19 HERSEY ST - BPA-8-536 FOUNDATION ONLY i
��� �� CITY OF SALEM
PUBLIC PROPRERTY
, �'`�` DEPARTMENT
� w�U11FRIF.YURt9[:ULL
�1.\VUt „ ►Zj`.�ASN.�G'falg'1}lI1T�Sll ..
�w.il.��iM.Ya.o7'rs019TS
ec
�r�9�a.sysqs .F..::,r�sa.o.vx,s
Wurlcen' Compen�sdos Iasunoce Aflid�vtt: Bnliden/Coatractors/ElectrteirAs/Plumben
A Ile 1 fo Y
io
eaa et Legi
�II . Vameiuuvn�uror�runriwv�ny��A�l): Mla�t.� �Du—�� � ,A�g.'c Q ._ ,
Addreas•_ �_ c7 . �soY� 4- `�
Cit /Stste/Zi �'�-atk.�.t_.'�.0 �� c��� .
Y P� � o t'doaeN:--- Z9C—lQ3(—�5, ' toi7- 7�e(- S�z.i
.�re yon x�empbytr'CAael[tAt aPP+nP+�t�Do�c TYP�Or�Ja�(n9�1�
I.� 1 wp u empbyet wit6 4. Q 1 am a ycm,yai eoalcaetor and! b, �ew co�uuructian
�tmpluywc(full uuYut paro-time)•' lmvr hircJ thc ,ub.cuiuractors
3 U 1 om a sok proprietar or putna. listed oe the attxlied Ylxet = �. � Remodelia�
. yAip and have no ampioyuer T6pt�haw tl. � Demolition
�vwlcina fw me in rny capxiry. workrn'comp. insuranca 9. � BuilJius•rdditioo
(no workcn'eomp. insurance 3. 0 We arc a wryaation and ia
' nquired] ot7teen have cxciciwai e6e'u lO.Q Eleciripl repain or addi[ions
3.0 I �m a homeowna doinQ all work right of weemption pa MGL 1 I.Q Plumbing rcpain or adJitions
�nyxlf.(To workcrs'wmp. c. 152.9 i(e).aad wa(�ave no 12.0 Ruof npain
insuroate requircd.J � �mpbyccx(I�o woAcer!' 13.0 Ot1ur
comp inwran�reyuir�xl.]
�'��7�'VPIitYtl tIM C�ICCYi b0{!� 111Yq i�W 11u Nt 1�1C fCC11JO�K�O1M��IOMIO�I�MIf WW�di�GMIp/O�Y�IIyq pWK'y iORMNIWIWL
'I�w�a�wmn w�u u�bmil Mi�af114vii iadka�uy 4wy an Juiy�al�wMt aa0 Nm E4a aetid�eaa�a+as mm�.uhnu a�rw aff46vd imliarin�we►.
'CuN,XY1Mf IMI C�L'[t dp/�1111W i1�iCI1M ill iId11IO11�I allMl�IIOWYI�fEC II�N OIIII��i11O IbM(WYlYII�'m�0•Odk7'Mfbma�Gr
1 u�w un riup/oyrr that&provldlnX warkera'rompenradon Luurnnea jor my eisp/�ytas B�low!s the pa/fcy anJJob a1li
....a..._infurwatiws.,,..,�.�..,..M_._...»�....�....._. _...._.,�. .,,,�r....,.......-.,..a «. _. , ,�- - - —.� . _. .. . _ ... -
Incunncr Company Name: �"t'�-.��.1� G' � - -
I'oliey Y ur Snlf•i�u. LiC.q: ._ .. .._ Ecpirruon Date:
l�b �itc A�Ircau: �q ��e2S a`y � Ci�yi�WtuZip: S�bl.t cA.`� 1 id
.��tach r cupy of�d� workers•compensaHon pultcy declar�Uoo pa��(showinR the pollcy numbcr and c:pir�tiva daeej.
