0007 BERRYWOOD LANE - BUILDING JACKET 7 BEP 5KC1:' LPDS
No.�`^' Ward /
APPLICATION FOR
PERMIT TO INSTALL A
SOLID FUEL BURNING STOVE
Location /
PERMIT GRANTED
GC./�, Z2 19
Appr
` � Building Inspec or
Plans must be filed and approved by the Inspector before a permit will be granted.
No. �t/� � / City Of Salem Ward
Fiy 'V ! T - 3
Home Phone # 54f- 1150 -,5777&7f
Bus. Phone # Of 7115-�(, S5J
APPLICATION
FOR
PERMIT TO INSTALL A SOLID FUEL BURNING STOVE
Salem, Mass.,
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a perm't to build according to the following specifications:
Owner's name and address
Architect's name 0 ��-
Mechanic's name and address
Location of building,No. 7 �
What is the purpose of buiidiig?
Material of building? _ too--VA-
If a dwelling,for how many families?
Will the building confgR to the rego' i f the1 v
Estimated cost �o'� - Contr tors Lic. o. �'
Signature of applicant
0
ONE,,
CERTIFICATE ISSUED
DATE December 8, 1993
CiTY OF SALEM
SALEM, MASSACHUSETTS 01970 BUILDING PERMIT -
CERTIFICATE OF OCCUPANCY
zu
1
ILA 5r. III
u
DATE PERMIT NO.
ns Cimarda
APPLICANT ADDRESS
(No.$ )STREET) ICOatR'S LICENSE'
�>Uild one `2mil , Dwelli.ag NUMBER Or
PERMIT TO I—) STORY DWELLING UNITS
I'llf a, 1.000NI.E.Il .0. IPAOPOSED USE$
AT (LOCATIONI 7 tierry,,yooifi Lame Ward ZONING
DISTRICT-
1.0.) ISIPCEII
BETWEEN AND
'CROSS STRI[Ill (CROSS STREET)
LOT
SUBDIVISION LOT—BLOCK SIZE
BUILDING IS 70 BE FT WIDE P, FT, LONG BYFT, IN HEPGNT ArO SI,ALL CONFORM IN CONSTRUCTION
TO TYPE _ USE GROUP BASEMENT WALLS OR FOUNDAY iON
T"El
REMARKS'.
onfla W.*l 71011 �¢.3.T1
K-Q'%fflj Ila=It
AREA ON
VOLUME
ME
C BIC SQUIRE ICE,. Imilawalm RUN pm—m mxm Wm 4
0- �
- P BE POSTED ON PREMISES
r r vc
OWNER ,.e K T
-ou I-ane
ADDRESS SEIJUV.MVSEJSJ,DEfOnlrDR(n7g*NS OF CERTIFICATE
DEPARTMENTAL APPROVAL,FOR, CERTIFICATE
�� of OCCUPANCY and COMPLIANCE '
"To be filled in- till
y each division indicated hereon i
,upon completion iof-, its final inspection.
,. BUILDINGS ! Permit No. "339-93
I
Approved by Johin J.I Jennings Date _ ;12/7�/93
Reniarks
' I
I i
PLUMBING t Permit No.
i
Approved by John LeClercl Date 12/6/93
i s I I
Reniarks
j ELECTRICAL Permit No
Approved by Al Fal owski 44 Date ' 12/7/93
Remarksj—
OTHER Fire != Permit No.
pv
s L[. Hudson 12/T/93 u
Approved by Date
y Remarks�—I I i
q
OTRER Permit No. a
i t
Approved by Date
ki
j Remarks
I
I
BUILDING
PERMIT
JOB WEATHER, CARD
DATE
PERMIT NO,
1
APPLICANT ADDRESS
t.o.) oct.111
tt n NUMBER OF
PERMIT TO STORY DWELL ING UNITS
ZONING
2
AT (LOCATiOkl r IT r V C.I:, L 4�f e ---�l DISTRICT
IND.) 1s ISTIHIEll
BETWEEN AND
(C*03y STACE11 (CROSS STPEETI
LOT
SUBDIVISION LOT—BLOCK SIZE
BUILDING 15 TO BE FT, WIDE B,— PT- LONG BY—FT, IN HEIGHT AND SMALL CONFORM IN CONSTRUCTION
TO TYPE _USE GROUP_EASEMENT WALLS OR FOUNOA7 ION III-E)
REMARKS:
GriMt io uccupy
L L
RE A M I I j
VOLUME
AREA 09 ESTIMATED COST FEE S
C9mlc,sou"E rEryl
OWNER 2 iiz a T -"AL,1 .'2148$ a u I a?
