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8 BEACHMONT ROAD - BUILDING JACKET ae���� �o 'Certificate No: 132-13 Building Permit No.: 132-13 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Pemtits This is to Certify that the SINGLE FAMILY DWELLING located at Dwelling Type 8 B EAC IMONTROAD in the CITY OF SALEM _... - -. ._... .. - -- - .._.. - ----- - - ----------- - - - ._ ......-- _..- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY 8 BEACHMONT ROAD This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires ......-___......___,---,-__-___.._ unless sooner suspende r revoked. Expiration Date Issued On: Wed Jan 30,2013 . _ ..- - - - GeoTMS®2013 Des Lauriers Municipal Solutions,Inc. -- - -------------------------------------------------------------- 8 BEACHMONT ROAD 132-13 GIS# 4435 COMMONWEALTH OF MASSACHUSETTS M�_ 27 sly; (Block t' CITY OF SALEM Loi: 0547 Category:; Addition W' 'AA � Pe=Intt# ` I3213;r BUILDING PERMIT Project# SIS-2013-000707,"J` ' Est Cost: $140,000.00 t4 Fee Charged' $985.00!'f' Balance Due:, PERMISSION IS HEREBY GRANTED TO: Const ClAi7 ;;r* - Contractor: License: Expires: Use Group: K-HOYLE CONSTRUCTION COMPAN Lot Size(sq ft.): 4999.8168 IZomng -� Rl ` ,_;; i. — Owner: MUNROEMICHAELP Units Gained; Applicant: K-HOYLE CONSTRUCTION COMPANY Units Lost:' AT: 8 BEACHMONT ROAD Pig Safe ISSUED ON: 15-Aug-2012 AMENDED ON: EXPIRES ON: 15-Jan-2013 TO PERFORM THE FOLLOWING WORK: (3) BEDFOOMS,(2) BATHS AND SUN DECK,40'X 12'AND A 30 X 28 SECOND LEVEL ADDITION(AS PER BOARD OF APPEALS)jbh POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plunlbine Building Underground: Underground: Underground: Excavation: Service: Met - Footings: Rongh;wl/8//� � gh. V/l �/�} Rough:o( � Foundation: Final: ilia Fina Rough Frame: ©K `r Fireplace/Chimney: D.P.W. Fire Health Insulation: l/COMeter: Oil: ;17— Final: Go /f3 Housef Smokt Treasury: Water: Alarm Assessor Sower: Sprinklers: Final' Dk 0 T141S PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VI ON OF AN OF ITS RULES AND REGULATIONS. _ Signature: Fell 1^e"1'n"!T:O'"!NER OR CONTQAWe eipt`No Date Paid: Check No: Amount 131�1vgIW� Kf'C 2013 000753 15-Aug-12 ppw•, 9 {p ....7ppp� 1w- t'$985 00 SAP i I F f 4_rti c, t . B Call aieF Po mit�0 OCBca]pY Ct'F P T i �4 1 r lt. ,IaT t F ?.i' .. i CALL 976-619-6341 fO oCnCJ.:LL-.N I Nv F FC l iGN GeoTMS©2012 Des Lau'iers Municipal Solutions,Inc. .�ONDITq� �F "Well VSQVE AD �'Qq•C11 y1NC Up CITY OF SALEM Certificate No: 132-13 Building Permit No.: 132-13 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the SINGLE FAMILY DWELLING located at ........ ------- -- - - Dwelling Type 8 BEACHMONT ROAD in the CITY OF SALEM Address Town/City Name IS HEREBY GRANTED A TEMPORARY CERTIFICATE OF OCCUPANCY 8 BEACHMONT ROAD This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires Sunday Feb 17, 2013 unless sooner suspended or revoked. Expiration Date _- - ... __ - -- -- -- Issued On: Thu Jan 17, 2013 - - - GeoTMS®2013 Des Lauriers Municipal Solutions,Inc. -'/ - - - - _. 8 BLACHMONT ROAD 132-13 ;cis# --__. I4435. 1 COMMONWEALTH OF MASSACHUSETTS iB ork. CITY OF SALEM t 0547. Category: Addition 'Permit#. 132-13 — BUILDING PERMIT i � . Protect# JS-2013-000707 Est Cost: $140,000.00 Fee Chargedt '$985.00 CBalance Due: &00 PERMISSION IS HEREBY GRANTED TO: Coust, Class: Contractor: License: Expires: Use Group: K-HOYLE CONSTRUCTION COMPAN .Lot Slce(sq:_ft.) 14999.8168 :Zoning: -Oroner: MUNROEMICHAELP g--- 'Units Gained:-- ained: -Applicant: K-HOYLE CONSTRUCTION COMPANY [,Units Lost:_ _ AT: 8 BEACHMONT ROAD Dig Safe#:-— ----- _� ISSUED ON. 15-Aug-2012 AMENDED ON.