Loading...
155 BRIDGE STREET - BUILDING JACKET 155 BRIDGE STREET c sy Titg of ttlrm, Maspsarflusrtto 6Al ��eAdR 1113 bel e 58 y ^. ALf�'. `AAS CI I Rn Ci i 10F DECISION ON THE PETITION OF JOSEPH SKOMURSKI REQUESTING A SPECIAL PERMIT FOR THE PROPERTY LOCATED ATr156—BRIDGE STREET AI(R2/I) A hearing on this petition was held April 15,1998 with the following Board Members were present: Nina Cohen, Albert Hill, Richard Dionne and Paul Valaskagis . Notice of the hearing was sent to abutters and others and notices of the hearing were properly published in the Salem Evening News in accordance with Massachusetts General Laws Chapter 40A. .t the request of the petitioner's Attorney, Stephen Lovely, the Salem Board of Appeal voted 4-0, to grant leave to withdraw this petition without prejudice for a Special Permit to convert a two family dwelling into a three family dwelling for the property located at Iso Bridge Street. Granted leave to withdraw without prejudice. CR .t:TED LEAVE TO WITHDRAW WITHOUT PREJUDICE Acrit 15 , 1998 Nina Cohen Board of Appeal =. COPY GF 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 -thin 20 days after the date of filing of this decision in the office of the City Clerk. Pursuant to 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 certification of the City Clerk that 20 days have elapsed and no appeal has been filed, or that, if such appeal has been filed, that 't has been dismissed or denied is recorded in the South Essex Registry of Deeds and indexed under the name of the owner of record or is recorded and noted on the owner's Certificate of Title. Board of Appeal APPLICATION ® ADULT NUMBER Trial Court of Massachusetts AM FOR COMPLAINT ❑ JUVENILEDistrict Court Department LlARREST FA HEARING 7 SUMMONS ❑ WARRANT COURT DIVISION The within named complainant requests that a complaint issue against the within tt3h�CledC,lt named defendant, charging said defendant with the offense(s) listed below. DATE OF APPLICATION DATE OF OFFENSE PLACE OF OFFENSE 65 W"hftVtM sueet 9/5/97 1 8/1/97 156 Bridge Street Salem UK 0t870 , NAME OF COMPLAINANT City- of Salem Building Inspector NO. OFFENSE G.L. Ch. and S ADDRESS AND ZIP CODE,OF COMPLAINANT State Building Code One Salem Green 780 CME Chapter $1 Salem, Masa. 01970 Article 103.1, 103.2 2 NAME,ADDRESS AND ZIP CODE OF DEFENDANT Jospph Skomurski City of Salem Zoning Ordinance 78 Washington Sq. East 3. Article VIII, Section 8-4 Salem, Mass. 01970 < COURT USE I A hearing upon this complaint application DATE OF HEARING TIME OF HEARING COURT US ONLY-----* will be held at the above court address on AT / `' F-ONL` I ! CASE PARTICULARS — BE SPECIFIC NAME OF VICTIM DESCRIPTION OF PROPERTY VALUE OR PROPERTY TYPE OF CONTROLLED NO. Owner of property, Goods stolen,what Over or under SUBSTANCE-OR-WEAPON person assaulted,etc. destroyed,etc. $250. Marijuana,gun,etc. t 3 4 OTHER REMARKS: ! Failure to address State Building Codes and City of Salem Zoning Ordinance violations. i I x ,- SIGNATURE OF COMP NA DEFENDANT IDENTIFICATION INFORMATION — Complete data below if kno DATEOF BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER SEX RACE HEIGHT WEIGHT EYES I HAIR OCCUPATION EMPLOYERISCHOOL MOTHER'S NAMEIMAIDENI FATHER'S NAME V of '150ttlrm, .Attssttr4usrtts tluhlir Propertq Bepartment iguilibing i3epnrtment (One t3slrm (krrrn 500-7,15-9595 Ext. 380 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer August 1, 1997 Joseph Skomurski 78 Washington Sq. East Salem, Mass. 01970 RE: 156 Bridge Street Dear Mr. Skomurski: Due to a complaint received by the Neighborhood Improvement Hot Line, I conducted an inspection and found the following violations: 1. Roof molding at front of building rotted out and birds are nesting. 2. Gutters missing on front and rear. 3. House needs maintenance by means of paint of exterior. 4. Smoke detectors are required in hallways. 