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12 SUMMIT AVE - BUILDING INSPECTION ti . . ��3 -o:��-� , fL�IN6�Ah6ii'�EfILi��ND AiP�PROVEO$Y ZiiE 1lI�P�It�R;�P91QA Tp!�':1+�tI111T BFJNG LiRANT�D '-� ` CITY OF SALEM �.�� - � — s � '' S �;�� � � � W.� s, � ,_ zo,r„o a.me, � �+�pM1Y Loe�W b � loeacios ot u»F1laalo OMAd'! Y�s No 1alldias 72 5 Uh,n,i T AUE .• CarNvMlan An�9 . YM No� Pemiit b: BWLDII�Ki PERMR APPIJCATION FOR: ` i (Citc�e whichaver apPNI �. RNoof, In�WI Sidinq� Conttnx:t Dack, SMd� Pool. Fapai�/R�plac�� Oth�r: PLEASE RLL OUT IladIBLY i COYPLETELY TO AVOID DELAYS W PpOCEBgMq TO THE IN8PEC'fOR OF BUILDIN(iS: '• , � herobY ePPHsa tor a permit to build axo�ip.to ths.tolbwinp � . Owners Neme T�OM f/UNTER ' Addreas d� Phone �2 s u�,M,`r A vE (784f 639'?OO�i M;hite�t's Nams JA�� S ,4LFR ED (I ' ,Of1�/ �ddroea a Pnons 7 w,`n�'r�R sT s�r'7E 4. (.�17R) .�3�- ��9 9 P�'f� 894 Y �A. . AA�F19�1if� NM19 �jFX RUDEF'SKY , C�rivtN Kipp � �JEG7�EiSHfIN p���BEk Address d� Phone �,Q71?)9779788 ��r�R�.�57,340� ( 1 Whtl is�WPoM cf buYdtq7 R E S i DE it/TA l /B 7�S l �t•, �S .� �ww a w�rqz r.dwMwq,ior now mr,y anrw.9 3_ MA aiYdiq aoda�e to I�w7 MbMbt9 /l��C7 � EMYnwd oat �y 0._D0. o o dq uorw r 81�M • c�S �6 72.39 �y���� � �� � � ��� L�c. � 3! 7,4 8.S n of t SI�iNEO lM�IDER 711E PENIILT'' OR PERJURY DESCF�PTION OF WORK TO 9E DONE ° �'N7 �ul1y ��r,,0�� � S Gt��"in AnrD TN�`RD F'IooR FDD Tw0 RA7'NR40�,S �.�, . filJlJ fl1JE K�`TCNFh/. RU��I1� N w �oQGN ON� TN SECOIUn Flop�e :.�° _ , ,_ BUi�D OUTES��pE' S7Ai2s , I/US7'A �� NE�w (,'UY7'ERS,. �F'iX ��OF �£,. AS_ 11/E�AED, P�aFo�e� ��ex ,� Ay RD �bHCE 0� �ARK%IUG � IOT � .. � �.,— ;�;� MIIILPERMITTO; �9'9k. �i�sr SH012E DR .' MARBI�HERO MA 099 'fS �` :�: . '"` ARA �VI G01USTo�UG7'IOIV .�NC . � , . � � :� . ` . � , � � . N i- � .� � � I � � � � I Q 0 �., � �� � � � � � � � " I € � � � ,�--c � � t �, �- I' � c � � � � � p — � i ' — �-- The Commonwealth of Massachuseds a,� � = Depanment of IndustrialAccidents !�� - O/flCeO1►OYa8�8tl9Df � 600 Woshington Street, 7'"Floor �,, Boston,Mass. 02111 �� �/Workers'Com ensation Insurance Affidavit: Buildin lumbio Iectrical Contractors �;-;+�r,•�a-_ . ... . _.. . namn: �ddress: citv state� ap� phone k work site location(full addressl• � ❑ I am a homeowner perfortning all work myself. Projec[Type: ❑New Construc[ion❑Remodel 1 am a sole ro rietor and have no one workin in an ca aci . ❑Buildin Addition �- I am an emPloyer prov�ding workers compensahon for my emQloyees workmg on this�ob � �V �Cf f.n� � F �_' 6"x"��q. .