16 BECKFORD ST - BPA-18-708 ROOF A The Commonwealth of Massachusetts
Board of Building Regulations mid Standards CITN' OF
Massachusetts Stine Building Code, 730 C'MR SALEM
fl�Il 'tip,.• HrrisrJ.l6tr_'ll//
YI 0 Building Permit Application 'ro Construct, Repair, Renovate Or Demolish u
"I One-orTtru-kanid Dwelling
This Section For Official Use Only
Building Permit Number: —_ Da Applicd: _
Building 011iciol(Print N�une) Signature 31Dute-Z
SECTION I:SITE INFORNIATIO
L1 / perc�J ress: 1.2 Assessan blap& P rc I NumbersI.la Is this an acce ted street? 'a no burp Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Imposed Use Lot Area(sq 11) FrontaBYard
1.3 Building Setbacks(It)
Front Yard Side Yams Required 1'mvided Required Provided RequiredviJeJ
1.6 Water Supply:tM.G.I.c. 40.§Sa) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Cl Private❑ Zone: _ OutsiJe Flood'Luna? Municipal ❑ On site Jisposul s-,tun
Cheek fifes❑ )� ❑
SECTION3: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Tw11
N;unc(Print) City.Sluts,ZIP
Nu.anJ Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) CKI Alterations) C3 I Addition ❑
Demolition ❑ I Accessory Bldg.❑ Number of Units_ Other ❑ SpecifyJho
Brief Descripl)'on ofProposed 1Vork=: Gbin-y / �ispit cKcl �ff2L ivSECTION J: ESTIMATED CONSTRUCTION COSTSEstimated Costs: Ofllclul Use O(tabor mtd .\Iaterials)I. Building S /j�jv, I. Building Permit Fee: f Indiis determined:2. Electrical S ❑Standard CitylTown Application Fee
❑Total Project Cost'(Item 6)x multipl1. Plumbing S 1. Other Fees: S _ ..--- —J. \Icchanicol illl.1('1 SList:
\Icchanical iFire
Su+ ressionf rotal .\II Fees: S n. Total Project Cost: S �,'/ k0a — Check Nu. ('heck Anuluot: —_ - unt: ..
❑ Paid in Full 0 Outstanding Hutmcc Due: -
SF.("PION S: ('ONS'I'RtiC'rION SFRVICFS
5.1 Construction Supen isor License(CSL)
I cease Number I cpiraiion Date
N:unc of l'Sl. i kidder
__-__ listCSLI'�pelseehclu,vl-__._--.__—__
L/ 3 _`�r tr 7� �/ I' Description
No. and weer
InreslncicJ l IhiilJin's ti to 1S,I111B at. 111
It Re,tricted I,2 Vamil D„cllin
c7mi roan,State,/II' %JjuA'ory
RC Roolin Coverin
\\'S \1'indoa,and Sidinit
SF Solid Fuel Burning Appliances
�;7k74/!'G�f �Jrn/f/lia^-.r/j ttvvrrtiyf�l�rvr7 1 Insulation
felt hone —� Email address X, C D I Denn+lilion
5.2 Registered Home Improvement Contractor(111C) t4�L_
inn=/ w f4 s d 111C Registration Number Espinaion Date
I IIC Cbmpan�,N.tm•or I IIC It• i.uant Name / / / � �t�/7L+'v of
No. tmd 5}n:el it address
L88 Ir
rr/rrrr /7s<r oi4�u Qjy-744
City/Town.State,ZIP tale hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 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...........O
SECTION 7s: 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 Umine s Nano:(Elcctrunic 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.irt this application is true and accurate to the best of my knowledge and understanding.
rim O,sner's or Authorised Agoll s Nano(Eleciruoic Signature) Dale
VOTES:
r2. \\
n Owner svho obtains a building permit to do his.her own work,or an owner who hires an unregistered contractor
not registered in the Hanle Improvement Contractor(HIC) Program),will no have access to the arbitration
rogram or guaranty fund under.M.G.L.c. 142A. other important information on the HIC Program can be found at
+++, ;m,,, " ',.i Information on the Construction Supervisor License can be found at,,
'hen substantial„ark is planned, provide the information below:
floor area(sq. B.1 - _— 1 including garage. linished basement attics.decks or porch)
Gross liv ing area I sq. it.l __-- Habitable room count __. .... .
i \umheroflircplaces \umherofbedrooms .. -.
Numhcrofbmhroonts . . .. . .. _ - . Number ofhalfhmils ..
1\pe of herring sy stem _ _ Number ol'Jecks, porches
i
1\pe of Cooling i,itemI�I1CIosed Open
7. "fatal I'n,jcct S,luarc 14nq.igc"m;n he auhslitulcd li+r"I'al;d Project Cbsi' -
- e.�CONOIT�f
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 does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District McIntire
Address of Property: _16 Beckford St
Name of Record Owner: William Tinti
Description of Work Proposed:
Replacement of 3-tab, asphalt roof'in kind(green/gray/red blend). Replace clapboards and copper flashing on
two dormers. No changes in color, material, design, location or outward appearance. Non-applicable due to
being in kind maintenance/replacement.
Option to replace roof with black or charcoal gray, 3-tab asphalt roof
Dated: March 2, 2012 SALE COMMISSION
By:
7
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.