0027 CHARTER STREET - BPA ANTENNAS (003) v3oo c�c 2'►�3
#u3PEGTfa13E CZ IV ED
KAL SERT;r. ._l;
The Commonwealth of Massausetts
Department of Public Safety *b JUN 2 0 A 8' S b
Massachusetts State Building Code(780 CMR)
n(� Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION
t _27 Charter Street Salem 01970 Salem Housing Authority
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
^ SECTION 2:PROPOSED WORK
-Fl Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Building Repair f lv Alteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 2)
Change of Use ❑ Change of Occupancy ❑ 1 Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes W No ❑
Is an Independent Structural Engineering Peer Review required? Yes No ❑
BFief Description of Proposed Work: Re-roof existing building
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDMON,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) 12 Floors 12 Floors
Total Area(sq.ft.)and Total Height(ft.) 7000 sq ft. 7000 sq ft.
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A5 ❑ A-4❑ A5❑ B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ H: HI Hazard H-1❑ H-2❑ H-3 ❑ H-4 0 H5 0
I: Institutional I-1❑ 1-2❑ I-3❑ I-4❑ M: Mercantile❑ Rt Residential R-10 R-2 m R-3❑ R-4❑
S: Storage S-1❑ S-2❑ U. Utility❑ Special Use❑and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 I11_p. ILA 0 11B O IHA 0 II111 0 IV 0 VA 0 VB O
SECTION 7.SITE INFORMATION(refer to 780 CMR 105.3 for details on each item)
Water Supply: -Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑
Private❑ or indentify Zone: or on site system❑ required 0 or trench or specify:
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process.
Not Applicable❑ Is Structure within airport approach area? TS their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction:
Does the building contain an Sprinkler System?: Special Stipulations:
Design Occupant Load per Floor and Assembly space:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Salem Housing Authority 27 Charter St Salem . 01970
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Carol McGowan 978 -774 -4431 dtucker@salemha.org
Title Telephone No.(business) Telephone No. (cell) e-mail address
if applicable,the property owner hereby authorizes:/t
/F f 1
Name Street Address City/Town fate Zip
to apply for and act on the pj ertyowner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here[3.
Otherwise provide construction control forms see section 107 in the code as required.
10.1 Registered Professional Responsible for Construction Control(the fessional coo rdinatin document submittals)
Raymond T.Guerfin 978 - 356 - 2749 RayORTGArchitect.mm MA 8627
Name(Registrant) Telephone No. e-mail address Registration Number
89 Tumpike Road Suite 207 Ipswich MA 01938 Architecture 8131/16
Street Address City/Town State Zip Discipline Expiration Date
102 General Contractor
LGR 1 INC
Company Name
Leo Garcia Jr. CS-097007
Name of Person Responsible for Construction License No. and Type if Applicable
141 Rice Road Winchester MA 01475
Street Address City/Town State Zip
978-802-9449 Igrlinc@g•nail.com
Telephone No.(business) Telephone No.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT .G.L.c.152.§25C 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes O No ❑
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Estimated Costs:(Labor
Item and Materials) Total Construction Cost(from Item 6)_$ 300,000
1.Building $ 300,000 Building Permit Fee=Total Construction Cost x 11 (Insert here
2.Electrical $ _appropriate municipal factor)=$ 6 r`3bU 1
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $ Enclose check payable to
6.Total Cost $ 300,000 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
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.
Leo Garcia Jr. �.r�i �� Construction Supervisor 978-807 - 9449 6 16 16
Please print and sign name Title Telephone No. Date
141 Rice Rd Winchester MA 01475 Igrlinc@gmail.com
Street Address City/Town State Z' Email Address
Municipal Inspector to fill out this section upon application approval: -'! " X 2
Name Date
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the 8`h edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Low-Slope Roof Replacement Date: June 16, 2016
Property Address: Charter Street 667-5 Elderly Housing- 27 Charter Street, Salem MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description: Replacement of all existing membrane roofing and insulation with new thermal insulation and cold
applied 2-ply modified bitumen roofing system. Related work includes replacement of existing lightning protection
system.
1 Raymond T. Guertin, Architect MA Registration Number: 8627 Expiration date: 8/31/16 , am a registered design
professional, and 1 have prepared or directly supervised the preparation of all design plans, computations and
specifications concerning':
Architectural Structural Mechanical
Fire Protection Electrical X Other: Entire Project
for the above named project and that to the best of my knowledge, information, and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. 1 understand and agree that I (or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept,shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control o ent'.
