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B-19-788 - 0016 BROADWAY - Building Permit � 1 The Commonwealth of 1VIag hV F . Department of Public Safety s 1„ Massachusetts State Building Code(tft'' (,l: CD Building Permit Application for any Building other than a One-or Two-lfamily Dwelling SectioriFoi•Official.Use.Only) (� Building Penrut Number. Date Applied Bu�ldtn^ Official k A <ti . 1 5ECTION L LOCATION(Please indicate Block`#and Lot#for locations for wlucli a street address is not`availalile) . ' I s 6' -- ci.vuv, Sla-Ltryl 070 , No.and Street City/Town Zip Code Name of Building(if applicable) _. SECTION 2:PROPOSED WORK., Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building Repair Alteration Addition❑ 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 W No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Bri Description o . roposod ork: 1 TC SECTION 3:COMPLETE THIS SECTION IF EXISTINGBUILDING 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.) yq ` SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ B: Business E: Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H4❑ H-5❑ I: Institutional 1-1 ❑ I-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-1❑ R-2❑ R-3❑ R4❑ S: Storage S-1 ❑ S-2❑ U: Utility 0 Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE,-(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV 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: pP y Public W Check if outside Flood Zone)6 Indicate municipal bdA trench will not be Licensed Disposal Site Private❑ or indentify Zone: or on site system❑ required Vor trench or specify:permit is enclosed❑ Railroid right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process: Not Applicable Is Structure within airport a proach area? Is their review completed? or Consent to Build enclosed❑ Yes El or No; Yes❑ No A 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 OWNER AUTHORIZATION Name and Address oL roperty Owner ,(r K� SIVA Name(Print) No.and Street City/Town Zip Property Owner(:o�}tact Information: 017YILC-7006 qJ6' Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable the property owner hereby authorizes Name Street Address City/ own 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) building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control thqr"heckrhere-�fand sldp Section 10.1 lO-A-Re_'stered 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 QJ ame of p-grson Responsible for Construction License No. and Type Ap licabl e VO Streetddress } City/Town State Zip Mai Telephone No. (business) Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.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 No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Estimated Costs: (Labor � 'sM Item and Materials) Total Construction Cost(from Item 6)_$ 71 1.Building $ 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 $ ®� (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 contained in.this a lication is true d accurate o the best of my knowledge and understandmi 6 � P -as pr .and si Title A ' Telepho e�No. Date Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: S� 1 Name Date Appendix 2 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required for this. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents' Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbin include local connections) 9 Gas(Natural,Propane,Medical or other 10 Surv� ed Site Plan Utilities,Wetland,etc. 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investi ation 16 Energy Conservation Report 17 Architectural Access Review 521 CMR 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction.Work started prior to approval may be subjected to triple the original permit fee. Registered Professional Contact Information ame(Ie&istrant) Telephone No. e-mail address Registration Nu ber Ve Street Address City/To State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State ZipDiscipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Discipline Expiration Date Street Address Ci /Town State Zi I` Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the ninth edition of the Massachusetts State Building Code, 780 CMR, Section 107 Pro ect Title: Date: ' Property Address: oAWvA1i' T �AL cm Project: Check(x)one or both as applicable: ✓New construction AExisting Construction Project description: Mom✓ c o M S't'A4.e,--Rom o F' 6,4#% C-e...Q T vc ICT,,,4 L,4L . 