157 BOSTON ST - BUILDING JACKET I lie CI11I111tUnsce;lllh olWasNachusclls
Bo%trd of Building Regulations and Standards CI I'), OF
' assachusetts State Building Code. 7SO CNIR ti.\ll"\I
M
� It'd I'iad/.16n''ll//
Building Permil Application To Construct, Repair. Renovate Or Demolish a
I- One-ur Tn'114'anfilr DlIvI11113r
n -- Phis Section For Otficiol Use Only — —
LJ Building Permit Nuntber: Date: pplied:
�� (hi'IJiny 011ieial(Prins N;une) Signaturetalc
SECTION I: SITE INFORNIAT ON
1.1Propertyl��ess:QoS�d^ S KP y 1.2AssessursAlap& Parcel Numbers
I.In Is this an acce ted street? es no Map Number Parcel Number
I.3 Zoning Information: 1.4 Property Dimensions:
Loning District 11nipnscd Ilse Lot Area IN 11) Frontage(11)
1.3 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Pruvided Required Provided
1.6 Water Supply:IM.G.I.e. 40.§sq) 1.7 Flood Zone Information: 1.3 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood"tune? Municipal❑ On site disposal a)stem ❑
Check if vs❑
SECTION1: PROPERTY OWNERSHIP'
2.1 �Ownert of Record:
y,. +s.'t
Nmne Print) �� City.state.LIP
/5 7 a57(o r`
Nu.and Street relephune Etnuil Address
SECTION J: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) O I Addition ❑
Demolition ❑ 1 Accessory Bldg.❑ Number of Units_ Other ❑ .Specify:
Brief Description of Proposed Work':
CJ O
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Ileul Estimated Costs: OM NI Use Only
II abor and \laterialsl
I. Building S I. Building Permit Fee: S Indicate how lee is determined:
❑Standard City'Tuwn Application Fee
2. Wecirical S
❑Total Project Cost(Item O x multiplier
I J I'IumMog S '• Other Fees: S_
J. \lc6h.IIIic•II III\ \('1 S List:
Sli rei31U111 rl❑I .\II Fee3: S
( hccA Vu. ( heck :\norms: ('.I,h Auunult:
0 1'utal i'rnject Cnst 1 0 Riid in Full O Oulslandiog li ILUIce Due:
SIA I'ION S: CONIN 'RUCTION SF.RVICTS
S,1 ('onstructiun Supenisur License(('SI.)
I icensc \'unlher I \piralion Date
V,unc of l'SI. I loldcr ....._—
I ist l'.til. I'%Ix:Isee
-------'----------------.. ..--- - ----' --'--- 'I)pe Description
Nu. .uIJ Slrcal
ll I Inrestrmcd tlhuldin s ti to 15,010 c11. It.)
_ R Re�nicteJ-1&2 I'mml D1lcllin
Cigi fall n..`late.Lll' \I \hlslm
RC Rix)Iiiiii C'u\erin
._—. WSF Window.wd Sidin
SF I Solid Puel litiming \ppliances
I I Insulation
I cte hone Fount address I D Demolition
5.2 Registered Home Improvement Contractor(HIC)
IIIC l4vill ation Number h\piraliun Dutc
I IIC C'anlpin) Name or I IIC Iteg6tram Name
No. w1d Street Email address
City/Town. State ZIP 'relc hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,e. 152. § 2SC(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 ..........Cl No........... O
SECTION 7e:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Own t7 subject property,hereby authorize
to act on m rral ive to work authorized by this building permit application.
Ihinl 09ic s Nui 1 (Electronic Signature) Data
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 informatiun
contained in this application is true and accurate to the best of my knowledge and understanding.
Print Dencei ar a\uthofileJ.\gent's Name I Electronic Sigmnurc) Dote
VOTES:
I. An Ooner%Ou obtains a building permit to do his her own work.or an owner who hires an unregistered wniractur
(nut registered in the Hume Improvement Cuntractur I HIC) Program), will nu have access to the arbitration
program or guaranty fund under M.G.L.c. 142.A. Other Impurtant information on the HIC Program can be found at
1 hlformation an the Construction Super isor License can be found at of 1•+ '„'\ I(1�
�. \\'ban subsuultial Durk is planned,pro\ide the iwl)rnntiun below:
fetal fluor area 1;4. 11.1 . ____.._1 including gauge, finished basement attics,decks or porch I
Gross li\iogareaIsy. It.l ...._. ._. _.,. . _. Habitable room count
\unlhcl of fireplaces \umber of bedrooms
\umher of hathroums .. ._ _. _ --- \'umilcr A hall haths ..
i
I'1 Ilk:of lleatifig i\♦I\'lll _ \mnhef of decks porOici
I'\pe��I iaahllg >\\lelll I'llcla\c11 llpell
1
I'oLd Prow $1(11:111' I'JnlJgd 111;1\ he .nb\Ilhlled lU! IoI,II I'fajeel(1ht i
f
CITY OF sm-E.m
PUBIIC PROPERTY
DEPARTMENT
V f u��ewt.rvv�
VwrOe IV 7VIDOW. 1 rheas• &ALAK VAAL#o-A WM QI O-S
rn.9-9.745.11" • FkA f73-?WW
HOMEOWNER LICLNSS EXSMMON
Plena Fria
lob Laeadoit
Home Owner Address
Home Owoer?elepbono
Present Madbel Address
T'he current exemption of''Homeowners"was extended to inchtdo ownw-occupied
dwellings of two Units or few and to allow such homeowner* to engage as individual for
him who.does not possess a licmae4 provided that the owner acts as supervisor.
