Loading...
10 PORTER ST - BUILDING INSPECTION (2) f5 J The Coliiinoriwealth'of:Massachusetts` ` ' ' °y Department of Public Safety Massachusetts State Building Code(7800 CMR) Building Permrt Application for any Bwlding other than+a One or Tw -Farm y Dwe, Ings . O � , wn,, (Tlvs Section For Offtc�al Use Qnly) r' °, �- ,;;f BurldmgPermtt Number w Date A lied '� k r 'Building Ofhetal PP,_ . .. ._ `.:� SECTION 1 LOCATION'(Please indicate Block.ff and Lop`;N for locations`fdr whie street address is not avuiable) t O 6LT:' ST "No and'Sti'eet .-- City/Town' '- < Zip Code ame Building(if applicable)F. SECTION 2 PROPOSED WORK " ' 7'. Edition of MA State Code used If New'Construction check here❑or cheek all that'apply m the two rows below Ex§ting Building +; Repair❑ Alteration ❑ Addiflon❑ Demolition ❑ (Please 6l1 out and submitAppendiz'1) CI>vtge,of Use . O` Chalige of Occupancy , ❑ - Other ❑ Specify Are building plan"s•and/or con`sfruchon documents being supplied as part of this permit application? Yes ❑ ` No Is an Independent Structural Engineering Pe Rteview.re uued?Y.. Yes ❑ No ! Brief Description of Proposed Work:.--.- SECTION ork W`1 6 •P (10 S e fia y £ SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION ADDITION'OR Check here if An Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34),❑;, - .. Er'istirigUse Groups) ,'t' - Prgposed U`se`Group(s)i;;: SECTION 4.BpILDING"HEIGHT F N_O AREA:+ Y' Exrsting. Pioposed� No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total A eg (sq.ft.)and Total Height(ft) r ' SECTION 5:U$E,GROUP(Check a9'apphcable)i A: Assembly A=l O A 2❑ Nightclub's` A 3 O_ A-4 O; ' -A-5❑ : - B: Business ❑.:` E Educational ❑ - F: Factor, F-1❑ F2.❑ H: Hi Hazard- H-1 ❑`- ' H-213 H-3 ❑ H-4 0 " ' H-5'0- - I: Inst tutiotial t-.1'O I-2 O- 1-3❑ I-4 O Mi Wr¢antiie� - Rc Residential 2-1❑ R-2❑ . .R-3❑ R-4 O:" S: Storage S-T❑ S-2❑ U. Utility O Special Use❑and please describe below: Special Use. SECTION 6.CONSTRUCTI.ONTYPE(Check as applicable) . . - - IA ❑ , -- IB IIA ❑ IIB ❑ : - IIIA ❑ IIIB '❑ IV VA`❑ VB ❑ .. - SECTION 7:SITE INFORMATION(ref er.to 780 CMR 1110 for d4ails on eacl'item)'Trench Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: - Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site O - Private❑ or indentify Zone: or on site system❑ required O or trench or specify: permit is enclosed 0 Railroad right-of way:.-, Hazards to Air Navigation: NIA 1 fistoric Comvmssu;n Ret icw t'rci-etis: Not Applicable❑ ;'.. Is Structure within airport approach area? - Is their review completed? or Consent to Build enclosed 0- `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: « . SECTION 9 PROPERTY OWNHR AUTHORIZATION _ `= r -�' Nanto and Address W.-Property 4,4U e /3b et;,s�,asv / 7l Co��-�cc � "t f/ kno!Ps iUame(Pant) " '`• .T No and Street 'r aCi /'PolvnpV' `'R r Zi s' Property Owner Contact Information �,' g r �,` „t � �% � t' a _` Title ;'mss `Telephone,No (business) Telephone No (cell) email address r M1 ,} If applicable;the property owner hereby authorizes '' s�v F r <+ , Name Aa ess ss �, Qty'/TownLl State: „Zip'�Y„ r - 'to act on the, roe 'owner s behalf iiall matters relahvG td work authoKjZe t}us buildm ermita heahon. a k v* SEC-1710N.10:CONSTRUCTION CONTROL(Please€ill ou(Appendix 2} `" , If buildin is less than 35 000 eu Et of encidse"d cg and-o?not iinder.Construction`Controi then check here;Q andrski"Section 101 ".' � , ''101 Re ;steied Professional-Res"-onsible Name(Registrant) Telephone No: t;` a marl address*�', Registratron Number ,t x, r. �, :.ti? Street Address zt a'' City/aTown e ' F;" State. 