4 SPRUANCE WAY - BUILDING INSPECTION (2) :rt�q
:D�.kPM0fTAEINlGGRANTED yi9�!ti
CITY OF SALEM
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BUILDM PERMIT APPLICATION FOR:
Permit to:
(Carole whlohawr s") . Install Sid kV. Construct.DNK Shad, Pool.
PLEASE FILL OUT LEGIBLY h COMPLETELY TO AVOID DELAYS W PROD
TO THE INSPECTOR OF BUILDINGS:
The urdwlWwI hmW aWIN for a pwmk to build according to do bNwA*p
ownoesName j-Jmpn c s QwG rCw S
Address dt Phan '� -D Sao r ran.,w W e„/ r 9791 734o
Amhltsds Name
Addroae a Phone r 1
Mechanics Name Ro,;ub Jt. L'�i.eurGrr,o
Address APhan /- a H4•r7 Wa,, r9791 7Y5-c14v1
whd M BIB p mpow of mcov!
md"m d talldnp9 Wed a a dwartiq,for how mmy r mwz
wil kik" in -to ko A �i
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Signaturo f Appbceril �".:
SIGNED UNDER THE lll*iv'
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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h' MAIL PERMIT T0: Dr, J 1►�cs �� c-e, s -!
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APPLICATION FOR
PERMIT TO
LOCATIOPI
PERMIT GRANTED
u- -
INsPWOA OF BUILDINGS
s _-
r " PUBLIC PROPERTY DEPARTMENT
• 120 WASHINGTON STREET, aRD FLOOR
SALEM,MA 01970
TEL (976)745-9595 ExT.880
FAX (978) 740-9846
STANLEY J. LISOVICZ, 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# 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 MGM c III,S150A.
The debris will be disposed of at: S./A,, �rA..Q �,• 5 �
Location of Facility
SignatizaaermitApplicat Date
FULLY complete the following k&rmstion:
(PLEASE PRINT CLEARLY)
o13er.4, JJ L '4
e,u.r
Name of Permit Applicant
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, S150A, and the building permits or licenses an to
indicate the location of the facility.
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Workers' Compensation Insurance Affidayit
«I
. . wit.h.a principal place of business at:
$c/t,.,.., MA of `C7o
do hereby'cerzify under the pains and penalties of perjury. the
() I am an employer providing workers' compensation coverage for my einplayees working an
this job.
Insurance Company Policy Humber
1 am a sole proprietor and have no one working for me In any opacky.
() I am a sole proprietor, general contractor or homeowner (cirde one) and have hired the
contractors listed below who-have the following workers' compensation pofieks:
Contractor Insurance CompatSy/Policy Humber
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
() I am a homeowner performing all the work myself.
I understand wt c cool of the avicennm,.a be io�aroed to ow Offee of 4,wdeevoro of dx DM for eo.erate•eeikaddn and out L*M m"Cure
co.erare as tewreo under Section 2SA of MCL 15 2 can kid w dx inoocttidn d crvtttrtat oetvttxs eorsaunt of a foe of w rot 1.500MO wWor one
rcars•inwootrnmt x hsa x riri "",Lie$ in tin form dl; STOP WORK ORDER and a fine of S IOC-00 a dal araitt"tnt.
Signed this � /f�o fir' day of 2oa-
ccnseei'F nttt iiuilding Gep rnent
'�cen ing heart
Stieccmens Office
r,t.Ith Lep:r-men•
- - - - - - - - - ,r
-
_ _ . _
American Properties Team, Inc. /\
TO: Dr. James Andrews, 4D Spru ce Way
FROM: Jill Fama, Property Manager
RE: Deck Repairs /Replaceme
DATE: April 27, 2004
Please be advised,the Board of Trustees for Pickman Park does not object to the
replacement of your deck. Please be advised, you may not change the dimensions of this
deck. A licensed contractor must replace the deck. A permit must be pulled prior to this
work commencing. A copy of the permit should be sent to me. Once the work is
complete and the Building Inspector has signed off on this work, a signed copy of the
building permit will be required as well.
Should you have any questions or concerns, please feel free to call me directly.
500 WEST CUMMINGS PARK • SUITE 6050 • WOBURN 9 MA 9 01801 • 781-935-4200 • FAX 781-935-4289
u
May 6;2004
City of Salem Building Inspector
120 Washington Street
3rd Floor
Salem, MA 01970
Dear Sir,
I have been asked by Dr. James Andrews, 4-1) Spruance Way, Salem, MA to
replace the existing stairs on his rear deck. Enclosed, I have included a copy of the
following documents:
• Completed City of Salem Building Permit Application
• Completed Disposal of Debris Affidavit
• Completed Workers` Compensation Insurance Affidavit
• Signed Letter of approval to perform the work from the Board of Trustees
for Pickman Park
• Sketch of the Proposed work
Please feel free to contact me if you should need additional information at home at
978-745-6141,or my cell phone at 978-578-4162.
I am looking forward to developing a professional working relationship with your
office. Since this is my first application for work at Rickman Park for work on a
unit other than my own, please let me know if there is any further information you
may required of me.
Sincerely,
�; ` Q '-d�
Robert J. Uheureux, (MA Construction Supervisor CS'018386)
1-8 Part Way
Salem MA 01970
RAILINGS
AND 10-1/2"
BALUSTERS
1z'- nll
TO REMAIN
5" O.C. �-
11-1/2"
Riser
detail
------------
1 �
II LJ
1
EXISTING
DECK, POSTS Weight Varies
REPLACE STRINGERS,
AND SUPPORT Field Verify
TO REMAIN Before Construction RISERS AND TREADS.
Existing
Concrete
Step
w... �� Existing Length Varies
Concrete Verify Before
Construction
Piers
PICKMAN PARK CONDOMINIUM
4-0 SPRUANCE WAY, SALEM,MA
LIMIT OF WORK PROPOSED REPAIRS TO REAR DECK
DRAWN SY:R09ERT J.L'HEUREUX
DATE:APRIL 10,2004 SCALE:NONI