�'3F.. �^�i�`"�*f T7=i3Y"wi�6. .s�;"' 1 .I3I' 7 x 3"`, � .. � ��. v � ,+�i�'�+E� - �.������"�"�'�"� ., addressi '�9J,le ��Sr* 'Su����'4"'W���'4'€��� ���.r � , ». +, j ��"�'�"'�''�'�r�'w .�, S g � � �ttv M AR t3 I t i•(EA� /41;4 t3'���✓� �' �.� �^� 'a$� '� ;q�r �,� a �; x�,� �.,� },�s '��x d� t 3 �` ar�'i �,.e�'°�c°'.�. �.�,.R.}ti-,y��"&��i'�i�2��.n��� F��`".t+`.�, �i �y� �,.�y 4 T^r ��`J7�35ab� n� kC 4''. �"'M�'� R�'EG,b +6 � ' � � . .�'. M; MlJTUti 1 ;.L./✓C..:�(y� c �v,: �� 4 �t �2 � �Y �`; � a� . : 1 �� ��O }° 4 , . ...._. ,,.. . .. , .. � . . . . _ . ,..2u ❑ 1 am a sole proprieror,general cootractor,or 6omeowner(circle oxeJ and have hired the conVactors listed below who have the following workers' compensation polices: . . . , . .. . . . . �^�'�t,�, + :- .�'� _{�'-'" v,- comaanv name: .. ~ -... � � Y ..�;; " Y -� � �: ' �. . . .. . . .� . �, . _ . . .,.., , � ,�.. a � address: � ' � � � ��� es � �: e . . , ,s • ,� a.G , :�, �y • i x� � s�y+ .. � ;��,�'� ".j� .,�4 s e`k§ I.t ` h �,$' �""' �s �: G f# � a � j 3i�'�r'�i. L 9 ��}� 1Y 4�Y^ . 4 �,t �'��'4t'- :: � "ian ' .t. kekw,e"+�Y'�'.+4�-":�� y�.o-+ ii:`�,�C.,sbs'."�' .,t, .:��`. *;..' ....7%�, a.*. �'� , .�� �1: Z.. . . . ,. _ .v. r... , �. ..:.a r �itrai{3:��*d.�J,�CY'.^;:f+^'�`�s3°i!�L:',: �'h :'*o.`'�'�-v�,.-y 33'��'� y� �:' �Er� .� ' -*�d-...€+�t �#.�� __ . - �Y; . ` _ _ ��f�'Y.. C"`��, i L�, -: �' 4 6� } comaaov name: � ! n�. - �'� .: 3... -.r "3�'fi address: } L n i h"� �$r'�. �������.-�`����h a��c'"'�E .n 'h�^�.r.��*� � 3 � b�� � ��S � '�Y � �6 4�i� �1#fik � .. T� � ip. . . . .�.. i � ts:v+r pr ' su� n3" � ?• � h s.c � � �. ,� i 5y ( .�� . � k ) vl$ '. '�' } '�P',� w��''9�,'r.^ i"tfin�M'��, x k +,� 1 . { :h s r ';xEhx< 'tv 9� ,:3+��:;f,`#' ;�J�:= Failure[o ucure covereee ss requlred under Sectbo 25A of MGL 153 cao kad m the impoaitloo of crim{nal pennlNp of a fine up to 53,500.00 and/or one years'imprisonment as well as civil peoaltln iu the farm ofa STOP WORK ORDER nnd a flne otS100.00 a day agaiost mz 1 understand t6at■ capy of Ihis atatemenl may be forwerded to t6e OlTice of Iovptigatlons of the DIA for covenYe veri(icatloo. /do hereby certify unde�the pains and penalties ojperjury�hat�he injormafion p�ovided above is frue and carrect Signature Da[e Print narne Phone N official use ooly do oot write io t6b area to be comp�eted by ciry or towo oliicial city or lowo: permiNicense q ❑Building Deparlmeot OLkemiog Board � ❑check i!immcdiale respoox Lv required �Selectmen's 01flce contact persoo: ❑Hcalt6 Depanmeot v..