8 BUENA VISTA AVENUE - BUILDING JACKET f 8 BUENA VISTA AVENUE
�ry
V Q INSPECTION REPORT DATE: � 17-
ADDRESS: U -
fief �+' .� ' ou �•2 c4�
OWNER: ,
USE GROUP:
NUMBER OF STORIES:
NUMBER OF" ROOMS (BY STORY) :
i HOW HEATED:
GAS: YES NO:
NUMBER OF SANITARIES: .
NUMBER OF APPROVED EGRESS DOORWAYS: !� 1
REMARKS:'
FEE RECEIVED: YES NO:
DateL/� %�,
Mr. 0-6&•-C2.ce� , Building Inspector
Town/ of
Mas chusett>>s77
Re !J Ge,� Q V CS�cc ✓ e .
Dear Sir:
In accordance with Section 111.43 and Section 120.3 of the State
Building Code, I, as the owner, hereby request an inspection of the premises
at _g Z3 O eW a Vlsia /P✓e. , and the issuance of a Use and
Occupancy Certificate.
Entry to the premises may be obtained by contacting
should you determine that an inspection is necessary or desired.
Will you kindly acknowledge that you have received this letter by
signing and dating theattachedcopy, and returning it to me in the enclosed
envelope.
Yours very truly,
r
On 19 , I received this letter for the
issuance of a Use and Occupancy Certificate.
An inspection will be made by our office within three days.
An inspection will not be made by our office.
Building Inspector
July 28,2005
8 Buena Vista Ave. w
Salem Mass. 01970
Wolsey Associates Inc.
112 Haverhill St.
No. Reading Mass.01864-0128
Atn.Michael Tripp
RE. Pre blast survey at 8 Buena Vista Ave w in Salem Mass.
Michael
I, as the immediate abutter of the blasting site at 10 Buena Vista Ave, in
Salem Mass. I have some concern that I want addressed before I sign off on any
permission slip (s). As I understand Wolsey Assoc. is the go between for the blaster
WAYNE JOHNSON Inc. And the builder and abutters, and is authorized to perform the
pre-blast survey for the blasting company. My concerns are as follows....
CONCERN#1.... I want a meeting with the blaster and a representative of the SALEM
FIRE DEPARTMENT to discuss with me, the precautions that will be taken to protect
my property during the blasting of the utility trench and foundation.
CONCERN#2 I am requesting a copy of the blasters insurance policy for this site for a
review by my insurance company and attorney.
CONCERN#3 '1 need to know what will happen if some cracking occurs in my
foundation due to seismic shock waves, after the blasting is completed, (3 months—6
months— 1 year) after repeated freeze and thaw cycles have occurred, and water has
settled in the fissures.
CONCERN #4 The waste pipe and the water pipe that is located 110 feet from the blast
site and is probably laid in a trench that was hewned out of the same ledge that will be
blasted, cast iron pipe does not react to good to movement, even if it is so slight, lead
joints will leak.
CONCERN#5 the chimney, it sits right on the cellar floor that was poured on the same
ledge that is being blasted.
CONCERN#6 the buried propane gas line in the yard, and is connected to a 500 gallon
above ground tank (approx 70% full)
CONCERN #7 the windows facing the site.
CONCERN #8 The 2 (two) shed that are on the same side as the blast site.
CONCERN#9 the possibility of flying shrapnel from under blasting blankets.
CC John J Walsh insurance co
Salem fire department, fire prevention
Salem Building department Thomas St.Pierre
Attorney Paul Cullinane
THANK YOU
ancis A. G on
The Commonwealth of Massachusetts
O Board of Building Regulations and Standards RECEIVED CITY OF
W
Massachusetts State Building Code, 7945MTICNAL SERVI ES SALEM
Revised Mar 2011
Building Permit Application To Construct,Repair,Re ov te.O1, 11 z Qebmo h 4
-r One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date li :
Building Official(Print Name) I - Signature / Date
SECTION 1:SITE INFORMATION
1.1 Pro ertyi�d dress-dre 1.2 Assessors Map&Parcel Numbers
lJue )CL V;tfu —
L l a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
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
1.6 Water Supply:(M.G.L c.40,§54) 1.71 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 Owyyer of Record: I c NnA
F-✓ra rl t' 'S �ra 9Na-✓ f �t I -n-r ,'a
Name(Print) _ f City,State,ZIP
tbueula V t > L 7NN-0-?3 SS
No.and Street Telephone Email Address
SECTION 3:DES CRII ION OF PROPOSED WORW(check all that apply)
New Construction❑ 1 Existing Building❑1 1 Owner-Occupied ❑ 1 Repairs(s) ❑ 1.Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other Specify: Z7��o..�naM1.J
Brief Description of Proposed orkZ:
SECTION 49 ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
Item (Labor and Materials ofricia1 Use Only
I.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 $ 2. Other Fees: $
4.Mechanical (HVAC) $ ( Lisp
5.Mechanical (Fire
Suppression) $ Total All Fees:$
Check No Check Amount Cash Amount:
6.Total Project Cost: $ [3 Paid in Full ❑Outstanding Balance Due:
r11Prl.ti=D IZ
1
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 2 -71-7—7 y 3
License Number Expiration Date
Name of CSL Holder
I;I1C W. 1'aAlll List CSL Type(see below) U
n rr•t.
