1 MALL STREET - BUILDING JACKET 7
IR. II. MIII1FNIIIK A. II. A.
�I �I
PLEASANT STREET.
GLOUCESTER, MIA. 01930
TFL. 978'283'7679 FAX 978' 2836289
E.MAIL bob@mitnikarch.com
January 4, 2011
Thomas J. St Pierre
Inspectional Services Director
Public Properties Department
120 Washington St., 31tl Floor
Salem MA. 01970
Dear Mr. St Pierre,
I am in the process of purchasing the property at #1 Mall St. which will be my primary
residence. We are scheduled to pass papers on March 15, 2011.
Our residence at 30 Warren St #5 is currently on the market.
The Mall St property is now a group home for the deaf. I intend to convert the building to a
single family residence. I had a conversation with your assistant Mr. Mc Grath and the actual
use of the building as recorded seems to be unclear. I would like to, for tax and mortgage
purposes, to clarify that this property will be a single family residence. I have prepared plans
showing the proposed changes and can submit them for your inspection.
I would like to request a meeting with you to discuss this matter at your convenience.
I can be reached by telephone or a mail at the above addresses.
Pk
Obert I. Mitnik
CITY OF SALEM, MASSACHUSETTS
BUILDING DEPARTMENT
120 WASHINGTON STREET,3RD FLOOR
f
TEL. (978) 745-9595
FAx(978) 740-9846
KINMERLEY DRISCOLL
MAYOR THOMAS ST.PIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
January 05,2011
Robert Mitnik A.LA
11 Pleasant Street
Gloucester Ma. 01930
R.E 91 Mall Street
Dear Mr. Mitnik,
I have reviewed the plans you dropped off for renovating#1 Mall Street. The City currently has
the building listed as two units. This is confirmed by your" existing conditions plan". Your
construction plans clearly indicate a conversion to a single unit home. This Department will issue
a building permit based on these drawings as soon as an application is received.This Department
forwards the building permits to the Assessors Department. The permit will state that renovations
are being done to convert a two unit building to a single unit. This will cause the Assessors
records to change and at the completion of the project and after the Occupancy Permit is issued
Assessors will arrange an Inspection to reevaluate and reclassify your home. If you have any
further questions, please let me know.
Thomas St.Pierre
G/ 1 '�
Building Commissioner/Zoning Officer
No.4City of Salem Ward
^ X
'pctmn.udJr
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, 11, Ill, IV, and/X.
��\ ',(/ ✓)
L AT(LOCATION) QS-T• ZONING
DISTRICT�-C2L
LOCATION (NO) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) )CROSS STREET)
LOT
SUBDIVISION BLOCK SIZE
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 ❑ Additlon(it residential,enter number of new 12X1 One family 18 ❑ Amusement recreational
housing units added,if any,in part D,13) 19 C] Chruoh,other religious
13 ❑ Two or more family-Enter number
3�Alteration(See 2 above) of units....................................................... 20 ❑ Industrial
4 ❑ Repair replacement 14 ❑ Transient hotel,motel,or dormitory- 21 ❑ Parking garage
Enter number of units ...........................
22 ❑ Service station,repair garage
5 ❑ Wrecking(H mudifamity residential,enter numberE] 23 ❑ Hospital,institutional
of units in building in Part D,13) 15 Garage
24 ❑ Ofhce,bank,professional
6 Moving(relocation) 16 ❑ Carport 25
❑ Public utility
7 ❑ Foundation only 26 ❑ School,library,other educational
17 ER Other-Specify 27 ❑ Stores,mercantile
B. WNERSHIP 28 ❑ Tanks,towers
8 Private(individual,corporation,nonprofit
institution,etc.)
29 ❑ Other-Specify
9 ❑ Public(Federal.State,or local government
C.COST (Omit 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 ......................._................................
$ parochial school,parking garage for department store,rental office building,office building
at industrial plant.If use of existing building is being changed,enter Proposed use.
To be installed but not included
aaEe above cost �O O
Electrical........................_.........................._.....................
_
b. Plumbing................................................_.............
