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11 FELT ST - BUILDING PERMIT APP
� �2 = c k-t� 2q z�( ' � The Commonwealth of Massachusetts , � • . ' Boazd of Building Regulations and Standards CIT'Y OF Massachusetts State Building Code �8o C1�EIVED SALEM � I�lSPECTIONAL SERVIGE'S RevisedMar2011 Building Permit Application To Construct,Repair,Renovate Or Demolish a p One-or Two-Famrly Dwelli ' - ' = 4' �" ,� " ' � � '"" u This Secrion For Ot&cial se� n y �- � t .N � 'n Buildmg Permit Number: x ' � `` . Dxte plied: ° UI • ' �� �i, lt9//5//� � Buildmg Official(PrintName) e , �'g� ,,,=�Signahue -� Date �. � ' � �.� '" 4 � � '���, SECTION 1. SITE INFOIt1�FATION = � " " " �` � 11 Pro erty A ress: 1.2 Assessors Map&Parcel Numbers :, �1, ��' �', 2'1 OS`�S l.la Is this an accepted s[reet?yes�_no Map Number Parce]Number 1.3 ning Intormatio �\ 1.4 Property Dimensions: � �.-��M� c�.�3o Arns � .0°1 Zoning District Propose se� Lot Area(sq-fi� Frontage(ft) 1.5 Building Setbacks(ft) Front Yazd Side Yazds Reaz Yazd Requ'ved Provided Requ'ved Provided Required Provided �S ��.y � \o s �. 30 � 3b � 1.6 Water Supply: (M.G.L c.40,§54) 1J Flood Zone Information: 1.8 Sewage Disposal System: Public Zone: _ Outside Flood Zone? 6d� Private❑ Check if yesjd' Municipal�9'On site disposal sys[em ❑ �_ ` `T ''r ;�SECTION 2: PROP�RTY OWNERSFIIP' ` z.i �ece�.�ne�o,�.� �l ��" � �w�� � ��- Ci1�`X) Name Print) � City,State,ZIP \l � �' �'1Ss��1°�\- Cc°1ZA �ere.�� w�c�am�o� C q'�cn� .Co� No.and Street Telephone ' Email Address �" SECTION 3:DESCRIPTION OF PROPOSED WORKZ(check all that apply) New Construction❑ Existing Building�" Owner-Occupied�' Repairs(s) ❑ Alterarion(s) �' Addition ❑ Demolition � Accessory Bldg. ❑ Numb r of Units , Other ❑ Specify: Bri Descnptlon of Proposed WQrl�: oV�r- k� v�cs � P� �'�. �a' 19�ar' �S Q �e.r> e�� e . �\ tv , SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: r; , Official Use Onl �' ` abor and Mxterials) y ' 1.Building $ ZQ V�Q 1•'Buildiog Permit Fee: $ Indicate how fee is determined: 2.Electrical $ �0 O ❑ Standard City/Town Application Fee ,.� ; O Total Project CosT�(Item 6)x mulhplier x`' 3.Plumbing $ �'�1� (� 2. Other Feesi $ � �. � f 4.Mechanical (HVAC) $ LisT. "' 5.Mechanical (Fire $ " ' ' Su ression) Total All Fees: $ �� � Y� � Check No Check Amount ' g"Cash Amount: 6.Total Project Cost: � � �Q ❑p�d in Full ❑Outstanding Bdlance Due: rn A.� ��v -r-� G�::r�rrzP,c.,-�'�r�, ,�� , �� ' ' F SECTION 5:;CONSTRUCTION SERYICES � 5.1 Construction Supervisor License(CSL) ���_0��•� �.2 �q \b �qcy,� License Number Expiration ate Name of CSL older ' ������ \ � List CSL Type(see below)�_ C�dV �`o.and Stre . �� Type ,,, Descrip[ion .„„ ► \_ �k�� ��t�'L� � U Unrestricted Buildin s u to 35,000 cu.ft. � C�R R Restricted i&2 Famil Dwellin City/Town,State,ZIP M Maso RC Roofm Coverin WS Window and Sidin J`� ��s�6�,Z�g�t��S�o�'� SF Solid Fuel Burning Appliances 0'-���.- I Insulation Te e hwe Email address D Demolition 5.2 Registered me Improvement Contractor(IIIC) ,p-����� Z� +b t; ���� - � HIC Registration Number Expiration Date HIC Co pany e r HI Registrant Name \21�Cev«�� � `���\Z\���.�Sn �e�h I�I,Q•and��bj..n ���� � ����_�.