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117 FEDERAL ST - BUILDING JACKET CX_ T t � � 2 Z,- 1 b �� � RECEIVED The Commonwealth of Massachusetts INSPI I ES Board of Building Regulations and Standards CITY OF Sr Ev Massachusetts State Building Cade, 780 CMR a201a +�• <}(? tse la 0 a Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date lied: Building Otlicial(Print Name).' Signature• Date SECTION t:SITE INFORMATION' LI Proper Address: 1.2 Assessors Map&Parcel Numbers �� /'P/7Pra r}L 5T 1.1 a Is this an accepted street?yes vno Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ill Frontage(11) L5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provide) 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Public❑ Private❑ P P y Check if es❑ SECTION2: PROPERTY OWNERSHIP! 2.1 caner of Record: teV e c .a-�, ''5 AL NN me(Print) �r City,Slate,ZIP G 11'7 reloe�zr sT 5ok-&s/-6733— No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORKS(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work': SECTION a: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only abor and Materials) I. Building ®pD — I. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing S — P Qther Fees: S 4. Mechanical (HVAC) $ List: 5. \lech;mical (Fire Total All Fees:S Suppression) to C Check No._Check Amount: Cash Amount: 6.Total Project Cost: S PU Amount:❑Paid in Pull ❑Outstanding Balance Due: SEA -r-o P�va tot �s n i SECTION 5: CONSTRUCTION SERVICES r. 5.1 Construction Supervisor License(CSL) O�5 ��3 ©. - —r i p � -' ���( S License Number E.epiratiun Uale Nance of CSL Mulder 1./ List CSL'rype(see below) �j r7a�G ab -T - Description No.and Street / Unrestricted(Buildings tip l0 35,000 cu. tt.) „�(Jt "44t-� CSL fir Z_ R Restricted 1&2 FamilyDwelling Ci y!I'oivn,State,ZIP iN Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 9ZF�G�71Ss� 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(II IC) /���3 �4l k r Ai dLyS HIC Registration Number spirution Date II Cutup- y Name or HIC Registrant Name in NV .1nd Street A Email address I yr.,_n. a 1 C.M} C7 r�3 i % ?1' Z.f.1'Z6S- Clt /Town State ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.GX..c. I52.g 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 Istuance of the building permit. Signed Affidavit Attached? Yes ......... No...........❑ SECTION 7a:OWNER AUTHO..RIZATION:TO BE COMPLETED WHEN: OWNER'S AGENT OR CONTRACTOR A TLIE,,Sl!FORBUILDING PERMIT'' I,as Owner of the subject property,hereby authorize "CL%t hd[ic 7an., S t9 act on my behalf,in all matters relative to work authorized by this building permit application. s4. 0 yc Print Owner's Name(Electronnalure) Date SECTION 7b:OWNEW ORAUTtIORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained!it this application is true and accurate to the best of my knowledge and understanding, bull6hw.. A/r-AolS _ ru Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: I. An Owner who obtains a building permit to do Iris/her own work,or an owner who(tires an unregistered contractor (not registered in the Home Improvement Contractor(HIC) Program),will nor have access to the arbitration program or guaranty fund under II.G.L.c. I42A.Other important information on the HIC Program can be found at www nn:us.cov:'oca Information on the Construction Supervisor License can be found at www.mass.nos:/dos 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. 11.) Habitable room count Number of rreplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches rype of cooling system Enclosed Open_ J. Total Project Square Footage'miry be substituted for"Total Project Cost" Co t � '�7M1I� Salem Historical Commission 120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970 (978)619-5685 FAX(978)740-0404 CERTIFICATE OF APPROPRIATENESS 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 will be appropriate to the preservation of said Historic District, as per the requirements set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: McIntire Address of Property: 117 Federal Street Name of Record Owner: Stephen Duguay &Kathleen Riley Description of Work Proposed: Installation of four (4) Pella Architectural Series 616 true divided light windows along the front fagade. The design to match the existing replacement windows along the side and rear of the house. Dated: September 22, 