39 CAVENDISH CIRCLE - BUILDING JACKET 39 CAVENDISH CIRCLE _z 1
UPC 10333
No. 153L-3
HASTINGS, MN
OP-2001-0018
Commonwealth Of Massachusetts
City of Salem
BUILDING,ELECTRICAL a MECHANICAL PERMITS DEPARTMENT
This is to Certify that the
___-_______-RESIDENCE located at
---------------------------
Dwelling -------
Type
0039 CAVENDISH CIRCLE in the
-------------------/----------- ----------------CITYOFSALEM
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'S HEREBY GRANTEDA PERMANENT
CERTIFICATE.OF OCCUPANCY,-)
Permit#1340-2000
New sing
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This permit is granted in conformity with
the Statutes tatutes and ordinances relating thereto, and
unless sooner suspended or revoked.
Expiration D
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Date
Issued On: Mon Oct 16,2000 - - - - ----
.
GooTME;& ,1998 Des Laurie . .......
Associates,Inc. -----------
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0039 CAVENDISH CIRCLE 1340-2000
GIS#: 10144 - COMMONWEALTH OF MASSACHUSETTS
Map: CITY OF SALEM
Block: 882
Lot: 0081
Permit: Building
Category: 102 New single famil BUILDING_ PERMIT
Permit# 1340-2000
Project# JS-2000-.0195 {�
Est. Cost: $95,250.00
Fee: $1,014.81 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: R3 Applicant: Fafard Development Corporation
Units Gained:
Units Lost AT. 0039 CAVENDISH CIRCLE
ISSUED ON: 22-Jun-2000 EXPIRES ON: 22-Dec-2000
TO PERFORM THE FOLLOWING WORK.
Bldg#185. Unit C. Coach Style
Construct 4 unit condominium building as per plans.T.J.S. , Call for Permit to OCCUPY
POST THIS CARD SO IT IS VISIBLE FROM THE STREET �J
Inspector of Plumbing Inspector of Wiring D.P.W. . Inspector of Buildings
Underground: ( '` Service: Meter: Footings:
Rough:v/1 2-'3t-0)-4M,,t-0)-4M,, Rough: ?//10 y�� House# Foundation: Y // /
Final:( ,/</()—r3 b Final:/p�2 6b ✓ t Rough Frame: (7'e U
f—h"t 'S ao
Fireplace/Chtmney:
Gas Fire De a tm t Board of Health _
��� G Insulation:
Rough:
Final:
(� �
j3- �� Smoke
FinalOryr %O/
Treasury:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF
ITS RULES AND REGULATIONS. •
Signature:
t .
Fee Type: Receipt No: Date Paid: Check No: Amount:
BUILDING REC-2000-000193 22-Jun-00 11166 $1,014.81
GeoTMS®2000 Des Lauriers Municipal Solutions,Inc.
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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
(This Section Por 0ffic`at Use_Only)
Building Permit Numbex s Date Applied Building Ofhctal..
SECTION 1:LOCATION(Please indicate Block#and Lot`#for locations forwhich"a"street address is not available)
Bldg 185 39 Cavendish Salem 01970 Green Dolphin
No.and Street City/Town Zip Code Name of Building(if applicable)
SECTIOIQ 2i P,ROPOSED MCORK - ` •`•'� ,, ``
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 Lt9 Addition❑ Demolition ❑ (Please fill out and submit Appenix 1)
Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: -w
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ �No ff)
Is an Independent Structural Engineering Peer Review required? Yes ❑G"No [X3 rn
Brief Description of Proposed Work: Remove and replace roofing shingles
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:SECTION 3:COMPLETE THIS SECTION IF EXISTING 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): mesidentiai Proposed Use Group(s): Residential
" SECTION 4:BVILDING,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 ❑ A4❑ A-5 ❑ B: Business ❑ E: Educational ❑
F: Factor F-1 ❑ F2❑ H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H4❑ H-5 ❑
I: Institutional I-1❑ I-2❑ I-3❑ I4 ElM: Mercantile❑ R: Residential R-10 R-2 EX R-3❑ R4 ❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below:
Special Use:
.tip'; c"SECTION6'CON
STRUCTIONTYPE Checkasa icable
( Pl>
IA ❑ IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ VA ❑ VB ❑
SECTION 7:'SITE7NFORMAt30N(refer'to 780 CMR.111.0 for detaiis:on each rtem)';-;(
D s Trench Permit: 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;GERTIFICATE OF,OCCUPANCY ;
Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
;' ? -'� `fi "�` :SECTI,ON;9 ;PROP,ERTYOW_NERAUTIIORTZAT_IO_N � ''` °'nr r ""'
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 lo:CONSTRUCTION'CONTROL(Please fill out Appendix
'(IfbiAlding ie less than 35000 cu,ft of enclosed ace and o'r noY under ConstruetipmControl thertcheck here C. and sid Sectaon 101
lOaRe 'ste ed Profess onal`Res onsible for Construction Control is + - �• ':e
Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractok, . 7 7r
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
} SECTION 11:.WORKFRY COMPftNSATION INSUR CE FP[DAViT M:GiL':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 13 No 0
CONSTRUCTION COSTS AND PERMIT>EE
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
SECTION-1
3i SIGNATURE OF`BUILDING PERMIT
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 acct,rate to the b st of my knowledge and understanding.
ry, President 603=895-0400 8/18/15
Please print and sign name aP '" i nesain Title Telephone No. Date
25 Spaulding Rd Ste 1 Fremont NH 03044
Street Address City/Town State Zip
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