68 SCHOOL ST - BUILDING INSPECTION 0068 SCHOo._ STREET 864-06
MS#: — ig?49 -- COMMONWEALTH OF MASSACHUSETTS
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Block: I_ CITY OF SALEM
Loft: _ _ 10318
Category: !REPAIRIREPLACE
Permit# . _ 1864-06 _ BUILDING ILDING PERMIT
Project# �S-2006-1725
Est.Cost: i$20,000.00
,Fee Charged: $i 255.00
Balance Due $.ol oT PERMISSION IS HEREBY GRANTED TO:
Const.Class: I Contractor: License:
Use Group: } :r- _ GEORGE QUEENAN General Contractor-CS074974
ILotStze(sq_ft) 15020_ GEORGE QUTFENAN
Zonme iR2 a .._- - -- -
!Units Game 1 tAiyueart. GEGRGGF ,Q,UE-EPttliN
Units Lost: ; ( -> 4z 0068 SCHOOL STREET
Dig Safe#:
ISSUED ON: 26-Apr-2006 AMENDED ON: EXPIRES ON: 26-Oct-2006
TO PERFORM THE FOLLOWING WORK.
Complete renovation of Unit B
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Building
Underground: Underground: Underground: Excavation:
Service: Y� [ /�{{/(1 Meter: / Footings:
Rough:_'i/tf-L/'/ // Rough: Rouglcj P' j /_ Foundation:
Final:��J//�p�¢jr� Final: Final:.-,. /� Rough Frame: Fj G 6 el, , /
Fireplace/Chimuey: 1
D.P.W. Fire Health
Insulation:
Meter: Oil: Final:
House _V�/ ^ -
� J `f
ouse# Smoke: �J/ 7
Water: Alarm: Treasury:
Sewer: Sprinklers:
D k Imo•,- coo �
THIS PERMIT MAY BE REVOKED BY THE CITY OF SAL UPON VIOLATION OF ANY OF ITS
RULES AND REGULATIONS. , r.
�iglolnooma— tire: 052
Fee Type: - Receipt No: Date Paid: Check No: Amount:
BUILDING REC-2006-002352 26-Apr-06 101 $255.00
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GwTMS®2006 Des Lauriers Municipal Solutions,Inc.
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_1HOOL STREET 708-05
820— —I COMMONWEALTH OF MASSACHUSETTS
Map_ ,17 CITY OF SALEM
Lot: 10318
'Category: 434 Residential:additi
Permit# 708-05 BUILDING PERMIT
Project# JS-2005-0779
iEst.Cost: $50,000.00
IFee: 1$505.00
C onst.Class: PERMISSION IS HEREBY GRANTED TO:
IUseGroup. Contractor: Licenser x
we
;Lot-Size sq.Sr) i 15020 � GEOR.GE QUEENAN General Contractor-CS074974, *'
Zoning: R2 —Owner: QUEENAN, GEORGE3
Units Gained: I Applicant: QUEENAM,GEORGE -
'Units Lost: -
Dig Safe#:
-AT. 0068 SCHOOL STRIS:T
ISSUED ON. 24-Feb-2005 AMENDED ON. EXPIRES ON- 17-Aug-2005
TO PERFORM THE FOLLOWING WORK:
REMODEL EXISTING KITCHEN & BATH AND ADD ONE V.'.WBATH
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Buil in r
Underground: Underground: Undergr.undo Excavation: V Service: Meter: - ,,..- - - - _.. _. . - Footings: -
Rough: Rough: Rough: - Foundation: t) 1
Final: Final: Final: Rough Frame: J
Fireplace/Chimney: IV
D.P W. FirHealth
Insulation: �.
Meter: Oil:
Final: c,<
[louse# Smoke:
Treasury:. � . .. ,. - . € . . ..
Water: Alarm: 1YPh -
Sewer: Sprinklers:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOL I
RULES AND REGULATIONS. r
Signature:
F'ee Type• Receipt No: Date Paid: Check No: csna m
BUILDING REC-2005-000984 14-Feb-05 315 - �y,� ,
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Geo TMS®2005 Des Lauriers Municipal Solutions,Inc.
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
s.nusa "Dancou.
M VASF$eti MSswraT a UUK McSACta7s<T7S01970
its:WW45-%%O FAX VW09M
Worken' Compemadoa Inswance Affidavit: BVUdwWCo8&wbra/Elee6jdaa6?hMbere
Ql Aa Oat Informa&a d t r.ems..
Names • y. Q(lC m-S, i _A
Addn=- o g jlLcz S' .
