21 BENGAL LN - BPA-16-533 REPLACE 4 WINDOWS, 5 DOORS l �u I(OoG r z (
.N-SPECTinpaj
RcCEIVEC
The Commonwealth of Massachusetts
Board of Building Regulations and Standards ZQ�� SAY P CITY
O
Massachusetts State Building Code, 780 CMR II201I
MBuilding Permit Application To Construct,Repair,Renovate Or Demolish a
M One-or 7wo-Family Dwelling
' n This Section For Official Use Cilly
V J Building Permit Number: Date App
Building Official Wrint Name) Signature .. � Dati
SECTION 1:SITE INFORMATION
1.1 Proppeerty Address: 1.2 Assessors Map&Parcel Numbers
21BENGALLANE SALEM, MA01970 12 12-0001-812
I 1.1 a Is this an accepted street?yes_ no Map Number Parcel Number
II`-- 13 Zoning Information 1.4 Property Dimensions:
CONDO
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 17 Private 0 Zone: _ Outside Flood Zone?- Municipal 0 On site
Check ifyes0 P disposal system 0
SECTION 2: PROPERTY OWNERSBTP'
2.1 Ownerr of Record:
ALEXANDRA TSYPORKIN SALEM, MA 01970
Name(Print) City,State,ZIP
21 BENGAL LANE 978-745-GO41
No.and Street - Telephone Email Address
'SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building If Owner-Occupied Of I Repairs(s) 1f Alteration(s) O 1 Addition 0
Demolition 0 Accessory Bldg.13 Number of Units_ I Other Specify:Replacement
Brief Description of Proposed Work': REPLACING 4 WINDOWS&5 DOORS
NO SCTRUCTUAL CHANGE
SECTION 4:ESTIMATED CONSTRUCTION COSTS:
Item Estimated Costs: Official Use O
and Materials) n�
1.Building $ 25, 408 . 00 1, Building Permit Fee.'$ hrdicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
❑Total Project Costa(Item 6)x mahiplier x
3,Plumbing $ 2- Other Fees: $
4.Mechanical (HVAC) $ List.
5.Mechanical (Fire Sion) $ Total All Few.$
Check No. Check Amount. Cash Amount:
6.Total Project Cost: $ 2S, 408 . 00 0 Paid in Full 13 Outstanding Balance Due:
rn A t 1,`T.�> t
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 90125 10-0 6-16
Jamie Moirn - - License Number Expiration Date
Name of CSL Holder U
List CSL Type(see below)
86 Gardiner St
No.and Street 'IYPe Description
Lynn; MA 01905 U Unrestricted(Buildings to35,000 cu.i
R Restricted)&2 Family Dwelling
City/rown,State,ZIP M Masonry
RC- Reefing Covering
WS Window and Sidi
SF Solid Fuel Burning Appliances
508-351-2214 I 1 Insulation
Tele hone : Email address D I Demolition
5.2 Registered Rome Improvement Contractor(HIC) 170810
17
Renewal by Andersen 12-23nDa
y HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
30 Forbes Rd
No.and Street 508-351-2214 Email address
Northborough, MA 01532
City/Town, State,ZEP - Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.a 152.J 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
1,as Owner of the subject property,hereby authorize Jamie Morin
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:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my nam elow,I he y attest under the pains and penalties of perjury that all of the information
contained in this llcation is and accurate to the best of my knowledge and understanding.
Print Owner's alto ' Agent's Name(Electronic Signature) - Date
NOTES:
1. An obtains a building permit to do his/her own work,or an owner who hues an unregistered contractor
(n tered in the Home Improvement Contractor(HIC)Program),will nnr 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.eov/oca Information on the Construction Supervisor License can be found at MM .mass.eov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.fL) (including garage,finished basement/atties,decks or porch)
(boss 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"
Sanctuary Condominium Trust
clo Crowninshield Management Corp.
18 Crowninshield Street
Peabody, MA 01960
(978)532-4800
May 4, 2016
Vladmir Tsyporkin
21 Begal Lane
Salem, MA 01970
RE: Replacement Sliders— Sanctuary Condominiums
Dear Mr. Tsyporkin:
Thank you for your inquiry regarding window slider replacements at your unit. Please be
advised that the Board of Trustees for the Sanctuary Condominiums does not object to
the replacement of these sliders providing that they match in appearance (no French
doors) to the existing, they must fit in the existing opening, trim/molding size and glass
size must remain the same and they will not allow grids etc.
We also require the permits be pulled in advance, and that a copy of the final approved
permit once completed is also submitted to our office. We also require that you hire only
a licensed contractor, with adequate insurance.
You will most likely need to show a copy of this letter to the Building Department in
order to obtain your permit.
Should you have any questions or require additional information, please feel free to call
me directly at (978)532-4800 ext#232.
Sincerely,
Jam''" 2Cr111 CL
Jill Fama, CMCA
Regional Property Manager
Crowninshield Management Corp.
Managing Agent for the Sanctuary Condominiums
cc: File