��ua sev�.zanl P6one p: QOther CITY OF SALEM� MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT � � 120 WASHINGTON STREET, 3RD FLOOR SALEM, MA 01970 TEL. (978)745-9593 ExT. 380 FNt (978) 740-9848 STANLEY J. USOVICZ, JR. MAYOR DISPOSAL OF DEBRIS AFFIDAVTf In accordance with the provisions of MGL c 40, S34,I aclmowlcdge that as a condition of Building Peimit# .all debris resuiting from the construction activity ' govemed by Uris Building Permit shali be disposed of in a properly licensed solid-waste dispoeal faciliry,as de5ned by MGL c III, S 150A The debris will be disposcd of at: L�e�/ C .� f�/.f'/�Q S f� � Location of Facility �-- � ,�,� o — Si ahue o B nit Applicant D, FULLY complete the following information: (PLEASE PRIIVT CLEARLl� � ,. �i�,"�",,•�'J �ctircc�t�J�/ Name of Permi¢App�icant Fum Name,if any �a.��l� /1�0�,� l',- ���;� .��,� oz��o Addresa, Ci 8c State The above statute requires tl�at debris from the demolition, renovation,nhab or other alteration of building or stcucture be disposed in a properly-licensed so�id-waste disposal facility as defined by MGL cID,S 150A, aad the building permits or licenses are to indicate the location of the faciliry. . t' �� �P�,���dlr/ o�.�tlo.�a�� BOARD OF BUILDING REGULATIONS ; License: CONSTRUCTION SUPERVISOR ; r' Numb,er. CS 067239 �8lrttidate:-02l25/1953 ,���==-`-�.i;:-' i. �Exp(res.i02/2512006 Tr. no: 1717,p y �_t:.� , Resv��ed:..ao , w�-:-,,,r RAYMOND KOVIfALSKI ' 10 ROCKY RIDGE�CIRCLE � TAUNTON, MA 02780' �`_�f� Commissloner , 10/24/2004 20: 25 508d2753:1. rRTREC4CLING INU PAuE � THE CUMrii�)NW�A1•'�H OF M.ASSAC[i[1S£TT9 � ReKiRtretiuo: 137385 Buard of Bdlding Aegulations tmd Standards � �tion: t ll5/2004 � Hatte improvement Contractor Regietration Progrem �i Z' One A56bwton Placa.Rtam]�01 � Lqeceived: )gostra�„IviA tlS108-1618 � Appllcatlon Pur Renewel af Segistratloa �I Horoe Impeuvement Contractot or Subcontractor hEGI. Chapler L�€2A,78Q CMA R6 i 1PLd:A5E lR6:AD INc�iuY;(TIOR'S C.�RF,Fi7T,I.P) i �-----^--- _.----"'----'-- Bnsint�S name c�o not chang�oo ren��wal form! . 1. PAYMOND KONIALS�I RAY'MONA KON'AI.SKI 2. 1D ROCKY RIAGE CTRCLE ; �. TAUNTON, MA 9278Q � f':Haap rtofe chanqat w irtal�'addt�ss. /. 