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5 CARPENTER STREET - BUILDING JACKET ' t5-CARPENTER STREET K. `. I HISTORICAL' + -w-- (situ of *a1cm, Massac4uoctto Ilublic Prn}tertq Department Nuilbing Department (Vne Omen Green 500-745-9595 E%1. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer February 1, 1993 Paul & Catherine Cragin 35 Marlboro Street Newburyport, MA 01950 RE: 5 Carpenter St. , Salem, Massachusetts Dear Mr. & Mrs. Cragin: The two problems mentioned in my previous letter of January 25, 1993 have been taken care of and I appreciate your prompt response in this matter. However, during my inspection of the cellar I noticed a gasoline powered lawnmower. This mower must be removed and the debris in the basement cleaned up. I have been assured this would be taken care and I would appreciate your written confirmation that this has been tended to. Again, I thank you for your prompt response. Sincer. ly, Leo E. Tremblay Inspector of Buildings LET:bms cc: Councillor Nowak, Ward 1 Health Dept. Margurite Smit, 5 Carpenter PM ' • SENDER: Complete items 1 and 2 when additional services are desired, and complete iib s 3 and 4. �5 JeN O Put your address in the"RETURN TO" Space on the reverse side. Failure to do this vr��i f prevent t1Q�y and from being returned to you.The return recei t fee will rovide ou the name of the ers's d and the date of deliver . For ad itional ees t e el owing services are avai able. onsu t"os or tees an c ec box es or additional service(s)requested. 1. ❑ Show to whom delivered, date, and addressee's address. 2. ❑ Restricted Delivery (Extra charge) (Extra charge) 3. Article Addressed to: 4. Article Number Paul & Catherine Cragin P 009226 539 35 Marlboro Street Type of Service: Newburyport, MA 01950 ❑ Registered ❑ Insured ertified ❑ COD eurn Re RE: 5 Carpenter St . , Salem Lj-txpress Mail fortMerchacndieiptse Always obtain signature of addressee or agent and DATE DELIVERED. 5. Si re —.Adaressee 8. Addressee's Address (ONLY if X .I requested and fee paid) CC'y 6. Signature — Agent X 7. Date of Delivery Inns PS Form 3811, Apr. 1989 ♦U.S.G.P.O.1989-238.815 DOMESTIC RETURN RECEIPT UNITED rSrTA�TTESf�POS�!T!��-AqLL SERVIC G.�-ESS�¢c I ;11D SU�'1ETHING (7-11" 171 dpFlCIAL BbrSINES'i t<1 ffJ SENDER INSTRUCTIONS y4 Print your name,address and ZIP Cod§' 26 in the space below. • Complete Items 1,2,3,and 4 on the reverse. U.S.MAIL • Attach to front of article if space permits, otherwise affix to back of article. PENALTY FOR PRIVATE • Endorse article "Return Receipt USE, $300 Requested"adjacent to number. RETURN Print Sender's name, address, and ZIP Code in the space below. TO Leo E. Tremblay , Inspector of Buildings One Salem Green Salem, MA 01970 .., (situ of *Utm massar4usetts " r Public Vrnpertp Bepartment �`0 °Ne4pUilbirig Department (ane efalem (6reen 500-745-9595 Fxt. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer January 25, 1993 "Paul & Catherine Cragin 35 Marlboro Street Newburyport, MA 01950 RE: 5 Carpenter St. , Salem, Massachusetts Dear Mr. & Mrs. Cragin: In response to a complaint received by this department regarding the above referenced property, an on-site inspection was made and the following was noted: 1 . The basement door is off 'it's hinges allowing accessibility to unauthorized persons. 2. The skylight is leaking and needs glass. Both the above conditions lend themselves to an extensive loss of heat and should be immediately corrected. You are hereby notified to contact this office within seven (7) days of receipt of this notice to advise us of your intentions in this matter. Sincerj4ly, _ Leo E. Tremblay Inspector of Buildings r LET:bms 't R cc: Councillor Nowak, Ward 1 Health Dept. Certified Mail # P 009 226 539 Page 1 of Z SALEM HEALTH DEPARTMENT 3 9 North Street '•`tee. Salem,MA 01970 State Sanitary Code, Chapter II: 105 CMR 410.000 Minimum Standards of Fitness for Human Habitation is Fr - Occupant: W i I l i aV-V , �y�Z � " Phone: �4�' 2t 52 Address: ✓ ��' Apt. Floor —' Owner: pau l + t�scl Y+P.