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36-38 PERKINS ST - BUILDING INSPECTION The Commonwealth of Massachlll§@WTIONd,4tL SER`/ICES b Department of Public Safety V Massachusetts State Building Code(780 CMR)sa ^„ � Building Permit Application for any Building other than a One-:9 L4Ya t we n .� r .(Phis Section For Official Use Onl ) I Building Permit Number. Date Applied: Building Official: n SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) o 36-38 F�kl/us_ SF511€1� ' ,f�1.�_(� 3�' f�r�Y//Ie5 LSA No.an-d Street City/Town Zip Code Name of Building(if applicable) -36 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 O Repair Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill aut:md submit Appendix I) Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes CY No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work: _Rt:mnulurn oj� vj UVCLQ i PEI / ((r� Umv 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) O 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 13A-2❑ Nightclub 13A-3 13A-1❑ A-5 E3B: Business ❑ E: Educational ❑ F: Facto F-I❑ F2❑ - H: High Hazard H-1❑. H-2❑ H-3 Cl H-4❑ H-5❑ 1: Institutional 1-1❑ 1-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑ S: Storage S-1 ❑ . S-2❑ I U: Utility❑ 1 Special Use❑and please describe below: Special Use: SECTION fr.CONSTRUCTION TYPE(Check as applicable) !A ❑ 16 ❑ IIA 13IIB ❑ IIIA ❑ 11111 13 IV ❑ VA ❑ VB ❑ �-' 4 SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Debris Removal: W Trench Permit: "s Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site]CO3 � Y\' required❑ur trench or specify: t0 \r Private❑ or indeatify Zone: or on site system❑ Permit is enclosed❑ '� Railroad right-of-way: I lazards to Air Navigation: y_IA I Iktnri_C.,l mksiyn Not Applicable O Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ f SECTION 8:CONTENT_OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: §rh Dins the bw ung nmlain an Sprinkler SyUcm? Special Stipulations, t_z, T p A • L_ . SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner _36- 3gsEWNs .. &P,9,Als $� SA P? 01770 Name(Print) K✓ No.and Street _ City/Town Zip Property Ownerontict Information: - RANklml �fZ _-_- 974 47y -7175 Af Title Telephone No.(business) Telephone No. (cell) e-mail add ess Iplicable,the property owner hereby authorizes If A - 699 Y9 of A N.une Street Address City/ own State Zip to act on the property owner's behalf,in all matters relative to work authorized b this buRdinpermit a ((cation. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If buildingis less thin 35.000 cu.ft.of enclosed space and/or not under Construction Control thenVndskip Section 10.1 10.1 Registered Professional Responsible for Construction Control Na r.e(Re istrant) Telephone.No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor - - �' rlX T_ _ Com ,ny Name ��K7` �6FA Name of Person Responsible for Construction License No. and Type if Applicable Y 5 544t4 - 3WA,yv it N C)l cf Street Address City/T yn State Zip Telephone No.business Telephone No. cell e-mail address SECTION 12:WORFER5'COMPENSA110NWSurz:LNCt:AFt'IUAVIT M.C.L.a152.§25C6 A Workers'Compensation Insurance Affidavit from the NIA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes O No O SECTION 12•CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Mate 'ais) I Total Construction Cost(from Item 6)_$ 1. Building $ Building Permit Fee=Total Construction Cost x—(insert here Z Electrical $ appropriate municipal factor)_$ 3.Plumbing $ d.Dtechanical (HVAC) $ Note:Minimum fee=$ (contact muyirfpaltfy 5.Mechanical Other $ Enclose check payable to r � ` P"Y' 6.Total Cost S V(]0 (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information container{in this application is true and accurate to the best of my knowledge and understanding. m7' A _ f?R ksf Q fv,�c�1 Q Z_�L-1 -331.1 Please print and sig name Title Telephone Date Yg ( S . Swa 77�sr'afi NA o Start Address Cily/Tpwn -.. Stat Zip Municipal Inspector to fill out this section upon application al Name Date The Commonwealth of Massachusetts Deparbnent oflndustrialAccidents I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass govldia Workers,Compensation Insurance Affidavit:Builders/Contractors/Electricjans/Plumbers. TO BE FILED vVrM THE pERAM-LING AUTHORITY. A licantlnformation NaivePlease Print Le •bl (Business/Organization(Individual): Address: City/State/Zip: S _ Phone Are you an employer?CAedc�the/appro Here box: � I19T m a employer with y leyees(full andfor . Type of Project(required): 2. 