275-281 ESSEX ST - BUILDING PERMIT APP - COVEN REST. ..� a9 , . �,� � �a �a1 �� �-aya� s
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, s _,. ^,►: The Commonwealth of Massachusetts
� �� � Department of Public SaEety I
1 +.<,.f .\t.u.wichu.clls Slalr Buildin�;Cudr 1780 C\IN)tie�•anth Editiun
IU City of Salem I
(I� � Buildin Permit A lication for an Buildin other than a 1-or 2-Fa ' Dw 'n
n u lThi,Srctiun Fur V((ici.il Use Onlv)
I !U� Uuilding Permit Numbrr: Datr Applird: U Building Inspectur.
\j j SECfION 1: LOCAT►ON IPlease indicate Block N and ot M for locatione for which a street a dress is not v ' ablel
YI
� O J
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.\��. .ind titrrrl Cilr /Town Zip Q�dr Nameuf Building(if applicablr)
SECiION 2:PROPOSFD WORK �
If Nrw Constructiun check hrre O ur check all that apply in the twu rows below
Eristing Building � ' Repair❑ Alteratiun ❑ Addition❑ Drmulitiun O (Please fill uut and xubmit Apprndix 1)
Chnnge uf Use ❑ Change uf Occupancy ❑ Other ❑ Specify: �
Are building plans and/ur con�truction documents bring supplied as part uf this permit application? Yes Nu O
Is an IndependeN Struclural Enginrering Peer Rrview required? Yes ❑ Nu �
Bri�f Dexriptiun uf Propo+ed Wurk . .�/1//1� OtJ'/- cT'Q�/C�� I-fi/z ��f� $"�-�/LF '
/�2fTrJ�?K�.l IT (J� - S� S e.A-�TS
SECIION 3:COMPLETE THIS SECT/0N IF EXISTING BUILDING UNDERGO[NG 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 Croup(s): Proposed Use Group(s): s �
Existing Hazard fndex 780 CMR 34: Proposed Hazard Index 780 CMR 34:
SECTION 4:BUILDING HEIGHT AND AREA
� Existing Proposed
Na of Floors/Stories(indude basement levels)&Area Per Floor(sq. ft.)
Total Area(sq.ft.)and Tutal Height(ft.)
SEGTION 5:USE GROUP(Check ae a licable)
A: Aseembly A-1 ❑ A-2r q-2nc O A-3 O A-4❑ A•5 0 B: Buainese E: Educafional �
F: Facto F-1 ❑ F2❑ H: Hi Hazaid H-1 ❑ H-2❑ H-3 ❑ H-4 H-5❑
1: Institutional I-1 ❑ I-2❑ I-3❑ I-4❑ M: Mercantile O R: ReeidenHal R-1❑ R-2 R-3❑ R-4❑
S: Storage S� O S2 ❑ U: Utility❑ Special Use O and please dexribe beluw:
Special Use:
SECiION 6:CONSTRUCTION 7YPE(Check as a Ilcable)
IA ❑ IBO IIA ❑ IIBO IIIA � IIIBO IV ❑ VAO VB ❑
SECTION 7:SITE INFORMATION Irefer to 780 CMR i llA for detaib on each item)
Water Su� Flood Zone Infomiation: Sewage Disposal:J Trench Pe it: Debris Removal:
PP Y°
Public C heck il out.ide Pluud Zunr❑ 6idicatr munidp,il gl .A Irrnch w}��nut he Licrnsrd Di.pus.il tiitr�
Pri��atc❑ ur indcnliA� Zunr: ur�m sitr.c.lrm ❑ rcyuirrd rdur trcnch ur.perilv:
� ��ermit i.enclu.rd p
Railroad righhof-way4 Hazards to Air Navigation: �I:\ I li>n�ri���,�mini..i��n Hr��i���� 1'r„r�•..;
\nt :\F�E+licablc IkV I.titrurlurc�cilhin air�,urt a�E+y��/�o,ich.irra.' I.Ihrir rrciitc cumplctrd.'
