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20 CHESTNUT ST - BUILDING INSPECTION (3) RECEIVED PECT►ONAL SERVICES OIL fvg -LI P b� 14 The Commonwealth of Massachusetts CITY OF Board of Building Regulations and Standards SALEM Massachusetts State Building Code, 780 CMR Revised Mar 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling © This Section For Official Use Only Building Permit Number: Date Applied: ® Building Official(Print Name) - Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers L la Is this an accepted street?yes no Map Number Parcel Number 1.3 Z Sling Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq R) Frontage(11) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public liY Private ❑ Zone: _ Outside Flood Zone? P y Check if yes❑ Municipal EYUn site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1�\(S�•Ica_ ner of Recoc d, /�1/� CJ 1 5 -76 Name(Print) City, State.ZIP I L,- C-I�—SVInln � S1rcL1— C,P 513 .S5 w -141 czc No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building Owner-Occupied Repairs(s) ❑ 1 Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': c U tT7z �r ✓t , r no c, �, 20 �v 1 11 1 6 C. I SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ )Cj pc a 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2. Electrical $ �0 ❑Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 000 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,5/0W ❑Paid in Full ❑Outstanding Balance Due: Grp+—L-e-1D 0 Z I o SP Cy(�t� SECTION 5: CONSTRUCTION SERVICES ) 5.1 Construction Supervisor License(CSL) C.0 _ i V S-GI 5 (e / / ( 2e. License Number Expiration Date Name of CSL Holder S. List CSL Type(see below)�_ C) ) (5 L_-e. It Type Description No.and Street 0 I c (.0 (J U Unrestricted(Buildings up to 35.000 cu.ft.) Yam`• �! /' R Restricted 1&2 Family Dwelling cityrrown.State.ZIP M Masonry RC Roofing Covering WS Window and Siding i \ SF Solid Fuel Burning Appliances 9r ZZ3�5 zE; ZG U >1JVZjL�Pha �•C 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) ) II �a.9�i zr Z6 `1" G " e ' HIC Registration`Number, Exp moon ate Hl�-Coruan Ny ame o,71Cte�istrant Name �1o7-G`S vj`'Z��:=`Y✓te", CL"'"1• o and Stree —�•~� Email ad` ess (y=",,bu' a- C(mi Ll City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION 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 .......... 8" No ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize E (CG to act on my behalf, in all matters relative to work authorized by this guilding permit application. Shawn Smith I 2/3/2016 Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION 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. Print Owner's or A thorized Agent's Nance(Electronic Signature) Date 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),will not have access to the arbitration program or guaranty fund under M.G.L. c. I42A. Other important information on the HIC Program can be found at ww•w.miss.goyIota Information on the Construction Supervisor License can be found at i w .mass.n,,,ov./dos �. When substantial work is planned, provide the information below: Total floor 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" t; 189" 15" 351" 24" 24" 18" 8" 18 —111 'a" " 108 44 " 15" 3 " 24" 24' 24" 3 24" i`I =w o-wae.lsrta� w C N ' 8waet sno _ ivr7-j DB24-3 He will be on Me cabinet wen, e he a sposer in the iaonb. T ------------ - he P Ingemitor was ice maker on the cabnet wall. ave Drawer next to the refrigerator.. Jolla munter lighting hem is a 14"disinheriton the batic able Island and an B"owrhenp Me right M Me Ielanb... phnn In the bathroom m m l br tan light in Me bathroom in m p. COT78555F55 m -BIPF 0_ 4p;• m �I^ 0 m 89" All dimensions size designations This is an original design and must Designed: 12/29/2015 given are subject to verification on not be released or copied unless Printed:2/4/2016 job site and adjustment to fit job applicable fee has been paid orjob conditions. 2020 order placed. Smith Final I All Drawing 4: 1 No Scale. _gON01T RECEIVED •1SPECTIONAL SERVICES 1816 FEB -9 P 1: 39 Salem Historical Commission 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (978)619-5685 FAX(978)740-0404 CERTIFICATE OF NON-APPLICABILITY It is hereby certified that the Salem Historical Commission has determined that the proposed: ❑ Construction ❑ Moving ❑ Reconstruction ❑ Alteration ❑ Demolition ❑ Painting ❑ Signage ✓ Other Work as described below does not involve an exterior architectural feature or involves a feature covered by the exemptions or limitations set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: McIntire District Address of Property:20 Chestnut Street Name of Record Owner: Shawn and Craig Smith Description of Work Proposed: Install one 8x10x4 stove vent on rear of back addition. Vent to be painted same color as house. The vent will not be visible from a public way. Dated: February 8, 2016 SALEM HISTORICAL COMMISSION By: �/ The homeowner has the option not to commence the work (unless it relates to resolving an outstanding violation). All work commenced must be completed within one year from this date unless otherwise indicated. Once completed,please submit a photograph(s) of the final result(maximum offour- i.e. one photograph of each affected fa(!ade). THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Buildings (or any other necessary permits or approvals)prior to commencing work.