19 GREENLAWN AVENUE - BUILDING INSPECTION 19 GREENLAWN AVE.
No. City of Salem Ward
' mss 6b
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, it, Ill, IV, and IX.
I.
AT(LOCATION) / 2 Cv/PB P�7 /Rru4j 10Va— ZONRICT ING P 1
LOCATION (NO.) is neen
OF BETWEEN /ylae/(fit iYu of liEe �� AND
BUILDING Icao sTRn (cnoss STREET)
LOT
SUBDIVISION LOT BLOCK SIZE ", 4,*L
11. TYPE AND COST OF BUILDING -All applicants complete Parts A -D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION'USE MOST RECENT USE
1 ❑ New building Residential Nonresidential
2 ❑ Addition(if residential,enter number of new 12 One family 18 ❑ Amusement,recreational
housing units added,if any,in part D,13) ! 19 ❑ Chruch,other religious
13 ❑ Two or more family-Enter number -
3 ❑ Alteration(See 2 above) of units....................................................... 20 ❑ Industrial
21 [:] Parking garage
4
E] Repairreplacement 14 ❑ Transient hotel,motel,or dormitory- 22 ❑ Service station,repair garage
Enter number of units ...........................
5 ❑ Wrecking(If multifamily residential,enter number 23 ❑ Hospital,institutional
of units in building in Part D,13) 15 ❑ Garage
24 ❑ Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
7 f4 Foundation only 26 ❑ School,library,other educational
17 ❑ Other-Specify 27 ❑ Stores,mercantile
B.OWNERSHIP 28 ❑-Tanks,towers
8 ® Private(individual,corporation,nonprofit
institution,etc.) 29 E] Olher-Specify
9 ❑ Public(Federal,State,or local government
C.COST (Omft cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
machine shop,laundry building at hospital,elementary school,secondary school,college,
10. Cost of improvement ......................................................... $ / O't/-TJ parochial school,parking garage for department store,rental office building,office building
at industrial plant If use of existingbuilding is being changed,enter proposed use.
To be installed but not included
in the above cost
a. Electrical...........................................................................
b. Plumbing
c. Heating,air conditioning.............................................
y ' -
d.`Other(elevator,etc.).....................................................
11. TOTAL COST OF IMPROVEMENT $
111.*SELECTED CHARACTERI DING •For new buildings and additions, complete Parts E-L;-demolition,
complete only Parts J& M, 11 others skip to
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ onry(wall bearing) 35 ❑ 40 1-1Publicor private company Will there be central air
31 Wod frame 36 Oil 41 ❑ Private(septic tank eta) conditioning?
32 ❑ Structural steel 37 ❑ Electricity 44 ❑ Yes 45 ❑ No
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
34 ❑ Other-Specify 39 ❑ Other-Specify 42 ❑ Public or private company 46 ❑ Yes 47 ❑ No
43 ❑ Private(well,cistern)
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
48. Number of stories ............................................................
49. Total square feet of Poor area, Approval all floors,based on exterior Has oval from Historical Commission been received
dimensions ...............-...................................._......_..._..... for any structure over fifty(50)years? Yes_ No_
50. Total land area sq.ft................................................... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed............ ..............................
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
52. Outdoors
Yes No
L.RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed............................................................................. Electric:
Gas:
54. Number of Pull................... .......... Sewer:
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial. BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No A (If yes, please enclose documentation from Hist Com.)
Conservation Area? Yes_ Nom (If yes,please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No_ NA
Is property located in the S.R.A. district? Yes_ No--L-
Comply
omComply with Zoning? Yes-K No (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No----!�_ (If yes,submit documentation/if no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yeses No_
Is Architectural Access Board approval required? Yes_ No X (If yes,submit documentation)
Massachusetts State Contractor License# Salem License#
Home Improvement Contractor# Homeowners Exempt form(if applicable) Yes-.& No_
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6) MONTHS OF ISSUANCE OF BUILDING PERMIT
CONSTRUCTION IS TO BE COMPLETED BY: If an extension is necessary,please submit
C/- 3 d` cI J� in writing to the Inspector of Buildings.