City/stitemp: 1�/tn / a. p)
An you u empleyOrt Cheek the approprtab hon
1.Q I am a employer with 4. Q I ere a Smad ceanac w ad I et a
employees 04 Snd/a paFtimejo haw hired the 6. ❑New cmetucdan
2.01 am a Sole pxopridor err pertaeo- Hetad on the attached shaft t 7. ®Remodeling
ship and have no employees Thus sub ccutr h
working for me is my capacity. workaa'comp,ioauana ome 8 Q Damolitlon
corporation and its 9.
(IVo workers'comp iosuance 3. ❑ We ire a i addition
required.] Oalcers haw exercised their 10.Q Electrical mpaim or additions
3..R,I am a homeowner doing aB worst right of exemption per MOL 11.Q Plumbing repairs or additions
myself(No workers'comp a 15Z 41(41 and we have no
insurance required)t employee•.(NO workers' 12.Q Roof repair,
camp,innusup ) 13.Q Other
'�eeeram mat chedo boa ei ores
r etefenatu.aedf.bew.eef.l,ribetr.ak.s+
Homeowmawho submit Ws maw""Goftdwyw dabs dwmk set Ase Ups amld ➢Mar h�emtlsa
'Coaaereme d0 cheek dde boe most oaemt9m met sS6StY a sw
resahees sladssa sink..
additloaelehest
MWMMW� sbaw4ia�hemmedihe �edrearheO•mmp
Doom fidwsawks.
tafernaWaeu &P^e l tag'rnwOf+rsaffoaunnanceformyemphryeea Bakwis AePoftandJobdo
Insurance Company
Policy N at self-ins.Lie. n
/ Expiration Date:1 � C�
_ ,7 .8 7
Job Site Addmm J Aa�
Ciry/Shte2ip:�ol�a���
Attach a copy of the worbra'compensation polley deeb nd a pegs(showing the poBey ammber and Oxpiratloa dMO)6
Failure to am=coverage as rwPkW under Section 25A of MGL o. 132 cm lead m the
fine up to 31.300.00 aoWOr Gne-year imprisonment.as well a civil �mpoSitiaa°f criminal penaltiesoff
of up to$250.00 a day a Penalties in the form of A STOP WORK ORDER and a&a
Investigationst Y10 sdv'W do a COPY of thin statement may be fotw=W to the OIIIca of
of the OU for insurAUG coverage vas l atio6
f do hereby eerd&under oho p&W and penaMw ofper/rry&W as.Gr/orererlowPrmfdd above is errs and temrd
Phone Ak
q(peld are onlp DO not wrAf IN thbt M94 to be completed by Cite or towns o,Qkld
l
City or Tows: PermltRJeensO M
Issuing Authority(circle oar):
1. Board of Health 2.Building Department ).City/rows Clerk 4. Electrical Inspector S.Plumbing Inspector
ti Other
Contact Person: Phone M•
Information and 'Instruc'Uun3
wow^.rontpeftoo fa their employwc
Msssschusema Geaeml Law^ehapuris defin "u"Y miO a of another wmdw any comae,othiie.
Ptmsmaa m this area,^. s
CC ao&A oral or Whoa "
asaoeisdam.oorpasadan Os other fell a+tmY.Or 'two Or more
As esrpfaYs*i^defined 0"m iodividmd.padP 1 :111fivell alit delO
ate"favVina enptyad in a�oins antasPs'a! aaoaadoa Or other fell mtiry,emplOY1ei
reviver.,:,fate of m indwedmal.p R ft and who maids^dtemim.or this oaupraot of this
�tmdomai
hour having cr wodt an such daenioli
been
owmar of a dttm� �deemed a b^m atiPbYsr•
dweft� bttndhtt &tor titan na bom m of each emvby
a on the tl
M(B.chaptw 152.42SQ6)go'er that"°very state er focal name bu d*P I sld a"emeawithu d oo bounce fer Say
or
to Opera"a buslaw W to contrast btal{ I tis W rs eosmemwaMY far ally
maawd of a tlamsa^r p^rmlt avldaaa et coupon"with the taanrsmaa avanp ra4�sd•""�
amt wba W eat ptrodutad atxeptsbls st"Vislan
apt;jSd GL 132.12SCC»mews"N�the commata�not air arith the inautanca
elite tr into
anti,����y pramted to the eonaaedsa sutbosity"
APt>ftmd mudw affidavit come et*.by cbabaa the boxy dui apply"your'w,W="it
pleas fin out the warkas s s).lei)sad phon^aumber(s)al"S wish their cadfiata(s)Of tbm this
i.i antes(L[.C)or Limtad Liali ft Psamaa6iPa(Lim ail eO Y"
ar Pssssaa does beve
we not matured to retry washes^' I the Deportollild f m LLC a of btdumiai
�p a policy is lle .e.vrbas. afl be may be Submitted to
this sffidavlf. 'fie afMavit shams
of inwmaea covaap Abe ba sttav"sip Of
