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29 LEACH ST - BUILDING INSPECTION (3) w The Commonwealth of Massachusetts Department of Building l�je(7 0� 'L ) p► ©�'1 Massachusetts State Building C r7e(7 0 MR) Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) - M Building Permit Number: Date Applied: S / Budding Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) f1jr0onaG No.and Street C /Town `S" `� Zip Code O /f',d Name of Building(if applicable) SECTION 2•PROPOSED WORK. tVY-\1 Edition of MA State C de used If New Construction check here❑or check all that apply in the two rows below Existing Building el, Repair UK I Alteration Addition❑ 1 Demolition ❑ (Please fill out mid 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 No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work: /✓0 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 CMR 34) O Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA 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-1❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: High Hazard H-1 O H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional I-1❑ I-2❑ I-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please desc ibe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ IIA ❑ I4130 IIIA ❑ IIIB ❑ IV ❑ VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Licensed Disposal Site❑ Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be P required❑or trench or specify: Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: :MA i h}t,i_i„_.Cononu-sion R,,vh ^ i nwv ,<: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ 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: �S C LL i Lo t L,L rJ.L1 (12- 6 a� SECTION 9: PROPERTY OWNER AUTHORIZATION , Name and Address of Property Owner 1 r-e--� Gy�t�, W�e,� )a�1.�Q VC( 4e1:e14 (3 /0 Name(Print) t—�'o t��, . r No.and Street City/Town Zip ! � f � Property Owner Contact Information: " ,fires, 6l1 -6F-6- r_3 _- - -1ti You f, ca Title Telephone No.(business) Telephone No. (cell) a-mail address If applicable, the property owner hereby authorizes None 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 budding is less than 35,000 cu.ft.of enclosed-space and/or not under Construction Control then check here 13 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 - - Company Name Z141ilL CS 076`Ztf6 N..) of Person Responsible for Construction License No. and Type if Applicable Street Address City/Town State Zip Gi?_-Syo — ���3 �q 2IN,�t�L � �' ��7 ,J� le hone No. business Tele hone No. cell e-mail address SECTION 11:W'ORICER.S'COMPIiNSA'I[ON INSURANICI::IP.FIUAWr 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 E3 No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1. Building $ Building Permit Fee=Total Construction Cost x (Insert here 2. Electrical $ appropriate municipal factor)_$ 3. Plumbing $ d. Mechanical (HVAC) $ Note: Minimum fee=$ (contact m�funGicipalTity)�\') 5. Mechanic.-it Other $ Enclose check payable to CXt JfCJ V -�j 6.Total Cost $ b00 (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 is true and accurate to the best of my knowledge and understanding. Please print and sign name Title Telephone No. Date Street Address City/Town /f�State Zip / Municipal Inspector to fill out this section upon application approval: Name ate XFINITY Connect Page 1 of 2 XFINITY Connect theharpoon@comcastnet +Font Size- Re:Condo#3 upgrades-immediate response requested....thank you. From :anne holden Leahy <aholden73@icloud.com> Sun,Jul 17, 2016 09:32 AM Subject: Re: Condo#3 upgrades- immediate response requested....thank you. To:theharpoon@comcast.net Yes, I have approved the changes for dryer vent placement and new exterior doors. Thank you Anne Holden On Jul 17, 2016,at 09:05,theharpoon@comcast.net wrote: Good Morning, As a protocol, please let us know if we have your approval for all the changes/ upgrades below with this email... You can call Greg if you have any further questions. Rob has approved the changes... Thank you. Sue and Greg #617-686-2753 From: theharpoon@comcast.net To: "J. Gifford" <rob9ifford9@gmai1.com>, "anne holden Leahy" <aholden73@ic1oud.com>, "Anne" <zymurgy01@hotmail.com> Sent: Sunday, July 10, 2016 7:55:52 PM Subject: Condo #3 upgrades - immediate response requested.... thank you. 29-31 Leach Street Condo Association Approval for Upgrades to Condo #3 req for Condo#3 to make upgrades: (at no cost to condo association): move