DEFINMON OF HOMEOWNER
Person(s) who owns a pared of on which he/she resides or intends to redds. on
which then iti or is intended to be, a one or two rhmily dweWng, attached or detached
structures accessory to.such use and/or farm structures. A person who constructs more
than one home in a two year period shall not bs considered a homeowner. Such
"homeowner"shall submit to the Building OQkial, on a forth acceptable to the Building
Official, that he/she be responsible for all such worst performed under the Building
Permit
The undersigned "homeowners'assumes responsibility for compliance with the State
Building Code and other applicable by4sw i and reluladona
The undersiped "homeowner"certifies that hdshe undentands the City of Salem
Building Department minimum inspection prmoc urn and requirements and that helshe
Mill comply with said procedures and requ' EL
HOLIEOWYERS SIGNATURE
APPROVAL OF 8 1 U LDfYG INSPECTOR
Sce other side for sate code
i
1
I he C'onumun weal Ih uP blassachusclts
is Board ofl3uill Regulations and St:uldards CI'I'1' OF
st Massachusetts Slate Building Code, 780 C NfR SALIM
1uilding Pernlil Application To Construct. Repair, Rcnuvare Or DCnL)Iish u
Ow-or ill kirulNl' Uu rllio.k:
This Section For Ot33cial Use only
Building Permit Number: Date Applied;
IludJmy 011icial(Print Muriel Sigsmture Dula
SECTION 1:SITE INFORMATION
.I Property Address: 1.2 Assessors,slap& Parcel Numbers
1 S 7 13os7'o )Z S
1.la Is this an acre ted street?yes no .Nap Number Puree-Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning Disiricl Prop Use Lot Arra(sq II) Frontage(R)
1.5 BuIldinS Setbacks(R)
Front Yard Side Yards Rear Yurd
Re4u(red I'mviticd Required Provided Required Provided
1.6 Water Supply:(M.G.I.c. Jo,§Ja) 1.7 Flood Zone Informallon: 1.3 Sewaya Disposal System:
Public❑ Private❑ Zone: — Outside Flood Zuna?
Check if es❑ Municipal❑ On site disposal s)stem ❑
2.1 Owners of Records
SECTION I. PROPERTY OWNERSHIP'
N;una f Print) fr!�r 7 � city,Slata•!r
Nu,and trees telephone F.mad AJdrvss
SECTION J: DESCRIPTION OF PROPOSED WORK'(Cheek all that apply)
New Construction❑ Existing Buildiny❑ Osvner•Occupied ❑ Repsinls) ❑ Alleration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ .Specttyt
Brief Description of Proposed work"
SECTION 4: ESTIMATED CONSTRUCTION COSTS
hem Estimated Costs:
ILabur and .Materials) Oft NI Use Only
1. Duilding S 1. Building Permit Fee: f Indicate how t'ee is deterntined:
'. Morical S ❑Standard City!Tussn Application Fee
Plumbing S ❑Tuml Project Costs l Item 6)x multiplier
_. Other fees: S {)/� �•._
J. \leihanic.d ill\ W) S Lisle
�u +reisionl S rraal 'All
T, o Total Project Cu..st: S 07, ('hccA No.
t]PAJ in Full 0 OuliLmdiny Hal.mce Due:
I
1
SECTIONS: CONSI'RtICriONSF.RVICF.S
..1 C'unstructimt Supervisor License(C'SL) _
I inns¢ hunlhcr I \plr;uinu D;uc
N.unc of l'sL IInIJcr - I Iit CSI. 1)pu hec help„1.__._--- -- —
No. .ulJ Slr.et ---- —_-- tl Ilnrvstriovd UluilJin s tin to 14,000 Co. It.I
It lu,lricled I\'t? I anlil D,\cili'l
l'ini I'a„n.Slue./.II'
Rl' Ra,lin C'o\erin
N'S Window ulumdiiiit
n
Sr Solid Fuel liuming Appliances
1 Inadmion
l'ak hone
I(mail aJJrcsi D Dcnwliliun
3.2 Registered Ilume Improvement Contractor(1114L)
IIIC Iicgistnniun Number Espiruliun Date
I IIC Conlpan) Nwne or I IIC' licgistrunt Nantc
Email uJJrvas
No. and Street
City/Town, State ZIP rele and
SECTION 6:WORKERS-COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. I32. 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this atidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? yes .......... 0 No...........Cl
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
to act on my behalf,in all matters relative to work authorized by this building permit application.