5. It appears to this inspector that there are three apartments at this address, my records indicate this property as a legal two family dwelling. 6. Please call so an inspection can be conducted of the interior, to determine how many units exist. Please notify this department within fifteen (15) days upon receipt of this letter, to inform us as to what course of action you will take to rectify these violation. Failure to do so will result in legal action being taken against you. Thank you for your anticipated cooperation regarding this matter. Sincerely, _ Leo E. Tremblay Inspector of Buildings LET: scm cc: Jane Guv Councillor Flynn, Ward 2 Health Department Fire Department CITY OF SALEM NEIGHBORHOOD IMPROVEMENT TASK FORCE Jurisdiction Hist. Comm. Yes ❑ No REFERRAL FORM Cons. Comm. Yes ❑ N( SRA Yes ❑ Ni Date: )i�� A Address: S ✓,2r, d O z Complaint: Complainant: do-J Phone#: Address of Complainant: BUILDING INSPECTOR FIRE PREVENTION ELECTRICAL DEPARTMENT HEALTH DEPARTMENT CITY SOLICITOR ANIMAL CONTROL SALEMHO 1SIN . AUTHORITY -"PLANNING D T ,'( y0c POLICE DEPARTMENT TREASURE ASSESSOR WARD COUNCILLOR DPW SHADE TREE DAN GEARY PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO DAVE WITHIN ONE WEEK. THANK YOU FOR YOUR ASSISTANCE. ACTION: r 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS ADMINISTRATION shall have had general knowledge of the accepted 105.6 Restriction of employees: No full-time or requirements for building construction, fire part-time building commissioner, inspector of prevention,light,ventilation and safe egress;as well buildings,or full-time or part-time local inspector az as a general knowledge of other equipment and defined herein shall be engaged in, or directly or materials essential for safety, comfort and indirectly connected with, the furnishing of labor, convenience of the occupants of a building or materials or appliances for the construction, structure. alteration or maintenance of a building or structure, Each inspector of buildings shall be certified by or the preparation of plans or of specifications the BBRS in accordance with the provisions of therefore within the city, town or region for which 780 CMR R7, the Rules and Regulations for the he or she is appointed,unless he or she is the owner Certification of Inspectors of Buildings, Building of the building or structure; nor shall any officer or Commissioners and Local Inspectors. employee associated with the building department Municipalities may require additional engage in any work which conflicts with his or her qualifications or experience az are deemed official duties or with the interests of the department. necessary. Note:See M.G.L.c. 143, §3Z(Local Option law 105.4relative to part-time employees). Qualifications of the local inspector: In accordance with the provisions of M.G.L. c. 143, 105.7 Relief from personal liability: Insofar as the § 3,each local inspector shall have had at least five law allows, while acting for the municipality, the years of experience in the supervision of building building official, charged with the enforcement of construction or design or in the alternative a two not be deemed personally liable N year associates degree in a field related to building the discharge 780 CMR shall ll his official duties. construction or design, or any combination of education and experience which would confer 105.8 Official records: An official record shall be equivalent knowledge and ability, az determined by kept of all business and activities of the department the BBRS. In addition,such persons shall have had specified in the provisions of 780 CMR. In general knowledge of the accepted requirements for accordance with the provisions of M.G.L. c. 66, building construction, fire prevention, light § 10(b), all such records shall be open to public ventilation and safe egress; az well as a general inspection