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0072 FLINT STREET, HALSTEAD SALEM STAT -BLDG 1 LLA Gti, It 5 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) 72 Flint Street Salem MA 01970 (Map#26 Lot#0091) Halstead Salem Station -Building 1 No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used_,qt If New Construction check here®or check all that apply in the two rows below Existing Building❑ Repair❑ 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 ISI No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No M Brief Description of Proposed Work: -All elevated floors above garage of 80-unit apartment building(BLDGt). 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): N.A. Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 4 storypprox. 20,600 Total Area(sq.ft.)and Total Height(ft.) 82,447 SF 40.9 F SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ I B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional I-1❑ I-2❑ 1-3❑ I-4❑ M: Mercantile❑ R: Residential R-1 13 R-2❑x R-3❑ R-4❑ S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe belom- Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) _ IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ 1 IV ❑ VA ❑ VB--M SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Permit- Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: TrenchLicensed Disposal Site C1Public M Check if outside Flood Zone❑ Indicate municipal® A trench will not be P required❑x or trench or specify: Private❑ or indentify Zone:_ or onsite system 11required is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review process: Not Applicable IN Is Structure within airport apprjeach area? Is their review complete or Consent to Build enclosed❑ Yes❑ or No M Yes❑ No a4 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: 9th Use Group(s): R-2 Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Yes Special Stipulations: None SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner DSF Salem Flint LLC 950 Winter St., Suite 4300 Waltham MA 02451 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Thomas W. Mazza, Maiming Member- 781-250-5940 - tmazzala-dsfadvisors.com Title Telephone No.(business) Telephone No. (cell) a-mail address If applicable,the property owner hereby authorizes ---------------------------------------------- N.A. ------------------------------------------------- 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) Of building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here❑and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control Daniel M. Skolski 978 965 3470 dskolski@dmsdesign.co 20038 ' ul�mirigi Center, Suite �'�Pc°ne N°8everly e-mai�acJ,dress 01915 PArc if ff Numb t8/31/2019 Street Address City/Town �V�NState Zip Discipline Expiration Date 10.2 General Contractor Fulcrum Associates Company Name Tom Ploude C5-083441 ( Unrestricted ) Name of Person Responsible for Construction License No. and Type if A plicable 5 Tech Circle Amherst, I�H 03031 Street Address City/Town State Zip 603/673.3200 (603)_732: 6845 tploude@fulcrum-nh.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 M No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor 12 736 385.59 and Materials) Total Construction Cost(from Item 6)_$_ ' 1.Building $ 7,778,785.59 Building Permit Fee=Total Construction Cost x$11 (Insert here 2.Electrical $ 1,344,000.00 appropriate municipal factor)=$_140,100.24_ 3.Plumbing $ 1,756,000.00 4.Mechanical (HVAC) $ 1,857,600.00 Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ 12,736,385.59 (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By enterin my name b o ,I hereby attest under the pains and penalties of perjury that all of the information contained in this applicati struiE�on acc ate to the best of my knowledge and understanding. X Thomas W. Mazza Managing Member 781 250 5940 X Please print and sign name Title Telephone No. Date 950 Winter St. Suite 4300 Waltham -ML 02421 Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date Appendix 2 Construction Documents are required for structures that must comply with 780 CMR 107.The checklist below is a compilation of the documents that may be required for this.The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents' Mark"x"where a licable No. Item Submitted Incomplete Not Required 1 Architectural X 2 Foundation X 3 Structural X 4 Fire Suppression X 5 Fire Alarm(may require repeaters) X 6 HVAC x 7 Electrical X 8 Plumbing include local connections X 9 Gas(Natural,Propane,Medical or other X 10 Surveyed Site Plan(utilities,Wetland,etc. X 11 Specifications X 12 Structural Peer Review x 13 Structural Tests&Inspections Program x 14 Fire Protection Narrative Report x 15 Existing Building Survey/Investiation x 16 Energy Conservation Report x 17 Architectural Access Review 521 CMR x 18 Workers Compensation Insurance x 19 Hazardous Material Mitigation Documentation x 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plan are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction.Work