dryer vent from underneath soffit,to edge of condo#3 dormer, up about Y,and close up hole back exterior deck door on second Floor with new insulated door-same style /3/e entrance door to condo#3 with 6 panel pine door 7"wide custom made-removable privacy wall-lattice lowered doors-with 1"holes-on condo #3 second Floor deck Please let us know via email response if we have your approval for these upgrades. Please print this email and mail a hard copy back with your signatures as soon as possible.... Thank you for your prompt attention.... https://web.mail.comcast.net/zimbra/h/printmessage?id=367351&tz=America/New_York... 7/17/2016 XN1N1'1 Y Connect Pagel of 2 XFINITY Connect theharpoon@comcastnet + Font Size- Re:Condo#3 upgrades-immediate response requested...,thank you. From :Rob Gifford <robgifford9@gmail.com> Sat,Jul 16,2016 10:43 AM Subject:Re: Condo#3 upgrades- immediate response requested....thank you. To:greg maitiand <theharpoon@comost.net> Cc:anne holden Leahy <aholden73@icloud.conl Anne <zymurgy01@hotmail.00m> Hi Greg, I have a better picture of the repairs you're proposing and agree to the changes. Rob On Sun,Jul 10,2016 at 7:55 PM, <theharpoon@comcast.net>wrote: 29-31 Leach Street Condo Association Approval for Upgrades to Condo#3 - A request for Condo#3 to make upgrades: (at no cost to condo association): 1. Remove dryer vent from underneath soffit,to edge of condo#3 dormer, up about T,and cl up hole Y No 2. Replace back exterior deck door on second floor with new insula door-same style 3. Replace entrance door to condo#3 with 6 panel pine door Y No 4.Instal ide custom made-removable privacy wall-lattice lowered doors-with 1"holes-on condo#3 second floor deck Y No Please let us know via email response if we have your approval for these upgrades. Please print this email and mail a hard copy back with your signatures as soon as possible.... Thank you for your prompt attention.... Greg and Sue Maitland 29 Leach Street-Unit 3 Salem, MA 01970 Rob Gifford Anne Holde Unit#1 Unit#2 Greg Ma' and Suzanne Champigny Unit#3 Unit#4 https://web.mail.comcast.net/zimbra/Wprintmessage?id=367241&tz=America/New_York... 7/17/2016 The Commonwealth ofMassachuseAty Depart went oflnduttria Accidents I Congress Street,Suite 100 Boston,AM 02114-2017 www massgov/di a WWorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/plumbers. TO BE PII.ED WITH THE PERNMTING AUTHORITY. Applicant Information Please Print Ibl Naive(Business/Orgamantiont adividual): �}/ / 4A"2 Address:_ City/State/Zip: /Ll �iy� 7� Phone#: Lma an employer?Check the appropriate box: 1YPe of project(required): n a mnploye with eagtloyes(full and/orpan-time). 7. ❑New construction m a sole prOluid r o partnership and have no employees working forme m y capacay Wo workers'comp,nicrance required-) S. Remodeling m a homeowner doing all work myself[No workers'comp.insurance reguimq t 9. ❑Demolition a homeowner and onH be biting conimcton to conduct as work an my property. I will 10 0 Building addition ure that all contractors aid=have workers'compensation insurance or are sole 11.0 Electrical repairs or additions rieton wick noemployes. a 12.0 Plumbing repairs or additions Mies S�a1��ctoraand i have hired thesubcontractors limd on the attached sheet.have employes and have workers'comp inset umt 13.0 Roofrepairs re a corporation and its offieers have exercised their right of exemption per MGL c. 14.0 Other§I(4),and we have no employees.[No workers'coop.i emana required-1 'Any applicant that rLeclw box#1 must also fill out the section bekna showing their workers'compensation pogry tnfmmation. Homeawrrers who submit this affidavit indicating they are doting a0 wok and then hire mM Wk contractors must submit a new affidavit indicating such 10anuactors that check this box must attached an additional sheen showing the tame of the sub-uuhactms and state whether or not those entities have employees Ifthe sub:conbactors have employes,they muu provide their workers'comp.polirynronber. I am an employer that air provldurg workers'compensation insurance for my employees. Below is thepoliey and job site information Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/StatclZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as We]]as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce►dfy under the pa at adon provided/ab7=ftwwe/°j�'d eorrect Si®store: /�/�� c A/A ate. Phone M r' tz Q 7-7 D,B9cia/use only. Do