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539 LORING AVE - BUILDING INSPECTION The Commonwealth of Massachusetts 1 a I2 Board of Building Regulations and Standards ^.�r� 17« SEIR Y,-017 u Massachusetts State Building Code, 780 CMR SALEM n18� H,Rer6et JVr 2011 Building Permit Application To Construct,Repair,Renovate e1 s IIJ One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Dat Applied: ^n s i Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers I _,39 korin AA. e9/ o3.1-6 ^ l.la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 O ner'of Name(Print) nn''__ City,State,ZIP sl RUC. t`Y1 r i /7 a FfYr/ n E Gl'V1A/I No.and Street 1 Telephone Email ddress SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ Demolition x Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': �u le dprrtolMrn &tit( remote( &tr <-lvccclur-e- SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ I.-Bu i lding Permit Fee: '-�"'�"'$ Indicca[e how fee is determ ined' 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: S 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$ o e Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ S Q ❑Paid in Full ❑Outstanding Balance Due: 11( 2z MNI I ----10 TU W INr)hAM SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) GS—DSrI yQ0 �5 1 A ber4 �j. PoEgi n License Number Expiration Date Name of CSL Holder amr,o S n n List CSL Type(see below) tc No.and Street I�6C z��p Type Description (,�lrlrUlArvi nN G3�0 � U Unrestricted(Buildings u to35,000 cu.8. R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding � tD i���mGt� LrLV trod SF Solid Fuel Burning Appliances 4g� �Ja�� I I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Co tractor(HIC) HIC R!!�d Expiration Date HIC Company Name or HIC Registrant N e No.and Street ess City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 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 .......... No...........❑ 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 ,�(s 11-1"�(( t�l F K'( h sea T/i - to act on my behalf,in all matters relative to work authorized by this building perm t application. 2wA- Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION 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. e llv thonzed gent's Name(Electronic Signature) Date NOTES: 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 not have access to the arbitration program or guaranty,fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.¢ov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halfibaths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" ! �a r Massachusetts Department of Public Safety Board of Building Regulations and Standards _ License: CS-081490 Construction Supervisor + A ROBERT J MORGATJ j ZERO ROMANS RI) i WINDHAM NH O001 - , a i n , Expiration: Commissioner 05/02/2018 f CITY OF SauENI, IMASSACHUSETTS • BUILDING DEPARTMENT 120 W ASHINGTON STREET,Sae FLOOR TEL(978)745-9595 FAX(978)740-9846 KI\IBF_RLEY DRISCOLL MAYOR T HoMAs ST.Pwims DIRECTOR OF PUBLIC PROPERTY/BUILDING CO%ZIISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectriciansiPiumbers Applicant Information Please Print Legibly. , 0 Name(BusineworganizatioNlndividual):—J(t�,-0 cc e1-1 W(flf'IC-eQ —6 . Address:Q0 M Ofc:�- City/State/Zip: Nhl f Y n . (� U � Phone i/: ld)3)-q o- g,�I�q Are you an employer?Cheek the �ppropriate box: Type of project(required): 1.Cy1 am a employer with-�Y 1— 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(fult and/or part-time).' have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet: 7. ❑Remodeling ship and have no employees These sub-contractors have S. Demolition working for me in any capacity. workers'comp.insurance. 9 gBililding addition [No workers'comp.insurance S. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs oradditions 3.111 am a homeowner doing all work right of exemption per MGL 1 I.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' comp.insurance required.] 13.