0035 SAINT PETER ST - BUILDING INSPECTION 0035 ST PETER STREET 261-2004
GIS a: i375 ` COMMONWEALTH OF MASSACHUSETTS
Map " 35 _ CITY OF SALEM
IBlock:
Lot: 0192
Category:" 437 Nonresidential:ad
Permit# 261-2004. BUILDING PERMIT
Project# JS-2004-0405 '
Es[ Cost $20,000.00 _
Fee: $205.00
Const. Class: PERMISSION IS HEREBY GRANTED TO:
Use Group ' `"Contractor: License:
Lot Size(sq. ft.): 51400.8 IFLOMP, PETER C. Gen.Contractor/Code IG- CS 070702
Zoning: B5 ,, Owner: P MAC LP
Units Gained: � Applicant: P MAC LP
Units Lost: AT: 0035 ST PETER STREET
Dig Safe#:
ISSUED ON: 18-Sep-2003 AMENDED ON: EXPIRES ON: 12-Mar-2004
TO PERFORM THE FOLLOWING WORK:
261-2004 NEW OFFICES BUILT OUT. FRD
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbine Building
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# 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 Type: Receipt No: Date Paid: Check No: Amount
BUILDING REC-2004-000420 12-Sep-03 2004 $205.00
GwTMSB 2003 Des Lauriers Municipal Solutions,Inc.
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(fCfr manwaa(th/�01 Mab. 6acLazff3
6 .Utparlmanl ol.Jud+�kial � 1
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600 w-11,11m.36...1
James J.Catnooel - Uoalon, /I/dLla6raatMMa 021 /1
Coe:mssxxw
Workers' Compensation Insurance Affidavit
1, ►��-r�• r F n.v�P
wither principal place of business at: p
3c W-Pa(terJ c l S 4ALFAA JIAA� h CfZ0 .
— tutrrsw✓slq
do hcreby'certify under the pains and penalties of perjury, that:
() I am an employer providing workers' compensation coverate 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 capacity-
() 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 In=1211�e Company/PolicyNumber
Contractor Insurance Company/Policy Number
Contractor Insurance Corn Policy Number
() I am a homeowner performing all the work myself.
1 unotrwna wt a CM of the avtertient*+'d befon aroto = the Orrct of Inrctitaoow of the DIA for corerate v"W"don and"LM m teevrt
coveratt as reoured under Section 25A of MGL 15
2 can lead w VxMo: 60A of cren�nai otnxem conuadnt of a fine of w to31,SODC0 mwor cot
yean•irarwo t v.ero at eir9 "naido in the lom+of a STOP WORK ORDER and;6"of S 100.00 a am at"t W.E.
Signed this Z day of ;2 O clI,
Licensee/Ftrmlit building Deparir +ent
Licensing board
Seiectmens Office
Health Depariment
{a :' OF SALEM. MASSAChtu:c L i =
PUBLIC PROPERTY DEPARTMENT
° '• 120 WASHINGTON STREET, 3RO FLOOR
9
SALEM,MAO 1970
TEL. (978)745-9595 EXT. 380
' pyo FAX (978) 740-9846 .
;TANLEY J. USOVICZ, JR.,
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,S34,I acknowledge that as a condition
of Building Permit# all debris resulting from the construction activity
govemed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL
�ceIII,S150A. t
192At1AM WRSE S`1SfEM5 TAC
The debris will be disposed of at Location of Facility
Signature of Perinit Applicant Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
E-1
E2 �LennP
Name of Permit Applicant
Firm Name,if any
3� t�A�cRen1 S; SALK^ (VtA
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 c1II, S 150A, and the building permits or licenses are to
indicate the location of the facility.
lat� e tI T-BE fiUEP ND APPROVED BY T*IE
N PFXJOR ,PF R TP.A .P.ERMIT BENG GRANTED
CITY OF SALEM
No. Z-& 1- zoo / `t vN ay .
Date l p SePT Zm3
Is Property Located in Location of 3S +&
_ST. PET%
/� S
the Historic District? Yes_No Building /p r eOenwk. S-1
Is Property Located in
the Conservation Area? Yes_No 7
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Ro of, Install Siding, Construct Deck, Shed, Pool,
Repair/Replac 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 1�- MAC- LP
Address & Phone So ►Sk;Ao Sr "�nu=r& (q-2& ) 7 ti-t -,2'7 12-
Architect's
2Architect's Name Anr uTTC-r_rQn.A� t2E.1oJA7-LQA" /mica flas r
Address & Phone LynW rkA ( )
Mechanics Name PT 2 C. FrcnnP
Address & Phone �<' "22rA1 S —',u to X) ?`iS 19So
What Is the purpose of building? co t n IC�,CE
Material of building? 12iCtiUc ��o JCkTc� If a dwelling,for how many families?
Will building conform to law? /a~ C Asbestos? N 0
Estimated cost '11 A.603 .ou City License # N A State License # C C b'1 0.7 0 �.
Home Improvement
X Signature of Applicant
Zp�y SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
A1---rJ Or-FcCES 9,jck: nj-% f od - LOAo BeAa--rA&-
t?FeLACE CETtt+3Cr TTUES ?AyJT . 0,4RPET
MAIL PERMIT TO:
1
No.�Ly ( - ZO O
APPLICATION FOR
PERMIT TO
LOCATION,
. 4-6-IL
PERMIT-GRANTED
r
APPROVFD
INSPECTOR OF BUILDINGS