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10 BRIGGS STREET - BUILDING JACKET I endaflO a Esselte 74520 400/6P4 J �CoNDIrq.� CITY OF SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01970 TELEPHONE: 978-745-9595 EXT. 380 uoe FAX 978-740-9846 KIMBERLEY DRISCOLL MAYOR 1 August 15, 2011 To Whom it May Concern: RE: 10 Briggs Street According to our records, it has been determined that the property located at 10 Briggs Street is a legal grandfathered non-conforming two (2) family dwelling located in a R-2 zone. This is to determine use only and in no way is meant to confirm or deny whether said property is in compliance with all building, plumbing, gas, electric, fire or health codes. Sincerel/� �. Thomas St. Pierre Zoning Enforcement Officer I' 4 The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF SALEM I[l�' W Massachusetts State Building Code,780 CMR Revised Mar 2011 JJ Building Permit Application To Construct,Repair,Renovate Or Dem a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date (pplied: Budding Official(Print Name) Sipature Date SECTION 1:SITE INFORMATION 1.1 PropertyA�,dress• 1.2 Assessors Map&Parcel Nyebgrs�{,� Lis Is this an accepted street?yes_-%L no Map Number - Parcel Number 1.3 aing Information: ' 1.4 Property0 Dimensions: �- Zoning District Proposed U� Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 111' Private❑ Zone: _ Outside Flood Zone? Municipal aJs On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Ow E 'ofRecd: James E . Name(Print) City,State,ZIP r No.and Street Telephone` Email AddressJ — SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) W I Alteration(s) Ef I Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units3_ Other ❑ Specify: Briefl7escription of Proposed Workz: 1 cx YJ InS SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ � 1. Building Permit Fee: $ Indicate how fee is detemtined: 2.Electrical $ OM ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 000 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Five $ Su ression Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ It ,o00 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 w.ft. R Restricted 1&2 Family Dwelling City/Pown,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Bruning Appliances I Insulation Telephone Email address DDemolitpio�nj 5.2 Registered Home Improvement Contractor(HIC) 14 l 0�0 VIM 1 tW MkS ?) 1 P U HIC Registration Number Expiration Date HIC Compriy Nqmq Ar HICRe 'sten N e vr� Coln No.and Street� U kc�- `I , Email address eyeriw , l Ci /Town,State ZIP Telephone 7 SECTION 6:WORKERS'CbMPENSATION 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 I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date 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. ;JCANs Print Owner's or Authorized Agent's Name(Electronic Signature) 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 wD .mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps Z. 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 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" 33 v The Commonwealth of Massachusetts CITY OF � Board of Building Regulations and Standards SALEM d!i Massachusetts State Building Code, 780 CMR � Revised,Llnr 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Tivo-Family Dwelling This Section For Official Use Only Building Permit Number.- - Date Applied:.1, Building Officio (Print Name): Signature Date SECTION t: SITE'INFORNIATION 1.1 Pru r dress: 1.2 Assessors Nlap& 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 R) Frontage(III IS 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 L3 Private❑ Check ifyes0 Municipal ❑ Onsite disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner of Record: )Yq)M7.g �G-LLI (� me riot) City,State,ZIP 1 <All tiu� �t�r -3Sy8� No.mid Str1 eet ele� Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑TRepairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work'-: SECTION 4: ESTIMATED CONSTRUCTION COSTS . Item Estimated Costs: Offteial Use Only Labor and Materials I. Building $ I. Building Permit Fee:$ Indicate how fee is determined: ❑.Standard City/Town Application Fee' 2. Electrical S ❑TotaLProject Costs(Item 6)x multiplier. x 3. Plumbing $ 2. Other Fees: S 4. Mechanical (HVAC) S List: . 5. iklechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount:. Cash Amount: 6, Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES, 5.1 Construction onsstructioSu m�risor License(CSL) s�SAy) 3 ? k )112W License Num ber Nuntco`CSLHolder Espir.tion ate iY � �/p' List CSL Type(see below) X C—HL� r� 'Cy e Description NO. aiyyy.d,,,Street - ' Unrestricted(Buildings LIP to 35,000 cu. ft.) fi'I C. R Restricted 1&2 Family Dwelling City/Towu,St--t at�P M Masonry RC Rooting Covering WS Window and Siding SF Solid Fuel Burning Appliances ( / 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) H[C Registration Number x ` on Date FITC C ny N. e kflC Registrant Nygq -: u tR<c No. anSiT�e ,n ^ r}- /r Email address Ci /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 Is§uance of the building permit. Signed Affidavit Attached? Yes .......... LV No........... SECTION 7a: OWNER AUTHORIZATION TO BE.COMPLETED WHEN: OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING.PERMIT 1, as Owner of the subject property,hereby authorize t9 act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) n Date 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 ' this appl' ation is true and accurate to the best of my knowledge and understanding. Pnnt Ow er s o :zed Agents 11rame(Electronic Signaave) D to NOTES: L 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.^ov:'oca Information on the Construction Supervisor License can be found at www.mass.,,ov/de 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 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'