10-12 FIRST ST - BUILDING INSPECTION (3) (\j The Commonwealth of Massachusetts
y Department of Public Safet�Ib OCT 20 A 1 13
Massachusetts State Building Code(780 CMR)
17 iv Building Permit Application for any Building other than a One-or Two-Family Dwelling
(Thus Section For Official Use Only)
1 Building Permit Number. Date Applied: Building Official:
SECTION I:LOCATION(Please indicate Block tf and Lot S for locations for which a street address is not available)
10-12 First Street Salem,MA Pequot Highland Apts.
No.and Street City/Town Zip Code Name of Building(if applicable)
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 Building.x Repair. Alteration x I Addition I 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? Ye .X No
Is an Independent Structural Engineering Peer Review required? Yes . No X
Brief Description of Proposed Work-
Moderate renovation to 250 units,with improvements to include; new kitchens cabinets bathroom fixtures
interior finishes(paint/flooring),windows,updated FACP,updated elevators,new roof.
Exterior work includes brick removal with facade replacement,parking,and ADA access improvements
SECTION 3:COMPLETE THIS SECTION IF EMSTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed Pee 780 CMR 34) J3
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.) 12 H.Pt No Change
Total Area(sq ft)and Total Height(ft.) 237,700 1 129 No Cbange
SECTION 5:USE GROUP(Check as a licable)
A. Assembly A-1. A-2. Nightclub A-3 . A 4 AS B: Business . & Educational .
F. F F-1. F2. H: Hi Hared H-1, H-2. H3 . H-4. H-5.
L Institutional I-1. I-2. 1-3 14, M. Mercantile. R: Residential R-1 R-2.X R3. R-4,
S: Storage S-1. S-2 U. Utility Special Use. and please describe below:
Special Use:
SECTION&CONSTRUCTION TYPE(Check as applicable)
IA IZ IB .n a O DIB 10 13 11113 ® 1 IV 0 1 VA .0 VB DO
SECTION 7,SITE INFORMATION(refer to 780 CUR M.0 for details on each item)
Water Supply, Flood Zone Information Sewage Disposal• Trench Permit: Debris Removal:
Public x Clerk if outside Flood Zone x Indicate municipal x A trench will not be Licensed Disposal Site.
Private. or indentify Zone: or on site system required x or trench or specify:
permit is enclosed
Railroad right-of-way: Hazards to Air Navigation MA Historic Commission Review Process:
Not Applicable.x Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed. Yes or No X Yes. No .x
SECTION&CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: 81h Use Group(s): r-2 Type of Construction IA Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
1rl\1e-s NI P. 51:n 5 0Y% (P fxw) -.5
SECTION 9. PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Pequot-Salem Limited Partnership 33 Silver Street,Suite 200 Portland,ME 04101
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Chris Poulin,Manager 207_ 780 - 9800 ext 1 cpoulin@thesilverstreetgroup.com
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
Eric M.Clory 25 Braintree Office Park Suite 200 Braintree MA 02184
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 perm't application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
building is less than 35AM cu.ft of enclosed space and or not under Construction Comrol then check here Cl and s1dp Section 10.1
10.1 Registered Professional Responsible for Construction Control
The Architechual Team,Inc 617_ 889 _ 4402 ( N3 t N�L #31191
Name(Registrant) Telephone No. e-mail address Registration Number
50 CotnmmdanYa Way Chelsea MA 02150 Arch 8/31/17
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Port Harbor Construction,Inc.
Company Name
Eric M.Clory CS-059357 Unrestricted 'EX P $I I b 16
Name of Person Responsible for Construction License No. and Type if Applicable
25 Braintree Office Park,Suite 200 Braintree MA 02184
Street Address City/Town State Zip
7-Ml- My
Telephone No.(business) Telephone No. cell e-mail address
SECTION 11:WORKERS;COMPENSATION INSURANCE AFFIDAVIT .G.L.c.152.§25C
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes W No D
SECTION 12.CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materiels) Total Construction Cost(from Item 6)_$ 17,247,000
1.Building $ 14,797,200 1000
Building Permit Fee=Total Construction x_ here
2.Electrical $ 636,800 appropriate municipal factor) 189 717,
3.Plumbing $ 423,000
4.Mechanical (HVAC) $ 400,000 Note:Minimum fee=$ (contact municipality)
5.Mechanical Other ev. $ 990 000
Enclose check payable to
6.Total Cost $ 17,247,000 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entelLng in name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
a is a and accurate to the best of my knowledge and understanding.
