3 DEWEY DR - BUILDING PERMIT APP JACKET �6- 1 sI
The Lommonwealth of Massachusetts fP � FQAII'f � �C ,
e Board of Building Regulations and Standards
g Massachusetts State Building Code, 780 CMR y�SAjL�EM�7p�(�
Building Permit Application To Construct,Repair,Renovate Or Demo a
N RflJedfia6 .7�1
One-or Two-Family Dwelling
This Section For OfficiA Use Only
Building Permit Number: I Date pplied:
Building Official(Print Name) Signature V Date
SECTION 1: SITE INFORMATION
1. Pro erty Addres 1.2 Assessors Map&Parcel Numbers
L l a Is t ed 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 Wa er Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage isposal System:
Public Private❑ Zone: _ Outside Flood Zone? Municipal PJ On site disposal system ❑
Check if yesO
y�7�`S/ECTION 2: PROPERTY
,iO_WNERSHI\P''2\I� er of1 §o�d � \11V V �Jaky. ) t IV)
(Pn ) (� V City,State,ZIP
W2� -�47I-25'0381 ylada, r ainho���� c��� r ov✓�
No.and Street ITelephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK''(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work 2: -e w•.o g i W C -f-
^ 5+40 en er e � r e�9
1� d r+� e h ✓t
f frin-, a 4 Q�e
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials
1.Building $ / U 25. 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) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
�y 7 Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 1 b C �� ❑Paid in Full ❑Outstanding Balance Due:
SE \)"T 6 t, l IT,
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) Cc — /b 8 c) (00 7
Qv o vt �L P i y Q y License Number Expba on D ta
ame of CSL Holder (f
List CSL Type(see below) �t
No.and Street y 7/ Type Description
wa Hr ,O 5 C D 7 3' ��{'f� Q /`t� '" U Unrestricted(Buildings u to 35,000 cu.ft.
Cityfrown,State,ZIP M Masonry ed 1&2 Family Dwelling
RC Roofing Covering
WS Window and Siding
99 J SF Solid Fuel Burning Appliances
07 $'Z7S- ar5CbvLS/?ye1� I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) /80 / Il 7
/T�e'✓t �1 b n'b✓✓1 HIC Registration Number Exp'vatiod Date ,i
HIC�n Pam'Name or RIC Regis(/pant Name
S® �F�1 4 5,0 f— &5
Nej and Street /�'�q s 7 1 U �pj-� Email address
<�Jlivu,yttySCzl"/�f '/Tbi a L 04�,3'�Ci
Ci /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 Issua0ce of the building permit.
Signed Affidavit Attached? Yes .......... 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
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) 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
�co tamed in application is true and accurate to the best of my knowledge and understanding.
a1 ,511
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
l. 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/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 Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
American Properties Team, Inc.
TO: 3B Dewey Drive
FROM: Jennifer Pappas, Property Manager
RE: Window Replacement
DATE: November 3, 2014
Please be advised that the Board of Trustees for Pickman Park has approved replacement
windows for the above referenced unit. This approval is contingent upon them matching the
existing windows and that they fit in the existing opening. Installation of the windows must be
completed from the interior of the unit and they must be the same in appearance from the
exterior. Should the installation be completed from the exterior of the unit, you will be
responsible for any damage that your contractor might cause (this includes painting). The Board
will not allow windows with grids, crank outs, etc. Should you contractor find any rot or
damage during the window installation,please make sure that it is reported to my office
immediately.
We also require that permits be pulled in advance (regardless of what your contractor may tell
you), and then a copy of the final approved permit once completed must be sent to APT for the
unit file as well. We also recommend that owners obtain a certificate of insurance from the
licensed contractor.
You will need to bring a copy of this letter to the Salem Building Department in order to receive
your permit.
