System:
Zone: Outside ood Z. e?
Public Private
Check i
Municipaitedisposal system 11
SECTION 2: PROPERTY OWNE HIP'
2.Ljgm
l =
ord:
Name(Print) City, tate,ZIP
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORKZ(cher a ata y)
New Construction Existing Building Owner-Occupied 1 Repairs(s) on ) Additi
Demolition Accessory Bldg. Number of Units Other Spec'
Brief Description of Proposed Workz:
1301
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item
Estimated Costs:
Official Use OnlyLaborandMaterials
1.Building 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical
Standard City/Town Application Fee
Total Project Costa(Item 6)x multiplier_
3.Plumbing 2. Other Fees: $
4.Mechanical (HVAC)List: LIj
5.Mechanical (Fire
Su ression
Total All Fees:$
Check No. Check Amount: Cash Amount:
J(\ 6.Total Project Cost: 5 / x 0 Paid in Full Outstanding Balance Due:
Y,CITY OF SALEM, MASSACHUSET'T'S
BUILDING DEPARTMENT
120 WASHINGTON STREET,3'0 FY.00R
TEL(978)745-9595
KIMBERI.EYDRISCOLL FAX(978)740-9846
MAYOR THOMAS STTIERRE
DIRECTOR OF PUBLICPROPERTY/BUIIDING COMMISSIONER
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE:
JOB LOCATION
HOME OWNER ADDRESS: t fe u S f 92Cr 99 0
PRESENT MAILING ADDRESS: 2Ao-v f Q (
N cfl 1-3 C
The current exemption of"Homeowners"was extended to include owner-occupied dwellings of two(2)units or less and to
allow such homeowners to engage an individual for hire that does not possess a license,provided that the owner acts assupervisor.
Definition of Homeowner.
Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a
one-or two-family dwelling,attached or detached structures access6ry to such use and/or farm structures. A person who
constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit
to the Building Official,on a form acceptable to the Building Official,that he/she be responsible for all such work performedundertheBuildingPermit.
The undersigned"homeowner"assumes the responsibility for compliance with the State Building Code and Other applicableby-laws and regulations.
The undersigned"homeowner"certifies that he/she nderstand the City of Salem Building Department minimum inspectionproceduresandrequirementsandthathe/she th 3uch pfe y^ es and requirements.
HOMEOWNER'S SIGNATU
f
APPROVAL OF BUILDING INSPECTOR
The Commonwealth ofMassachuseas
Department oflndustrial Accidents
Office oflnmWgations
600 Washington Street
Boston,MA 02111
www rias&gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
Name(Businesdorganization/Indivi .
Address:_ 6 0"A'A", w, 94 V i n
City/state/zip: Phone M
An you an employer?Check the appropriate box: Type of project(required):
1. I am a employer with 4. I am a general contractor and I
employees(fitll and/or part-time).* have hired the sub-contractors
6. New construction
2. I am a sole proprietor or partner- listed on the attached sheet. 7. Piemodeling
ship and have no employees These sub-contractors have g, Demolition
working for me in any capacity.
employees and have workers'
9. Building addition
No workers'comp.insurance comp'inamce'
10. Electrical or additions5. We are a corporation and its repairs
3.JJ I am a homeowner doing all work officers have exercised their 11.Plumbing repairs or additions
myself.[No workers'comp-
right of exemption per MGL 12.0Roof
insurance required.]t c. 152,§1(4),and we have no
repairs
employees.[No workers' 13.Other
comp.insurance required.]
Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employees. If the sub4=tractors have employees,they must provide their workers'comp.policy number.
law an employer drat is providing workers'coimpensadon insurance for nsy employees Below is the policy and joh site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby cethfy under the pains am Kry that the information provided above is true and correcx
i ature:Date: doll--IC 2
Phone M
OffWial use only. Do not write in this area,to be completed by city or town offmial
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone M
CITY OF SALEM, MASSACHUSETI5
sLUDIM DEPARMWW
120 WA9ffGMSTREET,PFL0CR
7kL.(978)745-9395
ILIMBERLEYDRISOOLL
FAX(978)740-9846
MAYOR THOMAS STAEM
DZEUORCFPUBUCFltaM0T/BLIDDM OMAMCMR
Construction Debris Disposal Affidavit
requiredfor all demolition & renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR,Section 111.5 Debris,
and the provisions of MGL c40,S54;Building Permit 8 is issued with the
condition that the debris resulting from this work shall be disposed of in a properly licenses
waste deposit facility as defined by MGL c 111,S150A.
The debris will be transported by:
name of hauler)
The debris will be disposed of in:
name of facility)
address of facility)
SignIturerufa plicant
today's date)