Me 1 .v"a I BY E P T "A'% .s ft f:i- ,s
—
ADDRESS INSPECTOR OF BUILDINGS
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET ALLEY 09 SIDEWALK OR ANY PART TII(EPEOF ETHER TEMPORARILY OR
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE. MUST BE AP-
PROVED By THE JURISOICTJON. STPEET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY RE OBTAINED
OM THE DEPARTMENT OF PUBLIC WORKS,,THE ISSUANCE.OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM T-HEC'ONDITiONS,
ANY PFI SCIISOI115104 RESTRICTIONS,
A RNL'CABLE SEPARATE
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS I WHERE.
F� FR
INSPECTIONS REQUIRED EOR IC F ITS ARE REQUIRED FOR
PRO KEPT POSTED UNTIL FINAL INSPECT ION HAS BEEN I ELEC RICAL,
ALL CONSTRUCTION WORK; PLUMBING AND
1. FOUNDATION$ 09 FOOTING] MADE. 11111 A CERTIFICATE OF OCCUPANCY tS RE-
MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL FOOTINGS.
GUFIEG'SLIC. BUILDING SHALLNOTBE OCCUPIED UNTIL
MEMSERSIREADY TO LATHI, FINAL INSPECTION HAS BEEN MADE.
3, FINAL INSPECTION BEFORE I I
OCCUPANCY POST THIS CARD SO IT IS VISIBLE FROM STREET '
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
TIP— 124" 1 lr,—o
7,01 F
POARD I-HEALTH GAS INSPECTION APPROVALS FIRE DEPT. INSPECTING APPROVALS
I I VI) 0)v, A
OTHER CITY ENGINEER 2 2
WORK SMALL NOT PROCEED UNTIL THE PERMIT R71A It ITT WILL HULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARO
STARTED BE ARRANGED FOR BY TELEPHONE
WORK 5 NOT
Co
tNSPE7 7IR HAS APPROVED THE VARIOUS WORKIS NOT STA ED WITHIN SIX MONTHS OF DATE THE CAN
STAGES �2IF CONSTRUCTION. PER M IS IS Ur RT S IN 09 WRITTEN NOTIFICATION.
PERMIT IS ISSUED AS NOTED ABOVE. I
No,91 " 9-S' City of Salem Ward
�N.to�4,q
A 00 t-'j
�teaMFt
AS
CITY OF. c�
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, It, Ill, IV, and IX-
�// o�,�, � ZO
I. AT(LOCATION) ,/ �a�'" s�""� DISTRICNINGT�XL_
LOCATION / � � /3 `
OF BETWEEN /� f AND
BUILDING CROSS STREEn /� CROSS LOTEn
SUBDIVISION - LOT W BLOCK SIZE 3 9 Z _
II. TYPE AND COST OF BUILDING -All applicants complete Parts A -D
A. TYPE F IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION'USE MOST RECENT USE
1 New building Residential Nonresidential
2 ❑ Addition(If residential,enter number of new 12 g One family 18 ❑ Amusement,recreational
housing units added,it any,in part D,13) 19 [_] Chruch,other religious
13 ❑ Two or more family-Enter number
3 ❑ Alteration(See 2 above) of units ....................................................... 20 ❑ Industrial
21 [:] Parking garage
4 ❑ Repair replacement14 ❑ Transient hotel,motel,ordormitory- 22 ❑ Service station,repair garage
Enter number of units ...........................