+–+✓ e, Address:.. ,. .. Mew MA- Inspection Date: 1., ZE; C13' Conducted By: v U•l l e .�� Acco r > y mpanied By Antici atad Reins echon Date:{,mo i., la,� u „ ' L I'1 •: et ., .a..'Ill)4 ��p•y ..Ziu�ik" .I�')i vT 1eV�.�'•' ... ..'.I'�i►-tom -.._. . , Specified :;Reg g .,.t. .. -41,Violationc iiIiZ„:, .,r,> Time 1 fill V ,.}:. C •t ... WdB' it: ttci-cd1. .. h0 ` FrsllaW:i 1._<Viol av�S - 494Rs A+H G `S l t,.4 ►r,cr� ..two I ccigc& i►-, i . . ,. 11.rw+ec�t�cr:.l-cJ cS� ' "��F•- �i Ltil-• 480 .. .. t•,->�-t+ 1 L'UAL x,' One or more of the above violations may endanger or materially impair the health, safety and wellbeing r the ocC, Code Enforcement Inspector Este es un documento legal importante. Puede qua afecte sus derechos. Puede adquihruna traduccion de esta forma. Page Z of 2- SALEM SALEM HEALTH DEPARTMENT a 9 North Street Date: Salem, MA 01970 Name: �''Zs� Address: Specified Reg # Violation Time 410. . . . V c -" dnr t"moi- u.t-•, lmw✓ +-u-L b Co►-,j•-Gt,�r,i 1., �Gt e• War1�S -1er�+-- I i vrt U-4S`l-- � �XuM��� Salem Historical Com b J0nT aCITY HALL. SALEM. MASS. ot97o r F An 16 8 112 Mm, 079 J qY ' RECEIVED CITY OF SALEM,MASS, CERTIFICATE OF APPROPRIATENESS It is hereby certified that the Salem. Historical Commission has determined that the proposed construction [ ]; reconstruction [ ]; demolition [ J; moving [ ]; alteration [ J; painting [X]; sign or other appurtenant fixture [ ] work as described below in the. . . . Federal Street Area Historic District. (NAME OF HISTORIC DISTRICT) 5 Carpenter St. Address of Property: Paul and Catherine Cragin Name of Record Owner: DESCRIPTION OF WORK PROPOSED: Change paint color of shutters from gray to black. will be appropriate to the preservation of said Historic District, as per the requirements set forth in the Historic District's Act (Federal Laws, Ch. 40C) and the Salem Historical Commission. Dated: August 2, 1979 SALEM IHISTORICAL COMMISSION By Chair' an e'y+,COX Salem Historical Commission 3a CITY HALL. SALEM, MASS. 01970 '�JgfOfMMt��t~ CERTIFICATE OF NON-APPLICABILITY It is hereby certified that the Salem Historical Commission has determined that the proposed construction [ ] ; reconstruction [x] ; demolition [ ] ; moving [ ]; alteration [ ]; painting [ ]; sign or other appurtenant fixture [ ] work as described below in the . . . McIntire Historic District. (NAME OF HISTORIC DISTRICT) Address of Property` 5 Carpenter Street Name of Record Owner: Paul & Catherine Cragin DESCRIPTION OF WORK PROPOSED: Replacement of 3 casement windows on 2nd story of rear addition. Painted to match existing color. Non-applicable due to being an in-kind replacement. Since there wassome confusion as to where weatherstripping would be installed on the windows, this application does not include the installation of any weatherstripping. Changing the color of the windows to white would require the submission of an application for a Certificate of Appropriateness (weatherstripping could be added to that application). Replacement of clapboards that have rotted on 2nd story of last addition. Stain to match existing. Non-applicable due to being an in-kind replacement. does not involve an exterior architectural feature or involves a feature covered by the exemptions or limitations set forth in the Historic District's Act (Federal Laws , Ch. 40C) and the Salem Historical Commission. Dated:: September24;�1990,� SALEM HISTORICAL COMMISSION By / /vE1t Chairman OtLI of 'A.7ttlem, massac4usetts Public Prnpertq Department Nuilbing Uepartment (One #alem Olreen 500-745-9595 FA 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer January 25, 1993 Paul & Catherine Cragin 35 Marlboro Street Newburyport, MA 01950 RE: 5 Carpenter St. , Salem, Massachusetts Dear Mr. & Mrs. Cragin: In response to a complaint received by this department regarding the above referenced property, an on-site inspection was made and the following was noted: 1. The basement door is off it's hinges allowing accessibility to unauthorized persons. 