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0072 FLINT STREET HALSTEAD SALEM STAT, BLDG 2 S -72_ 1 DG2 .1G +., 1l 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) ^ I Building Permit Number: Date Applied: Building Official: 1V SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) 6-- 72 Flint Street Salem MA 01970 (Map#26 Lot#0091) Halstead Salem Station -Building 2 ® No.and Street City/Town Zip Code Name of Building(if applicable) l tSECTION 2:PROPOSED WORK Edition of MA State Code used AbIf New Construction check here®or check all that apply in the two rows below Existing Building❑ Repair❑ Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes Do No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No M Brief Description of Proposed Work: -All elevated floors above garage of 42-unit apartment building(BLDG2). SECTION 3:COMPLETE THIS SECTION IF EMSTING 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): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 3 storypprox. 14,066 Total Area(sq.ft.)and Total Height(ft.) 42,198 S F 29.9 F SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H4❑ H-5❑ I: Institutional 1-1❑ I-2❑ I-3❑ I4❑ M: Mercantile❑ R: Residential R-10 R-2❑x R-3❑ R4❑ S: Storage S-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ 1 VA ❑ VB SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Trench Permit: Debris Retnoval: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Dis oral Site lel Public W Check if outside Flood Zone El Indicate municipal® A trench will not be P_ required 0 or trench or specify: R Private❑ or indentify Zone: AE or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Revie;]'-cess. Not Applicable 119 Is Structure within airport apprRach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No® Yes❑ No IN SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY 70 Perso 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 ofPro erty Owner DSF Salem Flint 950 Winter St., Suite 4300 Waltham MA 02451 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Nomas W. Mazza, Managing Member- 781-250-5940 - tmazzai-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 ern-it 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 f`afAmings Center, Suite 3' c°ne"Beverly a-mai 1kress 01915 HrcAfe"O�lvumbN/31/2019 Street Address City/Town /State 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, f�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 and Materials) Total Construction Cost(from Item 6)_$_ 6,553,886.12 1.Building $ 3,920,646.12Building Permit Fee=Total Construction Cost x$11 (Insert here 2.Electrical $ 724,700.00 appropriate municipal factor)=$_72,092.75_ 3.Plumbing $ 921,900.00 4.Mechanical (HVAC) $ 986,640.00 Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ 6,553,886.12 (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering y name b o ,I hereby attest under the pains and penalties of perjury that all of the information contained in this applicatio ' true and urate to the best of my knowledge and understanding. X Thomas W. Mazza Managing Member 781 250 5940 X Please t and sign n1me Title Teleh�o'nee No. Date 950 Winter St. Suite 4300 Waltham _ML 62421 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 applicable No. Item Submitted Incomplete Not Required 1 Architectural X 2 Foundation X 3 Structural X 4 1 Fire Suppression X 5 Fire Alarm(may require repeaters) X 6 HVAC X 7 Electrical X 8 Plumbing include local connections X 9 Gas atural,Propane,Medical or other X 10 1 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 Surve /hlvestiation x 16 1 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 S 22 1 Other(Specify) *Areas of Design or Construction for which plans 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 08131/2019 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 Zi Discipline Expiration Date James P Stroke 20068 06/30/2020 40 Willard Street,Suite 302 Quincy MA 02169 Electrical Eng CITY OF S.UXAi, 2AXSSACHUSETTS • BUUMMG DEPARTaMvT ` 130 WASHINGTON STREET,3'0 FLOOR TEJ— (978)745-9595 FAX(978)740-9846 KIMBERI-HY DRISCOLL MAYOR T HONIM ST.PMJM DIRECTOR OF PUBLIC PROPERTY/BI:ILDLNG CO.\LtiMlONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant information Please Print Leaibly Name(Busines Organizationrindividual): Fulcrum Associates Inc Address. 5 Tech Circle City/State/Zip: Amherst, NH 03031 Phone M 603/673-3200 EXT 214 Are you an employer?Check the appropriate box: Type of project(requires!): i.0 1 am a employer with -�J 4. ❑ I am a general contractor and 1 6. 