17-19 NAPLES STREET - BUILDING INSPECTION {
17-19 NAPLES STREET
(Atu of *41em, MUSSUc4usetto
1 Publir Fruptertq ]Department
Nuilding Bepartment
Out Salt (6rren
508-745-9595 E". 380
William H. Munroe
Director of Public Property
Inspector of Buildings
Zoning Enforcement Officer
September 29, 1992
TO WHOM IT MAY CONCERN:
RE: 17-19 Naples Road (R-1)
After inspecting the above referenced property and after researching
records relative to this property, I have determined this property to be
a legal nonconforming two family dwelling. 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,
Maurice M. Martineau
Acting Zoning Enforcement Officer
Acting Inspector of Buildings
MMM:bms
City of Salem Ward
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APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT•Applicant to complete all items in sections:1, it, III, IV, and IX.
�R�/�,S - ZONING
I. AT(LOCATION) / 7 DISTRICT
LOCATION "o.l srneen Ln �y -
OF BETWEEN eu /1 L✓ � AND
BUILDING caosssrnFp nosSL—� rnEen v
OT
SUBDIVISION LOT 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 ❑ Addition(It residential,enter number of new 12 ❑ One family 18 ❑ Amusement,recreational
/rousing units added,it any,in part D,13) - 19 [:] Chruch,other religious
13 I61,Two or more family-Enter number ❑
3 Alteration(See 2 above) ! of units ........... 20 Industrial
...................................
21 E] Parking garage
4 Repair replacement 14 ❑ Transient hotel,motel,or dormitory-
FA Enter number of units ...........................
22 ❑ Service station,repair garage
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
26 ❑ School,library,other educational
7 ❑ Foundation only 17 ❑ Other-Specity
27 ❑ Stores,mercantile
B.O77W777eecccwwwwwNERSHIP 28 E] Tanks,towers
!IN
Illi Private(individual,corporation,nonprofit
I1 29 [:] Other-Specify
institution,etc.)
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,
parochial school,parking garage for department store,rental office building,office building
10. Cost of improvement ......................................................... $ V,,) D at industrial plant If use of existing building is being changed,enter proposed use.
To be installed but not included
in the above cost
a. Electrical...........................................................................
b. Plumbing..........................................................................
c. Heating,air conditioning.............................................
d. Other(elevator,etc.).....................................................
11. TOTAL COST OF IMPROVEMENT $ 2.C903
III. SELECTED CHARACTERISTICS OF B ILDING For new buildings and additions, complete Parts E-L;demolition,
complete only Parts J&M,all others ski to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ❑ Gas 40 ❑ Public or private company Will there be central air
❑ ❑ ❑ Private(septic tank,etc.) conditioning?
31 Wood frame 36 Oil q1
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 Boor 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.B ................ Dig Safe Number
K.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 Full........................................... 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_ NOV (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_ NOV
Comply with Zoning? YesA 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_ No (If yes,submit documentation)
Massachusetts State Contractor License# alem License#
Home Improvement Contractor# Homeowners Exempt form (if applicable) Yes—V---*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
{/ Name Mailing address.Number,street city,and state ZIP Code Tel.N/
Lesseeo.
1. V` 60 J ' / / .�( 7 Y
Owner or
2. <!
Contractor
Builder's
License No.
3.
Architect or Al A
Engineer
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 agent and we agree to conform to all applicable laws of this jurisdiction.
Signat of applicant Address App ication date
Z '
e.
COMMONWEALTH OF MASSACHUSETTS
E k DEPAK MENT OF INDUSTRIAL ACCIDENTS
,L 600 WASHINGTON STREET
lames� camooei, BOSTON, MASSACHUSETTS 02111
cmm•ss one WORKERS' COMPENSATION INSURANCE AFFIDAVIT
1,
(I icen seei perminee)
with a principal place of business/residence 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
( ] I am a sole proprietor and have no one working for me.
[ ] I 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 lnsurance 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 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 Act(GL C. 152,secs. 1(5)), application by a homeowner for a license
or permit may evidence the legal trams of an employer 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 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$100.00 a day nst me.
Signed this //' day of19 y
Licensee/Permittee Licensor/Permiaor
Ile
CITY OF SALEM
3UILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE 2 //� /
JOB LOCATION / 7 lG 5 &C' . f9 q /G
Number / treet address Section of Town
"HOMEOWNER 19 Lo2rt ¢/o ✓�Ty2Cl Z5�`�G,1 /Cf' 2 cilI
Name Home phone Work phone
PRESENT
�MAILING ADDRESS //�.¢� �z3 L
City/Tow ,tate [ip Lode
The current exemption of "homeowners" '.vas 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 oerformed under the buildina permit. Section 109.17
-he undersigned "homeowner" assumes responsibility for compliance with the State
Z,uiiding code and other applicable codes . by- laws, rules and reguiations.
The undersigned "homeowner" certifies that he/she understands the City of Salem
Building Department minimum inspection procedures and requirements and that
he/she willcomply with said procedures and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
O
NOTE: Three family dwellings 35,000 cubic feet, or larger, will be requ red
to comply with State Buildina 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.
-o 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.
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19
Fire Grading
Building po
Permit Fee $ 40 Live Loading
Certificate of Occupancy $ occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ /J
O crxY T LE
NOTES AND Data a4F �
,,// / X
111(6 kill
Y PERMIT TO BE MAILED TO' C t.rf iZ¢Jz
k' 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