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26 HIGH STREET - BUILDING JACKET 26 High Streets 4 e tp of 6alem' '41a!6garbU!5ettg s Public Propertp Mepartment iguilbing Mepartment One&alem Oreen (978) 745.9595(Ext. 360 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer October 1, 1998 Fran Nutting Carlson Realty 207 Washington Street Salem, Mass. 01970 RE: 26 High Street Dear Ms. Nutting: According to the records on file in this office, it has been determined that 26 High Street is a lawful, nonconforming four (4) family dwelling located in a R-2 zoning district. This is to determine use only and in no way is meant to confirm or deny whether said property is in compliance with all building, plumbing, gas, electric, fire or health codes. Sincerely, Kevin G. Goggin Inspector of Buildings KGG: scm 1 7� GtG ► 2,$ 2 The Commonwealth of Massa. i �e n4 Department of Public Safety we ft ti/ p hiassachuscusstaw Building Code(780CIvfR) q1 S RVI ,' ' Building Permit Application for any Building other than a amily Dwelling M .(This Secfion For Official Use Only) Building Permit Number. Date Applied: Building Official: rEdition SECTIONe1:LOCATION(Please indicrateABlock#and Loot-#lfor locations for which a street address is not available) ( Jl Sa e,- IVA n(-1 +o .and treet City/Town Zip Cale Name of Budding(if applicable) SECTION 2.PROPOSED WORK of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below �J Existing Building❑ Repair 13 1 Alteration ❑ 1 Addition❑ 1 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 ❑ No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work: SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANCE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CIvIR 34) ❑ Existing Use Croup(s): I Proposed Use Group(s)— SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor.(sq.ft.) Total Area(Al.ft.)and Total Height(R.) SECTION&USE GROUP(Check as a licable) A: Assembly A-I❑ A-2❑ Nightclub ❑ A-3 O A-1❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-t O F2❑ Hi h Hazard H-1❑. H-2❑ H-3 ❑ H4❑ H-5❑ L• Institutional W O I-2❑ 1-3❑ 14 O M: Mercantile❑ R: Residential R-10 R-2 O R-3❑ R4❑ S: Storage S•1 ❑ S-2❑ U: Utility❑ Special Use O and please describe below: Sp�Yial Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ Ill IIA ❑ 1100 IHA13 IIIB ❑ 1 IV ❑ 1 VA VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public K Check if outside Flood Zone h hudicate municipal A trench will not be Licensed Disposal Site❑ Private O or indentily Zone: or on site system❑ required Al or trench or specify: permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: (_\I liuori.�_pngtrisslon Not Applicable Is Structure within airport approach area? Is their review completed? or Consent to Budd enclosed❑ Yes❑ or Now, Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Grnup(s): Type of Construction: OLcnpant Load per Floor: Dims the building contain.in Sprinkler System?: Special Stipulations: _ SECTION 9: PROPERTY OWNER AUTHORIZATION Name nd Address of Property Owner r v� Moss )6 k6-u St - M Satz, Name(Print) No.and S reef - City/Town Zip Property Owner Codact Information: . __ `1�8831�`TI� P„//rtm�ssleurl2P�tw�r:l, Title t t r " Telephone No.(business) Telephone No. (cell) a-ma6 ad ss If applicable,the property owner hereby authorizes Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this budding 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 hem 0 and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. email address Registration Number Street Address - City/Town State Zip Discipline Expiration Date 10.2 General Contractor -r - - ,I-F,V , �9 'G✓ (cOwL Name of Person/fR esponsible for Construction // License No. and Type if Applicable e`y/r/ll(ywu AV-e hY�,^J lox el9oz— Street Address City/Town State Zip 370 Aa(g 0172 /•cber i,U ,< 6-3 E_ 4, �. ee---'l Telephone No. business Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSUItANCli AI:FIUAVIT M,G.L.c.152.