0038 FLINT STREET - BPA-13-234 I'lie C•onnnonwealih uf';bl:us:I huscRs
Ihiard of IluiWing Reg ;mi .' CI IT
S SIauJ: 1 D'
S trJs F
khls"ehu xtts Srttc Building CuJc.'7S0('M1iR S.\LI:.\i
Building Permit Application TO C'ons(ruct, Repair. Renovate Or Demolish a
(Ire-urTnu-fiunlll Du'ellin.y
this Section For 0 ieial se oni
Building Permit Number: Date pplied:
4 /Iluddmy 011lctul IPnnt N;une) Signature
Ualc
SECTION I: SITE INFORAIA ON
t ry A jTn C:5j 1.2 Assessorso ap ft el Numbers
Via Is this an acre ted street? es no Map Number Purcel Nuuther
I.J Zoning Informatlont 1.4 Property Dlmenslonsl
Loniny District I'ntposcd(l.se Lut An:a(s IT)—4Pronl clu(11)
I.! Building Setbacks(R)
From Yard Provided
Yunls
Reyuircd Provided Rear Yard
Reyuircd . Provided Reyuind Provided
1.6 Water Supply:(M.G.I.c.40. §Sa) IJ Flood Zone Information:
Ihrbllc❑
Zone: Outside Flocd Lun*I i.tl Sewage Disposal System:
Priratu❑
Check(r cs0 Municipal 0 On site dispusul s)stem ❑
SECTION2: PROPERTY OWNERSHIPI
—Owner'of Rec�: AM
_s_1LJX_L h� []fin �i' ,1 /Vy l
Munc(Print)
Nu.unJ Street Pule hung
P Emuil Addn:ss
SECTION Jt DESCRIPTION OF PROPOSED%VORKs(check that apply)
New Construction❑ Existing Building❑ Owner•Oceupied ❑ Repairsls) Alteradon(s) ❑ Addition ❑
Demolition ❑ Accessary Bldy.❑ Number of Units_ Other 0 .Spcci)y:
BriefOescriptionofProposed Work':
SECTION y: ESTI;MATED C INSTRUCTiON COSTS
Item Estimated Costs:
11.ahor and.Mmerials) Omclui Use Only
I. Building Sa QS— I. Building Permit fee: S Indicate how tee is determined:
2. Electrical S ❑Standard Ciry:Tossn Application Fee
v7U0 S ❑Total Project Cost'i Item 6)x multiplier
I s Plumbing
1. Other Fees: S
). \Icch.mic.tl ill\ \('I j List: _ J�
Vcchanicul illru _ _— ----- — l•,/
I Cu Ve5)IUn) j tUlal \II Fees: S
I'mil l'rnjeet Cn,t: jOa7 6�� (lied \'u. _< hccA .\uwunt: l'.uh \mom t:
0 P.iiJ m Full ❑Oulslanding 11.11.mce Doc:
r t
SE("I'IUN S; ('ONSFRIIC ION Si RN 1('F:.0
S.1 Cunstructiun Su Ica isur License(CSI•k p„i ,uiau I .ne
1 iceu,c hun,hur I
Nwne ol'l'SI. I ldder I ,N l'SL I')psr l.ee bclual.__._
p l _ - _._._. -- - '11fX Description
l� l J \-�_.S��i7.__ .
N'In.lid Street it 11nrestrict A I Bit I in f li la 14,010 al. It.I
Rlasoll eJ IS?F.unil I)ttcllin
V_�1L _ - \I llaiun
l'ipifarm.5law.Lll' RC µnsoin l'oscrin
µs Nllldnrl',etJ�ldlll
SF .S lid Fuel Ilurniny Appliances
I Insulation
•' �- (— 3_v�d3S� p Demolition
1'ele bona 14naiI;tJJrcas
ZG�� � �
3 2 Registered 11uma t rru4ronlet�tl\Contractor(IIIC) IIIC Reglatrdion Numlxr L%pirulion Dale
J °CACvvA S aid ,
III(.* oulpana Nanw or I Ill„Itu I. rani Nantu �
} tv\bl.__ 1� ,:mailuJJnxs
N tJ S wt -( -:OS oz _
C Tmle hone
Ci 'Town,State ZIP
INSURANCE AFFIDAVIT(M.G.L C. 1�1. 35C(
SECTION 61 WORKERS'COMPENSATION
Workers Compensation Insurance affidavit must be complebtuddanrd s emutedwith this application. Failure to provide
this atlldavit will result in the denial of the Issuance No g O
Signed Affidavit Attached? Yes ..........
SECTION 7al OWNER AUTHORIZATION TO BE C011IPLETED W HEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject property,hereby authorize
to act on my behalf,(n all molten relative to work authorized by this building permit application.
C.C. ,17AaC� �6l�/ -@-� Dale
Print Ur.nci s Nwne(Ewetru%ic Signature
SECTION M OWNER' OR AUTHORIZED AGENT DECLARATION
By entering Illy name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Dow
I'riut l)a nef's ur:\uduvinJ,\�ent's Nwna Ililecunnie Signau,rul
No'FES:
I nutOregistered inbherHume h11praving pcmentermit tCon r ctor IHIC) Progranll.o do his her own stork. n ill =olivner shave access to the arbitration uaclur
pmg,mntor guar.1yhfo aunt tin tin the Cuostructian Other
upers sor License information
an be found at
Program c'nrbelrlbwtJ at
1\'hen substantial Durk is pl:mncJ, pros ide the inf urination
inclVdi b g gma e. Iinished basement attics, decks or porch
� b
total flour nrca 1 ay. Il.l . --- Habitable room count
Groisliiing area lsy. 11.l .---_ -. . .. Nulnhcrol'hedruonls
\unlher ol'lireplaces .. _ Number of hall'h.uht till,her al t,adirvows . . - Nunlher of decks parches
I)pc of haVulg i),mm I'nclo,cd . ,,liters
I
11 pa rl'aad,ny quern
l'r d,ll 'ru�dil(a,l'
1 ..I'"I.11 Paged Srlt,aer fan Ll4e' ,Ill,\ he <uh,hlutcd ti,f..
pONDITA
5T �.
3 � �
Ae�IMIN6W
,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 J53r- 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 39 Flint Street
Name of Record Owner: Sheri Rosenzweig
Description of Work Proposed:
Replace all siding with Mabee white cedar super clear shingles stained Spruce Blue. Change trim over door to
l x 5. Add drip edge to bulkhead roof Install a double row ofshingles across the bottom of the front gable to
create a shadow line or install one course of diamond pattern shingles. Cut down bottom of bulkhead door and
seal edge. Change downspouts from square to round fluted Paint trim Tudor Ice.
Dated: _ Alert rust 20, 2012 SALEM H TOR[CAL O N
By:
The homeowner has the option not to commence the work (unless it lates 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.