- EXPIRES ON: 15-Jan-2013 TO PERFORM THE FOLLOWING WORK: (3) BEDFOOMS,(2) BATHS AND SUN DECK,40'X 12'AND A 30 X 28 SECOND LEVEL ADDITION(AS PER BOARD OF APPEALS)jbh POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Building Underground: Underground: Underground: Excavation: Service: Met - aI� Footings: I ugh. V/l �JA Rough:*JCs'-o -lk Foundation: Final: Fina Fina' *j Rough Frame: Fileplace/Chl"11 y: D.P.W. Fire Health U. Insulation: iN9ctc•r: OiL•' n G X311; Final: House# Smoke: Treasury: Wafer: Alarm: Assessor DkSewer: Sprinklers: Final: � (�0 THIS PERMIT MAY REVOKED BY THE CITY OF SALEM UPON 22TrON OF AfN.Y OF ITS RULES AND REGULATIONS. Signature: F&yp 37r,`?'" r)v4 r.ng C^i'!TP Rcccipt'i\b Date Paid: Check No: Amount: 131�1�1)INf _ - RIC 2013-000/53 15-Aug-12 4658 5985.00 �� �g 1 emit to OCCUPY 1 cV Gni FNIS©2012 Des Lauriers Municipal Snlnfiuns,luc. r r odnrr�„r CITY OF SALEM, MASSACHUSETTS BOARD OF APPEAL n' 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01970 ' n TELEPHONE: 978-745-9595 FAX: 978-740-9846 FEBqy KIMBERLEY DRISCOLL IIII D - 1 AD lb MAYOR FILE If CITY ELERM. SALEM,MASS. February 1, 2012 Decision City of Salem Zoning Board of Appeals Petition of MICHAEL MUNROE requesting a Special Permit under Sec. 3.3.5 of the Salem Zoning Ordinance to expand a nonconforming single-family home on the property located at 8 BEACHMONT RD (R-1 Zoning District). A public hearing on the above Petition was opened on January 18, 2012 pursuant to Mass General Law Ch. 40A, § 11. The hearing was closed on January 18, 2012 with the following Zoning Board of Appeals members present: Annie Harris (acting as chair), Richard Dionne,Jamie Metsch,Jimmy Tsitsinos and Bonnie Belair. Petitioner seeks a Special Permit pursuant to Section 3.3.5 of the City of Salem Zoning Ordinances. Statements of fact: 1. Attorney Scott Grover represented the petitioner at the hearing. 2. in a petition date-stamped December 20, 2011, petitioner requested a Special Permit to extend an existing non-conforming structure, in order to allow expansion of the existing single-family house on the property located at 8 Beachmont Road. 3. A petition was submitted at the hearing, signed by nine (9) residents, in support of the project. 4. At the hearing, numerous residents spoke in support of the project. No one spoke in opposition. The Board of Appeal, after careful consideration of the evidence presented at the public hearing, and after thorough review of the plans and petition submitted, makes the following findings: r 1. Desirable relief may be granted, since the project would not be substantially more detrimental than the existing nonconforming structure to the neighborhood. 2. In permitting such change, the Board of Appeals requires certain appropriate conditions and safeguards as noted below. On the basis of the above findings of fact and all evidence presented at the public hearing including, but not limited to, the Plans, Documents and testimony, the Zoning Board of Appeals concludes: 1. A Special Permit under Section 3.3.5 is granted to construct the addition to the property as shown on the submitted plans. In consideration of the above, the Salem Board of Appeals voted, five (5) in favor (Harris, Metsch, Dionne, Belair and Tsitsinos) and none (0) opposed, to grant petitioner's request for a Variance and Special Permit subject to the following terms, conditions, and safeguards: 1. Petitioner shall comply with all city and state statutes, ordinances, codes and regulations. 