�� Email address \Y� V"� Ci /Town S[ate ZIP Tele hone ` . SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVTT(M.G.LIc. 152:§ 25C(6)) ' `4 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failwe to provide this affidavit will result in the denial of the Issuance of the building pernut. . ' Signed Affidavit Attached? Yes ..........S�' No...........❑ . SECTION 7ar OWNER AUTHORIZATION TO BE COMPLETED WHEN , s 'OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUII.DING PERMIT t I,as Owner of the subject property,hereby authorize \Qi1�U��1 �"I to act on my behalf, in all matters relative to work authorized by ttu building ermit application. �ere.����a.yan 0 � 1 Print Owner's Name(Electronic Signa e) Date � �� -"� � �SECTION�7b: OWNER'�OR AIITHORIZEp hGENT DECI;ARATION' "�',��,� e`-`� By entering my name below,I hereby attest under the pains and penalties of perjury that all of the informalion contained in this application is true and accurate to the best of my knowledge and understanding. ���h� Q�w \0 Print Owner's r Authori ed AgenYs Name(Electronic Signature) ate ,R . NOTES: .. „� ; ,; 1. An Owner who obtains a building pemut to do his/her own work,or an owner who hires an unregistered contractor (no[registered in the Home Improvement Contractor(HIC)Progam),will not have access to the azbitrafion program or guazanty fund under M.G.L.c. 142A.Other important information on the HIC Progam can be found at www.mass. og v/oca Information on the Construcfion Supervisor License can be found at www.mass.eov/dks 2. When substanfial work is planned,provide tl�e information below: Total floor area(sq.ft.) (i�cluding garage,finished basemenUattics,decks� Gross living area(sq.ftJ Habitable room count Number of fueplaces � Number of bedrooms Number of bathrooms Number of half/baths O Type of heating system \C�'�� Number of decks/porches � Type of cooling system \ e. 2 ���.> Enclosed 1 Open Z 3. "Total Project Square Footage"may be substituted for"Total Project CosP' � ,�a .. i Sub-Contractors • 11 Felt St. � Salem, MA i Contractor Name Address Employees Workers Comp � Policy# R.J. Cunningham Construction 86 Park St. Yes O8WERCRI7689 . Beverly, MA 01915 Brian Nadeau Pliumbing and Heating 119 center St. No NA(Sole proprietor) Groveland, MA 01834 Keith Pelletier Electric 35 Sable Rd No NA(Sole proprietor) � Salem, MA 01970 ELK Construction 320 Paradise Rd. Yes WCC-5005014215 Swampscott, MA 01907 Sullivan and Son Painters 27 Lovett St. Yes WCC5001481012015A Beverly, MA 01915 i 31 ' �� � �T , sr ,� �o�.�.. �� ��ru.�s:m� � I Jvai�.smm� T n,��� iiawu�ua.y ' �' Liqs�nea ,. A ' amanv. � "t � c�ya.�.a v.n�. �23. ��� , o �„�.�. N � Twm Bounauy . �� AUWO�Y� � �IMer�We We � � �� �Nivnb��nERONen ��`h qpylb�OTvwn�eGli .8.... � " ... HLWtliqTwme�NOLW a 15 ,� { �.� F as� 17610 R < f�J1616R a` 1 ��' � � �� �36�OR � ` .� � A �J660R 5 O rc �'ry7 � ��'1 �60.8oR Q, �:a� �� s io'n R �o , x� s 11 .,�, r �..m � .. � � � ti � N � � �� ���';� t „�.: � ��p � 8 �;,� � 63} , ��,Q' �.� ' �r` � .� �'t f ' . Q � . '. � � ,�s � �'� 6�' � , . � � � ���� � �� 2 57 O�� na � ti �Q. 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J � ��.��.i.� ��,I .�Y � ' _�� ,t" • w �'l �. � ., � ' r .reA.� L� � �' ' .� • !� e s�� � .r ' �� =�::. ,� ,� -.�c*�'i �' i � t, u�„�:�� � � ,�� � ` r �� � E � �� � ��- .��.� 1�, I ' . �. � � . �y 4�,, � .� � � 4 . � Wi4 . ..: r.� , . � � t��... �� � � �� �� �y � .. k I'4 _ ��: � � A ��. ; � : _ L , � f , , � , ��,, � _ �,���'���t ,�'i � ;� � � � � ����� ,.