Should you have any questions or require additional information, please feel free to call me
directly at (781)569-2675.
cc: Unit File
500 WEST CUMMINGS PARK-SUITE 6050• WOBURN •MA -01801.781-932-9229 -FAX 781-935-4289
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The Commonwealth of Massachusetts
1\ litt' Department of Public Safety
Nlassachusclts Slate Building Code(780 CN1R)
\ 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(Please indicate Block k and Lot k for locations for which a street addr yss is not available)
No.and Street City/Town Zip Code Nance of Bu' ding(if applicable) —
SECFION 2:PROPOSED WORK
Edition of NIA State Code used If New Construction check here❑or check all that apply in the two rows below
Existing Building❑ Repairle I Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1)
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 ❑ No JZ
Is an Independent Structural Engineering Peer Review required? Yes ❑ No Bey
Brief Description of Proposed Work: � .��rP(, c7
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CNIR 34) ❑
Existing Use Group(s): I Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
L Institutional I-1 ❑ 1-2❑ I-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use
SECTION 6:CONSTRUCTION TYPE(Check as applicable) '
IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ 1 IV ❑ VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CNIR 111.0 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: Sewage Disposal: Trench
Disposal Site❑
Public❑ Check if outside Flood Zone El Indicate Municipal❑ A trench will not be p
Private❑ or indentify,Zone: or on site system required ❑or trench or specify: _
❑ permit is enclosed ❑
Railroad right-of-way: Hazards to Air Navigation: .AIA I In1,nrtgn
Nol Applicable❑ Is Structure within airport approach area? Is their review annplehtd?
or Clnscnt to Build enthused ❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Ed Ilion of Code: _ Use Group(s): TN pe of Construction: Occupant Load per Flour:
Does the building Crnudin an Sprinkler Sy stem?: Special Stlpu I'll ions: .___
SECTION 9: PROPERTY OWNER AUTHORIZATION
Namc and Address doff Property Owner n / �
SEAL/N't/i�C ,/��r A�UIRJ� 3 n //��'Zc j N� Pd-',4 G/F7G
Name (Print) No.and Street City/Town Zip
Property Owner Contact Information:
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable, the proper_q,owner hereby authorizes -
��E'F� Y . �-J' �zf-�-�S'4 wC--;t G!f Z
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.o,
enclosed a ceand or not under Construction Control then check here O and ski Section 10.1
10.1 Registered Professional Res , i e for Construction Control
Name(Regis5a< Telephone No. e-mail addres stration Number
/ C rA,&) ZZ rho vU-a- G Y ( iz — /Z
Street Aldress city/T n State Discipline Expiration Date
10.2 General Contractor
G1
,ICti��&/ /ire �✓J 4Y— .✓
Company Name
dt S�zrz�� 7X7 7 'Z
,me of Person Responsible for Construction License No. and Type if Applicable
Street Address City/Town State Zip
-'-) -: �'29�- 4}&r-y `f?ol- ti/ —
Telephone No. business Telephone No.(cell) / e-mail address
SECTION 11:Nti1)RKI'IS'CON11T.NSA I ION INSURANCI;:UTIDAVI-I M.G.L.c.152.§ 25C6
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❑ No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs: (Labor
and Materials) Total Construction Cost(from Item 6)_$�Z
1. Building S Building Permit Fee-Total Construction Cost x (Insert here
2. Electrical $ appropriate municipal factor)_$
3. Plumbing - $
4. Mechanical (HVAC) $ Note: Minimum fee=$ (contact municipality)
5. Mechanical Other $
Enclose check payable to6.Total Cost $ 2, (contact municipality)and write check number here _
SECTION 1 :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 I. st o my knowledge and understanding.
cr�F �accr %7/ 2 Y—YjYd' f/Y 1(
Please print and sign name Title Telephone No. Date
Street Address City/Town ate Zip
Municipal Inspector to fill out this section upon application approval: GJ I
ame Date
MAY-12-2011 21:47 FROM: TO:197e7417666 P.1/1
American F ropertles Team, Inc.
TO: 3D Dewcy Drive
FROM: Jennifer Pappas, Property Manager
RE: Window/Slider Replacement
DATE: May 19, 2011
##kk$#kk$#$ $####$#$&$$M Y$##Yriki##►$$kk##$k$k$#kk$#r#$###$$#######$$##4$k
Please be advised that the Board of Trustees for Pickman Park has approved replacement
windows/slider for the above referenced unit. This approval is contingent upon them matching
the existing wi dows/slider and that they fit in the existing opening. Window installation must be
completed frot i the interior of the unit and they must be the same in appearance from the exterior.
