129 COLUMBUS AVE - BUILDING INSPECTION ly35- 676 - 1Y
The tommonwealth of Massachusetts d�ISPEGRECEIVTIONAL S RVIC OF
WBoard of Building Regulations and Standar SALEM
Massachusetts State Building Code,780 CMR��pp gg ����pp vts� Mar 1011
Building Permit Application To Construct,Repair, RenovateldIl7h}1 IZ?a `
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Da t Applied:
Building Official(Print Name) Signature V �Dat
SECTION 1: SITE INFORMATION
1.1 Pro Address:pe 1.2 Assessors Map&Parcel Numbers
12 g Aus Avc-
L l a Is this an accepted street?yes W-11_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq to Frontage(ft)
1.5 Building Setbacks(it)
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❑ Private❑ Zone: _ Outside Flood Zone?Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
/ &W12MCC 1-D69erilN C46t/AIMV SALE �'�/� 01g70
Name(Print) City,State,ZIP
IL9 C6c.umr3yS 1\- ve `e 79S IC13L L�IctkltnuLi) PMSIJ zo*l
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Constmction)A Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work': DEM OL I S F} C% 1 ST I PEA IA32M C 2E Call �O
�ti 'E><IST FO yA/�f!'f1D7U /�S P Q �LP c -I— S PEC'S
AUIPPLIEZ.
2r 9
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ ZC 000 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression $ Total All Fees:$
do Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ 20 SOCO ❑Paid in Full ❑Outstanding Balance Due:
9 - 5 19 -- ) y(vI
t'/LJ
c:�Ai,t.G5D 31
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 2� /
,�7i-ET C t Eyl - N I"LL_, License Number E irat n Date
Name of CSL Holder
List CSL Type(see below)
c4
No.and Street Type Description
����� ► q QI 4 v U Unrestricted(Buildings u to 35,000 cu.ft.
City/Town,State,ZIP i 1- 1 R Restricted 1&2 FamilyDwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
�783784�G� PCA-WGLS?LOe& Af;r I Insulation
Telephone - Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) ,_ ,, ���
1 k 14,%L-1.- HIc Registration Number pira on Date
HTC Company Name or HIC Registrant Name
16 A AVO-
No.and Street Email address
,.�l
t���rn /✓!� 979 s74 /4G "
City/Town, State,ZIP Telephone ��YrTCLBq&C&*JC Or.NET
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 ..........l" No...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACT-OR APPLIES FOR BUILDING PERMIT
F--
T, as Owner of the subject property,hereby authorize ei-c kSlt I 4k Lt:
to act on my behalf,in all matters relative to work authorized by this building permit application.
y- ag� ; 21 k
Print Owner's Name(Electronic Signa ' ate
`,
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.
/4 Z / G1�t a i4
Print Owner's or Authorized Agent's aine(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. 142A. Other important information on the HIC Program can be found at
www.mass. og v/oca Information on the Construction Supervisor License can be found at www.mass.gov/dls
2. When substantial work is Atan/n`ed,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 3
Number of bathrooms Number of half/baths
Type of heating system 6AS P=HJAJNumber of decks/porches
Type of cooling system Enclosed Open
3. "To al Project Square Footage"may be substituted for"Total Project Cost"
CITY OF SiuxN, 4 NI LksSACHUSETTS
• BUILDING DEPAR-M&NT
120 WASHINGTON STREET,3'o FLOOR
TEL (978) 745-9595
FAX(978) 740-9846
KI,NIBERLEY DRISCOLL
MAYOR THOMAs ST.Pwim
DIRECTOR OF PUBLIC PROPERTY/BUI DLNG COMMISSIONER
Workers' Compensation Insurance Affidavit: Builders/ContractorslElectricians/Plumbers
Applicant Information Please Print Legibly
Maine(8usilxssiOrganization/Individual): T' LC'lZ �f6� HI—\l—L
Address: / 6 FE-P- H
City/State/Zip: : L�nI- HA 01970 Phone#: c?7& S78 /-16 /
Are ou an employer?Check the appropriate box: Type of project(required):
VI. I am a employer with 2 _ 4. ❑ 1 am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2_❑ I an a sole proprietor or partner- listed on the attached sheet: 7• ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp.insurance. 9, ❑ Building addition
[No workers comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 1011 Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions
myself.[No workers'comp. C. 152.§1(4),and we have no 12.[1 Roof repairs
insurance required.)t employees.(No workers'
COMP. insurance required.] MCI Other
'Any applicvd that chedts box 01 most also fII out the seclim below showing their work—'eompenation policy information
'I lomeuwtxns who submit this affidavit indicating they are doing all work and then hire outside contmctora must submit a new aRtdavit indicating such,
"f.,mlmvlat3 that check this box mint attached an additional sheet showing the name of the sub-contrapots and their wo*—,comp.policy inrormotim.
