10 NORMAN ST - BUILDING INSPECTION (4) What is the current use of the Building? �o
Material of Building? 3 rI t( I/ If dwelling.how many units?
Will the Building Conform to Law? / S Asbestos? /U�7
Archited's Name
Address and Phone ( )
Mechanic's Name Ii n
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost of Project
t�$ °c'O' °v Permit Fee Calculation
Permit Fee$ Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
An Additional$5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to Vu*d the�ve stated
specifications. Signed under penalty of perjury
Date L v v 6
V
a
L
o
l N
a
6 i 0
6
> .fir
!z' a a a
!A TIED 1NsuRA1% 7,�1- 3 S —077f �o. baa2
CERTIFICATE OF INST` J7�K e NCE E 3/3
PRODUCER �"`4 u ISS'e DATE(My/DD/1'Y)
Diwirgilio Insurance Agency RIG AE A MATTER F
CO:YI+ERB NO RIGHTS UPON THE CERTIFICATE p pg�THIS� Y AND
PO PPOOtF,CCINF�S BELOW E OR ALTER THE COVERAGE AFFORDED BY7
PO Box 80G5 0�
TEE
Lynn, MA 01904 COMPANIES AFFORDING COVERAGE
—
INSURED
Robert Picone
dba RMI Construction COMPANY A A.I.M. Mutual Insurance Co
14 Arnold Terrace
Marblehead, MA 01945
COVERAGES
TPnS t5 TO NOTWITHSTANDING
THAT NDI POLICIES OF INSL7lANCE LISTED EELOW FIgyE BEEN ISSUED TO THE INStJgep N4MEp AgOyg�R,��uCy PIItIOD
INDTCATEU,NOTWI7HSTANDNG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR
CERTIFICATE MAY BE ISSUED OR MAy PERTAIN,THE INSURgNCE AFFORD
EXCI,U.SIONS AND CDNDTCIDNS OF SUCH POLICIES. LLMlTS SHOH'N MAy HAVE BEEN REDUCED By pgip CLALNUMENT WITH RESPECITO WMCR TF0
ED BY THE POLICIES DESCRIBED HEREIN IS SUBIECT TO ALL THE TERMS,
CO
I.TR TYPE OF LNSORANCE POLICY NUMDER I POI.ICV BFFgOnn MR. -�--���
EKPD
NER UhAL LLIEIt,I7y DATF.(MMIUDIYY) DnTE(TE(MM/DONY)D/YY) LLMTE
('OMMERf.IAI,GF,pERM1L WAbILITT GENERAL A...... ATF
S
A INS MA%=X(;OR PRODIICTSCOMP/OP
OW NPR'.5,4 CON;µACG'OR"S 11RU I, YERSDM1'AL 4 ADV.INIVRY
S
P-ncN occvRRENa S
PIRG Dn.NnOE(A�ry uik lire) S
�AIfITXyOgII.E LL\DILTr3' NED.EXPENSE(kVd.P ) I S
ZANY ALTO I CNM91NFD SINGLE S
ALL OWNED AUTQti
GCNFLULF.0 nUfOS - - I ,.
--BODILY IW URV.
MIRED AUTOS lftrporom) J '
NON{IWNED AUTOS tlODILY INJURY
�CARAOE LIAOILIrY Pcr:+ziGoul I t
PROPERTY DAMAGF, I II�A('Cy-`1.LVIrLTTY
P IMDREI.LA rnRM CACIJ OCCVARE.NCE $
,U'1'1iERTIUNl1MERELLAFORM AGORGOATG S
WORKER'S COMPENSATION AND
GMPI,OY[R$'LIABILN Y
X wcs Aru- orn..l
A THF;,ROPRIE'low ^ 6011610012007 02R7R007 02 ti
PARTN C, XbCVfWE INOI. I - /27/2008 T
Act, � s
Di"Fµ:ERSARB'' FI,yISEASfi.-POLICY I.IMI S 5
OTHER x fx�:i 00000
IEL
DISC SF-FA EMPLOYEE S 100 ow
DIL(CRSITIUN OF OTERATIOM1:Sa.00ATIONiNpA1(7,ENSpBCtAL ITRA(S
CERTIFICATE HOLDER
CANCELLATION
HOULD
Y Op THE ABOVE
ALL MAINTENANCE PROPERTIES EXPIRATION ATE THEREOF, HE ISSUING NG COMPANY WILL D E RE Tf¢
CIO MARKWOOD MGMT. \/ MAIL 10 DAYS WRITTEN NOTICE TO THE CBRTII7CATEHOL ENDER O To
1` LEFT.BUT FAILURE A TO,MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
HE
LIABILITY OF. ANY KLVD UPON THE COMPANY,
REPRESENTATNES. -ITS AGENTS OR
,IITHORIZEEp REPRP$ENTATIVE �`..
