58 BUFFUM STREET - BUILDING JACKET 55 urs STREET
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1APOS )ONSuMEn
Certificate Number: B-2014-0537 Permit Number: B-2014-0537
Commonwealth of Massachusetts
City of Salem
This is to Certify that the Two Family Building located at
Building Type
58 B UFFUM STREETin the City. of Salem
............... ........
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY
This Perrint is granted in conformity with the Statutes and Ordinances relating thereto, and
expires Nq(4PP#!*k...-.. .............. unless sooner suspended or revoked.
Expiration Date
Issued On: Thursday, March 27, 2014
ti
5$ BUFFUM STREET 514-14
��s# —
�f COMMONWEALTH OF MASSACHUSETTS
iIvlap _ X27
'Block: _ CITY OF SALEM
Lot 0097 I
Category: REMODEL —~
Permit# -- 514-14 BUILDING PERMIT
Project# JS-2014-001128
Est. Cost: $18,500:00`
II
.Fee Charged: $131.0
Balance Due: $.00 j PERMISSION IS HEREBY GRANTED TO:
Const. Class__ Contractor: License: Expires:
Use Group -: MJM CONSTRUCTION Home Improvement Contractor- 177370f. -
ot Stze(sq ft) 6699.9636 ---JOwner: GENCI KOLICI
mmt R2
GA
its Gamed: IAppiicant: MJM CONSTRUCTION
Units Lost: _ AT. 58 BUFFUM STREET
Dig Safe#
ISSUED ON. 08-Jan-2014 AIIIENDED ON. EXPIRES ON. 08-Jul-2014
TO PERFORM THE FOLLOWING WORK:
REROOF, INSTALL NEW KITCHEN CABINETS,UPDATE PLUMBING K ELECTRICAL
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas / Plumbing Building
Underground: Und�gi ,7�, "f(/kA Underground: Excavation:
(Service: I, Meterr. 1 1(�I'/,(/l1/ Footings:
2ougl — I /0 ✓ anngh:dv�/ '�'/ Foundation:
:"inat: Final: Final: Rough Frame: it
ei
Fireplace/Chimney:
O.P.W.eter; r Oil:Fiq Health _
KVO..- t..rcl '—
Insulation:
1it7eter: II II''
Final:,LMIt,-�
House q Smoke: «`��IIII"''''^^^^^^ 3- I�}
Treasury:
Water: Alarm: Assessor
Sewer: Sprinklers: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOL AukI( v OF TS
RULES AND REGULATIONS. lG�^
Siyn:uw'c:
Fee Type: Receipt No: Date Paid: Check No: Amount:
BUILDING RFC-2014-001127 08-Jan-14 216 $131.00
GeoTAINOa 2014 Des Lanriers Municipal Solutions,inc.
62 Lawrence St.
The Commonwealth of Massachusetts
;� Board of Building Regulations and Standards CITY OF
dY+// Massachusetts State Building Code, 780 CMR SALEM
Building Permit Application To_COnstr ct, Repair, Renovate Or Demolish a Revised Atur 2011
One-or Two-Fnmi Dwelling
Building Permit Number: This Ses60 Official Use Only ;.
Date;Applie� (.
` Building ORlcial(Print N,une)
':- Signature Date
SECTION L•SITE INFORMATION'
1.1 raperty l dress:
S�— Q C 1 1 � 1.2 Assessors Map&Parcel Numbers
I.I a Is this an accepted street?yes_ 110 Map Number I T arcel Number
13 Zoning Information: 1.4 Property Dimensions:
Toning District Proposed Ua— e—�—
Lot
1.5 Building Setbacks Area(sq ill Frontage(II)
(ft)
Front Yard Side Yards
Required Front
Rear Yard
Required Provided Require 9 Provide)
1.6 Water Supply:(M.G.L a 40,§54) 1.7 Fland Zone Information:
Public[3 Private[3 Zone: _ Outside Flood Zone? 1.8 Sewage Disposal System:
Check ifyes❑ Municipal❑ On site disposal system ❑
2.1 Owert of Recor SECTION2: PROPERTY OWNERSHIPI
Cne
O 41 / 11
yhme(Print)J h-t (J/^� p
CrtY,Swte,ZIP
Telephone Email AdJress
SECTION 3: DESCRIPTION OF PROPOSED WORK?(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied Repairs(s) Alterntion(s) ❑ Addition ❑
Demolition ❑ Accesso Bldg. ❑
Number of Units_ Other ❑ Specify:
Brief Description of Proposed 1Vark2:
_ � t
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materiels) Official Use Only
I. Building I. Building Permit Fee:$ Indicate how fee is Determined:
2. E)ectrical S 'go
47 ❑Standard City/Town Application Fee
3. Plumbing S ❑Total Project Cosy(Item 6)x multiplier x
U J I. OtherFees: .S
4. Mccltanical (HVAC) S List:
p 5. Mechanical (Fire
) ) : TotalAll Fees;S
6. total Project Cos J Check —
No._Check Amount: Cash Amount:
G� Soo ❑Paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supe lN'lsor License(CSL) `j "
`t\\\ �p
\ License Number Expiration Date
Name o L to der List CSL'rype(see below)
.Type. , - -Description �
No. an Strcc U Unrestricted Buildin sit to 35,000 cu. llJ
- R Restricted 1&2 Family Dwellin
h1 Mason
Citylrown,State,LIP RC Roolin Coverm
WS Window and Sidi"
SF Solid Fuel Burning Appliances
;1 I Insulation
M
- e7- D Demolition
' e hone Email addresss Z� I
c 0 1
ntractnr(HI ) 7
t o 7 3
5.2 Registered klome (mprovemen G 7
.. � ( G``�_� , `�` J +-� HIC Registrationr Esp"ation Dute
111 imp'try Name or HIC RAstranl Name 1*�A\ y r
C JEmad address
No.and Streev ('lam
'role hone
Ci /Town,State,ZI
SECTION 6:WORKERS'CONIPENSAT[ON INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(�)
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 p
ermi
Signed Affidavit Attached? Yes ..........❑ ""
11 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED W HEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
'v
I,as owner of the subject property,hereby authorize
t9 act on my behalf,in all matters relative to/w/orIkpauth�orrized b his building permit appltcatton,
Pi
C, Dale
Print Owner's Name(Electrum-Signature)
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
entarin my nam below, I here y attest under the pains and penalties of perjury that all of the information
6y cot ill in this ap is ion is true. d accurate to the best of my knowledge and understanding.
co
Date
nt( t is or Authorized Agent's Name lectronic Signature)
NOTES:
g will not have access to the arbitration
I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregisteredcontractor
(nut registered in the Home Improvement Contractor(HIC)Program)
......
WgVannts ca inform
ation t on on he Construction olSupery sot License can be for nd mlt—inn on the atCv��Srt lgs trod at
the information below:
(including garage, finished basement/attics,decks or porch)
� 2. When substantial work is planned,provide
'total Iloor area(sq. ft.) Habitable room count
Gross living area(sq. It.)_----- Number of bedrooms
Number of fireplaces Number of half/baths
Number of bathrooms Number of decks/porches
Type of lieating system Enclosed____—Open
'type of cooling system
3. "Total Project Square Footage"may be substituted for`"rota) Project Cost"