'Zip Discipline a Expiration Date p u ? r JV, s 'v Company Naive t z a �zgaa � k � - d .� Name of Person Responsible for Construction S #Luense No and Typeif Applicable Q Q ,.`(� 0/9�V� Cl. s•.C�/�r t .a'c ° ' P-P/1-�2p-'�f� �T S r �' _ O� Street Address , t' " - s S1 i to Qty/Town '� , State Zip '", _ F /ire i. pa ;Cele hone No busmes`s• r. i,_. .,fes, ::Tele bone eell e-mazl address t SEC'T'ION 11yy RkLRS cOR!PtN8XTTON A VVo�ker's Compensation Insurance Affidavit from'tFfe MA Department of Industrial Accidents must be cogipleted and subnutted with this application Ea,'dure to provide ttus.affidavit will`iesult in'the demal oEthe issuance of the buili3mg p`erniif _ ". .:,`:Js a si ned Affidavibsubmitted.with tlus'a`�'lieahon. : „� Yes❑ 'No;O' <3> s";F ;; SECTION 12`.CONSTRUCTION CQSTS`ANTJPERMIT FEEs- '� `EstimatedCdsts (Labor .rt M '�' `�` - y '- e Item - '-_ a r Total Construction Cost from Item 6 •_$ tP`'° r and Materials) ( ) . g.j r 1:'Building Building Permit Fee Total Constrvchoh Cost x (Insert here - 2.Electrical .::. $.._ `' appropriate municipal . .Note Mu»miim fee=$ (contact municipality) '. 4.Nfecharucal.(f{VAC) $ ` - - 5.Mechanical Other , $ 'r - ,Enclose check payable to - 6.Total Cost $ - f © (contact municipality)and write check number here SECTIO 13 SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pazns'and penalties of perjury that all of the information contained in tlu's application is true and accurate to the est my know ge-and understanding.- - - �� Please print and sign nam Title - - Telephone No. Date Street Address City/Town to Zip MunicipalInspectorto fill out this section upon;application approval:. flp .... NaiiYe.: - ate . APft ALEK 1 C11 v` V i-JJJ�VSAMSEi i, �/BUIDIW�ARDA / IM 30RAXIt 71;I.(978)79995. HIl�ffitIBY i PAX"740-VM �� 7ialrtisSh'.Aa�e IOt8mitcFFU xPxMtM/BiIIliMoMfiaWC M Construction Debris Disposa/Affidavit (required forall demolition and.renovatibn wonky In accordance with the ShM edition of the State BuMAW Code, 7W CIA Section 111.5 Debd& and the provisions of MGL coo,S 54;BulAft Permit B is tswed with the condition that the debris resulting from this work shall be disposed of In a property licensed waste deposit facility as defined by MGL c 111,S 156A. The debris will be transported by. ( ).0 gpdy PSN Co N� T, (name of hauler) The debris will be disposed of in: U rwo "T CyyC i j (name of fadlity) (address of facility) Signature of applicant Date The CommenweAM olMampehyseur Depafinent ojlndudyriallacdcnfs I CongressSYn 4 sumelfl0 Bostorb AL4 02114-1017 wwwmassgov/die Workers'Compensation Insurance Affidavit:Bugdera/CoMractors/FJockidans/Plumbers. TO BE Fff"WITH THE PE Naas(B �U�,l�1'r� A-z� Address: S— City/Stetemv _ .. - Db A4 .Rhone#.j 78 -. � '7-6o nre yon empbyaT Oita PoeapprMpriate has: - of meet . ,.,� Ti7K P 1 (ragairtd) iL�]®aeWlora..rti - i (fuuaoduwpotumoo)•% y 0Newconstroeti_m 2Qlam a•wkprop:ielarQpmtppehpmdheve no ea�lolpes worlm AnWiD S: :o Remodchus agefpaety lfJD ortaa Amy:foduomee eaiidredj - _ 3❑Ism a homeowmdaaoE on wmkmyadt.(l'lo wmima'eek.mammocrmpmed.)l 9: �Demzlitim, . . 10 Q Bpt7dhig edtblicro. 4�1 am a haanfownermd w�l hehvmg ommsatma m taodaet e-0 vrodc oaasypmpeaty. 