259 HIGHLAND AVE - BPA-15-648 REPLACE 3 ROOF TOP UNITS 2-7 r 30! r
The Commonwealth of Massachusetts
� n� 1rySpECTrONAL Department of Public Safety
y� SERV)CESAlassachusettsStateBuildingCode(780CMR)
IQ� Bftypipg Permit Application for any Building other than a One-or Two-Family Dwelling
f: ' its Section For Official Use Only)
Building Permit Numbec Date Applied: Building Official:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
o2SQ l�, t—Kb -A19f._�04 A tot 7D N)Pj2FP— 4fky -
No,anti Street (City/_Town—4 Zip Code Nome of Building(if applicable)
\,-J ) SECTION 2.PROPOSED WORK
Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below
Existing Building❑ Repair❑ r\Iteration ❑ 1 Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix l)
Change of Use ❑ 1 Change of Occupancy ❑ 1 Other ❑ Specify:
r
'Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ Nu
Is an Independent Structural Engfneenn$Peer Review required? Yes ❑ No ❑
Brief De criptio of Proposed Work: 1C �D/ F/-�>+�- cPJ� �j
�AT�C*Av^7L �mt�Tbf R1�l4� '
la
SECTION 3:COMPLETE THIS 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 CNIR 34) ❑
Existing Use Group(s): Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
- - I 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-!❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ - H: High Hazard H-1❑, H-2❑ H-3 ❑ H-4❑ H-5❑
1: Institutional 1-1❑ 1-2❑ 1-3❑ [-a❑ M: Mercantile❑ R., Residential R-113 R-2❑ R-3❑ R4❑
S: Storage S-I ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as a licable)
IA ❑ IB ❑ IIA ❑ 118 O IIIA ❑ IIIB ❑ IV ❑ VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
i Trench Permit Debris Removal:
Water Supply: Flood Zone Information: Selvage Disposal: us d Licensed Dis Site❑
Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Disposal
required❑or trench or specify:
Private❑ or indentify Zone: or on site system❑ permit is enclosed❑
Railroad right-of-way: - Hazards to Air Navigation: I
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ 1 Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: Use Group(s): Typeof Constriction: Occupant Load per Flour:
Does the building contain an Sprinkler System?: Special Stipulations:
f y SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner f
(tv1�1e L11 r AIA oIt? o
Name(Print) No.and Street City/Town Zip
Pro erty Owner Contact Information:
Title Telephone No.(business) Telephone No. (ceB) a-mad address
If a plicable,the property vner herebygytthorizes
M ► 2 / ,yeyftff92,xgowwvF,�l All12/n�( 1'A I:0137;a
Name I Street Address City/Town State Zip
to act on the property owner's behalf,in all matters relative to work authorized by this budding permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
If building is less than 35,000 cu.It,of enclosed space and/or not under Construction Control then check here O 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
r-bgoab
Company Nam
Name of Person Respo�nsibple� for Construction License No. and Type if Applicable
K/76
'30
Street Address City/Town I State Zip
r36 SrZ�il 7�� t �urll��h �Dl�r�ic�cyr c)� ��
Telephone No. business Telephone No. cell e-mail address
SECTION 11:tVORFEF9'COt.IK.NSAI ION INSURANCE AFFIUi\Vfl' 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 O No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE'
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
I. Building $ Building Permit Fee=Total Construction Cost x_(Insert here
2.Electrical $ appropriate municipal factor)_$
3. Plumbing $
Note:Minimum fee=$ ontact munin
d. Mechanical (Other) $ c
( ^
5. Mcrhmtiril Other $ Enclose check payable to
6.Total Cost $ 0 To (contact
municipality)and write check number here
SEC IO 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering rimy name below, I hereby attest under the pains and penalties of perjury that all of the information contained to his
appation true aiccuri / Ah f my knowlealge and understanding. CO�
6'/�/7A%37/9
Please I h9�A int and sign na (a Title Telephone No. Date
I �� R/ 14 01S 7�
Street Address City/Town ' �l,S,ta�te Zip
Municipal Inspector to fill out this section upon application approval: zv 171c '7 ) �
Name Date
r
City of Salem Sign Permit Application Worksheet
