106 MARGIN STREET - BUILDING JACKET 106 MARGIN ST.
No. _1ZQ — ql� City of Salem Ward
�H.corrort�
� x
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, It, Ill, IV, and I
I. AT(LOCATION) I 0 1, m R RTo 66 3t2=-_
�L DISTRICT
LOCATION (NOT (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS LOTET )
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING -All applicants complete Parts A -D k
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
(rousing units added,if any,in part D,13) 19 ❑ Chruch,other religious
of
13 ® Two more family..Enter number
3 ❑ Alteration(See 2 above) of units ....................................................... 20 ❑ Industrial
i
21 ❑ Parking garage
4 ® Repair replacement 14 ❑ Transient hotel,motel,or dormitory-
Enter number of units 22 ❑ Service station,repair garage
5 ❑ Wracking(R multifamily residential,enter number23 E] Hospital,institutional
❑
of units in building in Part D, 13) 15 Garage
24 E] Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
7 ❑ 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 ❑ Other-Specify
9 ❑ Pubfk(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,
11A/� .�. parochial school,parking garage for department store,rental office building,office building
10. Cost of improvement ...... ..'.lL,.11...7..11.....>....................... $ at industrial plant.If use of existing building is being changed,enter proposed use.
To be installed but not included
in the above cost 7 Z
a. Electrical..................
{...,V.1..n.................................................
b. Plumbing................fl..0._M.E...................................
c. Heating,air conditioning..�01)E7.....................
d. Other(elevator,etc.)_?..............................................
11. TOTAL COST OF IMPROVEMENT $
111. 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 1. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ❑ Gas 40 ❑ Public or private company Will there be central air
31 Wood frame 36 Oil 41 E] Private(septic tank etc.) conditioning?
32 ❑ StnKtural 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 stones ................................
as. Total square feetf area,
all floors,based o Has Approval from Historical Commission been received
nfloor exterior
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
Full........................................... Sewer:
-
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ NoX— (if yes, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ No-X (If yes,please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? YesY No_
Is property located in the S.R.A. district? Yes_ No
Comply with Zoning? Yesy— 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? Yes_ No_
Is Architectural Access Board approval required? Yes_ NoY— (If yes,submit documentation)
Massachusetts State Contractor License# Salem License#
Home Improvement Contractor# Homeowners Exempt form (if applicable) Yes—VO'5o'
CONSTRUCTION TO BE COMMENCED WITHIN SIX (6)MONTHS OF ISSUANCE OF BUILDING PERMIT
If an extension is necessary, please submit
CONSTRUCTION IS TO BE COMPLETED BY: 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.
1. tagiLO
Owner or
Lessee
2.
Contractor
Builder's
License No.
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner t0 make this application
as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applica ♦ - Address�� �� i Application dalp,�
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building �_n FOR DEPARTMENT USE ONLY
Permit number �( 7
Building (a Use Group
Permit issued A—E 19
Fire Grading
Building J o0 n .
Permit Fee $ �� r� /i/ Live Loading
Certificate of Occupancy $ Approved by: I
occupancy Load
Drain Tile $
Plan Review Fee $
TITLE
NOTES AND Data• (For department use)
�c Afo vzc o cD PL ,6^ s%Cr Gv,911 RNs v w%c
p s // lVFc✓ f3 )30,4 R Di
SND S �ia7 cO ��
PERMIT TO BE MAILED TO:
DATE MAILED: &1,1A
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
(. �I
CITY OF SALEM
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE nl,-f(,--(j,3
JOB LOCATION =C'E
Number Street address Section of Town
"HOMEOWNER
ame Home phone Work p one
PRESENT MAILING ADDRESSMph
� �
City/Town State n p I 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 an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor. (State Building Code Section 109. 1 . 1 )
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 responsible
for all such work performed under the building permit. Section 109. 1 . 1
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 re irements and that
he/she will comply with said procedures and r ireme
HOMEOWNER' S SIGNATURE pjY�p
APPROVAL OF BUILDING OFFICIAL
L�
NOTE: Three family dwellings 35,000 cubic feet, or larger, will be required
to comply with State Building Code Section 127.0, Construction Control .
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
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.
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 certifv 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.
MGM 4
COMMONWEALTH OF MASSACHUSETTS
� E
�' E�(R JEFAIr:MENT OF INDUSTRIAL ACCIDENTS
k
_ 600 WASHINGTON STREET
fames Gamooei, BOSTON, MASSACHUSETTS 02111
omm,sslone, WORKERS' COMPENSATION INSURANCE AFFIDAVIT
I,
(licensee/permirree)
with a principal place of business/residence at:
(City/St=/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
[ ) 1 am a sole proprietor and have no one working for me.