§25C b A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents most be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the budding permit. Is a signed Affidavit submitted with this application? Yes 0 No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE - Estimated Costs:(Labor Item and Materials) Total Construction Cost(from Item b)_$ 60 ovu.,Ud i 1. Budding $ 000-o Building Permit Fee=Total Construction Cost x_(Insert here 2.Electrical $ /g7L7C�-,Z)61appropriate municipal factor)_$ 3. Plumbing $ S nc""a d. Mechanical (HVAC) $ Note:Minimum fee=$ (contact coin all' ) 5. Mechanical (Other) - $ Enclose check payable to 6.Total Cost $ (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.cod accurate to the best of m vied and understanding. Plese pr in,annd sign mm�e Title Telephone No. Date Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date The Commonwealth of Massachusetts Department of Public Safety NIa9S11ChUSett5 State Building COLIC(780 CNIR) ` 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) No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition Of NIA State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ 1 Alteration ❑ Addition❑ Denwlitiott ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of OcrupanLy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this pennit application? Yes ❑ No ❑ Is an Independent Structural Engineering Peer Review required? r Yes ❑ No ❑ Brief Description of Proposed Work: �X15'�lr—r1� ( noral 44PIrla� �EC✓l 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): MSt Proposed Use Group(s): E SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Z Z Total Area(sq. ft.):and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4 ❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-I ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional I-1 ❑ 1-2❑ 1-3❑ 14❑ M: Mercantile❑ 1 R• 1 dentia R-I❑ R-2❑ R-3❑ R-a❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ Ill ❑ IIA ❑ IIB ❑ ❑IA ❑ IIIB ❑ 1 IV ❑ 1 VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal: PubliC❑ Cheek if Outside Flood Zone❑ Indicate munieipol❑ A trench will not be Licensed Disposal Site❑ required ❑or trench or specify- _ Private❑ or indentify Zone or on site s}'slem ❑ permit is enclosed❑ Railroad right-of-way: Ilazards to Air Navigation: V,a l li.6gq �.qn n -I Not Applicable❑ Is Structure within airport approach area? Is their raview completed? Or Consent to Build oncosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY 1?diliun of Code: Use Group(s): 'Iv pe of Gmslnaction: Occupant Load per Hooe UOcs the build ing con lain an Sprinkler Sy stem?: _Special Stipadntions: SECTION 9: PROPERTY OWNER AUTHORIZATION e Name and Address of Property Owner Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable, the pro(� �fiAvop�`e1rty own•�r�here by,,not/ion.zes M Y(tA.r- V l0 tr l 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 and ski Section 10.1 10.1 Rqgistered Professional Responsible for Construction Control MWAVi ( 7V 3 _ 50 Nar re(Rego rant) Tele6on• o. e-nail ddress Regifne on Number i2 . .V Street Addr ss City/Tow Zip Expiration Date 10.2 General Contractor Name of Person Responsible for Construction License No. and Type if Applicable A7,,,AlA4,.7o a A-J &J ba Am /W d2l-ff, Stre Address City/Town State Zip Telephone No. business Telephone No. cell a-mail address SECTION 11:lVpRKH6'C0P,11'LNSA['ION"INSUR:AN(T: ]FWAyl f M.G.L.c.152.ji 25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents st be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the is ,nce of the building permit. Is a signed Affidavit submitted with this application? Yes No O SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor ` and Materials) Total Construction Cost(from Rem 6)=5( �-,Y60 1. Building 5 Building Permit Fee=Total Construction Cost x_(Insert here 2. Electrical $ appropriate municipal factor)=5 3. Plumbing $ �- T. Mechanical (HVAC) $ i Note: Nlininmm fee=5 (contact municipality) 5. Mechanical Other $ Enclose check payable to - - 6.Total Cost $ (� > (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 thebest of my knowledge and understanding. 61U17 Y_��9. 2ss� 6/s// I'lease print and sign name Title Telephone Da Street Address City/rown ` Slate Zi Municipal Inspector to fill out this section upon application approval: Name Date .� D004- I i I d ?• SAPS , �0 5� �Po9 LaK C�r1 6SiVQ• l2.,� l �' � � �'7 , l •� i J - , �.