at all appropriate times and according to knowledge of other equipment. and materials reasonable rules to maintain the integrity and essential for safety, comfort and convenience of the security of such records. occupants of a building or structure. Each local inspector shall be certified by the 780(M 106.0 DUTIES AND POWERS OF BBRS in accordance with the provisions of THE BUILDING OFFICIAL 780 CMR R7, the Rules and Regulations for the Certification of Inspectors of Buildings, Building 106.1 General:The inspector of buildings and local Commissioners and Local Inspectors. inspector (herein after building official) shall Municipalities may require additional enforce all of the provisions of 780 CMR,521 CMR qualifications or experience as are deemed (Architectural Access Board) and any other state necessary. statutes, riles and regulations, or ordinances or bylaws which empower the building official. The 105.5 Reporting Requirements: building official shall act on any question relative to 105.5.1 Annual report by city or town clerk the mode or manner of construction and materials to In accordance with the provisions of M.G.L. be used in the construction, reconstruction, alteration,repair,demolition,removal,installation of c. 143, § 3, the clerk of each city s town shall, equipment and the location, use, occupancy and annually, not later than April first,transmit to the BBRS the names and official address of each asmaintenance of a otherwise of all buildings and structures, except herwisis e specifically provided for by statutory inspector of buildings,building commissioner and az ot local inspector az well as at such other times az requirements or az provided for in 780 CMR 109.0. required pursuant to 780 CMA R7,the Rules and 106.2 Applications and permits: The building Regulations for the Certification of Inspectors of official shall receive applications and issue permits _ Buildings, Building Commissioners and Local for the construction, reconstruction, alteration, Inspectors. Such reports shall be submitted on repair, demolition, removal or change in use or forms prescribed by the BBRS for said purpose. occupancy of buildings and structures, inspect the 105.5.2. New appointments: The clerk of each premises for which such permits have been issued city or town shall additionally report to the BBRS, and enforce compliance with the provisions of the name, capacity and status of any new 780 CMR. appointee within the time periods-prescribed in 780 CMR R7 on fours prescribed by the BBRS for said purpose. 2/7/97 (Effective 2/28197) 780 CMR-Sixth Edition 15 Rky � fY. ;z. NONCONFORMITY SALEM ZONING ORDINANCE Art.VIII, §8.5 of the lots do not meet the requirements for increased in height, except as provided for lot width and area as established by this in section 8-6. However, if such structure ordinance, the lands involved shall be con- used for single- or two-family residential sidered to be an undivided parcel for the purposes can be enlarged or altered in con- purpose of this ordinance, and no portion of £ormity with the lot coverage, front yard, said parcel shall be used or sold which does side yard, rear yard and distance require- " ' not meet lot width and area requirements ments of Table I of Article VI,said enlarge- established by this ordinance,nor shall any ment or alteration shall not be deemed an ° division of the parcel be made which leaves increase in the nonconformity of the strut- (' remaining any lot with width or area below ture and permissible even though the lot € the requirements stated in this ordinance. area and lot width are nonconforming. TW, (2) Should such structure be destroyed by any Sec. 8.3. Nonconforming use of land. means to an extent of more than fifty (50) Where use of land exists that is made no longer percent of its replacement cost or more than permissible under the terms of