8 TRADERS WAY - BUILDING INSPECTION (3)�r
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BUILDING PERMIT APPIJCA M FOR:
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PLEAM PILL OUR LROKY a COMPLETELY TO AVOID DELAYS IN PROON11M
TO THE INSPECTOR OF BtALDINIM
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FCHRIS ASAFF
Project Manager °o�tM°r°9m
°geOPPS
BOSS CONTRACTORS, INC.
304 Route ii9
Rindge, New Hampshire 03461
Tel: (603)899-9630
Fax:(603)899-9636
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PRFPARED BY
PAGE
DATE �'
PROJEGTAMUN NOTES PROJECT PLANNING NOTES
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CITY OF SALEM
ROUTING SLIP
IJ CHECKED DEPARTMENTS REQUIRE SIGNATURES BEFORE BUILDING PERMIT WILL BE ISSUED.
fin . `C /n � / J
LOCATION: " � �5 ��FY�{ DATE: �31U
APPLICANT: yV OS/ r!) A/ lqe Me
ASSESSORS OFFICE
\ @ 93 WASHINGTON ST.
FRANK KULIK DATE: l
—�' CITY CLERI a new street)
E URKINSHAW DATE:
PUBLIC SERVICES(Engineering Dept.)
@120 WASHINGTON=— A
DDr.
BRUCE THD30DImo). DATE:
—� WATER DEPT.
@120 WASHINGTON .J
�d CROSS CONNECT SUP'R I
BAB HES2II£tdE (/
@120 WASHINGTON ST,t]FL. DATE:
I✓T PLANNING. 1�dR
@120 WASHMTON ST.,30.D FIL DATE:
(Planning Dept.
N-GEF*LO 4 DATE:
FrorK Taus.,;Ad
ELECTRICAL
@ 48 LAFAYETTE STREE 2 L.REAR
JOHN GIARDI _ DATE:
—� FIRE PREVENTION
@29FORT AVE(WILLOWS AREA)
CAPT.HUDSON DATE: S /3 0 Lf
�] HEALTH
@120 WASHINGTON ST.,4rH
JOANNE SCOTT LJLQ/ DATE:
BUILDING DEPT
@ 120 WASHINGTON ST_31'FL,
TOM ST. PIERRE DATE:
***SUBMIT WITH PERMIT APPLICATION WHEN COMPLETED***
f
Valerie Gingrich
From: Joe Nerden
Sent: Thursday, May 20, 2004 9:55 AM
To: Valerie Gingrich
Cc: Denise McClure; Thomas Stpierre; Bruce Thibodeau
Subject: 8 Traders Way- Pizza Hut Routing Slip
Valerie,
I'm sending you the plans and routing slip for the Pizza Hut project, as requested by the project developer/proponent.
Engineering is waiting for a revised site plan/(stamped &signed) with a dedicated domestic water service for the Pizza Hut
side of the building. Its to run from the City's main in Traders Way into the building with all the necessary appurtenances
(valve, backflow). This was explained to the designer mid last year during their discovery work for the project. I just spoke
with Chris Assaff (sp?) at 603.674.2002 regarding the revised plan.
Once we have the revised plan we expect to sign-off on the routing slip.
Joseph E. Nerden
Asst. DPW Director &
Asst. City Engineer
Department of Public Services
120 Washington Street, 4th Floor
Salem, Massachusetts 01970
tel. 978.745.9595 x321
fax. 978.745.0349
email:jnerden@salem.com
1
-- PUSUC PROPERTY DEPARTMENT
120 V"ZHINGTOR BTRERT,3RO FLOOR
SALZH,RA 01➢70
TEL.4078)7A8-9595 EST.380
FAX(➢78)740-98"
STANLEY J.USOVKZ. JR.
MAYOR
DWOSAL OF DEBRIS AFFIDAVrr
In accordance with the provisiom of WX c 40,S34,I sclmowledge that as a condition
ofHinlding Permit M .all debris resulting f m fbe constuction scbvity
governed by this Building Permit shalt be disposed of in a paopedy licensed solid-wade,
disposal facility,as defined by MOL a III,S130A.
7bedebata will be disposed ofat wood Waste of Boston Boston Street
IacationofFaciw Everett, M
Sigmdac of Famit Applicad Date
FULLY complete the followi➢g m&maWm
(PLEASE P024T CLEARLY)
BOSS Contractors, Inc.
Name of permit Applicant
Firm Name,if any
304 Route 119 Rindge, NH 03461
Addrms,City&State
1be above statute requires that debris from the d®olition,renovation,rehab or orbs
akcabon of building or sauctm be disposed in a propaly-licensed soH&wute digmal
ficility as defined by MGL cIII,SMA,and the building permits or lieenaes are to
indicate the loation of the ficility.
4.€F; — �arr'')m,,monund(1/taD�/ l/jn(iSaq[htcfa�S
s'.o' _:Japa.Gael e/J�J.d.iMJieeivalf .
a 600 ywyasyb:c.J�slcaai
asays s.Can:oces 02111
camnaaala _
Workers' Compensation Insurance Affidavit
1, BOSS Contractors, Inc. (Scott Honkala)
. 1�1
..wis_II.a principal place o1 business act _ J
304 Route 113 Rindge, NH 03461
do bcrcby'ccm7y under the pains and penitsie,of perJM,th=
i i am an employer providing worker' compewsaWa covente for my employees working oe
this Jab. -
Acadia Insurance WCA0090393-10
leuuran[e Compavy Policy Numb"
1 am a sale proprietor and have no one working for me in any opadcy.
() 1 am a sale proprieser,-gtnenS contractor ar homeowner(circle am) and have hind due
cantneton listed belvw,who-have she following worker%' compensation porseitl:
Contractor Insurande Company/Policy Number
Contractor insurance Comparry/Policy Number
Convaaar Imurance Company/Policy Number
0 1 am a homeowner performing all the work myself.
"^O^w^e^�:. d ago w,mrta va 0<iori.ygi¢as ORea el Imausaaw of Ace DIA Ice ca.narr mikigan aaa aul lima r®r
.a...m o,eovrro vro,r 5.etol 15A of MGL 152 ran kao w vu as a ar el as w4l SWAG aaaa w
.ao m Nc I..of:STOP WORK ORDER am,by et s 100A0a an a+:w ac
Sirned this 13 day of May 2004
.:cc nsc ci Fem, iurc _ cuildin€ ueparzn.en!
Uct asinf eoarc
5vienmens Office
=c:I[4 lie par.2ce'.
1M- �rrm nue.— txaWa;
. �.4e �anmKaiu�ldE a�.� rraedd „ �
BOARD OF BUILDING REGULATIONS d
'CPNSTRUCTION,,90PERV15OR
Nun*0r. CS 071195 'I
.� BlrthAot! 04/30/1968 .)
. OQ130/2006 Tr.no: '11174
-� 'Restricted OQ �: ,-
CHRISTOPHERA` SAFF� (
1 OLOCATHEDRAL
�?rFIDC.iE,
•Ad
NN 03461 t-a* ':' ..
_'yt . ministrator
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