12 POPE ST - BUILDING INSPECTION (3) I r
0012 POPE STREET 32-2004
GIs#: 701 I COMMONWEALTH OF MASSACHUSETTS
Map _-----
15 CITY OF SALEM
Block:
Lot:_ 0308
Category: REPAIR/REPLACE
Permit 4 32-2004 BUILDING PERMIT
lProject# JS-2004-0055
Est. Cost: $2,672,870.00
IFee: $26,733.70
lConst. Class: PERMISSION IS HEREBY GRANTED TO:
:Use Group: Contractor: License:
!Lot Size(sq. ft.): 283140 !Keith Construction
,Zoning: IR3 !Owner: SALEM HEIGHTS APARTMENT CO
Units Gained: --,------Applicant: SALEM HEIGHTS APARTMENT CO
Units Lost: L I
AT
Dig Safe#: : 0012 POPE STREET
ISSUED ON: 14-Jul-2003 AMENDED ON: 21-Jul-2003 EXPIRES ON. I I-Jan-2004
TO PERFORM THE FOLLOWING WORK:
32-2004 REMODEL 41 KITCHENS&279 BATHS, ELECTRICAL WORK, PLUMBING AND A NEW ROOF. TJS. ALSO,
UPDATES TO ELEVATOR. TJS 08/18 CHANGE OF CONTRACTOR TO KEITH CONSTRUCTION CO. TJS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbine rFootings:
Underground: Underground: Underground: n:
Service: Meter:Rough: Rough: Rough: n:
Final: Final: Final: me:
Fireplace/Chimney:
D.P.W. Fire Health
Insulation:
Meter: Oil:
Final:
House q Smoke:
Treasury:
Water: Alarm:
Sewer: Sprinklers:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS
RULES AND REGULATIONS.
Signature:
Fee T)'pe: Receipt No: Dale Paid: Check No: Amount
BUILDING REC-2004-000057 II-Jul-03 0432 $26,733.70
LGjeoTMS@ 2003 Des Laurier Municipal Solutions,Inc. _
OF SALEM,- MASSACHUSETTS
�Co3 e PUBLIC PROPERTY" DEPARTMENT
®' 120 WASHINGTVN STREET, 3RD FLOOR
l SALEM, MA 01 970
K. TEL. (978)745-9595 EXT. 380
�Grma FAX (978) 740-9846 . .
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40, S34,I aclmowledge that as a condition
of Building Permit# 32- o debris resulting from the construction activity
governed by this Building Permit sliall be disposed of in a properly licensed solid-waste
disposal facility,as defined by MGL c III,S150A- CAJ W
cL .
The debris will be disposed of at: 17V(5t_4 // c
Location of Facility ��I�J�/ 1);�4
f 't pa D oA�e o Aplicnt
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
/l"Jl9k—, �2: J; LV/V
Name of Permit Applicant
Firm Name,if an 2010
Address, City& State
The above statute requires that debris from the demolition,renovation,rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIII, S 150A, and the building permits or licenses are to
indicate the location of the facility.
UDF.RAI.I)FNTMICATION
No. 04— 31,4 25 3 -7
The QCommontnealtb of T9asoachugetts
Examiner William Francis Galvin
Secretary of the Commonwealth
One Ashburton Place, Boston, Massachusetts 02108-1512
ARTICLES OF AMENDMENT
(General Laws, Chapter 156B, Section 72)
Dame
Approved Christopher Knollmeyer
We. 'President /
and Stephen Knollmeyer `Clerk / •l f ,
Knollmeyer Design and Building Corporation
!Exact name of corporation)
located at 50 Page Road, I,ii1CX51n, Massachusetts 01473
(Street address of corparation in Matsachusetu) '
certify that these Articles of Amendment affecting articles numbered:
Article I
(Number close arricies 1, 1. 3, 4, 5 and/er 6 bring amended)
of she Aaida of Organization were drily adopted at a. meeting held on SePtember 5, 20 Q1 , by vote o`
100 acuttlnn stock 100
shares of _of__ shares outstanding,
(eype, 4,14tj d caries, if any)
shares of_ _ of snares outstanding, and
(type, Hatt d series, if any)
shares of ,�__of_ .-___ shares ovutandmg,
C � (type, tldtt r5' series, if anyj
'beif
M ❑ o - . , or znc�ing ac
least two-thirds of each Ipe, class or series 'outstanding and enrided to vore thereon and of mch rype, eJaaa or
RA =' series of stock whose rights are adversely affected thereby:
- •Ddar the rnappBrab/e oords, -Delete the inappiioable dear,
' For amendmort: adapted partaenr to Chapter 1568, Section 70.
