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190 ESSEX ST - BUILDING PERMIT APP i t - �� , ;►l The Commonwealth of Massachusetts � �,� ,� Department of Public Safety v",..✓ \la.sarhinelt.til,itr Bwldinh C'udr 1780 C�IR)tir��rnth Editiun ' City of Salem 1 Buildin Permit A lication for an Buildin other than a 1- or 2-Famil Dwellin �1� (This�tiun Fur ufficial Usr Onlv) � lluilding Prrmit Numbrr: Date ApF�lird: Building Inspectur. SECTION 1: LOCATION IPiease indicate Block M and +at M for locations for which a streef address is not available) ��x s7� 4G'�' 7 . \'ii..tnd titrret . CiIY /To�cn Zip Cude Name of Buildin� (iF.ipplir.iblr) SECTION 2: PROPOSED WORK If Nrw Cun+tructia�n chrck hrrr O ur chrck.ill that.pply in the twu rows beluw Ecisting Buildin• Repair❑ Altrratiun� Addition ❑ Drmulitiun O (Plrase fill out and submit Apprndix 1) ChangeufUse ❑ ChangeufOccupancy O Other ❑ Specify: Are building plans and/ur mnstn�ctiun ducumrnts bring supplied as part of this ermit a lication? Yes � Nu ❑ P PP Is an Independrnt Slructural Hngineering Peer Review rrquired? Yes O Nu�,l Brief Descripliun of Prupu.ed Wurk' �� f�l'� �02 A/�GIT 7�S�L�Y� .a�-�-Z�_/� .—�—�� SECTION 3:COMPLETE TH15 SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDI770N,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Evaluation is enclosed (See 780 CMR 3402.0) O � Existing Use Group(s): Proposed Use Group(s): P Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: SECTION 4: BUILDING HEIGHT AND AREA � � � Existing Proposed No.uf Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area (sy. ft.)and Tu[al Height(ft.) � SECTION 5: USE GROUP(Check ae a licable) A: Asaembly A-1 ❑ A-2r O A-2nc O A-3 O � A-4❑ A-5❑ B: Businesa ❑ E: Educafional ❑ � P: Fatto F-1 ❑ F2❑ H: Hi Hazard H-1 ❑ H-2❑ H-3 O H-4❑ H-5 O 1: Institutional I-7 ❑ 1-2 ❑ 1-1❑ f-�7 p M: Mercantile R: Residentfal R-l0 R-2❑ R-3 O R-4 ❑ S: Storage 5-I ❑ S-2 ❑ U: Utility❑ Special Use O.nd piea�r drscribe beluw: Special Use: � . � SECTION 6:CONSTRUCTION IYPE(Check as applicable) IA ❑ � IB ❑ IIAO 1180 I►IA � 1116 ❑ IV ❑ VA ❑ VBO SECTION 7: SITE INPORMATION frefer to 780 CMR 111.0 for detaile on each item) bVater Supply: Flood Zone Infomiation: Sewage Disposal: Trench Pertnit: Debris Removal: Public ❑ Check il��utsidr flu,id Luni•❑ Indic.itr municip,il ❑ '\ trench �vill nut be Licrn.rd Uinpi�..il tiilr❑ , myuired O ur trench ur .F•ccil�': I ncate❑ ��r indenlilc Zune: ur�m.ite.t'.tem ❑ �,rrmil i.enclusrd ❑ Railroad righl-of-way: Hazards to Air Navigation: \I.\ I 1i.6�n:l�„inmi..i��n Rcci��. I'r„�o..: .\ut :\��F�hial�la• ❑ . I.titrurlurcwithin ,�ir��urt,if+F+nairh,irra:' I. lh�•irrr��ic�cc��inF•lctcd.' ,�r l��n.rnl l�� Rudd rnd�ncd ❑ Yc.❑ nr \'�i❑ 1"r. ❑ \�i� ❑ SECTION 8: CONTENT OF CERTIFICATE OF OCCUPANCY I[.fili��n,�l C��dc: l�.r(�r��uF,�.l: i�F�c��ICun.trurtiun: l)ccup.inl L�r.id �,cr I�lu��r: Il��c. Ihi•buiidin�cnnl.iin an ti�,rinklcr ti��.lem.': �F�acial tiliF�ulalt�ma� S�Mo � /�t� �SS � S , SECf10N 9: PROPERTY OWNER AUTHORIZATION �l.im�.ii��i_.