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331 LAFAYETTE ST - BUILDING INSPECTION 5 SS C-Ac 1 t 3� .C\- The Commonwealth of Massachusetts Department of Public Safety Massachusetts State Building Code(780 CMR) 4 Building Permit Application for any Building other than a One-or Two-Family Dwelling (Phis Section For Official Use Only) Building Permit Number: Date Applied: Building Official: SECTION 1:LOCATION(Please' dicate Blo k#and Lot#for locations for which a street address is not available) 331 't - e& S _ , �Ateol Al�_ 00.70 No.and Street City/Town Zip Code y Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ 1 Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ 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:_ ^ P I - , C; 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): 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(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-1 ❑ F2❑ FRIHigh Hazard H-1 ❑ H-2❑ H-3 ❑ H-h O H-5❑ I: Institutional I-1 ❑ 1-2❑ I-3❑ 1-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA 13 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❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑ Private❑ or indentify Zone: or on site system❑ required❑or trench or specify: permit is enclosed❑ Railroad right-of-way: I Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: 10111 Cf::,�L-4gD 14 P' V SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner 331 �6,sj j4t CCC 7S N4vlePa5llewtefi WAJ�k, eJ Name(Print) No.and Street City/Town Zip Property Owner Contact Information: p qy' f nff Rog �3V✓r r1?��Z 00 _ ���� l2l vW tl/r/vrrlrweT/YeaT� orb Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property o ner 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 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 0 and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor lYC0 YJ Company Name A, Stow T:�-J Viw CS- (j6s4Yb Name of Person Responsiblefo r Construegqon License No. and Type if Applicable i? b 5VV4WD5 oke- Pd , Q� lM M &_ —_ ____0(41b Street Address City/Town State Zip Telephone No. (business) Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT .G.L.c.152.§ 25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes O No E3 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs: (Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ Yb U b Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)_$ 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ 5—b O (co ct municipality)and write check number here SECTION 13:SIGNATURE OF ILDING PERMIT APPLICANT By entering my name below,I hereby attes under the penalties of perjury that all of the information contained in this application is true and accur to to the best kno le a understanding. r? 617 to IV Please print an i n e � t .A1 �ATi�t,lAe� M , Telephone No. Date �i �" �w d U.-f1 SG'ty�--l�vJ.t 01 J/�1 �'!� �-f�11 Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date SALEM LEGEND: 114 AVENUE FOREST BIT BITUMINOUS UE CONC CONCRETE NUE � FOREST RIVER PARK" DH DRILL HOLE CLIFTON t A LOCUS �os 9�F C0w EOP EDGE OF PAVEMENT St P�NVE O U z z w FND FOUND Z 00 d N IP IRON PIPE / V wA� Co J�" J ROPO z ? W-. IR IRON ROD c�� nn z o TO TOP CURBING ^ Q / p�P�� �� STATE U TE �� spy ROAD LL g w /4 pQ COLLEGE" SP D > U) S VGC VERTICAL GRANITE CURB o W ` ( w = , TRAFFIC LIGHT DMH w J 22s � O co o RIM=29. 07 c c 18" INV.