started prior to approval may be subjected to triple the original permit fee. Registered Professional Contact Information Daniel M.Skolski 978 965 3470 dskolski@dmsdesign.com 20038 Name(Registrant) Telephone No. e-mail address Registration Number Architect 08/31/2019 100 Cummings Center,Suite 339c Beverly MA 01915 Street Address City/Town State Zip Discipline Expiration Date Rimantis M.Veitas 781 535 5816 rimas@veitas.com 34028 Registration Number Name(Registrant) Telephone No. e-mail address 69 Granite Street,Suite 101 Braintree MA 02184 Structural Engineer06/30/2020 Street Address Ci /Town State Zip Discipline Expiration Date George Dubin 617 376 8877 dubinengrs@verizon.net 29370 Registration Number Name(Registrant) Telephone No. e-mail address Sanitary Eng 06/30/2020 40 Willard Street,Suite 302 Quincy MA 02169 Street Address Ci /Town State Zip Discipline Expiration Date James P Stroke 20068 06/30/2020 40 Willard Street,Suite 302 Quincy MA 02169 Electrical Eng CITY OF S�UYINI, XWSACHLSETTS BL'II.DING DEPART%CLNT r 130 WASHINGTON STREET,3w FLOOR TEL (971) 745-9595 FAX(978)740-9846 KI.NfBERI..E.Y DRISCOLL MAYOR THOMAS ST.PmERRB DIRECTOR OF PUBLIC PROPERTY/BUILDLNG CmaasstONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information Please Print Leeibl„x Name(Busirx-ss.OrganizatioNlndividual): Fulcrum Associates Inc Address: 5 Tech Circle City/State/Zip: Amherst, NH 03031 Phone#: 603/673-3200 EXT 214 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with � 4. ❑ I am a general contractor and 1 6. Q New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.-' 7• ❑Remodeling ship and have no employees These sub-contractors have S. Q Demolition working for me in any capacity. workers'comp.insurance. 9. Q Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 1 O.El Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.Q Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.Q Roof repairs insurance required.)t employees.[No workers' 13❑Other comp.insurance required.] •Any applicant that checks box it I must also fill out the section below showing their workers'compensation policy information. 'I hmwowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an aJditional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that Is providing workers'compensation Insurance for my employees, Below Is the policy and fob site information. Acadia Insurance Company Insurance Company Mame: Policy#or Self-ins.Lic.#: WCA5173208-14 Expiration Date: 11/1/2019 Job Sire Address: Assessors Map 26 Lot 91,95&97 City/State/2ip: Salem, Ma Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiratlon 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 S 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. He 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 certify under the pains and penalties of perjury that the information provided above is true and correct Sittnalure: Dote. 2/11/2019 Phone#: 603/673-3200 EXT 214 Oficial use only. Do not write in this area,to be completed by city or town oJrrial City or Town: _ Permit/l.icense# 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#• FULCASS-01 KPETTIT CERTIFICATE OF LIABILITY INSURANCE DATE F10/24/2018 / ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kathy M.Pettit 1 NAME: Davis 1 5 AI port Roadorrill 8 Everett,Inc. PHONE ) �A/�C,No):(603)225-7935 &Towle ac,No,Ext:(603 715-9739 Concord,NH 03301 1 EMAIL ADDRESS:kpettit davistowle.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Acadia Insurance Company 31325 INSURED INSURERS: Fulcrum Associates,Inc. INSURER C: 5 Tech Circle INSURER D: Amherst,NH 03031 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE �OCCUR CPAS173204-14 11/01/2018 11/01/2019 DA I ETORENTED 300,000 PREMSES Ea occurrence $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICY❑X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 IxANY AUTO CAA5173205-14 11/01/2018 11/01/2019 BODILY INJURY Per person) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED X NON-OWNED PROPERTY AMAGE AUTOS ONLY AUTOS ONLY Per acadent A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 10,000,000 EXCESS LIAB CLAIMS-MADE CUAS173207-14 11/01/2018 11/01/2019 AGGREGATE $ 10,000,000 DED I X I RETENTION; 0 A WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LUIBILITY CA5173208-14 11/01/2018 11/01/2019 1,000,000 Y/N E.L.EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE MFFICER/MEMgER EXCLUDED? NIA andatory In NH) E.L.DISEASE-FA EMPLOYE $ 19000'000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) Workers Compensation: 3A States-NH,MA,ME,VT,CT. For Informational Purposes Only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Informational Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN rP y ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE - ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Initial Construction Control Document = To be submitted with the building permit application by a ifj* Registered Design Professional for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Halstead Salem Station- Building#1 Date: February 13,2019 Property Address: 72 Flint Street,Salem, MA Project: Check(x)one or both as applicable:X New construction Existing Construction Project description: New construction of a mixed-use project. All residential units will be rentals,not condominiums. Building #1 will have 80 apartments with wood frame construction over one story of at-grade podium parking. I, Daniel M. Skolski, MA Registration Number: 20038 Expiration date: 8-31-19, 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: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, 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. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be 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 is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a'Final Constru Document'. Enter in the space to the right a"wet" or s ck,� electronic signature and seal: Phone number:978-965-3470 Email: dskolski@dmsdesign.com Building Official Use Onlyy 1T�{OF MQ' •/ Building Official Name: Permit No.: Date: Note 1. Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised. If'other'is chosen,provide a description. Version 01 01 2018 Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the Ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Halstead Salem Station-Building#1 Date: February 13, 2019 Property Address: 72 Flint Street,Salem, MA Project: Check(x)one or both as applicable:X New construction Existing Construction Project description: New construction of a mixed-use project. All residential units will be rentals,not condominiums. Building#1 will have 80 apartments with wood frame construction over one story of at-grade podium parking. I, George Dubin, MA Registration Number: 29370 Expiration date: 06/30/2020, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': Architectural Structural Mechanical X Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, 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. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be 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 is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a'Final Construction Control Document'. Enter in the space to the right a"wet" or electronic signature and seal: GD Consulting Engineers,Inc 40 Willard Street, Quincy,Ma 02769 rfi FeF:eF;GE 1'�. Phone number:671-376-8877 Email:dubinengrsQverizon.net -a o. 70- 1 s Building Official Use Only � Building Official Name: Permit No.: Date: \SSS'-NAL Note 1. Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervis--d. If'other'is chosen,provide a description. Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional 4 for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Halstead Salem Station-Building#1 Date: February 13,2019 Property Address: 72 Flint Street,Salem,MA Project: Check(x) one or both as applicable:X New construction Existing Construction Project description: New construction of a mixed-use project.All residential units will be rentals,not condominiums. Building#1 will have 80 apartments with wood frame construction over one story of at-grade podium parking. I, Rimantas M. Veitas, MA Registration Number: 34028 Expiration date: 06/30/2020, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural X Structural Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, 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. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be 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 is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a'Final Constructi ntrol Document'. Enter in the space to the right a"wet" or N OF MASs9 electronic signature and seal: Ru+Arr<As �y VEFAs N 0 STRUCTURAL mi Phone number:781-843-2863 Email:rimas@veitas.com 'W28 co o S Building Official Use Only S N Building Official Name: Permit No.: Date: Note 1.Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,provide a description. Version 01 01 2018 Initial Construction Control Document k ick To be submitted lvfth the building permit application I)\.,- a Registered Desion Professioual U10Fk per the ninth edition offhe Alassiichusetts ,�tl7tr- B11.iliji,W, Code, 780 CAM, Section 107 Project Title: Halstead Salem (Station- Building#1 Date: February 13,2019 Property Address: 7/2 R Int Street, Salem, N-1 A Project: Check (x) one or botil as applicable: X New construction Existing Construction Project description: Nevv constr-Lictiot, of a fill xccil-use project. All residential units be rental,-;, n.ot condoi,ninium.s. podiLL11L Pdr1<iJJ c01'1'-,trUC.t1011 over one stork'of at-crrade _9. 