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103 LAFAYETTE ST - BUILDING INSPECTION 114 -1a1_� 2--70�5.t RECEIVED INSPRIMNA CES The Commonwealth of Massachusetts ➢Q Department of Public Safety 2014 APR 10 A Sl 1IyV Massachusetts State Building Code(780 CMR) 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#and Lot#for locations for which a street address is not available) 103 14-�_Aye.C(e 5(— �g �2yh Y, No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2•PROPOSED WORK Edition of MA State Code used_ If New Construction check here O or check all that apply in the two rows below Existing Building® Repnir❑ Alteration .FS1. 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 '2�- No ❑ Is an Independent Structural Engineering Peer Review required?- Yes ❑ No 9 Brief Delscripti�n of Proposed Work: rl7i e- SLi,Q�-!Dell .tYl2lFi F��'aL w4(� 'rnkk^' S�.eeS-/br1� 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 CN1R 34) ❑ Existing Use Group(s): 43 Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)8r 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-4❑ A-5❑ -1 B: Business.. E: Educational ❑ F: Facto F-1❑ F2❑ H: Hi h Hazard H-1❑ H-2❑ H-3 ❑ HA❑ H-5❑ 1: Institutional I-1❑ I-2❑ I-3❑ 14❑ NL• Mercantile❑ R: Residential R-10 R-2❑ R-3 Cl R4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use[],and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ HA ❑ 1160 IIIA ❑ IIIB ❑ I IV ❑ I VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Debris Removal:Trench Permit: Water Supply: Flood Zone Information: Sewage Disposal: Public Lam'- Check if outside Flood Zone Indicate municipal0- A trench will not be Licensed Disposal Sitc 1IZ— requiredj2turtrench orspccify: Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: \;I_A IIistui Cn,}nu ssi o l .,ic,,_I r, ess: Not Applicablel0- i Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed ❑ Yes O or No`R_ Yes❑ No ❑ 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: f SECTION 9: PROPERTY OWNER AUTHORIZATION �pU.Imy�anilYt\ililr ss.of,Property Owner - 3: Nannet(Print) No.and Street City/Town Zip f c ;8 x, U i f yrt 015 Property Owner Contact Information:Title Telephone No.(business) Telephone No. (cell) e-malladdress If applicable,the operty owner hereby authorizes GAL /Q� /4e �f 4 (� Name Street Address City/Town State Zip to act on the property owners behalf,in all matters relative to work authorized by this building permit application. SECTION 10,:CONSTRUCTION CONTROL(Please fill out Appendix.2) If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control thencheck here❑and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control fy�,me(Registrant) (Telephone No. a-mail address Registration Numbe a� � D/ - h-zo( Street Address Ci /Town State Zip Discipline Expiration Date 10.2 General Contractor - Ct ud&k lt Son Company Name 11XIPY-D (iU&C40- Name of Person Responsibl,for Construction License No. and Type if Applicable Street Address ity/Town State Zip 8' �172 ? 492(o G✓AUr5�rr�® C©�c�tsF- ar�� Telephone No. business Telephone No. cell e-mail address SECTION 11:lV0kKFR.9'C0%N0'[N5A I1QN INSURANCE ActlnAVfr 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 13 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1. Building $ Sao- 0Z> 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 able to 6.Total Cost S (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 us ue and accurate to the best of my knowledge and understanding. 1�tlt� 6�d wyff wy)W U16 r Please print%sign name r Title nTeelephon�e7�Noo.�/ Date K L/Pn u122 S F c - LJ� —L/�-712& Street Address ( y/Town Shute Zip Municipal Inspector to fill out this section upon application approval: Name Date 1 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet (991m')of enclosed space. _. t , Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS licensing information visit vn+w.Mass.Gov/DPS ;.1,cgase� ttratlpn yandJortindivtdul use only fo'Ykh7ie exptratton date' If found return to: ice'of Consumer Affairs and Business Regulation <y d ` Site 5170 " 5s•:�O Park Plaza,i_4 Boston,iVIA 02116 �. . —IeL/ otvafli with a signature Massachusetts -Department of Public Safety +Board of Building Regulations and,Standards Comtrr._tian Supen'isor -- License: CS 102121 . W H,FRED M AUMT E' - 'r 48 Denver St#1095 4 _ Saugus MA 01906 f Expiration Commissioner 07/01/2014 Vuntett t 0.�Si a S.Ne , OtTiee o oosumer A sit gu _tto-w VUDt17E HOMEIMPROVFMENTCONTRACTOR Registration .jIU71&. Type:Expiration: 4/61Z0V i DBA &SONS HOME IMPROVEMENT y WILFRED.AUDETTE 1' ' 8 REED RD � ' � 'q PEABODY,MA 01960%y„ Undersecretary r !her CITY OF S:u Emi NLUSAC �`• HUSETTS 7't tl llu=LNG DEPAIMI&VT } 130ASHLYGTON STREET, 3 W 'FLOOR TIL 978 745 ) 9( ) 5 5 F.ux(978) 7•10-9844 Ifd1BF�2LcY D81SC0[.L AILY01L THOILu ST.PIERR$ D f.4ECTo R OF PG BL1 C PROPER 7Y/B(.'ILDLNG CO\C\ffSSION ER Construction Debris ,Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 730 CNIR section l 11.5 Debris, and tie provisions of tNIGL e 40, S 54; Building Permit # is issued with the condition that the debris resulting ftom this work shall be disposed of in a properly licensed waste disposal facility as defined by tNIGL c l 11, S 150A. The debris will be transported by: y (name of hauler) 'file debris will be disposed of in (name of Facility) (address of titcility) V" tore afpermit appheanr d.uc � a NOTES: INFILL EXISTING OPENING. e" TYPE X, G.W.B. EACH SIDE OVER 2X4 @IIII G" O.C. II II 5 �I L�� 1 1-01 Q _p 613 5.F. H.C. BATH W — O 30G5 w P H I—LLJ 53'-4° o' 5' / 0' 20' Q FI R5T FLOOR PLAN 0 FIRE PROTECTION KEY FI Ln ! EMERGENCY LIGHT H.C. BATH ® FIRE—_ RE EXTINGUISHER O © PULL STATION 3058 ® HORN STROBE P H ® EXIT SIGN O SMOKE DETECTOR 53'-4° D ARCyIl NOTE: ,\AN R9 For ONLY ONE EXIT REQUIRED: �a FIRST FLOOR PLAN - ALT. TRAVELoSTA CE'TOEXTTSAE55 ° N aTBI �" o R OKLINE � h THAN 75' FEET O Sp 4(T FMP� RENOVATIONS DATE` JONATHAN RAISZ 26 THORNDTKE STREET FLOOR PLAN MAR.31,2014 A 1 PHONE(6 734-1040 103 LAFAYETTE STREET REVISIONS: ARCHITECT JON @ RAISZ.COM SALEM, MASSACHUSETTS 01970 SCALE: 1/8"=1'-0"