Accidea t for�mmdoh fbr the Paul,or liana is beint regttated,me dta Depauddd
. Should you have aw 4ae�doa^"govdimi�law or if you as m4uirod to Obtain it wO ' t
�p�*a po",p�an die Depos"I 4 at this eumbe hated below. Sel�hwtedshould entx
self btamansa firm^^tttmdaar On the _ _
VOL
CRY or Two Ofrielab has provided a space at the bottom
Pleas be me diet the affidavit is wmPlae acid printed lsil�lY• The Depammsnt
the a8{dait for
you to fin out in the even the Office of InvesdptiOw ha to contact you reprdinp the APP�
of will be used a s mfaence number. In ad&dm an aPP�
Plisse be sue to fill is the pamrNiemse licodow in my gives year,need only admik one of davit t�cAft�
that must submit mu1dPL P )�eae�"�Silo Add rase the applicant should writ"an locedaw in__(c►sY a
pow Wfatnsdan(• that ha hem offioially stamped a,narked�'the cuY tx towm may be provided to the
towa)•"A copy of dW affidavit i^on tfk far tbwre Pamib oc licrosa. A ww&CMW&O vu moA ba tined out each
app�a proof that a valid affidavit a lieeass a patnit not mlated to my business a co mactal"mate
yen.Whew a hams Owner a cidsm is obtaioinfi is NOT regteired a complete this affidavit
(La.a dog license a pamtt to burn lea".ate.)am pason
This Office of Invadptioe^would WO to thsdt You in advaaw for your eoopaatian a^d should you have my questions.
Please do not hesite a to live us a can.
The Dep"MeWs addrea6 telephone and fax numbs.
The COMMawa tb of Mmuhtlse"
Depuf um of hihislnat Atxtdwb
Ofl14ft Of 1avtlWpdoas
600 WaS11108 oa
Bodoni MA 02111
Tel. 0 617-727-49M W 406 of 1-877-MASSAFB
Fax N 617-727-7749
Revised 5-26.05 WwW.mss Vv/dia
. J
Crry OF SAmm
' PUBLIC PROPERLY
DEPAWrMENr
�.�. 1��.eo�asarsnu�.sua�N.iuoa�,sat.»
Co"tMd an Debi Dbpft d AA"VfA
(�equird dttt sit demum sod IWAVWer wade)
�, wttb the shcar edWaa a[the Stave Hnt{dto�cods 7s0 cDds seeds.t tt.!
pdrts�d tlrpeovtstana db10t.a d4 s sN
Bw• lenniR is bnd witCr ft 000dt a that the&b&cmd is be
yde wah,ball b•disposed o[isi a po��►goessea wwste dtspaad ddltgt>.dented byldLS{.e
l«.stso�.
•n�.debris wiu be aaeespoetd by:
µ (vee dbseldl
The debris will be disposed of in:
!'4 c(�,rliV �
(sasee of
5,4 S,ytar.re A� S
�' ��os o/paavt�poliaal
1
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CITY BPCEnC A` �—dt -
f' PUBLIC PROPERTY�`���t �� r��
DEPARTMENT
KIMBE LLEY ORMOL
MAYOR I2D WASHINGTON 5IMEEr•
"U.EK M,USAOH1:5t'1'IS O1970
TEL-978-74S-959S•FAx 978.740.9N6
APPLICATION FOR THE REPAIR.RENOVATION, CONSTRUCTION.
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.o SITE INFORMATION
Location Name: r / o// �1 u�..{<_.e Building:
PropertyAddress:�g. Jc�lo /- C20 8 ( f
Property is located in a; Conservation Area YIN Historic District Y/N _
2.0 OWNERSHIP INFORMATION
P.
2.1 Owner of Land
Name: co c< a✓L
Address:
26 6
Telephone: 7(?- - 77 (�Z o>o
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation 4/ Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (so Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
Cgf10etnq, 4 ,041`.1
Mail Permit to: U 8 5 0
What is the current use of the Building? —
Material of Building? d-)O If dwelling, how many units? _
Will the Building Conform to Law? c C Asbestos? 4r)'
Architect's Name
Address and Phone ( 1
Mechanic's Name � d✓�2 c<yi 9
Address and PhoneSS L,a 97k ` 7 7/'Zo�
Construction Supervisors License# C,)C 7 97 HIC Registration#
Estimated Cost of Project Permit Fee Calculation
Permit Fee$ Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
An Additional $5.00 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 Building Permit
$to build tothe above stated
specifications. Signed under penalty of perjury X
N
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