2. The skylight is leaking and needs glass. Both the above conditions lend themselves to an extensive loss of heat and should be immediately corrected. You are hereby notified to contact this office within seven (7) days of receipt of this notice to advise us of your intentions in this matter. Sincer ly, Leo E. Tremblay 7 Inspector of Buildings LET:bms cc: Councillor Nowak, Ward 1 Health Dept. Certified Mail # P 009 226 539 Marguerite Smit Will Sonzski 5 Carpenter Street Salem, MA 01970 January 26, 1993 Dear Marguerite and Will, This is to inform you that we have received a letter from the Inspector of Buildings in Salem today that, per your request, two items on our property need repairing. I have enclosed a copy of said letter for your reference. We wish to make these repairs as soon as possible which, allowing you 24 hour notice of our need to access the property to make necessary repairs, will be Thursday at 9: 30 AM, January 28, 1993 . Since you have not returned any of our phone calls to you, we have left notification of the scheduling of the repairs on your answering machine at 6: 30 PM on January 26, 1993 . S . c nre,�y,� Paul A. Cragin Catherine Cragin Owners: 5 Carpenter Street Salem, MA 01970 Mailing Address: 35 Marlboro Street Newburyport, MA 01950 (508) 463-4369 cc: Leo E. Tremblay, Inspector of Buildings, City of Salem C to of #ulem, Massar4usctts Publir Propertg Department Nuilbing Department (One Snlem Green 5BB-745-9195 ext. 380 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer February 1, 1993 Paul & Catherine Cragin 35 Marlboro Street Newburyport, MA 01950 RE: 5 Carpenter St. , Salem, Massachusetts Dear Mr. & Mrs. Cragin: The two problems mentioned in my previous letter of January 25, 1993 have been taken care of and I appreciate your prompt response in this matter. However, during my inspection of the cellar I noticed a gasoline powered lawnmower. This mower must be removed and the debris in the basement cleaned up. I have been assured this would be taken care and I would appreciate your written confirmation that this has been tended to. Again, I thank you for your prompt response. Sincerely, Leo E. Tremblay Inspector of Buildings LET:bms cc: Councillor Nowak, Ward 1 Health Dept. Margurite Smit, 5 Carpenter N05B5 & WARREN. INC RUBOsHeRS FORM 499 i+ OFFICERS RE-UFN BOSTON. MASS. DUCES TECUM REVISE❑ OEC IDii �i�hr (I�nutnuanz>x�saltt� of �����r1�1�,�ei#s ESSEX Docket No. 93-SP-00218 f Leo E.:.. TremblaY..................................... City of Salem, Building Dept - .................. ept . ............ . .I....... .----------------- ------------ --- One Salem Green --------------- _.. ---------------------------------------------------- MA ----------------- .__....._...---- ............. Salem.,._ MA- greetiv:g. `\ ................................................................... ....... — �Ull UTC heYe�ll1 tUtll's13ttl�e�J, i.r r:nze of nnrhe �.Oppnnnllunlzealtb of iliasiachusrtYs, to appear .. .,. 'rlh.,ry ! r:<-r .l.U!l rt.....:J a,i.Pn�.. .k..... -t-_s_........._......_....g.. n heron' . .: ....:,.r,. ..._ ...,... _..._ .... ....-.. pf 65 Washin to tom. .... ;i a7.elll Essex ..................................... bidden al ......