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7 MAJESTIC WAY - BUILDING INSPECTION (2) � f21 L i�'x 832— �•. 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 (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 stre t address is not available) In 7 Mof e_&4iC tjM eM w 01970 ( No.and Street City Town Zip Code NamJ of B ing(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 .(1 Existing Building❑ Repair&( I Alteration`11 Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy O 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 I Brief Description of Proposed Work: ' DQ WA.(( a11d Fl00✓;flq /,iP tJaS SECTION 3i COMPLETE THIS SECTION IFEXISTING 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.ft.)and Total_Height(ft.) SECTION 5:USE GROUP(Check as applicable) - - A: AssemblyA-1 ❑ A-2❑ Nightclub ❑ 'A-3 ❑ A4 ❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional I-1❑ I-2❑ 1-3❑ I-4❑ M: Mercantile❑ R: Residential R-12' R-2❑ R-3 ❑ R4 ❑ S: Storage S-1 ❑ S-2❑ U: Utility 0 Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIBD IV 1 VA VP SECTION 7:SI_TE INFORMATION(refer to 780 CMR 111.0 for details on each item) " Trench Permit: I Debris Removal: Water Supply: Flood Zone Information: Sewage Disposal: Licensed Dis osal Site❑ Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be P Private❑ or indentify Zone: or on site system❑ required ❑or trench or specify: 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❑ 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: MI-Alt_tz�0 Ze SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner Name Zlt�0. Mf filC(A N�aMR 2Sj C I�Q SCL �2/�J City/Town M� of q70 rin Zip Property Owner Contact Information: `nd � 609 _g86_ g979 617. 37,2_ aZ68 ( Zet9 fai¢iku@°gMat'r. arm Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes Name Street Address City/Town State Zip to act on the property er owner's behalf,in all matters relative to work authorized by this building ermit application. ` SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If buildingis less than 35,000 cu.ft.of enclosed s ace_and/or not under Construction Control then check here O and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control .DOUGI-AS AP,EaCo _417- Sq;t, ISO cs — o877/97 Name(Registrant) elephone No. e-mail address Registration Numb 7 SO Ful Number S� LVedef-F MA od-I l Street Address City/Town " State Zip Discipline Expiration Date 10.2 General Contractor - Company Name /3 8 301 oUGLA-S 6U Lo Name of Person Responsible for Construction License No. and Type if Applicable 50 merle r S-fYee4 C j14e-ems 1'1 A o a 1q_ Street Address " City/Town State Zip 5012-1561 Telephone 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 the issuance of the building permit. Is a signed Affidavit submitted with this application? Yes ❑ 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 $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check payable to 6.Total Cost $ i aa.� . 9 (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. j iZIf+a k(A 372 2269 Please t and sign name Title Telephone No. Date prin M 4 o4i-C w�i S'altm MA d 1 g 9 Street Address City/Town State Zip Municipal Inspector to fill oufthis section upon application approval: Name Date rl Appendix 1 For the demolition of structures the building permit applicant shall attest that utility and other service connections are properly addressed to ensure for public safety. Please fill in the information below and submit this appendix with the building permit application. The building permit applicant attests under the pains and penalties of perjury that the following is true and accurate. Property Location (Please indicate Block # and Lot # for locations for which a street address is not available) No. and Street City /Town Zip Name of Building (if applicable) For the above described property the following action was taken: Water Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Gas Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Electricity Shut Off? Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ - Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Yes ❑ No ❑ Provider notified and Release obtained? Yes ❑ No ❑ Other (if applicable) Appendix 2 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required for this. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete_ Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing include local connections) 9 Gas Natural,Propane,Medical or other 10 Surveyed Site Plan Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investi ation 16 Energy Conservation Report 17 Architectural Access Review 521 CMR 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 -Other(Specify) 'Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction.Work started prior to approval may be subjected to triple the original permit fee. Registered Professional Contact Information Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Discipline Expiration Date Street Address City/Town State Zip The Commonwealth of Massachusetts w e Department of Public Safety A} Massachusetts State Building Code (780 CMR) s @' Building Permit Application to Construct, Repair, Renovate or Demolish any Building other than a One- or Two-Family Dwelling Code and Other Requirements for Building Permits The Department of Public Safety has issued these building permit application forms so that municipalities across the state can move toward use of a single permit form and consistent permit application process. The MA State Building