r
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
Knrariati,t tutmcou
MA
lX WA9Q!'T►St'aur a sets K MA39ACMWM0lW0
Workers' Compensation Insurance AffIdavlt: BnfldeyCootnc bmvMo
�KMda A_Qnikant InSormallos ns/Plambera
te.r •Last[
Names �)' R ✓ T
Address:
�
Cit3atate2ip: /l'l a� lr 1���� Ma 0/a ,�- —Phone
F' Fp
am employer?Cheek the appuoprlaa boat
employer with 4. ❑ I am a Scustal eonnacter and I �of Project(�m�e'
cosiouccloo
(11r11 and/or paeFtime).• have hired the sub contractor 6 ❑Neroproprietor a par>oea lined oa tke seethed s6eef t 7.d have no empioyeea These hawtg fa me m any eapaciry, worker'�ingnance, g' �Demolitfan
rker'�insurance S. We ar a corporation and ion 9, Building additim
3. I a�mms d� o>fkan have 7=orkm'
their IO.Q glectricat repair or
additions
homeowner doing all work right of IU9104MGL 1113 Plumbing repair or addldono
myself.(No worker'comp. C. 152,41(4), ave no
rnsutan� dl t employees(N 12.0 Roof re�pjair_ comp.insurance ) 13.Q Other I�rl c,�C 0
ftemaowaau r0bo adrk this boa atlld.d:1 noon w.fin set rim taedaa 6aloe drwlaa dWrwwkaa•aamp�ply Whnu aa,
rCoaracl=drat dw*dds boa mint mael add doing
dmoheg eweds ad®Of��e�mirk w�6adt•saw of m"md{e�g toA,
sobcoofteing and ttrtr aalora comp D�.Y kknudaa/oar am eatployp that LprovldLkr worbrs'co wag
arsare for My err lnjonwadoro W ployeea Belote 4 At policy and job rip
insurance Company Name;
Policy#or Self-ins.Lie.#
ExPirldon Date
. Job Site Address:
Attach a copy of the workers'compenserjon Polley declarations Ciry/StateJZip;
page(skewing the policy number aad expiration rise}
Failure w secure coverage as required under Section 25A of MGL a 152 can lead to the impos fires of criminal Pon
fine up to S 1,500.00 and/or one-year imprisonment,as well as civil Penalties im the form of a STOP WORK ORDER amend of flu
of up to$250.00 a day against the violator. Be advised that a c
Investigations of the DIA for' °�°f statemeor maybe be forwarded to the Offte of
uwuance coverage verification,
/do hereby tern de the petits d ea/des o
fPerJary'Aar 48 injormadon provldel ve is and Correa
Sianaturc ���
Phone C
011leld use only, Do not write In this area to be compleed by city or tows o,Qlcid
City or Town:
Permlb'Lkeme#
Issuing Authority(circle one):
1. Board of Health 2. Building Department J.City Ows Clerk 4. Electrical Iaspector S.Plumbing Inspector
6.Other
Contact Person
Phone*
Information and Instructions
`tassachusema Gemeral Laws chapter 132 ngtsua employers to Provide workers' other under
a for ontrfti ct o(hi sI,
Pursuant to this statute.an empteyea
is defined requi a "...avety Prayers m the Se wOr of another undo[any C06Qaet Of lure. �
express ac MPI14 onl or iNnum.- a ocher legal entity.of any two of mot
An employer is defined as"ad uldividud,Pa p ves of a deceased employer,of e
the ea However
of the foagomg engaged in!jogs emtecpciae. association of other kgd entity,employing employ of the
receiver a ttt►soea the
of an individual,Parmash* who resides therein,a the oocnpant
owner of a dwdnng bouts having
not mere than tbs�main. weds an rich,dwtdling battse
of npaa
dwelling wow of aratdw who employs ahau no beaus of itch smploYm�be wed to be m emPh►yar'
or on the groumda errbtuildinf appt reffil r " a that wwdiold tw lummes or
MGL chapter 152,425Q6)am rum that eve ataa wt beat tlara e g �meamoaw��err!
