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OP-2002-0043 Building Permit No.: 833-2001
Commonwealth of Massachusetts
City of Salem
BUILDING,ELECTRICAL&MECHANICAL PERMITS DEPARTMENT
This is to Certify that the RESIDENCE located at
Dwelling Type
0018 CAVENDISH CIRCLE in the CITY OF SALEM
Atltlress " TowNCi Name
IS HEREBY GRANTED A PERMANENT
CERTIFICATE OF OCCUPANCY
New single family attached
This permit is granted in conformity with the Statutes and ordinances relating thereto,and
expires -------------------------------------------- unless sooner suspended or revoked.
Expiration Date
Issued On: Wed Nov 7,2001 ------- (j�'
C, 4 1 - � ----------
GecTMS®2001 Des Lauriers Municipal Solutions,Inc. -----------------------------------------------------------------------------
0018 CAVENDISH CIRCLE 833-2001
GIs#: 10279 COMMONWEALTH OF MASSACHUSETTS
Map: 07
Block 828 CITY OF SALEM
Lot. 0081
Permit: Building `
Category: 102 New single famil BUILDING PERMIT
Permit# 833-2001
Project# JS-2001-1606
Est. Cost: $102,500.00
Fee: $1,026.25 PERMISSION IS HEREBY GRANTED TO:
Const:Class: Contractor: License:
Use Group: Fafard Development Corporation General Contractor-052848
Lot Size(sq. ft.): Owner: MARINER DEVELOPMENT CORP
Zoning: Applicant: Fafard Development Corporation
Units Gained:
Units Lost: AT: 0018 CAVENDISH CIRCLE
ISSUED ON. 30-May-2001 EXPIRES ON: 30-Nov-2001
TO PERFORM THE FOLLOWING WORK: raI (�► (�r� t t ®!ccupy
Bldg#170,Unit A,Super Coach style. Construct 4 unt condominium a-Ilinl($srpeVp'1 l �u�mi1 . T.J.S.
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: -Meter:. Footings:
Foundation:
Rough�l./ O fiPyt Rough: �aJ�b/��� House#
Rough Frame: /0////0
Final:/ �Gi 'fl/ �d" Final:/�/��� Fireplace/Chinmey: �L
Insulati' v�,' �'
Gas Fire Depar ent Board of Health Final( /C
Rough:D�/01-�C)/ ,,W. Q///�/f/(J1 Treasury: /
Final: 11`19-01 1;, " SmokerT—D Excavation:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF
ITS RULES AND REGULATIONS.
Signature: ✓ ta"" e/ h
Fee Type: Receipt No: Date Paid: Check No: Amount:
BUILDING REC-2001-001782 30-May-01 01 $1,026.25
GeoTMS®2001 Des Lauriers Municipal Solutions,Inc.
GVE A0
CITY OF SALEM
BUILDING PERMIT
The Commonwealth of Massachusetts
Department of Public Safety
Massachusetts State Building Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
' his Section'FOL Official Use.Only) ``=
Building Permit.Number. -Date Applied ;Building Official
'.SECTION 1:LOCATION(Plea'seindicate Block#and Lot#for locations'for which a street address is;pot available)
( I Bldg 170 18 Cavendish Salem 01970 Green Dolphin
'n 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❑or check all that apply in the two rows below
Existing Building❑ Repair❑ Alteration IN I Addition❑ 1 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 ❑ !E!No EC
Is an Independent Structural Engineering Peer Review required? Yes ❑ ANo [
Brief Description of Proposed Work: Remove and replace roofing shingles
orn
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SECTION 3;COMPLETE THIS,SECTIONJF EXISTING BUILDING UNDERGOING RENOVATION,AMITI�I,OR ','
` CHANGE IN'USE-:OR OC- -UPANCY -
Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): HesidentialProposed 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'applieable) 4
A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ElH-2❑ H-3 ❑ I -4❑ H-5❑
1: Institutional I-1 El ❑ I-3❑ 1-4❑ M.
Mercantile❑ R: Residential R-10 R-2 CY R-3❑ R4 ❑
S: Storage S-1 ❑ S-2❑ U: Utility ❑ Special Use❑and please describe below:
Special Use:
SECTION&CONSTRUCTION TYPE,(Cheek as applicable)" ;^ ?
IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV VA ❑ VB ❑
sECTION 7:SITE INFORIVIATION`(refen't_o 780 CMR 111.O.for details on each rteinp '1
Water Supply: Flood Zone Information: Sewage Disposal:
Trench Permit: Debris Removal:
Public❑ Check if outside Flood Zone❑ Indicate municipal❑
A trench will not be Licensed Disposal Site❑
Private❑ or indentify Zone: or on site system❑ required❑or trench or specify:
permit is enclosed❑
Railroad right-of-way: FH—ds to Air Navigation: MA Historic Commission Review Process:
Not Applicable❑ ure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION B:�CONTENT OF CERTIFICATE OF OCCUP1.ANCY sY - .
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
- :SECTION,9: PROPERTY OWNER AUTHORIZATTONa,
Name and Address of Property Owner
Green Dolphin Salem 01970
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
Title Telephone No. (business) Telephone No. (cell) e-mail address
If applicable,the property owner hereby authorizes
Charles Minasalli 25 Spaulding Rd Ste 17-2 Fremont NH 03044
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,CONTffOL(Please fill out Appendix
If buildin is less than 35,OOD Cu:.fk of enelosed-s ace'and/or not under construction`Contro6 then cIt heie,[4 an'd ski Section 101
-111:1 Re istered Professional-Res c nsible for Construction Control ' V
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General`Contractor<
KTM Properties LLC
Company Name
Charles Minasallli 160139 HIC Exp. 6/25/16
Name of Person Responsible for Construction License No. and Type if Applicable
25 Spaulding Rd Ste 17-2 Fremont NH 03044
Street Address City/Town State Zip
603 895 0400 603-231 1677 tara@ktmproperties.com
Telephone No. business Telephone No. cell e-mail address
?' ,y sEC 'ION 11: ,fJRKE?R4'CC3bfPF.f4S H'RJN 1N5UKANCF AFTIDAVLE(M,G.Uc.152.§25C 6 x. 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 0 No ❑
"SECTION 12 CONSTRUCTION COSTS AND,PERMIT-FEE
Item Estimated Costs:(Labor 5,000.00
and Materials) Total Construction Cost(from Item 6) =$
1.Building $ 5,000.00 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 $ Enclose check payable to
6.Total Cost $ 5,000.00 (contact municipality)and write check number here
SECTTON;13iSIGNAT.UREQF.BUILDINGPERMITAPPLICANT ""
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 d accurate o the best of my knowledge and understanding.
President 603-895-0400 8118/15
Please print an si me �naSa i Title Telephone No. Date
25 Spaulding Rd , e 17-2 Fremont NH 03044
Street Address City/Town tate Zip f
-Munrctpal Inspector to fill out this�see4on upon appheat on approval
Name