V. IDENTIFICATION - To be completed by all applicants
Name Mailing address-Number,street,city,and state ZIP Code Tel.No.
Owner or Mr c40/1 U !5 ]a
Lessee, ?h e ply 6 8 Qo .t v�t�4J t
2. L/ti��� �M.J �. %� y ec/.y /2vc - ,oCWY,-- r>,r�+a' o/y7c 7yL�.i7eo
Contractor / /� Builder's
YJ AMr JfQ�(c-14rl ei /e,a �/1� ��LLo "o'/• r1s6er4f 011, y License No.
3. 0.6esla/d a i.1 ' Pf // C7ecdoir os-rn /393 c.1-
Architect or
7 J' 35J
.r Engineer V6 v
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his authorized Wt and we agree to conform to all applicable laws of this jurisdiction.
Signatu of a t Address Ap licatio to
•� t
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19
Fire Grading
Building 19 /fh
Permit Fee $ 7 ` Live Loading
Certificate of Occupancy $ ApprovedOccupancy Load
by:
Drain Tile $
Plan Review Fee $ � ,
LE
NOTES AND Data - (For department use)
PERMIT TO BE MAILEDJO:
DATE MAILED:
Construction to be started by: Zzz -oz
Completed by: j f
a:
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
SITE OR PLOT PLAN -For Applicant Use
o N.
�' COMMONWEALTH OF MASSACHUSETTS
E t DEPAlr:MENT OF INDUSTRIAL ACCIDENTS
�„_�y' 600 WASHINGTON STREET
fames� Gamooeu BOSTON, MASSACHUSETTS 02111
-ornm,ss,As,c'ne, WORKERS' COMPENSATION INSURANCE AFFIDAVIT
(licensee/perminee)
with a principal place of busines residers at:
(City/state/Zip)
do hereby certify, under the pains and penalties of perjury, that:
[ ] I am an employer providing the following workers' compensation coverage for my employees working on this
job.
Insurance Company Policy Number
[ J I am a sole proprietor and have no one working for me.
flQ I am a sole proprietor, general contractor o omeowner (circle one) and have hired the contractors listed below
who have the following workers' compensation insurance policies:
C d"74e0er 21LO O Lr 0,1 2- -l",
Name of/, Contractor 1 Insurance Company/Policy Number
✓ 0(,j4M JT�CY L/ �/ �rl� Lia -5Pc- MksS
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
(] I am a homeowner performing all the work myself.
NOTE: Please be aware that while homeowners who employ persons to do maintenance,construction or repair work no a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally
considered to be employers under the Workers' Compensation Act(GL C. 152,sect. 10)), application by a homeowner for a license
or permit may evidence the legal status of an employer under the Workers' Compensation Act
1 understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' Office of Insurance for coverage
venncation and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to 51500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of S 100.00 a day against me.
/Signed this -7-1 -sem day of cc-,71y 6-e`t- ' 19 9 `�
Li en e/Permitt� Licensor/Permittor
f \ CITY OF SALEM
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE
JOB LOCATION—1 q 6R'Peti (AwrA Cie -1) _
Number Street address Section of Town
MtZ/// {
"HOMEOWNERJ/9 HHP � 3 .f°i- 7` j7WW JV J- 74F-41b
/ Name Home phone Work phone
PRESENT MAILING ADDRESS 70 L- P9,4 rte, + Z�
Swims Yl� fl O t 5 -l"
City/Town State Zip Code
The current exemption of "homeowners" was extended to include owner-occupied
dwellings of six units or less and to allow such homeowners to engage aT-
dividual for hire who does not possess a license, rovide
acts as supervisor. (State Building Code Section 109.1 .1d that the owner
DEFINITION OF HOMEOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to re-
side, on which there is, or is intended to be, a one to six family dwelling,
attached or detached structures accessory 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 shall be res onsible
for all such work performed under the building permit. Section 109. .