I�riluro w x:curc coverrQe os requiml w�Jer S�Ytion 25A uf�fGL c. I52 csu lead ro Hu impo�ition of etiminsl pentlties of a
_ .,_:*„tinc.u�tn SI,S00.00 anJ/or one-ytar imp►immnent,.w�vo0�;u civi!pcnultiu in ihe form of a STUP WORK ORDER an.1 a fine m T
tnf up to 5250.00 a Jry aguinnl ihe violarnr. Ik advi�cd that a cupy uf this aietemcnt muy br CurwarJeJ io ihe URice uf
IIm�.�hgau�i�u�I'tt3e Dlrl for u»unr.cc coecr�3u ��cri6crlion. �
!Ju lrerrb�r.nrjy audei�he pwini m�d ptnul�irs u/perJury�hut ihi ii��araW/on provideJ ubow it i�u�uud rorrrce
�—
�i��:r.�ture' -- � I)�rc � �oCJ e`]
rh���:��:
CS � S $ 3 � l0
O/Jleia!rrt un/�c /b wa wrlii/p iab orru.to dr ruiwpld�/by dry oi/oww aJJli•!aL
Ciry or Tnwn: __ PcrmitlLfecnse M
la�uinK Aul6urity (circk onc): --- _ .
t. Itu�rJ �dI/r�lth 2. 1luiWin� Dcprrnncnt ]. CilylfoNp Cletk a. Eleclrical (uspccfor 5. Plum6in� Inspector
4. O�hrr
C��nt�ct Pcrsou: _ ._ Phonc M: +w
Information and Instructions
11y;�hu,etu Gccrcnl[aws chap�a l52 crquin�+11 cmploy�m��s�ecvic�f anoihu uaSer anyoconusete of hi�e.
(Lrwam�o�his aatucs,an ewoloytt ia defueed at"...eraY P�
r�press,x impli�,ura�oc wri►tea� '
�+erp�arn is d�u"�n individWl.P��P.
at�oeiatio�.aorporaaos or odm�kgai turi�X.a any nw a mae
af�he fum�oin�rn�a�qed�u aloint eeuecprias.snd io.lwtin�{the lepl rcpreunndva ota dece:ued emPtoyer.��hs
�u e lo ees. Nowcvec�he
uwe�ation or o�hec le�al endty.emPbYai mP Y [he
lCCdjVCf Of{[11�YCO P�yll Wd1Y1��� �WIW['q�tblRlD.Q tb0 O�O�NI�
�Mrt1lf O�i QM�C���1�h1V1of dOl IROK 1�0 fb100��
_ 1wcUicy�housa o[aood�er wtw anP�°Y*P���m do mainconauce.cooatruccm or repair work oo wch Jwellin�houss
tbneoo shatl mt beause ot sueh employme�be deemed w ba ra employa.
or on�he�ads a buddin$appurtenaM ,
�iC!L ctrtipter 152.42�(6)also s�ates�hat.•„,ary stW or loed Nee�sh�ap�sLaG witiYeld tN ivaaaa or
' of a Ileeue or permlt te operob a Aosl�as or b eootruet pu{Idtsp h tAr eommo�we�MY[�r uy
reuKv++at. �blt avidaae�ot compW�u witl tYs losunw eovents requlrN."
�ppliea�t wM W at yrud�e�d�eeeP� o!ib 1iea1 wbdivis��
.aJditicmally.MGI,chapter 152.$23C(71 staoes"Neidier tAe cocnn�w�alt6 na mY V�
f�� ���f publie work unul accepuble eviitence uf compliance w i�6 the insuranea
rnoar iato any conaaet P�.- au�aity.'
rcquiromena ot ihit chaPcar have been Presenad w tAe eonoraean�
�pplieann
Please fi11 out the aorkets' tompensaaon alMidavit eompkcdY.bY cltec�in;the boxes that upply to your situation an4 if
sa '
n�c��.����on���f)�+).�p)�d P6oee ewnber(s)alon�witR t6eir certificatt(s)of
Compmies(I-LG�u Limited Liabiliq PartnenhiW lLl-P)wim no employas otlmr�hm tha
�nsuranee. Limitat LiabilitY ��, (f an LLC oc LLP doa have .
