5 BECKFORD ST - BPA-12-133 ENLARGE DECK r
I'he Commonwealth of Massachusetts — CITY OF --
?i,i Board of Building Regulations and Standards SALEM
Massachusetts State Building Code. 780 CMR
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Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Ttvu-Family Drelling
This Section For 01 -ial Use Only
Building Permit Number: ate Applied: _
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Propert�Address: 1.2 Assessors Map& Parcel Numbers
l5 _ 1G JEC L S1.
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 Area(sy Ill Frontage(It)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.I.c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal ❑ On site disposals)s stem ❑
Public❑ Private❑ Check if yes❑ F P y
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
_1 E - 21 fiLL&fv r rzfi3 i Touch S'hLc-m ✓t'l A 0197 Ce
N;une(Print City.State,ZIP
S 3G-cKrc2t� S2. `37x 317 o3j9 S,41Cn 3acj& ' CoMCAyTr T
No.and Street 'telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ I Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify:
Brief Description of Proposed Work': S7l N
is i.' B " x $ l iJl—fN A LAtIt, -,(L J>d n 7 ' 10 >< 142
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building S I. Building Permit Fee:$ Indicate how fee is determined:
❑Standard City/Town Application Fee
2. Electrical S ❑Total Project Cost.(Item 6)x multiplier x
i, Plumbing $ 2. Other Fees: $
4. Mechanical (IIVAC) S List:_
5, Mechanical (Fire S Total All Fees: S
Su �ressionl
C/ G �r�-�� Check No. _('heck Amount: —cash ,\mount:-_--
6. Total Project Cost:
S O U U V ❑ paid in Full ❑Outstanding Balance Due: ____
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) ,
__ Licse Nunther lixpiralinn Dale
N:unc ol'C'SI. IIu IJer — en .
List CSL 1)pe(see below) _
Nu, :wJ Street Type Description
U f Inrestricted(Buildings u' to 35,000 cu. It.l
Cinlforrn.Slate,ZlP R Restricted l&21amil Dwelling
M Masan
RC Roofing C'overin
WS Window and Sidin
SF Solid Fuel Burning Appliances
_ I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
I IIC Company Nuntc or I IIC Registrant Name I IIC Itegistr;nion Number Expiration Dale
No.and Street
Email address
LC' /Town, State,ZIP "fete hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M,G.L.c. 152. 1 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.
Pant Owners Name(Electronic Signature)
'Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below, 1 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.
I not Otwer s or Authorized Agents Name(Llectrunlc Signature) Dale
NOTES:
I. 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 Hume improvement Contractor(HIC) Program), will not have access to the arbitration
program or guaranty fund under M.G.L.c. 1-t?A.Other important information on the HIC Program can be fi)mtd at
y�t�y..nu.p±�4Y_ca Information on the Construction Supervisor License can be found at y_}Ntr.ncu:.yo�-11p,
_' When substantial work is planned, provide the information below:
Total floor area(sq. ft.l (including garage, finished basentent'attics,decks or porch)
Gross living area(sq, 11.l P
Habitable room count
N'wnber of fireplaces_
--__-____ Number of bedrooms
NLlmber of bathrooms
� rooms N ---
---------_...--- umber of half.baths -
Ty pc of heating system
—.---.-------- -- Number of decks, porches_
I)pc of cooling sx stem --------------
. ---- ------- -------- Inclosed --- -------Open
7 'Total Project Square Footage-ntay be substituted titr-folal Project Cost"
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Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978) 619-5685 FAX(978)740-0404
CERTIFICATE OF APPROPRIATENESS
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction � Alteration
❑ Demolition Painting
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: McIntire
Address of Property- 5 Reckfard Street
Name of Record Owner: Robert Allen & Robert Soucy
Description of Work Proposed:
Replace existing second./loor deck in rear (6'2"x 8) with larger deck(7'10"x 16'), painted to match house.
Balustrade railing design and construction to comply with Salem Historical Commission guidelines.
Dated: July 21, 2011 SALEM TORICACOMMIS [O
By:
• ('ill
The homeowner has the option not to commence the work (unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals) prior to commencing work.
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