No.and Street �-rtm6tYQuffe Type Description
.Salem MA 01970 U Unrestricted(Buildings up to 35,000 cu.ft.
City/I own State,ZIP R Restricted 1&2 FamilyDwelling
M Masonry
RC Rooftn Coverin
WS Window and Siding
��, "'�('�� SF Solid Fuel Burning Appliances
VO -1 I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(MC) ' �-Cl
Atlantic w aidiefiz
�HIC Company Name or HI Nam ' �'TIC
i HIC Registration Number Expiration Date
�6 a rm Avenue
No.and Street Salem MA 01970 Email address
—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 ........It. No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR`APPLIES FORM
PERMIT
I,as Owner of the subject property,hereby!uthorize C..ri-C Ca /M
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) I Date
SECTION 7b: OWNER' 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 is appfica' n is true a curate to the best of my knowledge and understanding.
1' ( Z 14
Prim Owner's or Authorized Agent's Name(Electronic Signature) Date
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.LI c. 142A.Other important information on the HIC Program can be found at
www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dos
2. 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 I 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"
l
T6— [ q - I 3 25 °D GIB R 9 (� a
The Commonwealth of Massachusetts
og Board of Building Regulations and Standards RECEIVED CITY OF
Massachusetts State Building Code, 71% TIONAL SERVI ES SALEM
Revised Mar 2011
�— Building Permit Application To Construct,Repair, Retio�' tG,�z DGtnoh�_ U .
One-or Two-Family Dwelling UU 1 Wool
This Section For Official Use Only
Building Permit Number: i Date li :
^ - Building Official(Print Name) - - Signature - Dare
IV`11. SECTION 1:SITE INFORMATION
1.1 Property efddress: S �� 1.2 Assessors Map&Parcel Numbers
L I a Is this an accepted street?yes_ no Map Number Parcel Number
13 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rem Yard
Required Provided hi Required Provided Required Provided
I
1.6 Water Supply:(M.G.L c.40,§54) 1.7!
Public❑ Private❑ Zo Flood Zone Information: 1.8 Sewage Disposal System:
ne: Outside Flood Zone?
_
I Check if yes❑ Municipal❑ [3On site disposal system
SECTION 2: PROPERTY OWNERSHIP'
2.1 O�wy�terr of Record: c
7 V74 m 's Q q^J '-) I �t l ei*7
Name int) City,State,ZIP
� 614 til A Vt- hK �- :ZYW-O�23 Sr
No.and Street I Telephone Email Address
SECTION 3:DESCRII'I ION OF PROPOSED WORK=(check all that apply)
New Construction❑ Existing Building Oj Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ 1 Accessory Bldg.❑ Number of Units Other Specify:
Brief Description of Proposed orkt: I
�I &1. I C
I
SECTION 42,ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materials Official Use Only
1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined:
2. Electrical $ I 17 Standard City/town Application Fee
❑Total Project Cost'(Item-6)x multiplier x
3.Plumbing $ I 2. Other Fees: $
4.Mechanical (HVAC) $ ( List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
Check No. —Check Amount- Cash Amount:
6.Total Project Cost: $ p�((f jf , �� ❑Paid in Full ❑Outstanding Balance Due:
rnpLL_� p 1z1 q
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) R .7 C
License Number Expiration Date
Name of CSL Holder
Eric W. 1':d ni List CSL Type(see below)---
No.and Street 3 Hilton Street - Type Description
Salem MA 01970 U Unrestricted(Buildings up to 35,000 cu.ft.
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masor
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I I Insulation
Telephone Email address D I Demolition
5.2 Registered Home Improvement Contractor(HIC) ' �-Cj L I4,
Adantid VLF tto I r
Ba��1@[I78.--I1� HIC Registnttion Number Expiration Date
HIC Company Name or HI Nam
eWM Avenge
No.and Street Salem MA 01970 Email address
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 ........Ir. No...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR T
`APPLIES FOR BUILDING PERMI
I,as Owner of the subject property,hereby i uthorize C ✓-1 C Ca /M
to act on my behalf in all matters relative to work authorized by this building permit application.
�
F � --I L
) l vl
1`/tA.rnr r r ,
Print Owner's Name(Electronic Signature) I Date
SECTION 7b:OWNER' 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 is applies ' n is trpy, curate to the best of my knowledge and understanding.
a
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
I 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.L1 c. 142A.Other important information on the HIC Program can be found at
www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basementlattics,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 i Number of decks/porches
Type of cooling system I Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"