membeis ur Puct°�.am nat required ro carry walcas'eempenurion
employeea.a poliry is roquiced. Be�ised dut�h�+stTdavit may be sabmitoed to ffie Deprm��sn[of lndwaial
Accide�us for cont3rmadon oP insurance wv�a Atso W�ur or l�icenx�s bein$requesce4 not the De 1paranent of d
6e retumed w[he city w town tha�the application for the pecmi
lnJustriul A�:.:iJanu. Should you have any quesriooi re�ar�ng d►e low or if you are required co obtain a worken'
cumpensuion Poli�7'.V�°�l���°�u cha number liamd Delow. Se1P-inau:ed compania a6ould aaur theu
se1P-insuraace ticenaa number oa the line.
Clty or Tow�O[tklsb '
....,.�,...«.,,�,,.,,. . . ,..,,,.���..�,:,�. W, ;8: -�, � p .
Plcax be wro tha[fie afftdavit is complate and pnnted 1� ibly. Ttu De' enrhes ro���ed n ePuce ut th�+b°tt°°4:+"^,���,w'^� ,
ot che affidavi[for you w fill ou[in ehe evrnt the O�ce of Investi�acions haa to coatact you reQudina the applicant
pl�a� be sure co till ia ida pa�mitllicen�w number which will be u+ad a+a rcference numbar. In addidun.an applican[
ihrt uiust,ubmit mul�ipk permivlicense appticarians in�ny given yeaz,need only submit one •r�dovi�indica�in�currcnt
u
policy information lif necessary)and under"1ob Site Addreu"the appticant should write"oll loc:ationr io_(���Y ur
tuwn►."A coPY oPthe aft"idavit th•rt tus bern officially sumpe�l or muked by ehe ciry,or cown may bo provi�cd to cht
:,pplicant se proof chat a vuliJ af'fidavie is on file for fuwe pertniu or licenses. A naw af8davit mus[be tilled out each
� y� �y���Ome uwner or ciu�cn is obtainia`s licenve oc penni[no[rclateJ to nny busineas or cammercial vanturc
�i.e.a du�{license ar j�etmit toburn-lesve�.etc.)sa!d Rar!w.�ir YOT,cequir�ed co c�om6 ple�at�it�
I'hc Oftix ot Invastig�tiuns w'uuld Ii:xe�u ihank y��u in�dv;u�cc for your cooperetiun and should yuu h•rve:ury queseions.
pleaae du nut hesieate to give us r c�ll.
Thc DcpartmrnPe�ldrass. ce�oPhone and fu number:
The Comamnwealth of Massachusetts , ,
" � pepactmeat of Industrial Accidents ':. . '.
ptlkt ot I�w�tlpdo�s
600 Wa4dio�Lm Sdeet
gosoon,MA 021 l 1
Te1. 1i 617-727-4900 ext 406 or 1-877-MASSAFE
Fax M 6t7-727-7749
;tcoi+cd i-2G-US v�ww.masa.gov/dia
^ - _ . _ ... _ __�- �..... ... �. _ _ _
f �/�a � O� V�
PUBLIC PROPRERTY
D�tutT�tF.iv'r
..w:+��ar•'�a`��
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"hl:'�0►���911/�t.�9�J�6'1W
-�
1�
Coastrucdos Debrls Disposst .�►t'tidavit
(reyuircJ tut al0 daaaolitioa and tmaysuias walt) ,
(a xecniance w ith dt�sixdl ed{tioa oldM Statt HuiWtn�Cod�,�90 Cl►iR sattioa 11 l.S
peeri�sad fis peovisiaeu of�tGL e 40r 3 Sk
� 9uildin�Pwm�A _ . ia iaw�ad ailb th�eoadittos tAat tht debri�rowidn�IItia1
chii wort rAall bt diaposod olin s proparty Iiceased wasa dispoaa! tSeiUry as deMad br�!(8.e
� u�. s tww.
rne a�;.��i be ��oRen ey: .
