100-110 FEDERAL ST - BUILDING INSPECTION 610q'', 42-Iss
' The Commonwealth of Massachusetts
¢ Department of Public Safety
Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: Building Official:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
/!>f� d At JrwJ
No.and Street City/Town Zip Code Name of Building(if applicable)fl ff0 .
SECTION 2:PROPOSED WORK
Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below
Existing Buildin Repair I Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No
Is an Independent Structural Engineering Peer Review required? Yes ❑ No D—'
Brief Description of Proposed Work:
e.oq,A—
.e L
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ VM:
Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional I-1 ❑ I-2❑ I-3❑ 1- antile❑ R: Residential R-1❑ R-2❑ R-3❑ R-4 Doe
S: Storage S-1❑ S-2❑ y❑ Special Use❑and please describe below:
Special Use: C 0/�
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB.❑ IIA ❑ - IIB ❑ IHA ❑ IIIB ❑ IV ❑ VA ElVB ❑
SECTION 7.SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: Sewage Disposal: Licensed Dis osal Site❑
Public❑ Check if outside Flood Zone❑ Indicate municipal❑ . A trench will not be P
required❑ or trench or specify:
Private❑ or indentify Zone: or on site system❑ permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation FMIA�jj&toric Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Proper wrier `
'l�vp L fl (� /off'� � ge&A2Z IL f ig �t ®O9l
Name Print) No.and Street City/Town Zip
ro rty ner on t nformation:
Title Telephone No.(business) Telephone No. (cell) e-mail address I'�✓t-�
If applicable,the property owner hereby authorizes
30 AA
Name Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control
5 An
Name(Regf trant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
/7 / / GAA-I!e-f Lief
Company Name
l-may e,,3�e f Z a l�(
Name of Person Responsible for Construction License No. and Type if Applicable
Street Address City/Town State Zip
Telephone No.(business) Telephone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C 6
A Workers'Compensation 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 signed Affidavit submitted with this application? Yes O No O
SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1.Building $ 00 Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ appropriate municipal factor)=$
3.Plumbing $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipal�i
5.Mechanical (Other $ Enclose check payable to / Z
6.Total Cost $ Y�,9` (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
entering my na below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
a plicatton is true nd accurate to the best of my knowledge and understanding.
1 98�1
lease print and sign name itle Telephone No. Date
?-3 �
Street Address City/Town State Zip j 7�
Municipal Inspector to fill out this section upon application approval: ^-�
Name Date
. A
Salem Historical Commission
120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970
(978)619-5685 FAX(978)740-0404
CERTIFICATE OF NON-APPLICABILITY
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction ❑ Alteration
❑ Demolition ❑ Painting
❑ Signage ❑ Other Work
as described below does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District: McIntire } '
Address of Property: 109-1 10 Federal Street
Name of Record Owner: Julie Dematteis
Description of Work Proposed:
In-kind replacement of 3-tab roof on rear addition. Non-applicability due to work being in-kind replacement.
The new 3-tab roof will match the existing roof color and the front main house roof color.
Dated: August 26, 2013 SALEM HISTORICAL COMMISSION
- --By;
The-homeowner has the option not to commence the work (unless it relates to resolving an-outstanding
violation). All work commenced must-be ccmpleied within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals) prior to commencing work.
�108 Federal St, Salem, MA 01970-3245 June 22, 2013
North Side
Rt ;
E r
i,
w'
p
V r jS
P °�+ M
South Side
-
s
a rb V' Pa i
i 4
e �
.1
4
i I
9 a
Tnit eommey.,"nowd o tuber L—,,,by Eagkvlew TetMok91e5 to the tenuestor lw her Internal use only suged ro the terms and<a,alO n'riwie sry a9ee0 on
to Uy me
reQuator when tyre/reglstwed kr use 0 EagkVlew T1h1obbt,Se yle,,It,emaln,me p,opvty W Ea9kVlery T<cnnob9lea anti may ee reprodu<�and delribut to only
Report: 6871483 within the rennesorA<wnpany.Any ,prWURign er dathbndon to aneone om.re
m therewertws<oniootwwnnow Etnt. 'sp^�wdtren permtssron s:okay
EaeteV rew' prohiblled.All aspects aM paneling W th6 report the sublen to the Tenn'and Condhbns voyty sly agreed he by Me raTuezlw.
AB Carnes Roofing Copyright 0 2008-2013 EagleView Technologlesr Inc.—All Rights Reserved —Covered by U.S.Patent Nos. page 2
8,078,436;8,145,578;8,170,840 and 8,209,152 Other Patents pending.
108 FEDERAL STREET 221-14
81S# ,;: ; .G 13835w ,:' COMMONWEALTH OF MASSACHUSETTS
Mali;. :-: r. 26
P.lock. CITY OF SALEM
Lot: 0594-802
Category New Roof
Permit# __ � 221-14 ' Y BUILDING PERMIT
Project#{ JS-2014 000433
Est. Cost: $4,200.00,
Fee Charged: $109.00
Balance Due: , $.00„ :, PERMISSION IS HEREBY GRANTED TO:
Coast. Class .* _ - 4 Contractor: License: Expires:
A.B.CARNES, INC. STATE-068139
Lot Size(sq.`ft). 8469.8064 i s
Owner: Julie Dematteis
Zoning �a :-j't R2 ," �,� ja.
Units Gamed: . _ :,. :Applicant: A B Carnes Inc
Units Lost: :"-` AT: 108 FEDERAL STREET
Dig Safe
ISSUED ON: 05-Sep-2013 AMENDED ON: EXPIRES ON: 05-Mar-201�t
TO PERFORM THE FOLLOWING WORK:
108-110 Federal St,REAR MANSARD/APRON 700 SF; STRIP &REROOF WBLACK SHINGLES
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Building
Underground: Underground: Underground: Excavation:
Service: Meter: Footings:
.Rough: Rough: Rough: Foundation:
Final: Final: Final: 12nngh Frame:
r.
Fir eplace/Chimney:
D.P.W. Fire Health
- Insulation:
Meter: Oil:
Final:
House# Smoke:
Treasury:
Water: Alarm: Assessor
Sewer: Sprinklers: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS
RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
BUILDING - REC-2014-000472 05-Sep-13 2755 $109.00
j;.
j
1,.
t�
I;
GeoTMSO 2013 Des Lauriers Municipal Solutions,Inc.