Eric M.Clory President 617. 291 _ 1988
Please print and sign a Title Telephone No. Date
25 Braintree Hill Office Park Braintree,MA 02184
Street Address City/Town State Zip
Municipal Inspector to fill out this section upon application approval• ''°t° .+ - 2
Name Date
CM OF SM EN17 NILAISSACHL'SE17S
• Bc1 DIING DEP I ME.NT
120 WASHINGTON STRUT,r FLOOR
I'EL (978)73S-9595
FAX(978)740-9846
KIMBFRi RY DRISCOLL
'MAYOR THoms ST.Pmm
DiRECrOP OF PC BLIC PROPERTY/Bt:t MNi3 CO3,04ISSiONER
Workers' Compensation insurance Affidavit: BuilderslGoutraet4rslEtectr-icianvPlambers
Applicant Information Pies 319 Legibly.
Name(BusincssiOrpoiratio,vindividual):. Port Harbor Construction,Inc
Address: 25 Braintree Hill Office Park,State 200
Cityl$tatc/zip: Braintree,MA 02184 Phone#:
Are you an employer?Check the appropriate box: Type ofpiroJect(required;
I.0 1 am a employer with 4. [3 1 am a general contractor and 1 6. (,}New construction
employees(full and/or part-timey* have hired the sub-contractors
2.0 I am a sole proprietor or partner- listed on the attached sheet.t 7- ( Remodeling
ship and have no employees These sub-comeactors have S. 0 Demolition
working for me in any capacity; workers'comps insurance: 9. 0 Building addition
]No workers'comp,insurance 5. 0 we are a corporation and its 10.0 Electrical errs or additions
officers have exercised their �
3.0 1 am a homeowner doing all work right of exemption per MGL I LEI Plumbing repair*or additions
myself,(No workers'comp. c.1522,§1(4);and we have no 12.0 Roof repairs
insurance required:)t employees.(A'o workers'
comp.insumance required.] 13.0 Qther
•Any urpgeaathar ehacka�dt moat slap nor aatiae seetioo bcio+v�howi�tta+irvmrkm'tntttprnaation iwlieyxtfotmation.
•Ih+menwnrq who$uhwnthis 901 *ya indicating(I"an;doing all work and tharhko amide conadon;mast slaps a new Aft wit i dicoing wah.
fiummtius dtm dtsh tha hmr must anxttof an additmno stmsshowing des t>mne of ran A&ftwactortaid their s odcna':ox"P.Pokyidwaotion.:
law an emph yartb'atls pieviding workeii,eompeasadon tnaara+uejor my empooyee Below tr the ptrffry and fob rlM'
information
Insurance Company:Name: ACE Group
Policy 4 or Self-irts:Lie,It: 6S62UB-2E14064-5-16 3-31-17
Expiration Date-
Job Site Arkkess: 10-12 First Street Ciry/State/Zip= Salem,MA
Attach*copy of the workers'comp*rttattoa Policydeedar*ttm page(showing the pollgy outabor and eiphr d on dsht]
Failure to secure coverage as required under Section 25A of MGL a 152 can lead to the imposition of criminal penalties of
fine up to S1,500.00 anldor one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine
of up to 5256.t0 a day against the viotator. ac advised that a iwpy of this statement tray be'forwarded to the office of
Investigations of the DIA for insurance coverage verification.
f do hereby r n fat nod nntttes n pe fpsrJury that the fufarmatlercpraeWdd cbave is trus and earns&
Ir' Paw,.
�d 1S 16
Elleny It,
Ojflciol uwas* An net write fn Wr area to be eonoeted by ci(y or,town offieW
City or Town. PermidLicenseA'
Issuing Authority(circle one):
1. Board of Ilealth 2.Building department 3.City/Town Clerk 4,Electrical inspector 5.Plumbing Inspector
6.Other
Contact Persodt Phone
CITY OF SsUE"N1, L sS.�CHU'SETTS
` BLUMUNiG DEP.MM.tE�1i T
130WASHINGTON STREET, 3m FLOOR
TEL (978) 745,9595
FA.t(978) 740-9W
KINfBERLEY DRISCOLI.
MAYOR Tkom 5 ST.Pmm
DIREGMROF PUBLIC PROMry/BE:B,omaco%t,,%mstoN.Fx
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In,accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit# is issued with the condition that the debris resulting fmm
this work shall,be disposed of in a properly licensed waste disposril facility As defined by MGL c
1.11;S 150A.
The debris will be transported by:
Republic Services,Inc
(name ofbauler)
The debris will be disposed of in :
TBD
(name of facility)
(address of facility)
signature of permit aWlIcant
dale
,JebnsjITd(x
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the 81b edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Pequot Highlands Date:9/30/16
Property Address: 10-12 First Street, Salem,MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description:Moderate rehabilitation of existing apartment building.
