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5 BARNES RD - BUILDING INSPECTION t _ _ � � y� The Commonwealth of Massachusetts CITY OF � °�,, - . Board of Building Regulations and Standazds SALEM \`� � � Massachusetts State Building Code, 780 CMR RevisedMar 2011 Building Pennit Application To Construct,Repair,Renovate Or Demolish a One-or Two-Family Dwelling - 4 4 . �, .u,.M' F�4 ,y,�, d ,�" H } '�"3�.'w+ ^r�. Y.' } ��" "�x.St�M. �,,�5 � U . � , �� � � . ;�Tl�is S�ectt�'on�'br Of£xcial�Ts�' �al �'��x`� �� �`���� > _.� � Buildi�g�'ertn�tNumber ���"���'����"�� .���.'����g �Dafe A�PI d�,�'��"�������`«:,��'� <��k� €� z�$''xK�. � ,. �rs� � � .3��"'-��"` e`.` x .:"` ,'* .c s«��'r ���`� '� ��'��....� `� '"";:�r��£� a� �';�:�y�cy,�' *'�= 3�t'�;,�X ��, d� �Y , az.��.�t �� � -, y ,��'��i�g�e."»�+ r,'�..`�,�^°������} `�€€�� � '^� � t �'#e4 � Builiiuig Officta4(Print�Name)� ,� ���">��,� `���„�'�t�,s;Signati�ir�e;;����. ��.� �n h �^��< �:,� ^, ate �. �� � <�.: � '� ..r..,. 'S�+C`I`ION`1 STTEIlYFORMA'II01�,�s;"�R; '�`��'`�.;x „t , ;� �pi , >. 1.1 Pro er ddress: 1.2 Assessors Map&Parcel Numbers � r-��� �� 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 P.rea(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) � Front Yard Side Yards Reaz Yazd � � Required Provided Required Provided Required Provided � 1.6 Water ply: (MG.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private❑ Zone: _ Outside Fiood Zone? Municipal� On site disposal system ❑ Check if yes❑ �� . . . . k: � ` �s` SEC�`IOA�2„�PRQRERTX OWN�RSAIP'k�:����,m��°��'�� �<�:.;''�... ;.' �' �, 21�Own�i�Coxord� . . �w.�. , .., �� I-�'�'L 1 lC� ��'l ��i � p f Name P n �- C`ty�j`�IP^ �� 3 ( � / Sr mQ5 jZv� i' �� No.and Str'eet Telephone Email Address � �'� r ;>SECTI,ON 3�D�SC,121P'IIONyOF��ROPOSEb�ORT��(ch�ckall that�a�ply) � x;, x��„ ,;� New Construction❑ xisting Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition � Demolition Accessory Bldg. ❑ Number of Units Other ❑ Specify: ' n q /d�1. Brief De cription of Pro osed Work2: , ��'' ^o J�'oC�� � W C� �a, � � 4 eX� c. � ;;� , 3 ��2� t�SE`C�ZON4nES'I'SIVIATED�'CON3x7�`CIC��I' Ok�COSs=S �� k� �'� ��� ��� ��x � Y��.� z. . �.,.x:.,_ , s,.=.Er n��..��.a .: %. :u:u,:.,x-s:a�� c �• "��+��:e� -r �.s� �.���w;�.�`�iN'u"'' `}.'; ; � .�- �;"�"'z�`,,.����`���4' �..-��u n^�..m,�r��� Estimated Costs: � Item Labor and Materials �,"{���� ��� �Off��aTUse�On1Y�� �,�� �����;�� �^� 1. Building $ �I�Bml�d�g�,Pe�ik��$ ���.��'Ind�cate'how�fee de�tennmed " O�Stan�'a{dhGity( o�n�icahvo,n,�kee�� ��� t� � �; 2.Electrical $ �"�` z $%w"'a�€.�,.��f='� �.. r�y,�':�i�"�� W tr �.'''µ'.: ` _, � x��Trptaf�Pr �ct = si�Ite 4'`)�t'm�tzpl�ei��x�' -��� � � . ���,�.����� ��� `� , �y� � 3.Plumbing $ 2 a< ee�$r �:. ,� +`�' � � '��.,�1�.�'` ���'Y ,�.�.,� p} � � '��t �' �. �"���r ',-;�:n',�p *? �„;. l� "� t'-. 