10 BALCOMB STREET - BUILDING JACKET bd %OV OZSbL
SaCem F. ,te Department
APPOINTMENT FOR FINAL: ~
F.i�ce P2evention Bu-ceau + APPOINTMENT
INSPECTION MUST BE
MADE AT LEAST ONE WEEK
48 L'ajayette Sttteet 'INSPECTION N MUST E`
Salem, Ma 01970
MADE AT LEAST ONE:WEEK
(508) 745-7777 AHEAD_...
FZRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT
In accordance with the p2vvt�6ton6 o4 the Mao-6achu,6ett6 State Buttding Code
and the SaCem F.,ce Code, application i,6 heviceby made 402 app20va2 o4. ptan4
and the t-6-6uance o4 a ceA%ti4tcate 04 app2ovaC 4o2 a bu td-Zng pe2unjt by .the
SaC'em Fite Depaztment. (Re4. Section 113. 3, Ma44. State BZdg. Code)
Job Location:
/DSLG/.�t B N�o
Owne2/Occupant:
77
EZect,ricaQ Contnaato2:
T 2�
F.Lce Supp2e64ton Conttacto2: i p
T
S.ignatu,te o4
Applicant: tv
Phone
Add t"-a o4
Appt-„cant: � City 02
�L_KLdC _ Town:
App2ovaZ date: 3 A 7
Ce,tt46 .cafe o4 app2ova -i 6 he Leby g2anted, on app2oved ptan6 02"'4ubmittaZ
04 p2oject deta446, by the Salem F-Zte Depaatment. Ale ptan.6 a-%e' a.pp2oved
4oZety 4o2 .4denti-4tcati.on o4 type and Zocation o4 4tte p2otection devtce6
and equipment. Alt ptan.6 ate 6ubject to app2ova2 o4 any vthe2 authoA ty
ha.v-4ng juAL�6dtc .Lon. Upon comptetion, the applicant o2 -in.6ta test (4) .6haZZ
2equ"t an t"Pectl,on and/o2 te4t 04 the 4 i re p2oteeti vn dev i ee a and
equipment. ( '�* FOR ADDITIONAL REQUIREMENTS, SEE REVERSE SIDE ** )
New eon.6tnu.cti,on.
P20pe4 ty Zoca tion ha,6 no eomp.P fiance wi th the p2ovt4ton6 04
Chapte,t 148, Section 26 C/E, M. G. L. , 2etatZve to the
t"ta.Eat-Zon o4 app2oved 4ihe ata rm devtc”. The owne2 o4
th.l.6 p2ope2ty t.6 tequ4,ted to obtain compt once a4 a
condition o4 obtatni,ng a Bu,i.2di.ng Pe%mct.
P2ope2ty Zoca-Zon 4-6 tin compliance w.rth the p2ov-(,6to" 04
Chapter 148, Section 26 C/E, M. G. L.
Exp.iAati,vn date:
S i gnat vb F ci.aZ
Fee tua: under. 7 . 500 Sq. Ft. - `'
'^*231• $,
' _-;"'" .• J`,�,�'� v r s�^.'`; a ��s�`�, # �'7g:5�'� '�'q ^ .yam�.Y„ .c
.. 7 u � .r...SZ' KF+•! �S�`� (�,/q�s.��9M � � tm t L i" i" 0.�ka+
-�-'- ' FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT
In compliance with the provision of Section 113.5 of the Massachusetts ( -
State Building Code, and under guidelines agreed upon by the Salem Bldg
Inspector and the Salem Fire Chief, the applicant for a building permit ^ '
shall obtain the Certificate of Approval (see reverse side) and stamped
plan approval from the Salem Fire Prevention Bureau.
