28 BRITTANIA CIRCLE - BUILDING JACKET 28 Brittania Circle
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�,CITY,�OF�SALEM, �r =.�.�"� J,7,„�,�..,..,�. :..,�... .; �..�-x•.
SALEM, MASSACHUSETTS 01970-'°
W i �PERM1A
r
g _ DATE96PEnMrrNo 4:16-1996
APPucANr- FAFARD DEVELOPMENT CORP -^ ADDREss IOT ST
---(NO) (STREET) w. (CONTR'S UCENS
CITY STATE MA CE)
CITY•.,. ASHLAND MA .. C ODE TEL.NO.R _.. 3W;•” -.`_ . 508-740-0122
NEW BUILDING "" TWO OR MORE FAMILY NUMBEROF 4
PERMITTO STORY DWELLING UNITS
-, ,'y. iF„(TYPE OF IMPROVEMENT)�aC,. :NO.� (PROPOSED USE) .+ y'q xy✓,,;.
0055 SWAMPSCOTT ROAD
rte• - zoNING
AT,(LOCATION)' DISTRICT
yry+i£' -(NID) (STREET)
* 'BETWEEN "�-n r isic . .
AND
(CROSS STREET) w (CROSS STREET)
" MAP 07 0043' LOT' 36. 54 ACRES
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT.WIDE BY FT.LONG BY FT.IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USEGROUP BASEMENT WALLS OR FOUND TIO ------
_C,
-
Q _ (TYPE]
REMARKS:
BUILD 4 UNIT CONDOMINIUM AS PER PLANS R (BLDG #150) ,
2,�;6fa�k•:110� 6.1
AREA OR Call for Permit to Qccupy
VOLUME ESTIMATED COST
FEEMIT� 2603. @@
(CUSIClSOUARE FEET) 333, 002-
OWNER FAFARD R. E. & DEV CORP BUILDING DEPT.
ADDRESS 290 ELIOT ST BY L. E. T
THIS PERMITCONVEYS NO RIGHTTO 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 MAY BE 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 OFTHREE 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 APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
' 1-7� D / '`f °� —O�l6/ate P�
BOARD OF LTH GAS INSPECTION APPROVALS FIRE DE .INSPECTING APPROVALS
OTHER CITY ENGINEER
'9'—' 2
CERTIFI AT OF OCCUPANCY
1 � Issued:/ g� ermit #:q116,' E
City of Salem Building Dept.
WORK SHALL NOT PROCEED UNTIL THE [AS
ERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS INSPECTIONS INDICATED ON THIS CARD
INSPECTOR HAS APPROVED THE VARIOUS OT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED CAN BE ARRANGED FOR BY TELEPHONE
STAGES OF CONSTRUCTION, NOTED ABOVE. OR WRITTEN NOTIFICATION.
IThe Commonwcallh of Massachuscits
Boardb(Bfuilding Regulations and Standards Tour
Massachusetts Slate Budding Code, 780 CMR, 7.",edihon
,Building Dept
Budding Permit Application To Construct iR`epair• Renovate Or Demolish a
One. or ro-Punuls uel Dling ,.':
Ti
Section For Official Use 0n1
Building Permit Number Date Applied:
Signature:
Buddin#C t aner/Inspector Date
SE ION : SITE INFORMATION
1.1owrty ddrssj:, • ,�. 1.2 Anessan,Map& Parcel Numbers
1.Is Is this an ace teal stre_e1Tyn no I Map rjurrrbef Pa'a,Nurriber, ,
w
IJ Zoning Information: r.• 1.6 Property Dimensions: '
Zoning District Proposed Use La Area(sit R) Frontage(it)"
1.5 Building Setbacks(R)
Front Yard Side Yards Rea Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40.154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public O Private O Zone: _ Outside Flood Zone? Municipal O On site disposal system O
Check if vesO
SECTION 2: PROPERTY OWNERSHIP'
2.1 „_turr of gm ^ R n 7f A l vtw ( c/
cr Name(Prie�) 1 o Q� Address far Service:
cl CG / oCfl7
t te a Telephone
SECTION J: DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction O Existing Building(] Owner-Occupied O Repa,irs(s) O Altention(a) , . Addition O
Demolition O Accessory Bldg. 0 Number of Units_ Other O Specify:
Brief Description of Proposed Work': ar/
artalf
SECTION♦: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: 'Official Use Only
Labor and Materials
1. Building f I. Building Permit Fee: f Indicate how fee is determined:
O Standard City/Town Application Fee
2 Electrical f O Total Project C sit(Item 6)it multiplier x
J Plumbing f 2. Other Fees:
4. Mechanical (HVAC) f List:
t NechantcaI (Fire f Total All Fees: f
Su ression
^�— Check No. _Check Amount: Cash Amount_
n Total Project Cost: S 4 0 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor ICSL) M/17/
/ •;—IP
EAh�1 �Q V�lorl 1-wenw Number Espirunon Duce
N,.4ror ofC L- II er �,atA Li,i CSL Type(w c heluw) V
T Description _
U I Unrestricted u to)3.000 Cu. Ft.
R Restricted lh 2 Family Dwellm -
Sgnumre •y M Mason Only
&Q ac�7 Ya-70 RC Restdenual Roofin Covennic
Telephone w'S Residential Window and Sidm
SF I Residential Solid Fuel Burning Appliance Installation
D I Residential Demolition
5.2 R littered Ho a Improvement Contractor(HIC) / // aJ`7d
l sn £n .ten�� T.f c. /• !i
HIC Com any Name w IC Regturant Name RlgSsitaiiohVIumber
/� -/S•-Jv
Add
G(7 Eaptraiion Date ..
signs Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L e. 152.1 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 Alrtdavil Attached? Yes.......... O No........... D
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1 oo S/ (2 9¢L� _ as Owner of the subject property hereby
authorize OLN✓f/7 ('J If erN to act on my behalf,in all matters
relative to work authorized y tl is building permit application.
A �� /4)A,/v f
Si azure of owner loor Dates or
�7 SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
//A , 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. r ' s", sr.
f vfSln
Print N /Q A 9
Signaiureo tier rized Agent Due
(Signed under the 12112121 and penalties ofperjury)
NOTES:
I. 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),will2ii have.access to the arbitration
program or guaranty fund under M.G.L. c. I42A. Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.R6 and 110 R5, respectively.
2. When substantial work is planned,provide the information below:
Total Goon area(Sq. Ft.) (including garage, finished basement/artics,decks or porch)
Gross living area(Sq. Ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halfbaths
Tvpe of heating system Number of&cks/•porches
Ts pe of cooling system Enclo.ed Open
3 Total Project Square Footage" may he .uh,muted for 'Total Prolcct Cost'
970
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71
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