�1�1 �' Q�if Pn��;�rl�CJ�vnrh�J g�� S� �� j!' ' �� oi9�d (.0 'f�. � N�F1 /y ��_�.— tiamr(Nnntl Nu. ,ind titrrrl Cif�'/To�vn Zi�� Pru �erl �lTcner Co ut INurm.iliun: �� v (�j.�.. �� , , c��9��io o y —— Tillr TrlrphunrNu. Ibu,inr�.) Tr1rF�hunrNu. (crll) r-mail.iddress If af,pli.,iblr, thr pruF,�rt�•uwner hrrcbV authurizrs ��e�E ArTs��,�P� [��T7�tft — Vamr Strcrt Addrrsa Ci[v/To�.•n Stale ZiF� , t��act�m thr �nr�rrt�� cnrr's brhalf, in all m.ulrrs relati��e tu wurk,iuth��rized bv this buildin • �rrmit a � �lic.itiun. � SECTION l0:CONSTRUCTION CONTROL IPlease fill out Appendix 2) - (If buildin•is los.lhan 3i.U1W n�.ft��f enclo�.d s�aee and/or nul undrr Construetiun C��ntrul then<heek hnre�and ski Su.liun IU.0 10.1 Re istered Professional Res onsible for Construction Control - y Name(Rrgistrant) Tr ph �e o. e-mail address Registration Numbrr . � S[reet Addrrss Ci[y/To n titate Zip Discipline 6xpiralion Date 10.2 Genenl Controctor � /U c o Si�9 Goti S � .�/i/C ��m��"i�e� N�cAs i�1 � cs o5�'019 Na�u uf �r�nnRe+�}�tq�.iblr�l�r Cun�tructiun ��n . _/11-�`r�nse No. and Type if App�cable_ ,�� Jf K„� ) / � ( nl (11.J ?' /i"! � ��eet ddress City/Town ^State Zip 2 ydS —-- Tele hone No.(business) Tele hone No. (cell) �mail address SECTION 11: WORKERS'COWII'ENSAIION RVSURANCE AFFIDAVIT(M.G.L.e.152. 25C(6)) A Wurkers'Cumpensation 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 si ned Affidavit submitted with this a lication? Yea O No O SECI70IY 12:CONSTRUCTION COSTS AND PERMIT FEE - Item Estimated Costs: (Labor and Materials) Total Construction Cost(from Item 6) _$ 1. Building $ Building Permit Fee=Total Construction Cost x_(Insert here 2. Electrical S appropriate municipal factor)=S 3. Plumbing $ 4. Mechanical (HVAC) $ Note: Minimum fee=$�(contact municipality) 5. Mrchanical (Other) S Hnclosr check payable to ' 6. T�ital Cust 8 (cuntact munici ality).nd write check number here - SECTI N 13: SIGNATURE OF BUILDINC PERMIT APPLICANT l3v entrri . m i namr belnw, I hrrcby attrst imder thr pains and penalties uf periury that ali nf thr infnrmatiun cuntained in this appl`cat� i i ' ru , nd cu . tu the best�i y knuwled}�rand undentandin}�. c 19c.isi�print .ind .i�;nnamr � ��iNr Tc �hunr. '��. Uatr I >Ireel :\d.1rc.. Citt�iT�ncn ti , e Lip � ' �tunicipal Inspector to fill out this�section upon application approval: 9 ame I .�te _ . �, S�,'° � � ,; . , �7 � �� . s��.� �' . I i s�:��«�,� - ��., � �� P1�P ce,c,N� _ � i s�� !f._._ � .a __ .�. -t-..� __ _ __._ - - ---f---- = S�2 C � TU ��'o� s; � . ____� "r � g�j `'= �. — �- .� _ . —,— _ ee� G s TS . _ —�-; y_--I-----;--= =� -- - - � _ _ S[.�4T t,c� c.� �____ __-____�_.____.-_ 3�'g�' � �sS �� sr�e � �"' ; � 9�-Y « �s,De , a _ _�. s .