The undersigned "homeowner" assumes responsibility for compliance with the State"
Building code and other applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands the City of Salem
Building Department minimum inspection procedures and requirements and that
he/she will comply with sayd�procedures and
�requirements
HOMEOWNER' S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
NOTE: Three family dwellings 35,000 cubic feet, or larger, will be required
to comply with State Building Code Section 127.0, Construction Control .
GI
HOME OWNER ' S EXEMPTION
The Code states that: "Any Home Owner performing work for which a building
permit is required shall be exempt from the provisions of this section
(Section 109.1 .1 - Licensing of Construction Supervisors) ; provided that--is--
a Home Owner engages a person(s) for hire to do such work, that such Home- y~ ',
Owner shall act as supervisor."
Many Home Owners who use this exemption are unaware that they are assuming,
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for Licensing Construction Supervisors, Section 2.15). This lack of aware "
ness often results in serious problems, particularly when the Home Owner --
hires unlicensed persons. In this case your Board cannot proceed against `
the unlicensed person as it would with licensed Supervisor. The Home Owner;-
acting as supervisor is ultimately responsible.
Y
To ensure that the Home Owner is fully aware of his/her responsibilities,- -
many communities require, as part of the permit application, that the Home
Owner certify that he/she understands the responsibilities of a supervisor.
On the last page of this issue is a form currently used by several towns.
You may care to amend and adopt such a form/certification for use in your
community.
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CUhJlli�cZUR SHALL 1JU�1�Y I J p �(� Q� a F c ' w
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-KU CUt\\ STQUr11U- HYD aC , o. �E�^1 �� GUL•\�Rlul P.�, ��RAI E�
`''•"• ..PROPOSED _ —
H• Ewv,�ca`c �Et�t D1.1� ,rN PLOT' PLPN OF LAND
V� Z 1U �c flG�wFv�wS o `
IN I
L ` "` ° SALEC/1 , MASS.
138xS cx�s1lt c SPuT 6,ZnJc PREPARED BY:
U - P.J.F. do ASSOCIATES
11 LEA
S
�. PAUL J. NOCCHIO-P.LS .
PAUL (617)395-7662
SCALE, 1
_ DEEM REF., Div PL.
DATE, I p- Z 1 a
�U'ZI-tet 4
PAULP.L.S. DATE FILE Noi 3 4 1 5
' Sh"
e _ - `+ ✓
Pul
lease Note: Foundation as shown is sized to rough frame size of home 48'0" - (n
If exterior insulation is used on foundation walls, concrete pour must a
0
be downsized from dimensions shown the thickness of insulation. Sills must __________ _____ ___ _ --- - E
overla insulation and match dimensions indicated.. - '--- ------ -----------------------------------------------------------------------------------------------------
i _
i
� `oNrkd & FefaFd 6y CC : i I l 0
i 160
Jvo 1
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120 — 120 — J
r_ ________________________________ _____ -- 1 x
___________________________ __ 7S04
0) 001
-, NK �..
LL 64 z4t�
i 8'0" 810" - 810" 8,0n810.1
- O[
Prellminary plan
LNotfor construction use ----
- ` L------ - - -- M
z „
CAM
Star, ; w
a
04
1 ; I I ; - 6mte Iktatxr 1 1
i 1611 E C!
Garage
atdatinn Wal----------------- -1
___"_________ �•...�* i I Fiattag Ul
1 , _
1 � I
1--------------------------------------------------- 1
b
Note: These plans represent the closest approximation to the. ! <
submitted design allowing for established building codes,
saftey standards and design limitations. 'I
Please make all
1
and sign and dateeach to ans n
Thenre return to CSI for RED pen or acorrections,
If no revisions are desired; sign and date each page
_
Ir----i i si nifm Final A roust & Return to CSI
-------------------------------------------------- R06
------------------------------------- -
8'1 3/16" --'"r Tit 3/16" ----��, T113/16` I Tii 3/16" ----+1- 7'11 3/16" -.---. . "i 8'2 3116,-
21'0"
/16"24,0„
1/2"05" Anchor Bolls or straps @610"O.C.
and 12" from corners by builder,dealer,G.C. NOTES
_ . Top of Side Wal I �.