-:oftbzn and for the cour:iy of....... ..............-- March 1993 at �3 ..._ ... J ...9.:00. iuc'.L in ibe .. .GX ?--.goon, and from !ay tD day t{iereafter, until the action .. ..........._.-...... .. J hereinalAr :zamrd is r:r :r! r ; sail/ Coiio, !c gine evidence o% what )ort know relatir+g to a 1 action a summary pro,_'ess _ &,n and i!hvc to be heard and tried between-.................. ...................... ✓� ..... .. ....... ........... lainti�. . s , and .................P..au.7 ..G.x:?:gzxl..&...5 .a.*.�ex.ine...�,ralAin ................ . William Sonzsl. iq & Diarguerite Smit........................... )ou are further ruquir::i to bring uilfi. You......---------- - .................................................. Any and all d.;cuments of any nature or description pertaining to ................ ' .. •...... ............... ------------------- "--------------------- --". . . .. an rtcuest f :r ins ection yx reins ection of property..located at y.....'..1_..._.......' _._ ......P......:..... P..: .............. .. 5 Carpenter Street , Salem, MA from August 1 , 1990 to the present . ............................ ..................................................................... ..... ------------------------I.......................... � ...................................................................................... ...........................I-------- _. . .................................... ..................................................... CZPAf tdil IIA s, ac you n will asucy your default :znder the pains and penalties in the law in that behalf made an.i provided. . New ;uryport '' th ......da o March J matedat ............... the..:....._...... . ............. -.. Y of....................... A. D. 19 93 � Nozuv Pu6lI:�13t'jMctC�'ixilYsX'.ktY My Commission Expires; 01/13/95 Please Ask Foc : n Daniel 'f . Bowie , Esq. (508) 462-4416 ✓�ivr/L 90 4 ck&,� �dmn a 1 LAW OFFICES BEIT, STEVENS & O'FLAHERTY JOHN C.STEVENS,III HARVEY BER KAY MACK 104 STATE STREET WILLIAM J.OELAHERTY OF COUNSEL PAMLEGAL NEWBURYPORT, MASSACHUSETTS 01950 DANIEL T.BOWIE TELEPHONE(508)462-4416 WALTER L.LANDERGAN,III FAX(508)462-6844 March 29, 1993 Leo E. Tremblay City of Salem Building Department 1 Salem Green Salem, MA 01970 Re: Paul and Catherine Cragin v. William Sonzski and Marguerite Smit Docket No. 93-SP-00218 Dear Mr. Tremblay : On behalf of Paul and Kay Cragin, I am writing to inform you that the above matter was resolved in the Northeast Housing Court on March 22 , 1993 , and accordingly , your attendance at anyfuture proceedings will not be required. The Cragins thank you for your assistance in this matter , as do I . ours ruly , Daniel T. Bowie DTB/kg cc: Paul and Kay Cragin 35 Marlboro St. Newburyport, MA 01950 February 5, 1993 Mr. Leo Tremblay Inspector of Buildings One Salem Green Salem, MA 01970 Dear Mr. Tremblay, I am writing concerning our property at 5 Carpenter St. This morning at 10: 00, Paul Cragin met Julie Forsberg at the property to reinspect the dwelling in compliance with the letter we received from the Board of Health. She approved all the items mentioned in the letter except the skylight, as Mr. Sonzski would not admit her to make the inspection. She was present during the removal of the debris and the lawnmower from the basement and the property and will verify that these items have been tended to properly. I trust that we have satisfied both the Building Department and the Board of Health on all matters. S ' erely, C �n�-- � �lnj Tir g Paul A. Cragin cc: Ms Julie Forsberg, Board of Health of Kimberley A. Russell 5 Carpenter Street Salem, MA 01970 978-744-1822 February 4, 2004 Building Department City of Salem 120 Washington