__ __ __ _ __ _ � � � i _ n \ S�QCi ioa� V� ec-J So�� vi R �,vA�� . � , �; ree� USS ' . �� " �� \ � �� ' 'I .. , R�''��e�j�� —1'i ao S�,n�� . S�,µ:�eY . � Y� �-- ' --i ; G�p,,�u�g _ �A Ce��iNG 7- WflLL � � �'�i � �rT .. p� ; I �� Tee� ST�D �[� wr� � , d � ; i � L��y�j _ , I �'��J SP�'ta�(teR� ` sP;z,:,�+ecec_� � � ; (�exA� CeXA,� - ' �i � .. � � �� j - Vr ��v m;,�vm sraee F�n� _ I '��_,� � � � " --__ _ __- _ �.___' � �1}�CX. �eX�� , �L�.'� Le,�AN � ~ ��c`��fJ . ; �`l�� ( .� -_�-- rn �S-��m�p ,s �L s , ; r, �i , .. ,� t � �� rSPLq� (��;�[.(. c�2Cr,o �V ��t - 1-0 ' �G�(C.fl �_ ��G' ,F� _��____�-_- -__.__ .-.---. ,------_._ e 190 �ss�x s� �� C�r� m�1 o ��7J � Print Page 1 of 2 . � ��From: ML (m1321@its-mart.com) To: delielab@yahoo.com; Date: Mon, September 20, 2010 113735 AM Cc: Subject: Re: owner of#190 As beneficiary of BAY STATE TRUST and owner of 190 Essex Street Salem MA., I hereby give my permission for construction and permitted work to install the atCraction. Please feel free to contact me d'uectly if you have any other issues. Sincerely, Marco Lerra BAY STATE TRUST Tel: 321.613.8550 On Sep 20, 2010, at 10:17 AM, Deliela Bettencourt wrote: Hi Marco, John, our carpenterjust called from city hall and the building inspector needs a letter from you stating that your ok with the work that we're doing for the attraction. Also, I've gone to speak with Barbara 2 times and she's not there...so on Saturday I left her a message letting her know that unit #192 is available for lease/purchase and to give me a call if she was interested. I haven't heard from her...but will follow up on Thurs. or Friday to make sure she was given the note. Word around town is that Mollie's competitor's interested in her spot...l'll pay him a visit on my way to work this afternoon. I'll keep you in touch, Deliela From: ML <m1321 its-mart.com> @ To: Deliela Bettencourt <delielab@vahoo.com> Cr. Sumiko Kuboi <sumiko@its-mart.com> Sent: Mon, September 20, 2010 9:58:40 AM Subject: Re: owner of #190 Deliela, You can put it under BAY STATE TRUST. I will be happy to sign off on any work, as well. Were you able to catch up with Barbara? Marco On Sep 20, 2010, at 9:53 AM, Deliela Bettencourt wrote: http://us.mg2mail.yahoo.com/dc/launch?.�c=1&.rand=5ddd96dl0aaq7 9/20l2010 Print Page 2 of 2 . � , Hi Marco, I need to have the name in which#190 is under so that my carpenter can fill out the application for peimit. I think you told me Bay state...but I need to be certain so that plans don't run into next meeting which is in Oct. Can't afford to close in October...been waiting all year for October. Thanks, Deliela Marco Lerra 830 N. Atlantic Ave Unit B304 Cocoa Beach, FL 32931 Tel: 321 .613.8550 Fax: 305.675.2781 Marco Lerra 830 N. Atlantic Ave Unit B304 Cocoa Beach, FL 32931 Tel: 321 .613.8550 Fax: 305.675.2781 http://us.mg2.mail.yahoo.com/dc/launch?.gac=1&.rand=5ddd96dl0aaq7 9/20/2010