........... Q
c. Heating,air conditioning............................................
d. Other(elevator.etc.)..........................................
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions, complete Parts E-L;demolition,
complete only Parts J&M,all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30_0 Masonry(wall bearing) 35 ❑ Gas 40�Public or private company Will there be central air
31WOOd freme 36 ❑ Oilconditioning?
41 ❑ Private(septic tank,etc.)
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_)o Public or private company
as ❑ Yes 47 ❑ No
43 ❑ Private(well,cistern)
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
48. Number of stories —es . ..........................................
49. Total square feet of floor area
all floors,based on exterior Has Approval from Historical Commission been received
dimensions ........................................................................ for any structure over fifty(50)years? Yes_ No_
50. Total land area sq.ft. - ............................................ Dig Safe Number
IC NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed.........................................................................
52. outdoors................................................_...................... HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed...................................._......._........................ Electric:
Gas:
54. Number of Fen......................................... Sewer:
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial................................... BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No_ (If yes,please enclose documentation from Hist Com.)
Conservation Area? Yes_ No_ (If yes, please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No_
Is property located in the S.R.A. district? Yes_ No
Comply with Zoning? Yes_ No_ (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No (If yes,submit documentationfif no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ No_
Is Architectural Access Board approval required? Yes_ No_ (If yes,submit documentation)�
Massachusetts State Contractor License# � �(co Salem License # �acrn) -)
Home Improvement Contractor# �C -') — 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
in writing to the Inspector of Buildings.
V. IDENTIFICATION • To be completed by all applicants
Nacre Mailing address-Number,street,city,and state ZIP Code Tel.No.
Owner or
Lessee �e '7F ft ;cfe 4
2.
Contactor
6uildeN p
cen
Lise No.
3.
Architect or
Engineer
I hereby certi hat the roposed work i authorized by the owner of record and that I have been authorized by the owner to make this ap lication
as his authoriz gent a0d we agrpe4Qjqonform to all applicable laws of this jurisdiction. I
Signature of applica t Address
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building
Permit number /5/_ �y FOR DEPARTMENT USE ONLY
y
Building /1// _ / Use Group
Permit issued tiM J! tg--L-L
Building
Fire Grading
�j
Permit Fee $ S Q•, (�a 4eLive Loading
Certificate of Occupancy $ Approved by: Occupancy Load
Drain Tile $
Plan Review Fee $
TITLE
NOTES AND Data• (For department use)
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by: Completed by:
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
n 6
COMMONWEALTH OF MASSACHUSETTS
`c JETAR1MZNT OF INDUSTRIAL ACCIDENTS
600 WASHINGTON STREET
— BOSTON, MASSACHUSETTS 02111
ur
;aes ::anooeu
- ss,one• WORKERS, COMPENSATION INSURANCE AFFIDAVIT
(IICCDsee/DCRRIRe[l
with a principal place of business/residence ar:
(Ciryisramizip)
do hereby certify, under the pains and penalties of perjury. that:
] I am an emolover providing the following workers' compensation coverage for my empiovees working on this
loo.
Insurance Companv Policy Number
v
1 am a sole proprietor and have no one working for me.
( J 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below
who have the following workers' compensation insurance policies:
Name of Contractor lnsurance Company/Policy Number
lame 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 wort[on a
ral
dwelling of not more than three units in which the homeowner also resides or on the gmunds appur awl thereto am not genely
considered to be empiovers under the Workers' Compensation Act(GL C. 152.sect. 1(S)), appiication by a bomeowper for a license
or permit may evidence the legal sum&of an empiowr under the Workers Compensation ACL
i understand that a copy of rhis statement will be forwarded to the Dewrtment of Industrial AccidentsOffice of insurance for eoveraae
�enneauon and at failure so secure mvenee ss repmmd under 5ccrion 25A of MGL 152 can iead to the imposttion of criminal pertaides
consisun¢of a Fn f up to 51500.00 andior imprisonment of up to one yew and civil penaities in the form of a stop Work Order and a
Fine of S 100.00 a d nit me.
Signed this day of 19
Licenseei Pcrmiaec licensor/Permittor