� ��r l�nn.cnt lu liudd cndn.cd ❑ yi�.� i�r Vn Q 1'r.❑ \u ❑
� SECTION 8:CONTENT OF CERTIFICATE Of OCCUPANCY
G.1iUnn nf C��dc: C.i•(�niuEy.�: i��,e��l G�n.trucUun: l)cai��anl Lu.id per Pluar:
Ih�r. Ihebwldin�;.��nLnn.uitiF�rinkli�rti��.lcm.': �prcmititiF,�datiuns: �
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Addres.ol)'rupertv Uvnrr
T�I'r �IOCL.�f-/Lr�N e
NamrlPrint) Nu.,ind5lrert Cih�/T�nvn Zip
PruE,ert�•l)��'nrr C��nt.ut Informatiun� — Ci''74v��ZSY7
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Title Trlrph�me No. (busine�.) Telrf�hunr�1��. (cell) r-m,iil addrr.s
. If,ipplic.iblr, Ihr pruprrh�u�.�ner hercby.iuthurizrs
v,�mr ti�rcet Addre,s Citv/Tuwn tilale Zip
t��arl on thr ,ru,rrl��o�vnrr's Urhalf.in all maltrn relati��r w w��rk.uiih�,rizrd bv ihi.buildin � �rrmif a ��lic.ili�m.
SECTION 10:CONSTRUCf10N CONTROL(Please fill out Appendix 21
(I(l.uildin�is li�.s Uwn 3i.U�M1 cu.ft.��F cnduxvi> a.c and/or nut und.r G�nstru.tion Cunlrol thcn check herc O and.ki S.�c�ion IU.U
� 10.1 Re istered Profesaional Res onaible for Construction Control
� 0 Z�373
/I�ARlC //Ze.�rd��l7 �/
Namr(Rrgistrant) y� Telephone Nu � e-mail address Regisfration Numbrr
� �/�!-cJ/ZlC"�.�/� .�iQLP�� � �
Strrel Addreu City/Town $tate Zip Discipline Expiralion Date
lOZ General Contractor
l iY-'� ���lY` ����/'Z l�� .
Cumpany Namr: �t�'D'7/ �(//
/YIRa2�TP�y��_ l� / fJ �(rJ
Namr uf Person Res �nsible(ur Cunstruch License No. andType if Applicable
��J,�r1�',� nJ. .��1r�.�
�� pd��e��3�� -- City/Town State Zip
� S
Tele hone No.(business) Tele hone No. (cell) � e-mail address
SECTION 11:WORKERS'COtvII'ENSATION INSURANCE AFFIDAVIT(M.G.L.c.152. 25C(6))
A Workers'Cumpen�tion Insurance Affidavit from the MA Department of(ndustria�Accidents must be completed and
�ubmitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a si ned Affidavit submitted with this a lication? Yee O No 0
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
. I[em Estimated Costs: (Labor �p O G �
and Materials) Tutal Construction Cost(from[tem 6)_$J
t. Building S 00(7 guiiding Permit Fee=Total Cons[ruction Cost x_(Insert here
2. Electrical 8 21 ��� appropriate municipal factor)_$
' 3. Plumbing g p OeD
4. Mechanical (HVAC) $ ��T— Note: Minimum fee=$ (contact municipality)
5. Mechanical (Othrr) S :D • Enckvsr check payable to
6.Tutal Cust 8 ,b�(7 (contact munici alit )and writr check number here
SECTION 13:SIGNATURE OF BUILDINC PERMIT APPI.ICANT
Bv enterinK my name beluw, I hrreby altr+t under the pains and pen.ilties uf periury that aIl uf the infurmatiun cuntained in this
applicaliun i.trur and accurate t � rst n rtTV-knuwledge and understandin�;. -
A�r�4� �e l� 'n� n�,c1N�2 �-�0 Z� 7� 3/ /a
Plia..�F�rint and �ihn n.ime ��illr Tvlcf�hune \u. I)alc
� � Ltiv✓t,'�'�z �2d ��� �. �
titrri4 Addre.. Cih�i7�nrn Ft,t Zip
ltuniiipal Inspector m fill out this section upon application approval:
\, r )�ne
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n I
• BL¢n�c DEr�xn�.vT
;• � t 30 W�SHINGTON STREET,3'D FLOOR
� 'I�t.. (97��45-9595
FAX(�78j 740-98A6
(Q\igERLEY DRISCOi1.
