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25 BECKFORD ST - BPA-2009-330 REPAIR CLAPBOARDS The Commonwealth of Massachusetts Board of Building Reg u 'ons and Standards Town of Massachusetts State Buildi Cod , 7aZ CMR, 7ih edition Wilbraham Building Dept Building Permit Application To nstruct, R pair, Renovate Or Demolish a 413-596-2800 One- or T vo-Fa till, elling Ext 118 This ectio r O cial Use Only Building Permit No er: Applied: {� c�7 Signature: %✓ / f� o D Building Commissioner/ Spector of uildings Date SEC O :SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 25 RzC/ _ AN/Omsr_a sj _ I.la Is this an accepted treet7 yes_ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use 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 O Private❑ Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' Owner Qf a rint Address for Service: e Telep o � �� SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ 1 Number of Units_ Other ❑ Specify: Brief Description of Proposed Work 2: 4wo STFi9 j`/t/iA/1r_ 17,_ .�.siJy�roti ,rxiST�-� cv�nyini� A,vt7 �.,,�-�qC n•r� C r}a13a�vR17 x SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building $ `j f30(D, 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x _ 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Su ression Total All Fees: $ �y7�) vU Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ /(, L(/ram r 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 1?0-BF=C 00aLr,1TF- License Number Expiration ate Name of CSL-Holder JA4 Fr©� � —� List CSL Type(see below) Address 1 Type Description !D —••-- U Unrestricted u to 35,000 Cu. Ft.) R Restricted 1&2 Family Dwelling Signature p. M Masonry Only at — � y y —o© b� RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Company Name or HIC Registrant Name Registration Number Ad- dress-Expiration Date Signature Telephone ——L 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 Issuance of the building permit Signed Affidavit Attached? Yes ..........9 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_ Rr oNrYU VUFz 1C 17T- to act on my behalf, in all matters rctatiae' :vork auth ¢ed ' -b7i1 ' ermt Fpplication. a ure of Uwner Dale SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION 1, a C1J�6r� ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application-are true and accurate,to the best of my knowledge and behalf. € �c-3-C -- ----- --- - — Print Name Signature of O`rt r or Abthorized Agent Dale (Signed under the pains and penalties of perjury NOTES: 1. An Owner who obtains a building permit to do hWher 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 and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I iO.R6 and 1 IO.RS, respectively. 2. When substantial work is planned,provide the information below: Total floors 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" 0 n 1� '�ayrneuo�' Salem Historical Commission 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (978) 745-9595 EXT 311 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: 25 Rerkford Street Name of Record Owner: David A- Trainor Description of Work Proposed: Remove clapboards on Beckford Street side (front of house) and repair cause of bowing. Replace clapboards in kind. Replace skirtboard to replicate existing Repaint to match existing. No changes in color, material, design or outward appearance. Non-applicable due to being kind maintenance/replacement. Dated: October 14, 2008 S7, TOMMISSION 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. 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.