4.Meahanica] (HVAC) $ � ..���,e s{,A;,-�"�' "�'` rr �:.., u < s s - �- t � �n:'�"'��''Y*°��'�?„'��s�A:ti£.�w s,�v��`���..�«��u�.''`�;" . .,: S.Mechanical (Fire $ � m� � � ,��� ���� x � t � �.; Su xession) �,TO�a�'.�„�.,�"Eegs $�^���'�.����'�;�r��,�'%�,�� ��`�",v,'�.�,':��,�?'a.� :, � � ���� � < �C�h�c�kY�To ���Cl�ecic����,oun��':��iashA�nouno���"�� 6. Total Project Cost: $ /G O a a0�aielF�u Fuil�� �°���xOutsta�nd�anc� �ue`w���`'�'°� :��'3w / � .,��"���A� ?fig �-�...�;,��, �^�-c� � a 1C�pc�Pj� _. _._ . . ... , � ., ..,.� . ... ._ , . m ... . . ._., ... � .r / � SECTION 5: CONSTRUCTION SERVICES s., 5.1 Construction Supervisor License(C ). �Q .7� G � I n� �� � �� �'lQ 'J� �!�' V� LicenseNumber Expi�LonDate Name of CSL Hol r v � �'�� ^ d'� (^� � � List CSL Type(see below) l� No.and Street � � ,Descr�ptrni[� � � �. ��f p�� /�„ /�_ Q�� l` ���� Unrestricted �Buildin s u to 35,000 cu ft. � ����� ` •�`—� R Restncted 1&2Famil Dwellin City/Town,State,Z[P M Maso RC Roofin Coverin WS Window and Sidin ��� S�� ���� SF Solid Fuel Buming Appliances I Insulation Tele hone Email address D Demolition 5.2 Register d Home I provement Co ctor(HIC) �}/'J//3 C c�.es (���s � t ,3a� � 9 HIC Registration Number Expiration Date HIC ompany Name or HIC Regis ant Narne �r�-� tio. and'/SVeet��, �/ Email address G G< " `L- Ci /T wn, tate,ZIP Telephone � ..__.. . . . .. . . ..._ . . . ... .. ... . . . .. . . .. . ... . . . ... . .. . . . . .._.. _ . . .. . . . . . . . . . . . .. .. .. . . . . ... . .. . .. . .. . . .._.. . . .. . .. . _.. ` ` SECTION 6: WOI2KERS' COMPENSATION INSURANCE'AFFIDAVIT(M.G.L. c. 152.§ 25C(6)) _ __ _ __ ._ ., __ . . F _ 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 e building permit. Signed Affidavit Attached? Yes .......... No ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO'BE COMPL�TED WHEN ' OWNER'S AGENT',OR CONTRACTOR APPL FOR BUTLDING PERMIT , , ' I,as Owner of the subject property,hereby authorize l,' to act on my behalf, in all matters relative to work au onzed by this buildin permit application. L�,��� :l�� ��/� r3 Print Owner's Name(Ele tronic Sig�ature) Date � . . _ . . .. .... . _. .. .... ....,... . . . . .. .. . .. .. ...._.. ._..._. . ...... . . . .. . ... ' ° SECTION 7b: OWNER'OR AUT�IORIZED AGENT DECLA,Z2ATION a ' ' `` 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. C'�qr(.e5� )-C��� � � /� � 3 Print Owner's or Authorized AgenYs Name(Electronic Signawre) Date NOTES: s� ._ ' ,,�. ,<._,. >.�. �_,.. _ � 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 unportant information on the HIC Program can be found at w4ti�.mass. o�Information on the Consuuction Supervisor License can be found at w��vw.mass.