27 CEDARCREST AVE - BUILDING PERMIT APP 12�1 The Commonwealth of Massachusetts
Board of Building Regulations and Standards Town of
Massachusetts State Building Code, 780 CMR, 7'"edition Wilbraham
Building Dept
Building Permit Application To Construct, Repair, Renovate Or Demolish a 413-06-2800
Otte-or Two-Family Divelling Ext 118
This Section For Official Use Only
Building Permit Number: Date Applied: Is 0, (j6
Signature: /Z• Z•ol�
Building ommissio er/ t of Buildings Date
y� SECTION 1:SITE INFORMATION
1.1 Pr peJ�y Address: -7 1.2 Assessors Map& Parcel Numbers
I.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
�—/ .,
1 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
/7 /r7 / o
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
X Public D1 Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check i f yesO
SECTION 2: PROPERTY OWNERSHIP'
�( 2.1 Owner'of Record:
Address for Service:
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ - Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify:
YY Brief Description of Proposed Work': G./ / "B-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials y
I. Building $ I. Building Permit Fee: $ Indicate how fee is determined:
2. Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
X 3. Plumbing $ 2. Other Fees: $
` \ 4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ a�„• ❑Paid in Full ❑Outstanding Balance Due:
t`-J.IV �(;P' � r721'K 17 2 4
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(978)352-3399
- (978)352-3398 FAX
kearwo & 4 C670wrw eaffitz eamy 9ne.
\t General Contractors
MIKE MO ONE INDUSTRIAL WAY
Cell(978)8)375-375-6074 GEORGETOWN, MA 01833
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SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) 91941� L7 _
In le4aw /({y/C`ts!O Lie en Number Expiration Date
Name of CSL- Holder List CSL Type(see below)
/S �- �%I�"' swa ��• Type Description
Address-7/7�,� 1 U Unrestricted(up to 35,000 Cu. Ft.)
R Restricted 1&2 Family Dwelling
Signature .t + - M Nlasonry Only
Residential Roofing Covering
Telephone .. WS Residential Window and:Sidin
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Registered Home Improvement Contractor(HIC) ,
Registration Number
HIC Company Name or HIC Registrant Name
Address Expiration Date
Signature Telephone
SECTION 6: WORKERS'CONIPENSATION 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
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.
Signature of Owner Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
1 _ _ ,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.
Print Name
Signature of Owner or Authorized Agent Date
(Signed under the 2ains and penalties of erju
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 and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and 110.RS, respectively.
2. When substantial work is planned, provide the information below:
Total floors 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"may be substituted for"Total Project Cost"
PROPOSED \
n/1 '�o• DWELUNG �Re• So/��
8 �
11p
Ar PROPOSED
�Y DWELUNG
LOT 0
8Y710.7 gO ,
0.08 ecW6B'
8.70
80800.E ACA68 80o.1T.
BUILDING PERMIT PLAN
NOTES.
27 CEDARCREST AVENUE
°�' SALEM MA
PROPOSED STRUCTURES ARCHITE FROM PLANS ' '
iATEED 9/80/08° Dom' LLC U CARUSOP & MCGOVERN
ItummCSS: CONSTRUCTION, INC.
LXUSD DEED:
BPAUL292 CASSBLL KANE LAND SURVEYORS ,
1,0CDS DEED:OWNER: 22288 SS 646 U'�
LOCUS PLAN: PL. BK 380 PL 2 72 HAUMTON AVENUE
& PL BE 366 PL. 6. ra MOAN AT SOUTH HAMILTON, MA �ASSESSORS' MAP 21 PARCEL 37 MM SQUIRE COMIM OY
BONING DISTRICT: 9-1 �. SCALE: 1"-40' NOVEMBER 13, 2008
Y
�. eAcoxnrn�
W CITY OF SALEM
CONSERVATION COMMISSION
Mike Mercurio
One Industrial Way
Georgetown, MA 01833
December 1, 2008
Dear Mr. Mercurio,
The work you have proposed at your property, 25-27 Cedarcrest Avenue, including the
construction of a single family home, is exempt from review by the Conservation
Commission. Based on the site plan you provided to me(dated November 13, 2008,
stamped by Peter J. Kane, Professional Land Surveyor) the proposed dwellings and
associated proposed embankment are located outside of a resource area and outside of the
100 foot buffer zone of resource areas. Therefore, you do not need to file any permits
with the Conservation Commission. Please feel free to contact me if you have any
questions.
Sincerely,
Carey ques, CP
Conservation Agent/Planner
CC: iTom_McGrath,-Assistant Building Inspector\
David Pabich, Chairman Conservation Commission
130 WAsIIIrj(;pm S r!aith:r, SAL(a M, Mnssn� 01970 ♦ TPa.: 978.745.9595 FAX: 978.740.0,10.1