2. All construction shall be done as per the plans and dimensions submitted to and approved by the Building Commissioner. 3. All requirements of the Salem Fire Department relative to smoke and fire safety shall be strictly adhered to. 4. Petitioner shall obtain a building permit prior to beginning any construction. S. Exterior finishes of the new construction shall be in harmony with the existing structure. b. A Certificate of Inspection is to be obtained. 7. Petitioner is to obtain approval from any City Board or Commission having jurisdiction including, but not limited to, the Planning Board. 8. Unless this Decision expressly provides otherwise, any zoning relief granted does not empower or authorize the Petitioner to demolish or reconstruct the structure(s) located on the subject property to an extent of more than fifty percent (50%) of its floor area or more than fifty percent (50%) of its replacement cost at the time of destruction. If the structure is demolished by any means to an extent of more than fifty J 3 percent (50%) of its replacement cost or more than fifty percent (50%) of its floor area at the time of destruction, it shall not be reconstructed except in conformity with the provisions of the Ordinance _ _� A' L Annie Harris, Salem Board of Appeals A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY CLERK Appeal from this decision, if any, shall be made pursuant to Section 17 of the Massachusetts General Laws Chapter 40A, and shall be filed within 20 days of filing of this decision in the office of the City Clerk. Pursuant to the Massachusetts General Laws Chapter 40A, Section 11, the Variance or Special Permit granted herein shall not take effect until a copy of the decision bearing the certificate of the City Clerk has been filed with the Essex South Registry of Deeds. : � ' � �'f��s , e� �� � �� • 7 � � I'h� C'omnwn�vr;ilih ol'M:u,;iihu�rlts �,-�.A �1,u,irJ ul'iluilJing Nrgulatiuns ;uiJ Scmd;irJs - _ (��I'1'OF �� � � , ��f;iss:�rhuscus S�atc �uildin� CuJr. 79U C'MR �,�Lli.�l � '�%,•� Rdri�r�l Ihu�:l!// 13ui�Jing Perinit Applic;itiun 'fo ConstrucL R�p;iir. Rcnuv:rt� Or Dcmulish a U�ir• ur Ticu.f�um�lr Dirdllin,�� � fhis Src�ian Fur irinl Us�( r DuilJing Permit Numbur. ata;lpplio : IIuilJiny 011lci�l�I'rinl N;une) tii' 1,/1 ! � i i W' Ualc �] SBCTION I:SITE IIVF R 1.1 F 1.1 Properl AJJre�r. $ � A��Mn� �,�p 1.1 .1» � I�pS� PurcelNumbm I.la Is Ihif an atte �rd sveet? -e� no Ahip Numhcr I'urcd Numhcr I.! Zanln�Infonnutlan: I,� Praperty Dimen�lonf: Luniny DiaVicl I'n�pu,eJ U.w Lut Anu Isy Ill fnmi�yu�Il) I.� BuIlJlnaSetb�tk.�(II) Fn,nt Y:vd SiJc Y� Rcor Yard Rayuirod I'ruviJud Reyuired pruvid.d Reyuind 1'ruviJaJ 1.6 1V�ter Supply:�M.G.I.c.JU,§3�) 1.7 Flood Zone Inform�llont I.!Sew�`�Dl�po�al Sy�tem: I§iblic O pri����O Tona: _ OuLtiJt Flood'Lunt1 Chack il' wO Municipd O On siro Jiepuyul y�vt.m O SECTION7: PROPBRTYOWNEIiSHIP� 1.1 Owner�of Record: M�,�� /wvvl?p'� ��r,J✓� Mt\. Nam¢l PnnU (uy.Sl�ic.l.IP �a 6���� nn.o..� c<" `t7$ 8.5'3 6313 Nu.:mJSinel . f.lephuna EmuiFAJdna� ' SECTION J: DESCRIPTION OF PROPOSED WORK�(tAeck all th�t opply) Naw Construction O Hxis�iny Building p pwner.Occupied O Repain�s) O �1lterut(on�f) ❑ Addi�iun Deuuli�ian ❑ ,�cca�soryBldy.O NwnberofUnita " Oiher O Spuciry: DriefDattiptionofProposrd4Vark'; U $ L L � �1CL E WO S G o' \2' �, ,r,p A SECTION�; lSTI,�I.