[ ] 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 Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
Vam a homeowner performing all the work myself.
NOTE: Please be aware that while homeowners who employ persons to do maintenance,construction or repair work on 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 Aa(GL C. 152,sea. 1(5)), application by a homeowner for a license
or permit mey evidence the legal:=-as of an emp!oyr under the Workers' Compensation Act
I understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' office of Insurance for coverage
verification and that failure to secure coverage u required under Section 25A of MGL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to $1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 5100.00 a day against me.
Signed this day of 19
Licensee/Permittee Licensor/Permittor
� R
_ wry' J �� �I.erJuiaGosr� mniai Jrsawaawtvs
_ J
MichaelDukakis
G �` ��� � ___iJ•__
ovamor
Kentaro Tsufsumi G v f� •llamas ✓io0a2.408
Chairman
16171 7^_'•3;
Charles J. Dineuo
Administrator
MEMORANDUM
TO: All Building Departmcnts6tatc Building Inspectors
FROM: Charles J. Dineuo. Administrator
DATE. October 31. I989
SUBJECT. MGL cad, S54, Added By e5PA. S9 of the AM of 19117
71tc above-mentioned statute requires that debris resulting from the demolition. renovation. rehabilitation
or other alteration of a budding. or structure he disposed of in a praperiv licensed solid waste disposal
iaatuv as defined by MGL c111. S150A anu that huddine permits or licenses arc to indicate the location
of the tacildv at which the said debris is to he disposcu. THIS REOUIREMENT DOES NOT
,\PPLY TO NEW CONSTRUCTTON.
In order to simotifv the process and to provide uniformity, we arc attaching a copy of a form which you
can either reproduce and use as it is since the completed form will be attached to the office utpy of butlding
permits or licenses: or reproduce it on your Icucrhad.
In ase of municipal,commercial.industrial,ur multi•umt housing construction. the contractor may not know
the dumpster subcontractor at the time of the budding permit application. In such cues. the attacked copy
of an Affidavit an be used.
The complete taw is contained in the November issue of CODEWORD which will he matted to you in the
next two weeks. If you should have anv question. please let us know.
CJD/km
s ;
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S
150A.
The debris will be disposed of in:
� uneQ �Rllc�ulG � �6�pi�L
(Location ofFacility)
Cron I MPS
Signature of Permit Applicant
Date
7A �
4
Cow
�Wna 1P�S
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
9 North Street
ROBERT E. BLENKHORN Salem, Massachusetts 01970
HEALTH AGENT
508-741-1800
February 24, 1993
John Occupinti G.M.A.C.Mortgage Company
108 Margin Street 3451 Hammond Avenue, P.O.Box 780
Salem,MA 01970 Waterloo, Iowa 50701/07
Dear Sir/Madam:
In accordance with Chapter 111,Sections 127A and 127B,of the Massachusetts General Laws, 105 CMR 400.00:State
Sanitary Code,Chapter I: General Administrative Procedures and 105 CMR 410.00: State Sanitary Code,Chapter II:
Minimum Standards of Fitness for Human Habitation,an inspection was conducted of your property located at
106 Margin Street Apt l occupied by Nancy Allphin conducted by Virginia Moustakis,Sanitarian of the Salem Health
Department on February 17,1993 @ 10:30 a.m.
Notice:If this rental unit is occupied by 4 child or children under the age of 6 years,it is the property owner's
responsibility to ensure that this unit complies fully with 105 CMR 460.000:Regulations for Lead Poisoning Prevention
and Control.For further information or to request an inspection,contact the Salem Health Department at 741-1800.
You are hereby ORDERED to make a good-faith effort to correct these violations in accordance with the enclosed report.
Failure on your part to comply within the specified time will result in a complaint being sought against you in Salem
District Court.
Should you be aggrieved by this Order,you have the right to request a hearing before the Board of Health. A request for
said hearing must be received in writing in the office of the Board of Health within 7 days of receipt of this Order. At said
hearing,you will be given an opportunity to be heard and to present witness and documentary evidence as to why this
Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have
the right to inspect and obtain copies of all relevant inspection or investigation reports,orders and other documentary
information in the possession of this Board, and that any adverse party has the right to be present at the hearing.