8trtet Addreaw(Itditterml) �; 16 ROCKY RIDG�E GIRCLE _. . A f 1� �.... ��.. ..� -- �_ .._:_._..._..�- jt�._------ _..:. ..,... . _ _ ._ � FkvEWonuFs al1�s:D9lfCat3ddtP96. 5. AppEkantqpr. Mdividual ._� ; 6. Fed�rallANo ��—� See lnahuc[rons Ev cAeng»APpticalron NFe� i 1. No.o[EmpbY�e' �Nn.Empbyees i 9. Ic�divldoel r t61e ta Home I roveaxnt Cou�rnets: � i NAYMOND KOWALSKI ' — Fi;et � Mrc1 Lpat 10. Yltle a[IudlvWnd res 'bk t�Hcuoe Im ro.meent Contracts: � OWNER Pkuss na �chenyes tn 6Ha. SoclalS�rity No: �7� �/ j 9i/ PhoaeNa. (508)8 •3990 r i l. poes Ne apo!lcant ar resporoibk pccyun 6oid any nther wmxcru�iun related,ewte,ciN,wvna�IkFnses or e��btreiioos" �ea � No Cons4'uGlon Snperviwm Li�nse: �` 67239 ! Explres: t?��s�� 7-7 M000r vd�Ide]tepnir 51�: � _ Eacpkes: � IZ. LAB�AII PAi'f1141Try{NS���OYRb.'!'P�Al1ECW['L N�d R16,VP 6NIIFfS(In�: (�f j:�E&1CI D�OM�oe�':Cll�p)OP�011 nPPI�CA11�QMfi9c�tihlP Uf C01'�O/'OtlOtl bdrnv. Use addkiona(papea if ne�emaKy � Chx��k heee if you wleh[o receive an nppiicat'vpa for sddltionet CD curda tot�key peesons. '_' . I.oei Firsl� Mid. . 'fitk in Appliomt bush�ess ?u O.ma. . . .. ._. Adde`av�e . — '-7�------� — - — --�--�--- --- l3. Ie the applicaat dalming e=emptlon Prom the rcgistraNrs¢fee!(Sec th�Instrudioaa) I �4'oa �No 14. Regislration fw an�luscd:5�.,.,-- Guareet�Fund fae encicreed:S .: i[nara�aey.indude twn separak certiCud c6ake M 4aoaey aders-one trerkW"R�;istntion Fu^;one marked"Guue'epty Fund". Sce ivahuct�rxu lor am�wnt o[ fees.M�ke ell arfl[kd chala at mmey ordees payabl�te'Y:onvnonwerlth o(Mass�chasetes". �� NO PF:R,�{,�NaL Ult BUS[NE�y�21El:fSS VYLI,L BE ACGEPTFD ONI Rc6 THE A E S'F. TYFIFA. Putsurnt 4a MassacEusetls C�eneral d.aws Chapter 62C§49A,I cerxifp unJor tAe peneie{i.�g oP perjury tlme I, to my 6est Wowledgo and hclfef qave tfled aU sm��ax retnrns and pe�id alP sta�Sax�s raqulrcd uminr bK. �� . ,�1��,� ��,�./'� ? a `i�"� $ u[toPapp cant�p(�ap�pl'efepee9enW4ive TitleheldwitAoppkeant�� 9 te A[ohe enawer b wny qaatiwa 1a tb1�upp�lartian rnnxt�teta grouWa fin euspeaaion or reva�catipn ot ehe applirnnt'a reglstration. � ---^�-�+-....r..r--- __-. v......::_...�... _" _'--_ . .. � _.. . . . . '_"_'_'�- . . M ts .._ _. .. A�A- �ZSF � _ , -:; • Btnx t¢iw ur o ,:,, � . . I A�(A . �o2s� • ' r.�, , • ,;: ..... � � . �° � � ° � Ci .� � � o ���. , � o � o ;�... o q . � DEN . OOM ; . � ' � , 6 _.'�,. i O � � —. _ Q.1, 0 7;6„ , . ' 1 �� '3 ' ' I � P � �6' � _ � 1_3' , , �' S .