359 R ESSEX ST - BUILDING JACKET n' . t 7
The Commonwealth of Massachusetts � ��r�-o
4t.�ttz� jK:
r ' Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code,780 CMR �Nltl DEC AmX V A,
Building Permit Application To Construct, Repair, Renovate Or Demolish a
One-or Two-Family Dwelling
y� This Section For Official Use Only
I Building Permit Number: I Da Applied:
% ,., t„S
1 Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
LIa Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use - Lot Area(sq II) 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 ❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP[
2.1 _eorl���inP\Is SgJtWA O)a Dt9-70
Name(Print) City,State,ZIP 11
3s9F, street Lam
Kl)c,' co
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) CK I Alteration(s) 1fQ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify:
Brief Description of Prop sed Work': U P
GA N
00T—
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Building $ Q OQ 1. Building Permit Fee: $ Indicate how fee is determined:
i o 00� ❑Standard City/Town Application Fee ^^II//
2.Electrical $ ❑
Total Project Cost (Item 6)x multiplier x
3.Plumbing $ t 000 2. Other Fees: $
4.Mechanical (14VAC) $ pp List:
5.Mechanical (Fire $
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project COS[: $ ,Cj 000,00 ❑Paid in Full ❑Outstanding Balance Due:
A6t`)
3S� R �sse�
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
City/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 Issuance of the building permit.
Signed Affidavit Attached? Yes ..........V 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
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:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attes rider the pains and penalties of perjury that all of the information
contained in this application is true d ac o t best of my knowledge and understanding.
Leo K re4vh2 �S I�2)257116
Print Owner's or Authorized Agent' ( c runic Signature) Date
NOTES:
1. 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.2ov/oca Information on the Construction Supervisor License can be found at www.inass.gov/dps
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"may be substituted for"Total Project Cost"
i
UTILITY i Ili Mud Room
11'-5"x 6'-9" —UP- 9'-6"x 5'6" n r
ENTRYp�
17..8"x 4._9" _
BATH
may:
STORAGE
23'-0"x 22'-11"
tl A
BEDROOM
13'-6"x 12'-9"
LOSE
9"x T-6'
i
359R Essex Street
Carriage House
1 st Floor
Living Area
566 sq ft
I
T
I � /
STORAGE OF STORAGE //
6 23'-i"x 5'_3" 14'-3"x 5'-3
/
BEDROOM
.._._.� /
I � / 74'-3"x70'-0" j
Kitchen&Great Room
26'-5"x 26'4" ,/T\�
BEDROOM
1 Dead Space // Dead Space
1
✓. .
359R Essex Street
Carriage House
2nd Floor
Living Area
1224 sq fi
Commonwealthlof Massachusetts
City of Salem
120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641
Return card to Building Division for Certificate of Occupancy
Permit No. - B-15-1398
FEE PAID: $1,190.00 PERMIT, TO BUILD
DATE ISSUED: 12/28/2015
This certifies that LEO KRAUNELIS
has permission to erect, alter, or demolish a building—359 ESSEXSTREET, �` Map/Lot: 250231.0
as follows: Renovation CREATE FIRST FLOOR UNIT AND SECOND FLOOR UNIT (TOWNHOUSE)
Contractor Name:
T
DBA: _
f r €
Contractor License No: ' f
12/28/2015
f -
Building Official Date 77
This permit shall be deemed abandoned and invalid uniess the work authorized by this permit is commenced within SIX months after issuance.The Building Offigial g
may grant one or more extensions not to exceed six months each upon written request.
7
All work authorized by this permit shall conform to the approved application end 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 thlocal 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 for pubfic inspection for the entire duration of the
work until the completion of the same. J }
The Certificate of Occupancy will not be issued unfit all applicable signatures by the Building and Fire Officials are provided on this permit. }I
H IC #: 'Persons contracting with unregistered contractors do not have access to the guaranty fund'(as set forth in MGL c.142A).,
Restrictions: f
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER. i
I
Commonwealth of Massachusetts AL-11
Citv of Salem
120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641
n Return card to Building Division for Certificate of Occupancy v
Structure CITY OF SALEM BUILDING PERMIT
Excavation
PERMIT TO BE POSTED IN THE WINDOW
Footing INSPECTION RECORD .,
Foundation
Framing
Mechanical
Insulation INSPECTION: BY -
ta, DATE
Chimney/Smoke Chamber �,f�
Finale D 7 {LIt/try bf'W�l;
folds Plumbing/Gas
3 f
i
Rough:Plumbing
Rough:Gas,, _ ' r
Final
o Electrical
Service
r
Rough
Final
FiraWepartment y .0
Preliminary
Fina
Health Department
80
Preliminary
Final ��'