�ov:�ctns 2. When substantial work i$planne^d,,provide the information below: Total floor area(sq. ft.) �L1 f�v (including gazage, £mished basemenUattics, d cks or porch) Gross ]iving area(sq. ftJ Habitable room count p Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Gj�S Number of decks/ ches Type of cooling system � v�� Enclosed � Open 3. "Totat Project Square Footage"may be substituted for"Total Project CosP' Q� - . i:'% . . CITY OF S.1I.E�I, I�L�SS:ICHL;SETTS . .' BL'ILDG\G DEP iR'i�lE.�i'C ����• l�O\�7.�SH4�IGTON STItEET,3�D FLOOR � � T12i. (978)�45-9595 F.tx(978) 7�i0-98�{6 KIIBERLEY DRISCOLL � L�YOR - THOR4ISST.PiF1tR8� DtREGTOR OF PL:HLIC PROPERTY/9CIID�IG COSLUiSSIONER _..._._._.__.-- Workers' Cumpensation lnsurance Affid•avit: Duilders/Contractors/Electricians/Ptumbero A � ilic�nt Informat(on Plcase Prfnt Le ibt � V;t111C(Uuaiixs.�Ur�,tnizaiiarvindividual): � S Acldress: S r-�� CG �Cn� � ' 1 City/StatclZip: � �� � � Phane�: 9�� S �� �5�3 Are ynu an employer?Che¢k the appropdate boY: 'Cype oP,proJect(requlred): J.0 I a cmployer with �• � ���g��l canuactor and 1 6. r '�N conswction ployea(fLll and/or paR-tima).• have hinKt tha�ulxontracWrs ��� � 2, mn a sole propricror ur pwtm:r- lisrod on the attachcd.rheet= �• � odeling ahip and have no employeea 'I1usa sub¢ontracrorg havo 8. e lition � wurking fur mo in any capacity. worken'comp. inswance. g, uilding addition . . (No workon'comp.insurance 5. 0 We are a corpomtioo md ih reqwrcd.� officershave ezqreised thnir �0.❑Ekchical rapairs or additions 3.Q 1 am a homeuwner doing nll work right of exemptiun per MGL I I.�Plumbing repuirs or udditiore myulf.(\o workeri cump. e. 152, p 1(4),anS we have no 12,�J Roof espnirs insurance reyuired.]t umployaea.[A'o wo�icen' cump.in.eurance rcquircd.J ��•0 O�K •�ny appll.:un ilw ducka baz AI mus�alyu 011 uW iha ucliuo bclow�howiny tlwu wmken'compenudun�wtl�y infwmation. �I L�nuuwmas wAo�ulm�il tAi��171dnvi�indicminy ihry um doiny oll workand thm hGo uultide coNmatm musl pu6mft a new afltJavil indialiny wch �Cunuac�on tM1oi ch�ck Ihi�6ox mw�t anachcd an mWitiuwl xhmi shuwinp Iho mm�e of Iha yubcnntneton dnd thc4 wuhm'eomp.puliry infortnnNon. !um an au�ploye�rhat Lr provlding ivorkes'comprnsadan in.rurance jor my emp(uyerx Be/uw!s fhi poJlcy nnd fab y!!s Lijanourion. r /� In.ur�nceCompanyName:__ 1 \ 0.�'���� Pulicy d ur Self-i�u. Lic. q: (� ��� G Ecpimtion Date• , JubSi�eA�IJress: � ���5 K Ciry/Statr/2ip: �lPfln � 01�� .\ttach n cupy o[tho worken'compensatlon palley declaration paga(showfng tho polky numbo�and expiratlon data� Fuiiuiv to w:curo covernga as required uaJer Seclion�25A of MGt c.`(32�eui lead ro the imposi[ion of criminal penal[ias of a tine up ro SI,500.00 unJ/or one-yaar imprisonmcnr,�a wcll ag civil pcn�lfies in tha form uf a STOP WORK ORDER nnJ n fine of up ro S'_SO.QO a Juy against rha violaror. 