57 OSGOOD STREET - BUILDING JACKET u`�� cod
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ORDER
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WE'T`LAND PROTECTION ACT
G.L. C. 131 s. 40
FILE NUMBER : 64-41 PROJECT LOCATION: 57_Osgood Street
Salem; Mass.
TO: Helen Beharrel CERT. MAIL NO: 7167922
57 Osgood Street .
Salem, Massachusetts 01970
RE: NOTICE OF INTENT AND PLANS DATED: DATE OF RECEIPT BY
April 24, 1979 CONSERVATION COMMISSION: April 23, 191
DATE OF PUBLIC HEARING:
May 15, 1979
Pursuant to the authority of G,L. C. 131 s. 40, the Salem
Conservation Commission has considered your notice of intent and plans
submitted therewith, and has determined t:%zt. the area on which the pro-
posed work isto be done is significant to one or more of the interests
described in the said act. The Salem Conservation Commission
hereby orders that the following conditions are necessary and all work
must be performed in strict accordance with said conditions and with the
Notice of Intent and Pians, unless modified by said conditions:
f
CONDITIONS
1 . Failure to comply with all conditions stated herein, and with all
related statutes and other regulatory measures, shall be deemed
cause to revoke or modify this order.
2 . This order does not grant any property rights or any exclusive
privileges; it does not authorize any injury to private property or
invasion' of private rights.
3. This order does not relieve the permittee or any other person of the
necessity of complying with all other applicable federal, state or
local statutes, ordinances, by-laws and/or regulations.
4 . The work authorized hereunder shall be completed within one (1) year
from the date of this order unless otherwise stated below Dursuant
to Regulation 6.7. The order may be ex-
tended by the issuing authority for one or more additional one-year
periods upon application to the said issuing authority at least
thirty days prior to the expiration date of the order or its extension.
5 . Any rill used in connection with this project shall be clean fill,
containing no trash, refuse, rubbish or debris, including, without
limiting the generality of the foregoing, lumber, bricks, plaster, t
wire, lath, paper, cardboard, pipe, tires, ashes, re`rigerators,
motor vehicles or parts of any of the foregoing.
oDn
- 26
,rd ;"xC , =; _UED PAGE 2 FILE NO. 64-41
6 . No work may be commenced until all appeal periods have elapsed from
the order of the Conservation Commission or from a final order by
the Department of Environmental Quality Engineering:.
7 . No work shall be undertaken until the final Order, with respect to .
the proposed project, has been recorded in the Registry of Deeds
for the district in which the land is located within the chain of
title of the affected property. Copy to be furnished to issuer of
this Order showing book and page Prior to comencerent_ of work.
8. Upon completion of the work described herein,- the applicant shall
forthwith request, in writing, that a Certificate of Compliance be
issued stating that the work has been satisfactorily completed.
9 . A sign shall be displayed at the site not less than two square feet
or more than three square feet bearing the words, "Massachusetts
Department of Environmental Quality Engineering. Number 64-41
10. Where the Department of Environmental Quality Engineering is
requested. to make a determination and to issue a superseding order,
the Conservation Commission shall be a party to all agency pro-
ceedings and hearings before the Department.
11. The work shall conform to the following described plans and
j additional conditions.
That the work conform to the plan dated April 20, 1979 entitled " Plan
of land in Salem", showing proposed new stone rip rap to repair storm
damage. for Helen Beharrel, April 20, 1979 and prepared by Essex Survey
Service Inc. , 47 Federal Street, Salem, mass. 01970.
-27-
GC"-D IT IONS CC:;T`"M70 PAGE 3 FILE No. 64-41
1
The applicant, any person aggrieved by this order, any owner of
land abutting the land upon which the proposed work is to be done, or
any 'ten residents of the city or to,,m in which such land is located,
are hereby notified of their right to appeal this order to the Depart-
ment of Environmental Quality Engineering provided the request is made in
writing and by certified mail 'to the Department within ten (10) days from the issuance
of this order.