Said application and approval is required before a. buiiding permit may be �w
issued. The Massachusetts State Building Code requires compliance a yam
approval of the Salem Fire Department, with reference to provisions of
Articles 4 and 12 of the Building Code, the Salem Fire Code, MassachusettsU0: f-'0
General Laws, and 527 Code of Massachusetts Regulations. ' '� j �p"
The applicant shall submit this application with three (3) sets of plans, r '^ w z _J
-g 0 -ti!
drawn in sufficient clarity, to obtain stamped approval of the Salem Fire � t- i= F- _:
s ..z0
Department. .This applies- for all new construction, substantial
- WW d
alterations, change of use and/or occupancy, and any other approvals
required by the Massachusetts General Laws, and the Salem Fire Code. ` y
Exception: Plans will not be required for structural work when the ' :•
proposed work to be performed under the building permit will
not, in the opinion of the Building Inspector, require a >
plan to show the nature and character of the work to be '
performed.
Notice Plans are normally required for fire suppression systems, .fi x
fire alarm systems, tank installations, and Fire Code ="
requirements.
Under the provisions of Article 22 of the- Massachusetts State Building =,A--,',+,�
Code, certain proposed projects may not �require7mission of plans or
complete compliance with new construction requirements." In these
cases, provisions of Article 22, Appendix T:9,4nd Tables applicable
shall apply. -This section shall not however.,. supersede the µ '
-'�11u z
provisions outlined in the Salem Fire Prevention Regulations, Chapter , -
148, MGL, or 527 Code of Massachusetts Regulations. '=All permits for
fire code use and/or occupancy shall apply- for the entire structure-,
rt4k�*
fire alarm and/or smoke detector installation shall apply to the
entire structure based upon current requirements as per Laws and/or
Codes, but the existing structure may comply with regulations
applicable for existing structures.
Notice: Sub-contractors may also be required to file individualirY
applications for a Fire Department Certificate of Approval , ✓;
for the area of their work. Such sub-contractors shall file
an Application to Install with the Fire prevention Bureau
prior to commencing any work for those areas applicable.
z .
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PLUMS A.R PPROV® SOLELY FOR IDENTIFICATION Or
.i .001 "NE ANO.1)CATION QF FIRE-PROTECTION 99YCM I 1
ALtr F7R, ,P QT,FOMN DEVICES AIRE SUBJECT TO A t C
' 1;AUNT Mp IN4PL�TO FOR'CONIPLETEI , 00118
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BUILDING
PERMIT
Ar r JOB WEATHER CARD,
DATE PERMIT NO.
I.ftR Y.y-. }I :'11:'.• "
M,^:lli
APPLICANT ADDRESS -
(NO.) (STREET) ICONTR•S LICENSEI
t T¢€. NUMBER OF
PERMIT TO (_I STORY DWELLING UNITS
(TYPE Or IMPROVEMENT) NO. IPROPOSED USE)
vary ZONING
AT (LOCATION) DISTRICT
(x0.1 (STREET)
BETWEEN AND
ICROSS STREET) ICROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE By FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
:DBC-' I rw;- rgbls;RTE.; . : !OOP. B5E'e:' :'D^_i! !�ew n1UVAI%!nw and 01PE'_2 :CRI.
REMARKS:
AREA OR Call for Permit to occupy
!?(!r, PERMIT
VOLUME ESTIMATED COST FEE S
- ICUEIC%BOYAR[ FEET)
OWNER' ltus"I I BN'R:\Fr• y
ADDRESS IO I{-B�^OYI) C•t PRT, C-•iFiau._ 1E98'c BYILOLifyOEPTp. JB.'::5.1228
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR
► PERMANENTLY.. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP•
P.RAL;D,BY._'F.�i{:...JUA•<^+^'^Nr STREET-OR A"RY..GRADES AS WELL-AS-OCASM.AMO COCA„TSON QF P B}yF.SG.W6 S,!1s Y-BE 08-AINED
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED PAR CARD KEPT POSTED UNTIL FINALINSPECTION HAS BEEN PERMITS .ARE REQUIRED FOR
ALL CONSTRUCTION WORN: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTIN65. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECH 4NICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(READT TO LATH). FINAL INSPECTION HAS BEEN MADE.
S. FINAL INSPECTION BEFORE
OCCUPANCY.
'POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION`/AP/PRROVAA��LSSS ELECTRICAL INSPECTION APPROVALS
/pct/
BOARD O HEALTH GAS INSPECTION APPROVALS FIRE DEPT.INSPECTING APPROVALS
I AX\'\ I
OTHER CITY ENGINEER Z Z
WORK SHALLNOTPROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD
INSPECTOR HAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE
STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION.
.EONUI�
a t, CERTIFICATE ISSUED -
D
F' CITY OF SALEM ATE 11/25/94
SALEM. MASSACHUSETTS 01970 BUILDING PERMIT -
Ta4� CERTIFICATE OF OCCUPANCY
DATE Ali` _ O(,. ` /03 �1
19 PERMIT NO.
APPLICANT----
S..I h n.
ADDRESS
1N0.1 ISTPE(TI (CON,R'S LICENSEI
A I- :E7 S' .C . t l!1J�IFs NUMBER. OF
PERMIT TO STORY - DWELLING UNITS
ILPf OF INPROVEME MII MO. IPPOPOSEO USE)
l•.3L❑ L .
,AT ILOLAT{ON I ZONINGDISTRICT
' IN0.1 (STREET) - '
'EER,�,w
... .. . -:
C = (J , ICR095 STREET) - p. ' (CROSS STRE(T1 -.
.0 - - LOT I _
6�lBDIUISIt1N"� ` '1OT BLOCK • .SIZE --
HI+
$DILDING AS �A-Op$BE FT. WIOE P., FT. LONG BY - FT. IN HEIGHT AND SHALL•CONFORM-IN CONSTRUCTION
dL:TMPE �J Ili_USE GROUP BASEMENT WALLS OR FOUNDATION
'
- (TYPE(
IIu c..6LTtie* oo_ asEeeT anc�pp w �l!urah"cns ziii elet'tsl ._ .
ot
1 �
IN
����jl�.j��,����``�.�^�jR�'��(j�1l�j�j��1yQy�EBEI�R NVI(YEIYf 9YWNWE• „ 1 17ER6'LYIYAYYIY
tl
AREA OR -
VOLUME
]} / C BIC SOUIRE!I(CTI
OWNER - LZIA58el I BnrnP I. _ _ pftlsl�Ip'R,pl�IsITIOT"II6f�LOfNIbC'EM7•CFlpnl p�'.'Elpl7l EftNprnplNRl
TO'BE-POSTED ON PREMISES
ADDRESS, 1n .:�7 c 'CY e'_r,, ?f �S'. - SEE IIC�YEPSE,'SIOFL{(Oq LDNL4TIONS OF CERTIFICATE
.. __�.„an...��.iY?ca:• `� - ..{ .,.: .� _-.._. ., ..:` �:�: 1.
DEPARTMENTAL APPROVAL FOR CERTIFICATE
of OCCUPANCY Pant COMPLIANCE
To be filled in by each division indicated hereon
upon completion of its 'final inspection. i 1
BUILDINGS ? Pe: n'it No. lol-94
JOHN JENNINC 11/35/94 ( '
Approved by Date
I
Remarks !
P'
r ! I o p
PLUMBING Permit No.-"' � I '
Approved by DENNIS ROSS ! Date 11/4/94 f }
Remarks j
lr
ELECTRICAL I Pe mit I�lo. }lrb w v y
JOHN GIARDI( ' 11/4 94a
Approved by ! Date
Remarks € I( � �' at;
OTHER' Pum!it No. 2t 4
Approved by_ }s=
Date F
!Remarks
OTHER I Permit
sF
Approge.'d by Date
MN
�v I p•�3s
�Remarlfi
M
No. 1()S -�q City of Salem Ward
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, 11, Ill, IV,and IX.