�c z �is�f-os�,-� _
- u�n.,�tnoW.rl
rne:k-bri, w�U ba ai�vc.ea orin :
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(n+rcw uP I'xd�ty)
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CITY OF SALEM
ROUTING SLIP
• �TEW CONSTRUCCIUN�L
CEBTffiCATE OF OCC�JPANCY
LOCATION. ,���`� �� DATE /l1 /�' p �—
. �-�^-�-.� � "���1 �''''``�-- '
APPLICANP:
��
ASSFSSOItS � � DATE: �d /£� � {
FRANY KULI � r s oY _1 ` '
(9 3 W u h in 4 t o n S a e a)�7z.b��-�� �a .�k:�-r /�s,s l f h` e s
C1TY CLF.RIC _f�r��J ����'� DATB: /� /� dJ
CI�itYL I.APOII�IT� ,{
(93 Waahin;ton Street)
PUBLICE SEAVICE4 ` I�II� ��� �L-� DATE: ���I�
s � - ,t.. �v j��lvcl.�No{e�, C3 in {+�..'I" d� 41d y �r !{t w4,...�1�,(�r<.br��-
. (I�J Washin�tonStreet)4 Floor ih
�r 0��'l nec n � � n i,.�cr .
6�
WATEA (�ZJ� ATE: a $ �.ftC�/"T
ppTTIE THIBODEAU `J*Z"�' �'�'L
(120 Washin�ton Street)4°Floor . `Q/� �-- � �i'6. °
CROSS CONNECi SUPE1tVi30R �/ � �
HR1AN THI80DEAU ���• DATE:��p �
(S Jeffuwn Avenue)
� PLANNING � ,y,, (���,`- N/�`\ DATE: S 2�v O�-
(12u �Vashington Svat)3'�F1oa
CONSERVATION COMMISSIO_l�/ � DA.I.E: $/Z3 0
� �� �� .._., /V
�'� (120 W�ahin�ton Street)3'�Flaor
O,ECTRICAL '
JOHN GIARDI DATE:�O �
(48(afayette S t)
FIRE PRE ON • � ���'
ERIN GRIFFIN� DATE: (� L
(29 Fart Avenue)
HEALTH ,
JO
AN�IB SCOTT ` DATE: /�'�
(120WuhingtonSvee(���t El
BUILDING ^
THObtAS S'f.P[ERRE �i�� � DA'fE: I O�
(l20 Wuhing[oa Streeq 3`d Floor
i
_.
. . �
� � 1 2
5 '
�„ 2„ 2„ 2„ 3„ N
� (2)—#5 BAR ^ ^
�
100'-0" -
� � . . ^ C
N . � ♦ ♦
B . . o . . � o N _
_ � ' ' ' D 4" • • � � o
1 2 3 , , 4 „ 5 N � � �" 8�� �
i
1'-0'
� 24'-0" 25'-0" 25 -0' 24'-1 ��• 1" ��_��� ���� 9��� � �
T.O.W. 103'-10" T.O.W. 103'-10" 8 ��
T.O.F. 96'-0" � I � T.O.F. 96'-0" TYPICAL � 2D, 3D & 4D
p T� � O
I � '
� r_______________________— __________'__________—__ ___— —____ ______ _____'_______ ___________________ �
��—z�� e e
8,� �Q,� � � �Z)-#5 BAR
p :: , . � :: -- ------ -- --, :: -- --- D
, � i �------------------ --- L �-------------- ------- `_ �------- - L_ �-------- -- -- ---- �• i
� � J � i i
' I I I -� �
� I I I . a a O 4,., s e s ♦ Q
o � i i i . /� . . i � • ♦ s . I #3HOOK �
� i i i i � . . N /-� �- :- 12" O.C. �
� I I I /� � * � ^�
� I I I ���� � �
� I I I � 8'•
i • i i I o � Z,� 2�� 2�� 2' e)-i" DIAM. X 18" (2)-#5 BAR
o i i i " DEEP SAW CUT i i i 2„ 2„ 4�� HOOKED A.B.