Code specifies the requirements of building permits and the applicant is advised to review and be familiar with these requirements in order to avoid some of the common permit application problems. Likewise the applicant should be aware that some municipalities require that the owner confirm, even prior to acceptance of the building permit application, that no outstanding property taxes, water fees, etc. exist. Filing Instructions 1.Please contact the city or town where the work will be done to ensure that the city or town will accept this application form and if any additional information is required, and obtain the correct mailing address. After doing so, print the application, fill in completely and then submit to the local city or town where the work will be done. 2.All applications shall be considered complete and will be reviewed if construction documents, specifications, fee, and other materials that may be required as indicated in the Building Permit Application are included with the application. 3.Please include a check for the Building Permit fee. The fee may be calculated using the information to be supplied in section 12 of the Building Permit Application. The check is to be made payable to the local city or town where the work will be done. The✓ Lamk condominium Trust January 20, 2016 To Whom It May Concern: Please be advised that due to damage from frozen pipes at 7 Majestic Way in Salem, the owner(Tizita Mitiku) will be conducting renovations to the basement including drywall repair and painting. The owner will obtain a building permit and the work will be conducted by a licensed contractor. Should you have any questions,please contact this office at 978-532-4800. Sin ly, Ptu 1 he: CROWNINSHIELD MANAGEMENT CORP., As Managing Agent for Hamlet Condominium I Managed By Croivninshie(it T4anagement Coy., 18 CroivnbuhieffStreet, Peabody, AA oig6o Pbo1e (978)532-4800 , J-az(-078).532-Go23 - wtriv.crowrtinsh.ieCdconi Commonwealth of Massachusetts ° City of Salem i° 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 Return card to Building Division for Certificate of Occupancy Permit No. B-16-57 PERMIT TO BUILD FEE PAID: $121.00 DATE ISSUED: 1/20/2016 This certifies that MITIKU TIZITA K MITIKU ZENEBE W has permission to erect, alter, or demolish a building 7-U122E_MAJESTIC WAY Map/Lot: 120003-801 as follows: Repair/Replace REPAIR DAMAGE TO DRYWALL & FLOORING:CAUSED BY BURST PIPE Contractor Name: DOUGLAS AREVALO� I DBA: DSC PAINTING AND CONSTRUCTION I Contractor License No: CS-087797 1/20/2016 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. I N All construction,alterations and changes of use of an)building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visib`le 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. I The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials,are provided on this permit. HIC #: 138301 rsons contracting with unregistered contractors do not have access to the guaranty fund'(as set forth in MGL 042A). Restrictions: Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. Marcia Kirkpatrick From: Harry Wagg Sent: Monday, January 25, 2016 3:29 PM To: Marcia Kirkpatrick Subject: FW: Letter from Condo From: Tizen Mitiku [mailtoaizen.mitiku@gmail.com] Sent: Monday, January 25, 2016 8:59 AM To: Harry Wagg Subject: Re: Letter from Condo Good morning Harry, I would like to update my permit application to close up drywall at my Condo located at 7 Majestic Way, Salem MA. 01970. The Drywall contractor who agreed to do the work when I submitted the permit application said he is no longer available to do the job. So, I hired another contractor to do the job. I have provided the old contractor and new contractor's info below. So, please remove old contractor's info from my permit application and update it with the new. OLD Info: Contractor Name: Douglas S. Arevalo HIC# 138301 License# 087797 Scope of work: Repair Damaged to Drywall & Flooring Caused by burst pipe New Info: Contractor Name: Thomas Cromer HIC# 114517 LIC# 050958 Scope of work: Insulate and repair drywall caused by burst pipe. Please let me know if you have any questions. Best Regards, Tizita Mitiku On Wed, Jan 20, 2016 at 9:53 AM, Harry Wagg <hwaggC&salem.com>wrote: Hello Tizen, Thanks. Go ahead and close things up. Call me when you are finished. 1 Good Luck. Harry Harry Wagg Assistant Building Inspector hwagg(@salem.com 978-619-5643 From: Tizen Mitiku [mailto:tizen.mitiku(algmail.com] Sent: Wednesday, January 20, 2016 9:46 AM To: Harry Wagg Subject: Letter from Condo Dear Harry, Please find the attached letter from our condo association management confirming that we will be doing repair work at our condo located at 7 Majestic Way, Salem MA. 01970. Please let me know if you have any questions Best Regards, Tizita Mitiku 617-372-2268 Please note the 1t:rssaehnsetts Secretary of Sta"C"s office has determined that most emails to and fronm mnuniciplll Officials are pubiie records.lilt please refer to; littp:/hrww.sce.state.ma.us/pre/preidx.litm. Please consider the enviromnew before}hinting,this email. 2 Good Luck. Harry Harry Wagg Assistant Building Inspector hwagg a(�.salem.com 978-619-5643 From: Tizen Mitiku [mailto:tizen.mitiku(aOgmail.com] Sent: Wednesday, January 20, 2016 9:46 AM To: Harry Wagg Subject: Letter from Condo Dear Harry, Please find the attached letter from our condo association management confirming that we will be doing repair work at our condo located at 7 Majestic Way, Salem MA. 01970. Please let me know if you have any questions Best Regards, Tizita Mitiku 617-372-2268 Please note the:1lassaehusetts Secretary or State's office has determined that most ennails to and fr(ml auunicipal oflieiais.u-e pulilie records. P*11 please refer to; http://www.see.state.ma.us/pre/preidx.litm. Please consider the environment before painting this email. 