1 G13o/ I MA Registration tration Number Z o Z e y;is .3�-�'1$'Expiration date: ,am a registered design professional,and I have, prepared or directly supervised the preparation of all design plans,computations and specifications concerning': Architectural Structural Mechanical Fire Protection E ectric er: for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perforin the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with`the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. t When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the buald official a'Final Construction Control Document'. Enter in the space to the right a"wet"or CHWER electronic signature and seal: - S.®ER 18 8 Phone numbfT: *7 P1 -.S'01S-11L S Email: ' .. r,>°� UCfgN H&4 A OL. Gorit Building OffWd Use Only Building Official Name: Permit No.: Date. Note 1.Indicate,with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,provide i description Version 01_01_2018 Main Level 9, 33'4" Left Elevation Front Elevation M �o Right Elevatioia14 0 . LJ Main Level 6/27/2019 Page: II I SE 4a ISS 4tl NUMBER �- 4n 1122-22-2�Eb NOA- 3 S �675:� 4 D NONE :.... x .� 1-RAFFAELE �7 z GERARDO A a 47 SEAVIEW AVE % - NAHANT,aWA 01908 1548 , 1 � . -DO 1223-2015 Rev wos-V09 - MA 1 www.MA12 23: islrmv I 04-07-1970 CLASS- 1Emil 2 D: Smll vehicle less than 26,001 Ibs,except school bus. ENDORSEMENTS- ..._.._, RESTRICTIONS- NONE NONE CHANGE Of ADDRESS.PRINT BELOW.PERMANENT INK 4 AGENCY CUSTOMER ID: 4125 LOC#: ACC)REP® ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Benevento Insurance Agency Inc. Raffaele Construction Inc. POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ACORD 101 (2008/0:1) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CITY OF S��LEI�i, iNLA SSACH SETTS BUILDING DEPARTN1LNT N 120 WASHINGTON STREET,31°FLOOR TEL (978) 745-9595 FA..c(978)740-9846 Kj\iBEyJ EY DRI,SCOLL NMAYOR TrIOMAS ST.PIERRB DIRECTOR OF PUBLIC PROPERTY/BL'n.DING COND-USSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anplicant Information Please Print Legibly Tattle (Bu:sincssiOrganization/Individual): Address: 2 �3-) Ru2 e ILL S City/State,:/Zip: 3I.UP LIPS0:5�/ Are an employer?Check the appropriate box: Type of project(required): 1.LI I am a employer with /5- 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).' have hired the sub-contractors 2.❑ I am a�sole proprietor or partner- listed on the attached sheet. 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9, ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions requirtd.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.)t employees. [No workers' 13,,2 Other comp. insurance required.] Any applicant that checks box M must also fill out the section below showing their workers'compensation policy information. t I Wwowners who submit this affidavit indicating they are doing all work and then hire outside contracrors must submit a new affidavit indicating such. -Contractors thai check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy infomwtion. 1 um an employer that is providing workers'compensation insurance for my employees. Below is the policy and Job site information. insurance Company Name:. l� Policy#or Spif--ins.Lic.#:-4/-2 2 C-905-9 V 3 3 O Expiration Date: /G Z W2r Job Site Address: /� O� I Uf/ City/State/Zip: fa,"< /`7A 0/97O Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S25Q.00 a day against the violator. Be advi.,cd that a copy of this statement may be forwarded to the Office of Invesligatioms of the DIA for insurance coverage verification. I do hereby kerb y under the pain and penalties of perjury that the information provided above is true and correct. Signature: Date: 7 ZZ(-111 Phone fit: r,7,Cr/ '.,50CC-57S'g OJrcial use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/I.icense# Issuing Authority(circle one): 1. Board Ohealth 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other,.. Contact Person: Phone#' A6OZ@ DATE(MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 01/02/19 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. If the Certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject 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 UUNIALA NAME: Ingrid Benevento Insurance.Agency Inc PHONE Ext: 781-599-3411 Arc No): 781-581-7200 497 Humphrey Street ADDRESS: Swampscott,MA 01907 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Arbella Protection INSURED INSURER B: Commerce Insurance Company Raffaele Construction Inc. INSURER C: Arbella Indemnity Gerry Raffael PO BOX?36 INSURER D: Nautilus Swampscott,MA 01907 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD F MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX_1 OCCUR PREMISES Ea occurrence $ 100,000 X completed ops MED EXP(Any oneperson) $ 5,000 A X XCU Y Y 8500045245 10/24/18 10/24/19 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIN41TAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: 1 1 $ AUTOMOBILE LIABILRY Ea aBcid Di SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B AUTOS ONLOWNED X AUTOS SCHEDULED Y Y BGLJMS 11/17/18 11/17/19 BODILY INJURY(Per accident) $ Y X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LJAB CLAIMS-MADE Y Y 4600066433 10/24/18 10/24/19 AGGREGATE $ 5,000,000 DIED I I RETENTION$ 10,000 $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? � N/A Y 4220059433 01 10/24/18 10/24/19 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Salem ACCORDANCE WITH THE POLICY PROVISIONS. 120 Washington St Salem,IUA 01907 AUTHORIZED REPRESENTATIVE Bryan Benevento ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD / 1 ® DATE(MMIDD/YYYY) ACoR1 CERTIFICATE OF LIABILITY INSURANCE 05/14119 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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject 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). UUNIAGI PRODUCER NAME: Ingrid Benevento Insurance Agency Inc A/CON No. Ell: 781-599-3411 1 A/C No): 781-581-7200 497 Humphrey Street ADDRESS: Swampscott,MA 01907 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Arbella Protection INSURED INSURER B: Commerce Insurance Company Raffaele Construction Inc. INSURER C: Arbella Indemnity GerryRaffael - — - -- - INSURER-D-:Nautilus _-- PO Box 436 Swampscott,MA 01907 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 1%UULr POLICY TYPE OF INSURANCE KI POLICY NUMBER MM DD F MM/DD LIMITS POLICY EXP LTR INSD WVD X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR PREMISES Ea occurrence $ 100,000 X completed ops MED EXP(Any one person $ 5,000 A X XCU Y Y 8500045245 10/24/18 10/24/19 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIESPER: GENERAL AGGREGATE $ 2,000,000 X PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JI:CT $ OTHER: AUTOMOBILE LIABILITY COMBINED aBcdentSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED Y Y BHLPQN 11/17/18 11/17/19 BODILY INJURY(Per accident) $ B AUTOS ONLY X AUTOS PROPERTY DAMAGE X HIRED X NON-OWNED $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAR H OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE Y Y 4600066433 10/24/18 10124/19 AGGREGATE $ 5,000,000 DED I I RETENTION$ 10,000 _ $ WORKERS COMPENSATION X STA UTE I I ERH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVEI N/A Y 4220059433 01 10124/18 10/24/19 E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D I L DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 16 Broadway Trust 22 Woodbine Ave Swampscott,MA 01907 AUTHORIZED REPRESENTATIVE Bryan Benevento ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i QP Y OF SALE }� M, MASSAMU$ETTS BURDING DEPARTivlENT 12.0 WASHINGTONSTREET,3'DFLOOR AL.(978)745-9595 $ ERLEl'DRISCOLL FAX(978)740-9846 MAYOR THOMM STYMRRE DIRECTOR OF PUBUCPROPERTy/BLjHZR G COM&SSIONER Construction Debris Disposal Affidavit (required for all demolition & 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,S54; Building Permit# —is issued with the condition that the debris resulting from this work shall be disposed of in a properly licenses waste deposit facility as defined by MGL c 111,S150A. The debris will be transported by: (name of hauler) The debris will be disposed of in: (name of facility) (address of facility) Signature of applicant (today's date) JMP Commonwealth of Massachusetts Division of Protessional Licensure Hoio-nig Eh jnper r` HE-163608 empires:,Z 4 04/07/2020 GERARDO A RAFFAEt 47 SEAVIEW AVENUE L NAHANT MA 01908 Commissioner Restricted to: Hoisting Engineer HE-2A-Excavators DIG SAFE Call Center:(888)344-7233 In case of accident call: 508)820-1444 For information about this license Call(617)727-3200 or visit www.mass.gov/dpl office of Consumer Affairs&Business Regulation Registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: TYPE:Corporation Registration Fxpi�atian Office of Consumer Affairs and Business Regulation 177g19 12/;21rat 9 10 Park Plaza-Suite 51TO Boston,MA 02116 RAFFAELE CONSTRUCTION.CORP. GERARDO A.RArr-AELi � 0 21 ELM PL Not Valid WithOut Signature SWAMPSCOTT,MA 01907 Undersecretary Undersecretary Igo=,Valid wi-, oul s2�a^t3ture i 70. ¢¢ e s 06, UAKWZY ? ;r g a oV Loading Dock gg M Tede Sprink/Al H.H. Morant & Co. Inc. Jason Architects Conf Chris P.O. Box 44M 221 Washington street Copy Salem. Massachusetts 01970-3633 R Ru - UP 0 Waiting (978) 744-5354 Warehouse Reception (978) 740-9161 Fax Consultants: Sandy pig Central File M T D shy Warehouse `lob Number. w 03— 056 Matt & Dan G. Date: September 4, 2003 V No. Date Revision By. Warehouse — Loading Dock — rh 274' 9" Project: Sound Down Renovation 11 First Floor Plan ( Proposed ) , 1 /16" = 1 ' - 0" Sound Down Corporation 16 Broadway Salem, Ma sachusetts Library Joe Office DN 0 en To Office pBelow Admin. Office Roof Below First Floor Plan & Mezzanine Office Q v tKtch Open To Below Scale. 