2014 SALEM HISTORICAL COMMISSION By-� 9 /(/1, The homeowner has the option not to commence the work(unle s it relates to resolving an outstanding violation). All work commenced must be completed 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. EITY-OF SALEN - PUBLIC PROPERTY 1611, DEPARTMENT KI%03F I.EY DRISCOLL MAYOR 120 WASHINGM14 S MU•S&XK MASSACSQStl1S 01970 TEL 978-745-9595 0 FAR:97&740-9846 APPLICATION FOR THE REPAIR, RENOVATION, CONSTRUCTION, DEMOLITION OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUILDING 1A SITE INFORMATION Location Name: Building: Property Address: 'Fe-lem Property is located in a; conservation Area Y/N ►V Historic District Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land _ Name: S" Q Address: Telephone: 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation ✓ Number of Stories Renovated Change in Use New Demolition Existing Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New Brief Description of Proposed Work: ' J ,.,,y6�1nn 4rsans iJ c`M 4ek,- ��tuxt� � �Ulq . �fciCe. �tue- (.lYlndid� s -----Mail Permit to: — A - What is the current use of the Building? Material of Building? Wd C C If dwelling, how many units? � Will the Building Conform to Law? Asbestos? Architect's Name Address and Phone ( ) Mechanic's Name Address and Phone Construction Supervisors License# HIC Registration# Estimated Cost of Project$ a-O 100 o Permit Fee Calculation Permit Fee$ *QO Estimated Cost X$7/$1000 Residential Estimated Cost X$11/$1000 Commercial An Additional $5.00 is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of perjury X Date d 14 o N S i oe v > o --- l � Salem Historical Commission 120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970 (978)745-9595 EXT 311 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: 117 Federal Street Name of Record Owner: Stephen J_ Dug1y Kathleen R_ Riley Description of Work Proposed: Replace one wood, 6 over 6, true divided light window to replicate existing. No changes in color, material, design or outward appearance. Non-applicable due to being in kind maintenance/replacement. Dated: March 14, 2005 SALEM HIST MISSION By: 1?7 I The homeowner has the option not to commence the work (unless it relates to resolving an outstanding violation). All work commenced must be completed 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. fLwAIS*TdST-BEfiUEG-ANG APPROVED By T44E .IAISpZCTDB PRIDR Tp A PERMIT S,FING GRANTED CITY OF SALEM os No. `� ' Date . 1 Is Property Located In / Location of p the Historic District? Yes V No_ Building L trr�0ta1 - Is Props"Located in the Conservation Area? Yes No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof• Install Siding, Construct Deck, Shed, Pool, Repair a lace, Other: w i"ow5 C 3� PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: I Owner's NameS- Address & Phone --- Architect's Name R Address & Phone L Mechanics Name Rti-kD-- Address & Phone What is the purpose of building? re(4,e* e-o- - Materiel of building? Wood II a dwelling, for how many families? Win building conform to law?e 5 Asbestos? go Estimated cost - City License« N �' State License N 'Boise Improvaent Lie• Y Signat re o Appli SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE OWNe< WWII rae�( l9�iln�dr� S . _ �(e� 6-�" I Lj t1t f���f(Q (r —c IUaYt DYI�(c f if (� Q� - Y`2_ MAIL PERMIT TO: Sieve_ �uOI' f ` 7— N0 APPLICATION FOR PERMIT TO LOCATION sT PERMIT GRANTED APP OV D p PlE C CTOR OF BLOLDINGS r U I Salem Historical Commission 120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970 (978)745-9595 EXT.311 FAX(978)740-0404 CERTIFICATE OF NON-APPLICABILITY It is hereby certified that the Salem Historical Commission has determined that the proposed: CJ 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: 117 Federal Street Name of Record Owner: Stephen J- Dugu y Kathleen R Ril v Description of Work Proposed: Replace one wood, 6 over 6, true divided light window to replicate existing. No changes in color, material, design or outward appearance. Non-applicable due to being in kind maintenance/replacement. Dated: March 14, 2005 SALEM MST MISSION By: The homeowner has the option not to commence the work(unless it relates to resolving an outstanding violation). All work commenced must be completed 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.