10 CARPENTER STREET - BUILDING JACKET I�0 CARPENTER STREET
� H_ LSTORICAL
DANIEL J. LYNCH
Post Office Box 1303 Registered Professional Engineers&Land Surveyors
Marblehead,Massachusetts 01945 Ph: 6yf/631-6145 • Fx: C/7/631-9969
7r�rli 4911
October 29, 2004
Building Commissioner
One salem Green
Salem , MA 01970
Re: Structiural Design and installation of beams @ 10 Carpenter St/ Land of Michael
Please be informed that the above work is complete and In accordance with the Mass Bldg
, Code , and Art 116 Construction Control .
VTY
Daniel J Lynch PE Mass No 23331
Copy : John Michael
The Cummonwcalth of Massachuscits Town of
VY
Board of Budding Regulations and Standards
VYMassachusetts State Building Code, 780 CMR. 7"edition Building Dept
Building Permit Application To Construct. Repair. Renovate Or Demolish a
One-or Two-Funufl Dn offing
This Section Forlulliciall Use Only
Building Permit Number ate Applied:
Signature:
Building Ca issioner/I Ins ori i gs Dole
I:SITE INFORMATION
1 Property Address, 1.2 Assessors Map 6 Parcel Numbers
1.1 a Is this an acce ted street?yes Wo Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Arca(sq R) Frontage(R)
1.3 Building Setbacks(R)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.l.c.d0,ssq 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zona: Outside Flood Zone? MunicipalO On site dis sal system O
Public O
Private
— Check if sO Po y
SECTION 2: PROPERTY OWNERSHIP'
Owner'of Re rd: 1_ Al . & I� A.�/
l ctif r 1ST r7
Name inq
Address for Service
Signature telephone
SECTION l: DESCRIPTION OF PROPOSED WORK'(cheek all that apply)
New Construction O Existing Building O Owner-Occupied O 1 Repairs(s) O 1 Alteration(s) O Addition O
Demolition O Accessory Bldg. O Nu Units Other O Specify:
Brief Description of Proposed Works:
6L Ow'atin
SECTION 4: ESTIMATED CONSTRUCTION COSTS
F3PIumbingg
Estimated Costs: ODlclal Use Only
Labor and Materials
ilding f 1. Building Permit Fee: f Indicate how fee is determined:
O Standard City/Town Application Fee
ctrical f O Total Project Cost/(Item 6)x multiplier x
f 2. Other Fees: f
chanical IHVAC) f List:
s Mechanical (Fire f Total All Fees: f
Su ression
Check No. _Check Amount: Cash Amount:_
ts Total Project Cost: S ' O Paid in Full ❑Outstanding Balance Duey
��2Z 171/-�Oy �1i�
SECTION S: CONSTRUCTION SERVICES
5.1 Licensed Constructlon Supervisor(CSL)
Uccme Number Evprranon Dau
NNyx of CSL- Itylder List CSL Type(wv below)
1. Type I Description
escn tion
AJdmss U Unrestricted u to 73.000 Cu. Fl.
R Restricted IAI Family D%eltin
Sgneurt M Masonry Only
RCRtsidenual Roofin Coverin
Telephone w5 RrsiJenI Window and Siden
SF Residential Solid Fuel Burning Appliance Installation
D 1 Residential Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name Registration Number
Address Expiration Date
Signature Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 25C(6))
Workers Compensation Insurance affidavit 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.
Signed Affidavit Attached? Yes.......... O No...........O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I. , 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.
Si nature of Owner Date
SECT�/I^ONN7b:OWNER' OR AUTHORIZED AGENT DECLARATION
►, (�70 , as Owner or Authorized Agent hereby declare
are that the statements and information on the foregoing application atrue and accurate,to the best of my knowledge and
behal.
0—��
i arm
Signature of net or Authorized Agent Dau v�
Si ned under the sins and penalties ofperjury)'
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 W have access to the arbitration
program or guaranty fund under M.G.L. c. I42A. Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 790 CMR Regulations 110.R6 and I IO.RS, respectively.
2. When substantial work is planned, provide the information below:
Total floors area(Sq. Ft.) (including garage. finished basement/anics,decks or porch)
Gross living area(Sq. Ft.) Habitable room count
,'umber of fireplaces Number of bedrooms
Number of bathrooms - Number of half.baths
Type of heating system - Number ofdecks/porches
Ts pe of cooling system Enclosed Open
3 "Total Project S4uare Footage"may he substituted for"Total Pro)eci Cost"