1 /16" = 1 '- 0" Storage Open Below Drawing Number: 21 Mezzanine Plan ( Proposed ) , 1 /16 " = 1 ' - 0" 03-056 (7/03) DEED DESCRIPTION A certain parcel of land in Salem, Essex County, Massachusetts, located on the westerly side of Broadway, bounded and described as follows: Beginning at the northwesterly corner thereof on the westerly side of Broadway at a pk— nail found, thence running; S 32' 22' 40" E by said Broadway a distance of one hundred seventy nine and eighty nine hundredths (179.89) feet to a point AT land of Thomas Mackey & Sons, Inc., thence turning and running; S 57' 37' 20" W by land of said Mackey a distance of three hundred fifteen and ninety nine hundredths (315.99) feet to a point at land of the City of Salem, thence turning and running; by a curve to the right having a radius of 1665.00 feet by land of the City of Salem an arc distance of seventy two and thirteen hundredths (72.13) feet to a point at land of the M.B.T.A., thence turning and running; N 17' 45' 23" W by land of said M.B.T.A. a distance of one hundred eight and one huundredths (108.01) feet to a point at land of 8-10 Broadway Realty, LLC, thence turning and running; N 56' 54" 21" E by land of said 8-10 Broadway Realty, a distance of two hundred eighty two and forty hundredths PK—NAIL , \ (282.40) feet to the point of beginning. FOUND (HELD) S Said property contains 53,928 f square feet or 1.24 f acres. , OVERHEAD WIRES & — , oh—wires UTILITY POLES — ENCROACH INTO ABUTTER'S PROPERTY e5 SEE REC. BK. 14413 PG. 593 FOR EASEMENT co 8-10 BROADWAY REALTY, LLC REC.BK.17679 PG.189 / C2rq / o� PLAN REFERENCES 6°``��% j / �PSSo°c / %Ptp G G• � PLAN 232 OF 1944 �\O� 6g, �,���/ °o� PLAN 24 OF 1948 �� yco 0�` °� Q PLAN 605 OF 1950 / `� `L`� G 'L°' " PLAN 217 OF 1958 � p�0• '�i° PAVED PARKING PLAN 698 OF 1963 / Destination nown / / ��m o� AREA PLAN BOOK 105 PLAN 25 / / gas meter PLAN BOOK 131 PLAN 17 o PLAN BOOK 190 PLAN 39 I-ool PLAN 146 OF 1980 P<- Origin Unknown RAILROAD VALUATION SECTION V.7.11 SHEET 2 5 ,� C- / PLAN BY EASTERN LAND SURVEY DATED JUNE 14, 1996 ° LAND 1N SALEM, MASS., BOSTON AND MAINE CORP. TO / �' p/ o0 CITY OF SALEM" ON FILE WITH CITY ENGINEER. \ \�G,��� ®/ ��p overhead window grat 1% / S 3.3' — Transformer \ on concrete pad BUILDING IM EASEMENT IRON ROD SET IRON ROD LEGEND SET underground ele ric / electri meter ® Catch Basin Sewer Manhole S N ' S 1 STORY s BRICK & CONCRETE BLOCK �• IRON ROD FOUND Telephone Pole N 9 / BUILDING IN EASEMENT 1.48' FROM LOT a Guy Wire \ 0 6 — 5.5' CORNER 03 s Sewer Line o ! o Drain Line •� i SIXTEEN BROADWAY REALTY TRUST c Gas Line REC. BK. 14130 PG. 429 Z oh—wires Overhead Wires \ PLAN 698/1963 & 146/1980 — — — — Edge of Pavement CITY OF SALEM —x x— Chain Link Fence REC.BK.13827 PG.596 LOT AREA = 53,928f S.F. OR 1.24f ACRES to N_ ��yg �j6 Q THOMAS MACKEY & SONS INC. ZPNG0A \ PROBATE #282315 NO •y 9 �see 1 pin TO — DANVERS SAVINGS BANK THIS IS TO CERTIFY THAT THIS MAP OR PLAN AND THE o�'o ALTA/ACSM LAND TITLE SURVEY SURVEY ON WHICH IT IS BASED WERE MADE IN �� �� �� s ACCORDANCE WITH "MINIMUM STANDARD DETAIL 16 BROADWAY REQUIREMENTS FOR ALTA/ACSM LAND TITLE �. SURVEYS," JOINTLY ESTABLISHED AND ADOPTED BY �, ,soo SALEM ALTA, ACSM AND NSPS IN 1999. ESSEX COUNTY, M ASSACH U SETTS Over PURSUANT TO THE ACCURACY STANDARDS AS ADOPTED BY ALTA, NSPS, AND ACSM AND IN 0.51' EFFECT ON THE DATE OF THIS CERTIFICATION, prepared for UNDERSIGNED FURTHER CERTIFIES THAT THE Step a �. SURVEY MEASUREMENTS WERE MADE IN ACCORDANCE Over 0.14' a% J O S E P H I . S M U LLI N , TRUSTEE OF WITH THE "MINIMUM ANGLE, DISTANCE AND CLOSURE �. REQUIREMENTS FOR SURVEY MEASUREMENTS WHICH 16 BROADWAY TRUST CONTROL LAND BOUNDARIES FOR ALTA/ACSM LAND TITLE SURVEYS." GRAPHIC SCALE . Scale: 1"=20' October 28, 2003 20 0 10 so •o so NORTH SHORE SURVEY CORP. min men 47 Linden Street, Salem, MA 01970 DATE REGISTRA110N NO. 35043 IN FEET ) (978)744-4800 1 inch = 20 ft. #2154