For amendmrnn adepred para,ane m CAapur 156B, Section 71,
N er, if the epoee pr..Ud d v.do, amy ortiele or :ten, .. 1bi,fee,. it mraj]'icienb od d.. ,bah bo or fereb o ride
.ody of,oparoeo 6 1/2 a II ,been of paper odtb a 1-21 ntmyi. a or lads I laeb. Addi,4 .e to more eh.. ... .reie(r awry bo
P.C. made on a tingle abeer to lend ar each attirlo rrgetinaa Barb addnaon le dea.ly ii.dieatod
iemoT.n.yoe
FEB-21-1900 07:22 F,03
To change the namn of the Corporation from KnollTeyer Design and Building
Corporation to Knollrrnyer Building Corporation.
The foregoing amendment(s) will become cffcaivo when these Articles of Amendment are fled in accordance .virh General
Caws, Chapter 156B, Section 6 unless these articles specify, in accordance with the vote adopting the amendment, a Liter
effective date sor more than thirty day; after such filing, in which event the amendment will becorne effcetive on such leer
date.
Liter effective daze:
51t LND PENALTIES URY,this 17 day of ��f�7 _ , zo OL
i t
`President
Yam'
'Clerk I KIPORKNOW
I
57io O
F' V Pc� 64& V
JWe,A', 0o&v1z, 02133
William Francis Galvin
Secretary of the
Commonwealth
July 8, 2003
TO WHOM IT MAY CONCERN:
I hereby certify that according to the records of this office,
KNOLLMEYER BUILDING CORPORATION
is a domestic corporation organized on January 9, 1992, under the General Laws of the
Commonwealth of Massachusetts.
I further certify that there are no proceedings presently pending under the Massachusetts
General Laws Chapter 156B section 101 for said corporations dissolution; that articles of
dissolution have not been filed by said corporation; that, said corporation has filed all annual
reports, and paid all fees with respect to such reports, and so far as appears of record said
corporation has legal existence and is in good standing with this office.
In testimony of which,
I have hereunto affixed the
Great Seal of the Commonwealth
on the date first above written.
Secretary of the Commonwealth
*MGL Chapter 156B Section 83A provides that certain consolidations and mergers may be filed
with the division within thirty days after the effective date of the merger or consolidation.
.elk
j
KNOLLMEYER IBC 44C G3 OCR 4G3QG`]��]044LQ�
DESIGN & BUILDING CORP. '
10 HENSHAW ST. SUITE 20M
WOBURN, MASSACHUSETTS 01801
DATE Q JOB NO.
(781) 259-5000 fax (781) 259.5001 ATTENTION
60
WE ARE SENDING YOU V Attached ❑ Under separate cover via he following items:
❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order 6o Lo_�
COPIES DATE NO. DESCRIPTION
3 51 9M 0 p� C ter► JY�S
r 5_� D4-rz MA, 8 zo()3
o nr s A-,z s ,rzs .
2 a�12M; !1,1V6-
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted ❑ Resubmit copies for approval
❑ For your use ❑ Approved as noted ❑ Submit copies for distribution
L%( As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and comment ❑
❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
1 S X1oi C� S
COPY TO
SIG
If enclosures are not as noted,kindly notify sat nce.
. BBt,I MM r1
`.ornrrtanwtiaUh 0/ /4eachtt.4ett.4
y �eParlmanlor.la�biaf.ieeiaenls
F A,,
np 600 WnaLylon.3lreel
James J.Camobes f A.., ///atssack..Us 021 11
ccar.-.mrssana
Workers' Compensation Insurance Affidavit
(ae�.v►erreee)
with.a principal place of business at: /ej S/—
frJq/asssdtp)
do hereby certify under the pains and penalties of perjury, that:
0 1 am an employer providing workers' compensation coverage for my employees working on
this job. // r x e4lc'n
Insurance Company Policy dumber
I am a sole proprietor and have no one working for me in any capacity.
