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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.