�� _ �„ � V f,,„„ e � F'�f� �, �rwEe��� I ,,:�� i t, � r"� �. � � f-�� , y, , ,�,� � � ; , h,.��. _. � ' •j� 1.- � ' i�1��� y �' ; �' f � � •{���. � t ` � � �. ` �' . . -- � '`�'`� y � . � • � � -' � . � _�w�r.�,..��v,- .:�,�� ' ' �`�' . �4{,�if:'lr; . � •� ",^a,,,t - �. .-� .. . �� : '� .r z .� , 'j , �y +, . . .. . � t �.� f ,�, if� �i 1� y � . E ^ �1Y , !' ,Y � y .. A �� 4 � �J� � y :�- ,,=��� .; �.. , � �-�r ,:,�i°�r ��� � "'�d�1,���� 4 t 4 - �� �. �f„t+�'.'qlt�y�`.}`f'�''�� +... la: ! , d � � /' ►� � ;, y�7 a����,��;� ,�,�,�, � t e� � s, ' • . ."�'�,�`�,�,'�' ti ,, �"`"�`'" Commonwealth of Massachusetts ��� ,; � I�l / l �1 {/ � ,l, • s� � ° �� Citv of Salem - �°�����z� 120 W ashington Sl�3rd Floor Salem.MA 01970(978)745-9595 x5fi41 . �/A.INk P� Retum card to Building Division for Certificate of Occupancy � Permit No. 8-15-1105 � � � � � FEE PAID: $224.00 �ATE ISSUED: 10I15I2015 This certifies that FLANAGAN MEREDITH E has permission to erect, alter, or demolish a building 11.FELT�STREET Map/Lot: 270545-0 6' < 4 t { Wv ! ..{,tt ..:iZ._ as follows: Renovation REMOVE SECTION OF ROOF OVER EXISTING'FINISHED 2ND FLOOR BEDROOM AREA. BUILD EXTERIOR WALLS TO ACHIEVE'8'.CEILWG HEIGHT.=:INSTALL NEW FULLL BATH IN BEDROOM SPACE. �� `�?� � � �'�` HE�s�,� " �� k j x���� -�� ��� �a.'�,�e,a.. uu«r�'- i��.xi�,'�','„! l ", a' Contractor Name: TIMOTHY BERRY rw`�:t° _� d+, s� ��Ri�� � I P�a a F '{ ;y„ e DBA: ytia � � '°� �`�'�--,a �=; � Contractor License No: CFSA052026 ,��' �����,e'� �' x,, .� f � � �+ _� � " - "�'�� � � � _ �I�">>,� '�,�{ a�d�ki ' d�U�'j�}���� � t xaz��w�� �Par:�--,�t�n �,: � " i,; �,,= 1 011 512 01 5 �'i`�"r �;di"� i� ; ". . ... � ,�„���,�x,�� Bu�ilding Official � � `� ..� � Date �;r . 7�iI s 5(�"" � `t . �= i4".k:'�",..u`°,f�p ;;tu4. . v , -+�g + ....-. ,��,.,.� :; :. �=...r� .::��.,. This permit shall be deemed abandoned and invalid unless the work authoriied by Ihis�permit is�commenced within�siz months after issuance.The Building Official may grant one or more extensions not to exceed six months each upon written�reques[,„��,�„ ,��y� ��:=��������� � ;'�� �t6 All work authorized by this permit shall conform to the approved appli at on and the approved construction documents.for which iliis permit has been granied. 5 ^ r .'s 1.,.mt� �nt,..,,t y.i4. K �_sN,. All construction,alterations and changes of use of any budding and structures shall be in compliance with the local zoning by laws and codes. �m.*r.'� � ''fl i; £�- ° G .. r�_�'� This permit shall be displayed in a location dearly visible from access street or road and shall be maintained oped for pubLc��.inspection for the entire duretion of the work until the completion of the same. � 3,� . � ��'� +� "";` .� ,� � &;� i.F, � i�,.:� .s#?.. :,�: � The Certificate of Occupancy will not 6e issued until all applicable signaWres by the Bwlding and Fre Offiaals are provided on this,permit � �` . [( �.,t ., y� e s� .. :: , - , .� ; y x a .� ' _ ..�n,�' r ' `. �; �.. : �-{�C $k: 172775 "Persons conhec6ng�with unregistered coNracrors do not have access to the guaranty Fund"(as set(orth in MGL c.142A). - - 't, � i. � x � �-.� Restrictions: � � `"" ` .. ,.a, .:.�,., . ...,. Building plans are to be available on site. 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