16 BECKFORD ST - BPA-12-744 GUTTERS q 7-0
lyI'he C'onunumse;thh of Mwsachuseus
/ 1; ',� tt Board ot'lluilding Regulations and Standards CITY OF
l{I +I !9 Massachusetts State Building Code, 7SO C NIR Sr\Ll :\I
Building Permit r\Pplication 'ro Construct, Repair, Renovate Or Demolish a
Otte-ur Tn u-PLntily Uu elli)kq
This Section For O tcial Use Only
Building Permit Number: Date Appli :
`�
Building 0111cial(Print Marc) Sign• u Date
SECTION I:SITE INFO IATIO
I.I Pop rt Address: f J 1.1 Assessor 1als dty cN e umber
fr 1� l_
I.la Is this an accepted street?yes ✓ no Map Number I'urcel Number
I.! Zoning Information: 1.4 Property Dimensions.
Zoning District Proposed Use Lot Area Oil 11) fronluge(11)
1.5 Building Setbacks(n)
Front Yard Side Yams Rear Yard
Required Provided Required Provided Required Provided
I.0 Water Supply:(M.G.I.c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public G Prisate G Zone: _ Outside Flood Zone? Municipal G On site disposal system G
Check if yesC3
SECTION 1: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Wi11Ae,t Se&7 e 174 tl
Kane(Print) city.State.ZIP
jro /S ra k F..W J/
No.and Street felephune Email Address
SECTION J: DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction G Existing Building OTN
Owner-Occupied ❑ Repairs(s) Alteration(s) G Addition O
Demolition G Accessory Bldg. Gumber of Units_ Other G Specily:
Brief Description of Proposed Work':
SECTION 4: ESTIAI.ATED CONSTRUCTION COSTS
llcm Estimated Costs: Official Use Only
1 Labor and.\laterialsl
I. Building S x w _ 1. Building Permit Fee: S Indicate how lee is determined:
'. Electrical S G Standard Ciry,Tuwn Application Fee
❑Total 6 .Project Cast' 11etn t
1. Milt ing S 1 1 s x multiplier —,_ x
_. Utter Fens: S
4. \1Cih.12.11 111\.\('1 S List:
• �. \lech.tnicctl (fire --'u+ rassiunl Total \II Fees: S
Check No. (Itock:\nunun: Ca. h \mammy:
Tula) Project Cast: i SY04, 0 P;,id in Full 0Outstanding Ilakince Due:
7 •A
St:('I'ION S: CONSTRUCTION SF.RVI('F.S
5.1 ('unstruction Su pen isor License(CSt.) `9?a q zU�4r�/3
I it;vime Numhcr I \piruiou Date
N:unc ul l'SI. I(older
(' /• IutCSl. Ilpelseehelua).__._�_—.._
No. .mJ Slrccl
(I I InrestriaeJ I IIuilJin s tin p1 34,111)Il cu. It.)
µe'triovd I&I F. Dllcllin
Cirri I'o+n..State.LIB' ..\t Mason
NC' Ituolin C'userin
\1'S O'indow':wd Sidin
SF Solid fuel Burning Appliances
I Insulation
Talc bona f:muil aJJrcis D Denullitiun
5.2 Registered IIome ImpruvemeeyI Contractor(HIC) /6Z •f6G
/ Anon "tf 1 o14 `1I I IIC I g6trutiun Nuaftr lispinlliun Uwe
IIIC Compan) Nanlu nr IIIC Itegistrunt Name
A O /3Jec o262
Nu. w1J Sln:et Email address
Sw/ice/ /7411 7Yrt �rf&
City/Town.Slate,ZIP felt hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L e. 152.§ 23C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this atfidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes No...........O
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 Nwne(Electronic Signulure) Dute
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 i true and accurate to the best of my knowledge and understanding.
3. r•f svtSlr. �/ rrr<rrfa f /
Print O1uwr'!nr:\w veJ,\gem'v Hume l lileclrunic Signature) Dula
NOTES:
I. An Owner who obtains a building permit to do his.her own work,or an owner who hires an unregistered contractur
I nut registered in the Hume Improvement Contractor IHIC) Program).will nu have access to the arbitration
program or guarani) fund under M.G.L.c. 142A.Other impurtant information on the HIC Program can be round at
„++ m.r•. , + ,.,.I Information on the Construction Supervisor license can be found at+t,1,+ 111.1,; ,,. 1 All,
1 U'hen substantial wurk is planned, provide the int rinatiun below:
rotal flour area(iy. tl.l _ _ 1 including garage, finished basement attics.decks or porch)
G roii lit ing Habitable room count
\anther of lircpin%:" Number of bedrooms _ .. . . . .
Vumherof hadvooms ... ._. .. — \umber olhalf halhi
IN pc of heating i)ikltl - . . \umber of Jecks• porches
l
I'1 pa of i0phllg it ilelil I�Ilclo,ieJ (l,dn
I
1. "lotal l'roiccl Square root•14e 11111) J,e itib,ftutcd IUr"Tonal Project CLIA"
'��irynyg sA
Salem Historical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978) 619-5685 FAX (978)740-0404
CERTIFICATE OF NON-APPLICABILITY
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 Tin i
Description of Work Proposed:
Replace gutter on front porch to replicate existing. No changes in color, material, design, location or outward
appearance. Non-applicable clue to being in kind maintenance/replacement.
Dated: March 19, 2012 SAL COMMISSION
By:
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.
"fl-iIS 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.