13e adv(.red thut a copy uf ihis statement may be furwardud to�he OlYce oF Inve>Iigaiimuc uf tl�e DIA fo�insurance cover�ga vcrilicWiun. � /do herrby rrrri�der idr � pen 9r ujprrJu rul!he iujunnutlar proviJrJ abuve ie rue urtJ rarrrct 5�„n.�t11fC' I)JN' � //v � � � a �, ri• OJJicru!use ouly. Ou imf rvrrfe in dtfr urrg m bs cump/eted by city u�Iown n/Jlc/uL I City ar'Pown: __.__ Prrmltlf.lcenye q IssuinK.\utl�uri�y(circloune): � ---J— 1. ISuard uf Ileallh 2. Ouildin6 Ocpartment J.f.ity/fown Clerk J. Eleehlcal fnspector 5. Plumbin{; Inspector � 6.Other--- Cunt•rct Pcrsnn: � _ _ Phone B: I . _ . . .. . _. . . _. ._. . .. ! • � ,: �°" CITY OF S.�LE1�I� ��-�SSACHL'5ETI'S • Bti1LDL\G DEPAR"I1SE�i'C � �° 1�O W.1SHL�IGTON STREET, 3°O F'1.00R '�'�b'` T�I.. (978) 745-9595 F,.�c���a� �aa�aab {��{gFR1 FY DRISCOLL itii.�YOR �i09LLS ST.PIERR& DtRECI'OR OF PtiBUC PROPER"IY�HCII�L\G COSL�(75SIOVER C'onstruction Debris Disposal Affidavit (required for all demolition and renovation work) 1n accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S i 50A. 1'he debris wi11 be transpoRcd by: �/✓_���� t�� � (name of'hauler) The debris will be disposed of in : ���s�.� �� (name of facility) � (address of F,�cility) C7 / signature af permit applican[ �// �� �ate debrisalf J,x E �.-.. 2x' 1 Z � 'p`"j �= � � 5� cD� S�E�' � � � r 3c �/�i �45 .y.v �� S�wt�' So� I Z � � � 5�F/ /GP/5�/�'�h'f"��' r�.s�4� t g �� ,�i c -�"c�"� f{za 5H*�z.� �'�a�'�5 7 f ZXf 2 ��O �o. c . 6YC�f�� 7`0 /�C,�f , .t' �43�r��. � ,rCms�µ i �� ,-� �2 '�go4��5''�[""� +�. D�g CE 2oc6�!A�'�P� � , `� ��/r� s qt�' �1.YCo � �6 "o .c � � � � '/bL9P'e cx.rd-d,�1����^�nuq , V 2kt2 /� '`�, c . ��D�.� T� �+T�'9 ��'✓ . � � .TNS . - -� 8 ��F<<D � \`�ti r•�r�sk� co.arP r� °o y „ �,� t- '�� V 8 ¢•�s48`a���E. �w-Ty 6x� c C�/.4+�w✓. �• �ID ca,crC �D�tC WiQ� ���i�����, �-/2 �',x ?.¢�i/.s70C �r'" �— �8 �C' s�Q�G'�'�n�a�..o �o� . ��N� �nro►�Tur�.t�iL �,�� � A.e. 1 � DBL SILL T /�� - O ///�� � SILL SEAL w L , � � � .--GRADE HEAOER SCHEDULE ��� (/S \�/K OP=NING c�ZE HEADER SIZE ` � /> � lass inan 2'-0' �T S . � 12!2�B � ^ a �-9':o'c'J" :Zie"i"'u (1) g1 REBAR TOP e'L";0 9'-p° ' ANO BOTTWA �2i?x+.2 2�4 KEY R �GSP,5C?p�2f SL^P'JJI[' •��.evs`ev:c:��eus oaca�bacfaa.,,.-�s (3) p9 REBAR UNOISNRBED ,� BEARING SURFACE .'•• �, �•�.��. 2-0- , p a TYPICAL FOUNDATION DETAIL � � . �� w. sEr�rr 1'l /2�'�� nr S.f.R�UCTU � � .� y � �!� . No.325P.a �1 i - L _� . � •v i�rru��E� JZC� . --- `h 5.E-��✓1� � • S, .. `4 � • General Notes: 1. All existing dimensions, conditions and elevations shall be verified by the contractor. 2. Contractor is responsible for temporary bracing and support during beam installation. 3. All wood framing shall be 1000 psi fiber strength in bending. 4. Afl framing shall be free from large knots, cracks or other structural defects. 