RECEIVED
t INSPECTIONAL SERVICES
29Jun-15
Far From the Tree 1015 N 30 P 2- 42
108 Jackson Street
Zoning(res/non-res) B4
Entrance Corridor(YIN) N
13- Lot frontage 269 feet
1 Building or tenant frontage 161 feet(2 frontages)
#of businesses on site 1
Bidng dist from street center <100 feet
Multiplier 2
( uif n'°and�Iade: n
maximum area permitted 322.00 sq ft
total proposed sign area 289.27 sq ft
sign 1
length 308.50 inches
height 51.00 inches
sign 2
length 161.00 inches
height 161.00 inches
sign 3
length 0.00 inches
height 0.00 inches
sign 4
length 0.00 inches
height 0.00 inches
sign 5
length 0.00 inches
height 0.00 inches
reestarwd(fa St'nsv
maximum area permitted sq ft(per side)
maximum#of signs permitted signs
maximum height permitted It tall
sign 1
proposed sign area 0.00 sq ft
length 0.00 inches -
height 0.00 inches
proposed sign height 0.00 ft(approx)
sign 2
proposed sign area 0.00 sq ft
length 0.00 inches
height 0.00 inches
proposed sign height ft
Application meets standards set
forth in the Salem Sign Ordinance Yes
Recommend approval Yes
Permit Number
APPLICATION FOR PERMIT TO ERECT A SIGN
r NOTE: BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECTED
!� Location, Ownership and Detail Must Be Correct, Complete, and Legible
Salem, Massachusetts Wo
D to
To the Building Inspector:
The undersigned hereby applies for a permit to rest, ❑Alter, ❑Repair a sign on the following described buildings:
Street Address 2oning District
❑Urban Renewal Area ❑ ntrance Corridor
Q$ S F S + ❑ Historic District YNone
..• O eyx LL(Z-- Use ofBuilding
Telephone — _ 1° floor lNI-WP
• eyy\ 2 floor
Address 2 ` aci en 3 floor
Telephone tol 7— 87-7-oAoS 4 floor
E-mail ' -G� +kt ay How many businesses are in the building?
if a corporate body, name -.
ofresponsible officer
OWNt=_� Building �/�f linear feet
Construction Sup's License No Applicant's Space(if multi-enant) AWlinear feet
Address Property linear feet
Telephone
E-mail Sign Owner o Sign Erector o Other:
Proposed
Si nt Si n2 Sign 3
Surface urface ❑ Surface
❑ ight Angle to Building - - ❑ ight Angle to Building ❑Right Angle to Building
❑Free Standing ❑ Free Standing ❑Free Standing
❑Awning ❑Awning ❑Awning
❑Portable(A-Frame) ❑Portable(A-Frame) ❑Portable(A-Frame)
❑Other(specify) ❑ Other(specify) o Other(specify)
Sign Materials t- ar-1.r1c�)n H p _ Sign Materials to Sign Materials
Sign Dimensions « d� �,(al Sign Dimensions a �r Sign Dimensions
x �(L l
Sign Area Sign Area Sign Area s ft �l) s ft sq ft
Sign Height(if free standing) Sign Height(If free standing) Sign Height(if free standing)
Estimated Cost of Net Work
Existing Signs
Type Sign Area To Be Removed? $i•n Owner
❑Surface sq ft ❑ye o
❑ Right Angle to Building sq ft yes ❑no
❑Free Standing ❑ yes ❑no te
s Authorized Representative
❑Awning sq ft ❑yes ❑no
❑Other(specify) sq It ❑yes ❑no
ro er
Internal Review
PlahnirJ&Community DeveTooment Department Historical Commission
Approval
Building Insp ctor
oerza+o rev
51"
) f5Far,-"�Fr 0M)L' The �4TrewC,"
3U8.5"
Color Scheme
`eV FONT:
Dro.,w,l km.,,,, Far From the Tree Tasting Room CdSlOD ADt1gUe, Title Case MEF
Banner
AndD.,g"
tune 25,2D15 Black Pantone 201 White
•nm ..,
OfAe's-
ReturnCommonwealth of Massachusetts
City of Salem
120Washington St,3rd Floor Salem,MA01970(978)745-9595x5641
card to Building Division for Certificate of Occupancy
Permit No. B-15-649
IN U
FEE PAID: $0.00
PERM IT TO BRUN I LELE41r)
DATE ISSUED: 7/1/2015
This certifies that 102 JACKSON STREET, LLC
has permission to erect, alter, or demolish a building=. 102-108 JACKSON STREET Map/Lot: 250390-0
as follows: Signs SIGN PERMIT>AS APPROVED FOR: ,h u
FAR FROM THE TREE
Contractor Name:
DBA: g
Contractor License No: zj
7/1@015
Building Official Date
w=
IV T
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six monthsafter issuance.The Building Official
may grant one or more extensions not to exceed six months each upon written request
u M „
f .
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. P
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
HIC#: Persons contracting with unregistered contractors do not have access to the guarantyfund"(as set forth in MGL c.142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.