lam an employer that it providing lvorkers'compeiisalon insurance for my employees. Below is the policy and job site
information.
Inwrance Company dame: i m.
Policy N or SeiFins.Lic.#: r' L '4 2 [ 9 Expiration Date:Job Site Address: CjcpL a r-1 Q u r VC City/State/Zip: a f I_L,-M, M ^�. 61976
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under a pains and penalties o perjury that tire information provided above is tru and correct
. i riat tie• /
Date:
Phone X• 976' `5'7 B 1-4 /
OJjicial use only. Do not write in this area,to be completed by city or town ajju•iaL
City or Town: Permit/l.icense#
Issuing Aulhorily(circle one):
I.Board of IIedlth 2.Building Department J.City/town Clerk 4. Electrical Inspector]Fn]"]
6.Other
Contact Person• Phone#:
CONSTRUCTION CONTRACT
This Construction Contract (the "Contract") is made as of fE& 21 , ��4 (the "Effective
Date")by and between Lawrence & Deborah Callahan of 129 Columbus Ave., SALEM,
Massachusetts 01970, and Fletcher Hall Construction of 16 BEACH AVE., SALEM,
Massachusetts 01970.
Fletcher Hall Construction desires to provide Construction services to Lawrence & Deborah
Callahan and Lawrence & Deborah Callahan desires to obtain such services from Fletcher Hall
Construction.
THEREFORE, in consideration of the mutual promises set forth below, the parties agree as
follows:
1.DESCRIPTION OF SERVICES.Beginning on 2 4 4 Fletcher Hall
Construction will provide to Lawrence &Deborah Callahan the following services (collectively,
the "Services"):
Construct 1 family home as per plans & specifations
2. SCOPE OF WORK. Fletcher Hall Construction will provide all services, materials and labor
for the construction of residential one family home described above at the property of Lawrence &
Deborah Callahan located at: 129 Columbus Ave, Salem, Massachusetts, 01970 hereinafter
referred to as ("Worksite").
This includes building and construction materials, necessary labor and site security, and all required
tools and machinery needed for completion of construction.
Fletcher Hall Construction is only responsible for furnishing any building improvements related to
construction of the structure,but not related to landscaping, grading, walkways,painting, sewer or
water systems, steps, driveways, patios and aprons, etc., unless they are specifically agreed to in
writing.
3. PLANS, SPECIFICATIONS AND CONSTRUCTION DOCUMENTS. Lawrence &
Deborah Callahan will make available to Fletcher Hall Construction all plans, specifications,
drawings, blueprints, and similar construction documents necessary for Fletcher Hall Construction
to provide the Services described herein. Any such materials shall remain the property of
Lawrence &Deborah Callahan. Fletcher Hall Construction will promptly return all such materials
to Lawrence & Deborah Callahan upon completion of the Services.
4. COMPLIANCE WITH LAWS. Fletcher Hall Construction shall provide the Services in a
workmanlike manner, and in compliance with all applicable federal, state and local laws and
regulations, including, but not limited to all provisions of the Fair Labor Standards Act, the
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r
Americans with Disabilities Act, and the Federal Family and Medical Leave Act.
5. WORK SITE. Lawrence & Deborah Callahan warrants that Lawrence & Deborah Callahan
owns the property herein described and is authorized to enter into this contract. Prior to the start
of construction, Lawrence & Deborah Callahan shall provide an easily accessible building site,
which meets all zoning requirements for the structure, and in which the boundaries of Lawrence &
Deborah Callahan's property will be clearly identified by stakes at all corners of the property.
Lawrence & Deborah Callahan shall maintain these stakes in proper position throughout
construction.