1 am a sok T �) ❑ proprietor m partnership and have no employees working 7. ❑New construction any capacity.fNo workers, ) +lms forme in $• ❑Remodeling comp.insurmce required. 3.❑I am a homeowner doing all work myself.[No workers•comp,insurance required]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insorarce m are sole prolnietors with no employee I I.❑Electrical repairs or additions 5.EJ I am a general contractor and I have hired the sub-contractors listed on the attached sheet 12.EJ Plumbing repairs or additions These sub-contractors have employees and have workers,comp.msmaam, 13.❑Roof repairs 6.0 We are a corporation and its officers have exercised their r ❑ r 152,§I(4),and we have no to °f exemption eperd] c. 14• Other employees.[No workers'comp.insurance required] *Any applicant that checks box NI must also fa ore the section below showing their workers' t Homeowners who submit this affidavit indicating they are doing all work and then hire outsides coontraccttion Policy ors mos[submkaationnew affidavitindicating such. $Contractors that check this box must attached ao additional sheet showing the name of the subcohtmctors and state whether or not thou entities have employees. If the sub-contramms have employees,they must provide their wozims'.comp.policy number. I am an employer that fsprovfdmg workers'compensation insurance or m em information. f y ployees. Below is thepolicy and job site Insurance Company Name: �, Policy#or Self-ins.Lic.#: WC -2 .. 13 3 7// 7N�/(-- � // ? n Expiration Date-S5 :1-7- Job -7-- Job Site Address:�10'J t'�,O IA6 Attach a copy of the workers compensaLon policy declaration page(showin r th/e�Z� I� 7 Failure to secure coverage as required under MGL c. 152, 25A is a g ation punishable cY Dumber r and a fine expiration t $1date). 500.00 and/or one-year imprisonment,as well as civil penalties in the font ofc a STOP WORK ORDER land a free of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage veri5cation. Ido hereby cenijy u r t e pains aenalties ofpery'ury that the urformanon provided above is true and corrfL Signature, '['1 Date Phone#. FFOther only. Do not write in this area,to be completed by city or town o iciaL n: Permit/License# hority(circle one): ealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son Phone# ACORO® DATE(M161013 YYY) CERTIFICATE OF LIABILITY INSURANCE 11/1912015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: B the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,sub)ect to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jacqueline Marie Melanson,CLCS MassPay Insurance Services,LLC PHONE FAX 27 Garden Street,Unit 18 Nu Eat, (978)7744338 x105 AIC No),(978)774-1318 Danvers,MA 01923 E-MAILADDRESS: jad(ie@philrichardinsuranoe.com INSURE SAFFORDINGCOVERAGE NAICIf INSURERA: Arbella Protection 41360 INSURED Dr.Fix It,LLC INSURER B, Liberty Mutual/AR LIB 49 Salem StAssociated International Insurance A0597 Swampscott,MA 01907 INSURER L INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rypE OF INSURANCE ADDL SUER POLICY EFF PDuCYEXP LIMITS LTR W POLICY NUMBER MD MMIDD/YYYY A COMMERCIAL GENERAL LIABILITY 9520038867 05/17/2015 5/17/2016 EACHOCCURRENCE $ 1,000,000 —DAMAGE T RRENTED 100,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(My one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JECT 1-1LOC PRODUCTS-COMP/OP AGG S 2,000,000 POLICY❑ OTHER: $ A AUTOMOBILE LIABIUTY 1020028632 04/14/2015 04/14/2016 COMMUNED SINGLE LIMIT S 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per actitlent) $ AUTOS AUTOS NON—OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident E C UMBRELLA LIM