� i � � SLAB CONTROL � � `* `
N 2 0
� � � i JOINTS, TYPICAL i � � �
`v ¢ � ii PATTERN. i i
J �
o , � � , � � ��
� � i � � � � TYPI�AL � 3A, MIRROR � 4A
� � � II I I TYPICAL � lA & 1D
I � �
� � I I • • ll.l I I C .
x SECTION F-F
o ; i i B L�• i � C . T�'PICAL WALL SECTION � �
�' B 2'-0' , • • � � to„ a,
` #4X20' EMBEDDED IN SLAB, � i T.O.W. 103'-10" W
� I r� LAP SPLICED TO �4 HOOK I I 2 � .
��4X20' EMBEDDED IN SLAB, '
. i i i i � T.O.WJ. 99'-6„ O-#5 BAR
I i LAP SPLICED TO #4 HOOK AT 5C.
I I
i i @ �B� E-(2)—#4 EMBEDDED IN SLAB, T.O.S. 100'-0" i i � \ �
. i i L�AP SPLICED TO #4 HAIRPIN i i " �
I i 6" CONCRETE SLAB F • _ _ _ �
AT 2A & 2D, TYPICAL AT 3500 PSI CONCRETE i i o � � � A N 8° o
o i i COLUMN ROWS 2, 3 & 4. � 2g DAYS. � � � - ;�
i i � F � � N �o �
N i � � (2)-1/2" DIAM, X 12" HOOKED �
i i i 3„ � M A.B. O �J
i i
� � i i N 2" SEE PLAN FOR �OPENING 2
` � � i i L—__
q ' � i i , E , , � 'i i � � DETAIL A (2)-#:s eaR I �
� q i ::�-------- ------------r : ---------------- ----f : �--------------- -----r: : ---------------- ---• �.. i TYPICAL � 5A & 5D . �
--------------- .. q
---------------
� : � -- - --------------- ---------------- ------ ---------------- Q
- -------- ---------------- ---- - �
, �i G DETAIL A _ G DETAIL A G � #3 HOOK � �-#3 STIRRUP
F � � �
- rr � �2�� �.C.
T.O.F. 96'-0" �' N T.O.F.N9fi � _to �
� 16'-0" 7 -0 0 16'-0' 6'-1
T.O.W. 103'-10" 2 3 4 5 -°, (2)-#5 HOOK :� 8 (2)—#5 BAR � �
(2)—#S BAR �
FOUNDATION PLAN �
SCALE 1 /8" = 1 '-0° s�AB o 5 1( " , . . �
(3)—#5 BAR �
� � 2'-0" � EQUALLY SPACED. �
M � Z
� a SECTION G-G O
� " TYPICAL WALL AT COL LINE A I � �
. � -�-J A . . W O .
BAR DE-AILS � WALL OPENW� WALL SECTION �
' ' ' ' CUT BAR
' ' ' , SEC:TION H—H, TYP. EA. END OF DET. A � JOINT HORIZONTAL
#4 HAIRPIN, LAP SPLICED #S BAR. �
' , , TO (2)—#4 EMBEDDED •
#4 HAIRPIN, LAP SPLICED IN SLAB. �1/4" x 2" REVISIONS:
TO (2)—#4 EMBEDDED #4 HOOK LAP � FORMED CONTROL
IN SLAB. #4 HOOK, LAP SPLICED TO 4 JOINT, CAULK
# 10/31/'07, RELEASE FOR
SPLICED TO #4 EMBEDDED IN SLAB. 4 HAIRPIN, LAP SPLICED CONSTRUCTION.
EMBEDDED IN SLAB. TO (2)—#4 EMBEDDED - GENERAL NOTES:
� �� IN SLAB.
i n
� �� ;; ;; - 1 . THIS FOUN�ATION PI AN IS FOR PACKAGE INDUSTRIES PROJECT
- " ' " " ID 0710-027, D,�TED 10/19/'07.
u „ , � ��
�� � '`' - 2. PRESUMED SOIL BEARING 3000 PSF, CONTRACTOR TO CONFIR�1.