6.MATERIALS AND/OR LABOR PROVIDED: Fletcher Hall Construction shall provide to
Lawrence & Deborah Callahan a List of each and every party furnishing materials and/or labor to
Fletcher Hall Construction as part of the Services, and the dollar amounts due or expected to be
due with regards to provision of the Services herein described. This List of materials and/or labor
shall be attached to this Contract as Exhibit A. Fletcher Hall Construction declares, under the laws
of the State of Massachusetts, that this List is a true and correct statement of each and every party
providing materials and/or labor as part of the Services herein described.
Fletcher Hall Construction may substitute materials only with the expressed written approval of
Lawrence & Deborah Callahan, provided that the substituted materials are no lesser quality than
those previously agreed upon by Lawrence & Deborah Callahan and Fletcher Hall Construction.
7. PAYMENT. Payment shall be made to Fletcher Hall Construction, SALEM, Massachusetts
01970. Lawrence &Deborah Callahan agrees to pay in installment payments of$7,500.00 per
weekly.
In addition to any other right or remedy provided by law, if Lawrence &Deborah Callahan fails to
pay for the Services when due, Fletcher Hall Construction has the option to treat such failure to
pay as a material breach of this Contract, and may cancel this Contract and/or seek legal
remedies.
8. TERM. Fletcher Hall Construction shall commence the work to be performed within 30 days
of and shall complete the work on or before November 15, 2014, time
being of the essence of this contract.
Upon completion of the project,Lawrence &Deborah Callahan agrees to sign a Notice of
Completion within ten (10) days after the completion of the contract. If the project passes its final
inspection and Lawrence & Deborah Callahan does not provide the Notice, Fletcher Hall
Construction may sign the Notice of Completion on behalf of Lawrence &Deborah Callahan.
9. CHANGE ORDER.Lawrence &Deborah Callahan, or any allowed person, e.g. lender,
public body, or inspector, may make changes to the scope of the work from time to time during
the term of this Contract. However, any such change or modification shall only be made in a
written "Change Order" which is signed and dated by both parties. Such Change Orders shall
become part of this Contract. Lawrence & Deborah Callahan agrees to pay any increase in the
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cost of the Construction work as a result of any written, dated and signed Change Order. In the
event the cost of a Change Order is not known at the time a Change Order is executed, Fletcher
Hall Construction shall estimate the cost thereof and Lawrence & Deborah Callahan shall pay the
actual cost whether or not this cost is in excess of the estimated cost.
10. PERMITS. Lawrence &Deborah Callahan shall obtain all necessary building permits.
Fletcher Hall Construction shall apply for and obtain any other necessary permits and licenses
required by the local municipal/county government to do the work, the cost thereof shall be
included as part of the Payment to Fletcher Hall Construction under this Contract.
11. INSURANCE. Before work begins under this Contract, Fletcher Hall Construction shall
furnish certificates of insurance to Lawrence & Deborah Callahan substantiating that Fletcher Hall
Construction has placed in force valid insurance covering its full liability under the Workers'
Compensation laws of the State of Massachusetts and shall famish and maintain general liability
insurance, and builder's risk insurance for injury to or death of a person or persons, and for
personal injury or death suffered in any construction related accident and property damage
incurred in rendering the Services.
12. CONFIDENTIALITY. Fletcher Hall Construction, and its employees, agents, or
representatives will not at any time or in any manner, either directly or indirectly, use for the
personal benefit of Fletcher Hall Construction, or divulge, disclose, or communicate in any manner,
any information that is proprietary to Lawrence & Deborah Callahan. Fletcher Hall Construction
and its employees, agents, and representatives will protect such information and treat it as strictly
confidential. This provision will continue to be effective after the termination of this Contract.
Upon termination of this Contract, Fletcher Hall Construction will return to Lawrence & Deborah
Callahan all records, notes, documentation and other items that were used, created, or controlled
by Fletcher Hall Construction during the term of this Contract.
13. INDEMNIFICATION. With the exception that this Section shall not to be construed to
require indemnification by Fletcher Hall Construction to a greater extent than permitted under the
public policy of the State of Massachusetts, Fletcher Hall Construction shall indemnify Lawrence
& Deborah Callahan against, hold it harmless from and defend Lawrence & Deborah Callahan
from all claims, loss, liability, and expense, including actual attorneys' fees, arising out of or in
connection with Fletcher Hall Construction's Services performed under this Contract. This
indemnity shall be provided even if Lawrence & Deborah Callahan is partly responsible for the
claim, damage, injury or loss, but Fletcher Hall Construction shall not provide indemnity against
claims or losses deemed to be caused by the sole negligence or willful misconduct of Lawrence &
Deborah Callahan or Lawrence & Deborah Callahan's agents or employees.