0 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.t 7• ❑Remodeling ship and have no employees These sub-contractors have S. Q Demolition working for me in any capacity, workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. C. 152,§1(4),and we have no 12,0 Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] Any applicant that chedm box 01 must also fill out the section below showing their worktxs'compenration policy information. f I lomeowner who submit this affidavit indicating they ars doing all work and then hire outsidt:contractors must submit a new affidavit inditaWng such. :C.mu -tors that cheek this box mums attached an additional sheet showing the name of the sub-contractors and their worker'comp.policy information. I am an employer that Is providing workers'compensadon Insurance for my employees. Below is the policy and Job site information. Acadia Insurance Company Insurance Company Mame: Policy#or Self-ins.Lie.M WCA5173208-14 Expiration Date: 11/1/2019 !ob Sire Address: Assessors Map 26 Lot 91,95&97 City/State/Zip: Salem, Ma Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration slate). 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations ot'the DIA for insurance coverage verification. I do hereby certify under the pains and penahles of perjury that the information provided above Is true and correct Signature: Date: 2/11/2019 Phone#: 603/673-3200 EXT 214 Oficial use only. Do not write in this arra,to be completed by city or town official City or Town: Permit/License# ___ _ Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/ own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other , Contact Person: Phone#: FULCASS-01 KPETTIT CERTIFICATE OF LIABILITY INSURANCE DATE F10/24/2018/ 1 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(les)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 CONMTA NAE:CT Kathy M.Pettit Davis Towle Morrill 8 Everett,Inc. PHONE 115 Airport Road cc,No,Ext:(603)715-9739 ac,N.):(603)225-7935 Concord,NH 03301 E-MAIL kpeftit@davistowle.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Acadia Insurance Company 31325 INSURED I INSURER B: 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 EXP LIMITS LTR A X COMMERCIAL GENERAL LU►BILITY EACH OCCURRENCE 1,000,000 CLAIMSMADE FOCCUR CPA5173204-14 11/01/2018 11/01/2019 DAMAGE TO RENTED 300,000 PREMISES 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[_x1 JEIQT FX LOC PRODUCTS-COMP/OP AGG $ 2,000, OOO OTHER: A AUTOMOBILE LIABILITY =SINGLE LIMIT 1,000,000 X ANY AUTO CAA5173205-14 11/01/2018 11/01/2019 BODILY INJURY Per person) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NONAWNED PPe0a�dent AMAGE $ AUTOS ONLY AUTOS ONLY A X UMBRELLA LIABX 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 PEROTH- AND EMPLOYERS'LIABILI Y STATUTE ER_ CAS173208-14 11/01/2018 11/01/2019 1,000,000 ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT �FF15ER/MEMBER EXCLUDED? C! N/A illanatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If 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 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#2 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 #2 will have 42 apartments plus approximately 5,000 SF of commercial space-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 Mork 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 ocument'. Enter in the space to the right a"wet" or electronic signature and seal: Phone number:978-965-3470 Email: dskolski4ldmsdesign.com o Building Official Use Only �� r 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#2 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 #2 will have 42 apartments plus approximately 5,000 SF of commercial space-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 1 (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 Building Official Use Only �P 6 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 Vii' I 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#2 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 #2 will have 42 apartments plus approximately 5,000 SF of commercial space-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 Construction Control Document'. Enter in the space to the right a"wet" or , OF ggqs electronic signature and seal: R�wsrAs ss�yG z vetrAs m 0 STRUCTURAL. .U028 r~n Phone number:781-843-2863 Email:rimas@veitas.com ..g1STti Building Official Use Only 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 t~Nr; To he suhralitted vcith the building perlalit appticatiora by a iy t it } Registered Design Prof essimiai O yr zc-vrk iE>r the nintheclftinlr of tlxe f, , =�p Massachusetts State Building Code, 7/80 CAM, Section 70 Project Title: Halstead Salem Station- Buildinz-#2 Date: FeF rruart• 13, 2019 Property Address: 72 Flint Street, Salem, kli% Project: Check_(x) one or Doth as