=22.6 2 r3 FREDERICK NEMIROVSKY 2 �,� LOCUS MAP N.T.S. N w � ® GAS METER (GM) 327 LAFAYETTE STREET a �� CONCRETE p LL z Co -� 16330/93 tTj PAD 1 O V z N 4, v7 29 - -�'Y V m © GAS GATE (GG) m ` NEW ENGLAND TELEPHONE AND /� 0 Z Z o ° / TELEGRAPH COMPANY EASEMENT DEED N65'01'OTE. 113 B6' VERIZON J is a ® CATCH BASIN (CB) ' o � BOOK 10961 PAGE 60 _ TRANSFORMER > , OChi: yo'n° 5j _ _�. _-�z�5 o �i RECORD OWNERS: v s SEWER MANHOLE (SMH) / 2823 o s� ` ` - o n / DRAIN MANHOLE DMH D �� Q = 3 2 '8 f `�� �- L / LEE FAMILY ENTERPRISES (DMH) DR - +27.2 a ? f� o \ -30� NEW ENGLAND TELEPHONE 331 LAFAYETTE STREET �VSETT HYDRANT z / \ 0 AND TELEGRAPH COMPANY DEED BOOK 18842 PAGE 485 EASEMENT DEED BOOK 11 60 �y a dd 2J f� O ry +29.6 ' \ PAGE 461 PATRICIA GROVE & LILLIAN PRINCE BIT. GONG.POLE LBJ� o o z< a _ / \ lr ?9 PARKING LOT ��/ 11 WEST AVENUE r UTILITY POLE WITH LIGHT / / 02897 ry o +30.6 / m �- DEED BOOK 25955 PAGE 113 t '� � � +;!8.8 s T $ hN LIGHT POLE (LP) 3 / `'� / o rg o I ti '1 0 331 LAFAYETTE LLC °rywoo P M OHw �Hw w� -30- I /a� of +27.7 5-7 WEST AVENUE METAL POST �' o DHw oHw---�_ q],UY o �l ( DEED BOOK 34478 PAGE 81 SIGN 3 / o Mo ...........„ ,.,,,,,,, ,„ ,,OHW „ .,,, ,,......... DHw„ „ ,,,,,,,, ,,,,,, , #RE �v� )3.9' � / /� pF '1:s'' ' ' _ REFERENCES: MAILBOX W / / 029.47 , M j Ak\4$22 GAS METER +30.Py/ o ^ 12g, 11 234 v c� Co +73.86 �^� DOOR=0.83 /'� o I'I N R PATRICIA cRovE &03 ESSEX COUNTY REGISTRY OF DEEDS } o SPOT GRADE / / / 1� I 1 / DEED BOOK 18842 PAGE 485 a J O ILILLIAN PRINCE „ 81 DEED BOOK 24030 PAGE 425 a WI J 0 11 EST AVENU\ 32 DEED BOOK 13366 PAGE 150 N c� N W WATER LINE o / c a / 4 r J ? 235 n r 7,750± Sq. Feet - ` ) b PLAN BOOK 866 PLAN 147 o N D DRAIN LINE / 0.171 Acres / i } m I m m / 0 30.05 % a °, / PLAN BOOK 183 PLAN 76 m m m CO # 32 of / PLAN BOOK 951 PLAN 113 C° S SEWER LINE o' � 331 231 (� / / 3 / PORTION OF ; 30.4 O +29.8 I "d / > W ' o w UGE ELECTRIC LINE a /F LEE FAMILY ENTERPRISES BUILDING / -_ -J IYKj \ PLAN 134 OF 1972 ���., � = a U a / 331 LAFAYETTE STREET CONCRETE ENCROACHES 5.4' \ PLAN 226 OF 1972 `` " a_ < 18842/485 0 PLAN BOOK 388 PLAN 93 Cn o U a V) 0 T TELEPHONE LINE z 3 =/ E j PAD PORTION OF O Q / 23,525± Sq. Feet BUILDING N/F 0.540± Acres ENCROACHES 2.3' EOP GREGORY & CYNTHIA GAS / SI GAS LINE / Y / 1.60' E,,,,,, 76.90' GRAVEL \ o S ........N7,B;22'J,7�. 07 13 WEST AVENUE OHW VI000 """""" � -� AREA 25955/113 3 3 / �,,,,.,„ �- EOP 3 0 OVERHEAD WIRES w / ENCLOSURE 1-- r N11'37'37�W 0 -- WOOD FENCE + / / a3D.9s V i / 16.00' " J �3 L cD to N75'29'22'E 74.60' 8 SPACES +30.9 e ASSESSORS MAP LOT I / - - (Nor STRIPED) 32 / - 't "' "'� DOOR= IN 6'42'23°E N N PARKING LOT =J - i B 335 31.58 j \ 3 90' BIT, CONC. N£ 1.4' w p 1, # 232 v mnrn - WOOD / , „,,, -i°� o� 11.5' WOOD STEPS / o co 3 / /y / /6�'9 N/F THOMAS TRUONG % 5 0, i i / STEPS i 61o, - l. P� 335 LAFAYETTE STREET I ' , % , f•31.5 ' / m v/ / I / 31.60 ,/ M / DQE 24030/425 DOOR= S $„ ' / „ „ 2 1 2 STORY - zo ^� o ; 4,918± Sq. Feet 33.24 % 5,8651 Sq, Feet 2 / Y r I HEREBY CERTIFY THAT THE BUILDINGS ARE LOCATED AS SHOWN AND THAT THIS w 1 lit 0 / 0.113± Acres y 0.135± Acres u 3 / WOOD FRAME ' c = / 25, i 233 0 0 2-FAMILY i PLAN IS BASED ON AN ON-THE-GROUND SURVEY AND PRESENTS THE FACTS AS Cf Ln O WOOD DECK ; PEAK=66.58' 331 CAFAYE17E LLC \ ` ' 32.5 #13 w n / & STEPS % % 34478/81 % DWELLING FOUND AT THE TIME OF THE SURVEY. o D ` BIT. CONC. i i < o f i WOOD 3I %/ �1ti %„""'✓ MDRIVEWAY- m ' DOOR- #5-7 % `/32_ V 0 LANDSCAPED ` STEPS BULKHEAD �P 1 _ /o Q DOOR= / « "4 /' BIT. C NC +32.2 # 4, c� S I /� �„ 6.86„i/ O,y/L o cJ', \. I .3, „ m ,,,,. , DRIJ 11.7 ,,,.,, 1,,. / STONE PAVER 2��ySt+°FnSgo 0 3 / / r 3VrG WALL DOOR= +33.7 }3 \ J o / GRASS o GRASS° EDWARD tiG z / M 3.0' 33.52 OS{y ti / \ �7 '� 33 o DIXON " Ld 32.66 J " '^" '^"'••' •^ ' ' S7618'18'W 8830'_ 84.00' 6 J o 7 8'16"W 38.00' 40.00' 50.11' 47.44' No. 34304 c - - -CONCRETES WALK 'Y - - -3? �RF d o ° BIT. CONC. SWL D D ly s% p 2d� VGC ��� ry? �x o VGC VGC �9 �> r u uum WA1FR /_ `j., ( 12" VC DRAIN ? y A ° `'?? �S BIT. Q ( S T" S=W, D? D D D D D[- D D D D - -a- D -D ' D D D CANE- D D D D D D D - -Z�� �Gj• S -�-�-w w N W w w ` _ WALK PROFESSIONAL LAND SURVEYOR DATE (! �r _-� 1 " VC SEWS w W W W W w�- M 3 (Bt) s '� S._ S S o vii w w w w o w w w w w w - r. D - - _ 1T _S S S S S S o 5 S S o 1S11 / I R1 �� - i2" WATER oy ``�0 5 S S S S S S S i N O w. , w w w w -B o w w w w w c w w w w w W W w -�- w w w - (n _s G G G G G G3 G G --�''- G 4" GAS G G v G G G G G G G G G G G G G G EOP - _ EOP Ld 0*8 N V N _ - - - -- -33- - - Q � ^ J 3 I MH (BLOCKED) DMH I SMH DMH J = N / I RIM=33.58 115' INV.087.1 RIM=32.31 R8" INV.o22.6 LL_ V N B" INV.=28.3 8" INV.=26.8 O Q N O Lo Z C/5 �p PLAN NOTES: 05 n a g 1. THE EXISTING CONDITIONS INFORMATION SHOWN HEREON FOR 331-335 LAFAYETTE STREET AND 5,7 N & 11 WEST AVENUE WAS OBTAINED FROM ACTUAL FIELD SURVEYS PERFORMED BY DGT SURVEY M GROUP-NORTH SHORE ON JUNE 1 & 2, 2015 AND JANUARY 14, 2016. W vi (� JW of 2. ELEVATIONS BASED ON NAVD88 AS ESTABLISHED BY GPS OBSERVATIONS. r ocr) 3. THIS PLAN IS PREPARED FOR OUR CLIENT USE ONLY FOR THE SPECIFIC PURPOSE OF OBTAINING V- N PERMITS AND LOCAL APPROVALS, AND IS NOT TO BE USED OR RELIED UPON AS A CONSTRUCTION DOCUMENT OR ANY OTHER USE BY OTHERS WITHOUT THE WRITTEN CONSENT OF THE MORIN-CAMERON GROUP. M M 4. ZONING DISTRICT BOUNDARIES COMPILED FROM CITY OF SALEM ZONING MAP DATED AUGUST 2006. � 5. ABUTTER INFORMATION OBTAINED FROM THE CITY OF SALEM ASSESSORS AND GIS. M M 6. ALL UNDERGROUND UTILITIES SHOWN ARE APPROXIMATE ONLY AND ARE BASED ON LOCATIONS OF OBSERVABLE FIELD EVIDENCE AND RECORDS OBTAINED FROM THE CITY OF SALEM ENGINEERING FLOOD CERTIFICATION: DEPARTMENT. ACTUAL LOCATIONS MUST BE DETERMINED IN THE FIELD. BEFORE DESIGNING, DGT SURVEY GROUP - NORTH SHORE U) EXCAVATING, BLASTING, INSTALLING, BACKFILLING, GRADING, PAVEMENT RESTORATION, REPAVING OR A DIVISION OF DIGITAL GEOGRAPHIC TECHNOLOGIES INC. PLAN BY EXAMINATION OF THE CURRENTLY APPLICABLE FEMA FLOOD MAP THIS OTHER CONSTRUCTION, ALL UTILITY COMPANIES MUST BE NOTIFIED INCLUDING THOSE IN CONTROL Z O Z N SCALE: 1" = 20' PROPERTY UES WITHIN A ZONE X (AREAS DETERMINED TO BE OUTSIDE OF UTILITIES NOT SHOWN ON THIS PLAN. SEE CHAPTER 370, ACTS OF 1963, MASSACHUSETTS. F-- Q I THE 0.2% ANNUAL CHANCE FLOOD PLAIN) AS SHOWN ON THE FLOOD CALL "DIG SAFE" AT 1-888-344-7233. THE MORIN-CAMERON GROUP ASSUMES NO 18 CENTER STREET TEL: 978-465-9992 u) pj J RESPONSIBILITY FOR DAMAGES INCURRED AS A RESULT OF UTILITIES OMITTED OR INACCURATELY U INSURANCE RATE MAP, COMMUNITY PANEL NO. 25009C0419G WHICH SUITE 1 info®d tsurve com IZ 0 10 20 40 BEARS AND EFFECTIVE DATE OF JULY 16, 2014. SHOWN. BEFORE FUTURE CONNECTIONS, THE APPROPRIATE UTILITY ENGINEERING DEPARTMENTS 9 y' X Z z NEWBURYPORT, MA www.dgtsurvey.com W 0 CD MUST BE CONSULTED. 01950 V 0 THE MORIN-CAMERON GROUP, INC. 2016 0 PROJ. #3359