114 MARGIN ST - BUILDING INSPECTION $2(i�o 103
The Commonwealth of Massachusetts RECEIVED CITY OF
� Board of Building Regulations and StanONSPECTIONAL SE VIC18LENI
4Yt / Massachusetts State Building Code, 780 CMR Revised,Mw 2011
�^ Building Permit Application To Construct, Repair, Renov4#11,M Ig h A 4; Ob
One-or Tivo-Family Dwelling
This Section For Official Use Only
( Building Permit Number. Da pph
Building OBicial(Print Name). - Signature,: D to
SECTION 1:SITE INFORNIAT101V
I.I Properly Address: 1.2 Assessors Map&Parcel Numbers
I I�} Mp, ItJ 5
1.1 a Is this an acce ted street?yes Z_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dlmenslons:
Zoning District Proposed Use Lot Area(sq 11) Frontage(11)
1.5 Building Setbacks(D)
Front Yard Side Yams Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§5d) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone1 Municipal❑ On site Disposal system ❑-
Public❑ Private❑ — Check if esCI P
SECTION2: PROPERTYOWNERSHIP!
2.1 Owner'or Record:
EMILL� `)YUAeT/PAULA PEAQCE SWAMP Crf1--
NN me(Print) City,State,ZIP
I C-AL! WPES TCQ. 61-3- `16+-:M6
No,and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORW(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repair$1 ❑ Alteration(s) Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work-: REBUILD 1Xr STEPS SIDE Fazg( .
Q�1JOV 7C KITCN =tJ t.Yo-'A2 T L'kj 1 L THROD T .
s1 a-tALF M .
cot zs� r NEL0 AIf -1 s fA INS ccJ.
SECTION a:ESTIbIATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials)
I. Building S 2O O1Db I. Building Permit Fee:$ Indicate how fee is determined:
❑Standard City/Town Application Fee
2. Electrical S I Q, OZSC7 ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing 'S 10,OD 0 P Qther Fees: S
q.blcchmical (FIVAC) S List:
5. Mechanical (Fire S rotal All Fees:S
Sup ression)
Check No._Check Amount: -Cash Amount:_
6. Total Project Cost: $ 40,000 0 Paid in Full 0 Outstanding Balance Due:
1
SECTION 5: CONSTRUCTION SERVICES '
5.1 Construction Supervisor License(CSL) CS- 1 6G3q q a 22 IS
:(AG-T)0 W ILL JAMS License Number Expiration Date
N:une ofCSL Holder , 2
List CSL'fype(see below)
401(o NUMpll-l2c� 5T• — -Type - : - Description
No.and Street �yUnrestricted
S W AH FM )CCITT • U cdl2 Falnn a Dwellito ng
00 cu. Il.
R Restricted I&2F:unil Dwellin
Cityfrown,Slate,ZIP M masonry
MA- OL 2 2-2- RC Roofing Covering
WS Window and Siding
SF Solid Fuel Uuming Appliances
5� 353 CIS ��12V1YUi>nC �(j�yylp(� 1 Insulation
Telephone nail address D Demolition
5.2 Registered Home Improvement Contractor(HIC) F-1-1pr2-
I(,
3(J 5 T 10 (,Jl L-L 1 AT''\S HIC Registration Number Espirulion Date
HIC C�pa Nnm �HI�CRe l5nt.Name
k4 2 \�1PVu't�tnC @ Flo L
0.
01 JL�Mi�`�COr( - ro, SO% Email address
City/Town,State ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M G.L.e.152.$2SC(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 7o:OWNER AUTHORIZATION,TO BE.COMPLETED,W H EN.
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING.PERMIT'
I,as Owner of the subject property,hereby authorize TU,Tl IJ L,a li—L 1 A nS
t9 act on my behalf,in all matters relative to work authorized by this building permit application.
Ltl) /l5-
Print Owners Name(Electronic Signature) Date
SECTION 7b:OWNER!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.
L/ ZLL 411lls
Print W is or Authors Agent's Name(Electronic Signature) Date
NOTES:
I. 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 no have access to the arbitration
program or guaranty fund under 1M.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.ntass.eov:'dns .
2. When substantial work is planned,provide the information below:
'total floor area(sq. R.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. 11.) 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 ofcoolingsystem Enclosed Open
]. "Total Project Square Footage"may be substituted for"'total Project Cost"
1 i e `
CCL•l OF 5.1.I.E.%[a %L1SSACHUSEITS
\\JJ Ul:IL01\G DtP.4;tT>IE.\T
I_t m
0 CV.15HLVGTON SPIFFY, ) FLUOR
TEL (979) 7)5-9595
Jtn Iw
F.uc(979) 710.9M
:UNIBERLEY DFUSCOILL
I,LAYOA T�iosu3 Sr.P1>✓Qana
DIRECTOR OF PL'OLIC PQOPERTY/Sun.Dr\O CmLNIIISSIO SER
Workers' Cuirtpensatlon Insurance A17lduvit: Builders/ContractorvJElectrlcfans/Plumbers
1ppileant Inrormutinn T Pfeave Print I
.Nam:llhasiocvvOrganI lalidn,I nrlividu,dl: J�TIIQ
,Address: L i 9 L }-(o PrieE:-y S t tv 2
Cily/State/Zip:_ 3(/)AMRSC.CJ7-W PhuneN: isO�K _7�5
,1re you an employer'!Cheek the appropriNaxerclicd
Type of project(req73dditions.