0 1 am a sole proprietor, general contracto r homeowner (circle one) and have hired the
contractors listed below who ave the following workers' compensation policies:
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
() I am a homeowner performing all the work myself.
I understand chat a coot of"tatement wa be fonearced to the Office cf Imcstieaoons of the DIA for coserat9 verification and"(dime to secure
covetart AS «oared under Section 2SA of MGL 152 can lead to the imooation of crvninm ce"ties coruuint of a fine of da td-S 1.50000 Mwor one
rear''iiewwnmrnt as tea at cn2 oenafdes in the form of a STOP WORK ORDER ano a fne of s ioo.00 a an atairut me.
Signed this , day of
Licensee/Permittee Building Deparcratent
Licensing Board
Seieetmens Office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 517.727-4900 X403, 404, 405, 409, 375
ib M k
ite�
f7
-ft* Q 1dN-4ST-0E ffLfB--A+i0 A?PROVED BY T*IE
UaI5P &TDA ,PF�WJ3 TD.A .PERMIT BEWG GRANTED
CITY OF SALEM
No. l-2U Oil \ Date
l ( D
� �HINC
Is Property Located in Location of
the Historic District? Yes_No_ Building I Z c 5 r
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owners Name
Address & Phone 153
Sat rF _io o o ZI A
Architect's Name lgqAc-r-Q` 1E �i'Coc, tLzn
Address & Phone
�meevti��� m� (f-Z-VK
Mechanics Name
t o t{c— S� BtiJ 5r S1-E 2oM
Address & Phone wz&/).__��� ln/� 0/ Q01 OVO
What is the purpose of building? Kea ���-,�r ✓LL Q
Material of building? 57�a 7� Come fV dwe II ing, for how many families? Z 4 awl/
Will building conform to law? � Asbestos? N T'C
2
Estimated cost 2 70 City License # N A State License #
Rome Improvement
2(a -7 3 3— Lic. 1
n WtuAreoiZpplicant'
0Lf ?vZ SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
?
2'JI
MAIL PERMIT TO: � �6~ Z ✓`�' ��� r
C3o
pass cacti cNs �� L-c /��jc� .
No. ap2—ZZcf:v
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
19
APPROV�D
IN PECTO OF BUILDINGS
t
i
K E I T H CONSTRUCTION , INC ,
532 Page Sheet
Stoughton, Massachusetts 02072
(781)828.8474
FAX (781) 828-0010
Fax 1t7 Q Date
Please deliver the following pages to:
FIRM
FROM 6 —
Total number of pages including this cover sheet: ---�
Additional Comments:
KNOLLMEYER BUILDING CORPORATION
GENERAL CONTRACTORS
10 HENSHAW STREET SUITE 20 M WOBURN, MASSACHUSETTS 01801 (781)259-5000 / FAX(781)259-5001
August 7, 2003,
City of Salem
Public Property Department
120 Washington Street
Salem, Ma. 01970
Attention: Mr. Thomas St. Pierre, Building Inspector
Re:Building Permit No. 32-2004
Salem Heights Apartment Renovations
12 Pope Street, Salem, Ma.
Dear Mr. St. Pierre;
Please be advised that the owner, Preservation of Affordable Housing, Inc(POAH) has
just informed us that we will not be the General Contractor for the above referenced
project. Therefore, Knollmeyer Building Corporation is returning the original Building
Permit No.32-2004 issued on 14 Jul 2003 and as amended on 21 Jul 2003. We are also
enclosing one(1) set of the Contract Drawings stamped by the City of Salem, Building
Department.
Please advise if we can be of further assistance.