�7ED CONSTRUCTION COSTS ������ Estimatrd Cosb: Il..�hor:md �I;uerio�f� Ofllclul Ufe Only I. Ouilding S I. BuilJiny Permit Fee. f Indicate huw fae if JetrnnineJ: � '. 1`Iretrical S O Standud Cily:Tu��n ,lpplicmion Fte O Tu�ol Projeci Casl�I lirni 6)� muliipiier _ __ � ____ i 1 I'huuhin8 S � _ ..._ _ _. Uther Fer�: S � J. \I��.h.inii.il ill\� \('1 S lisC . . i ? \Ir�h.mic,il ifv¢ -------�--- -- ---- -.. _.. ..._ . . �u�vt:5iunl S �atal .\II Fres: S -- �-- � .. ._ . (�hrcA \'u. ChrcA :\muunC l',nh \ui��unC � o Tul�l I'roject Cn�l: ) � _— .. .._.. ,�V � ❑ P.iiJ m Full ❑UwsianJing If.il.wr¢ I)u.� ���%e���-�1���/�v� ' �. r se< ri��n s: c i�us rRi�t n�i�V tiEH�'1('F..S SJ (bnsl�ucliun Supcniw� I.ic¢iur(Ctil.) / �QL` .. . � 1� 1 icenr. Nmuher r\`�al m 1),u� ---�'-�.�-�-`^c/ �.�c�/\r.__ .._ . .. .---- � N.unc�dl'SI IlaLkr ` ,� Ii,:ICSI. I\�xl�.ehelo��l.__. -- - _,Q�--1�����._.�Y�� - ' -.-"-.--- 'f�pu Ikiirip�iun ,Vu. .inJ�Ucel �+ � i l4vc�tridcJ ilfwlJin�t�i 1�� 1<,Illlq.u. Il.l _��.1� 1/�..�/�_=�� ,�_� R I1c.Irie1.J I.'ll I�.und Docllin Cil�i f�ren.Sl.ilc. LII' .\I 11:u��u RC H�Mdin C���crin µ'ti � N'inJi��r.mJ.4iJin � ...—. tip SoliJfuellluming,\ppliunc.y ,�. � � ► q � �,L.�oy�c�o An� � �n,u���L,� � �(.Ic hnna 14na I:iJJn..r D Dunudiliun S.2 Rr�blereJ Ilume Impru�emenl Cuntnulor 1f11C) \ �$«�G� $ i� �2 � ��'���\r" /'����'��7 IIIC RcOlelrutiun Nwnlx:r If nruu�n Umm I IIC';�auu�`�y�e ur I IIC t-yi+��m NAu� _ � L�"'�0��/�"�`� ♦.A��`, v` Ii111:11IU�lINY! Nu. wd Sinet �.�3\1,,��j�� Ci ITown. S��nt Z�P� � '�elc hune SECTIOIV 6t WORKfRS'COMPENS,►TION INSURANCE AFFIDAVIT(M.G.L.e. 1!2•� 2SC(6)) Worken Compensa�lon Insurance ofTldavit mu�t be compieted end�ubmitted with thb applicstion. Failure to proviJe thf�aflldavit will result in the denial of tha 1 ance the building permit. SignedAffldavitAuached7 Ya .. ...•.• No....... ...0 SECTION 7�:OWfVER.►UTNO(UZATION TO BE C0111PLETED WHEIV ' OWNER'S AGENT OR CONTRACTOR APPWES FOR BUILDING PERDIIT L m Owner of the subject properry,hereby authorize � ���� � �J� - to act on my ehal ,in sll mo�ten relative to work nwhorized by thi�bulldin�{permit opp cution. �/� � -� �/ / 2 � � !�f/.�..-�'— o�� rji U��ncr WOC(If 0l'll nw Signuluro) SECTION 7b: OWNER� OR AUTFIORIZED.IGENT DECLaMT10N By entering my mm�e balaw, I hereby atta�under the pnim and penalties of perjury Ihat all uf the infurmotiun coNainad in thif appliwlion ia true and ucurote ro ihe best of my knowledge and undemm�ding. � , , / D � \\ \'L-� 1/\/�• )�la I'rinl0��ncr'ear:\mhurinJ,\y;.m'.+ � ma1lfl.elrunwSiynaiurul VO'fES� I, .\n O��nar ��hu ubiaias a building permit la do his�her u�vn ��urk,ur an ownet��ho hirn an unregis�ercd cununcWr Iiw� registared in�he Hume hnproven+ent Cbmr�cwr IHICI Pragroml.��ill no have accese �o ihe arbitra�iun progrem ur yuaranty 1'unJ und.r\I.G.L.c. I1?A. U�hur nnpunant infbrmmian on the HIC Program can be �l�und ai ������ �p,i.. ���� •h i h�formaiion un ihe Consiruc�ion Supervisor License can be found at����'� �����`° �'�'� �I�t. + \\�han subsi:mlial ��ork is plaun.J, prw iJe ihe intunn�lion bclow: fbial Iloor arca I;y. ILI . ----..-I in.luJing garogt. IinislirJ 6oscmcnt aui.s.Je.As or porclu litniili�ingarcaliy. �l.l ._, . _ _... . ll:ibi�.iblt ruum�uunl _ -. ... . . .. . � Vumh.rul'h�•Jraums . . . . . . � \unibcf��l lircpla:et .. _. _ . .. -- \untb¢f�dh;lll'h,uhi . � I \umher�d'haihnwms , _ . � I . ��paathe.ilingi),I.nt . \umher�dJcel.i p��nhcs � I'n.I�,.cJ (i�,.n �����c ��l':��oliny .