❑001er •Any opplicam Ihet checks bas a I must also fill out the section below showing choir workers'ctonprpdon policy infurtatim t I Indtuownrcn who submit this affidavit indicating they me doing all work and then hire Omide etomtmetors most submit a new affidavit indicating seek. :Ctonrtrwrs that duck this box must noodled an additional sheet showing the tome of Qu abcontractors and their workrn'stoop.policy information. 1"man employer that b providLrg workers'compensadon Insurance for my employees Below Is the polley and fob site injormwion. Insurance Company dame: lJ Policy#or Self-ins.Lic.#: -75 p,� U q Expiration Date: �D Job Site Address:, k rjry?� /' w , City/State/Zip,�/P/yt _ MIq Attach a copy of the worken'compew on polity declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. l do hereby Gerd under the pains and enali ler ojperfury that the iajormallon provlded above is true and correct r nr Date: A0 Ph, — Offtcial ust auly. Do not write in t/tit urea,lobe completed by city or town ofciaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Ilealth 2.Building Department 3.Cily/f•own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: ___ Phone#• CITY OF SM EN19 1'L�SS�ICHUSETTS ' ButLDLNG DEPAR'[1cF.NT 130 W 1SHINGTON STREET,3'°FLOOR TEL (978) 745-9595 FAX(978) 740-9846 iC1,N[BERLEY DRISCOLL MAYOR THo&w ST.PIERRE DIRECTOR OF PIBLIC PROPERTY/BI:n.DING CO%L%assIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal 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 (na bf acility) (address of facility) sign�permitnt l Ilo��LO date JcbriulLJuc Unofficial Property Record Card http://salempatriotproperties.com/RecordCard.asp Narrative Description of Property This property contains 0.195 acres of land mainly classified as Two Family with a(n)Multi-Garden style building,built about 1940,having Vinyl exterior and Asphalt Shgl roof cover,with 2 unit(s),9 room(s),4 bedroom(s),2 bath(s),0 half bath(s). Property Images �r y� Disclaimer:This information is believed to be correct but is subject to change and is not warranteed. 2 of 2 8/2/2016 1:33 PM Unofficial Property Record Card http://salempatriotproperfies.corr✓RecordCard.asp Unofficial Property Record Card - Salem, MA General Property Data Parcel ID 21-0232-0 Account Number Prior ParcellD 72-- Property Owner 2 PARADISE RD.,LLC Property Location 539 LORING AVENUE Property Use Two Family Mailing Address 3 ROCKAWAY AVENUE Most Recent Sale Date 9/9/2015 Legal Reference 34360-577 CIty MARBLEHEAD Grantor 539 LORING AVE NOMINEE TRUST,THE Mailing State MA Zip 01945 Sale Price 345,000 ParcelZoning B2 Land Area 0.195 acres Current Property Assessment Xtra Features Card 1 Value Building Value 201,000 Value 0 Land Value 92,600 Total Value 293,600 Building Description Building Style Muiti-Garden Foundation Type Concrete Flooring Type Hardwood #of Living Units 2 Frame Type Wood Basement Floor Carpet Year Built 1940 Roof Structure Gable Heating Type Forced H1W Building Grade Average Roof Cover Asphalt Shgl Heating Fuel Oil Building Condition Average Siding Vinyl Air Conditioning 0 Finished Area(SF)2254.2 Interior Walls Drywall #of Bsmt Garages 0 Number Rooms 9 #of Bedrooms 4 #of Full Baths 2 #of 314 Baths 0 #of 112 Baths 0 #of Other Fixtures 0 Legal Description 1 of 2 8/2/2016 1:33 PM Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-081490 Construction Supervisor ROBERT J MORGATJ li ZERO ROMANS RDA WINDHAM NH 03087 ` Cyr E%}16ra11Gn: Commissioner 0610212018 AT&T-CLD05950-26 9/23/2016 8 : 51 :54 AM PAGE 2/002 Fax Server FROM: AT&T Long Distance Cable Protection Center GFI This is to notify you about status of received tickets. This does not mean that another utility other than AT&T Long Distance is clear OR that future and/or different activities at the same location would be clear. This message does not include any AT&T cable formerly known as SBC, Bell South or TCG. If you have any questions about this message or if you believe you have received this notification in error, and that AT&T cable is actually in the vicinity of your excavation activity, please call 1-800-252-1133. Locate requested