Loading...
35 BUFFUM STREET - BUILDING JACKETr 35 Feu �n�M WendafleMr 48420 P4 www.pendaflex.com MADE IN USA 30%PCW cutLess® Mile Folder •FEWER PAPER CUTS Commonwealth of Massachusetts / City of Salem 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 D Return card to Building Division for Certificate of Occupancy -- 9 P Y Permit B-14-841 PERMIT TO BUIL D FEE PAID:: $1$100.00 DATE ISSUED: 4/30/2014 This certifies that ANDERSON DAG ANDERSON EVE has permission to erect, alter, or demolish a building 35 BUFFUM STREET Map/Lot: 270051-0 k e. as follows: Renovation ADD BATHROOM. PREP WALLS_FOR PAINT. NEW COUNTERS IN TWO (2) KITCHENS. (TWO FAMILY DWELLING 4/25114),,, , Contractor Name: Mark Fournier DBA: NORTH SHORE BUILDERS , Contractor License No: 055614 r 4/30/2014 Buildingctal^ = Date p i This permit shall be deemed abandoned and invalid unless ffie.work authorized by this perrna rs commenced within six months after issuance.The Building Official may grant one or more extensions not to exceed six months.each upon written request:` All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open forpulilic inspection for the entire duration of the work until the completion of the same. s The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. HIC#: "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A). Restrictions: " Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. Commonwealth of Massachusetts City of Salem n 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 -- Return card to Building Division for Certificate of Occupancy - Structure CITY OF SALEM BUILDING PERMIT Excavation PERMIT TO BE POSTED IN THE WINDOW °' s Footing INSPECTION RECORD Foundation Framing+.-$ IS 14 Mechanical Insulation INSPECTION: DATE Chimney/Smoke Chamber - Final lumbing/Gas ra . Rough:Plumbing w 4{ r' Rough:Gasp Final Electrical Service ^y.1 M' X05 Rough S Flna�tO5E1)-PEYt 5.6. Fire Department Preliminary Final a Health Department La Preliminary Final SIN The Commonwealth of Massachusetts 4 ridT Board of Building Regulations and Standa?4§EC-.T(f 4` R Massachusetts State Building Code, 780 CMR, 7iheditionE LITY EBuilding Permit Application To Construct, Repair, RenoVIMC0eanuary One- or Two-Family Dwelling08 ^ This Section For Official Use Only BuildingPermit Number: Date Applied: Q Signature: _ IZ`I I ICS v ,Building Commissioner/lnsp ctor tildings Date SECTION 1: SITE INFORMATION 1.nProperty rens: 1.2 Assessors Map &Parcel Numbers I.]a is this an accepted ted s 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) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public l7 Private TI Zone: _ Outside Flood Zone? Check if yes❑ Municipal PJ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP[ 2.1 Owner of Record: �I-iANrJnnl dgST �jS 'fix Lw, Name(Pr' t) Address for Service: 97T-979 - /q2I Store Telephone SECTION 3:DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction Existing Building Owner-Occupied Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units__ Other ❑ Specify: Brief Description of Proposed Work': 1` SECTION 4: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 $ Q ❑ Standard City/Town Application Fee ❑Total Project Costs(Item 6)x multiplier x 3.Plumbing $ Q 2. Other Fees: $ r, 4. Mechanical (HVAC) $ 0 List: 5. Mechanical (Fire Suppression) S Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 1600 ❑ Paid in Full ❑ Outstanding Balance Due: MkI.-e7o to[y Nr7lL Ta -Hvv� SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) License Number Expiration Date Name of CSL-Holder List CSL Type(see below) Address Type Description U Unrestricted(up to 35,000 Cu. Ft.) R Restricted 1&2 Family Dwelling Signature M Masonry Only RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Company Name or HIC Registrant Name Registration Number Address Expiration Date Signature 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 .......... ❑ No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, nan r as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to wQrk authorized by this buildingpermit application. '32,0-1 to Ware of Owner Date SECTION 7b: 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. 