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4A SPRUANCE WAY - BUILDING INSPECTION
What lithe can ent use of the BufWing? Matedal of,Buflding? © -If dwelling how mahy;units? - Willthe Builtling Coritorm to t aw?° Asbestos?; Arehitecfs Name Address and Phone Mechariicis;Name�^'` �" " a Address.and'Phone Q Cansbucdon Supervisors license iot$P53 HIC.Registration Wl Estimated,CofA of Project s — Permit-, 0 calculation Estimated Cost'X Z71S1odo Reaidentlal Permit Fee - -__---- ---- — -:------- - Estimated coat X 849'fS100�f�enirnercial An Additional$6.00:Is!adtled�aa an Acfintnistraiive.ch8�gs� ok Make•sure that all fields are:properly and`legibly written to avoid delays in Vprocessirig; The-undersigned doesrhereby apply-for a-BuildingVermK to bulld to the above stated, speoiflcations. Signed,urider penalty of.,Oddury ✓' Date " N r sIs i -z t SL _._ :._. - - ( t 00-�35,000 cf enclosed space ' (MGL C.112 S.601.) - i 1A-Masonry only i G-1 &2 Family Homes - j Failure to possess acurrent edition of the i Massachusetts State Building Code I -4 is cause for revocation of this license. t t DIG SAFE CALL CENTER: (888)344.7233 ��l1 V �s¢lomronn w o� '�a WW.4ivaella I BOARD F BUI DIN O G REGULATIONS.f f License: CONSTRUCTION SUPERVISOR gZ Number. OS 053897, > Birthdate: OS/ w962'--', Expires,05/0212007- Tr no:-12107 Restrlctede 00 TIMOTHY J FINN - ` ' 8-VALDORA DR/PO BOX 53 ' STONEHAM, MA 02180 Commisslorio�fi'" '! CITY OF SALEM ,a , - PUBLIC PROPRERTY DEPARTMENT anaaERM ORSOM M WutmucM kiln *Sorest.MAUMMtnaMOI970 M L•M745-""•FAX 9W40.9M Workers' Compensation Insurance Affidavit: BuildeWContractorsMectliclanyplambm Applicant Information Cenon.Ae:wr Q..__a_tr�e@ P1ee••Dower� � Name P.O. Box 53 am, Address; City/Swamp: Phone#:_ -12 L Vi `a — 441 An ass employer?Cheek the appropriate post Type 1.F am a aeaenl contractor and I et project(re9Wred): employer with 4. (] I am a employes(!loll and/or ttme)• have hired the subeonnEctas 6. 0 Now construction 2.❑ I am a sole proprietor or parmaN listed on the saached abaft t.t 7. ❑Remodeling ship and have no employees These sub-oomeicrors have L 0 Demolition working far we in any capacity. workerro0 coup,ioauaoa. NO workers'comp.inanranCe S. 0 We son s corporation and its 9. 0 Building addition ro9uired.1 officaro have eaarcised their 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of a mption.per MOL 11.(]Plumbing repaint or additions myself(No workers'comp, c.1S2,11(41,and we have no 12.0 Roof tepaim rnsoroIICe required.)t employees.(No workers' camp•insurance 1 13.0 Other AnspoicM tdmbbaaeimwrdwrmVAdWseetbbdorr6ertyMdr�o�k�s±eom�ryrapd{�, .... ttamsowasmw8attibeud>issradrvtttedlMdydungwdoingd we*and amNat004 aaatraegaonussubeUastwsttidne rCoabaeeon art�aek th4 burr aver saa�had as ddtdaed Aess Amine ar omr ofew=I u'b ans an aatployer thar 4pronldbsl warkars'Coax nrsdon +nd a sad drk wastam camp V�aY 8stbsmstlaa Worwadow• M Lummwfjoian'rmp/oyeea Brow is A*J"k,7'and/ob,ft Insurance Company Name: Policy>y Of Self-ins Lie.N �O Expiration Date �g D Job Site Addreu: J CI /S �,ty tatelLiP: LMo Attach a copy of tlr workers' mpamadoa Fogey deeupng the potley number and expiration day}Failure to secure ooverege u required under Sectioa 25A