Very Truly Yours, 7
R. v
Pr ject Man ger
cc:Cliffod J. Boehmer, AIA, Mostue& Associates
Patricia L. Belden, POAH
C
ACDRD- CERTIFICATE OF LIABILITY INSURANCE KEITH 1 °"08112 o
PRODUCER THIS CERTIFICATE IS ISSUED A$A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Thomas Gregory Associates Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
601 Edgewater Drive 8235 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Wakefield MA 01880
1 Phone: 782-914-1000 Eas:781-246-2601 INSURERS AFFORDING COVERAGE NAIC9
IN41iNEu INSURER A +.. -Acadia Insurance
INSURERS: Occupational Health Onderwr er
Andy Kogi
Reich ineS Construction Inc. INSURER C:
t�
$toughJonsMA V q2072 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING
ANY REOUIREMENT,TERM OR CONDITION DF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONOITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR D --w- MM D M LTOTO&IRATfON
LTR NSR TYPE OF INSURANCE POLICY NUMBER PATE DATE IM LIMITS
GENERAL LIABUAiY EACH OCCURRENCE $1 000,000
A x x COMMERCIAL GENERAL LIABILITY CPA0069013-12 06/30/03 06/30/04 PREMISES a N. s300,000
CLAIMS MADE OCCUR MED EXP INN bne pereen) $15 000 _
X Per Project PERSONAL S ADV INJURY 81,000,000
sa ate _ GENERAL AGGREGATE $2,000 000
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPAOPAGO $2 000 000
PR
POLICY x ET LOD
AUTOMOBILE LIABILITY
ANY AUTO emSINGLE LIMB
(EaCOMBINEDaftifbM) $1,000,000
(EA
ALL OWNED AUTOS `
BODILY INJURY
A X SCHEOULEDAUTOS M"1301266 06/30/03 06/30/04 (Pw P18PR) $
X HIRED AUTOS
X NON-OWNED AUTOS BOOILYRLURY $
x Physical Damage__ $500 COMPREHENSIVE PROPERTY DAMAGE
Deductible $500 COLLISION (PWWd&TO $
GARAGE LIABILITY AUTO ONLY-EAACCIDENT $
ANY AUTO OTHER THAN EA ACC S .__
AUTO ONLYT AGG $
EXCEBSIUMBRELLA UABILITY EACH OCCURRENCE $10,000 000
A X OCCUR F-1CLNMsMADE TO BE DETERMINED 06/30/03 06/30/04 AGGREGATET _ 1110 000,000
DEDUCTIBLE $'
s.
x RETENTION $Q I IT
-""
WDRIERS COMPENSATION AND C EMPLOYERSTORY LIMIT$ X ER
LIABILITY MCC43238x31 06/30/03 06/30/04 E,LEACNACCIDENT E500,000
PNY PROPRUiTpplpAfiTNEIVEXECUTIVE � _
OPPICEWMEMSER EXCLUDED? 10 DAYS ICE E.L DISEASE-EA EMPLOYE $500 000 _Nyaa,eem be weer
SPECIAL PROVISIONS botm E.L.DISEASE-POLICY L$e1T $SQQ QQQ
OTHER
A Contractors Equip. CPA0069023-10 06/30/03 O6/30/04 Leased/ $100,000
$500 Deductible i Rented E
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADOED BY ENDOROZMENT I SPECIAL PROVISM$
Project: Renovations to Salem Heights Apartments - Naming Additional Insured
per "Holder Notes" under Commercial General Liability for this project
only. Evidence of Insurance for work performed within the Insureds scope of
normal business operations. Notice of Cancellation 30 Days -10 Non-Payment
of premium.
CERTIFICATE HOLDER CANCELLATION
SALENHE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
Salem Heights Preservation DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
C/o Preservation of NOTICE YO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 50 SHALL
Affordable Housing, Inc.
40 Court St. Suite 650 IMPOSE NO OBLIGATION OR UABILITY OF ANY AND UPON THE INSURER,ITS AGENTS OR
Boston MA 02109 REPRESENTATIVES,
AUTOO RESENTA
ACDRD 26)2007108) 0ACORD CORPORATION 1988
IN
Y'0
#W N 0NM4��4 I -%= LMRV�' .11 3"
Salem Heights Apt, Additional Insureds under C ......
O=Qrcial General Liability
f for this project only: Massachusetts Housing Partnership Fund Board, its
SUCCessora 6/or assign ATIMA, Two Oliver St. 9th rl Boston, MA 02109-
Fleet National Bank ISAC>A M Box 2984 Mail Stop CT CH 4151 MP Hartford, CT
06202-2984; Banknorth,NA 370 Main St. Worcester, M 01608; Massachusetts
Housing Equity Fund 2002 LLC, 70 Federal St. Boston , MA, 02110, Wataru
MatauYasu Preservation Of Affordable Housing, 40 Court St. Suite 650,
Boston, MA 02108
OF SALEM.