�.� � iO � , „ anxnrrcE 8- � . � � c�ossEr . i } a.6 ' O vs/� , W/0 � c�o • �/� � 5 ` , � � � $ ' y �A�e{�= o r ,. � ' � xnu. Y ' . -- . � 0 35 � ' , - . . . . . __. � � ,� �.��,,t . ' � � I 5��c�, � � � ��ac� �PAcE. _ S��cFi un ' ' ., . _ 'P��Qa6N: - ��. � � ( � �y ' $2 .� 3 � � , ' �'b-9 � � Q _ I , �� �f STORAGFE AREp I ;�I � ' i �� 1. \O -6 � • I>O i KiTCI�I ' � ' � BIDROOM . . « � O � I 2-!p ' O ' ��' � � _ — _ _ �_ • , �'�, � i � . � ii I _ . CIASET � �''�� "f TE=U�I j�{.-I' T'O P>fi ' I I . ? ��� I�y �, ' I � I �, � � ' 1'3-q • � G. j . �Cc�1Etr .._� . O � \ 1 { �F��✓G✓ .. � � � , ��. .. ' _ N , � ;: oo - -- - ---� � � ' . � � . oo � OC�00 �— . _ �� _ I . • , r i STORAGE ARFA • � '� � ', � � �' _ O�� l �-$ — � I� � � • . _ 1 ` �4 ! . . „ 'P>E ¢ �J � � � � � 13-'� :. � `------- �. I � . . ., BIDR00 � 0 . 5 LiVING ROOM M I '� ; w PL�- ( � /, ' . � � " . BIDROOM � I 4—'1 � � DMQdGR00M Y� _ �L�b--_-- ^ • —'_'�(�.1I.N� -�� �� I i f 51 --- - , � . � , � I � _ � S . Z,-0� _ N � -._ __ ..__ UN•r( �.3. � � � q�1S� S �,g% ' 13 5 - - _._. � - • � — �3d U c,. _ _ • p 1.1T1tT � 1 — . . — , ' , _ __ ._.__�� _ . . .� c f �'Z. . . - p . , n� =,i r 3� �F w� �o- ( __ �� �'2F�� ��-I O._ SF. 7 . -- LA M Rs�A t�, CIASEI' "� • '— ' • . , : STORAGrE • � I / �� { ' __ -��r,,�'C _ � ,. — � �'�l��f 11J00p � e 1-� ' � ��„ k "_" . '�P�`'�(. . , ` � ` : j . / . � � � �� 'I, i . . ' �� -3 ` � �� . . �_ � -----:.....--- �� � . . I.iVIIdGR00M � tWd.w�Y , . J�j ' . --- - fDl�M(1)T-� � �./ �� .. , i , . � ' � , I ' � � . l4- � cona�oN� � _ _ i4�1� , _ -��� o ' sEn�ooM � lo-lu � . , . � •�C• � �J,I, . M �� MLI� � . , , II � �J�O � i , Frrrxnxce "T9 SF. - �4-S - � • �_ uv , � 12. '� , . S - O � . _. . 5 '-a� . i -_~f#ra�� � , . _ __I � • . � � � �. . _ . � � �� % FxoxrroxcH � . . . , , . ��-_. x � �R�H � � r- c�+oN �, *, , � ,v�,, , 8, ' � � GRAPHIC SCALE� - _. � �RAPHIC SCALE�, - GRAPHIC SCALE � ; � • � �, - � . _ ��--�� 4'I, � .. . ( n� i'arr ) , . , s/ie �nah - i re. � � �' ) I � . � s/Se lacn - 1 rt , 9h`�ah�i n � � . . ,� \ � h5 � „ �._.._._--- . � • .. �rnmU^ �o.. �rnr�- � � iTNIT 1. FIR.ST FLOOR � iT1VIT 2. SECOND FI.00R . . iJ1VIT 3. THIRD FLOOR i-,u�r ic��r,�- �,,eP,rcpt - S U M M I T AV E br G�mm� . - - _ -- - -- � ' ' 1 n'IcvLchvte� I i D� �NOTE: THE CONDOMINIUM _.__ = IJhns1" � UNIT SHOWN HEREON IS _ .__ , . .— - 1 Ff8!!DY C6R71FY THAT iflb I!}tOR±1CTY LiNE3 EFIOrVl1 HERSOTI . �� �. �.