' �-�.�" (8)—#5 VERTICAL, #3
(4)-#s vERrica�, TIES � 10° o.c. 3. CONCRETE IS 3000 PSI @ 28 DAYS, EXCEPT AS NOTED ON
#3 TIES � 10" O.C. (4)—#5 VERTICAL,
PLANS.
� � g3 TIES � 10" O.C. (4)-#S VERTICAL, `° � 4. REINFORCING ROD IS ASTM A615, Fy=60 KSI.
� —{ N 1 0 #3 TIES � �o-:..c. � � 5. CONCRETE woRK SHALL CONFORM WITH ACI 301 , "SPECIFiCATiONS
^� �� � i _ .��.. � „
�
_ � � o �� C � c� FOR STRUCTURAL CONCRETE FOR BUILDINGS
�i' o° � 8�� I� � � � �' 6. ALL ANCHOR BOLTS ARE ASTM A36, 3/4" DIAMETER, 18" HOOKED
T� io" a" 8" i'-o" WITH 2 1 /4" PR��JECTION, EXCEPT AT NOTED ON PLANS.
. .� � �. 8„ �p��
8" ��_�.,
3 -a x 2 -s � �--�--� 7. W.W.F. (WELDED WIRE FABRIC) SHALL COMPLY WITH ASTM A 497. ,,+p�""'"��, .
(5)-#4X26" o c
. x �2' FTc. 4)-#5 oowE�s , 40" x 24�� - aa° x as�� 8. SLAB DETAILS SHOWN ON THIS PLAf�I MEET OR EXCEED REQUIREMENTS � �ROp�r f'F
o�� x 2a' (4)—#5 DOWELS 44° x 3s�� x iz�� Frc. FOR THE METAL BUILDING ONLY. SLAB DETAILS DO NOT PROVIDE . N�3�RR '
, ,� X 12" FTG �
X 12" FTG. 6)—#4X32" o � �2S�q(
(3)—�4X40 s' x 12 FTG. a., FOR ANY SPECIAL LOADING, FINISH OR OTHER SERVICE CONDITIONS f,'''��r
(6)—#4X20" (2)—#4X36" 1 $�� (4)—#5 DOWELS
V (6)—#4X20" � (8)—#4X32° (3)—#4X40 ,, c�co
8 (2)—�4X36" 8"" (3)—#4X40
RtQUIRED BY THE OWNER. '°�+�.FM���*
' � 9. WHERE TIES ARE SHOWN IN PIER SECTIONS, TIES AT TOP AND BOTTOM
i
� � OF PIERS SHALL BE SPACED NO MURE THAN 1 /2 THE SPEGf�IED TIE PREPARED eY:
� • ROBERT T. GORE, JR. P.E.
3�-8" � . � � SPACING FROM PIER E� DS. CONSULTING STRUCTURAL
3'-4" � 3 -8 10. LAP SPLICES OF #3 OR #4 BAR EN1BEDDED IN SLABS SHALL BE LAPPEC� ENGINEER
3'-4" 3 -8�� A MINIMUM OF� 24". LAP SPLICES SHALL' BE STAGGERED AT LEAST 24" P.o. eox �90, ACTON, ME
� SECTION A—A ' ' ' NOTE: CENTER FOCTING WHERE TWO OR MORE BARS ARE SPECIFIED. BARS SHALL HAVE AT TE�: 20�-4��-zs��
TYPICAL AT 2D, 3D & 4D. ON COLUMN ROW'. �
_ SECTION B-B SECTION C— C SEC ITION D - D _ _ �LAST 3" CONCRETE COVER UNDER THE BAR AND 1 1 /2" CONCRETE � D � — �
SECTION E— E COVER OVER THE BAR. BAR SHAL� NOT BE CUT BY SAW CIJT SLAB
TYPICAL @ 3A, MIRROR CONTROL JOINT CUTTING. ,
@ 4A. 0 � �
_-
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_ ------ ______ �
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'r U Sb� �' sLt2 �E(�v�l G�'
vuh,e r n+.«,n.�e us•a n,.9uild�w
It dwNnO.Aow m�►u�s� ...
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