6 PARADISE RD - BUILDING INSPECTION CITY aFLEl -
�'' PUBLIC PROPERTY
DEPARTv1E,'�TT
KmaERLEY DRISCOLL
MAYOR 120 WASHINGToN SHREEr•SALEK XAbSAC HLSh1-rS 01970
TM 978-74S-9S9S*FAX;978.740.9846
APPLICATION FOR THE REPAIR, RENOVATION CONSTRUCTION,
DEMOLITION OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building:
Property Address: 9R4 JI sC of6,4-6
Property is located in a; Conservation Area YIN_L_Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: ✓ t7�.J�r (,�Rr✓ _
Address:
Telephone: 7— 23 S U
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING. BUILDINGS ONLY
Addition Existing
Renovation ✓ Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation I ����, New
of existing building
AriPf Description of Proposed Work:
A-r'iJ �bt5£� 4���✓ £ Tl�i�o.cb �-
-------Mail Permit to: J ✓��Z Jr �• -- - —
What is the current use of the Building? t'+�Y✓
Material of Building?C/�� - � If dwelling, how many units?
Will the Building Conform to Law? Asbestos? /V U
Architect's Nameo%3�/' e�Sr�✓1 C �u c/
Address and Phone ( )
Mechanic's Name
Address and Phone
Construction Supervisors License# 062 'C�F HIC Registration#
Estimated Cost of Project S 3(vt/ 06 0 Permit Fee Calculation
Permit Fee$-5 9(P 5 760 Estimated Cost X$71$1000 Residential
Estimated Cost X$11/$1000 Commercial
An Additional $6.00 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 Buildin ermit to bull to a
Signed under penalty of e u
specifications. g p lty P
Data d— a - 07
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Martins
Design . Construction
Real Estate Development
130 Sylvan Street
Danvers,MA 01923
Charles Harting t: 978.777.9084
/7 g f: 978.750.4281
lu�� Pn c: 978.836,6323
e: charles@martinscompanies.com
)PPgc�y w: www.martinscompanies.com
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6 j4 IFIC ikTE OF LIABILITY INSURANCE pppp,D B DATE(MWDWWYY)
PRODU46R NARTI-3 01 18 07
THIS CERTIFICATE RG 1SBUED AS A MATTER OF INFORMATION
De9aneki• Insur ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
36 Cuamin • Par Agcy, :no.
HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
Woburn GBLg01 BOl ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Phone: 781-935-8 rax:7 -933-56d5 INSURERS AFFORDING COVERAGE NAIC0
W SURED
INSURERS. Acadia Insurance
CMRBiiIY
!darting ructi Company, INSURER B:
��331i �Byy INSURER C:
Dannvo a t INSURER D:
INSURERb:
COVERAGES
THE POLICIES RE OF XIENUNCE LOW HA EEN ISSUED TO THE*dURED NAMED ABOVE FOR THE POLICY PERDD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OF ANY TOROneROOCUMENTWITN RESPECT TO W1iICN THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE O D BY THE ME DESCRIBED MOWN a SUBJECT TO ALL THE TERNS.IDICLUSONB AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LMR WY HAVE REDUCED BY PAD CLAIMS.
LTA NM TYPEW E POLICY NU10ER CIA LIMITS
GENERAL LMBLJTY
EACH OCCURRENCE i 1 OOO OOO
A X COMMECIAL LIABILITY PA008139713 02/01/06 02/01/07 PREMIns EA.oeaP s250 000
CLAMS OCCUR MEDEXP(Myon pP ) i5 000
PERSONAL&AW INJURY {1 00D 000
GENERAL AGGREGATE s2,000,000
GEMLAGCIREGATE MEN PER PRODUCTS-OOMPIOP AGO {2 000 000
POLICY X LOC
AUTOMOBILE UABIU
ANY AUTO , SMBINED SINGLEUNIT {1,000,000
ALL DINNED
A X sa+muED
008739913 02/01/06 02/DS/07 GODLY
O°P 6
X HIRED AUTOS
X NON-OM4M AMUI i
PROPERTY IDAMAGE f
GARAGE LIABMJTY AUTO ONLY-EA ACCIDENT 6
ANY AUTO
OTHER THAN EA AOC {
AUTO ONLY A00 i
FYOENiUMeIWLIA EACH OCCURRENCE $10 00D 000
A X OCCUR MADE A000740013 02/01/06 02/01/07 AGGREGATE i 10 000 DOO
DEDUCTIBLE
I
RETENTION
WORKHERSLIABILITYRB N X T YLMITS ER
A A�P�PRIETOWPA 009463113 09/30/06 09/30/07 E.L.EACH ACCIDENT 61 000,000
OFFCERJMEMBER EXCL
R yweAPPb UWw E.L DISEASE-CA EMPLO ii 000 000
SPECIAL PROVISIONS Wow
OTHER E.L.DISEASE-POLICY LOUT 181 000 000
DEQCNPTION OFORRATON6/LI rs IVENOLISIEICLLIaONl ADDEDryE100118FJ{ENT/EPEOML PRoyIaDRg
Project: Beverly Onal Bank, 6 Paradise Road, Salem, M&, $950,000
Renovations to Zx nq Building and Drive-Up
CERTIFICATE NO CANCELLATION
BZVP,g-5 WOULD ANY OF THE ABOVE DENCROED POLICIES EE CANCELLED BEFORE THE ERPIRAnoN
DATE THEREOF,THE RRIUNG Raw=WILL ERDEAVoR To MAN. 30 DAYS WRITTEN
Beverly N O S Be NOTICE To ne CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DD BO SMALL
240 Cabot t IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE*URWAIC ITS AGENTS OR
Beverly 2115 REPReseNTATIVII
AUTHORam
ACORD 2E(2001/06)
0 ACORD CORPORATION 1888
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CTTY OF SALEM
PUBLIC PROPRERTY
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