applicable: X New const action Existing Construction Project description: Nevv- construction of a mixed-tts project. i'sl residential units vv i be rentals, not coruiomiuziums. Bttildin— 42 will have-42 apartments p!us apnroximatehr 5,OU0 SF cf ct,t��T��erci41l space-wood frame construction over one store of at-gz`actepodtiutn parking 1, lan-tes P. Stroke; lti' l A egistratiatl ;' UMber: 10068 .;cpiratiort Gate. 06 30 20M am a rti�ister�df rt£s%;1a profession at, and I have prepared or directk supervised t le preparation of all design piens,c:otnt�utations and specifications concerning': Architectural Structural Mechanical Fire Protection X Electrical X Other: Fire Alami for the above named project and that to the best of tntiv knowledge, information, and belief such pians, coinputatin��s z�ncl 4pecific atians moot th<� ap,lical� e p c visions of the lfass TchUS ttS State Buiiding C.ocie, {7813 f the �1 project. l understand and agree that 9 (or my C:�IP), and accepted engineeTu�Y practices ter u:Iz }iro��ostc t designee) shall perform t;1e r'ecessdr\' PrOfessk)"n tf ser\I.C's anti l?' present on the COt1StrUctlotl STtC't?T1 a rP.gtdldr a-ad periodic basis to: 1. Review, for c'ot� orTnance to this code and the design concept, shop dravvingti, SatrT1}les and other submittats b�� ttte contracts>r i11 accardanc-t����itis the re]uirements of the construction d€�cuments. 2. Perform the duties for registered design professionals , 78i'C'v1R Chapter i , js applicable. {. Be present at ?nter2ais appropriate to the stage of construction to become generally fari'liliar v'ilh th(- progress and quality of the work and to tleterr�ine if the vvo k is be'ng performed in a r1 x�user consisteTvt vviththe approved construction d l-luments and this cede_ tti'othing ill this ciocumr of r.ITeves the contractor o€ its rest,onsii�ilitt reeding the Ir c}'visions of X80 C. 'I t� "1 Oi. ��ilaorl rei{uiret by the brlikli.ng Official, 1 sh��il sulmiit field/progress reports (see item 3.)to;ether vvith pertinent cornrnents, in a form acceptable to the huilding offici'IL Upon completion of the ^,�ork, ? small submit to the b'_iitding official �t'Pinal Construction Control Doirt�3C'rlt' Pw�J 'fit Enter in the space to the right a "vvet" of electronic signature and seal: JAMES P. �J+ UD Consu ta ,;_ 'rt e>rs lii�. ; ilri> SPAriE *a�s 40 willard Strt.et,Quin r, Ma 1?2 Phone number:617-376-88"77 Email c�t�binet�t�s 'v�ertzon.rvet Br,itrtht�Of(r.ial Usc f�uh/ �►� �,'�--' ted" L13uildingOfficial Name: 1'ernrit tiv.: mate: I Note 3., ti7di<:at= t.iL1 an s arc jt> ttsc r:s uricl..j?c:itc ,t urk� f._t vc t re 'i—q,or i rovido a do4cril,tior,- Initial Construction Control Document To be submitted with the building permit application by a M 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#2 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 #2 will have 42 apartments plus approximately 5,000 SF of commercial space-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 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. n 40 Willard Street,Quincy,Ma 02169 Phone number:61.7-376-8877 Email: dubinengrs@verizon.net "��' A Building Official Use Only x ;. 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 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#2 Date: February 13,2019 Property Address: 72 Flint Street,Salem, M A 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 #2 will have 42 apartments plus approximately 5,000 SF of commercial space-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 concerningt: 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 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 deternune 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 Wdlard Street,Quincy,Ma 02169 =' Phone number.617-376-8877 Email:dubinengrs@verizon.net Building Official Use Only i s a 4 f Building Official Name: Permit No.: Date: ' Note 1. Indicate with an`>I project design plans,computations and specifications that you prepared or directly supervised. If'other' is chosen,provide a description. �W , vc ) 2 1,V17�� CITY OF SALEM F7 Q2-- ROUTING SLIP New Construction Certificate of Occupancy LOCATION �Z FIW c�red DATE 3 /1 /20/ c7- ASSESSORS 11 '201q.ASSESSORS DATE 3 7 93 WashingtonSt. S7ebrak A.Jaen CITY CLERK ATE 31( ..2b 93 Washington / PUBLIC SERVICES 1 (d / DATEl �l f 120 Washington St. WATER - '� �" DATE 120 NN'ashington St. i CROSS CONNECTION, :jbATE� Y �� 5 Jefferson Ave PLANNING[ /DATE 120 Washington St. CONSERVATION �ADATE 3 / 7/ SOI O 120 Washington St. ELECTRICA DATE 48 LafaVet e - OTZ %� FIRE PR ELATION DATE I( 29 Fort AvenuI HEALTH -.JI DATE 2- 120 120 Washington St. BUILDING INSPECTOR DATE 120 Washington St.