PUBLIC PROPERTY DEPARTMENT
° • 120 WASMINGTON STREET, 3RD FLOOR
Oyp SALEM,MA 01970
may' TEL. (978)745-9595 EXT. 380
�G FAX (978) 740-9846 .
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,SA I aclmowledge that as a condition
of Building Permit# all debris resulting from the construction activity
governed by this Building Permit shall be disposed of in a pmperly licensed solid-waste
disposal facility,as defined by MGL c III,S150A.
The debris will be disposed of at: ��(� n of o' rl.�tyy '
03
ignature o ermit Applicant Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
GoevS7'7-Clc 1727/"/ /lV c,
Firm Name,if any
Aal- c �Sfov�l Rh 7�
Address, City & State
The above statute requires that debris from the demolition,renovation,rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIll, S 150A, and the building permits or licenses are to
indicate the location of the facility.
(f0ctrrnmonwr:aUltn01 MO-»acL6effi
- '' ,. ..LJepa,lmanf ol.Jad�rial sccics�+
S =
n6�00 ryW-1:aaR pl .�L..f
,fames I Cafnooes Rr a,a,cL.Us 021 /1
Cwr.mssaorta
Workers' Compensation Insurance Affidavit
AlTi/ ��jtisi f1 u07, �s�
with-a principal place of business at:
�--
. tcaarso=.ra+q
do hemby'certify under the pains and penalties of perjury, that:
I am an employer providing workers' compensation coverage for my employees working on
this job.
Insurance Company Policy Number
I am a sole proprietor and have no one working for me in any rJ1paeity.
0 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation policies:
Contractor Insurance Company/Policy Number
Contractor Insurance Compatry/Poliq Number
Contractor Insurance Company/Policy Number
O I am a homcowner performing all the work myself.
I undcrZono wt a coot of the wtemmt wa be fora aroeo to the 01frc9 of Imesdeaoont of the DIA for Coraratt.erWkadon MW due faaan to fewre
co.tratc n rec.+reo under Section 25A of MGL 1 52 cm Iead to the irwomion of crsninan Cements corsadnt of a fine of to cei 1.S00 CO anwor one
rears•imoruonwent x R fl m eirff eauftits it the lortn of a STOP WORK ORDER ono a fire of S 100.00 a oar atarot we.
Signed is , day ofT �p�
ccnscc/ c 'ittcc building Department
Licensing Board
Seiectmens Office
Health Department
GO00 X4C= 404, 40S, 40°, Zit
-C VE;i COVER1,i:- iNFO�- 01r CALL: .. 1 , _ ,
r
0012 POPE STREET 32-2004
visa " _—J7oi COMMONWEALTH OF MASSACHUSETTS
iMap �15
Block -,T r CITY OF SALEM
- ---
!Lot: "0308
Cat � _ Bnddmg tegegoq x "' REPAIR/REPLACE BUILDING PERMIT
�Permtt# to ,32-2004
I-=-
,Project# JS-2004 0055 t
Est Cost: $$26 733 00 J
iFe-e S26,7133.70 ---� PERMISSION LV IILREB I' GRANTED TO:
Coast Class: ; �Cm:tractor: License:
jUse Group:�i _ 1KNOLLMEYER BLDG. CORP. SPATE - 069323
LotSize(sgrft.): 1283140 - Owner: SALEM HEIGHT`S APAK'rM1-NTCO
Zoning R3 ]APP licmit: SALEM 'HEIGHTS APARTMENT CO
jUnrt Gamed:
- L - '�AT: 0012 POPE STREET
�llmts Lost:,
ISSUED ON: 14-Jul-2003 z AMMENDED ON: EXPIRES ON: 1 I-Jan-2004
TO PERFORM THE FOLLOWING WORK:
32-2004 REMODEL 41 KITCHENS& 279 BATHS, ELECTRICAL WORK;PLUMBING AND A NEW ROOF.
