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22 SAVOY RD - BUILDING INSPECTION 1 C3 t S I iSi EfiL 1fJD APPROVED BY T+IE ,IUS,P 13 P R'T-D,.REBMT BRING GRANTED f CITY OF SAALEM ra No. � ..�„�� 'hb, '��� Date i D -,;1 7-D 3 Ward \° rmNrW' Zoning District Is Property Located In Location of the'Histodc District? Yes_No Building q 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: je,4,ke — PQ .,_jj 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 P, )lk-+I-r Address & Phone 0:9;;� '-S'9Isola AA CA (9761 SZI.5 - -,275F/ Architect's Name Address & Phone Mechanics Name J'?ttr1 f3lz. « �4nn•o ,a. �w( �t ���i Address & Phone Ue 14eme-POWAU What Is the purpose of building? Material of building? i *,_ , ( If a dwelling, for how many families? I Will building conform to law? Asbestos? Estimated cost L,gol7 City License # State License # !n 0-0 Home Improvement 'n+ \ l Lic. / L� ` 61 ono lnyi_ Signature bf Applidaht SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO pp BE DONE fa MAIL PERMIT TO: L b ea p4 AM .i a .._.. _. ... _. ... ,.._.. .,.,, .�A. `Y':✓k:.�A�+`S 7 .it.:% t•` t`1�.e ttN ., �vi; .��rrV4y� p r� #i4Mt� a+ ., '3p.MsSxyvf . i i ,41, t4•td� � ty Pq. sr, - 't a=etf%� ,)� i.C4N1 it� 41� ;,p ai{�SY+ - I �• .,.:"x �fi t':nf"'...✓ y,r e',J '�.( ...e{�,@i a�'Y�F�S iJ,�' ^70r_,4 e,y�$1t,)L3.1 �) � �S � 1l`i' 1 '7M4d.; t 'aeaa A �wm�iu�S7 ;t� fit_ ywF _...._ r +,4tY r�ei,. t 4:IA cn ? xtY . .__ . _......... ,k �� b�� z Cc �, �.µ �. ..o. _ � wh . ca A Z OF �. L as ',�la k,') tu o a p w aCL z a a Z t 8'8 0 Ou ED LIVING AREA 61 sq ft 22 Savoy, Road Salem, MA 01970 16 Hemenway,Road Salem,Ma.01970 Tel/Fax(978)744-4418 Crown Point Consnction.Co October 27, 2003 Re:Bathroom Renovations Pelletier Residence 22 Savoy Road Salem,MA.01970 To Whom It May Concern:The cost of this project is$6,800 to complete the project above.Please note the scope of work listed below. 1. New drywall and finish 2. New tile floor 3. New paint 4. Install new fixtures Sincerely, Arnold Jaynes . . . . . . . . . . . . . . . . . . . . . . . . . . . If the point of your construction project,Is to receive Quality Craftsmanship that is Guaranteed. Call Crown Point. �o CITY OF SALEM9 MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR }' SALEM, MA O 1970 TEL. (978)745-9595 EXT. 380 FAX (978) 740-9846 STANLEY J. LISOVICZ, 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 governed by this Building Permit shall be disposed of in a properly licensed solid-waste disposal facility, as defined by MGL c III, S 150A. The debris will be disposed of at: L,_. 4-h`S i j L CAS 14i n.<�i Location of Facility 11AD 7- 6.3 Signature o Permit A licant Date FULLY complete the following information: (PLEASE PRINT CLEARLY) A z Name of Permit Applican Orgi.ly h1 U © f ri1`1� �c�Ti 5 ✓c`TiD:n.J Firm Name, if any 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. �: ✓�ie '�ioarmw�u�aa/.tl o�✓�omoc/u..ae�a '�, +1i BOARD OF BUILDING REGULATIONS f License CONSTRUCTION SUPERVISOR k Number.-CS 072450 Blrthd6te ,10/22/1957 � Expfres:xl0/22%2005 Tr.no: 7457.0 Restricted00 it ]I ARNOLDL JAYNES, ' � 3 16 HEMENWAY RD"< (J SALEM MA 01970 Administrator - - - ✓/<e oy✓l�Lakfac/usdetla Board of Building Regulati ns and Standards HOME IMPROVEMENT CONTRACTOR Registration: 133411 Expiration: 6/19/2005 Type: DBA CROWN POINT CONSTRUCTION ARNOLD JAYNES 16 HEMENWAY RD. SALEM,MA 01970 Administrator V S—\ ny^y^' C�01Pr&=lttalt:ab1 01 I/10.33aC�.¢tt6 Jeparfmanf ar 7, iaf.,4eei1u+la '' r 600 W" inlLon Slmef JamesJ.earrood f�oafon, ///.,aarlyu.ttf 02111 Corrmsagrar Workers' Compensation Insurance Affidavit • to ��e — ��pfA� � ��a�o�—D �t?�-iN - fao�..na.rt.ef with•a principal plan of business at: j( JL+J o L7) E:x, GIZCx *,J To f N . . to.ri>rwsfu do hereby certify under the pains and penalties of perjury, than: () I am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number 1 am a sole proprietor and have no one working for me in any CaPaetty. () I am a sole proprietor, general contractor or homeowner (circle ore) and have hired the contractors listed below who have the following workers' compensation policies: Contractor insurance Company/Policy Number Contractor insurance Company/Policy Number Contractor insurance Company/Policy Number O I am a homeowner performing all the work myself. I wr4,, ahe out 3 CM of this iutement wiN be fon.armd w the Offrt a 1m 6"Lvw of the DIA Ior eo.erate TerwCauon ane V x(a➢we to aaeore co irate n revived under Section ISA of HGI f S 2 can lead to the inDouejan of crvmnm es oenau cormcint of a fne of w to-4 1.5=00 ender one r<an' iraruonrtxnt a+ tru u eiri o<rultiu M the Toren of; $TOP WORK ORDER an0 a fru of S 101.00 a ear stirrer me. Signed thisA (lsc_ day of j j�3_��2—_r — - ccrseei rermittee buildin€ Depamrn ent Jcertsing isoard Seiectmens Office iie<IZ , Gegar.men, -_ �r c: }:; .. - - 'U'. `n�- . �. _ -=COG . . .e