0043 MARCH ST - BPA-14-961 (0-m i
The Commonwealth of MassIgOOTAWAL SERVICES
Department of Public Safety
Massachusetts State Building Code(78UZI 0 ) ' O O a
Building Permit Application for any Building other than a amt y elling I
(Phis 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)
43 ffAffyi Stet del I" m(4 D)G-:i-o
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 ❑ 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 ❑ No 18
Is an Independent Structural Engineering Peer Review rem red? Yes ❑ No 11
Brief Description of Proposed Work: 2 L
1 S.
tie
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
r -
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: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E. Educational ❑
F: Facto F-1 ❑ F2❑ 1 H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional I-1❑ I-2❑ I-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R-4❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA"❑ IB ❑ IIA ❑ 1I11 ❑ IIIA ❑ 1I111 ❑ 1 IN ❑ 1 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
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:
- t
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Modmill (( rmlow 43 fficc N q-1-C)
Name(Print) TU5t No.and Street City/Town Zip
Property net Contact Information:
IyLn ?mil-( -- CAYel W(ai JOWYXII,Wlj
Title pF TT�'elephone No.(business) Telephone No. (cell) e-mail dress
If applicable,the pr perty owner hereby authorizes
DlYl1Q-1 T-eMVCW Si,, &iAr 1 Peuh� MA DR(on
Name IStreet 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)
ff building is less than 35,000 m,ft.of enclosed space and/or not under Construction Control then check here O 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
Omw YY`G 1c�exv��n 1n�.
Company Name
\�( IrnP.I Te�vwbll�xa C5 - C4283 0
Name of Person Responsible fortonstruction, License No. and Type if Applicable
ta Fos-+-r R(kbc&A Mq _ 0\C1tV0_
Street Address City/To n State Zip
cooC(ke_oQZco( ,I • My)
Telephone No. (business) Telephone No. cell e-mail ad ress
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT .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:(tabor
and Materials) _ Total Construction Cost(from Item 6)_$
1.Building $ 35,OOO,OU Building Permit Fee=Total Construction Cost x (Insert here
2.Electrical $ 5 t 000.00 appropriate municipal factor)_$
3.Plumbing $ V31CO3,(DO
4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality)
5.Mechanical Other $
Enclose check payable to
6.Total Cost $ (5010W-QQ (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 kst of my knowledge and understanding.
oj) Rl
,rrlease r nt and sign name Title Tel
lU� del' Sul fc,
Street Address City/To b State Zip
Municipal Inspector to fill out this section upon application approval: s
Name Date
May 22, 2014
City of Salem
Building Department
120 Washington Street,#4
Salem, MA 01970
RE: 43 March Street, Salem
To Whom It May Concern:
Please accept this letter as an acknowledgement that the unit owners of 43 March Street,
Salem, MA have hired Danco Management, Inc. as a general contractor for the interior
renovation of units 1-4. We understand the work that is to be completed.
If you have any further questions please feel free to contact me directly at (978) 361-6846.
n e�
Courtney A dr ws
Windmill Point Condominium Trust Representative
1ST Sub
;ga The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
�Al Massachusetts State Building Code, 780 CMR Revi.edMar SALEM2011
,.
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building OfficiaP(Print Name) Signature Date
SECTION 1: SITE INFORMATION
Propr�AlddresY + 1.2 Assessors Map&Parcel Numbers
M
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?Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
Ownert of Rec rd:
rlrnill ))CW �C)GklLm W4 0n-4�
Name(Print) City,State,ZIP
+6 �ro,c� �r� ��� � —��C-4re-mhl" a C)
No.and Street Telephone Emall Addre
SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply)
New Construction❑ 1 Existing Building❑ Owner-Occupied ❑ Repairs(s) R� Alteration(s) Addition ❑
Accessory Bldg.R Number of Units I Other ❑ Specify:
Brief Description of Proposed Work':
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
Labor and Materials Official Use Only
1.Building $ 1S5eQQD.0C 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ lot d�� c)V ❑Standard City/I own Application Fee
❑Total Project Cosl3(Item 6)x multiplier x
3.Plumbing $ rj r DDD,b6 2. Other Fees::y$ Ir--
4.Mechanical (HVAC) $ List: 2V
5.Mechanical (Fire
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost $L�t ((� ❑Paid in Full ❑Outstanding Balance Due:
v
SECTION 5: CONSTRUCTION SERVICES
55.1 Construction Supervisor License(CSL) (0A 2 &0 � !R 9,o14
D0,1`1 0 —ffefyIV*l t l License Number Expiration Date
Name of CSL Holder
Win�,()�,////tttt. --Ri`a(� List CSL Type(see below) �1
.��1��,�1 L-V V Type Description
No.and S et YP p
�/�/`11 ni,,f1� 1 ^ OI(.t O U Unrestricted(Buildings u to 35,000 cu.ft.
e AV� Y M l"I R Restricted 1&2 Family Dwelling
City/Town,Sthte,ZIP M Mason
ry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
Q� 53'��cel2- (.�C>._u1000i�llerrl r�fa II� CCYh I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) t0q I�t G 3 ,7C)I
p 1-tl�l 1��- ' HIC Registration Number Expiration Date
C m anly�Name 1] ICRegistrant Name
II r�(QVY')(c)Ll, � 9GmCciI ,CUB
o.and St et Email ad' ess
City/Town, tate,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 ..........Ild No...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this build ng permit application.
Ohn l el_Tram c�u, I=row Cou q, &adco IlGrr�� 1/7 / —
Print Owner's Name(Electronic gnature) Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
By entering W name below,I hereby attest under the pains and penalties of perjury that all of the information
"orttain d it iVappl;t a and accurate to the best of my knowledge and understanding.
er's r ut orized Agent's N me(Electronic Signature) I b ateI
NOTES:
1. 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.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dpss
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 half/baths
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"