14.WARRANTY. Fletcher Hall Construction shall provide its services and meet its obligations
under this Contract in a timely and workmanlike manner, using knowledge and recommendations
for performing the services which meet generally acceptable standards in Fletcher Hall
Construction's community and region, and will provide a standard of care equal to, or superior to,
care used by service providers similar to Fletcher Hall Construction on similar projects. Fletcher
Hall Construction shall construct the structure in conformance with the plans, specifications, and
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any breakdown and binder receipt signed by Fletcher Hall Construction and Lawrence &
Deborah Callahan.
15. FREE ACCESS TO WORKSITE. Lawrence & Deborah Callahan will allow free access to
work areas for workers and vehicles and will allow areas for the storage of materials and debris.
Driveways will be kept clear for the movement of vehicles during work hours. Fletcher Hall
Construction will make reasonable efforts to protect driveways, lawns, shrubs, and other
vegetation. Fletcher Hall Construction also agrees to keep the Worksite clean and orderly and to
remove all debris as needed during the hours of work in order to maintain work conditions which
do not cause health or safety hazards.
16.UTILITIES. Lawrence &Deborah Callahan shall provide and maintain water and electrical
service, connect permanent electrical service, gas service or oil service, whichever is applicable,
and tanks and lines to the building constructed under this Contract after an acceptable cover
inspection has been completed, and prior to the installation of any inside wall cover. Lawrence &
Deborah Callahan shall, at Lawrence & Deborah Callahan's expense, connect sewage disposal
and water lines to said building prior to the start of construction, and at all times maintain sewage
disposal and water lines during construction as applicable. Lawrence &Deborah Callahan shall
permit Fletcher Hall Construction to use, at no cost, any electrical power and water use necessary
to carry out and complete the work.
17. INSPECTION. Lawrence & Deborah Callahan shall have the right to inspect all work
performed under this Contract. All defects and uncompleted items shall be reported immediately.
All work that needs to be inspected or tested and certified by an engineer as a condition of any
government departments or other state agency, or inspected and certified by the local health
officer, shall be done at each necessary stage of construction and before further construction can
continue. All inspection and certification will be done at Lawrence &Deborah Callahan's expense.
18. DEFAULT. The occurrence of any of the following shall constitute a material default under
this Contract:
a. The failure of Lawrence &Deborah Callahan to make a required payment when due.
b. The insolvency of either party or if either parry shall, either voluntarily or involuntarily,
become a debtor of or seek protection under Title 11 of the United States Bankruptcy
Code.
c. A lawsuit is brought on any claim, seizure, lien or levy for labor performed or materials
used on or famished to the project by either party, or there is a general assignment for the
benefit of creditors, application or sale for or by any creditor or government agency
brought against either party.
d. The failure of Lawrence &Deborah Callahan to make the building site available or the
failure of Fletcher Hall Construction to deliver the Services in the time and manner
provided for in this Contract.
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19. REMEDIES. In addition to any and all other rights a party may have available according to
law of the State of Massachusetts, if a party defaults by failing to substantially perform any
provision, term or condition of this Contract(including without limitation the failure to make a
monetary payment when due), the other party may terminate the Contract by providing written
notice to the defaulting party. This notice shall describe with sufficient detail the nature of the
default. The party receiving said notice shall have 21 days from the effective date of said notice to
cure the default(s) or begin substantial completion if completion cannot be made in 21 days. Unless
waived by a party providing notice, the failure to cure or begin curing, the default(s)within such
time period shall result in the automatic termination of this Contract.