this ordinance or fifty(50)percent of its floor area at the time amendment,such use may be continued so long as of destruction, it shall not be reconstructed ..x Y g it remains otherwise lawful, subject to the fol- except in conformity with the provisions of lowing provisions: this ordinance. (1) Such nonconforming use shall not be en- (3) Should such structure be moved for any larged, increased or extended to occupy a reason for any distance whatsoever,it shall greater area of land than was occupied at thereafter conform to the regulations for the effective date of adoption or amend- the district in which it is located after it is ment of this ordinance. moved. (2) No such nonconforming use shall be moved Sec. 8.5. Nonconforming use of structure. in whole or in part to any other portion of t the lot or parcel occupied by such use at the If a use of a structure or a structure and pre- effective date of adoption or amendment of mises in combination exists that would not be al- this ordinance. lowed in the district under the terms of this ordi- »' (3) If any such nonconforming use of land is nance or amendment, the use may be continued " •! discontinued for any reason for a period of so long as it remains otherwise lawful, subject to ' twelve (12) consecutive months, any subse- the following provisions: quent use of such land shall conform to the (1) No existing structure devoted to a use not regulations specified by this ordinance for permitted by this ordinance in the district the district in which such land is located. in which it is located shall be enlarged, ex- t' 1. tended, constructed, reconstructed, moved 6ec. 8.4. Nonconforming structure. or structurally altered, except in changing r the use of the structure to a use permitted Where a structure exists which could not be built under the terms of this ordinance by reason in the district in which it is located. of restrictions on area, lot coverage, height, yard .J (2) Any nonconforming use may, be extended r dimensions, or other characteristics of the strut-throughout any parts of a building which tt ture or its location on the lot, such structure may were manifestly arranged or designed for be continued so long as it remains otherwise such use at the time of adoption or amend- lawful, subject to the following provisions: ment of this ordinance,but no such use shall " l M be extended to occupy any land outside such is (1) No such structure may be enlarged or al- building. x tered in a way which increases its noncon- formity, except as provided for in section (3) On any building devoted in whole or in part 8.6. In addition, such structure may not be to any nonconforming use, work may be ;s r 51 CITY OF SALEM NEIGHBORHOOD IMPROVEMENT TASK FORCE Jurisdiction Hist. Comm. Yes C7 No 19 REFERRAL FOR14 Cons. Comm. Yes t7 No i7 SRA Yes o No o Date: _ /1 Address: Complaint: /I ef IG/ Complainant: Phoneif: Address of Complainant: BUILDING INSPECTOR A6F PREVENTION F7FCTRT AT. DEPARTMENT s /HEALTH DEPARTMENT CITY SOLICITOR AN A- CONTROL SALEM HOUSING AUTHOR= PLANNING DEPARTMENT PDT.ICE DEPARTMENT TREA ST TRFRICOT.T_FCTOR ASSESSOR WARD rQUNCTI LOR DPS►' SHADE TRFF DAN GFARY PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO DAVE SHEA WITHINWEEK. THANK YOU FOR YOUR ASSIS CE. ACTION: C CITY OF SALEM NEIGHBORHOOD IMPROVEMENT TASK FORCE Jurisdiction Hist. Comm. Yes 0 No 0 REFERRAL FORM Cons. Comm. Yes 0 NO 0 SRA Yes 0 No 0 Date: / q,) — Address: /LL 4.