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12 BRITTANIA CIRCLE - BUILDING JACKET 12 Brittania Circle TOB SITE COPY ° CITY OF SALEM BUILDING . 11. SALEM, MASSACHUSETTS 01970 PERMIT DATE JULY 24 19 96 PERMIT No Y 414-1996 APPLICANT FAFARD DEV CORP. ADDRESS 290 ELIOT ST 1562 (NO.) (STREET) (CONTR'S LICENSE) CITY ASHLAND STATE MA ZIPCODE TEL.NO.NUMBEROF — — PERMITTO NEW BUILDING STORY TWO OR MORE FAMILY DWELLING UNITS-4 .(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 0055 SWAMPSCOTT ROAD ZONING AT(LOCATION)' DISTRICT (NO.) (STREET) BETWEEN .rt. •. AND (CROSS STREET) (CROSSSTREET) SUBDIVISION MAF' 07 Lor 0043 BLOCK SIZE 36. 54 ACRES BUILDING IS TO BE FT.WIDE BY FT.LONG BY FT.IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE '-" USEGROUP --- ( BASEMENT WALLS OR FOUNDATION G__GIfGI REMARKS: BUILD 4 UNIT CONDOMINIUM AS PER PLANS @ CIR. " (BLDG #146. Call for Permit to Ncupy AREA OR @ PERMIT VOLUME ESTIMATED COST$ 333, 000 FEE $ 2603. 00 (CUBICISQUARE FEET) OWNER FAFARD R. E. & DEVELOPMENT BUILDING DEPT. ADDRESS 290 ELIOT ST BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY,ENCROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION,STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL INSPECTIONS APPROVED PLANS MUST BE RETAINED ON JOB AND THIS CARD KEPT WHERE APPLICABLE SEPARATE REQUIRED FOR.ALL CONSTRUCTION WORK: POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A PERMITS ARE REQUIRED FOR 1.FOUNDATIONS OR FOOTINGS. - ELECTRICAL,PLUMBING AND 2.PRIOR TO COVERING STRUCTURAL CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH BUILDING SHALL MECHANICAL INSTALLATIONS. MEMBERS(READY TO LATH). NOT BE OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 3.FINAL INSPECTION BEFORE OCCUPANCY. :POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION 6,PPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS •P 2 ` / 24 /to� (/y VI 7 BOARD OF H TH GAS INSPECTION APPROVALS FIRE DEPT.INSPECTING APPROVALS OTHER CITY ENGINEER /� „' 2 � 3 `�j 2 WORK SHALL NOT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCT!ONWORKISINSPECTIONS INDICATED ON THIS CARD ';INSPECTOR HAS APPROVED THE VARIOUS NOT STARTED WITH IN SIX MONTHS OF DATE THE PERMIT IS ISSUED CAN BE ARRANGED FOR BY TELEPHONE STAGES OF CONSTRUCTION. AS NOTED ABOVE. OR WRITTEN NOTIFICATION. r� The Commonwe, a ac usetts (1 Department of Public Safty C Massachusetts Statnlpoi�*23ie PO C V Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) I Building Permit Number: Date Applied: Building Official: SECTION 1:LOCATION (Please indicate Block#and Lot#for locations for which a street address is not available) o ICU No. and Street City/Town Zip Code Name of Building(if applicable) SECTION 2:PROPOSED WORK UEdition of NIA State Code used If New Construction check here❑or check all that apply in the two rows below I-xisting Building Repair❑ Alteration Y&, Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or constriction documents being supplied as part of this permit application? Yes ❑ No Is an Independent Structural Engineering Peer Review required? Yes ❑ No Brief Description of Proposed Work: �ttl0vck.�, '3a �t�C,rn CSL.!' V el ev t tit @u t� V`C1L x J J SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING.RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): ze coow% Proposed Use Group(s): 0-001r— y SECTION 4: BUILDING HEIGHT AND AREA Existing Proposed No. of Floors/Stories(include basement levels)& Area Per Floor(sq. ft.) a\trU Z 1 O O Total Area(sq. ft.) and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ F B: Business ❑ E: Educational ❑ F: Factor F-1 ❑ F2❑ 1 H: High Hazard H:1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional [-1 ❑ [-2❑ I-3❑ I-4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑ and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA 13 IIB ❑ IIIA ❑ IIIB ❑ 1 IV 1 VA 13 VB ❑ SECTION 7: SITE INFORMATION (refer to 780 CMR 111.0 for details on each item) Trench Permit: Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Disposal Site ElPublic-, Check if outside Flood Zone Indicate municipal A trench will not be P required)&pr trench or specify: Private❑ or indentify Zone: or on site system❑ permit is enclosed ❑ Railroad right-of-way: Hazards to Air Navigation: p_IA Historic Conpnisswn- iew"rocrs": Not Applicable Is Structure within airport approach area? Is their review completed?N 1n or Consent to Build enclosed❑ Yes❑ or No lK Yes ❑ No ❑ �7 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use.Group(s): Type of Construction:�oo Occupant Load per Floor: Does the building contain an Sprinkler System?:, @_Special Stipulations: ��.3o N1RIL�� To G.G SECTION 9: PROPERTY OWNER AUTHORIZATION }�ume and Address of Properly Owner _7 )MJ jlGQ 'S�-) ia;cI{�ip�Hca Name(Print) No.and Street City/Town Zip r) Property Owner Contact Information: ' Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable, the property owner hereby authorizes Name Street Address City/Town State Zip to act on the property owner's behalf, in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu. ft.of enclosed space and/or not wider Construction Control then check here nd skip Section 10.1 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor i ,,^ T"6\ t9 ✓-�C` ?/ V �i`F%r('7'C2S1'e `(yl'� OC�)-4(OCN Y� Company Name ('NoJ'rcxm c) t lM L-g G © o`23 18c( Name of Person Responsible for Construction L'cense No. and Type if Applicable Street Address City/Town I State Zip Le C-1 Z- Z QOa k At 6 092 (k\-C,g\ Lo M Telephone No. business Telephone No. cell e-mail address SECTION 11: WORKERS'C'0'N4PENSAIION INSURANCE A'FFMAVU M.G.L.c.152.§ 25C(6)) A Workers'Compensation Insurance Affidavit from the NIA Department of Industrial Accidents Hurst be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes L7 No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs: (Labor 2 and Materials) Total Construction Cost(from Item 6) 1. Building $ Building Permit Fee=Total Construction Cost x (Insert here 2. Electrical $ appropriate municipal factor)_$ 3. Plumbing $ 1 64D6 4. Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5. Mechanical Other $ Enclose check payable to 6.Total Cost $ , Q(, (contact municipality)and write check number here SECTION 13:SIGNATUM OF BUILDING PERMIT APPLICANT By entering my name below, f hereby est under the enalties of perjury that all of the information contained in this application is true and accurate to th est of my understanding. Icase print and sign name Title Telephone No. Date Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: 'yW Name Date