0001 NEW LIBERTY STREET - PKG GARAGE BP-17-171 The Commonwealth of Massachusetts
Department of Public Safety
Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(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)
t' 1 Church Street Salem, Ma. 01970 Museum Place Mall Parking Garage
No.and Street City/Town Zip Code Name of Building(if applicable)
SECTION 2:PROPOSED WORK
Edition of MA State Code used 8th edition If New Construction check here❑or check all that apply in the two rows below
Existing Building® Repair❑ I Alteration ❑ 1 Addition❑ 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 ❑
Is an Independent Structural Engineering Peer Review required? Yes ❑ No
12
Brief Description of Proposed Work: Demolition of the existing and repalcement of the egress stairs within the four stair towers located
within the existing parking garage.
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): Grotlp U - Parking araQP Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) E78,850
15,770 5
Total Area(sq.ft.)and Total Height(ft.) 59'-6" 78850 59'-6"
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 13A-2❑ Nightclub ❑ A-3 ❑ A-4 13A-5 07B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H 4❑ H-5 111: Institutional 1-1❑ I-2 11I-3❑ 1-4 11M: Mercantile❑ R: Residential R-10 R-2❑ R-3[IR-4❑
S: Storage S-1❑ S-2❑ U: Utility M Special Use❑and please describe below:
Special Use.
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 13 IB 13IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ VA 13VB
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: Sewage Disposal: A trench will not be Licensed Disposal Site❑
Public❑ Check if outside Flood Zone❑ Indicate municipal
El ❑or trench or specify:
Private❑ or indentify Zone: or on site system❑ 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:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
-City Of Salem 93 Washington Street Salem,MA. 01970
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Michael Lutrzykowski 978- 745 - 9595 - - mlutrzykowski(o)salem.com
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
Jay Veillette 175 Industrial Park Road Middletown,CT 06457
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
_7�oN o S tFrg- - -
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Kronenberger&Sons Restoration, Inc.
Company Name
Don Ruel Dom", `-r} 1K6e_L_ CS-098880 4 - 1- Z013
Name of Person Responsible for Construction License No. and Type if Applicable
79-6 Orchard Road East Haddam CT 06423
Street Address City/Town State Zip
860-462-4068 - - don r _kronenbergersons.com
Telephone No.(business) Telephone No. celle-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.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 12 No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ 840,650.00 Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ 67,472.00 appropriate municipal factor)=$
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $ Enclose check payable to
6.Total Cost $908,122.00 (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
application is true and accurate to the best of my knowledge and understanding.
Jay Veillette Project Manager 860--&94-- 1167 3/13/2017
Please print and sign name Title Telephone No. Date
175 Industrial Park Road Middletown,CT 06457
Street Address City/Towntate Zip
Municipal Inspector to fill out this section upon application approval: (,�J, 7 l
Name Date