ISSUED By Salem Conservation Commission Ill
I I I
JUNE 5, 1979
Date of Issuance
on this __Z-_Z_/ dap of �� 19J/, before me
personally appeared%/�1_ c�+_;--.i l ��i�> � ���✓'
to me known to be the
person described in and who executed the foregoing instrument and acknow-
ledged that he executed the same as his free act and deed.
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CITY OF S.U.EM
PUBLIC PROPERTY
DEPARTMENT
K110FilhY ivw-n�
130 w"A9aWTOM STxsa7•WSK MAMMN SEM 01970
Tm-97L73S-9S"9 Fnx.97L7d0.9W
HOMEOWNER LICENSE EXEM"ION
Please Print
Date
Job Location � Q
Home Owner Address 51 —
Home Owner Telephone q Z 15— ?'F S— D��
Present Mailing Address D'�,irp amp
The current exemption of"Homeowners"was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who,does not possess a license,provided that the owner acts as supervisor.
DEF24MON OF HOUWWNMt
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on
which there is, or is intended to be,a one or two family dwellin& 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 be responsible for all such work performed under the Building
Permit.
The undersigned "homeowner" assumes responsibility for compliance with the State
Building Code and other applicable by-laws 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 said procedures and quiremrnts.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING INSPECT R
See other side for state code
CITY OF SALEM
PUBLIC PROPRERTY
1 lid,
,� r DEPARTMENT
."%I:::%I el I'M1lx `I 1.
�I.vi K 11C W.%9 It\(;:oN S:QEET ♦S.%Li'M, MA<iAC!LL ,LI
978J45•')595 • r..alc:978-74G9846
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 730 Ch1R section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit Ai-._ _ is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by v1GL c
1 11, S 150A.
The debris will
be transportedby:
(name of hauler)
Hie debris will be disposed of in
Inamr of tacihty)
?> _ � � Octa
� The Commonwealth of Massachusetts I OR
Board of Building Regulations and Standards
• ' Massachusetts State Building Code, 780 CMR, T"edition MUNICIPALITY
V.I'll'
USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a Reviser/Junum;%
One- or Two-Fmnrly Dwelling /, 204
This Section For Official Use Only
Building Permit Nu \ Date Applied:
Signature. '> (0 t ��
u v
Building Commi)ssigger/ Inspector of Buildings Date
SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map & Parcel Numbers
•S'7 f�Crn7�� � -
-r Ma Number Parcel Number
L la Is this an accepted street'?yeses no_ p
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq It) Frontage(tt)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system
❑
Public❑ Private❑ Check if yes❑ p po y
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner[of Record:
F M�
Name(Print) Address for ice:
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction ❑ Existing BE
g Owner-Occupied Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory . ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work 2: r7 F r,�g' C�A2 S,4A[e FS
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/town Application Fee
2. Electrical $ ❑Total Project Cost(Item 6) x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees: $
Pinmressionl
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ (�,6jCF Paid in Full ❑ Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
License Number Expiration Date, ,
Name of CSL-Holder List CSL Ty
pe(see below)
Address T Description
U Unrestricted(up to 35.000 Cu. Ft.)
R Restricted 1&2 Family Dwelling
Signature M Masonry Only
RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Registered Home ImprovetQent Contractor(HIC)
IJ �c � 0`1 IIA�_LY
HIC Company Name or HIC Registrant Name Registration Number
\ Address
Expiration Date
Q� Signature Telephone
0 SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152.§ 2506))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .......... O No........... O
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property hereby
authorize to act on my behalf, in all matters
relative to work authorized by this building permit application.
Signature of nei Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
[, as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and
behalf.
Print Name
i"
Signature of Owner or Authorized Agent Date
(Signed under the pains and penalties of perjury)
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC) Program), will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.116 and 1 IO.RS, respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq. Ft.) (including garage,finished basementlattics.decks or porch)
Gross living area(Sq. Ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage' may be substituted for"Total Project Cost"