�.i.ni � � 1 ..�'��1.1� ��fi���Yl tii�1ItIC �'�hq.I�C III.1\ ��C .Uhd11111C�� ���f "��d,l� ��f��f dCl ����ll.• _—_ _—._—i'__-- _� _ _ —_� __—_— . A�" � � �s � �•,usr ..e A G�"�,` .� ������������ ������ �������� ��� �� '' 7/9/ 2012 � Contract for HERS Rater Services For Prescriptive Path This contract shal] be Ueriveen the parties, KEVIN HOYLE, i9 Kimball Ave., Wenham, MA oi984 (herein after called the "Genera] Contractor" or"GC"), and JSR Adaprive Energy Solutions LLC, 6 Pilgrim Road, South Hamilton, MA oi982 (herein after called the "HERS Rater"). This contract is for third-party verification, compliance advice and reporting of the Niunroe residence to be located at 8 Beachmont Rd., Salem, MA. 0197o Ser�ices of HERS Rater are based on plans (incomplete set) by MTD Architects re�ised i/9/i2. This contract is for revie�v of plan documents, consulting ser��ices and verification of the "Prescriptive Path�lpproach"to satisfy MA Stretch Energy Code (Town of Salem) requirements. This applies only to the second t]oor addition. Sen�ices to be provided Uy the HERS Rater: i. Letter to Salem Building Department stating that I�vill per£orm Prescriptive Inspections per Stretch Code of second floor addition for issuance of building permit. 2. Performance of ENERGY STAR Va Qualified Homes Thermal Bypass Inspection Checklist 3. Verification of fenestration U-factor requirements as listed in the ENERGY STr1R program requirements for residential doors, windorvs and skylights. 4. Duct testing (required�vhen installing new spstems) 5. Submission of items contained in items i-4 to Salem Building Department Fees for Services The HERS Rater�vill charge the GC $350.00, required as a deposit�vith signed contract to commence �vorlc, �oith the second/final payment of$450.0o due and payable following insulation inspection and duct testing. Re-inspection fees will be charged, if necessary, at the rate of$ioo.00/hr. ��ith a $200.0o minimum. Deviation from the"Prescriptive Path" will trigger compliance with the "Performance Path", �vhich would incur additional cost. Additional services quoted upon request. i. The GC has the right to terminate this agreement 1t anv time but must compensate HERS I Rater for ��rork pei�formed prior to dismissaL 1 ( " .i _ �- ---- --- -�- - �� �,� s: -� _ � �,;� ;�' a o �,�.�������� ������ �����.a��� .��.�' � � , 7/9/2oi2 . Contract for HERS itater Services For Prescriptive Path a. The GC�tiill indemnifp and hold harmless the HERS Rater for work performed by others and HERS Rater shall be listed as an "Additionally Insured Party°on O�vner's/GCs policy. The HERS Rater shall provide liability and workmen's compensation insurance. 3. In the event that there is a break do�vn or grievance that cannot be settled by the parties, the parties�vill settle the dispute by arbitration. Arbitration will be conducted by the�nerican Arbitration rlssociation and apply RESNET rules for home energy raters. The la�vs that go��ern these processes shall be those of the Commonwealth of Massachusetts. 4. The services provided herein do not guarantee energy performance of the home or the�vork performed by others. Placing signatures below constitutes an acceptance of this contract. Signature of General Contractor, � �- � �n� Date Lo /2 JSR Adaptive Energy Solutions LLC, � - . 'J:.-d � �7 '2e'� � Date John S. Rodenhizer � I �' �� � • ; � . �---- �'�.�-C�,�vu-oJS �������" _. _ �� , . �---, ,Gv�.