B-17-717 - 0007 BOARDMAN STREET - Building Permit CK-
The Commonwealth of Massachusetts
Board of Building Regulations and StandOF
9 SIALEM
Massachusetts State Building Code,780 CMR _
evrsed Mar 2011
Building Permit Application To Construct,Repair,Reno4 CJVLDeZlisl2 a
One-or Two-Family Dwelling /`� � 4
This Section For gfficial Use OnI" ,
Building Permit Number Da
}
Buil Official(Print Nast e) Signature Y{ h :Date
�" SECTION1 SITIaINFOItM,ATION,
1 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District 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❑ On site disposal system ❑
Check if yes❑
SECTION OWNERSHIPt
�2.1 Owner'of Record: Pe den S 0.��/h �A 0(q` -0
_�!'i1'('o rOber
Name(Print) City,State,ZIP
7 GOQrQMqA S� 9�8-5�8—�1�y Chi►Fefe apey"4�Cdrn
No.and.Street Telephone Emai Address
.SECTION 3:DESCRIPTION OF PROPOSED WORK(check Ghat apply):.
New Construction❑ Existing Building G( Owner-Occupied W I Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work2: 3c cj 416e C
0.-(ic CaAtrer5yw% 40 lirek4k s(JL�--re, + ba4i, 4
.{ca -(n tu--e-
-Pry a- Ce-A4a( uni 3,- N � f
SECTION 4:ESTIIVIATEWCONSTRUCTION COSTS ,-
Estimated Costs
Item OffieW Use Only
Labor and Materials
1.Building $ 15,1340 "1 Building Permit Fee Indicate how fee is determined
2.Electrical $ 5-t aa� 13 Standard City/Town Apphcattpn Fee
0 Total Protect Costa{Item"6)x muittplrer x
3.Plumbing $ 3, c a.) 7-77
4.Mechanical (HVAC) $ (,, 00 List
5.Mechanical (Fire $Suppression) i� poo Total All Fees:$
Check No Cheek Amount Cash Amount:
6.Total Project Cost: $ 30. sa o O Paid in Full 0 Outstanding Balance Due .
I
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name ofCSL Holder List CSL'fype(see below)
Type '. '. . Description ._
No.and Street
U Unrestricted(Buildings up to 35,000 cu. It.
R Restricted 1&2 Family Dwelling
Citylfuwn,State,ZIP Masomy
RC Roo Impt Covering
WS Window and Sidin
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
IIIC Registration Number Expiration Date
IIIC Company Name or HIC Registrant Name
No.and Street Email address
City/Town, State ZIP Telephone
SECTION 6:WORKERS'.COMPENSATION INSURANCE AFFIDAVIT(M:G.L.c.ISZ. 25C(6)},.
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Is§uance of the building permit.
Signed Affidavit Attached? Yes..........0 No...........0
SECTION 7a.OWNER AUTHORIZATION TO BE COMPLETEQ WHEN:
OWNER'S AGENT OR CONTRACTOR APPLIES:FOR BUILDING.-PERMIT:
I,as Owner of the subject property,hereby authorize -
t9 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 this application is true and accurate to the best of r y knowledge and understanding.'
�er k
riot Owner's or r thorized Agent's Name(Elcctr Signatu Date
NO
1. An Owner who obtains a building permit to Jo his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program);will nut have access to the arbitration
program or guaranty fund under 1I.G.L.c. 142A.Other important information on the HIC Program can be found at
\vww.mass.cov.'oca information on the Construction Supervisor License can be found at www.mass.gov/dos .
2. When substantial work is planned,provide the information below:
'focal floor area(sq. ft.) *A (including garage,finished basement/attics,decks or porch)
Gross living area(sq.It.) 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 counn;system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Tutai Project Cost"
' i
OWNER:
Chris Peters
7 Boardman Street
- Salem,MA 01970 -
M 0—ripti.n Date
1
A201
WIN
t
� a fiq
C b Y:R
0_I T
i
s
- 18 I 10._70y. �,rL --�i ii 7,6� r
EXISTING WINDOW - h IL-----�1
BEDROOM \�EXISTING STAIR - MASTER BA\
171 sgff NC ;F - '+xa 83 sgff EXISTING WINDOW
EXISTING SKYLIGHT — ——
........ _........ i.... . ... n r 04
GREAT ROOM 'q O7
267sgff MASTER BEDROOM
.... ii 204 sgff .N
'[8]PROPOSED SKYLIGHTS "L ..................... ..................— �'
02
k, MASTER CLOSET
W"
sffPROJEC\
A � II II Attic
� Conversion -
---I
.� 7' 11 5" ADDRESS:
7 Boardman Street
0_11
Salem,MA 01970
TITLE:
PLAN
�1 3rd FLOOR PLAN
lid•.r.a'
- CADD BY: AVM
DATE: 07/25/17
DRAWING NO:
a
A101
2 - L-{ e (used
OWNER:
Chris Peters
7 Boardman Street
Salem.0.1A 01970
x o.xaptm" D-
.o
' .. PROJECT:
V
Attic Conversion
ADDRESS:
7 Boardman Street
,t,F .»y ` � ii� rya .;a:, t?`,,., &•. t Nq y„«., a' Salem,MA 01970
TITLE:
SECTION
SECTION
CADD BY: AVM
DATE: 07/25/17
DRAWING NO:
A201
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