6 FLYNN ST - BUILDING INSPECTION (2) C(� /S3d-
-PLAM MUST-BE fiL{-B-ifJ ;APPROVED BY THE
W5P,XTD13 ,PFWR Tp'A.PERMIT 13FJNG GRANTED
CITY OF SALEM
No. \. Date 9 a y a
Is Property Located in 1! Location of / n
the Historic District? Yes_No /_\ Building
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) (Lool Reroo0nj all Si ' Cgnstryct Deck, Shed, Pool,
Repair/Replace O`t Je
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:
Owner's Name C{1a/D' 13 PaU/'A cl a
Address & Phone b r/vg/!
Architect's Name
Address & Phone L )
Mechanics Name
Address & Phone r/T y�/+�l /(/%�(y (177$ )
What is the purpose of building?
Material of building? �/DD//� If a dwelling, for how many families?
Will building co form to law? ��� S Asbestos? / / (/
tt
Estimated cos J City License# N A State License #
Home Improvement `
/ Lic. i
Signature o Applical t
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
Coll AaYK
MAIL PERMIT TO:
No� �
APPLICATION FOR
PERMIT TO
LOCATION
h
PERMIT GRANTED
/oL9 to 2f3r
APPR D
! ,
INSPECTOR OK BUILDINGS
SCvP` vF_ vJoRK _ . _ - - - - - - - - - - - - - - - - - - - - - - - - - - I
DOUBLE HUNG UNIT
n tJ rl3r avA by any ottise � [Ell �
In
VINYL SIDING
N[F^Sa �TTiTJ 9 I TYPICAL
- . ...... ...V.r!� .r. ,;Cp...Ci'TO A — — — —
NCE IT THEI.i^P;CODEi�,FOP,CCivir�.ieCOPdPIF I �
ONCE WITh!THE.'-IRE CODE.
F[lK A k-Y.a I EX I.STI N �ST L�Vti L
0
3(o - oll
� �_ _ C, FrRI
� 0 Ye L 14
QQ
BED RW"
STU DY 13'(D" 12 12'- (o '
>3�TN
QED R�bM '�
13EDRbOM DOWN ly '_ O" )(
tun LEVEL FLOOR TLNKI
Z "° L E V E-L A
�o OF SALEM, MASSACMuDC 1 I
PUBLIC PROPERTY DEPARTMENT
12 o WASHINGTON STREET, 3RD FLOOR
< SALI M,MA 01970
TEL. (978)745-9595 EXT.380
' pp FAX (976) 740-9846 -
;TANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,S34,I acknowledge that as a condition
of Building Permit# all debris resulting from the construction activity
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL c III,S150A
The debris will be disposed of at: 7 /��C S��/
Location of Facility
Signature o Permit pplicant Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
Firm Name,if any
r1_ l qi Sd bf� �
Address, City & State
The above statute requires that debris from the demolition,renovation,rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cM, S 150A, and the building permits or licenses are to
indicate the location of the facility.
CITY OF SALEM
BUII DING DEPARTMENT
Mh EOWNER LICENSE EXEMPTION
Please PAM
DATE
JOB LOCATION 5�/ems
HOME.". fiI�ln sT
ADDRESS
Howow ER
TELEPHONE
PRESENT MAILING ADDRESS
The sorts exemption of"homeowners"was cncrded to include owoeroeeupied dwcMev of TWO
Units or less and to allow such homeowners to engage an individual for hire who does TO possm a
limnse,.provided that the owner act as supervisor.
DEFRIITION OF H0I4EOWNEk
Person(s)who owns a pm=l of land on which hrJshc resides or intends to reside,on which that K or is
intended to be,a out to two family dwelling,attached or coated str=wcs axessoq'to taxh rase andlar
farm strucwm A person who construm more than om home in a two-year period shall mt be considered
a homeowner. Such"honacowtcf shall submit to the Boding Official,on s form seer? bk m 00
Building Off ewl,that bcJshc lx rssponstblc to all stub work paforcaed under the building permh.