-�.G✓Gc n w c�.'� ��a, ' DESICNATED F'OR ' AR�7��s����T��SHIPS A?1D THH t.M6s I RESIDENTIAL USE. . OF STRH87'S AT1D NAYS SH01N4d Alt$'If103B OF PUB1.iC OR P1WAT8 STAE6T'S OR � , . „ 1VAY3 AIRHAD'1'BSTABG13Hf'L+D AND t10 Ni'1V LiN63 FOR - _ � Z 4_ �� 5_n n►v�oN oF o�rr ox i port xew srrt�se�s oR w�vs�rts�st�o�vrr. GRAP HIC S C ALE � . : � � I HEREBT CERTiFY THA7 • TNB SURVBYINO OF'1�B LAT�[ID!OR'11115 HAS E�1 DONE eY MH OR MY P'F..O�D �I`� D� . � ._ ^ _ THtS PLAN FULLT AND '. , . �V�� �. �UMM Ir��eO►h �TA tuATFT� � -- �v ,T i} �A�. ACCePSIED I.AND SURVBYINO MtAC17CeS AND • m ° ° '° \ uLt�D��l� - ��,. 1 iI m LOCATION L UNR NUMBER E � � 1JN�T _ ll: O ._.VN��T— _ � . , . . � 1 H81t88Y C81t77FY 7fi13 PLANi COT1P'ORMS 1'O Ti�RULES AND�tEUU1.AflONS OF �, ( IN FEE'f ) T�T_`'c_.�: _;.�, ._: . _ ;J , bo5� ' ` o S�. i ► rHe RBa�srRY or oeens. 1 inch SO ft� py�_��� �. ' DINENSIOHS AND . . _ - , ; i • R,. - . i . i' . .. .._ . _ . _.. . . _.... __._ . . .. P A A > > .,. . .-- . P i f.' � ' APPROXIMATE AREAS OF S '� , � . ra THE UNR AND COMAfON . � . ' ., . -� �i ' � � ,w.+�Ts (0� �• �v • Nt7'Fi7'HSPROCBDI)RIILANDTBCFIMCALSTANDARD3 ARED1IdACCORDA?7CE rr . . I AREA. �/� . . , " � 1N'ITiS}RACI7CB OF I�ND 3URVEYINCi M 7N6 COMMOM�VFJU�TH OP • .,,r�.,, .. ". • ,� • � \� :�� ' � MASSACFIIJSSI,IS. I HEREBY CERTIFI' THAT • � . � ', ' i THIS P.LAN CONFORMS ' � ' • 1 H81tB8Y CBRTIFif THAT TH6 REI.AT(V6 ER1tOR M CLOBURE t9 NOT TO THE RULES AND C CoM r.v� � " ��1lEG�. ' I � .LBSS 7tIAN I 1N 12,000. ,' . .. RECUUTi0N5 OF THE RECISTERS OF DEEDS. . ' ✓ � � • , ' 1 Flt�1t8DY CBR74'Y TH1S M.A1N PUCLY AND ACCUItAT6LY DBMC�TS , '� CONDOMINIUl�Ii SITE PLAN ; � 3�-�� „�u,�„�.�►,�,«�.��,����� ; ' ___...�.. �DTh L f3fiS��'_��w1'�'" UNI'1'3 AND COMIr10N ARF.A31N THS CONDOMfN1UM.AS-BlHlL1. � . aRF� : , t 4�0 _ ' ' � � 12 SUMMI�' AVENUE ' '(�ivF�4 P_An � .. ' /1fC E SS � ,.,y � � � 1 HSRSBY CS1tTQ+Y THAT 7HH3 { l n : � _ _ -- . ,S - �N ` ���„�,, SALEM, MA , Q � -v�� : ��.��o�,,� f or . �,� . " _�.�` A,����,►��+�, � TOM HUNTER , . N � . • jl . . i � � --- ' — " ° M4s CEC LAND SUI�VEYORS INC . � GRAPHIC SCALE � ' '�� '. "' " ''y "' BASEMENT �"'�0 ` 7 WINTER STREET. SUITE 4 PEABODY, MA 01960 (978)531 - 1191 . • ' • ', g crvn. � • � °F�'�° ,. � SHEET N0: OF D�ATE: : JOB: I � � ( a� ra�r ) . . .a�te �noh - i rt . � . � DIRAWN BY: � ' -- �� f ^ , : : � _ _ - _ __ - -- - -- -- _ _ -- .. _ _.— _ _ _ -- __.._- _ � _ _ . _