I. AT(LOCATION) 1 fl Za ICD%rt tl f�F-e I DISTRICT
LOCATION No.. sTREE I
OF BETWEEN AND
BUILDING (CROSSSTREET) (CROSSSTREED
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING -All applicants complete Parts A-D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION'USE MOST RECENT USE
1 ❑ New building Residential - Nonresidential
2 ❑ Addition(1f residential,enter number of new 12 [A One family 18 ❑ Amusement,recreational
housing units added,if any,in part D,13) 19 ❑ Chruch,other religious
13 E] Two or more family-Enter number
3 Alteration(See 2 above) of units ....................................................... 20 ❑ Industrial
21 ❑ Parking garage
4 Repair replacement 14 ❑ Transient hotel,motel,or dormitory- 22 ❑ Service station,repair garage
Enter number of units ..................._......
5 ❑ Wrecking(if wildigin multifamily residential,enter number ❑ 23 ❑ Hospital,institutional
of units in building in Part D, 13) 15 Garage
24 ❑ Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School,library,other educational
17 E] Other-Specify 27 E] Stores,mercantile
B.OWNERSHIP 28 ❑ Tanks,towers
8Private(individual,corporation,nonprofit
14 29 ❑ Other-Specify
institution,eta.)
9 ❑ Public(Federal,State,or local government
C.COST (Omit cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
machine shop,laundry building at hospital,elementary school,secondary school,college,
parochial school,parking garage for department store,rental office building,office building
10. Cost of improvement ......................................................... $,j 0 O at industrial plant.If use of existing building is being changed,enter proposed use.
To be installed but not included
in the above cost
a. Electrical .................
.................
....... ................
b. Plumbing....................................... ..2._5.................
c. Heating,air conditioning.............L....P-f.................
d. Other(elevator,etc.).....................................................
11.TOTAL COST OF IMPROVEMENT
1111. SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions, complete Parts E-L;demolition,
complete only Parts J&M,all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL 1. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ❑ Gas 40Public or private company Will there be central air
31 Lo Wood frame 36 ® Oil conditioning?
FL—Jt 41 ❑ Private(Septic tank,etc.)
32 Structural steel 37 Electricity 44 ❑ Yes 45XNO
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
34 ❑ Other-Specify 39 E] Other-Specify 42 0 Public or private company 46 [:] r�.Yes 47 IyJ No
43 ❑ Private(well,cistern) J�
J.DIMENSIONS
48. Number of stories M. DEMOLITION OF STRUCTURES:....
49. square ors,based on
f floor area,
all Has Approval from Historical Commission been received
nexterior
dimensions ......................................................................... for any structure over fifty(50)years? Yes_ No
50. Total land area,sq.fl..................................................... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed ......................
52. outdoors ............................... HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed ._.......................................................................... Electric:
Gas:
Full..........._�........................... Sewer:
.54. Number of
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial---�------`..--..-- BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No-A (If yes, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ Nom (If yes,please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes-)L No
Is property located in the S.R.A. district? Yes_ No
Comply with Zoning? Yes✓ No (If no,enclose Board of Appeal decision)
Is lot gra6dfathered?' Yes_ No (If yes,submit documentation/if no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ No
Is Architectural Access Board approval required? Yes_ No ✓ (If yes,submit documentation)
Massachusetts State Contractor License # Salem License #
Home Improvement Contractor# Homeowners Exempt form (if applicable) Yes No_
CONSTRUCTION TO BE COMMENCED WITHIN SIX (6) MONTHS OF ISSUANCE OF BUILDING PERMIT
If an extension is necessary,please submit
CONSTRUCTION IS TO BE COMPLETED BY: in writing to the Inspector of Buildings.
V. IDENTIFICATION - To be completed by all applicants
Name Mailing address-Number,street,city,and state ZIP Code Tel,No.
Owner or iv fC �✓/y' la LGoicr/ off 70 2y5- o-30
Lessee
2.
Contractor
Builders
License No.
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signal of applicant Address Application date
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building /D 2 �GJ FOR DEPARTMENT USE ONLY
Permit number J /
Building Use Group
Permit issued �� 19� Fire Grading
Building
Permit Fee $ S' u7 9i1ICi Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ / C I
! TITLE
NOTES AND Data- (For department use)
2. t> Cv !a
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by: Completed by:
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
SITE OR PLOT PLAN -For Applicant Use
O N