5. Micro-Lam beams, designated as LVL's on design drawings, shall be 2.OE sections with an allowable bending stress of 3100 psi, as manufactured by the Boise Cascade Corp. or an Engineer approved equal. 6. Micro-Lam beams shall be connected together as follows: 2 ply members- 3 per row of 4" Fastenmaster heavy duty wood screws at 16" o.c. from each side: 3 ply members- 3 per row of 5" Fastenmaster heavy duty wood screws at 16" o.c. from each side. Unless othervvise detailed on the drawings. 7. All roof sheathing shall be 4' x 8' sheets of 5/8" CDX plywood and shall be nailed with 8D common nails at 6" o.c. along all edges and 8" o.c. throughout the remainder of the sheet. 8: In addition to code required nailing rafters in areas with cathedral ceilings shall be tied to structural ridge members with an LSU sloped hanger as manufactured by Simpson Strong-Tie Co. or an engineer approved equal. 9. In addition to code required nailing rafters shall be tied to the exterior wall double plates with Model H2.5 hurricane anchors as manufactured by Simpson Strong-Tie Co. or an engineer approved equal. 10.All structural steel shall be ASTM A36. 11.Structural tube steel sections shall be ASTM A500 Grade B. 12.Steel pipe shall be equiva�ent to ASTM A36 material. 13.Before welding to existing steel, clean and remove all dirt, grease, paint, etc. within a minimum of 1" each side of the weld. 14.Welding shall be in accordance with AWS D1.1 using E70XX electrodes. 15.All bolts, anchor bolts, washers and nuts shall be ASTM A307 unless othervvise noted. 16.Bolts for structural steei connections shall be 3/4" diameter ASTM A325, with a minimum of 2 bolts per connection using standard holes. Unless otherwise specified. 17.All steel connections and details shall be standard in accordance with the latest A.I.S.C. manual and specifications unless otherwise spec�ed. 18.Concrete work shall conform to the latest edition of Building Code Requirements for Reinforced Concrete (ACI 318) and Specifications for Buildings (ACI 301). 19.Construction shall conform to the requirements of the Mass. State Code Latest Edition and all other applicable state and local code requirements. . ��i�.; Specified ulti te compressive strength of concrete shall be a minimum of �. 00 psi 8 days. t RQ7CAilt w. �E3,���2 inf ng steel shall have a minimum yield strength of 60,000 psi ^ sr:Rvcru�;�,; ming to ASTM A615, Grade 60. ���YtY � No,}i5F,9 �L �/D� �� ' Y a �h �'�C�����'�?- " �' - Co l � --�� • 3o/YR��������e �l�Ltl �A�t-49E �� 2 C�/6 "o.c{ . � ��'��D�C,�i,���s 4 � ��`���6 'o.���� ��r%�5 . � � �d� T��� Y�> ocqr�co�'Q'°��" E.r�d'j � - � � �i �rF �'``��� � � �o �`��BE �� v�r� . � �C, A�c�� _.., _--_.. � _., 2n�r� ,1' Z 2��.Co� _ �. _. _ �_� —�. ���EG t�E�� --- --� -- ���Lo og N . 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