Please be advised that the conditions noted may enable the occupant(s)to use one or more of the statutory remedies
available to them as outlined in the enclosed inspection report form.
For the Board of Health Reply to:
A� c V
Robert E.Blenkhom,C.H.O Virginia Moustakis
Health Agent Sanitarian
cc: Tenant
Electrical Department
Fire Department /
Building Department
CERTIFIED MAIL P 348 634 492 John Occupinti
P-348-634-493 G.M.A.C. Mortgage Company
Pagel of to
SALEM HEALTH DEPARTMENT
9 North Street
Salem,MA 01970
'44Ma State Sanitary Code, Chapter lit 105.CMR 410.000
Minimum Standards of Fitness,for Human Habitation
occupant: %1N Phone: 71/51—9e�43
Address: Z0/ (a,&/N . ) Apt. _� Floor
` Owner , AI n 1D _ Address: _/ Zlke(y( k)Jf S& � MfG
C e-'u7k. e./✓IAG . .
Inspection Date: ,r24 / 23 Time:
Conducted By: J410 -IN aOUS7-A&_l.S Accompanied By: TZ� /aeiIZS
Anticipated Reinspection Date:
Specified Reg # Violation
Time 410. . . . ,.
A% 770 AJ L�4c
S N R
(7,000 &lAllrn�r
Y'✓ rE /✓
AIC /2 N
An Id
N
rP L
Y
a '& L,
One or more of the above violations may endanger or materially impair
the health, safety and well-bein or the occupants(s).
Code Enforc meet Inspector
Este es un documento legal importante. Puede que afecte sus derechos.
Puede adquidruna traduccion de esta forma.
APPENDIX 11(14)
Legal Remedies for Tenants of
Residential Housing
The following is a brief summary of some of the legal remedies tenants may use In order to get housing code violations
corrected:
1. Rent Withholding(Massachusetts General Laws,Chapter 239,section 8A):If Code Violations Are Not Being Corrected you
may be entitled to hold back your rent payments.You can do this without being evicted if:
A. You can prove that your dwelling unit or common areas contain code violations which are serious enough to endanger
or materially impair your health or safety and that your landlord knew about the violations before you were behind in
your rent
B. You did not cause the violations and they can be repaired while you continue to live in the building.
C. You are prepared to pay any portion of the rent into court if a judge orders you to pay iL(For this,it is best to gut the
rent money aside in a safe place.)
2. Repair And D , t(Massachusetts General Laws,Chapter 111,section 127L):7'he law sometimes allows you to use your rent
money to make the repairs yourself.If your local code enforcement agency certifies that there are code violations which
endanger or materially impair your health,safety,or well-being,and your landlord has received written notice of the violations,
you may be able to use this remedy.If the owner fails to begin necessary repairs(or to enter into a written contract to have them
made)-within five days after notice or to complete repairs within 14 days after notice,you can use up to four months'rent in any
year to make therepairs
3. Retalial=Rent laccaases or Evictions Prohibited(Massachusetts General Laws,Chapter 186,section 18,and Chapter 239,
section 2A):The.ownei may not increase your rent or evict you.in retaliation for making a complaint to your local code
enforcement agency about code violations.If the owner raises your rent to pies to evict within six months after you have made
the complaint,heoi she will:have;Wo show,a good.reasonfor,the increase or eviction:which.is.:unrelated to.your complaint-You
may be able to sue the landlord for damages of he or she tries this....,
4 Rent Receivership(Massachusetts General Laws,Chapter 11,section-127CGH) The occupants and/or the Board of Health may
petition the District or Superior.Court to allow rent to be paid mtoFcourt rather:than to_the.owner.The.courtmay then appoint a
"receiver"who may spend as much of the rent money as is needed to correct the violation.The receiver is not subject to a
spending limitation of four months'rent
5. Breach of Warranty of Habitability You maybe entitled to sue your landlord to have all or some of your rent returned if your
dwelling unit does not meet minimum standards of habitability.
6. Unfair and Deceptive Practices(Massachusetts General Laws,Chapter 93A):Renting an apartment with code violations is a
violation of the consumer protection act and regulations,for which you may sue an owner.
The information presented above is only a summary of the law.Before you decide to withhold your rent or take any other
legal action,it Is advisable that you consult an attorney.If you cannot afford to consult an attorney,you should contact the
nearest legal services office,which is:
Neighborhood Legal Services
37 Friend St.
Lynn, MA 01902
(617) 599-7730
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