I.❑ 1 atn a employer with 4. a suncral contractor and I
,,,/antployees(full and/or part-time).• hind the sub-canlnctars 6' , ,(New construc
2.pJ 1 am a sole proprietor or partnur. d on the attached.rheut, : f• f�l Remodeling
>hip and have no employees e sul►confneton he-,* 8. 0 r]emolition
working for me in any capacity, em'comp,insurance y. Q puilJing additi
INo workers'comp. insurance 1. re a corporation and iVrequired.) ers have axerclsed their 10.❑Electrical repai
J.❑ I tun a homcuwnur doing all work of exemptiu l per MGL 1 I.❑Plumbing repairs or odditlonsmyself. I\o workers'camp, 2,91(4),and we have no I1.❑Raof repairsinsurance required.j t yea. (No workers'. insurance requind.j 110 Other
•.v1ry applluud dot 01mlis but A mwl JIM all um rh•a.uliue twlow showing chair wevYm'I e•mpsnudun Peery maumullo0.' A.nvuwmw who.uhmil tnir s)tlrkvil indleulne ihry an doing ell rwra and rAen hiro uunide tuna a's mrwt ndn"ll a now atlidavil indlc`une such
rmlrywn th•1 ch6sa this box must auachud a"addulurvJ.hu•I,huwiny the nuwne of the vub.un risam and rhslr workers'cutup,pulley Infwmaaoe.
is elm an eloployrr that/s propldlnX workers'cumpeauallun Lasaranee/ar my el»Playtex 8rlow Is the policy undJub s!b
in�onuullnvl.
In,unncu Company Nmne:
Policy 4 ur Self-ins• Liu. d: Expirutian Date:
lub 5ile,Wdruss; City/Staletzipl
.Attach a copy of the)vorktn'compensatloe pulley declaration page(:howl",the policy number and etpindoe data).
F.liluru to vacura cuvenge as required under Section Il,\ul',%IGL c. 152 can lead to the imposition ofcriminal penalties of a:i%up to S 1,500 00 undlur one-year imprisonment, is well as civil penalties in this form of a STOP WORK ORDER and a line
or up al S2:000 a day against the violator. Ile advised that a copy of this.utemunt may W iurwurdcd to the Oflice of
lavr,ligutiunx"I ihd 01.1 G)r insunncd covaragc vcrilicvliun.
!du lrrrrby rrrri/y rra Jtr the 'au us. )tnulrh.r"f perjury rhut the inillurnratlulr provided ubovt is/rut'/red corrrrt
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v)/jicivl u,e surly. /Ls not i Wlir in liriv urru, la,Sea unrpltrdd 5y rr'ry ur rurvn n/Jlriut
City nr 1'uvn: ,. i'crmit/l.lccnve 'J
M uie+,,\ul lvu fly (rirclu
I. hoard nl Ilcahh !. Iluililing Ucporhnenl 1. !'ilyr l'nun Clerk 1. Vfeetricn) hnpcchir i. PhnnDin;� Invpauar;, Othar
l'nrin�l i'vruw:-
QTY OF SALEM MASSACUiUSEM
BMDjNGDEPARTMENT
120 WASIWGTON STREET,3ADFLOOR
T1 L.(978)745-9595
KIMBERL.EYDRISODLL FAX(978)740-9846
MAYOR THOMAS STAERRE
DIRECTOR OF PUTIM PROPERIYAUILDING 00MMISSIONM
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 c40, S 54; Building Permit# I is with the
condition that the debris resulting from this work shall be disposed of in a properly licensed
waste deposit facility as defined by MGL c 111, S 150A.
The debris will be transported by:
EQIC Z D IS?0SA2.
(name of hauler)
The debris will be disposed of in:
(name of facility)
(address of facility)
S ature of applicant
Date
Commonwealth of Massachusetts
! i1IM11111. -:
City of Salem a
120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 �
e
Return card to Building Division for Certificate of Occupancy
III Permit No. B-15-230
FEE PAID: $280.00 PERMIT TO BUILD
DATE ISSUED: 4/2/2015
This certifies that MARZA, LLC
has permission to erect, alter, or demolish ka_building 114_MARGIN STREET Map/Lot: 250500-0
as follows: Renovation REBUILD EXTERIOR STEPS (SIDE PORCH; RENOVATE; KITCHEN, FIRST
FLOOR HALF BATH, SECOND FLOOR BATHROOM; INSTALL NEW WINDOWS.
Contractor Name: JUSTIN WILLIAMS
DBA
Contractor License No: CS-106394
4/2/2015
Building Official f Date
t
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 constFuctiondocuments for which this permit has been granted.
i 1
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
I 1 1 k
This permit shall be displayed in a location clearly visible 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. -
The Certificate of Occupancy will not be issued until all`{kapplicable signatures by the Building and Fire Offcialsare provided on this permit.
HIC#: 173012 "Persons contracting with unregistered wntractors do not have access to[he guaran und"(as set forth in MGL c.142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.