1 vnV emmePoatall comma eithvhave vrmtas'mmpeosVima mamaooe ormaole 11.0 Electrical repairs or additions t >me 12 014 - bmog'repI. adfithft 5.01=aSommalmmarlsand Ihove Inked 6eadolee6dCAWeamrhed.twat: 1 76rse,miysamaauNaashmeoml6pleoeyseehaesvae dealaenveeuwedodPombevia�®apo.lmowBmem�p�ax'e+perhtQ... a 1KLPIft.9,aars,6 .QWemmandiscmemae�eYea1511](4) � lNo x'ulma'2'a®P'mmaaaregad.) . . •AayappHam Poet 1>m'isi molt also 8e-aadlhe eeeelaabelow -- sadr iaurloera eampmshon -: _ ', -- .. - _ l Homeowarm who aubait ttid�da6itiogffiey aadaby as wodc�eraieoe oidmde oaaaaetdta mint aola�f ariewaEfidavitmdiamig nrh: lContncom that check dus bazmma mtOrbed io•addifimal oheeahewag the aamCoftliesub-codmieoa mad areae mbegicianolftweldivahave - em4lonet.7ftbe anb-marotayYe ,. x> mylae�m-.vr�ea.� Rprnm�k :.: -._.. . - Iamatsorp/nye!4WArpro)*Uglpsrkers'coapes4aptonhawwm.jernsytaoyl�yae� Seioio+srhepol?ey.wvf�r e_ Infemadm e L J�✓ s InsuranceCoian Name n Policy#or Self-ins.Lic.# Expiration Dates Job Site Address!, _. �J ��II\, c�� �ey/sfefe/Z;p: c ) Q.u� ll^ /�t'1, � G q !7 Attach a copy of4be workers'Cmpenestion polley declaration page(showing the ppBey n mbw and irntion date). Fa7ure to wcwe coverage"required uniiwM&c.152,¢25A a]a Criminal violation punishable by a fine up to 51,500.00 and/or one-year impaisa�mt,as wen as Crvil penahice m the farm ofa STOP WORK Okb.ER and a line of*to$250.00 a day 88 th yrolatar.A copy of this titaDemtat msy ofJn be forwarded to the Office veatigaticiir of the DIA for inswamce coverage vai5catiop: " I do kereby emtify the sin=an ofpavjW that Me Information provided&bow is ase and aonve" U S - 0,01 ar ase onus Do nm owke in this area,to be edmpkied by dry ortoovn effe eL City or To": Permuniewn# Ieasing Authority(circle one): 1.Board of Health 2,Bogding Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Coated Person: Phone#: 8/19/2016 Unofficial Property Record Card Unofficial Property Record Card - Salem, MA General Property Data Parcel ID 34-0278-801 Account Number Prior Parcel ID 52— Property Owner CERDA ELIZABETH R Property Location 10 PORTER STREET Property Use Condo Mailing Address P O BOX 8752 Most Recent Sale Data 11/30/2005 Legal Reference 25136411 City SALEM Grantor VALENTE ILIDIO JR, Mailing State MA Zip 01970 Sale Price 130,000 ParcelZoning R3 Land Area 0.000 acres Current Property Assessment Card 1 Value Building Value 89,600 Xtra Features 9,200 Land Value 0 Total Value 98,800 Value Building Description Building Style Condo Garden Foundation Type Brick/Stone Flooring Type Hardwood #of Living Units 1 Frame Type Wood Basement Floor Carpet Year Built 1915 Roof Structure Flat Heating Type Forced H/W Building Grade Average Roof Cover Tar+Gravel Heating Fuel Gas Building Condition Average Siding Brick Air Conditioning 0 Finished Area(SF)933 Interior Walls Plaster #of Bsmt Garages 0 Number Rooms 4 #of Bedrooms 2 #of Full Baths 1 #of 3/4 Baths 0 #of 1/2 Baths 0 #of Other Fixtures 0 Legal Description Narrative Description of Property This property contains 0.000 acres of land mainly classified as Condo with a(n)Condo Garden style building,built about 1915, having Brick exterior and Tar+Gravel roof cover,with 1 unit(s),4 room(s),2 bedroomis), 1 bath(s6 0 half bath(s). Property Images I I7 D A Disclaimer.This information is believed to be conect but is subject to change and is not wananteed. http://salem.patriotproWties.cam/RecordCard.asp 1/1 i ;II j - (f4C c J2i � S � 'i i 'i i 'I