l�1AYOR "11�toMAs ST.P�RRS
D(RFCfOA OE PI:HLtC PROPERTY/BL'IIDII�SG CO�L�A55I0.iER
CONSTRUCTION�ONTROL DQCUMENT
Project'Citle: CQ(�'✓� Date: � ?'� /� I
Project Locadon: �� �.7.�X �
Scope oC Project: _(��•,�1�(���7��l17� ��C4 � 1�
13,�sr'a,�„�r-i"
tn acwrdance wi�h SEGTION 1]6.0-116.4.2 of the 6th edition of the Massachusetts State Duilding Code :
1, DvU«� /�� Musa.Registcation Number �I/ D
--r--
being a registered professional Engineer/Architect dereby CERTIFY that I have prepared or direcdy supervised
the preparation of all design plans,computadons and specifications conceming:
[ J Entire Project [�cchitectural [ ] ShucNral ( ) Mechanical
[ j Fire Protection [ ] Elcctrical [ J Othor(specify)
for the above named project and that ro the best of my lrnowledge,such plans,computations and spec�cations meet
the applicable provisions of the Massachusetts Srate Btilding Code,all accepwble engineecing practices and aU
applicable laws for the proposed project.
Furthemmre,l understand and AGREE ttu�t I shall perfortn the necessary professional secvices and be present oa
rhe constcuction si[e on a regular and periodic basis to detercnina that the work is proceeding in acco�dance with the
dacuments approved by the building pamrit and shall be responsble for t6e following as spec�ed in secaon t
1 I6.2.2:
� t. Review of shop drawings,samples and other submittals of the cnntractor as required by the conshuction
wnaact documenu as submitted for the building pem�it,and appmvat for the confortnance to the design
concepc.
2. Review and approval of thc qu�lity controi procedures for all code-required coatrolled materials.
3. [3e present at intervals appropriate to the stage of consuucfion w become geaerally famitiaz with
the progress and quality of the work nnd to dctetmioe,in general,if the work is being performed in
a mannet consistent with[he construction documents.
I shall submit periudically, in a form acceptable to the building official,a progress report togethtt with pertinent
comments. Upon completion of the work,[shall submit ro the building official a final report as to the
satisfactory completion and readiness oF the project fot oecupancy.