Should the wh dow installation be completed from the exterior of the unit, you will be responsible
for any datnag that your contractor might cause(this includes painting). The Board will not
allow window with grids, crank outs, etc. Should you contractor find any rot or damage during
the window ini tallation, please make sure that it is reported to my office immediately.
We also requir that permits be pulled in advance(regardless of what your contractor may tell
youX and then copy of the final approved permit once completed must be sent to APT for the
unit file as wel . We also recommend that owners obtain a certificate of insurance from the
licensed contr8 aor,
You will need o bring a copy of this letter to the Salem Building,Department in order to receive
your permit.
Should you ha a any questions or require additional information, please feel free to call me
directly at(781)932-9229.
cc: Unit file
SOONEST CUMMINGS PARR-SUI7EG090.W08URN •NIA 01801-701432.9229 .FAX 78Lr988-0289
The Commonwealth of Massachusetts RECEIVED
Board of Building Regulations and$)2{ (Tg0NAL $ERVICE CITY Massachusetts.State Building Code,786 CMR SALEM
WOO 5 Revised Mar 2011
Building Permit Application To Construct,Repair,RMJbvN(AOklPe lis
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date ppbed:
fBuilding Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION
1.1 P peter'Addrl ;s: 1.2 Assessors Map &Parcel Numbers
•� l � Cq
1.1a is this an accepted steel?yes --'—no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use ' Lot Area(sq ft) Frolgage(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'? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
wne'o yd'
i %Atl O Kn A, 01
tOl
t
N me(Print) Ci[y,State,ZIP
,ADO IS4mnl;nSsle
No.and Street _Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORW (check all that apply)
New Construction El I Existing Building ❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work':
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials)
1.Building $ 0 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) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees:$
n* Check No. Check Amount: Cash Amount:
6. Total Project Cost: $,� ' V D D 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
51 str perviso on Sur Li use(CSL) /� C _ D 7C �E# -7 -7/7
0),, flim � License Number/ O 'Expiration bate
,. Na le off CSL Holder
Lis
A� � [CSL Type(see below)
V0
7 Type Description
Noffile • /h� U Unrestricted(Buildings up to 35,000 cu.ft.)
WW J R Restricted 1&2 Family Dwelling
C"oOfi,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
396- SNaD rr rr SF Solid Fuel Burning Appliances
IA)TVCIDYIS4Tye1a4) I Insulation
Telephone Email address I) Demolition
�5.2 Reg�iste/}'ed H/ �.,e ImprQlveemen Contractor(HIC) /� 33 C/
'v 7 ti/n A- / ►t • 1 HIC Registration Number Exp rati n ate
f HC Company Name or HIC Reaisnoor� s Name
o��•+qy`Stre YW' &n4.I, of
N � �•
3� p/ Email address
Ci /Town, State,Z -�J Telephone �f -
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 .......... ❑ No.......llz�
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
to act on my behalf, in all matters relative to work authorized by this building permit application.
Prior Owner's Name(Elecuunic Signature) "- 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 4s application is true aild accurate to the best of my knowledge and understanding.
I 1'y i L
Tuff caner s or Authorized Agent's Nam (ElectWhic Signature) Date
NOTES:
1. An Owner who obtains a building per-lit 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. ci 142A. Other important information on the HIC Program can be found at
www.riiass.gov/oca Information on the Qonstruction Supervisor License can be found at www.mass. ov/dps
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 Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
American Properties Team, Inc.
TO: Salem Building Inspector
FROM: Jennifer Pappas, Property Manager
RE: Roof Replacement — 9, 12, 14 Russell;
3, 4 Dewey; 3, 13 Fillmore; 2, 4 Hart;
2 Nimitz; 2 Spruance
DATE: March 2, 2016
Please be advised that the Board of Trustees for Pickman Park have
approved a roof replacement project at the above referenced buildings.
This work will be completed by Thor Roofing & Construction.
Should you have any questions or require additional information, please
feel free to call me directly at (781) 569-2675.
500 WEST CUMMINGS PARK•SUITE 6050. WOBURN -MA 01801-781-932-9229 •FAX 7 81-9 3 5 42 89