`A!�L. Tr�.5 :L:X !. h �c„ "c�/C : : � i� ��.T _ : : . ��,�,� ��s� �x �z� ��a �SPW��.� �01.�✓��. _ � 3 . � . .. , , . , , � �-v"�G� �,% wA�� , : , ; � ��� S�'�'���w�_ � �����v.�:;T�s��'• o N �Q.3� � � . , ; , : , � ���� , t ; � _ , . . �. . - ��� "�::— �.. ., .� ��.»..:i .� X'7 q',� ' 7' , ;a.. i... i ', -' - . . R� �JC�o �(. .. ;-_.:. _ . . . �`""C�. , -� ,.,..- � �. � � ��'S�---�..__�. , ; , . ; � , : t . _ � , , _ Y- , , �_ �.�`-� _ _„ ��... � . � � ; V � 'c� , ` � 5��\��n/ . 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IRENA DRUZBA LOBSENZ ���t o OLGA SIEMIENIAKA �,t 11 FELT ST. u, s...:�.• .:. ��nm,-> — • - - , 'o PROPOSED ."" � � � , ..,, „ 6't - � `" . DECK . .... ; . 12'f , , , ,,,,,,,, ,,, ,, S.tl PROPOSED ��t BALCONY . exisling _'°"d'"9 - EXISTING �� b� DWELLING removeA . #8 r _ � 50't PROPOSED I I PORCH MAP 27 LOT 546 I c, I MICHELLE MACADAMS ' �' : exst��9 I Y I STEPHEN MACADAMS +� londing I Q I to be N 6.0 {{ removed a 15 FELT ST. � * m � '� ' so.o' � BEACHMONT ROAD ZONING DISTRICT — Rt . � PROPOSED REOUIRED EXISTING ADDITION � LOT AREA 15,000 4998 4ggg LOT WIDTH 100 Sp 5a FRONT 15 g't 7't SIDE 10 1't : �'t REAR 30 59't q7•t ' - . LOT COVERAGE 30� ,9% 29.6� . PLOT PLAN OF LAND 8 BEACHMONT ROAD ���'�"��;`�'°'� SALEM �;!/,<d�;;.-„-_..qss,� ' J%•�fj cHi� °y- PROPERTY OF _ i I CERIIFY THAT TNE BUILDINGS � � � � MICHAEL P. MUNROE � � SMITM i�„ HEREON ARE LOCATED ON No.asoaa � THE GROUND AS SHOWN. ���\�:. `Fr ea >�Q SCA�E 1" = 20' NOVEMBER 23, 2011 »SlEA 4, � ,�'J � l�� � �,� " s�,, �^,}��%� NORTH SHORE SURVEY CORPOR{l110P1 � z-3 � 1 ' >` /�c=��_J^�'-L-� 14 BROWN STREET — SALEM, MA i DATE 'REG. PROF. LAND SURVEYOR 978-744-4800 #3656 , , '` � The Commonwealth of Massachusetts CITY OF Q Board of Building Regulations and Standards SALEM �l Massachusetts State Building Code, 780 CMR Revised Mar 2011 I Building Permit Application To Construct Repair Renovate Or Demolis One or Two Family Dwelling This Section For Official tJse Only Building Permit Number '? + �Date'Ap Building Official(Pnnt ,SECTION..1 SITE INFORMATION , � . . 1.1 Property A dress: 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 W terOSupply: (M.G.L c. 40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if yes❑ Municipal ElOn site disposal system ❑ SE:CTION2;':PROPET2TY0WN);RSHI$' - 2.1 Owneri of Record: Name(Print) City State,ZIP $ QyL`�MQoj, � C97% No. and Street Telephone Email Address SECTION 3.DESCRIPTION OF PROPOSED WOj (cbeck'all that apply) New ConstructitmEDItExisting Building ❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Addition ❑ Demn ssory Bldg. ❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work: l..)( OCAZV A P6.2S SONArA:7V t SECTION 4 ESTIMATED COISTRUGTION COSTS, Estimated Costs. k Official Use Only'- Item Labor and Materials 1. Building $ 0oo l,"Builduig Perrnrt Fee $ �`� *^r tlndicatehow fee isdetermmed;; ❑Standa d GitylTown Application Fee s 2. Electrical $ ❑Total PFolec}Cost''{Item 6)xmultipher ::- x 3. Plumbing 4. Mechanical (HVAC) $ Llst f 1. Mechanical (Fire $ Total All Fees $ l Suppression) No: Check Amount Cash Amount 6. Total Project Cost: $ / U©o ❑Pa1d ;FIn ❑;Outstandu gBalance DIue: SECTION 5: CONSTRUCTION SERVICES f , 5.1 Construction Supervisor License(CSL) ����V \,-ypy�,� License Number Expiration Date Name of CSL Holder j List CSL Type(see below) No. and Street -Type - .Description - `_ , g A ,� ` �„^ _ n O\� U Unrestricted(Buildings u to 35,000 cu. ft. City/Town,State,ZIP `� ` , _V� R Restricted 1&2 Family Dwelling M Mason RC Roofin Covering WS Window and Sidin SF Solid Fuel Burning Appliances 1g ,,:J,� ...T�-t� ���,�,ry�r�►L � " G I Insulation Telephone Emai a dress D Demolition 5.2 Registered Home Improvement Contractor(HIC) �08o0 VZratiolate L—\-\pqCo�S �� HIC Registration Number ompany 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. 