20. FORCE MAJEURE. If performance of this Contract or any obligation under this Contract is
prevented, restricted, or interfered with by causes beyond either party's reasonable control
("Force Majeure"), and if the party unable to carry out its obligations gives the other party prompt
written notice of such event, then the obligations of the party invoking this provision shall be
suspended to the extent necessary by such event. The term Force Majeure shall include, but not
be limited to, acts of God, fire, explosion, vandalism, storm, casualty, illness, injury, general
unavailability of materials or other similar occurrence, orders or acts of military or civil authority, or
by national emergencies, insurrections, riots, or wars, or strikes, lock-outs, work stoppages, or
supplier failures. The excused party shall use reasonable efforts under the circumstances to avoid
or remove such causes of non-performance and shall proceed to perform with reasonable dispatch
whenever such causes are removed or ceased. An act or omission shall be deemed within the
reasonable control of a party if committed, omitted, or caused by such party, or its employees,
officers, agents, or affiliates.
21. ARBITRATION. Any controversy or claim arising out of or relating to this Contract, or the
breach thereof, shall be settled by arbitration administered by the American Arbitration
Association in accordance with its Commercial Arbitration Rules [including the Optional Rules for
Emergency Measures of Protection], and judgment on the award rendered by the arbitrator(s)
may be entered in any court having jurisdiction thereof. During any arbitration proceedings related
to this Contract, the parties shall continue to perform their respective obligations under this
Contract. In the event arbitration is necessary, each party shall be solely responsible for its
attorney fees and costs.
22. ENTIRE CONTRACT. This Contract contains the entire Contract of the parties, and there
are no other promises or conditions in any other contract whether oral or written concerning the
subject matter of this Contract. Any amendments must be in writing and signed by each party. This
Contract supersedes any prior written or oral agreements between the parties.
23. SEVERABILITY. If any provision of this Contract will be held to be invalid or unenforceable
for any reason, the remaining provisions will continue to be valid and enforceable. If a court finds
that any provision of this Contract is invalid or unenforceable, but that by limiting such provision it
would become valid and enforceable, then such provision will be deemed to be written, construed,
and enforced as so limited.
24. AMENDMENT. This Contract may be modified or amended in writing, if the writing is
signed by each party.
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25. GOVERNING LAW. This Contract shall be construed in accordance with, and governed by
the laws of the State of Massachusetts, without regard to any choice of law provisions of
Massachusetts or any other jurisdiction.
26. NOTICE. Any notice or communication required or permitted under this Contract shall be
sufficiently given if delivered in person or by certified mail, return receipt requested, to the address
set forth in the opening paragraph or to such other address as one party may have furnished to the
other in writing.
27. WAIVER OF CONTRACTUAL RIGHT. The failure of either party to enforce any
provision of this Contract shall not be construed as a waiver or limitation of that party's right to
subsequently enforce and compel strict compliance with every provision of this Contract.
28. SIGNATORIES. This Contract shall be signed on behalf of Lawrence & Deborah Callahan
by Lawrence & Deborah Callahan, and on behalf of Fletcher Hall Construction(Contractor's
License: 44209) by Fletcher Hall, and shall be effective as of the date first written above.
Owner:
Lawrence & Deborah Callahan
rN
By: �N o/
awrence &Deborah Callahan
Contractor:
Fletcher Hall Construction
Contractor's License: 44209
By:
Fletcher Hall
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CITY OF SALEM
ROUTING SLIP
New Construction
Certificate of Occupancy
LOCATION 129 6XUn6U,(U DATE
ASSESSORS DATE
93 Washington St.
CITY CLERK DATE
93 Washington St. I q
PUBLIC SERVICES DATE
120 Wash' ton St.
WATER DATE b Pb Ilv1� r,�
120 Washington St. j� n
CROSS CONNECTION ATE _ t
5 Jefferson Av �j l
PLANNIN
120 Washings n St. \\ J
CONSERVATIO DATE
120 Washington St. I
ELECTRICAL DATE 2J L
48 Lafayette . S
FIRE PREVENTION ru DATE "NIA
29 Fort Avenue
a . �� �apgANFooc.