The hmdusigned'homeowner"ammha responsibility for compliance with the State Building Code hind
other appksblc goes bylaws,TWes and tcguladomt.
The tmdasignc�d"homeowner certifies that hdshe undmm ds the City of Salem Boding Dcparoaat.
n=mtun mspccuon procedures and regmrernents that hl wt co with said ptomdum sad
regWr=ocntL
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING INSPECTOR �' c
See other side for start code
HOMEOWNER'S EXEMPTION
The code states that "aT homeowner performing work for which a building permit is required shO be
exempt from the provisions of this stction (Section AIM Licensing of Construction Supervisors);
provided tbat is a homeowner engages a person(s)for Wm to do.such work,that such bomeowner shall act
as SupervtSWr"
Many homeowrmn wbo use this cxcrpdoa are unaware that lhcy an asstrtnutg the sespoattbMdft of a
yup SOT(ace Appendix Q,Ruics and Regulations for Licensing Construction Supervisors,Seetia�
2.15} This lack of awarcnas often results in serious problems,particularly when the bomeowaer Litt{
unlicensed persom in this ease your Board cannot proceed against the nnlitzaged person as It wvttld with
licensed Sticnisor. 7Le bomeoever acting as supervisor is uhimately respousibIL
To ensure that the homeowner is fully aware of hM=retiponsib"'ties,marry emnmur"es requae:as part
of the permit application,that the homeowner otnify that helshe understands the responsibilities at
super.•ism. You may care to amend and adopt such a fumvocrtifreation for use in your eommuck.
JUL-31-2003 THU 03:00 PM C. L. PLUNKETT PC. FAX NO. 1 978 744 5577 P. 02/02
MORTGAGE INSPECTION
BAY STATE SURVEYING ASSOCIATES INC. JOB #
100 CUMMINGS CENTER, SUITE At 316J, BEVERLY,MA., 01915 ! /7
LOCATION :.:? E NOTES:
1)Thls Is■mortgage Inspection survey and not an
SCALE • 1 s LO/ BATE 9-p Instrument survey,therefore this plot plan Is far
mortgage Inspection purposes only.
2)This survey le based on survey marks of others,
REFERENCE : .4tri-S. 01L!. ..SILL............. 31 gushes,shrubs,fences and tree lines do not
,.FS EX so✓7• ... !.%.TP I r-7- � necessarily Indicate prop"from
••Ri(.I STD{ q OF D 5 d)whenever an offset Is V a.or lass,an Instrument
E'...................... survey Is recommended to determine property
lines.and an
TO:.....E� �TER..�1L aflNK ypaadblaeneroachmenls.
TDre locatlon of the building(s)as shovm,either 8)Offsets shown are spproxtmnria,and are to he
compiled with the Jowl coning sethacka at the time of used only for the determination of zoning.Not to
construction or Is exempt from violation enfore n used to establish property lines.
under Mass,O.L Title Vg c tr1emt action III at ProfessionalInhe Spec opinion the hazard
zone,
as
an not
Chapter 4tlA Bedlam 7 looted In the special good harard zone,as
4:7:n.d by ILUA MAPM
LoT A4
LoT '1y
LOT
1.oT g
r - - �
� •�Cw�1gi�1�eC''
L_ J
FLYNN ST
(U 0 1 of Salem, Massachusetts
"ire Departwnt
484fayetteStreet 29 Fort Ave.
