0005 - 0007 BOARDMAN ST - BPA-14-522 1ST FL HALF BATH A
The Commonwealth of Massachusetts
UlfBoard of Building Regulations and Standards CITY OF
Massachusetts State Building Code,780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Ap lied'
Building Official(Print Name) Signaruoe o Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
5-- 1 Boardman SF• 'Salenn ttAA
L 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(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 a 40,§54) 1.7 Flood Zone Information: 1.8 Sewage Dysposal System:
Public RJ Private❑ Zone: _ Outside Flood Zone? Municipal EI/On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
ChriS�o�hp� A.
Kim Peet-s SZI�m , MA 01970
N (Print) r City,State,ZIP
7 13pardma, Si. 97P-57*-71(04 otrigeliQA4MA?rrrre2h•VP.Cart
No.and Street Telephone 9mail Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied e Repairs(s) ❑ 1 Alteration(s) 4 Addition ❑
Demolition ❑ Accessory Bldg. El Number of Units Other ❑ Specify:
Brief Description of Proposed Work': ConVflririn5 nloCPk 4e t12 ba+b an Firs+, -Cleor
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 1,500 1. Building Permit Fee: $ _.. Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ 500 ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2 00 2. Other Fees: $
4.Mechanical (HVAC) $ 0 List:
5.Mechanical (Fire $ -
Suppression) 0 Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 14,500 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
R Restricted 1&2 Family Dwelling
CityfFown,State,ZIP M Mason
ry
RC Roofmg Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
H
HIC Company Name or HIC Registrant Name IC Registration Number Expiration Date
No.and Street Email address
City/Town,State,ZIP Telephone
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 ..........❑ 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.
CA)6skoohet A- ?e}2rS I/g/14
Print Owner's Signature) ' Date
SECTION 7b: OWNEW 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 is true and accurate to the best of my knowledge and understanding.
C.hrY:s�o phQr q• Qe-leers y
Print Owner s or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. 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 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 can be found at
www.mass.-ov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos
2. When substantial work is planned,provide the information below:
Total floor 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"maybe substituted for"Total Project Cost"
201308090I05�85I�gIkIII32I7I3I5IPIg:265
p1rglej 4ir""i1±1 '!, t� Massachusetts Quitclaim Deed 08/09/2013 03:38 DEED Pg 1/1
I, "Barbara` R.4 Elser, an uninarried person, of Salem, Essex CTo��v��,+�),%, Commonwealth of
Massach ?�e}}��fo sideration paid and in full consideration of Z,l 'Cndred Nipo4, Fgw;
Thousa_n_ Dollars 00�grant to Cluistopher Peters and Mackenzie Peters, Husband and
.nlirety of 7 Boardman Street, Salem, Essex County, Massachusetts with
g
Wbether with the buildings thereon in Salem, Essex County,
� Wetf�
s rtts beingknown as No. 7 Boardman Street in said Salem, more
,gw , ��
1A0A bed as follows:
by laird now or formerly of Phippen, eighty-five (85) feet;
t f by land now or late of Goodspeed, seventy(70)feet;
by Boardman Street, eighty-five(85) feet; and
by and now or formerly of Bowden, seventy (70) feet.
€ ,.' .r 4 ,_ ,- ,t t e exfentlapplicable are hereby waived'.'
�Libert3 : , - ascribed premises is known as: 7 Boardman Street, Salem,MA.
WWW.1lberrymuivalgroup comes conveyed i6'the within grantor, Barbara R.,User (and Frances E. Eisner,
:e co 'of Death Certificaie filed herewith dated February9, 1981 and recorded
with the Essex South District Registry of Deeds in Book 6790, Page 758.
Witness my hand and sealthis day of` 2013. 11R ,b nwt „ r ,,t NR
.r. .,.i Southern Essex District ROD
* Date: 08/09/2013 03:38 PM
%i ',�` -*y F us• -•, •` ID: 976474 Doc# 20130809005850
Fee: $1.826.28 Cons: $400,500.00
` Barbara R. Elser
nn COMMONWEALTH OF MASSACHUS TTS
Zd d9� SS 2013
On this % day of 2013 before me, the undersigned Notary
Public, personally appeared Bai a,R.,, Iser .personally known to me and whose identity was
proved to me through satisfactory evidence of a picture identification/Driver's License to be the
person'vmose name is signed on the within document, who swore and affirmed to me that she
signed the document vol un_ tarily for its stated.purpose.
t': arHart a. vorvrzauoes Notary Public
Notary Public My Commission Expires:
COMMON WF.ALiN OF MASSACHU3Eii5
I,. My Commission Expires
May 16, 2019