G\}`EPED Aq�y�r�
Signature and Seal of registered professionaL• Q�"o G�S ho A°l
o A
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ALEM �
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FOOD PREPARATION- NO
� EXHAUST REQUIRED DHAI'CFllt@Ct
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_ _ _ � .� . _ � PERMIT 3/17/10
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IXIT D ISCHARGE '
TO IXff
DISCHARGE
P�ajecl
F LOO R PLAN PLAN LAYOUT AS PROVIDED BY TENANT COVEN
281 ESSIX STREET f
SALEM MA 01970 y
d
LEGEND CODE REVIEV� CODE �
ANALYSIS �
1
� 1 . AREA: 1774 SQ. FT. �
�v � LIMIT OF TENANT SPACE 2, OCCUPANCY: A 2r ASSEMBLY, RESTAURANT
3. BUILDING HAS AUTOMATIC SPRINKLER SYSTEM
PATH OF EGRESS, 44" WIDTH MIN. o�aWhgrna �
4. CONSTRUCTION T`�PE: ASSUMED TO BE 3-B
5. FIRE RATING OF BUILDING EIEMENTS FLOOR PLAN �
ASSUMED TO BE IN COMPLIANCE '
FOOD PREPARATION & SERVICE 3
AREA 6. SOUND TRANSMISSION FLOOR/ CEILING �
ASSEMBLY AT 2ND FLOOR SHALL BE INVESTIGATED . ;
�--_ .—� OR TESTED FOR CAMPLIANCE WITH 780 ,EPECAF�ti,i
RESTURANTAND RETAIL CMR1207.0. PRIOR TO ISSUING CERT. OF F'��'JG�S H AACj s�� �ig'=�'-o^
k. � ' ,-. .� .� -I AREA: 935 SQ. FT. OCCUPANCY
L•� �—•-J o r� DrawhgNumber
7. ALARM SYSTEMS: ALL REQUIRED BY 780 CMR ° Na.4„o p �, ;
� ILLUMINATED EXIT SIGN & 9•00 ASSUMED TO BE INCOMLIANCE. � SALEM ^ � ;
EMERGENCY LIGHTIS 8. NUMBER OF RESTURANTS OCCUPANTS LIMITED °- � J /'1
TO 50 AS BASED ON 248 CMR 10.00: UNIFORM STATE � �
' PLUMBING CODE.
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��,�,/ � PERMIT 3/17/10 `
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. • . . • - • . � NOTE:ELECTRIC OVEN FOR
FOOD PREPARATION- NO
� EXHAUST REQUIRED ' DHACCIlIt2Ct
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- • • DWGIAS HOPPERARCHITECT
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_ 1 . . '. - ,1j' 'j, .�! - . Issued fw: Date
��'��� � PERMIT 3/17/10
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EXITDISCHARGE • ���' - - �
_�TO IXIT
DISCHARGE
Project
FLOOR PLAN PLAN LAYOUTAS PROVIDED BYTENANT COVEN
281 ESSIX STREET
SALEM MA 01970
LEGEND CODE REVIEW CODE
ANALYSIS
� 1 . AREA: 1774 SQ. FT.
�v � LIMIT OF TENANT SPACE 2. OCCUPANCY: A 2r ASSEMBLY, RESTAURANT
3. BUILDING HAS AUTOMATIC SPRINKLER SYSTEM
PATH OF EGRESS, 44" WIDTH MIN. 4. CONSTRUCTION TYPE: ASSUMED TO BE 3-B oraWnyr�na
FLOOR PLAN
5. FIRE RATING OF BUILDING ELEMENTS
FOOD PREPARATION & SERVICE ASSUMED TO BE IN COMPLIANCE
AREA 6. SOUND TRANSMISSION FLOOR/ CEILING
ASSEMBLY AT 2ND FLOOR SHALL BE INVESTIGATED
r---�� OR TESTED FOR COMPLIANCE WITH 780 tFPeo,aF�y
RESTURANTAND RETAIL CMR1207.0. PRIOR TO ISSUING CERT. OF F,�.�'" �+.s Mp rFo�. sca�e vs�=�'-a� '
I.�.= .' -. .- .� -I AREA: 935 SQ. FT. OCCUPANCY �� A
�`"—� �—�J o c� Drawng Number
7. ALARM SYSTEMS: ALL REQUIRED BY 780 CMR ° No.a,aa � y
� ILLUMINATED EXIT SIGN & 9.00 ASSUMED TO BE INCOMLIANCE. � SAIEM
EMERGENCY LIGHTIS 8. NUMBER OF RESTURANTS OCCUPANTS LIMITED �� � A�
TO 50 AS BASED ON 248 CMR 10.00: UNIFORM STATE
,, ' PLUMBING CODE. � - ' ��� �
. �
tissue r:
� ; �n^� �� � PERMIT 3/17/10
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