'D Stroke, NIA Rq�, ttratioii Number: ?i Expiratiloni date: 06/30/2020, andEi re&isteredde ,;n s� rl"OfesSiW'111, and I have prepared or cli-roCtly supervised the preparahon 4 all de s 11 VLIfIS, COMPLIta concerning;: tions and specifications c Architectural Structural Mechanical Fire Protection X Electrical X Other: Fire Alarm for the above named project and that to th" best of my knowledge, information, Fnd belief quch plans, co-l"putdtionli and splx- ificatiOlIS Meet the applicable provision; of the AlrISSaChLlsettsState Building Code', (730 OvIR), and accepted engineering practices for the propOsed project. I widers-endl and agree that I (or 111lr designee] shall perform the C�' 0 .necessary processional services ani be present on the construction site on a regular and periodic basis to: 1. Revievv, for coiiforrnance to this code and the ,desq'gil onceptshop drawings, sarnples and other 1 submittals by the contractor in accerdance with the reqUirements of the Construction dc.)cunienfs. 2 Perform the duties for registered, desi L, gg professionals in 711,90 CNIR Chapter 1-11". as app-licable. 3. Be present at intervals arri-opnatt to the stage of construction to b(�ceme generalh-, familiar with the progress and qualitv of the vvcrk and to deferrni�ie if the work i,�,being pe -) e ill a manner consistapt0 �n rf�1-111 ci with the approved C01IStrUCtilon documents and this code. Nothing,in this document the its responsibility regarding [lie previsions Z-1 .1 of 78()is 1R 107 When required by the building official, I shall submit field/progress reports (see iteni').) together with Pertinent corninents, in a form acceptable to the buildinc, official. Upon completion of the work., I shall suhnili I to the nuild ing offilcial a'Final Construction Control Document'. Entor in the spice to the right a."wet" or electronic signature and seat: w '0`A14e, GD Consultitia E1111incers-, Ili,, 4 JAklz- P STROIG 0 WdLlrd SLreeL,Quink-v,IMIa(Y-L69 Phone number: 671-376-8877 Email: N000 20C Bu ildiltg Official LISe 00if FSSi�M Ls Building Official Name: nnit No.: Date; -Note 1. Indi—Av willi an"x' rroi,,ct cjt.�sigll pj<jjjs, (Orllru I cho,-'on,provid,,a dos, 4^,1,101 L Initial Construction Control Document a To be submitted with the building permit application by a Registered Design Professional for work per the ninth edition of the sY° Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Halstead Salem Station-Building#1 Date: February 13, 2019 Property Address: 72 Flint Street,Salem, MA Project: Check(x) one or both as applicable: X New construction Existing Construction Project description: New construction of a mixed-use project. All residential units will be rentals,not condominiums. Building#1 will have 80 apartments with wood frame construction over one story of at-grade podium parking. I, George Dubin, MA Registration Number: 29370 Expiration date:06/30/2020, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural X Mechanical Fire Protection Electrical Other: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, 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. Perform the duties for registered design professionals in 780 CMR Chapter 1.7, as applicable. 3. Be 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 is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a'Final Construction Control Document'. Enter in the space to the right a"wet' or electronic signature and seal: GD Consulting Engineers,Inc:. p; 40 Willard Street,Quinc ,Ma 02169 ;J'•:. �';..____.' .. , Phone number:617-376-8877 Email:dubinengrs@verizon.net ;t Building Official Use Only No'ass 0 p, ,v e Building Official Name: Permit No.: Date: Note 1. Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised. If'other' is chosen,provide a description. Initial Construction Control Document U To be submitted with the building permit application by a Registered Design Professional �m for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Halstead Salem Station-Building#1 Date: February 13,2019 Property Address: 72 Flint Street,Salem, MA Project: Check(x) one or both as applicable: X New construction Existing Construction Project description: New construction of a mixed-use project. All residential units will be rentals,not condominiums. Building#1 will have 80 apartments with wood frame construction over one story of at-grade podium parking. 1, George Dubin, MA Registration Number: 29370 Expiration date:06/30/2020, am a registered design professional, and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning': Architectural Structural Mechanical Fire Protection Electrical X Other: Plumbing for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and.periodic basis to: 1. Review, 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. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be 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 is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work, I shall submit to the building official a`Final Construction Control Document'. Enter in the space to the right a"wet" or electronic signature and seal: GD Consulting Engineers,Inc. 40 �,• Willard Street,Quincy,Ma 02169 Phone number:617-376-8877 Email: dubinengrs@verizon.net /� a cr Building Official Use Only Building Official Name: Perniit No.: Date- Note 1. Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,provide a description