7R-9 ENGLISH ST - BUILDING JACKET L-f C-K 5
i The Commonwealth of Massachusetts RECEIVEDY
Board of Building Regulations and StandardstiSPECT►CiNAL S FYiSA��TLEM
Massachusetts State Building Code, 780 CMR
Revised Mar 201I
Building Pemrit Application To Construct, Repair, Renovate 61MMh' 6 A $* 34
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number
Date'A lied:
1 Building Official(Print Name) 'Signature - , Date -
SECTION l: SITE INFORMATION,
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
I.f a Is this an accepted street?yes )0 no Map Number Parcel Number
1. oning Informatio 1.4 Property Dimensions:
3
L �«"
Zoning District Proposed Use Lot Area(sit 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 Private ❑ Zone: _ Outside Flood Zone? Municipal 1:�bri site disposal system ❑
Check if yes❑
' SECTION2: PROPERTYOWNERSHIP'
2.1 w 'of Recnr
Name(Print) City,State,ZIP
14
No.and S eel Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK #beck all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alteration(s) Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units__ I Other ❑ Specify:
Brief Description of Proposed Work2: LS -4�d .e,,j a n 3 fr-1' o d S t
�C...II Q i Sa�`1 ^Qy c Li=� }} 9 4-weS
SECTION 4:ESTIMATED CONSTRUCTION COSTS..,
Estimated Costs:
Item (Labor and Materials Official Use Only x ,
1.Building $ YO 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee`
2.Electrical $ 3
plier x
3_Plumbing $ 2. Other Fees:' $
4. Mechanical WAC) $ List: Y e� U�_l
5. Mechanical (Fire $
Su pp on) Total All Fees: $
Check No. Check Amount Cash Amount:
6. Total Project Cost: $ v UJ �/
Y ❑Paid in Full° " " ❑ Outstanding Balance Due
V
SECTION5: CONSTRUCTIONSERVICES
5.1 Construction Supervisor License(CSL) CS - ) o� 63
C'h0.d 7? Dc,^wS,S License Number Expiration Date
Name of CSL Holder U
List CSL Type(see below)
0-91 -1"0c(c�n5 6%".ct
No,and Street Type Description
U Unrestricted(Buildings to 35,000 cu_IL
N c J rha.r6c-li-r R Restricted 1&2 Family Dwelling
City/Town,State,ZIP _ M Masonry
RC Reefing Covering
WS Window and Siding
SF 1 Solid Fuel Bunting Appliances
573-4 1 Ss [ I rmaiteim
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
C'(� d DO-W-NUS.'s )syIZS �Z/rsli-1
HIC Registration Number Expiration Date
HIC Company Name or HIC Re strant Name
02 1 A-AO k.'II3 b� lc..r
No.and Street Email address
I,w 01891 ci"3g 4-r) 41-a�
Ci /fown,State,ZIP Tdcphnm
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, as Owner of the subject property,hereby authorize���Gtl' ��) 1y✓St
to act on my behalf,in all matters relative to work authorized by this building permit application.
`Z-1im 6aJA. P & ,)!�k/6`-i/� e / Zo ' t(,
Print Owner's Nanic(Electronic Signatun ) 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 this application is true and accurate to the best of my knowledge and understanding.
Pn�Owner's r uthorized Agent's Name(Electronic Signature) ate
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. ove /oca.Information on the Construction Supervisor License can be found at www mass. ovg /das.
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 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"
�ONa1T, Commonwealth of Massachusetts _
i -
I
a City of Salem
s 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641
Return card to Building Division for Certificate of Occupancy
Permit No. B-16-534 PERMITFEE PAID: $440.00 TO BUILD
DATE ISSUED: 5/24/2016
This certifies that DIANE WALZER 9 ENGLISH ST SALEM RTY TR/
has permission to erect, alter, or demolish a building_9_ENGLISH..STREET�-� Map/Lot: 410182-0
as follows: Repair/Replace INSTALL NEW KITCHENS ON THREE (3) FLOORS: REPAIR WALLS, NEW
CABINETS & COUNTERTOPS
Contractor Name: CHADDANUSIS ; ---- -----
DBA: i r
Contractor License No: CS-101637 r
1 1 5/24/2016
I Building Official / Date
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within s`xi 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.
11 t
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. i I
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
l
HIC#: 184128 '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 _
Citv of Salem tl
a 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 t
` Return card to Building Division for Certificate of Occupancy -
Structure CITY OF SALEM BUILDING PERMIT
Excavation PERMIT TO BE POSTED IN THE WINDOW
Footing INSPECTION RECORD
Foundation
Framing
Mechanical
Insulation INSPECTION: BY DATE
Chimney/Smoke Chamber I
Final
Plumbing/Gas
r yy
Rough:Plumbing 1
Rough:Gas � �!
Final
�e = Electrical
Service .
Rough
Final I !
ism I Fire Department t
t
Preliminary
Final
Health Department
Preliminary
Final