I Michael D. Binette MA Registration Number: 31191 Expiration date: 8/31/2017 ,am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans, computations and specifications
concerning':
X Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge,information,and belief such plans, computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted
engineering practices for the proposed project. I understand and agree that I (or my designee) shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports (see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work,I shall submit to the building official a'Final Construction Control Document'.
AA
Enter Enter in the space to the right a"wet"or ,�5�aE D ED qr—,
electronic signature and seal: ¢��\o�pE A�na
j 1 No.31191
$ CHELSEA k ►
MA
Phone number: 617.889.4402 Email: mbinette@architecturalteam.com Gl TEP m
r
tr
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an'x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,
provide a description.
Version 06 11 2013
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the 8' edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Pequot Highlands Date:9/29/16
Property Address: 10-12 First Street, Salem,MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description: Moderate rehabilitation of existing apartment buildings.
I Richard Melling,MA Registration Number: 45062 Expiration date: 6/30/18,am a registered design professional, and I
have prepared or directly supervised the preparation of all design plans,computations and specifications concerning':
Architectural Structural X Mechanical
X Fire Protection X Electrical Other:
for the above named project and that to the best of my knowledge, information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review,for conformance to this code and the design concept,shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work, I shall submit to the building official a `Final Construction Control Document'.
VA s4
Enter in the space to the right a"wet"or m�
electronic signature and seal: o a r
MELLING
MECHANICAL
No.43062
Phone number: 919-810-3851 Email: retelling@mellingengineering.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised. If`other'is chosen,
provide a description.
Version 06 11 2013
Initial Construction Control Document
tA
To be submitted with the building permit application by a
Registered Design Professional
for work per the 8d, edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Pequot Highlands Date:9/30/16
Property Address: 10-12 First Street, Salem,MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description: Moderate rehabilitation of existing apartment building.
I Michael D. Binette MA Registration Number: 31191 Expiration date: 8/31/2017 ,am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans,computations and specifications
concerning[:
X Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge,information,and belief such plans, computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official, I shall submit field/progress reports (see item 3.)together with pertinent
comments, in a form acceptable to the building official.
Upon completion of the work,I shall submit to the building official a `Final Construction Control Document'.
_✓AA
Enter in the space to the right a"wet"or `g✓SEAED Atic
electronic signature and seal:
1 N0.31191 m 1 j
t o CHELSEA k ►
A MA �Q Phone Jy-
number: 617.889.4402 Email: mbinette@architecturalteam.com
[r �
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If'other'is chosen,
provide a description.
Version 06 11 2013
Initial Construction Control Document
.Uf* To be submitted with the building permit application by a
Registered Design Professional
for work per the 8n'edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Pequot Highlands Date:9/29/16
Property Address: 10-12 First Street, Salem, MA
Project: Check(x)one or both as applicable: New construction X Existing Construction
Project description: Moderate rehabilitation of existing apartment buildings.
I Richard Melling,MA Registration Number: 45062 Expiration date: 6/30118 ,am a registered design professional, and I
have prepared or directly supervised the preparation of all design plans, computations and specifications concerning':
Architectural Structural X Mechanical
X Fire Protection X Electrical Other:
for the above named project and that to the best of my knowledge, information,and belief such plans,computations and
specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR),and accepted
engineering practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary
professional services and be present on the construction site on a regular and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings,samples and other submittals by the
contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and
quality of the work and to determine if the work is being performed in a manner consistent with the approved
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments, in a form acceptable to the building official
Upon completion of the work, I shall submit to the building official a`Final Construction Control Documen '.
N of
Enter in the space to the right a"wet"or
electronic signature and seal: Ic aD A.
MELLING
MECHANICAL
No.45M
�ortrt�°
Phone number: 919-810-3851 Email: rmelling@mellingengineering.com �
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen,
provide a description.
Version 06 11 2013
Bank of Malne 1127
SILVER STREET DEVELOPMENT VIII, LLC The Portland,ME
33 Silver Street,Suite 200 - ----- - - --
Portland,ME 04101
207-780-9800 e2-7246/2112 10/18/2016
PAYTO THE CitySalem
ORDER OF of $ **189,717.00
0
One Hundred Eighty-Nine Thousand Seven Hundred Seventeen and 00/100`********* ********`****"'**********" • -
DOLLARS
City of Salem
n
8
w rif
MEMO __,�._— _._.._.__—..___NP.
Pe not
�6AUTHDRIZED SIGNATURE
'°F:o*° _
112001127w• 1: 211272465f: 000 ?012993711e
SILVER STREET DEVELOPMENT VIII, LLC 1127
City of Salem 10/18/2016
permit fees 189,717.00
Camden (formerly TB Pequot 189,717.00