not write in this area,to be completed by city or town orcial City or Town: Permdt/License# Issuing Authority(circle one): 1.Board otHealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more then three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"ivery state or local licensing agency sham withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contactors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Departrnent of industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the apirropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pernot/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02 1 14-20 1 7 Tel. #617-727-4900 ext. 7406 or 1-877-NIASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia OTYOFSALEM, MASSAOA SETP' BULUMDEPeaMdarr i2o w�srm�,o,,s�,3mltooe 7kL 745.9599. Flu[ 7449M HIA�ERIEYDRIS�. MAYOR 71io�isSST.P DinC7MCFPEMUCPYJMMY/BUMM4GCOMUMONOt Construction Debris Disposa/Affidavit (required forall demolition and-renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR, Section 111.5 Dew and the provisions of MGL c4Q S 54; Building Permit B is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste deposit facility as defined by MGL c 111,S 150A. The debris will be transported by: (name of hauler) The debris will be disposed of in: (name of fadlity) Z* (address of facility) Signature o applicant ate Commonwealth of Massachusetts ` City of Salem 3 W 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 Return card to Building Division for Certificate of Occupancy Permit B-16-831 PERMIT TO BUILD FEE PAID:: $2$25.00 DATE ISSUED: 8/2/2016 This certifies that MAITLAND GREG MAITLAND SUSAN E has permission to erect, alter, or demolish a building 29-U3 LEACH STREET Map/Lot: 330474-801 as follows: Repair REPLACE ENTRY DOOR Contractor Name: Mark Tremblay' DBA: Contractor License No: 076246 8/2/2016 Building Official Date This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official may grant one or more extensions not to exceed six months each upon written request. 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. 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. p°Na[p� Commonwealth of Massachusetts Citv of Salem 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 Return card to Building Division for Certificate of Occupancy 91 Structure CITY OF SALEM BUILDING PERMIT Excavation PERMIT TO BE POSTED IN THE WINDOW f Footing INSPECTION RECORD Foundation Framing Mechanical Insulation INSPECTION: BY DATE Chimney/Smoke Chamber Final 115A Plumbing/Gas Rough:Plumbing i Rough:Gas Final Electrical Service Rough Final Fire Department / Preliminary Final ��'9� Health Department Preliminary Final MOON➢rqy Commonwealth of Massachusetts ; t Citv of Salem 120 Washington St,3rd Floor Salem,MA 01970(975)745-9595 x5641 Return card to Building Division for Certificate of Occupancy Permit B-16-831 PERMIT TO BUILD FEE PAID:: $2$25.00 DATE ISSUED: ' 8/2/2016 This certifies that MAITLAND GREG MAITLAND SUSAN E has permission to erect, alter, or demolish a building___29-U3 LEACH-STREET Map/Lot: 330474-801 as follows: Repair REPLACE ENTRY DOOR; DRYER VENT, EXTERIOR DECK DOOR & AN INTERIOR ENTRY DOOR &A REMOVABLE PRIVACY LATTICE WALL (BETWEEN DECKS) \` Contractor Name: Mark Tremblay Y , DBA: Contractor License No: 076246 ' 1 1—---- 8/2/2016 Building Official Date This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six after issuance.The Building Official may grant one or more extensions not to exceed six months each upon written request... _ 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. The Certificate of Occupancy will not be issued until all applicable signatures_by the Building and Fire Officials are provided on this permit. l HIC#: "Persons contracting with unregistered contractors do not have access to the guaranty fund"(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. °'T Commonwealth of Massachusetts Citv of Salem s 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 ` Return card to Building Division for Certificate of Occupancy - Structure CITY OF SALEM BUILDING PERMIT " Excavation PERMIT TO BE POSTED IN THE WINDOW x Footing INSPECTION RECORD Foundation Framing Mechanical Insulation INSPECTION: ; BY DATE Chimney/Smoke Chamber Y Final Plumbing/Gas I � Rough:Plumbing I Rough:Gas Final Electrical Service I r Rough I Final 'f Fire Department I Preliminary Final ;F - Health Department __ Preliminary Final