1 Print 20'1(0 Si re of Owner or Authorized Agent Date (Signed under the pains and penalties of perjury) 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 and Construction Supervisor Licensing (CSL)can be found in 780 CMR Regulations I IO.R6 and I IO.R5,respectively. 2. 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" r 1s"s 0frc;l ,A /y `B .'m � r Y`I w LY E � � ( 6 t � 4 { $ g 3 $ VV r ��.,4 ; M�„ :.:�sr.;�wG'`�,r may``. ����� �i•. �� kt, 1� r p 111 r r a ✓e P4' n� � 'yy a{ pp � 'n ,'�.. "a u r r� a £ ' YINC k '� s k`, i �� ff f, � r air o� .l i 2 I � I , T r +-14 - - -F -+ MAL' -t- -�' -� _,V�`-�-• +--r+- _,._ } .�.-ate._. r � I �'i� i �l i I I I• f 1 �, 1 I ' ' 1 I I I r f � -f r - - I 1 I I 4 1 I I , I I } 4 I may. -'- ��-t-G—i--!'—+—h—'�-" —�—t—'fi-1—�i - + --i._—}_—�--_._ +-. _}---=—F--'--'--- . _ *-_ }-_-*._ r___l. - r _ �• �F- --r- --4-M�--Y— I _ _ —17 I , t I u r k ---E--I'- -I----l----r i E t---I—C—} -i- +--+ -�-- ` i_ i � _ �. . _ :. - - t _ _ cam;- -+ �--f---I• - I k ! M Cay 1 1 I i I i I 1 I I C--. + �—•--r--l--}—�—'�� i --ti. _+ ,-.r - fi- T`�--�--�"I.'—}_--�--t--'�"_� —_a". -r--�r—'_�• �----{ t I—� I � —i—.' + r .L_.. t—' 4 -• I---+-!---Fes_-i- I � I --+-}-- 4 i • i i { i • i 1 • t 4 i 35 Buff um Rear Dec k&s d . , . ... . � � � . . . �> . > , . � � > \ � . � \ \ . } 7 \ . � } . . .a . . . , y . yv :ee . / 47,; _ . > v ly-gq, $ICED cK lb3 The Commonwealth of Massachusetts m C§ Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Revised Mar 1011 y. 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) 'Sig atur Date SECTION 1:SITE INFORMATION 1.1 Propef-ty Addre 1.2 Assessors Map& Parcel Numbers _23 J rr,/-L) s T 1.la Is this an accepted street?yes L/no Map Number Parcel Number 1.3 .Zoning Information: 1.4 Propeo,Dimensions: Zoning District Proposed Use Lot Area(sq fQ Frontage(lt) 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: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Reco d: - E ve ANWer �c I `ly q Name(Print) City,State,ZIP a C�d�c, E s ri 9ZSr-(oDt/-Ri 7� FUe l p/h _ No.and Street Telephone Email Address 17Ar�. SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ Existing Building Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units I Other ❑ Specil'v: Brief Description of Proposed Work':A_ New Gov.✓ .evs aA) SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building $ �yr 0o 0 'd 1. Building Permit Fee:$ Indicate how fee is determined: 2. Electrical $ ❑Standard Gity/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (FIVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check.Amount:__Cash Amount: 6. Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due: M r� Lt=p S11 Teo N 5• (��« Ors SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) NI)rk %Qdr^�t/ l•e r/ - License Number Gxpva[io Date Name of CSL Holder 63 -(7rhM ON w.Cig-)J y I<� List CSL Type(see below) No.and Street Type Description ` Iy/ U Unrestricted(Buildings u to 35,000 cu. ft.) ,z�-//'J '' 4-- O y d R Restricted 1&2 Family Dwelling Clayfrown,State,ZIP M Mason ry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone L, C.OMail address D Demolition 5.2 Registered omeImprovementtGontractor(HIC) N6r Z w---e 13 yll evS HIC Registration Numberxpi anon Dale HIC Company Name or HIC Re��isgt Name n / P. O, ►3aX �'`f �C've�c�er�T`� ®f1�L.C�r o.ai Street ©/W ^ �G ./ ij ems/�r_ Email address N / `D !Aa( GOC7 Lf Cit /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 lssuan3w6f 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'' y k 1,as Owner of the subject property,hereby authorize U-Al f'e (/ 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:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below, 1 hereby attest under the pains and penalties of perjury that all of the information contained in this application i true and accurate to the best of my knowledge and understanding. Print wner's or Authorized Agent's Name(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.eov;!cca Information on the Construction Supervisor License can be found at www.mass.sov/dps 2. When substantial work is planned,provide the information below: Total Boor 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" 7�-f-3SI- 0720 - 6 iLL rip�rZV- wflc�j i