HEALTH � DATE 81 ,11 �1 U
120 Washington St.
BUILDING INSPECTOR DATE It3
120 Washington St.
y ONgD�ITA CITY OF SALEM, MASStACHUSETTS
PUBLIC PROPERTY DEPARTMENT -
120 WASHINGTON STREET, 3RD FLOOR
SALEM. MASSACHUSETTS 01 970
TELEPHONE: 978-745-9595 f
FAX: 978-740-9846
KIMBERLEY DRISCOLL
MAYOR
Section 116.0
DEMOLITION OF STRUCTURES
Structures over fifty(50) years old must have approval of the
Salem Historic Society
UTILITY DISCONNECTIONS REQUIRED
Authorized Agent Date of Disconnection
Water lit j L�l`I(see attached requirements)
Electrical
Fire t
Health 3�n
Sewer C
Salem Historic Commission
Dig Safe Number --0,2o t9 I oo I191F
Pest Control:
***DOCUMENTATION OF ALL THE ABOVE MUST BE ATTACHED BEFORE
PERMIT CAN BE ISSUED***
Fee for Demolition $5.00 application fee plus $2.00 per 100 square ft gross area,
Minimum $25.00
(°):�tCsftr�bhr(0,0VC0 Oc,or-a V&,0, re4 IA%�k(lyd �h��Li3��lvvkb
^�6vK0Ke-j eTb rklkh n, V."C�pfi(v �A 1F (5Lo(T. 7vL5-T*o +-CP6-C
CZ)•�(jte'v Scwci cu+ 6wfi1,. IN rj, 194 ®CCA1Pt-
����0
City of Salem, Massachusetts
-ire Department
48 Lafayette Street
David W. Cody Salem, Massachusetts 01970-3695 Fire Prevention
Chief Tel. 978-744-1235
978-744-6990 Fax 978-745-4646 978-745-7777
dcody@safem com
Demolition
a Before a structure can be demolished, the Salem Fire Department shall conduct a
preliminary demolition inspection, to ascertain any conditions which may require
a fire watch* or other preventative measures to be taken before, during, or after
the demolition process. Minimum of two weeks notice required to schedule
appointment
® A permit to demolish or remove a structure shall not be issued until the
preliminary inspection has been conducted and a report of requirements necessary
to prevent life safety hazards has been obtained by the applicant.
e The inspection report shall include but not limited to: cutting and welding permit,
fire watch, on site storage of materials, underground storage tank compliance....
® Proof of utility disconnects.
m The requirements outlined in the report shall become a part of the restrictions of
the demolition permit issued by the Building Inspector.
*Fire watch patrol Salem Code of Ordinances Sec. 20-124
October 5, 2010
NDI
CITY OF SALEM
SALEM, MASSACHUSETTS
ENGINEERING DEPARTMENT
120 WASHINGTON STREET, 4TH FLOOR
%M1NB Do� ' SALEM, MA 01970
Phone: (978) 745-9595 x5673
Kimberley Driscoll Fax: (978) 745-0349
Mayor
DAvID H. KNOWLTON, P.E.
CITY ENGINEER
October 25, 2011
Water, Sewer and Drainage Requirements
Regarding the Demolition of Structures within the City of Salem
In accordance with the provisions of the General Laws of the Commonwealth of Massachusetts
and the Salem Water and Sewer Department, the following regulations governing the demolition
of structures within the City of Salem shall be followed.
This regulation is made in the interest of protecting the city's water, sewer, drainage and public
way infrastructure at each connection located within the City of Salem, as well as to prevent
conditions which may cause danger to public safety, result in water loss, or damage to city or
private property due to water or sewer loss or back-ups, or cause pollution of the city's storm water
receiving waters.
1. Prior to demolition of structure, a licensed plumber shall ascertain where all water, sewer
and drainage lines are located entering,and leaving said structure. The plumber shall make
a determination of existing or prior use of each line, including, but not limited to domestic,
commercial or industrial use; irrigation; fire suppression; sewer, storm drain or septic
system; roof drain; or sump pump. After all lines have been located, the plumber shall
make a formal written report with plans of all lines found to the City Engineer.
2. Once the plumber's report has been reviewed and approved by the City Engineer, a
Registered Professional Civil Engineer (hereinafter referred to as "the Engineer") shall
make a determination of the point of origin or discharge on each city main, for each line
identified in the plumbers report. The Engineer shall also ascertain the location, use, and
point of origin or discharge of any other lines on the property that may or may not be
affected by the demolition or connected to the structure. The Engineer shall provide the
City Engineer, for review and approval, a stamped plan of the property and adjacent City
utilities, indicating the results of his investigations.
3. A request to the Department of Public Services, for assistance in shutting down any water
main, prior to cutting and capping it, shall be made only after the City Engineer has
approved the written reports and plans described above.