Dute
Print O,vner's Nwne(Electronic Signature)
SECTION Its: OWNER t O AUTIIORIZED AGENT DECLARATION
By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information
contained in thi calla is true and accurate to the best of my knowledge and understanding.
Dote
IhiN C ncr'i ur Authoriicd.\genl'i N,une I lilccuunic.Signaulnl
No'rES:
I. .\n Owner who obtains a building permit to do his her own „ark,or an owner who hires an unregistered contractor
or
registered in the Hume Improvement Cunanctur IHIC) Programl,will nu have access to the arbitmtiun
program or guaranty fund under.M.G.L.c. 142.>. Other impunant information on the HIC Program can be found al
„,\,\ ,1 ,,., „ ,•\ I Information an the Construction Supervisor License can be found at
?, \Tten substantial,wrk is planned. provide the inl'uI includinnflun ng g:rib e. :inished bascnlen:attics.decks%it porchl
rota) lioor area i iy tl.l - _— ---_ g g`
Habitable room count _
._ \unlhcrol'hcJruumi ..
\unlheroi tircplaces _- ._. .. -_ \umbaro:'Imll h;uhi
\uulhcrolhathnwnls . . _ . . \lunhero(decks, porchcs -
1')pe of hc.aing i)item -
i I'nclo.cJ llpen
1 i\Stem
I
I
t ..11u,d Proivo SquAre I11013gg alit\ he suhstivacJ ILr"I'ol.d Project Cost"
CITY OF SM-E.M
PUBLIC PROPERTY
lip DEPARTMENT
Vwrw i�es.ww.�a..ft+asr sKaa�Vw�owrsrn01v'0
rta.rw?45.91sy • f<.�&978-N&I&W
HOMEOWNER LICL,NSE EXEM"10M
Pies" plat
Date
Job Loeado. �S7 - �3G S%may' S / . SA L%IV . P/B
Home Owner Address / , ] 1?o-�?oA. S i c A L
Home Owner Telephone
Press Mailing Address
The curnaa exemption of"Homeowners"was extendad to include owner-occupied
dwellings of two Units or less and to allow strch homeownen to engage an individual for
hire who does not possess a Itemwt,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Penon(s) who owns a psreal of Lad an which hdshe resides or intends to reside6 on
which there is, or Is intended to be6 a one or two Otmily dwelling, attached or detached
structures accessory to such use and/or farm structures, A person who constructs more
than one home in a two year period shill not be considered a homeowner. Such
"hotnaownce jW submit to the Building OQici4 on a form acceptable to the Building
Ofticial, that hdshe be reaponsibis for all such work performed under the Building
Permit
The undersigned "honseowner"assumes responsibility for compliance with the State
Building Code and other applicable by6laws And regulations.
The undenigned "homeowner"certifies that hedshe understands the City of Salem
Building Department minimum inspection procedures and requirements and that hdihe
Will comply with said procedures aid requirements.
HOMEOWNERS SIGNATURE
s
APPROVAL OF BU[LDI.VG DiSPECTOR
See other side far state coda
CITY OF SALEM
BUILDING DEPARTMEN-T` '' '
120 Washington Street, V Floor, Salem, MA 01.%70 q,; 31
Im �?R A
ABANDONED AND FORCLOSED PROPERTIES REGISTRATION FORM
PROPERTY INFORMATION
Address: 157 BOSTON STREET, SALEM, MA 01970 Parcel ID # 16 0066, M 247953 91
Square Footage of Building: Number of Stories:
Sprinkler System: Yes_ No_ (Operational yes/no)
Pipe System: Yes_ No_ (Operational yes/no)
Fire Detection System: Yes_ No (Operational yes/no)
OWNER(S) *OF RECORD (*attach additional sheets if necessary)
Owner: Eric Moore
Address: 41951 Remington Ave. Suite 150, Temecula. CA 92590
Tel. No.: 877-338-3791 E-mail: propertvregistrations0broninc.com
CONTACT PERSON/REGISTERED PROPERTY MANAGER
Name: Code Compliance
Primary Address (No P.O. Box) 500 Grapeview Way, Hurst, TX 76054
Business Tel. #: 800-346-2432 Non-Business Tel. #:
E-Mail Address:propertyregistrations(a)-broninc.com
Emergency Telephone # - 24hr/day
IS THE PROPERTY LISTED FOR SALE? Yes_ No_
If yes, Real Estate Agency
Address: Tel. No.
VACANT BUILDING PLAN: Please check which applies.
1. _ The building is to be demolished.
2. _The building is to remain vacant.
3. _ The building is to be returned to appropriate occupancy or use.
SIGNATURE OF OWNERS)/OWNERS AGENT:
DATE:
REGISTRATION FEE $300 Cash/Money Order/Cert. Bank Check