Street Salem, MA 01970 I am Kimberley A. Russell, the owner of the property at 5 Carpenter Street in Salem, MA. The property was a two-family when I purchased it in 1993, but I have not used it as a two-family, but as a single family since moving in during the same year. Mine is the only family that has lived at this property since I purchased it. The second kitchen was torn out several years ago; hence,there has been only one kitchen for several years. I appreciate your updating your records accordingly. A representative of the Board of Assessors inspected the property today; you are also welcome to send a representative to inspect it if you would like to. Thank you for your attention to this matter. Sincerely L_- IC G (y A C Ki berley A. Russell Cc: Board of Assessors City of Salem Room 6—City Hall 93 Washington Street Salem, MA 01970 --------- I hC Commomo, alth td NI.nsachuu•(ts - ------ - - 11t,urd ,H Buildint.: RCgulauons and S(andaids t \II \I( II' \I ill y �I:usaclnueus State 111111Jing (',)de. 7SO l'\IR. 7 edrti,m I hp w, Iluildiu fermi( :\hplieaur,n TO (',mslru:(. Repatr. Rrm,sa(e l)r I)Cnt,ili.h a ' :(1rrC. ;,r Tnr,-hrtmih' Onrl/ial � I _.,r.� I his S,k For Official I'se Unly I Building Permit , umber: _ __ [),lie ApphrJ' _ _40 or_ u J g Ok 1,111..nm: InNIIek ,;r kit IludJmei SECTION I: SITE INFOR.N1,Yl'ION ----------------- I1-I Propvrlo, --- 1.2 \ssessors Map & Parcel Numbers . --- —Neel \In .\umher I'.u.il CuiuhC; j I I., In ihu .m ai.rpieJ strreY' ses.___.— n;i--_ - P 1.3 Zoning Information: 1.4 Property Dimensions: --- — Znnmg Oisinrt PrulwseJ I'u• '.. Lou :\nu Isy tit Funn age i li, I l 1.5 Building Setbacks (ft) i Fr,,n( Yard Side Yards Near Y:nJ -_ —yl NryuurJ PmsiJrJ RcywreJ PrueiJrJ Neyuu CJ Pio.iJrJ -- 1.6 Water Supply: (Al L r. 40. §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Znnc:' Municipal ❑ On .tit dis Koval .yycm ❑ Public ❑ Pro ❑ ('heck d yes❑ I SECTION 2: PROPERTY OWNERSHIP' 2.1 Ow' er'of ecord; sk ;PnpO Address Ii r Sees icte: --) q b' zZ 1 Sign:•turc Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ Existing Building ❑ Owner-Occupied Repatrs(s) ❑ :\Iteratiun(s) ❑ I Addnn'n ❑ Demolition ❑ Accessory Bldg. ❑ I Number of Units_ Other Specify Q.� `P S'PDJe A_S 1 Brief Descnpuon of Proposed Work-: ---- --- SEC]ION S: ESTIMATED CONSTRUCTION COSTS Esumated Costs: firm Official Use Only � il.ahur aril �lalenalsi _ - ___ _ , I BuilJuo¢ 5 I. Building Permit Fee ` —_ Indicate hoss tee is Jciri non.J ❑ Standard'City/Tmsn :\ppl;cation Fee ]. Electrical S —� ❑ rotal Protect Cush them 6) x multiplier _— x t. Plwnhing 5 '. Other Fees: 5 4 Slechamcal ilI\':\CI So List: Mechanical tFirr 5 fetal :\II Fees � _-- S ----- t_�___ !- ('heck No l'hesk .\rn,nmr _ l'.;.h \n;,,uni to fatal Project Cook 5 I � ^� ❑ Paid ;n Full ❑ t)ul>I.mJing B.d.ul.e Uue_ SECTION 5: CONSTRUC'riON SER% ICES - .1 Licensed Construction Supervisor IC'Sl.) —f � Lf.ruse ..\unlher Lynr.❑,�,u I7aIc \.Kite„I l'Sl. ILdder ►"'- ( 1 , of e,ln%1 cd Huh 1„ `.I MITI( u — __—__— R Rc,tt tv led IA' f,iiii I% Ii%%cl Ifile _—_ Sfenamfo \I �\LhUllr% lhtl% I Rk Re,f J:f11'.1 R,IV file l',,,.'I if le frl:phone \\S—rK..fJ;uu.,l \\ff W..„ .'rd do, lulfJ I frl Itwffiu`\(,L i_uf.; In.f.a�.ff: fi _ 5.2 Registered Ilome Improvement Contractor(I110 tit(' Conqun% Name or HIC Rep,trint Nallle Regunaunn Nlunhel \ddre„ F.vpn a( „n Date Signature relephonc SECTION 6: WORKERS' CONIPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152. § 2506)) Workers Cornpensation Insurance atfidivit must be completed :mil ,ubmitted with this ❑ppbcation. f=:ulure n, pnlude this affidavit will result In the dental tit the Issuance of the building permit. Signed Affidavit Attached'? Yes .......... O No .. .. . ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property herebv u authonze to act n my heh:alt, in all nutters i reiative to work authorized by this building permit application. i S1 nalureul'Owner Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION 1. �IYVI �1-�\PU �Vv��'IC,I( , as Owner or Authorized Agem hereby declare that the statements and i tormation on the foregoing :application are true and accurate, to the best of my knowledge and behalf. ` ( A- e Print Nam l Sfenature or Owner or \u oozed Age t Date (Sim ed dun •r lie afro and enalues of rju ) NOTES: I. An Owner who obtams a building permit to do his/her own work, or an owner who hires an unregi,tered r, illra, o,r (not registered In the Home Improvement Contractor IH1C1 Program). will rant hate acres, to me mbitrauon j program tit guaranty fund under M.G.L. c. 14'_A..Other Important nhumitton on the HIC Progr:un .Ind Construcnun Supervisor Licensing WSL) .an he found In 780('MR Regulations 1 IORG and 1 II) R5. rc,pcco%cl\ � ' When ,uhstantial work is planned. pro%Ide the information below: Total floors area lStl. H.I nncluding garage. Iini,hed basemen Vattics, decks or p,irh, f Gro,s Irvine area 1Sy. Ft.) `'umber of fireplaces___ Number of hedn,„nn, Nuntber ,d halhnunns _ _ N'wnher„t h.dtihalh, Numher ,ddc,k,ip„ivhc, 1\pe„i ,foling ,v,tern ___—_ I�if,I,,,ed _. lll::n i. "h,nal Pr„)ect S.{u,oe Footage" may he uhstn iced t„r ..r„t.Il Protect C',lsi' ----—. CITY OF S.UY-M PUBLIC PROPERTY DEPARTMENT 1u"DEAL"Onfic v. VArM 130WAWNCI MSTMW•$ArEKMAUA0&=M01970 Tm:978-7ii95" • FAx.97a:7J0.9&4 HOMEOW NER LICENSE EXEMPTION Pies" Print Date ZCe 110 F Job Location St Horne Owner Address Horne Owner Telephone 1 S — ZZ Present Mailing Address The current exemption of"Homeowners"was extended to include owner-occupied dwellings of two Units or less and to allow such homeowners to engage an individual for hire who,does not possess a license,provided that the owner acts as supervisor. DBFRNMON OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official,on a form acceptable to the Building Official, that he/she be responsible for all such work performed under the Building Permit. The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable by-laws and regulations. The undersigned "homeowner"certifies that he/she understands the City of Salem Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir5ments. HOMEOWNERS SIGNATURE L/ APPROVAL OF BUILDING INSPE 0 See other side for state code CITY OF SALEM •� BLIC PR RT OPRE Y 3 . I Pt, '�• -�-�` ����� DEPARTMENT \l.'- 'rc L'C VrAil IIX,CJN S:I EET • F\x:'ASJ+G')846 Construction Debris Disposal Affidavit (required for all demolition and renovation work) in accordance w ith the sixth edition of the State Building Code, 730 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # _ _ 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 MGL c 111• S 150A. The debris will be transported by: No-r`1-IDS i t� Ca^r — --- (name 01 hauler 1'hc debris will be disposed of in /VOY7hSlGCV 6P utlk�k (nave �I laahtyj 5 C6 SL 1L CITY OF SAi.Em PUBLIC PROPERTY DEPARTMENT �\Mc��CV NIf.YY MAVM 130wAMUOMMS REn•SAU[KNwWan:WrTS0197e Tm-978.74S-9S"* FA3L 978-74&9&W HOMEOWNER LICENSE EXLNWrION Please Print Date �N d Job Location �J C-0-f pen - Home Owner Address ('a✓ 2ev��1—�-c S Home Owner Telephone 9rl 4- 4'- z Present Mailing Address�k L �1 c r- S The current exemption of"Homeowners"was extended to include owner-occupied dwellings of two Units or less and to allow such homeowners to engage an individual for hire who,does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official,on a form acceptable to the Building Official, that he/she be responsible for all such work performed under the Building Permit. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable by-laws and regulations. The undersigned "homeowner"certifies that he/she understands the City of Salem Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE Liz APPROVAL OF BUILDING INSPECT R See other side for state code The Commonwealth of Massachusetts t Board of Building Regulations and Standards FOR m MUNICIPAITI Y Massachusetts State Building Code. 780 CMR. 7 edition USE Building Permit Application Const ct, Repair, Renovate Or Demolish a Revised Jaima .e 0/ - or Two-Ftu ilv P ti•elling i, 0os This S ction F r fficial Use Only Building Permit Number: Date Applied: Signature: -4 2�, o � Building Commissioner/I speetor t ildings Date ECTION 1: SITE INFORMATION 1.1 Property A�rMrnD y1� cam, 1.2 Assessors Map & Parcel Numbers a6 ASS$ I.la Is this an accepted street'?yes_ no Map Number Parcel Nundtcr 1.3 Zoning Information: 1.4 Property Dimensions: "J&005ii Ff Zoning District Proposed Use Lot Area(sq It) Frontage(it) 1.5 Building Setbacks(ft) Front Yard Side Yards - Reur Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40. 3 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone, Public Private❑ Municipal Check if yes❑ P On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: nn �I S n �� i S4 ICIryNlo c+ fT { lSµ Name(Prin ) (FLU-�"� Address for Service: 9f)� _ ,4y- Igz2 Signature JTelephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check al .that apply) New Construction ❑ I Existing Building e Owner-Occupied Repairs(s) all Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ 1 Number of Units_ I Other ❑ Specify: Brief Description of Proposed Work,: - R,OD(12 (1 LLa17 ,P f spt � u I ol- — 12o Sr! SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ 1. Building Permit Fee: $ Indicate how fee is d to ined: ❑Standard City/Town Application Fee 2. Electrical $ r)Total Project Cost' (Item 6) x multiplier 6�33x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List` 5. Mechanical (Fire $ Total All Fees: $ Suppression) Check No. Check Amount: Cash Amount: b. Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) License Number Expiration Date Nance of CSL- Holder List CSL Type(see below) Type Description Address U Unrestricted(up to 35.000 Cu. Ft.t R Restricted 1&2 Family D%ellin Signature M Masonry Only RC Residential Roofing Covenn Telephone WS Residential Window and Siding SF Residential Solid Fuel Burnm .A tliancc In,tallauon D Residential Dena)liuun - 5.2 Registered Home Irnprovement Contractor(HIC) HIC Company Name or HIC Registrant Name Registration Number Address Expiration Dale Signature Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152. 9 25C(6)) Workers Compensation Insurance affidavit must be completed and-Fobmitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... ❑ No ........... 13 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date ``-- SECTION 7b:: OWNEW OR AUTHORIZED AGENT DECLARATION i, �`)fYl C1�f 1c24 A • kt&sso I ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true'and accurate, to the best of my knowledge and behalf. C?IJtm ' e( ke _ � & SSP-1) Print Name \ UgI Signature of caner r Authorized gent bate (Signed under the a ns and nalties of perjury) NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home improvement Contractor(HIC) Program), will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I I0.R6 and 110.115. respectively. 2. When substantial work is planned, provide the information below: Total floors area(Sq. Ft.) (including garage, finished basement/attics.decks or porch) Gross living area(Sq. Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/ porches Type of cooling system Enclosed Open 3. 'Total Project Square Footage" may be substituted for"Total Project Cost"