11 CAVENDISH CIRCLE - BUILDING JACKET UPC 90330No.WX
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CERTIFI A E OF OCCUPANCY
CITY OF SALEM Issued. Per N: ' ,s
SALEM, MASSACHUSETTS 01970 City of Salem Building Dept.
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DATE FEBRUARY 11 19 99 PERMIT NO. 78-2999
APPLICANT FRFRRD DEV CORP. ADDRESS 290ELIOT STREET 162 -
(NO.) (STREET)TT LICENSE)
MA 01721 508-881-1600
'- CITY ASHLAND STATE_ZIP CODE TEL.NO.
NEW BUILDING TWO OR MORE FAMILY NUELLING !*
PERMIT TO (_) STORY DWELLING UNITS
\` (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ,
ZONING RJ
t�
AT(LOCATION) 0011 CAVENDISH CI RCL_E DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
`
SUBDIVISION MAP 07 LOT 0081 BLOCK 808 5°E 15. 79 ACRES
BUILDING IS TO BE FT.WIDE BV FT.LONG BY FT.IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TOTVPE USEGROUP BASEMENT WALLS OR FOUNDATION (TYPE)
REMARKS BUILD 4 UNIT CONDOMINIUM AS PER PLANS. BLDG 175, UNIT C, COACH STYLE. 3 0
QQ@ 6. 2v
AREA OR ESTIMATED COST W 81 o00 FEEMIT.( 5` 5
VOLUME
(CUBIGSOUARE FEET) -
OWNER FRFRRD R.E. D. C. BUILDING DEPT. S
ADDRESS 290 ELIOT STREET BY
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SCSI The Commonwealth of Mas�S�aRl
Department ofPublieA1s7t0Jfi A, RVICES
i ® Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other tft aRRe.0r W4"ily 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)
n Ygm Ish Ctf (A , %ea f ym o lqt�n
t No.and Street City/Town Zip Code Name of Building(if applicable)
— - . , -
SECTION2:PROPOSED WORK
9
Edition of MA State Code used If New Construction check here❑or check a0 that apply in the two rows below
Existing Building❑ Repair W I Alteration ❑ 1 Addition❑ Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ 1 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-0 No ❑
Brief Description of Proposed Work: 'e Shk��Y11Ci� O.. -.W
1
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) ❑
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.ff.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto P-I ❑ F2❑ II: High IIazard I I-1 ❑ I I-2❑ I I-3 ❑ 11-4❑ 11-5❑
I: Institutional 1-1 ❑ I-2❑ I-3❑ 1-4❑ M: Mercantile❑ R- Residential R-10 R-2❑ R-3❑ R-4❑
8' Storage 5-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ dB ❑ HA ❑ I111 ❑ HIA ❑ IIIB ❑ dV � VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: FLicen
emoval:
Public❑ Check if outside Flood Zone❑ Indicate miuiicipal❑ A trench will not beposal Site❑
Private❑ or indentify Zone: or on site system❑ required ❑or trench
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ 1 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:
YL1t1, t t 3D l l•O - glLs
SECTION 9: PROPERTY OWNER AUTHORIZATION
Na e and Address of Property Owner
ii �-Avwdr'h
Name(Print) No. and Street C��ittyy/Tpwn u� zip
Property Owner Contact Information: VVVV
rANW �U
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
V'P6 6MLV1min oe5Srlx(I(rdtng tzol, Su ( 1�2 > rer��nt IY+e
Name Street Address City/Town State Zip
to act on the property owner's 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 than35,000 m.ft.of enclosed space and/or not under Construction Control then check here❑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
ehV11 ofYIG/i'1k({ �PS WG1?�liY1C nC,
Company Name
Apr ftnGSIU6
Name of Person Responsible for Construction License No. and Tvpe if Applicable
Street Address City/Town State Zip
Tele hone No.(business) Telephone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT 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 ' suance of the building permit.
Is a signed Affidavit submitted with this application? Yes No ❑
SECTION 12.CONSTRUCTION COSTS AND PERMIT tEE
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 $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5. Mechanical (Other) $ n, Enclose check payable to
��,(JV
6.Total Cost $ (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.
k2 f l Vulraw.1.l i k�U P I-PS►CE?P y1 fi (Q K -3)-3-- 01 , LP T t
Please print and sign name Title Telephone No. Date
Street Address City/Town State Zip
Municipal.Inspector to fill out this section upon application approvals
Name
SCSI The Commonwealth of Mas�S�aRl
Department ofPublieA1s7t0Jfi A, RVICES
i ® Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other tft aRRe.0r W4"ily 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)
n Ygm Ish Ctf (A , %ea f ym o lqt�n
t No.and Street City/Town Zip Code Name of Building(if applicable)
— - . , -
SECTION2:PROPOSED WORK
9
Edition of MA State Code used If New Construction check here❑or check a0 that apply in the two rows below
Existing Building❑ Repair W I Alteration ❑ 1 Addition❑ Demolition ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ Change of Occupancy ❑ 1 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-0 No ❑
Brief Description of Proposed Work: 'e Shk��Y11Ci� O.. -.W
1
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) ❑
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.ff.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto P-I ❑ F2❑ II: High IIazard I I-1 ❑ I I-2❑ I I-3 ❑ 11-4❑ 11-5❑
I: Institutional 1-1 ❑ I-2❑ I-3❑ 1-4❑ M: Mercantile❑ R- Residential R-10 R-2❑ R-3❑ R-4❑
8' Storage 5-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ dB ❑ HA ❑ I111 ❑ HIA ❑ IIIB ❑ dV � VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: FLicen
emoval:
Public❑ Check if outside Flood Zone❑ Indicate miuiicipal❑ A trench will not beposal Site❑
Private❑ or indentify Zone: or on site system❑ required ❑or trench
permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ 1 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:
YL1t1, t t 3D l l•O - glLs
SECTION 9: PROPERTY OWNER AUTHORIZATION
Na e and Address of Property Owner
ii �-Avwdr'h
Name(Print) No. and Street C��ittyy/Tpwn u� zip
Property Owner Contact Information: VVVV
rANW �U
Title Telephone No.(business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
V'P6 6MLV1min oe5Srlx(I(rdtng tzol, Su ( 1�2 > rer��nt IY+e
Name Street Address City/Town State Zip
to act on the property owner's 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 than35,000 m.ft.of enclosed space and/or not under Construction Control then check here❑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
ehV11 ofYIG/i'1k({ �PS WG1?�liY1C nC,
Company Name
Apr ftnGSIU6
Name of Person Responsible for Construction License No. and Tvpe if Applicable
Street Address City/Town State Zip
Tele hone No.(business) Telephone No. cell e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT 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 ' suance of the building permit.
Is a signed Affidavit submitted with this application? Yes No ❑
SECTION 12.CONSTRUCTION COSTS AND PERMIT tEE
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 $
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5. Mechanical (Other) $ n, Enclose check payable to
��,(JV
6.Total Cost $ (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.
k2 f l Vulraw.1.l i k�U P I-PS►CE?P y1 fi (Q K -3)-3-- 01 , LP T t
Please print and sign name Title Telephone No. Date
Street Address City/Town State Zip
Municipal.Inspector to fill out this section upon application approvals
Name