1. FOUNDATION PLAN SUPPLIED FOR DIMENSIONS ONLY-Builder/Dealer/CC
1/2" Plywood / 8"(Mtn.) Site conditions is responsible for foundation design per local codes & site I,
may dictate thicker walls conditions.
2x8 Plate 2. CONTRACTOR IS RESPONSIBLE TO ASSURE FOOTINGS ARE BELOW q)
. - FROST LINE AND ON UNDISTURBED SOIL. ZO
2x6 Plates NOTE Wall height figured
for 2X70 Floor system 3. CONTRACTOR IS RESPONSIBLE TO INCLUDE CONTROL JOINTS AND N
as used with 13' & 14' Modules PROVIDE PROPER WALL THICKNESS TO PROTECT AGAINST
< III-IILIII- LATERAL PRESSURE ON LONG FOUNDATION WALLS.
2X6 Stud 4. LALLY COLUMN SPACING NOT TO EXCEED 8'0" ON 24' WIDE,8'6' ON
+' i11J11=III= / 28'WIDE,9'0" ON 26' WIDE.SPECIAL COLUMN LOCATIONS WILL BEFou
2- o SHOWN BY SOLID CIRCLE ON FOUNDATION PLAN. COLUMNS PROVIDED
3&I/2' C.C. Filled Lally Col. es
with Wtton Wolf - / a AND INSTALLED BY BLD/DLR/0.C.
2x6 Shoe 2x6 Sill with Walerprool in (by-6u i-[der/Dealer/G.C.) 14 Ul
5"x5" Steel Plate. �'' 5. CRAWL SPACES REQUIRE VENTILATION ON TWO OPPOSITE SIDES V-
;o WITH NET AREA OF NOT LESS THAN Isgft/150sgfl OF
—' Foundation Wolf with o
Foundation - ' ' -
FOUNDATION SPACE.REDUCE.TO 10S WITH APPROVED VAPOR
Concrete Floor :30"x30"x10" Concrete Waterproofing Wall Heights may vary BARRIER.
'J Because of site conditions REV ISION5
III- I= I III=III-III= 3" Floor Footing (Typical)cal ' : or foundation contractors 6. . BASEMENT SPACES NOT FOR HABITABLE OR OCCUPIABLE ROOMS MUST
_ )
=1I1-III- I11=III III_�il (Min)
/. BE PROVIDED WITH A GLASS WINDOW AREA OF NOT LESS THAN
III=III-111= ./ r T e
1/50 OF THE FLOOR AREA SERVED. TWO 72"X32" OPERABLE BASEMENT v S
O
Perimeter Drain �'� - 6 Mil Poly _=III=III=III + ' p"� ' • III=III=III=_ Perimeter Drain ARE REQUIRED IN R.I-HABITABLE SPACES MUST BE J�x'
WINDOWS
_ ! PROVIDED WITH GLAZED AREA OF NOT LESS THAN 8R AND 0 p,
as Required \ ` =III III=III-MIL-1-III III-1=I1 I11= as Required y OPENABLE AREA OF NOT LESS THAN 4% OF THE AREA SERVED. srr fsq
v =III=III=III=III-I I-III-IIIE11=111- , 6 Mi I Pol y
> , `..� r 7. SMOKE DETECTOR(S) SUPPLIED BY CUSTOMIZED STRUCTURES INC., S m rn E
NOTE: INSULATED.ON SITE BY BUILDER,DEALER,C.C. I11=IIID 'a. ' -1. 111=III=III 3" Compacted 1. Undisturbed oil \ F a
F (" loo FOR THE BASEMENT, LOCATED BY THE LCL OFFICIAL AND �+ `` 3 A
=W—I1ISIGravel \.. ,J '. c (min) rn
INSTALLED BY THE BUILDER/DEALER/G.C.. ONE SMOKE DETECTOR '` p., U
Mil-1I1=III-III=III\1I1-III-IIS=1I1= IIII 1-,III''Ot'I_� I1�I�''''11III'-'II11III-II h'I_ 3" Compacted Gravel PER/1200 sq.ft. IS REQUIRED IN MASS.& R.1.. [�� - U x
1 \ Undisturbed Soil . - W=Il 1-11=1=1='1_III=I1=. 8. ONE GFI PROTECTED RECEPTACLE' ,CIRE 20AW LAUNDRY RECEPTACLE �t Y
SPLIT ENTRY KNEEWAL•L TYPICAL SPLIT ENTRY WALL LALLY COLUMN FOOTING nl=nl=lu in=nl=nl=m=iw —� Q