Enter in the space to the right a"wet" or `y�EitEDAq��'
electronic signature and seal: �vtNW�ct�r�cA
rb.aw `n
Phone number: 978-356-2749 Email: Ray@RTGArchitect.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an'x' project design plans,computations and specifications that you prepared or directly supervised. Ir`other'is chosen.
provide a description.
awew noonmlmee A 1
ronlrveu xm4rmdrMrw+xa xewm'mvrodw.nuewm rmom r mi[M�preunemNnN nmp Nwnwlrwma non rm ( a -::.
nNrwmwmrne rre9O'ienroro.� "tlJo. Omar IRtlOrmo`ON�m.Yn�
enrwuoAW9"°"NI ew mN ma 1"�"ew nnmrde`w werw da «.MwromWlMWo LEGEND I e.Nwmxmwxww nmm mixn Jer. w[mMM'miPX+@'q]1 Mm eWll 1 r 0.'H fM ML P' L 4fiY ULILV+ �'�ur .
NY S q 6[GrNn MY� !"�M rmn Na'NrmYFw. / •
lalnn p
EYN ubl Pd.1xYP n q royEe Nra y IW {4 Ki MI 1 f
WYrMermdNp1a 491GW merr M1mm Pnn dYpxpVpyµv npxpN JVIWL IAC m NMMd MtmpedlxxN. 5 i Y.C i N 4 iV pLfh hAW /1 1 '
a IMrMnrnw EmPWxrprglµNpLtitaGAplMn lIGdMNGrdedP«d! -E 53[F IRl A Arl fl, 4Nr .�] I
wren emmwnMMvnmN mmrNadmM neae mrn.mwu ,Lr c Pc.l
i
mnwNnru4wcndmmme.G« w crnnRmdmMlM mueraacrxm -. va
IWloroeGw.W.M,[mrMFrp4yplPNy4xnglpryurq.pOgxm ( !' .INNq ( I: 51hCM 1. .•..
lll[RYbNG1nNIgYNMN.
[.ummrNpnanlYClmx,NNxmrrtrwnars.cwrwExn.Nmuu w I
M aowommwnrenroxa..xeN rw.nxnralwn.N Enr larwlc lw ¢M of rr r
�iannmm.mrw(re.mxM rw"w ro pnmx.run4rrM I, n >lo PrN.n m 1 rvr r ,.V "� vY wa -
MIMmI1LLYpN.1rGrNMre11N[N Y9V rl MI MI 1M
_ Ousr PLAN n
® r
°mm xs l9
1.1"n°tf4n .r r woxm .NI m If a.v iu NruN n lsl a n, n. arrn cx PENTH
�r - u «.mm�.tlwl<mwerrp «'i vwlmw.+
�elrvnwprMrG.l nM VNMnxr1IT«peliprruNNw � IIL'f1 Y41ArYI1WeANnW fNilfim4 AM
u Wtu[i[mvnproiww[n. A GI11V. S N. .I .'rf. rl'0
tlyN' "rY4ura0.lr`nw"cn aW Wr [wpurm.«�naW I.1rH wr. 1Y.•s1 rl'sP14✓Anl
.Yrmmredxco aan n tl' id rl cwLv ec rr'1 1nma�:
ni�.I.:oNYul°v lNNwrror Nwa rwr o-mNx"um'"mO1xn««aoo�"m rti E a�v cw' E«. rvsrl,
ul:�.niwrp .14wrwn
ww;nY`xw.d`e:°� iwinr,N. 900m coNuc w,; 1 L.,lelu>;4vr.rri' -
wxur4x. m +:4.nee:'ma^Wm raunrrrw �[WIlx.eovf lYYtl Au.r., vu.a<w.
e ""eduwreN«m. rvprN Pmmatlxr >t
I I _....
mNN xx m rmo[ rmm..a.xa«.w.pw
vmcrxcNm .va+m.. mpxrwwxNonNWmv 1
Iw°�"wNu.�""vwn Yowxo-xmwwonItN.
NMMnW. [W w<dnlm06rw mgrw
0
unmNOua "`' em eNLNa4rW rOw/b"M I ; N
V :
rOaOr [MW.iWrormM Wrtl I <
w rN,ne„rrdwmxwNr' v1 rN
wx Nx.+M"num NVWrm.vuN.dpumn eNNN I ns ••�••
1
rw+
rtrgxnNrWx@rmlrm nn NrrrNrN rrwn .r., ,. .. "
!
1 rorcN.n.<vmx.w.,nmw..nmdx.r4 rGrrxnxxNxm,m � �;;; I •,.-. ... II NI 'mr�. xNrprNnarwlo-lm.W[w«Nxw.rrr xx.rmM ` \ � I � t « w. �w�
'nxowrce.:rwWrmuNrmdnawnrx[4vaeN<o i, :/_ ,1 .' / <1 N
N"� a wmn numnw.rumuwl awvr rn Pw Nw�mruxva v `
I,.ti
I ( 1 1 e If
Sry G 1 .
1I �1 1 °1�WrPr1 ,�1;
_...
reeeaeQ-msuat ors e,em ar
;° wr..
nI s.rar ur. .x n.mww re vvniui wr .ur. Y 11•'
R%OOP PIAN x®
A2
Untitled Map ya '
Write a description for your map.
♦ '
Oak
two w '.
4� «.
♦VIO
i
JV.fr
` I
.GoogIe eaoh N
2016 C le I 40 ft
J