Water, Sewer and Drainage Requirements Regarding the Demolition of Structures October 25, 2011
Page 2
4. Prior to demolition of the structure and immediately following item #3 above, a City of
Salem licensed drain layer shall cut and cap the water, sewer and drainage lines at the city
main and arrange for an inspection by the Department of Public Services.prior to backfill.
Backfill, compaction, temporary and permanent paving will follow to current city
standards.
5. In the event that the lines will be used immediately after demolition for construction
purposes, a set of plans and/or dra.: ngs, stamped by a Registered Professional Engineer,
describing the lines to be used during construction, must be provided to the City Engineer
for review and approval, prior to obtaining a building demolition permit. Prior to receiving
approval to re-use any lines, the lines shall be inspected for condition and capacity. Sewer
and drain lines proposed for re-use shall be inspected by a Licensed Drainlayer with closed
circuit television equipment and a copy of the resulting DVD shall be submitted to the City
Engineer for review. Water lines proposed for re-use shall be inspected by a Licensed
Plumber and a written report shall be submitted to the City Engineer for review. Any other
lines identified shall be abandoned as described herein.
6. A demolition permit shall not be issued until the items above have been completed and the
Department of Public Services has conducted an inspection and signed off on the water and
sewer portion of the Building Department prerequisite Utility Disconnections Required
Form.
Mbproved by:
D H. Know n, P.E.
City Engineer
\\Salemdc0l\WaterAdmin\dknowlton\My Documents\miscellaneous\demo regulations water,sewer and drainage 1-30-09.doc
nationalgrid
40 Sylvan Rd
Waltham MA 02451
DATE\@ "MMMM d, yyyy" February 21, 2014
Fletcher Hall Construction
16 Beach Avenue
Salem MA 01970
RE: Service Removal for Building Demolition.
Dear Mr. Hall,
This letter is to confirm that, per your request,National Grid has removed the electrical
service and meter 69957355 from 129 Columbus Avenue Salem MA on 2/20/14. If you
have any questions or need further assistance, please feel free to contact me at(508)
357-4522.
Sincerely,
Deborah Correa
Customer Fulfillment
Ph # 508-357-4522
Fax # 1-888-266-8094
deborah.correa a nationalgrid.com
,
nationalgre
March 6th, 2014
Attn: Fletcher Hall
RE: 129 Columbus Ave. Salem, MA
This letter is to notify you that the gas service located at 129 Columbus Ave, Salem, MA was cut off on
the property on 03/05/2014
If you have any questions, please feel free to contact me @ 781-907-2915
Thank you,
Andrew McCabe
Gas Customer Fulfillment
National Grid
40 Sylvan Road
Waltham, MA 02451
Tel #:781-907-2915
Fax#:781-522-1057
Andrew.mccabe@nationalgrid.com
L_ ,
CITY OF SM.F.M 1%'LksSACHUSETTS
BumDLNG DEPARTMENT
\ � 130 WASHIRNGTON STREET, 3"'FLOOR
TEL (978) 745-9595
FAX(978) 740-9846
KI.NiBERLEY DRISCOLL
MAYOR 'IHmw ST.PmRRE
DIRECTOR OF PUBLIC PROPERTY/BL'II.DLNG CONMSSIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit# is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
�121°�S1{ M 1''•ST�'2S
(name of hauler)
The debris will be disposed of in
Woo 0 W Yt5'� i7 t=�OSy�
(name of facility)
8 S 73�x , Sry�zE -� MIN'.
(address of facility)
��1
signature of permit applicant
2 17//I
date
debrisaf.doc
�o r
Salem Hristorical Commission
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970
(978)619-5685 FAX(978)740-0404
WAIVER OF THE DEMOLITION DELAY ORDINANCE
It is hereby certified that the Salem Historical Commission has waived the Demolition Delay Ordinance for the
Proposed demolition as described below, as per the requirements set forth in the Historic District's Act (M.G.L.
Ch. 40C) and the Salem Historic Districts Ordinance.
Address of Property: 129 Columbus Ave
Name of Record Owner: Lawrence and Deborah Callahan
Description of Demolition Work Proposed:
Demolition of the structure.
Dated: 1/23/14 SALEM HISTORICAL COMMISSION
By:
THIS IS NOT A DEMOLITION PERMIT. Please be surObobtain the appropriate permits from the Inspector
of Buildings (or any other necessary permits or approvals) prior to commencing work.
I