of MOL a. 152 can Ind to the fuu up to S1.S00.00 and/or one-year imprisomnoat,as wellof up to S230.00 a day against tha violator. Be advised drat s u civil imposition°f n�! of a m of A STOP WORK ORDER and a line Investigations of the DIA for insurance coverage verification. of p0�u slnthecot mforaybe forwarded to the office of !do baret r Cull der rba and penaldu ojpar/ary spat ub In/arasadon provldad fboycfjs rrw and comas OfJktaf nee onlJe Do ant write L his ar94 10 be eontpleld by clgr opMWN g ej&L City it Tows: Perm(t/Lkesss N Issuing Authority(circle one): 1. Board of Hesith 2.Building Department 3.Ctty/rowo Clark 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone N• Crry OP SAtam :j PUBLIC PROPERTY DPPAWMENT �e.�+�t�s•r.,a m»a+w Consa ufta Debris Disposal AM&vit (n�itod a:t dt draotldos nd neovder wadi fa aooae�ooa wilt�s�.dWas ddw sm Haildte�Cady 7s0�tieetia�Ill.! Iodwk d dw peovidaer atUGL s 4%S A Bvmbs hdo r is td witt do aoedldo n dm dw ddbb m"g km ci+d wok"be digpm.d atlas a piopeb Somw wren d ""ad"u dwhw by mm a Tb.ddbk wiD b4 ttHVWW b!►t,` cm i10 doba will be dispowd otlo: ocj-,�b�o �'� l b(o ere E)A 8 1 (MeQrc�e Wl� vwO+danns'"Jig- (9I()� 04/12/2007 13: 22 9787443575 G T MCCARTHY INSVRAN PAGE 01/01 �h©n� -- '�jSt-� fon — tSloo PROPOSAL CONSTRUCTION SPECIALTIES UNLTD., INC. P.O.BOX 53 STONEEAK 1144 02180 Phone(181).665.4410 Fax V81) 664-4411 LENNOX sROAN-NUTONE HUMPRCWCB A NORTEK COMPANY �o�er Co d��z 3 D. t - a'? We hereby submit specifications and estimate for: cruc�nce ©p Pik" `t- C�n,� ney y� Ir,s4-a(( Lennox Ba - 3(o 'PXn �J�It9�rn Perm; � D)S-t We propose hereby to furnish material and labor-complete in accordance with the above specifications for the sum of ASABOVE Payment to be mado as follows: For special orders a 50%non-refundable deposit is required. For central vacuum and intercom installation,half is due upon rough-in and half is due upon completion For all Other work,payment is due upon job completion. Authorized Signature NOTE :All plumbing hook-ups,carpentry work&building permits ate the•responsibility of the job site general contractor or homeowner, Prices are effective for up to 3 months from date of proposal, Acceptance of Proposa ib.lew u. n.Mrwyr.,gk rm....MMamau NL we,sy 4.d� FO, wm bq,n .,wiwwa.mw, Signature Datc: please sip and.rearm. V IT -O -_ PUBLIC PROPERTY DEPARTMENT- KINOWUSY o MAYOR 130 WASWN W hn=*5.uE v&%%cH Emrs 01970 M-97&745-9599•FAX 979-7449506 APPLICATION FOR THE REPAIR. RENOVATION. CONSTRUCTION. DEMOLITION. OR CHANGE OF USE OR OCCUPANCY. FOR.ANY,EXISTING STRUCTURE OR BUII:DING ' , 1 1.0 SITE INFORMATION -- 17roperty-A — ---- i Properly is located in a;Conservation Area YIN Historic District YIN 2.0 OWNERSHIP INFORMATION 1 2.1 Owner of Land Name: p13 e r w Address: �{ <1p(UQ�C� Telephone o — -(O 3.0 COMPLETE THIS SECTION FOR WORK IN-EXIQj= 8UILDINt33 ONLYi Addition Existing ' i Renovation Number of Storlea Renovated f Change in Use New ' _ i Demolition Existin g I er Approximate year of. Area per floor(so Renovated j construction or renovation -of existing building New.: BrW Description of Proposed Work: L(( p e, px1$nyl�`t- � k�n`S • �1� C. Le-x�r10 Dem FYe flq 1 C�11,-AaN . rrs ---- — - -- = Mail Permit to: i