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17 BARR STREET - BUILDING JACKET 17 Barr St. e 7 i STREET PERMIT Nil - - 491 Citp of *alem mn� Office of Ingpertor of jsuilbing.1 19 .% (fitg of *111m. massitc4usttts Public f ru}iertil Department $uilbing Bgmrtment Mae e3atem Breen 500-745-9595 Fid. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer December 8, 1994 TO WHOM IT MAY CONCERN RE: 17 Barr Street, Salem (R-2) Please be advised that the records on file in this office indicate that the above referenced property is a lawful two (2) family dwelling located in a Residential R-2 District and said use may continue. This is to determine use only and is no way is meant to confirm or deny whether said property conforms to all building, electrical, gas, plumbing, fire or health codes. Sincerely, f Leo E. Tremblay Zoning Enforcement Officer LET: scm The Commonwealth of Massachusetts rw Board of Building Regulations and Standards FOR NI N Massachusetts State Building Code,780 CMR, 7 h edition USE �ITY \\\�1 Building Permit Application To Construct,Repair, Renovate Or Demolish a Revised January One-or Two-Fami1 fng 1, 2008 Y` This Seetio' or Official se Only Building Permit Number: D to p lied: 9 Signature: Building Commissioner/InspectorofB ildings Date SECT ON 1:SI INFORMATION 1.1 Property Addres : 1.2 Assessors Map &Parcel Numbers �✓r 5 Sa � e M u1nA 6101-1u 1.1 a 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 2c PROPERTY OWNERSHIP' 2.1 Owner'of Record: Llc.vy\ -Z)u\an 1 , {�r ✓r S� S (ems AAA ul �ilo Name(Print) Address for Service: 4 � bl Signature Telephone SECTION 3-DESCRIPTION OF PROPOSED WORK2S(check all that apply)' Aleu'Cons[ru^ti ❑ Eai Building ❑ O ^^ pied ❑ Pepairs(sj'. . ior(s) ❑' Add;:. ❑ 6 0 Demolition ❑ Accessory Bldg. ❑ Number of l_Inils Other 0 Spccilv:_. _. Brief Description of Proposed Work': e (4-',-0 Q I AJKu N U S uc+'t r< l C'Ao S SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 0 .(o y 0 1. Building Permit Fee:$ Indicate bow fee is determined: ❑Standard City/I'own Application Fee 2.Electrical $ [I Total Project Costa (Item 6)x multiplier x 3.Plumbing $ � 2. Other Fees: $ 4.Mechanical (HVAC) $ Q List: 5.Mechanical (Fire $ 0 airtFull ll Fees: $ Suppression) No. Check Amount: Cash Amount 6.Total Project Cost: $ �{ 0 tp q 1] ❑ Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1C Licensed Construction Supervisor(CSL) �' 90 S(� (v 7 It J C License Number Expiration Date. Name of CSL-Holder,�{{ ti o 4 i S J� • U d 6VU 6N,-0 IS List CSL Type(see below) V1 -- Add e .t= -.:..,. . . :' '. Dess iption . . U Unrestricted(up to 35,000 Cu.Ft Silfhature I V R Restricted 1&2 Family Dwelling sti S q l�i Sa M Masonry Only RC Residential Roofing Covering Telephone. - WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance lnstallation D Residential Demolition 5.2 Registered Hom Im$movement Contractor e n � �l bti r �1C-a,,. 5co ;-r P Tic) IL1 11 (o o I HIC Company Nameor HICRegi t Name Registration Number � f01 sjOti o isa � , last I (0 Add e s 5 0 Q -Ct (i Ogigta - Expiration Date - Si azure Telephone " SECTION 6:WORKERS' COTvIPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152. g 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit Signed Affidavit Attached? Yes ........... No...........❑ SECTION?a :OWNER AUT$ORIZATION TO BE COMPLETED:W$E'N`. 0. ER'S AGENT'OR CONTRACTOR APPLIES F.ORBUILDINti PER1kIiT" I, 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. Signature of Owner Date SECTION 7b::OWNER' OR AUTHORI#0 AGENT.- LARAnON . '. " I �� �U 4-'#- -_' 'i' �,i. }-I'r• i acproer or.hufhc+nzed At ent+ignebv decl:ize::i tliai tiie statcmemils and imSornntion on the Lo:egain g application are true behalf a d accurate, to the bell of niy know]edgz and . t .Print Nam - - . . . . . Jl a -p Signature of Owner or Authorized Agent _ Date (Signed under the pains and penalties of perjury) - " NOTES- 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 nor have access to the arbitration program or guaranty fund under M.G.L. c. 142A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL) can be found in 780`CMR Regulations I I O.R6 and 110.R5,respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq.Ft.) (including garage,finished basementlattics, 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 heating system Number of decks/porches ' Type of cooling system Enclosed Open 3. "Total Project Square Footage"maybe substituted for"Total Project Cost"