by JAY MOR ENTERPRISES INC to the Dig Safe Systems One-Call Ticket Message Number: 20163812575 Closed with status: AT&T is clear. Ticket was processed by GFI AutoScreener AT&T Reference Number: 40820822 Work Date &Time: Sep 28 2016 9:15AM Work Location: 539 LORING AVE, SALEM MA Near intersection: LORING HILLS AVE L AT&T-CLD05950-26 9/23/2016 8 :51 : 54 AM PAGE 1/002 Fax Server s� at&t TO: Company: Fax: 6034598858 Phone: FROM: GFIContingency@CAHYWRIGLINKD60. Fax: Phone: NOTES: AT&T GFI Ticket Status Notification Number of pages including cover: 02 Date and time of transmission: Friday, September 23, 2016 8:51:32 AM @ 2009 AT&T Intellectual Property: All rights reserved. AT&T,the AT&T logo and all other AT&T marks contained herein are trademarks of AT&T Intellectual Property and/or AT&T affiliated companies. verizonNI MA/RI OSP Center 385 Miles Standish Blvd Taunton, MA 02780 1-866-686-1195 ma-ri.osp.center@one.verizon.com To:Tracy Date:10/21/2016 Re: Facility Removal for Demolition This letter confirms that Verizon's facilities have been disconnected and removed from the address below. 539 loring av, Salem, MA Thank you, Hanley, Mary C OSP Engineer ELIMINATOR PEST CONTROL INC. 22 ALAN DALE ROAD MEDFORD,MA 02155 Jay-Mor Enterprises Fax 1-603-459-8858 Post Office Box 785 Hudson,NH 03051 Email: Jaymorent@comcast.net November 3,2016 Invoice#4989 Rodent Control Services performed for mice and rats at: 539 Loring Ave. Salem,MA Pest Control License# 16627 Integrated Pest Management for mice and rats. No problems upon inspection. Service $ 300.00 per property location. Amount Owed $ 300.00 Thank you for your business! nationalgrid 40 Sylvan Rd Waltham MA 02451 August 19, 2016 Jay-Mor Enterprises Inc. Tracy Lirette PO Box 785 Hudson NH 03051 RE: Service Removal for Building Demolition. Dear Tracy, This letter is to confirm that,per your request,National Grid has removed the electrical service and meter 079758025 from 539 Loring Avenue, Salem MA on 8/19/16. If you have any questions or need further assistance, please feel free to contact me at(508)357- 4522. Sincerely, Deborah Correa Customer Fulfillment Ph# 508-357-4522 Fax # 1-888-266-8094 deborah.correa@nationalgrid.com • 1 ... nationalgrid November 14, 2016 539 Loring Ave alern MA This letter is to notify you that the gas service located at 539 Loring Ave, Salem was cut off at the main on 11/12/2016. If you have any questions, please feel free to contact me at 781-907-3102 Thank you, Ashley Howes nationalgrid Gas Customer Connections ash ley.howesCa)nationalgrid com 781-907-3102 lvZ - IFS<7-9 /21 --`5� l -o �� - -- i CITY OF SALE1 MASSACHUSETTS BvILDLNG DEP kR NT • 120 WASHINGTON STREET,3tO FLOOR TEL (978)745-9595 FAX(978)740-9W KINtBERLHY DRISCOLL MAYOR 1�toatas ST.P>FJtRe DIRECTOR OF PUBLIC PROPERTY/BUILDING COMUSSIONER Demolition Permit Sign-Off pp & `� (Supplement to permit application) JC I, - Al ocyc/1 ,hereby supply the following releases as part of the application for a permit to demolish the structure located at U9 Lrina and shown on the Assessor's Maps of as being on Map # j I Block # O 3a Lot# O The sixth edition of the Massachusetts State Building Code, 780 CMR, states in part: "A permit to demolish or remove a building or structure shall not be issued until a release is obtained from the utilities, stating that their respective service connections and appurtenant equipment, such as meters and regulators, have been removed or sealed and plugged in a safe manner.,' -Utility to be Notified �A Notice Received by Date Received Gas 1-e-asP_ &(ee aA?_4 & Telephone. Electric Xectst see a4z,�k_& (AV gheAkLe Public Utilities (Municipal) nn Health Department Re 2 K p Fire Department Other - Other - Demolition debris hauler: Location of licensed I demolition debris landfill: �t� j_��,Q �� �n_n„ n4 Signature of Applican Date: Signature of O r Date: This sheet must be ret r 'e he Inspections Department along with a completed application for a permit, a site plan, and any other applicable information and fees. Demoperm.dot.