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12 DERBY ST - BUILDING INSPECTION JACKET ad r• 1 The Commonwealth of Massachusetts } Board of Building Regulations and Standards CITY \11 Massachusetts State Building Code, 780 CMR, 7'"edition OF SALEM 1V1/ ReviseJJunuurk {� Building Permit Application To Construct, Repair, Renovate Or Demolish a /. '008 �V One-or Two-Fumily Dwelling U This Section For Official Use Only Building Permit Num r: Date pplicd: Signature: V4I '!c �Z. ' Building Commissioner nspectorof Bd Date SE ION I:SITE INFORMATION LI Property Address: 1.2 Assessors Map& Parcel Numbers I.la Is this an accepted street?yes A no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq 11) Frontage(11) 1.5 Building Setbacks(R) 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: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if es0 Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 qw nert of Record: ryr.It 9 Garr r)(-,723 Y --)7- Name(Prime Address for Service: 'I 7�•.— L/ 'gnaturc Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building 00 Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work': ri5 e Ct- `JhrA N SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: 011lclal Use Only Labor and Materials I. Building S I. Building Permit Fee:S Indicate how fee is determined: 2. Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost(Item 6)x multiplier x 3. Plumbing S 2. Other Fees: S 4. Mechanical (IIVAC) S List: 5. Mechanical (Fire S Suppression) Total All Fees:S / � Check No. Check Amount: Cash Amount: 6. Total Project Cost: S r tp ❑Paid in Full O Outstanding Balance Due: �z SECTION 5: CONSTRUCTION SERVICES t 1 5.-1-T Licensed Construction Supervisor(CSL)) p66{oo3 `J�-g- 1 ! J 0.yr 2S w. ��"y OOC License Number Frpinuion Uate Name of CSL- I(older (� C I yn List C'SL fype(see below) Gfo55 Ada- J46"t r„ .f Description Address U Unrestricted u to 35,000 Cu. Ft. R Restricted I&2 Family Dwelling Sign M - Mason Ord 03 5 7 RC Residential Routing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Buminst Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) 111C C6mpmy Name or 111C Registrant Name Registration Number Address. Expiration Date Signature Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. 1 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 .......... K No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT t as Owner of the subject property hereby 1. '�'ow.gs Q- J P party Y authorize to act on my behalf,in all matters relative to work authorized by this building permit application. ag- t0 Si at of Owne Date SECTION 71b: OWNEW OR AUTHORIZED AGENT DECLARATION 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 010 Signature o' er or Authorized Agent e Si ned der the pains and penalties of 'u 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 Ugf have access to the arbitration program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and I IO.RS, respectively. ? 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" ja aPendatlar 74520 400/oP4 ODI T� CITY OF SALEM9 MASSACHUSETTS BOARD OF APPEAL z ` 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01 970 TELEPHONE: 978-745-9595 FAX: 978-740-9846 KIMBERLEY DRISCOLL _ MAYOR /..J I^. O• }2 August 20, 2010 Decision Petition of Thomas P. Cote seeking Variances from the minimum lot area and minimum lot frontage requirements to relocate the lot line for the property located at 12 DERBY STREET in the Residential Two Family Zoning District[R-2]. A public hearing on the above petition was opened on August 18, 2010 pursuant to Mass General Law Ch. 40A, Sec. 11, the following Zoning Board members being present: Annie Harris, Rick Dionne, Bonnie Belair(alternate) and Jimmy Tsitsinos (alternate). Petitioner seeks Variances under Section 4.1.1: Table of Dimensional Requirements, of the Salem Zoning Ordinance. The Board of Appeals, after careful consideration of the evidence presented at the public hearing, and after thorough review of the Petition submitted, makes the following findings of fact: 1. Petitioner Thomas P. Cote represented himself at the hearing. 2. In a petition date-stamped August 2, 2010, the petitioner requested to adjust the parcel boundary at 12 Derby Sheet to convey a piece of land to the property at 14 115 Fort Avenue to provide access to a public way and allow construction of a garage. 3. Ian Hunter, owner of 14 115 Fort Avenue, petitioned the Board separately for zoning relief related to the proposed lot line adjustment. 4. No member of the public spoke in favor or in opposition of the petition at the hearing. The Board of Appeal, after careful consideration of the evidence presented at the public hearing, and after thorough review of the plans and petition submitted, makes the following findings: I. Special conditions and circumstances exist affecting the parcel or building, which do not generally affect other land or buildings in the same district, and literal enforcement of the provisions of this ordinance would involve substantial hardship, Financial or otherwise, to the appellant, since the neighboring lot lacks access to a public way. l 2. Desirable relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or Purpose of the zoning ordinance, since the proposed changes to the parcel boundaries give the abutting lot access to a public way. 3. The petitioner may vary the terns of the Residential Two-Family Zoning District to adjust the lot lines as proposed, which is consistent with the intent and purpose of the City of Salem Zoning Ordinance. 4. In permitting such change, the Board of Appeals requires certain appropriate conditions and safeguards as noted below. On the basis of the above findings of fact and all evidence presented at the public hearing including, but not limited to, the Plans, Documents and testimony, the Zoning Board of Appeals concludes: 1. A Variance is granted from the minimum lot area requirement to adjust the property boundaries as shown on the submitted plans. 2. A Variance is granted from the minimum frontage requirement to adjust the property boundaries as shown on the submitted plans. In consideration of the above, the Salem Board of Appeals voted four(4) in favor (Dionne, Harris, Belair, and Tsitsinos), none (0) opposed, to grant the petitioner's request for Variances, subject to the following terms, conditions, and safeguards: 1. Petitioner shall comply with all city and state statutes, ordinances, codes and regulations. 2. Petitioner is to obtain approval from any City Board or Commission havingjurisdiction including, but not limited to, the Planning Board. Richard Dionne Salem Zoning Board of Appeals A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY CLERK Appeal from this decision, if any, shall be made pursuant to Section 17 of the Massachusetts General Laws Chapter 40A, and shall be filed within 20 days of filing of this decision in the office of the City Clerk. Pursuant to the Massachusetts General Laws Chapter 40A, Section 11, the Variance or Special Pernut granted lierein shall not take effect until a copy of the decision bearing the certificate of the City Clerk that 20 days have elapsed and no appeal has been tiled, or that, if such appeal has been filed, that it has been dismissed or denied and is recorded in the South Essex Registry of Deeds and indexed under the name of the owner of record or is recorded and noted on the owner's Certificate of Title. 7