5 ❑ Wrecking(if muttttamily residential,enter number 23 E] 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 ❑ Other-Specify_ 27 ❑ Stores,mercantile
B.OWNEHIP 28 ❑ Tanks,towers
e WPrivate(individual,corporation,nonprofit
institution,etc.) '
29 E] Other-Specify
9 ❑ Public(Federal,State,or local government
C.COST (Omit cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
�]L� machine shop,laundry building at hospital,elementary school,secondary school,college,
10. Cost of improvement ......... � /.._a.7� parochial school,parking garage for department store,rental office building,office building
"""" """"""""' $ at industrial plant.R use of existing building is being changed,enter proposed use.
he installed but not included
in 7 a ,
in the above cost
a. Electrical...........................................................................
b. Plumbing..........................................................................
c. Heating,air conditioning.............................................
d. Other(elevator,etc.).....................................................
11. TOTAL COST OF IMPROVEMENT $
III. 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 I. TYPE OF MECHANICAL
30 Masonry(wall beating) 35 n Gas 40 E7{Public or private company Will there be central air
31 Wood frame 36 10 Oil 41 E] Private(septic tank,etc.)
conditioning?
32 ❑ Structural steel 37 Electricity 44 ❑ Yes 45 NrNo
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
34 ❑ Other-Specify 39 ❑ Other-Specify 42 Public or private company
46 ❑ Ves 47 2"No
43 ❑ Private(well,cistern)
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
48. Number of stories ...............................1..........................
49. Total feet of Moor area,
all floors,ors,babased on exterior as HApproval from Historical Commission been received
dimensions ......................................./.. U.,..(J......... for any structure over fifty(50)years? Yes_ No_
50. Total land area,sq.n...... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed ............................................................................:
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
52. outdoors............................................................................. Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed ........................................ .................................. Electric:
Gas:
54. Number of Full...............�................... Sewer:
bathrooms PaDOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial............0.................... BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ NOS/ (If yes, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ No (If yes,please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes4ZNo
Is property located in the S.R.A.district? Yes_ No
Comply with Zoning? Yes✓diNo_ (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No ✓yes,submit documentation/if no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes-AZ/No
Is Architectural Access Board approval required? Yes_ No—L (If yes,submit documentation)
Massachusetts State Contractor License# Salem License# /3 9�
Home Improvement Contractor# / /7 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.
1. /fix CcPSce / 17r. - Cin Dl97CJ y�YvY1,4
Owner or
Lessee 42 11t r� [� •�
z. b -37d
Contractor Builder's
o3 X33 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 nform to all applicable laws of this jurisdiction.
Signature of a Addr ` Appli'cation date
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building //�� Op�� op Use Group
Permit issued C l l r-c � 6' 19 1
Fire Grading
Building
Permit Fee $ ,!5-z8,C b Live Loading
Certificate of Occupancy $ Approved by: occupancy load
Drain Tile $
Plan Review Fee $ ' o
TITLE
NOTES AND Data• (For department use)
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by: Completed by:
r
r.
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
i
SITE OR PLOT PLAN -For Applicant Use
O N
CITY OF SALEM
WATER DEPARTMENT
i
L
ALF iC
Assistant Director PubliC Services /
x Cit ofttlent,
uTING SLIP
REVIEW AND PASS ON AS INDICATED
LOCATION:
DATES �3
APPLICANT:k14t" 1�2 �Glpt4 t=11
INSERT DATE WHEN PASSING ON
Date
Assessor
CONTACT PERSON: Peter Caron /
2 Fire De artment &M,
Gam/Ca t. Turner or p. LaPointeL
Department of Public Services 5(�
Director _ t 2--/
4 DEPARTMENT: Water Oeoartment
CONTACT PERSON: Maroaret Hagerty/HelenJiadosz �' ! ( y,3
5 Planning Dept.DEPARTMENT $ fo
Beth .Debski
6DEPARTMENT: — City Clerk ( if involving new streets)
CONTACT PERSON:
PARTMENT: E12CMIC DEPT.
7 OE QIP /
PAUL TUTTLE elle A3
8 DEPARTMENT:
CONTACT PERSON:
RETURN TO
a..1` r=_. ",'- ti-:' ...� i • .� -•t2 , j X11
.. 55 Y3"2P: rya itirk'H'& R,SLEVEY,.. Z TEL.,517-6c 3— oh ��r
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,,PROPOSED,•KkVIN PLOT ALAN �r
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s � T .v F tY .t,ui ,i,,:♦ .i .• �� HINDS;i, v IN + �
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SALEM, MA; '
r; ?
COUNTY)'
, 'a +v µ �. 2 +� t y l f r (ESSEY.