2 Marcia Kirkpatrick From: Harry Wagg Sent: Monday, January 25, 2016 3:29 PM To: Marcia Kirkpatrick Subject: FW: Letter from Condo From: Tizen Mitiku [mailto:tizen.mitikuCalgmail.com] Sent: Monday, January 25, 2016 8:59 AM To: Harry Wagg Subject: Re: Letter from Condo Good morning Harry, I would like to update my permit application to close up drywall at my Condo located at 7 Majestic Way, Salem MA. 01970. The Drywall contractor who agreed to do the work when I submitted the permit application said he is no longer available to do the job. So, I hired another contractor to do the job. I have provided the old contractor and new contractor's info below. So, please remove old contractor's info from my permit application and update it with the new. OLD Info: Contractor Name: Douglas S. Arevalo HIC# 138301 License# 087797 Scope of work: Repair Damaged to Drywall & Flooring Caused by burst pipe New Info: Contractor Name: Thomas Cromer HIC# 114517 LIC# 050958 Scope of work: Insulate and repair drywall caused by burst pipe. Please let me know if you have any questions. Best Regards, Tizita Mitiku On Wed, Jan 20, 2016 at 9:53 AM, Harry Wagg <hwaggLcesalem.com> wrote: Hello Tizen, Thanks. Go ahead and close things up. Call me when you are finished. 1 Good Luck. Harry Harry Wagg Assistant Building Inspector hwagg(d)salem.com 978-619-5643 From: Tizen Mitiku [mailto:tizen.mitikuCQlgmail.com] Sent: Wednesday, January 20, 2016 9:46 AM To: Harry Wagg Subject: Letter from Condo Dear Harry, Please find the attached letter from our condo association management confirming that we will be doing repair work at our condo located at 7 Majestic Way, Salem MA. 01970. Please let me know if you have any questions Best Regards,g , Tizita Mitiku 617-372-2268 Please note t}si mnssachuseds Seeretary of St-ate's office has tieterminecl that most ernaits to and from muricip.ni officials are public record". P*11 pieasc,refer to; htip://www.sce.state.ma.us/pre/preidx.litm. Please consider the em irouirieut before printing this email" 2 Marcia Kirkpatrick From: Harry Wagg Sent: Monday, January 25, 2016 3:29 PM To: Marcia Kirkpatrick Subject: FW: Letter from Condo From: Tizen Mitiku [mailtoaizen.mitikuCalgmail.com] ��_._._........ ... .__.__._......__.�.__.__._. .�.m ...__.�w_.�.__._._...._..__ Sent: Monday, January 25, 2016 8:59 AM To: Harry Wagg Subject: Re: Letter from Condo Good morning Harry, I would like to update my permit application to close up drywall at my Condo located at 7 Majestic Way, Salem MA. 01970. The Drywall contractor who agreed to do the work when I submitted the permit application said he is no longer available to do the job. So, I hired another contractor to do the job. I have provided the old contractor and new contractor's info below. So, please remove old contractor's info from my permit application and update it with the new. OLD Info: Contractor Name: Douglas S. Arevalo HIC# 138301 License# 087797 Scope of work: Repair Damaged to Drywall & Flooring Caused by burst pipe New Info: Contractor Name: Thomas Cromer HIC# 114517 LIC# 050958 Scope of work: Insulate and repair drywall caused by burst pipe. Please let me know if you have any questions. Best Regards, Tizita Mitiku On Wed, Jan 20, 2016 at 9:53 AM, Harry Wagg <hwa�t<ilsalem.com> wrote: Hello Tizen, Thanks. Go ahead and close things up. Call me when you are finished. 1 Mr. Luis Minaya 3 Mason St Salem, MA 01970 Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPSS) Mass.Gov Home Slate Agencies ensee Details raph"r- Inform ull Name: O F CROMER ender: viner Name: go-p dress: ddress 2: ity: WALTHAM tate: MA ipcode: 02453 o nt U 'ted fates nr License o: ub-ubu9bb License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 12/24/2014 Issue Date: Expiration Date: 12/4/2016 License Status: Active Today's Date: 1/26/2016 Secondary License: Doing Business As: atus Change: Lic se Renew I o Pre—requisite Information 69 No Discipline Information ocumen um Close Window ©2011 Commonwealth of Massachusetts Site Policies Contact Us http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1&license_id=239920& 1/26/2016 Office of Consumer Affairs&Business Regulation- Mass.Gov https://services.oca.state.ma.us/hic/licenseelist.aspx The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation Home Consumer Rights and Resources Home Improvement Contracting Home Improvement Contractor Registration Lookup To search by registration number, enter the registration number in the textbox below and click the 'Search' button. Search by Registration Number 1114517 Search You must click the "Search Registrant" button to search by name or location. Search by Registrant Company name Search by Registrant Last name City/Town I Search Registrant State Tip code i Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Monday, January 25, 2016. Search Results REGISTRANT RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS NAME INDIVIDUAL NUMBER DATE CROMER REMODELING CROMER, THOMAS 114517 40 CHESTER AVE. 09/22/2017 Current WALTHAM, MA 02453 ©2012 Commonwealth of Massachusetts. Mass.Gov@ is a registered service mark of the Commonwealth of Massachusetts. i I of 1 1/26/2016 7:58 AM