�4s, clC7� Complaint: 0 4c,pol jl 11211,-2 7� Complainant: � /�/���c%r Phone#: Address of Complainant: G INSPECTOR /O� S LL�tinn ( 4 FIRE PREVENTION ELECTRICAL DEPARTMENT HEALTH DEPARTMENT CITY SOLICITOR ANIMAL CONTROL SALEM HOUSING AUTHORITY PLANNING DEPARTMENT POLICE DEPARTMENT TREASURER/COLLECTOR ASSESSOR WARD COUNCILLOR DPW SHADE TREE DAN GEARY PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO DAVE SF WITHIN ONE WEEK. THANK YOU FOR YOUR ASSISTANCE. ACTION: i C �� CITY OF SALEM NEIGHBORHOOD IMPROVEMENT TASK FORCE Jurisdiction Hist. comm. Yes ❑ No 11 REFERRAL FORM Cons. Comm. Yes 0 No 0 SRA Yes ❑ No ❑ Date: 11919 Address: — �c U✓}-� C���r� �� Complaint: 9 AIn 64 Complainant: Phone#: Address of Complainant: ILDING, INSPECTOR KEVIN HARVEY FIRE PREVENTION ELECTRICAL DEPARTMENT HEALTH DEPARTMENT CITY SOLICITOR ANIMAL CONTROL SALEM HOUSING AUTHORITY F.A IRF. / O . . . TOR ASSESSOR DPW SHADE TREE DAN EARY PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO DAVE SHE. WITHIN MM- EK. THANK YOU FOR YOUR ASSISTANCE. ACTION: l0 � . .. t#'z.^� t is "yam.s � • i. r fir^"-fro - r ,v3.4X& € 9 *1'`-. CITY OF SALEM NEIGHBORHOOD IMPROVEMENT TASK FORCE Jurisdiction Hut. Comm. YeS Q No u REFERRAL FORM Cons. Comm. Yes Cl No ❑ SRA Yes ❑ No ❑ Date: y20�5 Address: /,:U Compiaint: /hvsc s2 �w Comoiainant: Phone#: Address or Complainant: UILDING INSPECTOR KEVIN HARVEY FIRE PREVENTION ELECTRICAL DEPARTMENT HEALTH DEPARTMENT CITY SOLICITOR ANIMAL CONTROL SALEM HOUSING AUTHORITY PLANNING DEPARTMENT _ POLICE DEPARTMENT TREASURER/COLLECTOR ASSESSOR WARD COUNCILLOR DPW SHADE TREE I DAN GEARY PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO DAVE SHE WITHIN ONE WEEK. THANK YOU FOR YOUR ASSISTANCE. ACTION: A I - al Che Commonwealth of Massachusetts ITY Hoard of Building Regulations and Standards U Massachusetts State Building Code, 780 CMR, 7"'edition OF SAALL EM Revised Januury Building Permit Application'ro Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling i his Section For Official Only Building Permit Nwnber• Dat pplied: r7 Signature: �L` 2t' Building 'rmmissioner/I t'Nuildings Date SECTION 1:SITE INFORMATION 1.1 Propert,y Address: 1.2 Assessors Map& Parcel Numbers SSy�r�cSo SA Sakrt, YhA019)0 _ I.[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 11) Frontage(R) 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: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if yes❑ Municipal❑ Onsite disposal system ❑ �• SECTION 2: PROPERTY OWNERSHIP' 2. �ne/ iegeco1[.j�C &'1 �D IJX Nm a(Print) Address for Service: Sig...tSe Telephone ' SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building lit Owner-Occupied (A I Repairs(s) 0 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify: Brief Description of Proposed Work': Tr�_i� 0,CmoJ6 1 F-1 CA✓�t_Z 1 , N4 W [9C(,k,, % (20 rllnS♦ SA�asZS f1161`,n14C o4J. /5 ' St_v,li5!31 SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Of tial Use Only (Labor and Materials I. Building S 'a 00 I. Building Permit Fee:S Indicate how fee is determined: 2. ElectricalS ❑Standard City/Town Application Fee •o ❑Total Project Cost' (Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5. Mechanical (Fire S Su ression Total All Fees: S Check No. Check Amount: Cash Amount: 6.Total Project Cost: S S(P I 40•uo ❑ Paid in Full ❑Outstanding Balance Due: p 2to t r SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 9WPy Vin\(A�C–, License Number li.vpimlio Dale Na w of CSL-I IoIJFF J V� �'r PAM iV 5 �. J'� List CSL Type(see below) Address .►Nt/L'� 'y"'�' eiY23 Iv 1tion U Unrestricted u m 35,000,000 Cu.Ft.) R Restricted 1&2 Pamil Uwellin Signature M Masonry Only l^9�r•.3/y,�7� RC Residential Roofing Covering "telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Regist ed otne ImprovIntent Contractor(HIC) //_ L/1-a/ M r e fl& kZl565"— le 1-11 C Company N� ne oali I R1ltranj Name Registration Number } /�iPAN Sf "S /013")/</ Address — /– 47 Y–$ffr G.pirati n Date Signature "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 of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, Vh qr 0.4� Re.Q f 140 as Owner of the subject property hereby authorize IAI" S4 I SdKV1'e-ed Tale. to act on my behalf,in all matters relative to work authorized by this building permit application. 