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54 FORRESTER ST - BUILDING INSPECTION (3)
3-7.3 S CE N RVIGES. The Commonwealth of Massachusetts *" ' II Department of Public Safetyq y 21 P Massachusetts State Building Code(780i lRr Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only). Building Permit Number: Date Applied: Building Official: SECTION 1: LOCATION(Please indicate Block k and Lot N for locations for which a street address is not available) �1( ryPS�en Sr 5/+-lem . MA No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2 PROPOSED WORK Edition of Mr\State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building Cl Repair❑ 1 Alteration ❑ 1 Addition❑ 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? Yes ❑ No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work: re MOVe 2ha, d- 3r 6 F(e Al- P61C.f,. 0o1GlNo-. r11 �veSS✓re ;rtpzfad dec1cg 0-4 +-LleeaLcn' r snroe f�ensronc� 5 2` �mStnv�iwn.t cet-wn-F T'¢Yri• �7 i SECTION 3:COMPLETETHIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR _ CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ 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.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) - A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-1❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: F[i h Huard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional [-1❑ 1-2❑ I-3❑ [4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑ S: Storage 5-1❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) L\ ❑ IB ❑ IIA ❑ 1113 ❑ IIIA ❑ 111613 1 I•V ❑ 1 VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check if outside Flail Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑ Private❑ ,or indentify Zone: or on site system❑ required❑or trench or specify: .•�. . :�• permit is enclosed❑ - Railroad right-of-way: Hazards fo Air Navigation: %1A I fi tr n Comlmissi n i e,ww Pro, : Not Applicable Cl' Is Structure within airport approach area? Is their review completed?, or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No Cl "a ` SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: Goa L-4— 9-PM 'FOK- P , Cry- 1- 0 51 za°'�, A.Aure�d.�_ SECTION 9: PROPERTY OWNER AUTHORIZATION Name❑od A�ilFl_etis'o�Pkro t,rty°e0iv"ncr �H4a,y1Y.^,15�Qar- v p,Ifly Name(Prili o -S q rs No.and Street City/Town Zip Property Owner Contact Inf rn $np'sl tnlah W7-1 Elsa 9 �a9 �G3s Title Telephone No.(business) Telephone No. (cell) a-mail address If ap lica le,the property owner hereby authorizes Name Street Address City/Town State Zip to act on tine roper owner's behalf,in all matters relative to work authorized by this buildup 'erntit application. SECTION ID:CONSTRUCTION CONTROL(Please fill out Appendix 2) (If building is less than 35,000 cu.ft.of enclosed space and/or not tinder Construction Control then check here❑and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor _ k1j 12ume 9104 Company Na e S r Res on ible for Construction License No. and if Applicable T Name of Perscr r p Y Street Address City/ �own � State Zip Telephone No.(business) Telephone No. cell e-mail address SECTION 11:IVORKFR9'CORIPFNSAIION INSUPANCE AFFIDAVIT M.G.L.c.152.§25C 6 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❑ No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=S 1.Building S Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)=$ 3. Plumbing $ .1. Mechanical (HVAC) $ Note: Minimum fee=S (contact municipality) 5. Mechanical Other $ Enclose check payable to 6.Total Cost S 6 (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my 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 bes of my knowledge and understanding. JIM Oil t (AIM& MZ�,A j94 4� Please p fat and sign ti;fM1r inn Title Telephone No. Date Street Address City/ uuvn State Zip . Municipal Inspector to fill out this section upon application approval: 7 Name Date Office of Consumer Affairs and gusiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement (Z ctor Registration Registration: 161483 V1C-' �,F"—' 7 Type: DBA 141 "" _ (" Expiration: 10/23/2014 Tr# 233057 RYAN PROPERTY MAINTENANCE -5 3: JAMES RYAN 4 NEW HAMPSHIRE AVE. BRADFORD, MA 01835 \; J/ Update Address and return card.Mark reason for change. DPS-CA1 0 50M-04/04-0101216 Address Renewal Employment Lost Card � Office Vromer°""A(`a s&"BJinesR guhtiuo License or registration valid for individul use only VHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration 161483 Type: Office of Consumer Affairs and Business Regulation Expiration: 10/23/2014 DBA 10 Park Plaza-Suite 5170 r-; Boston,MA 02116 OPERTY MAINTENANCE:/ JAMES RYAN 4 NEW HAMPSHIRE;AVEI Y BRADFORD, MA 01835 r Undersecretary Not valid witho t signature 7RYAN etts - Department of Public Safety ulations and Standards jAMNIES uilding Regruction Supcn isornse: CS-079214e 0385$ �''r ,� „��` Expiration M ,, ��` 06/0?12ommissioner I,2 � fo II 5 -_ - - - � IF � - CITY OF ScU.EM, iNLNSSACHUSETTS t BUILDING DEPARTME-NT 120 WASHINGTON STREET, 3'u FLOOR T EL (978) 745-9595 Fox(978) 740-98.36 Kl\tBERLEY DRISCOLL ANYOR THowLs STTIERM DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER 1Yorkers' Compensation Insurance Affidavit: Builders/Contractorv/Electricians/Plumbers Applicant Information f�'^ p n Please Print Leeibly Name(Ilusinass Orgmiralinn'Individual): P V ` 1 J r / r ' 1 es /g{ P64 I - � � r Address: oti IIsLQA -i I A.Vke- City/State/Zip: A)' l4• Phone 11: !'7$ ']90 SI O O Are you an employer!Check the appropriate box: 'Type of project(required): L❑ 1 am a employer with 4, ❑ I am a general contractor and I 6. ❑New construction employees(full and/or pan-time).• have hired the sub-contractors 2.❑ I rim a sole proprietor or partner- listed on the uttached,rhect.; 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers'comp. insurance. 9. ❑ Building addition ,[No workers'comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I,❑ Plumbing repairs or udditions myself, (No workers'sump. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.) t employees. (No workers' cmnp. insurance required.) 13.❑ Other •Any upplteant our ellecks ho l AI must also rill out ilia section below showing their wockca'cumpenemiun policy inlii matiun. '1 lumeuwnen who uhn,it this amdavit indicating they am doing all work and then hire outside camneton most suhmil anew afrdaviI indicating such, :(•'nnmaton thug chink this box mtut all jelled in addoiurul ahein showing the nine ofthe subtomneton and their workers'comp.policy information. I ant an employer that Is providing Ivorkers'compensation fnxurance for my employees. Below is the policy and fob site information. II Insurance Company Nmne: Puficy Bur Self-ins. Lie. 0: r�C �31S 3.57 60'F3 Expiration Date: Job Site Address: _3--t I-orirIP 4 ST City/State/Zip: SeleN Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). h'ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a tine up(o S 1,500.00 und/or one-year imprisonment.as well as civil penalties in the form of a STOP WORK ORDER and a line Of up to S250.00 a day against the violator. Be advised that a copy of this statement may be I-unvarded to the Office of Invrstigatiunx ul'the MA for insurance coverage verification. I do hereby c•ertif rider ate is mid penalliev of perjury that the information provided above is true and correct. Uatc� Phone Y' Official use unly. Du not writ f e hr this area, tube completed by city ur town gjirciut City at mvn: _ — Pcrmit(Licensc N L+suing Authority (circle one): 1. Board of lleallh 2- Building Departm¢ttt .1.Cttylrown Clerk 4. Electrical luspcctur 5. Plumbing luspccror [.Other Con(act I'crson:_ Phone It: CITY UE SiV.ryyt N L1SS.1C H US ETTS ©UILOLNG DEPARTN NT Syr' 120 WA3HLYGTON STREET, 3'0 FLOOR ^� T EL (978) 745-9595 Rux(978) TW-98M Kl3lBEt2L.EY DRISCOLL ,bLAy0a Trt0.%vuST.PMR112 DIRECTOR OF PCBLIC PROPERTY/aL:MDLNG C0JaII55tONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) 1n accordance with the sixth edition of the State Building Code, 730 CMR section l l 1.5 Debris, mid the provisions of NIGL c 40, S 54; Building Permit !t is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by t�IGL c l l 1, S 150A. The debris will.be transported by: bunts at hauler) The debris will be disposed of in ame at t (n F edify) (� - resso 'Licility) i v naturaafpermi a li PP pant Evernote Web https://www.evemote.com/Home.action i Untitled Tuesday, May 13 2014, 9:48 AM Linda Nolan RE: 54 Forrester St. Salem, Ma. April 27, 2014. Work proposed: Pull permits for the following work Temporarily support roof overhang at top of right side decks Remove 2nd and 3rd floor porches and vertical posts Install new pressure treated decks, railings and vertical posts with similar dimensional lumber, using the original cement tiers Install all necessary flashing and joisthangers Remove all debris Stock and labor: $6800 Note: The floor joists would run perpendicular to the house. (Opposite direction that they are going in now.) They will not match the other side when you look up at them. Structurally they would be better. Let me know if that is a problem. list payment : 1 third at signing 2nd payment: 1 third at half completion (Boxes rough framed and joists laid) 3rd p Vment at mpletion Jim Ryan RPM 2 Laura Lane Newton, NH 03858 1-978-790-5100 F-1603-974-1679 E-jryanrpm@comcast.net I of 1 5/13/2014 9:50 AM }4r- CITY OE S:�„t, >tiL15S:1CHUSETTS t BL=LNG DEPAM. NT ` 120 WASHLNGTON STREET, 3'FLOOR C,X T EL (973) 745-9595 Rkx(978) 7.10-9844 I<l1tBERL.EY Dti7SCOLL. ,bLAYO;a T1-10.%Lu ST.PmW DIRECTOR OF PUBLIC PROPERTY/BCiLDLNG CONNISSIONER Construction Debris Disposal Arfidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 730 CNJR section 111.5 Debris, and die provisions of NIGL e 40, S 54; Building Permit k is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by t�iGL c 111, S 150A. The debris will be transported by: y y (name oClmulur) The ticbris will be disposed of in — (nameoeracday) —_—_—(aJdres.tot'titcility) i siynatureafpermitappGcmtt — J.uc --