22 RAYMOND RD - BUILDING INSPECTION (2) I
�H i
The Commonwealth of Massachusetts a f'
Board of Building Regulations and Standards gC�IT Y OF
Massachusetts State Building Code,780 CMR 101h AUG 29 eviSed'Flm 2011
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or TWo-Family Dwelling
Q This SeetiE+n Por t3Pf1eiel:Use .
.� Budmg Paratlt.AFimtlOer. . ; Date Applied: .'
Ot&eiat(Prist S>gflahae Date
QTsCT[ON,1:STCE 1ORlMIATDDIN
1.1 PropeAddress: T1.2Assessors Map&Parcel Numbers
qy ��1 .1 a Is this Se accepted street?yes ✓ no Number Parcel Naber
13 Zoning Information: 1.4 Property Dimensions:
Zoning f strict Proposed Use Lot Area(sq ft) Frontage(ft)
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:
Public❑ Private❑ Zone: — Outside Flood Zone? Municipal O On site disposal system ❑
Cbeck ifyes❑
SECTION 2. PROPBRTYOWNERSHI1Pt
2.1 er of Reif rd:
w / SAe? un �c�c%C
Nam42re(Pru't Jald 01
r �— City,State,ZIP
No..and Telephone F Address
SECTION 3:DESCRIPTION OF PROPOSED WORK$(cheek all that apply)
New Construction Existing Building❑ Owner-Occupied ❑ Repairs(.) ❑ Alteration(.) ❑ Addition ❑
Demolition ❑ 1 Accessory Bldg.❑ Number of Units_ Other ❑ Specify.
Brief Description of ProposedWo s e
a CILa !O
SECTION 4:ESTIIMATBD CONSTRUCTION COSTS
Estimated Costs: Official Use Only, .
Item official
and Materials
1.Building $ S<� 0 1. Building Permit Pea:S Indicate how fee is determined.
13 Standard City/Town Application Fee
2.Electrical $ J Oct 0,60 E3 Total Project Costs(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List'
5.Mechanical (Fire $ Total All Fees:$
Suppression)
G$edc No. heck Amount: Cash Amount:
6.Total Project Cost: $ o21 A50 0 0 0 Paid in Full 13 Outstanding Balance Due:
SEcrlox 5: CON>sTilwe olk SMVICBS
5.1 Construction Supervisor License(CSL)
.c , ,� P
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Tjpe -DutaciPn�
U Unrestricted uild ings up to 35,000 w.ft.
R Restricted Family Dwelfine
City/Town,State,ZIP M
RC I Roofiox Covering
WS Window and Siding
SFSolid Fuel Boning Appliances
I Insulation
Tel hone Email address D Demolition
5.2 Registered Home Improvement Contractor(RIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
Ci /Town State ZIP Tel hone
SEc rmx 4:WO)tKR a t dqSATIOIN IlauRANCE AFFIDAVIT(NLG.-e.152.4 25C*)
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 ..........❑ No...........❑
7a OWNER AUTHOR1ZA TO DIE C61OIL ETED W9M
WNER'S AGE. R FUR 13( INN PXRMr
1,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. `
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in 's applicatio m true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized Agent's Nay6jEldctronic Signature) Date
- : NQ
Sp .
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 can be found at
wlvw.mass. oe v,�oca Information on the Construction Supervisor License can be found at www.mass.eov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,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 beating system Number of decks/porches
Type of cooling system Enclosed Open
3. `"total Project Square Footage"may be substituted for"Total Project Cost"
ZONING DISTRICT: R1
N/F
DEBORAH BAYLE OF Y4s�
20 RAYMOND RD.
PARCEL ID: 32-0007-0 WILLIAM
ROD
No. 294
O "1 CERTIFY THAT THE DWELLING IS
./O LOCATED AS SHOWN. THIS PLAN WAS
o
�- 6 - PREPARED FROM A TAPE SURVEY."
GARAGE
2
2
RALPH W. REID P.L.S.
_ O
LOT 25 1 1/2 STORY 5'S —57,
5643± S.F. VINYL SIDED
PLAN DECK GRAPHIC SCALE
20 0 10 20 b so
T
�O. 21—
PROPOSED
IN S
POOL � � ET
APPROX. LOCATION 6 g5 1 inch = 20 ft
,V CHAIN LINK FENCE03.
\
y
N/F SALEM , MASSACHUSETTS
SHED MICHAEL BLADE PROPOSED POOL PLAN PREPARED FOR:
SALEM STATE 24 PARCEL ID: 3
COLLEGE ASSIST. CORP RAYMONDD005-0 LAUREN & MICHEAL SHAWN EDGE .
m PARCEL ID: 32-0020-0
22 RAYMOND ROAD
g PARCIL ID: 32-0006-0
P
REID LAND SURVEYORS
365 CHATHAM STREET R
NOTE: FENCES, WALL, SHRUBS,
LYNN, MASSACHUSETTS
r DRIVEWAYS, ETC. DO NOT NEC- PHONE #781 -592-2660
DEED REFERENCE: ESSARILY REPRESENT PROPERTY R16-054
BOOK 30539 PAGE 617 LINES. LTS DATE: AUGUST 23, 2016 SCALE: 1 "=20'
3 ,
0
6.
QTY OF SALEM, MASSAGIUSE TTS
BUILDING DEPARTMENT
. 120 WASHINGTONSTREET,3"DFLO0R
'ISL. (978)745-9595
KIMBERLEYDRISCOLL FAX(978)740-9846
MAYOR TrIOMAS ST.PIERRE
DIRECTOR OFPLIBLICPROPERTY/BUILDING COMMISSIONER
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
n J�Job Location
Home Owner Address aol Y�
Present Mailing Address 1444, d
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 that does not possess a
license, provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
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 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 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 understand the City of Salem Building Department
minimum inspection procedures and requirements and that he/she will comply with such procedures
and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING INSPECTOR