0 S—iunatulwbr wner at SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf. Print Name Signature of Owner or Authorized Agent Date (Signed under the pains and penalties ofperjury) 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 1 I O.R6 and 110.115, respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq. Ft.) (including garage, finished basement/attics,decks or porch) Gross living area(Sq. Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halfibaths 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" The Commonwealth of Massachusctts �V Board of Building:Regulalions and Standards CITY yMassachusetts State Building Code, 780 CMR Z'"pJt�)on OF SALEM y/ i !,,,, q t Reused✓anuurt- Building Permit Application To Construct,Repair, Renoyglq 9Fp5rnulish a 7. zonx one-or Avo-Fam' wr!!i/rg . . .' This Sectio or OfTt ial Use Only",;-` Building Permit Number: Date pplied: Signature: / 7 Iy Building Commissioner/Inspect Bu dings to SECTIO ORMATION IA Prope 5 Qdrear-?� �t I Assessors Map& Parcel Number J t; J +: L l a Is this an accepted street?yes no�=l Map Number Pa><,4 Number 1.3 Zoning Information: 1.4 Property Dimenslugs Zoning.District Proposed Use Lot Area(sq 11) Frontage(11) 1.5 Building Setbacks(it) Front Yard Side Yards Rear Yard Required Provided -Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Elood:.zone.Information: 11 Sewage Disposal System: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if es❑ - Municipal On site disposal system ❑ SECTION 2: PROPERTY OWNERSHII?t 2:1 order'ot(R S rde If S s �f (Print) n, Name(Print) - Addreas.for Service Signatu Telephone SECTION 9: DESCRIPTION OP PROPOSED WOIlka�cbgek all thpt apply) New Construction❑ Existing.Building❑ -Owner-Occupied ❑ Repags(s? Q', `Alteration(s) ❑ `Ad fition ❑ Demolitiong - . g {❑ Accessory Bld ❑ Number of O her, ❑,$,pacify: Brief Description or Proposed Work': her 5*,' ' / � r � G_ w ll c r- t r 5 . r ?. V. T� 61 SECTION 4-,,ESTIMATED CQNST"ki" OIY COSTS_ Item Estimated Costs: Ofllclal,l)ae,Only Labor and Materials .. __..... . .- I. Building S I. BuildingTermit'Fee:S. Indicate'how feeds determined: ❑Standard City/Town Application Fec 2. Electrical S ❑Totals Project Cost'�(Item 6)x multiplier x ). Plumbing S 2. Other Fees: S �� 4. Mechanical (IIVAQ S List: S. Mechanical (Fire S Suppression)ression Total All Fees:S AA Check No. _Check Amount: Cash Amount:6. Total Project Cost: 5 � _ p paid in Full 0 Outstanding balance Due: SECTIONS: CONSTRUCTION SERVICES S.I Licensed Construction Supervlsor'JCSL) g 7 g I —) L- a.3 Z - �rl'�trtg�l',,.+f Pajl�__ License Number Expiration Dutc Name of C'SI.- I folder 3 1•R�IW 1 rS'B{K. I.ist C'SL'rype(see below) r- Oescription. Address _ _ 41 tl Unrestricted(up to 35,000 Cu.Ft. R I Restricted-IR2 Family Dwelling SignaWrc � M Mason Only � RC I Residential Roolin Covcrin 1'e1cphone I WS I Roidential Window and Siding SF I Residential Solid Fuel Burning Appliance Installation D I Residential Demolition [;Aid—dress e btered Homelmprovemcnt Contractor(HIC) I 'l; O �S y m C a t•tm ume egistration Number MA0197O Expiration Dote re Telephone -- SECTION 6:WORKERS•COMPENSATION-INSURANCE AFFIDAVIT(M.G.L.e.I52.g_2SC(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 ..........0 No...........O SECTION 7s:OWNER AUTHORIZATION.TO BE COMPLETED WHEN y_ OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT s 1 , as Owner of the subject property hereby authorize f to act on my behalf,in all matters relative to work authorised by this building permit.application. sianaturcorowner SECT.I,QN 76:;OWNEW OR AUTHORIZED AGENT DECLARATION 1 Er r ln.� as Owner or'Authorized iAgent,herebydeclare that the statements and info'nhation omthe'foregoing application are true and accurate,to the bestof my knowledge and behalf Print Name Signalumof.