�
uilo `
. Y` �•"', ^ 'r,, Q' , y y' '8/11/1993
5C4LE:• 4
i ' 0 40� 80
4 KE VJ. yltV S, PLS DATA H &,R SURVEY
1068A MASSACHUSETTS AVENUE
-NOTE: THIS PLAN '16' NOT TO,BE USEO,LOR •PE4P+'ERTY ARLINGTON, MA, 02174 < {•'
LINE PURPOSES.
r I x617 i 648-5533
' � , r, ,._J..—•---.^. ON'G. N0_22403PP 7.DW0
Sa.2em Fite Department.
F4Ae Preventd on Sweeny.
48 La4ayette Street
Sat m, Ma 01970
(508) 745-7777
FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT
In accordance wZtfn the pAov-i.6ton.6 o¢ the Ma-6-6achu,6etto State Suttd i.ng Coda
and the Satem F.vice Code, applicatLon .tis hereby made 4or approvat o4 pta.n s
and the Z4zuance 04 a ce4.ti4tcate o4 approvaC 4or a buttding pe,,LT t by the
SaCem F4Ae Department. (Re4. Section 113. 3, Ma44. State Beds. Code)
Job Location: �3eAtIC y /"w
Owner/Occupant: /r`
Etect,. caZ Cont-tactor:
F.ih.e Suppre44ton Cont tactor:
S.ignatu�ce o4
AppPiear�t: > Phone #:
., Z � S36 s—
Addre44 o4 —� City or.
App.,c.caxt. /Z GK �2iy� Town:
Approvat date: /VVV'4415 , top/ �j
Cehti4tcate o4 app-sLov"`at i,6 hereby gnarcted, on approved p.Can,6 or. 6ubmtt-taZ
o4 project detatt-6, by .the SaCem Fite Department. AZE ptan4 ace approved
4oZe2y 4or -identt4Zcation o4 type and tocati-on o4 4.4-ee protection dev.icea
and equipment. Alt ptano ace 4ubjeet to approvaE o4 any other authority
havZng 1uAZ4d.Zct.Zon. Upon eomp.eetion, the appt,4=nt on eta ter(4) 6ha.Z2.
requ"t an to apection and./or teat o4 the 4.i to protection devil c" and
equipment. ( ** FOR ADDITIONAL REQUIREMENTS, SEE REVERSE SIDE ** J
New conztruction.
Property Zocatlon h" no compZ once with the provt-6ton s o4
Chapter 148, Section 26 C/E, M. G. L. , reZative to the
.i"ta2atZon o4 approved 4Z4e ata-tm devdce6. The owner o4
t lt,6 property 4,4 requ iAed to obtain compliance o-6 a
cond.iti,on o4 obta,inZng a Bwitding Peon t.
-P3ope,tty _loca .Zon a4` .in comp4.ance w.i>th the p-covf;62:on�s_.o4. , _
Cha.pten. 148, Section 26 C/E, M.G. L.
( ExpZ4.ati.on date: 44,U 30
Q / � .i,g e F ' a ie i s
Fee due. under 7 , 500 Sq. Ft. - 0. 00
7 , 500 Sq. Ft. or Ccvegen Form #81 (Rev. ? 0/90 )
FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT
i
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 building permit may be
issued. The Massachusetts State Building Code requires compliance
approval of the Salem Fire Department, with reference to provisions of
Articles 4 and 12 of the Building Code, the Salem Fire Code, Massachusetts
General Laws, and 527 Code of Massachusetts. Regulations.
The applicant shall submit this application with three (3) sets of plans,
drawn in sufficient clarity, to obtain stamped approval of the Salem Fire
Department. This applies for all new construction, substantial
alterations, change of use and/or occupancy, and any other approvals
required by the Massachusetts General Laws, and the Salem Fire Code.
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,
fire alarm systems, tank installations, and Fire Code
requirements.
Under the provisions of Article 22 of the Massachusetts State Building
Code, certain proposed projects may not require submission of plans or
complete compliance with new construction requirements. In these
cases, provisions of Article 229 Appendix T, and Tables applicable
shall apply. This section shall not, however, supersede the
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;
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 individual
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.
( Form 81X (10/90)
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