Robert'PV Turner Salem, Massachusetts 01970-3695 ire Prevention
Chief 'reL 978-744-1235
17 Bureau
978-744.699
FaX 97&745-4646 978-745-7777
FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE
AND THE SALE4 FIRE CODE, APPLICATION IS HEREBY MADE FOR THE APPROVAL OF PLANS
' AND THE ISSUANCE OF A CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT BY THE
SALEM FIRE DEPARTMENT. ( Ref. Section 113.3 of the Mass. Bldg. Code)
F JOB LOCATION:
OWNER/OCCUPANT: cJ�wrt/ 1-
k ELECTRICAL CONTRACTOR: �+�c� y f L<> • '1
I
, . FIRE SUPPRESSION CONTRACTOR:
� SIGNATURE OF ) _
APPLICANT: / PHONEADDSS OF
(( R
APPLICANT: Cp . F 1 t2�n . S CITY OT
( TOWN: ��C /rol« /�/�T •h
' APPROVAL DATE: 4C� o�C Ov 3 c
Certificate of approval is 'hereby granted.'°on approved plans or submittal of a,
project details, by the SALEM FIRE DEPARTMENT. All plane are-approved solely ,
for identification of type and location of fire protection devices and equipment
All plans are subject to approval of any other authority having jurisdiction.,, ;
i > Upon completion, the applicant or iustaller(s)' shall request an inspection and/or "
test of the fire protection devices and equipment. "(ADDITTIONAL REQUIREMENTS,
9 _ SEE. REVERSE SIDE
Q NEV CONSTRUCTION.
PROPERTY LOCATION HAS NO COMPLIANCE WITH THE PROVISIONS OF
� . CHAPTER 148, SECTION 26 CIE, M.G.L. , RELATIVE TO THE INSTALA-
TION OF APPROVED FIRE ALARM DEVICES. THE OWNER OF THIS PRO-
PERTY IS REQUIRED TO OBTAIN COMPLIANCE AS A CONDITION OF
OBTAINING A BUILDING PERMIT.
PROPERTY LOCATION IS IN COMPLIACCE WITH THE PROVISION OF CHAPTER
148, SECTION 26 C/E. M.G.L.
EXPIRATION DATE: %
SIGNATURE OF FIRE OFFICIAI.
7L" 'i[N. : LR±DER 7,500 SQ. 'FT. FOR•? ' ` '•; 3/93
30.90
500 SQ. FT. OR LARGFIR $50.00 —L 3 3
CHECK#
i
In compliance with the provision of Section 113.5 of the Massachusetts
State Building Code, and 'urder, guidelines agreed upon by the Salem Bldg.
Inspector and the Salem Fire Chief, the applicant for a building permit
shall obtain the Certificate of Approval (see reverse side) and stamped
plan approval from the Salem Fire Prevention Bureau.
Said application and approval is required before a building permit may be
issued. The Massachusetts State Building Code requires compliance
approval of the Salem Fire Department, with reference to provisions of
Articles d and 12 of the u'B ildin Code the Salem Fir
g , e Code, Massachusetts I
General Laws, and 527 Code of Massachusetts Regulations. (�
The applicant shall submit this application with three (3) sets of plans,
drawn in sufficient clarity, to obtain' stamped approval of the Salem Fire '
Department. This applies for all new construction, substantial .
alterations, change of use and/or occupancy, and and other approvals
required by the Massachusetts General Laws, and the, Salem Fire Code. ^
Exception: Plans will not be required for structural work when the
proposed work to be performed under the building permit will
Qot, ' in the opinion of the Building Inspector, require a
plan to show the nature and character of the work to be
performed.
Sotice: Plans are normally required for fire suppression systems,' .
fire alarm systems, tank installations, and Fire Code
requirements. - e,
Under the provisions. of Article 22 of the Massachusetts State Building
Code, certain proposed projects may not require;submission'of plans or.,.
{ complete compliance with new construction requirements. .,In these-
cases, provisions of Article 22, Appendix T,' and Tables applicable
shall apply. This section shall not, however, supersede the ,-
provisions outlined in the Salem Fire, Prevention Regulations,; Chapter �,�"'
148, NGL, or, 527 Code of Massachusetts Begulations. y Al1'permits forFI
fire code use and/or occupancy shall 'apply for the entire structure;." "
fire alarm and/or smoke detector 'instal lat ion shall apply to thoc
entire structure based upon current requirements 'as per, Laws and/or-
Codes, but the existing• atructure may comply with regulations
applicable for existing structures.
Notice: Sub-contractors may also be required to file individual
applications for a Fire Department Certificate of Approval
for the area of their work. Such sub-contractors shall file
an Application to Install with the Fire pretiention Bureau
prior to commencing any work for those areas applicable,
i
P`C:?l #81 R iA'. H,p)i