(wnerorAuthorrzed-Agem Date ! . (Signed under the pains and nalocs of" 'u - - NOTES: I. An Owner who obtains a building permit to do his/her cwn work,or an owner who hires an unregi'stercd contractor (hot registered in the Nome improvement Contractor OCC)Program),will_qd 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 110.115, respeetivcly. 2. When substantial work is planned,provide the information below: Total floors area(Sq:Ft.) (including garage, finished basement/attics,decks.orporch) Gross living area(Sq.Ft.) Flabilable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system' Number of decks/porches Typeof cooling system— Enclosed Open 3. "Total Project Square-Footage"may be substituted for"Total Project C t" Cos A I - al Che Commonwealth of Massachusetts ITY Hoard of Building Regulations and Standards U Massachusetts State Building Code, 780 CMR, 7"'edition OF SAALL EM Revised Januury Building Permit Application'ro Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling i his Section For Official Only Building Permit Nwnber• Dat pplied: r7 Signature: �L` 2t' Building 'rmmissioner/I t'Nuildings Date SECTION 1:SITE INFORMATION 1.1 Propert,y Address: 1.2 Assessors Map& Parcel Numbers SSy�r�cSo SA Sakrt, YhA019)0 _ I.[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 11) Frontage(R) 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: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if yes❑ Municipal❑ Onsite disposal system ❑ �• SECTION 2: PROPERTY OWNERSHIP' 2. �ne/ iegeco1[.j�C &'1 �D IJX Nm a(Print) Address for Service: Sig...tSe Telephone ' SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building lit Owner-Occupied (A I Repairs(s) 0 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify: Brief Description of Proposed Work': Tr�_i� 0,CmoJ6 1 F-1 CA✓�t_Z 1 , N4 W [9C(,k,, % (20 rllnS♦ SA�asZS f1161`,n14C o4J. /5 ' St_v,li5!31 SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Of tial Use Only (Labor and Materials I. Building S 'a 00 I. Building Permit Fee:S Indicate how fee is determined: 2. ElectricalS ❑Standard City/Town Application Fee •o ❑Total Project Cost' (Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (HVAC) S List: 5. Mechanical (Fire S Su ression Total All Fees: S Check No. Check Amount: Cash Amount: 6.Total Project Cost: S S(P I 40•uo ❑ Paid in Full ❑Outstanding Balance Due: p 2to t r SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 9WPy Vin\(A�C–, License Number li.vpimlio Dale Na w of CSL-I IoIJFF J V� �'r PAM iV 5 �. J'� List CSL Type(see below) Address .►Nt/L'� 'y"'�' eiY23 Iv 1tion U Unrestricted u m 35,000,000 Cu.Ft.) R Restricted 1&2 Pamil Uwellin Signature M Masonry Only l^9�r•.3/y,�7� RC Residential Roofing Covering "telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Regist ed otne ImprovIntent Contractor(HIC) //_ L/1-a/ M r e fl& kZl565"— le 1-11 C Company N� ne oali I R1ltranj Name Registration Number } /�iPAN Sf "S /013")/</ Address — /– 47 Y–$ffr G.pirati n Date Signature "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 of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, Vh qr 0.4� Re.Q f 140 as Owner of the subject property hereby authorize IAI" S4 I SdKV1'e-ed Tale. to act on my behalf,in all matters relative to work authorized by this building permit application. 0 S—iunatulwbr wner at SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf. Print Name Signature of Owner or Authorized Agent Date (Signed under the pains and penalties ofperjury) 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 1 I O.R6 and 110.115, respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq. Ft.) (including garage, finished basement/attics,decks or porch) Gross living area(Sq. Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halfibaths 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" The Commonwealth of Massachusctts �V Board of Building:Regulalions and Standards CITY yMassachusetts State Building Code, 780 CMR Z'"pJt�)on OF SALEM y/ i !,,,, q t Reused✓anuurt- Building Permit Application To Construct,Repair, Renoyglq 9Fp5rnulish a 7. zonx one-or Avo-Fam' wr!!i/rg . . .' This Sectio or OfTt ial Use Only",;-` Building Permit Number: Date pplied: Signature: / 7 Iy Building Commissioner/Inspect Bu dings to SECTIO ORMATION IA Prope 5 Qdrear-?� �t I Assessors Map& Parcel Number J t; J +: L l a Is this an accepted street?yes no�=l Map Number Pa><,4 Number 1.3 Zoning Information: 1.4 Property Dimenslugs Zoning.District Proposed Use Lot Area(sq 11) Frontage(11) 1.5 Building Setbacks(it) Front Yard Side Yards Rear Yard Required Provided -Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Elood:.zone.Information: 11 Sewage Disposal System: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if es❑ - Municipal On site disposal system ❑ SECTION 2: PROPERTY OWNERSHII?t 2:1 order'ot(R S rde If S s �f (Print) n, Name(Print) - Addreas.for Service Signatu Telephone SECTION 9: DESCRIPTION OP PROPOSED WOIlka�cbgek all thpt apply) New Construction❑ Existing.Building❑ -Owner-Occupied ❑ Repags(s? Q', `Alteration(s) ❑ `Ad fition ❑ Demolitiong - . g {❑ Accessory Bld ❑ Number of O her, ❑,$,pacify: Brief Description or Proposed Work': her 5*,' ' / � r � G_ w ll c r- t r 5 . r ?. V. T� 61 SECTION 4-,,ESTIMATED CQNST"ki" OIY COSTS_ Item Estimated Costs: Ofllclal,l)ae,Only Labor and Materials .. __..... . .- I. Building S I. BuildingTermit'Fee:S. Indicate'how feeds determined: ❑Standard City/Town Application Fec 2. Electrical S ❑Totals Project Cost'�(Item 6)x multiplier x ). Plumbing S 2. Other Fees: S �� 4. Mechanical (IIVAQ S List: S. Mechanical (Fire S Suppression)ression Total All Fees:S AA Check No. _Check Amount: Cash Amount:6. Total Project Cost: 5 � _ p paid in Full 0 Outstanding balance Due: SECTIONS: CONSTRUCTION SERVICES S.I Licensed Construction Supervlsor'JCSL) g 7 g I —) L- a.3 Z - �rl'�trtg�l',,.+f Pajl�__ License Number Expiration Dutc Name of C'SI.- I folder 3 1•R�IW 1 rS'B{K. I.ist C'SL'rype(see below) r- Oescription. Address _ _ 41 tl Unrestricted(up to 35,000 Cu.Ft. R I Restricted-IR2 Family Dwelling SignaWrc � M Mason Only � RC I Residential Roolin Covcrin 1'e1cphone I WS I Roidential Window and Siding SF I Residential Solid Fuel Burning Appliance Installation D I Residential Demolition [;Aid—dress e btered Homelmprovemcnt Contractor(HIC) I 'l; O �S y m C a t•tm ume egistration Number MA0197O Expiration Dote re Telephone -- SECTION 6:WORKERS•COMPENSATION-INSURANCE AFFIDAVIT(M.G.L.e.I52.g_2SC(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 ..........0 No...........O SECTION 7s:OWNER AUTHORIZATION.TO BE COMPLETED WHEN y_ OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT s 1 , as Owner of the subject property hereby authorize f to act on my behalf,in all matters relative to work authorised by this building permit.application. sianaturcorowner SECT.I,QN 76:;OWNEW OR AUTHORIZED AGENT DECLARATION 1 Er r ln.� as Owner or'Authorized iAgent,herebydeclare that the statements and info'nhation omthe'foregoing application are true and accurate,to the bestof my knowledge and behalf Print Name Signalumof.(wnerorAuthorrzed-Agem Date ! . (Signed under the pains and nalocs of" 'u - - NOTES: I. An Owner who obtains a building permit to do his/her cwn work,or an owner who hires an unregi'stercd contractor (hot registered in the Nome improvement Contractor OCC)Program),will_qd 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 110.115, respeetivcly. 2. When substantial work is planned,provide the information below: Total floors area(Sq:Ft.) (including garage, finished basement/attics,decks.orporch) Gross living area(Sq.Ft.) Flabilable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system' Number of decks/porches Typeof cooling system— Enclosed Open 3. "Total Project Square-Footage"may be substituted for"Total Project C t" Cos