OCCUR XOBW5938215 5/17/2015 5/17/2016 EACH OCCURRENCE $ 2,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WC2-31S-376761-035 05/17/2015 05/17/2016 ANDEMROYERS-LIABILITY YIN STATUTE ERH ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMSER EXCLUOED9 NIA wmrefatoryln NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedu)e,may be attached II more space ie required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 36-38 Perkins Street Condominium THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 38 Perkins Street ACCORDANCE WITH THE POLICY PROVISIONS. Salem,MA 01970 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CITY OF SALEA ALWAMUSETTS BuQDING DEramMEw 120 WASiiiiImMS7RM,3wFLOOR AL(978)745-9595 BIMBFAX(978)740-9846 ERLEYDRISCOLL MAYOR 111CMAS ST1'MM DmEcrca cFPuBucrxcrER7Y/BumDmmmmmomm Construction Debris Disposal Affidavit (required for all demolition and,renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR, Section 111.5 Debris, and the provisions of MGL c40, S 54; Building Permit#1 is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste deposit facility as defined by MGL c 111, S 150A. The debris will be transported by: vn/Ksr6-9 (name of hauler) The debris will be disposed of in: Shy6�os (name of facility`) J 6A6 _ 60�1 (address of facility) Signature of applicant ate a' License or registration valid for indivi'dul use only before the expiration date. If found return to:. �) Office of Consumer Affairs and Business It 10PnrkPla':o•-Suite 5170 'I OW/W/60 issiw uop Boston,MS\D2116 uoileaidx3 L06I0 VW 1103sdmn,s S Xi ZS IQS It✓S 66 _ c' 4SXYR V 18300a, Not valid withoutsignature J r W980-93 :asoaoll clon3pue4s pun suoguin6o�j Sulpling Jo piuog @' . Rlaleg oiignd to}uaw;jedaa- s}}asnyoessaU; Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m)of enclosed space. aiaasaapun !a - _ Z061,0b'W'1100SdWVMS ' '1S W31VS 60 Failure to possess a current edition of the Massachusetts is>lve 1a3e0Lf �,; State Building Code is cause for revocation of this license. " for DPS licensing information visit: www.Mass.Gov/DPS ll-Xl�i^LIO � Vea 91OZ/Ot/S :uopetldxa '. :ad61 eLZRI, :uoila,lsisaa v nonxi `1.O10"INOD1N3W3A021dW13WOHti ` " p5atl esaul 9 79 sa!o i •�rdr nrrnff;,��. J1V�awneuoD Jo aaUJO ;- r I KIB—Site tvaluatlon LIM� ly+( r Site visit August 9,2014 Summary:The site is in relatively good condition,and the organization has access to funds to pay for the cost of materials.They are looking for help coordinating projects and getting volunteer skilled and unskilled labor to help them improve the facilities.There are four"big ticket;'high-skill projects which are probably not a good fit for special service days.But this site could be a good candidate for a larger NRD project or a year-round service site. The site can accommodate 25-40 people depending on scope of work. Work requested—within RTB scope: 1. Replace the—they have 12 cases of tiles to replace old vinyl tiles in entry hallway,art room,and upstairs kitchen. About 10 workers a full day or more,no cost. 2. Rear hallway—install new base boards,replace a few missing/damaged acoustical ceiling tiles.2 works,3-4 hours 3. Rear stairs—fill in missing boards on landings of stairs.1-2 skilled carpenters,24 hours,$100 4. Landing at 2nd floor rear stairs—Repair damaged plaster ceiling(leak,fixed);repair stairs; replaster portions of wall.3-4 skilled trades,$250 S. Replace and reframe two exterior doors—they can supply new steel doors to replace existing wood ones that don't currently close properly.2-3 skilled trades,minimal cost. 6. Front door—re-frame front door and fix lock.2-3 skilled trades,minimal cost. 7. Upstairs dance room—repair portions of plaster angeled walls;replace ceiling fans which don't work.4-6 workers,cost TBD 8. Front porch—replace treads, repair posts and caps;new paint.They have some materials aleady.6-10 workers,cost TBD Work requested—out of RTB scope: 1. Repair/replace section of failing roof—they are making an insurance claim for their roof which started to fail 3 years ago and which is only 15 years.There is no infiltration at this point and while the work probably cannot be accomplished in our projects,the fact that it is failing I don't think should impact other scope items. 