AND ONE 25AMP WATER HEATiR RECEPTACLE (IF REQUIRED)TO m .7
BE PROVIDED AND INSTALL€D BY THE BUI LDER/DEALER/G.C.. ,p V}
I SCALE;3/8"=1'O" SCALE: 3/8"=1'0" SCALE: 3/8"=1'0" TYPICAL r TYP ICAL `MALL Undisturbed Soil 9: STAIRS TO THE BASEMENT SUPPL IEU,AND INSTALLED BY THE
SCALE: 3/8"-1'0" BUILDER/DEALER/G.C.. (See floor plan for exact location). �aldVtt v
I
BOARD OFASSESSORS
. 93 WASHINGTON STREET,CITY HALL,SALEM,MASSACHUSETTS 01970
r W 8 (508)745.9595 Ext 261
.rG (508)744.5918 FAX
July 29 , 1993
Deborah E . Burkinshaw
City Clerk
City Hall
Salem MA 01970
Dear Miss Burkinshaw:
Please be advised that the new single family home to be
constructed on the new lot to be created by the merging of the
three vacant lots at the end of Greenlawn Avenue and currently
addressed as 8 (Parcel #08-0166) , 10 ( #08-0162 ) , and 12 Glenn
Avenue__(#0.9,:,0165) , has been assigned the legal street address
of'1$ 19 Green1aawn_2 enue.
l- ery tr burs,
(
Pe M. aro��
Chairman
Cc : Postmaster Joseph L. Leccese
Acting Chief Robert Turner, Fire Department
Helen Jiadosz, Water Dept .
Leo Tremblay, Inspector of Buildings
Richard Lis, Engineering Dept .
Capt . Paul Murphy, Police Dept .
Richard Swiniuch, 16 Glenn Ave .
October 21, 1994
Mr. Charles Quigley
Director of Public Services
One Salem Green
Salem, MA 01970
Dear Mr. Quigley,
As part of the building application process of our efforts to
build a new house at(19 Greenlawn Avb,� we respectfully request a
waiver of Sec 26-105 Salem code of ordinances as it pertains to
curb and sidewalk requirements.
Our proposed home is located at the end of Greenlawn Ave,
the only house that will be built in that section of roadway and
Pedestrian and/or vehicle traffic will be non-existent.
Further, we have agreed to extend the finished roadway to
comply with the "Form A" as approved by the Planning Board on
July 7, 1994.
Respectfully,
Lauri A. Panneton
(f ltd of 'SUlem, 'Cttssar4usetts
Department of Publir �$eriiires
$a1em (preen
745-9595 3ixt. 321
CHARLES F.QUIGLEY
City Engineer
Director of Public Services
October 27, 1994
Mr. Leo Tremblay
Building Inspector
One Salem Green
Salem, MA 01970
Re: Proposed Residence
19 Greenlawn Avenu
Salem, 'MA-01970
Dear Mr. Tremblay:
The proposed plans for the above project, as they pertain to this
office, were reviewed.
I recommend that relief be given regarding Sec. 26-105 of the
Salem Code of Ordinances, since no pedestrian traffic will be
using the area in questions. As a dead end street, the only
vehicular traffic will be the resident builder, therefore there
is no need for sidewalks or curbing.
Very t ,
Charles .F. Quigley, P.E.
City Engineer
Director of Public Services
CFQ/cmc
cc: Lauri A. Panneton