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4B SPRUANCE WAY - BUILDING INSPECTION (2) CITY OF SALEM PUBLIC PROPRERTY Gay D DEPARTMENT MAvos uo WADOW MSTRE"a SAtsM,MANAC1nReM019M Tau 9W45.9M a PAsc 9W40.9a46 Worker' Compensation Insurance A davit: Buff&AWContnctorlMecbidaayplumbers ApaUcant Taformatton Cen0not-funn gr1eA�wi,s please Print t e..ts.ty Name(Busionworpnizationoudivi&wy P.O. Box 53 Address- .m City/SUWMP: Phone�/ �7 l — (n c s- - 441 o Are yob o ample or?Ckeek aDpropriab boss Type of project(eequiree: I. am a employes with 4 Q I am a seaeral eonpacWr sod I employes(Atli and/or part-time).* have hirad eke wbca Q New construction 2.0 I am a We proprietor or psrtsen lined on the attacked skeet,t 7. ❑Remodeling skip and have no employees These sub oontracnon have L Q Demolition worldns for me in any capacity. workers'comp inananoe, g, Q ng addition [No workers'comp.insurance !. Q We ass a cosporadon and its 9. 13 Electrical required.) officers have exmetsed their repairs or additions 3.Q I am a homeowner doing an work dskt of exmn din per MOL 11.Q Piumbins repair's or additions myself[No worker'camp o. 132,11(4),and we have no 12.Q Roofsepaira moutance required.]t employees.[No workers• co humaoce 13.Q Other ��l iA"wv�den shade box all scat am as out do swiss bonaw sbmv*a sakwwkes'aoeq�suon HMWwnM Who A*mk d&&Mdin*hbd=ft dWyMMdda.anWO&sodan.bWamia.emaee0eMMosob"rCOObadws We chest ibis boa minatdCbaaasadddmdsh"A&wbg 00 Oame ofdo wb•aaatraCmO see lbatr Wd*='pamp.Polky( &MMIM W"Mo o Aar b prov/dlnj war/brs'eawpoaratloe liarwaeeijorwy rwR&Yes Bdow Is the po!!ry andjob sft huumoce Company Nome:-q LJ P � t Policy#at Self-insrr Lie.#�_ cJ C l +O �l0 fn O Expinwou Date(E,:) Job Site Addraw'T f� 3 0(O cb1 CC', W(R y City/State/233p: p�Q 7� Attach a copy of thb workers'eompessattos Polley deelandes pap(showls the Faihtn to secure eovara as g Polly number sued expired"data} sal reWirad under Section 25A of MOL a 132 can laad to the impoddon of criminal Paraiba of a fine up to S000.00 and/or one-year imprisuumem,as well ss civil Irenaltim'a"form of a STOP WORK ORDER and a Are of up to S230.W a day aSsinat tine violater. Be advised that a copy of this statement my be forwarded to the Office of lavestipdons of the DIA for insurance coveralls veri icuion !do hereby ee�der the anted ptnaltlp ojper/wy chat dv In/orwaelow provldsd-`-�7.vi trrrt on/eorrsd Signature: ��./ /v Daw• i� �� Phone#: Z — G2 b S — q44 o FOloss'tarrd an only. Do sot write a th&erra,to be completed bye4 or tows ofyfehol s: Permit/Ltcense# hority(eircb one): Health 2.Building Department 3.Cityfrows Clark 4.Electrical Inspector S.Plumbing Inspector Contact Person: Phone#: CrrY of SAtEm PUBLIC PROPEXff DEPARTMENT 6 �.,�. ,3�.�m�or>AtiR.fata�l4�oa�,s01+'fd Coos&utdon Debrb Dbpood AAWavit (mooed S,r droolilios god ssaevsttes wset� to== m e wt&dw s6cttt.dWW O(&@ Stets BWWWS CW4 780 CUZ section ttIJ pa m%sd dtsp mvtdam atIM 6 406 ti Slt Bundles tymdt B to tensed wi t Ow soodt m fast dw dsI med 6s Bois ct,is arait sbsq�dtspos.d o[is s psops.�►tlesessd wads dtapassi tldttly s d.Qasd by!/R3.s Z7a dsbcis wilt b.tranaposad byt IU dohs will be disposed of in:I f Gbco (awn"of AdiuM ywsw a<v.�.