2. New Boiler and HVAC system—they are$55,000 into an$85,000 fundraising effort for a new boiler and system.This is not something that is a good fit for RTB. 3. Dance Floor/Program space @ 2nd Floor—This is their main program room and source of income. Needs to have wood floor removed and reinstalled in a different configuration.Can provide resources for materials.Probably a special service project,or larger part of an NRD sponsorship. 4. Upgrade 1-Floor Kitchen—they would like to upgrade their kitchen and apply for commercial food prep license so space can be used by independent caterers.They have a scope of work prepared by Crop Circle they will forward(3-bay sink,install floor drain,install hood over stove, fire suppression systems,etc.).Work is not something RTB could do CrTY OF SAUA MASSAGASETTS BIIIIDMDEPAMMMT 120 WASTA19M 09NS7REET,rFLOOR 7kL(978)745-9595. KTMAFAX(978)740-9846 RRIRYDRTS�LL MAYOR TEAS STAERRE DiREcfOR cFpuBuCrRcFERTr/EImDm comamomm Construction Debris Disposal Affidavit (required for-all demolition and,renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR, Section 111.5 Debris, and the provisions of MGL c40, 5 54; Building Permit d is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste deposit facility as defined by MGL c 111, S 150A. The debris will be transported by: ! (name of hauler) ASTER , 1-855 IUH 'U1#STE s IUNKS The debris will be disposed of in: _ pickup@junksterhag.Com I 1-855"JUNK-BAG,junk1.sterbag.com (name of facility) J VNKW- 6AG _ LU (address of facility) t Signature of applicant ate 36-38 Perkins Street Condominium Trust 36 Perkins Street Salem, MA 01970 978-979-7178 November 19, 2015 City of Salem MA Building Department 120 Washington Street Salem, MA01970 Re: Permit Application to Install New Stairway at Rear Entrance To whom it may concern: Please be advised that Dr. Fix It. LLC is authorized to deconstruct and install a new stairway at the rear of building 36-38 Perkins Salem, MA 01970 The stairway will be constructed with pressure treated materials as spelled out in the submitted plan details prepared by Paul Lessard, registered architect. It is my understanding that Dr. Fix It, LLC has filed all the necessary application documents with your department. All the condominium owners are aware that this construction is to take place. As the duly elected President of 36-38 Perkins Street Condominium Trust, I am notifying you that all the condominium owners have agreed to allow this project to move forward. Should you have any questions please call me at 978-979-7178 For the benefit 36-38 Perkins Street Condominium Trust by its President, Franklin Baez m e N U ALIGN NEW STAIRS EXISTING BALUSTRADE TO REMAI Q WITH SIDE OF HOUSE SECURE LOOSE BALUSTERS ASR IRED Ujr o W 2)1 P. . 2x,� 2 sTRINGERs Ll Jco W w NEW CONCRETE SIDEWALK W N ON 4" GRAVEL (2)1 P. . 2X12 STRINGERS o N 2jLP. . 2x1`STRINGERS Q w 8" THICK CONCRETE BLOCK I CL I TO WIDTH OF STAIRS GALVANIZED "SIMPSOW. OR EQUAL Lu POST CAP BRACKET E _ - m z NEW STAIR FRAMING REPLACE EXISTING POST WITH qt 1/4"=1'-0" NEW P.T. 04 WOOD POST STING BALUSTRADE TO REMAIN. URE LOOSE BALUSTERS AS REQUI N o NEW P.T. WOOD RAILING ON _I SIDE OF DEC -2" DIAMETER) �i S "S \ II (3) P.T. 2X10's BEAM M REMOVE EXISTING STAIR n \ NEW P.T. TREAD BOARDS & CUT BACK DECK TO ACCOMMODATE NEW CODE COMPLIANT STAIR H Q NEW iX P.T. RISER BOARDS 1E m o IGN NEW STAIRS W8" THICK CONCRETE BLOCK EE WITH SIDE OF HOUSE TO WIDTH OF STAIRS C, A z GRADE GRADE Q g NEW CONCRETE SIDEWALK p d Bim' a a d 1 REAR DECK ELEVATION E- ON 4" GRAVEL m '� 1 m L J m q� 1/4"=1'-0" e 0 GALVANIZED "SIMPSON", OR EWA a W iA BEAM/POST BRACKET 3 NEW STAIR SECTION qi1/4'-=V-0-' 3" DIAMETER SCHEDULE 40 V] STEEL LALLY COLUMN POFD Aqc / E+ �5 �.p LES GALVANIZED "SIMPSON', OR EQUAL ��yPJ POST BASE EMBEDDED IN CONC. B7 4 y U a NEW 12" DIAMETER CONCRETE O MA m "SONOTUBE" FOOTING Mass. 5` M DWG NO. FQ�TN OFMPSSP Al n_: