31 FRONT ST - BUILDING INSPECTION 4 I +w
�� y O�CITY OF Sm1 E., NWSACHUSETTS
• BUILDING DEP A.ATNELNT
• 130 W.%.SHINGTQN STREET, 3"FLOOR
w,= , TEL (978) 745-9595
F.Vt(978) 740-9846
KIJtBERLEY DRISCOLL
T
;MAYOR Ho"ST.Pmna
DIRECTOR OF PUBLIC PROPERTY/BUILDING COSL\IISSIONER
APPLICATION FOR THE CONSTRUCTION, REPAu%REWVAYfCFK CHANGE IN USE OR
OCCUPANCY,OR DEMOLITION OF ANY BUILDING OR STRUCTURE
Thts Seed"for OUT
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.Perrn�Project. ,.
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Eati"f Projbd Debw Ns6t End:
Co rnents:
1.0 SITE 140RMATION
L.ocaum Name: BWkiing:
Property Address: 3/ T .5 252. 2.1, NEt.I G eBJ STQEC r
' /SS 4///.S�/n/GToiv sT2EET
AssessorsMaplBlock: 3¢ LoUParcek *OS ¢2S ¢2�
2.4 QM�N Rini I ORMATION
2.1 Owner of Land
Name: W,9-c///1y.7'o1/ 47' 4:;'Ee,B9, LLG
Address: G/o RC 6 L.LG
/7 IVALoo, 6-0/1'Cioo
sanJE2V/LGE IV,4 00143
Telephone: G/7_ 2S— 7817
2.2 Owner or lessee of building or struetn"
Name: Slime
Address:
Telephone:
3.0 AGENCY OR AUTHORITY AUTHORIZING CONSTRUCTION
Agency Name:
Address:
A r.Agency Project Number
.Project Manager Name: Tel•
rAddressm
NAL DESIGN SERVICES:.
Architect:
�O/1<f1G[7 LA/�'JA DeE Seal and Signahue
// COe�befl7� W/vE AR
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g4TN OFMpSg
Telephone: Go. -527-9o9a Fm 16o3-SZ7-9i9/
4.2 Registered Pm(esst4nat F.Agtneert. (u— adr>itlonal ah�a a and attach Oe appka$=)
Name s"l afld S
Address;.. / 19d7-41/7711 6 -
Po071;- at)7".�I, /✓// 0390/ of s
+A bG
JSN /9 SSOC/i9TE5 /i✓C a J FFOEY S.
c". AWROCKI r'
STRUCTURAL
No.34166
Telephone: Fax /003'¢3/-28// '�o *talslE�EO��e
FSSIONAI ENO
A ..g Responsibilty:- 5r2acrUzs•L EGir%E�2 �CmllJ
Name: Seal and.Signature' .
Address:
Telephone: Fax
Area of Responsibility:
Name: Seal and Signature
Address:
Telephone: Fax:
Area of responsibility:
r
NAL CONSTRUCTION SERVICES:
tractor
g���-y�p�✓T, n/f1 0 3ZZo
Telephone: ,0,3- .5-Z7--9o90 Fax: �03- Sz7- 9i9�
Responsible In Charge of Construction:
7.0 CONSTRUCTION DOCUMENTS -to be prepared by applicant
Item J as Applicable
7.1 Plans (Note 1 this page) Submitted Incomplete Nat R uired
7.1.1 Architectural
7.1.2 Foundation
7.1.3 Structural
7.1.4 Fire Suppression
7.1.5 Fire Alarm ►�
7.1.6 HVAC
7.1.7 Electrical
7.2 Specifications
7.3 Structural Peer Review
7.4 Structural Tests & Inspections
Program
7.5 Fire Protection Narrative Report
7.6 Existing Building Survey
7.7 Workers Compensation Insurance t/
7.6 Other Documents (Specify)
(Energy Narratives, etc.)
Note 1 Areas of Design or Construction for which Plans are not complete at the time of
this application must be identified herein. Work so identified must not be commenced until this
application has been amended and proposed construction has been approved by the
Department of Public Safety District Building Inspector having Jurisdiction.
8.0 COMPLETE THIS SECTION FOR NE�tV CONSTRUCTION ONLY
For Existing Buildings Proceed to.Section 9.0
Number of Stories above ' ,1 Number of Stories Below
Grade W Gnats D
Story Height s /4 Flogr Area Per Floor
M,6 3 Z /o,459,
Total Building Height . Tot*Building Area Above
above Grade 49 Gratis
Total Building depth below: Total Building Area Below'
Grade,- . .. Grade.. o
Brief Description of Proposed Work:
Con/S7QdG77on/ 0,4C /�- 4 SToey, Z4 uNi 7
PCB/OE�Ti�I 6rrJ/6O/A/6 4,117;V
4 T Ts/E Z FEZ_
PFifz P4-A'NS .AW9 AS � MKZ11rO�A0 /a y liF7�iSIZ. Of�
�"'�io• O d
83 USE GROUP AND CONSTRUCTION CLASSIFICATION.(Now Construction Only):
USS GRO W I* USE'G ,:ROU SU&CATEGQRY CONSTRUCTION
(� ag appllgble} ., as'applicatite
v . , CLASSIFICATION
A ., Assembly / -1 A 2 " /@ A=4- 1A
B Business 1 B
E Educational 2A
F Factory F-1 F-2 2B
H Hio,Hazard H-1 H-2 H-3 H-4 26
InstitudonaE 1-1 1-2 1-3 3A
M Mercantile ' ✓ 3B
R Residential- ✓ R-1 R-2 ✓ R-3 4
3 Storage ✓ S-1 S-2 ✓ 5A
U Utility 58
Mx Mixed Use Specify.
Sp Special Use Specify:
9.0 CONSTRUCTION COSTS (See 780 CMR Appendix L)
Total Construction Cost Building Permit Fee Check Number
(1) _(1) x $0.001
SEE h'T1�9CYrE� o S 9S�a
10.0 AUTHORIZATION OF STATE AGENCY FOR AGENT TO APPLY FOR BUILDING
PERMIT (when applicable)
1, . on behalf of the authoxb*q State
Agency or Authority, hereby authorize, to apply
for the building pemvt for project number,
Signature Date
11.0 SIGNATURE OF BUILDING PERMIT APPLICANT
Name
S' na ure f yl Date
12. Certificate of Occupancy required on completion of project? Yes _ No
Inspector's Notes:
OPGCHEIE
CONSTRUCTION CORPORATION
G
Schedule of Values
Project: Washington at Derby Contract Date t 1/12/07
Location:Salem MA Contract Retainage 5%
Owner: Washington at Derby L1.,C Opechee Project No. 0707
Div. Description Scheduled Value
01 General Conditions $539,899
02 Sitework 635,179
03 Concrete 195,430
04 Masonry 273,859
05 Metals 626,333
06 Wood 453,701
07 Moisture &Insulation 122,932
08 Doors & Windows 468,480
09 Finishes 1,078,636
10 Specialties 53,768
11 Custom Equipment 133,810
12 lFurnishings 0
13 Special Construction 0
14 Conveying Systems 98,000
15 Mechanical 834,555
16 Electrical 326,233
Total Contract Amount $5,840,815
DI v. 2 -�' /� 5, 3ao� q/G x a. o // _ �5'81 3�0
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CITY OF SALEM
ROUTING SLIP
NEW CONSTRUCTION
CFXMCATE OF OCCUPANCY
LOCATION:
APPLICANTS
ASSI+MRS DATE:
FRANK KULIi
(93 Washington Strut)
CITY CLERK DATE:
CHERYL LAPOIIVTS
(93 Washington Street)
PUBLICR SERVICES DATE:
(I,%)Washington Street)4°Floor
WATER DATE:
DOTTIE THIBODEAU
(120 Washington Street)46 Flow
CROSS CONNECT SUPERVISOR DATE:
BRIAN THIBODRAU
(S Jefferson Avenue)
PLANNING - DATE:
(12u Washington Street)3°Floo
CONSERVATION COMMISSION
FRANK TAORMIIVA DATE:
(120 Washington Street) 3'Floor
ELECTRICAL
JOHN GIARDI DATE:
(48 Lafa*Avenue
RIN G FIRE p DATE: 1i i1J
(29 FortC^ v , f
HEALTH ,
JOANNE SCOTT DATE:
(120 Washington Street)4°Flow
BUILDING
THOMAS ST.PIERRE DATE:
(120 Washington Street) 3°Floor