152. § 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 f the building permit. Signed Affidavit Attached? Yes .......... V No ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property,hereby authorize .4 V to act on my behalf, in all matters relative to workauthorized by this building permit ap lication. Print Owner's Name(Electronic Signature) Uate SECTION 7b: OWNER' 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 my knowledge and understanding. M\�L� MOn�IZC � � 'J� A49 /Z Print Owner's or Authorized Agent's Name( ctronic SignaE e) Date 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 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 www.mass.00v.'oca Information on the Construction Supervisor License can be found at wvvw.mass.eov'dns 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 1A 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"may be substituted for"Total Project COST' Commonwealth ot' Massachusetts aJ\ Sheet Metal Permit Date: , 3 /� Pctmit 1/ -- --- ---- . - .. Q Estimated Job Cost: .5__ fJOOo Permit Fee: $ 11I:ms Submitted: YES _ NO DL flans Reviewed: YES NO 13usincss License 11 Applicant License # b b Business Intbrmation: I I Property Owner/Job //Location Information: N:une: AI4NSCe�t N6- J�x ' Name: Street: �� �rnel -4 �� Street: U 7� City/Town:/t/tip City/Town: `54LeeL-I Telephone: 7931 30 Telephone: I'huto I.D. required/ Copy of Photo I.D. attached: YES NO surn��w:�i J-1 / : I-unrc icted license J-2 / JI-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. R. / 2-stories or less Residential: 1-2 tamilyX Nlulti-family_ C ondo/ Tuwnhuuses_ Other Commercial: Office_ Retail _ Industrial_ Educational Institutional _ Other_ Square Footage: under I0,000 sq. t1t / over I0,000 sq. ft. _ Number of Stories: Sheet metal work to be completed: New Work: _ Renovation: I IVACA� Metal Watershed Roofing _ Kitchen Exhaust Systcm_ `etal Chimney / Vents_ Air Balancing PIM idu detailed description of work to be done: / INSURANCE COVERAGE: ^� I have a current liabilityInsurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Ye�`((J No El If you have checked Yos, indicate the type of coverage by chocking the appropriate box below: Y'/�, Other t e of indemnity ❑ Bond ❑ A liability Insurance policy ❑ YP OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 112 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. �t Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By chocking this boxC3,I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and accurate to the best of my knowlede and that incompliance with ail pertinent prov l installations ision of the Massachusetts Building Code and Chapter 112 of the General Lawsued for this application will be. Duct Inspection required prior to Insulation Installation: YES_NO Progress [nsuectinns Date Comments Final Illsnection Date Comments Type of License: By taster ` rrne ._ ❑ M r-Restricted i ❑iourneyperson Signature of Licensee ! 0 - — ❑.1ourneyperson-Restricted License Number: „u 5 — ❑ Check at ov!�1L I In sp ccto sign attire of Permit Approval