to operate a Weise"or a eettWreet d1dV0 Is
rerew>v ApplicanOf
h�u stoat�edoeed acceptable� m of eomplis wkY tM Wr An ny Of it a eon" than
AA��nally,MGL chapter 132,}2SCM sums" ' acceptable evidence
of compliance vruh die mausana
am into my of"cchantract ptpter,have to the contracting authO*•
requkemm"
III le RNMIIIIIIIIII,
AppU"to ,Wtchecking the boxa that apply m'Y=rnudm anti.tit
atlid dre eom)end phone.by numbetshi Al ng wi wttti ewe 8)of �°the
neat All out the workers a( � ��Ley
necessary.supply s�'COmu�Or(
insurance. LW&M Liability mania we not mpired 0 clay w or orkers,cm °u iasurs> if an LLC or LLP dot haw
that this affWavit way be submainai to the MP""Oser
e a le n9�rs& Be amembers at WOOMdvised ,Wi be ran to 84&era"date the atIIdavM The a@id<vit should
Accidents returned«confinnation of that application,tar du Permit or Hemse is being n9�not du Dqm meat of
m the city Should Yen have any 40Os the taw a if you an required m obtain a workers'
compmmtton policy.Pbsl"all the Depounat the ember Booed below. Salt-immed eompenm should enter their
self-ilia saga Scmss slumber oa the
City or Two Ofedab a space at the bottom
legibly. The DePutnt t has Provided
andutter.
complete printed a
cothe
Please be sure that the affidavit u the event the Offiea of Investigations has m contact you ngading
of the affidavit for you w out m enae number which will be used as a refamee number. In additio4 applicant
Please be sun to fin in the P°rmm licatione in any given yea,need only submit one affidavit indicating current
that moat submit n(if ne pamu)and se under
or minced by the city or town may be provided to the
policy must
submit
(d necasacY)and under"Jab Site Addme the applicant should write"an locations in__—(m9'or
town): A copy of the affi&'v that has hem ole for Y stamped or licenses. A now afudrvu mutt be filled out acb
applicant as proof that a valid affidavit it t fib f a license cc permit not mated to any business a eommac gal venture
year.When a home owner of cite=u obtaining is NOT required to complete this affidavit
(i.e.s dog license of Patent to bush lava am.)said person
ns would like to thank you in advance for Your cooperation and should you have any queemons4
The Otlica otinverigatio
please do not hesitate to give us a can.
's address,telephone and fax number
The Department ,U Commoweolth of Munchusett s
Depuament of bbst rid Accidents
Omae of 1RVVSdPdons
600 wsI same
Boston,MA 02111
TeL #617-727.4900 W 406 of 1-877-MASSAFE
Felt#617-727-7749
Revised 5-26-05 WWWxUss.$0v1du
Markwood
Management
Incorporated
April 3, 2007
Mr. Thomas St. Pierre
Salem Building Inspector
City of Salem Building Department
120 Washington Street
Salem Massachusetts 01970
Dear Mr. St. Pierre:
Please be advised that the Heritage Plaza Condominium Trust, 10 Norman Street, Salem,
Massachusetts, has contracted with Robert Picone (RMJ Construction) to reconstruct the
brick columns at the rear entry to 10 Norman Street. This work has been approved by the
Heritage Plaza Condominium Board of Trustees and Markwood Management.
Sincerel Y u ,
Mark W. ivermore
Property Manager
MWL/kd
Post Office Box 900 ■ Marblehead, Massachusetts 01945
Telephone (781 ) 639-4080 ■ Facsimile (781 ) 639-0228
markwoodmgt@hotmail.com
EITY-OF`'SALE. --
PUBLIC PROPERTY
DEPARTMEINT
I:I�MEttEY Dµ51:ULL
MAYO& 130 WAswNGuw bimwr•5'�%dtisna+t:stl'rs 01970
14i 971{US-%9S•FJM 976740.9646
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION,
DEMOLITION OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDING
rSiTEINFORIMtIATION
TION
' /✓�/r ti1/ Building:ed in a;Conservation Area YIN Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: V7 P
Address:
Telephone:.
3.0 COMPLETE THIS SECTION FOR WORK IN EXS1tNG BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per Floor (sn Renovated
construction or renovation New
of existing building
Brief Description of Proposed Work: ice V/O-;✓ ( //C/c
----- - ----Mail Permit to: `E r