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbil� rF
Underground: Underground: Underground:Service: Meter:
Knu,oh: Rough: Rough: Foundation:
Final: Final: Final: Rough Frame:
Fireplace/Chimney:
PD. W. Fire Health
Irsulatinn:
Meter: OiL. I -
Final:
�Housep Smoke: -
Treasu,v:
Water: Alarm:
i
kcwer; Sprinklers:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM GP-ON VIOLATION OF ANY OF
ITS RULES AND RE'GULATIONS.
Signi�ture: ()Jtvl�
~ . Fee'rype: Receipt No: Date Paid: Check No: Amount:
BUILDING REC-2=Lpan
0432 $26,733.70
nspeetiorl Is_I� .I i4=�t
n of work, pie.ase cat;
05 Ext,3s5
I,;eti fMS'g 203 6es i..aariers\'Iunicipai$olu eiun.c,lac
0
wr
f
V30ve AD
CITY OF., SALEM
BUILDING PERMIT
lq:AM MHST-eE flLft iND APPROVED BY T*IE
.WPFXT.D-R ,PFX9A TD.A.PEAMIT BEWG GRANTED
CITY OF SALEM
OF
No. Date40
Is Property Located in Location of
the Historic District? Yes_No Building / r�PE S:Qt-,ET
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roo Install Siding, Construct Deck, Shed, Pool,
Repair/Replace,Other:
PLEASE FILL OUT LEGIBLY &COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name 541,4'M
Address & Phone ( 1
Architect's Name &7-a &OGI lm
Address & Phone ! 1
Mechanics Name �E/Th' CaNS�IZ /NCB
Address & Phone C 57coasri
What is the purpose of building?�9rl/-%/ '—/r A/YI« V
Material of building? d If a dwelling, for how many families? a g 3
Will building conform to law? ( C S Asbestos? /" d
Estimated cost G7 3 3p City License re N A State L' se
Rome Improvement v
Lic. i I/►,
gnature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF 1WORK TO BE DONE
/f
/1-c i eo f eyyt) 02 7g 611 f I
fi(e c4-1�� ��� , DlUI��. kvp
e
MAIL PERMIT TO:
k'
1.
L
No. 3. z. oC c
APPLICATION FOR
PERMIT TO
U fad 1 Z
ao 51
N��J `Gore i-rG�c�-prc_
PERMIT GRANTED
APPROVED
INSPECTOR OF BUILDINGS
0012 POPE STREET 32A-2004
cIS#: 701 �� COMMONWEALTH OF MASSACHUSETTS
Map. 15 CITY OF SALEM
Block:
Lot: 0308
Category: 434 Residential: addill
PBI'Itt It# -- 32A-2004 BUILDING PERMIT
Project# JS-2004 0787
Est Cost: $0.00
Fee: $0.00
Cons: PERMISSION IS HEREBY GRANTED TO:
Use Group: !Contractor: License:
Keith Construction General Contractor-CS 096659
Lot Size(sq. ft.): �83140
]Zoning: R3 ]Owner: SALEM HEIGHTS APARTMENT CO
Units Gained: APPUCant: SALEM HEIGHTS APARTMENT CO
Units Lost: SAT. 0012 POPE STREET
Dig Safe#:
ISSUED ON: 30-Dec-2003 AMENDED ON: EXPIRES ON: 30-Jun-2004
TO PERFORM THE FOLLOWING WORK.
32A-2004 ADDENDUM TO 32-2004. SEPARATE ELEVATOR INSTALLATION FROM REST OF BLDG. JLC
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Buildin
Underground: Underground: Underground: Excavation:
Service: Meter: Footings:
Rough: Rough: Rough: Foundation:
Final: Final: Final: Rough Frame:
Fireplace/Chimney:
D.P.W. Fire Health
Insulation:
Meter: Oil:
Final:
House 4 Smoke:
Treasury:
Water: Alarm:
Sewer: Sprinklers:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS
RULES AND REGULATIONS.
Signature:
Fee Tcpe: Receipt No: Date Paid: Check No: Amount:
BUILDING REC-2004-00084I 30-Dec-03 X $0.00
GCOTMS®2003 Des Landers Municipal Solutions,Inc.