>ooucss dw � 1 i I i 00-35,000 cfenclosed space (MGL CA 12 S.60L) 1A-Masonry only iG-1 &.2 Family Homes II ; Failure to possess a current edition of the 1 Massachusetts State Building Code is cause for revocation of this license. DIG,SAFE CALL CENTER: (888)344-7233 ` '°-a " ✓�eei9omvrxoour%ea�C�C G/FREG�i 6LrTICWSdX I BOARD OF BUILDING REGULATIONS,v } License: CONSTRUCTION SUPERVISORr j Number CS 053897. x. r,a EEE -,: Birthdate 05/02/1962 L. Expires 05102l2007 Tr, no:'- 12307 Restricted: TIMOTHY J FINN r 8 VALOORA DR/PO BOX 53 STONEHAM, MA 02180' •'�'••- commisslo�� I i 02/09/2007 le:39 17619638610 CEDARHILL PAGE 02 _ A PROPOSAL CONSTRUCTION SPECIALTIES UNLTD., INC. P.O.BOX 53 STONRIUM, MA 021g0 Phone(781).665.4410 Fax(781) 6 411 LENNOX / �� s ROAN-NUTONE .HAM vROW�� 1 ' A ORT@K COMPANY �f3 -� ` 4ruosi cue� " I We hereby submit speciflcatious and estimate for: -c��,,� I 1 We propose hereby to fiunish material and labor-complete in aceo cc with the above specifications for the sum of: AS ABOVE Payment to be made as follows: For special orders a 50%non-refundab deposit is required, For central vacuum and Intercom installation,halfis due upon rough-in d half is due upon completion, For all other work.payment Is due upon job completion. Authorized Signahue yj,cl— NOTE :All plumbing hook-ups6 carpentry work& building permits are o responsibility of the job site general contractor or homeowner. Prices are effective fo up to 3 months from date ofproposai. Acceptance of Proposal ib.MwoMeawWl...w.wwW.r.n.r4srg w/w .y,rppr rw�..een.awaa.wn..w�a. Py� e..w....www w-.. Signatwe Date: 2 0 7f aeodpted please sign and return. �E CoNt�o !o eaY �, �_37sy �o(uai� � I �C3f�v Ol(�o✓P I CITY 0 'PUBLIC PROPERTY . KI. o. ba DEPr1RT'NiENT Irm.976 74 SW9 FA7c 974040=9M6 AIP LIGATION: OR'I`SE REP REN' YA ON CONSTRUCTION DEMOLITION. OR<C GE OF:USE!OR OC,IaMANCY. FORsANY_EXISTING: STRUCTi1RE OR.BUILDING' 1.0 SITE iINFORMATI N location-NOW.. _ic - co ._ x _ Bullding: ___ _ _ — propertyrkddress. _-- Property b located in a;Conservation Aisa YM Hisfaio Obtrk t YM -, 2A`OWNERSHIP"INFOR TIO.N 21 owner of Land Name: 6 Q 1ac Address: ��3�JCA✓��e :k'ocl l . 0 R .. 3LETE THI'S SECTM FOR`WORK IN`�rSIM EUIL01,A'U G&ONLY Addition Existing. Renovation `Number of Stories Renovated Change in-Use Demolition Exlstlrag Approximate,year of Area per floor (sf) Renovated conStruction or renovation of existing building New Brief Description of Propos Work: (� l�nnc� �e �a�i Mail Permit to: b (0 72-emn {oS� 8212 What is the current use oFthe Building? Material of Building? 2ac& If dwelling;how-many units? q WiU.the Building Cori nlft' o.Law?. Asherstos� =- ArchitecCs•Name Address.and Phone _ Mechank;'s:Nams- -Address W4 Ohbns Construction Supervisors l.ice*�nsneO#C ©S�a-1 HIC:Registiation# Estimated'Cost ofProject Ste= Permfu s.Caiculatiom Hermit Fee:i Estimated Cost X Sr/S 1000-Residential _ - ----— -- - ..... -- -- — - Estinrate�Cost)E S t#2S1066 — — -- M`Additional 35.o0`is ad'ded;aa ari- Admlhlb ative chargq . Make sure--that all flelds aresproperly and`.legibly written to avoid-delays<in..proces§ingc The-undersigned doewhereby apply for a:Building PParmit to build-to the.above stated; �w specMicationa. Signed under penalty of perjury X 450"jFFF N O V F e C7 8: w