54 TURNER ST - BUILDING INSPECTION (9) `L 1MiST-9E flLf� APPROVED BY T44E
.WSPXTpR ,PRWR TP A.PERMIT BEING GRANTED
CITY OF SALEM
. �oNurr��c
No� � � H` 'L 'Tr� Date
e
Zh
Ward
\ oimnso� Zoning District
Is Property Located in Location of
the Historic District? Yes No_ Building
Is Property Located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other: '/� V—
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name " #"f- S te✓ cSA�31� P
�
Address & Phone 5-V 7z11e1ySW- .Svc� 71141—d99/
Architect's Name
Address & Phone ( )
/!apA/�t. 7n+�i
Mechanics Name /fp��CPaA-) 15�?lLrn/ i�t�iFi�L
IS-7 Sw4a17aw S7—
Address & Phone lrieIAl1 ,✓e.PTZg 1,WX O�IKi4) (W) 7ai—�1040Z�>
What is the purpose of building? R-rzr?F V7r-V.I
Material of building?AUWtA.,&4-m 0A1Y1- If a dwelling, for how many families?
Will building conform to law? yfIf Asbestos?
Estimated cost 2(l1/Ur City License # S7atecense # !S a 6,6 2/9
Home Improvement
Lic. /
Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO: li 25Mw �
.t
No.
APPLICATION FOR
PERMIT TO
k T r,61np- l kwn !
LOCATION
5`f Tdledj e, .s T.
PERMIT GRANTED
z —
APPROVED
(ffiSotCTOR OF BUIL INGS
. ..........
;lF t 1 Ott o srs���n�rrs�l��n�n�r��n��ns�s�r ru���ul IMPORTANT DOCUMENT rsoararn -nar LrLss�r�n�n���ru�sl n o -
" : ` " of lamp �P�i5taRr1t I s
CPrtit�.ratP ,�' r 5
5 ISSUED BY 5
REGISTERED , r ,,�. Date of Manufacture C�
Ib APPLICATION Q s� WOR. I
44,
NUMBER GNIP TRIES INC.
r yaT= Order Number EVANSVILLE, INDIANA 47711 5
5 i.., 5 F031.02 MANUFACTURERS OF THE FINISHED 5
TENT PRODUCTS DESCRIBED HEREIN 5
This is to certify that the materials described have been flame-retardant treated 5
(or are inherently noninflammable) and were supplied to: 55
r L; 657150 J
�j PETERSON PARTY CENTER INC 5
5 139 SWANSON STr',t. 5
5
s 5 WINCHESTER MA 01890 5
5 5
Certification is hereby made that: ,I'�s' S
j 5 The articles described onf this Certificate have been treated with a flame-retardant approved ` 5
5 chemical and that the application of said chemical was done in conformance with California Fire 5
5 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5
The method of the FR chemical application is: 5
5 5 :
Serial #: 8271200(4)
Description of item certified:
.I 5 PTEN MID 40W X 20 VL W W 5
5 5
5 _ Flame Retardant Process Used Will Not Be Removed By
h`� S Washing And Is Effective For The Life Of The Fabric 5
DURACOTE RAVENNA,OH Signed: rj
SJJJ 5
C� Name of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC CU
tl 1,:>.
�u�rr� 0 V�n��ls����I�ns�n��ssss�r��s�I��n�n��nc
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IMPORTANT D O C U M E N T ��nu��n�ru�nu��ruu�rrs�rs rrc Irrs�u��u�� 1I
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5
Mi
Certif rate of if tamp �e'a9t re t��a� s 55+ a . 5
ISSUED BY ��smm'•%- 5
REGISTERED p� 5
'11 APPLICATION o- HOBO
Date of arw `
NUMBER apJo sL iNousrnies n+c �,. 1.
EVANSVILLE, INDIANA 47711 rder Nu n� -
5 `� v
F031.02 � MANUFACTURERS OF THE FINISHED
TENT PRODUCTS DESCRIBED HEREIN ..;. .
This is to certify that the materials described have been flame-retardant �Itreated 5
5 (or are inherently noninflammable) and were supplied to:657150
5
a 5 5 PETERSON PARTY CENTER INC 5
136SWANSON ST
WINCHESTER:MA 01890
�21 Certification is hereby made that: 5
r
y 5 The articles described on this Certificate have been treated with aflame-retardantW ved 5
5 chemical and that the application of said chemical was done in conformance with;Cali ' ` "' ,:Fire 55
5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5
5 The method of the FR chemical application is:
5 51 s 5
5 serial #: {� 5 8271500c4f
" 5 Description of itern certified:
p
t PTEN END 40W X 20 VLF WW
Flame Retardant Process Used Will Not Be Removed By
5 Washing And Is Effective For The Life Of The Fabric . i 5
L5
k 5 DURACOTE RAVENNA, Signed: e1Z 5
*, ;w 55 OH Si d 5 fir„ Name of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC r � 5
„s, ❑ WETf[P[P[PrJFL3rL3IL3PLJ-P[.P[rL3rL3l[P 1
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BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 060219
Birthdate: 04/27/1954
Expires: 04/27/2005 Tr. no: 9542
Restricted: 00
MARK TRAINA
33 HANFORD RD
STONEHAM, MA 02180 Administrator
The Commonwealth of Massachusetts
Department of Industrial Accidents
h = officeofinuesd9adons
600 Washington Street, 7`4 Floor
s° Boston,Mass 02111
Workers'Compensation Insurance Affidavit Building/Plumbing/,Electrical Contractors
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uDlicantinformafiont:_., pleasePR7NT?1etlbly wE ,. , ,,,,
name:
address:
city state: zip: phone#
work site location(full address):
❑ I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel
❑ I am a sole.proprietor and have no one working in any capacity. ❑Building Addition
I am an employer providing workers compensation for my employees working on this job
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❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers compensation polices
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'AtCaeh edditiaoal sheetif necessary 'ryf�t�E��tdr.atlP ;,�,q�;;iy ;s,;,;� ' ,;E
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature �XLZ� Date
Print name NO?k 772AIN?4 Phone#771—, a f 0ar32_>
official use only do not write in this area to be completed by city or town official
city or town: permit/license# ❑Building Department
[]Licensing Board
❑check if immediate response is required ❑Selectmen's Office
[]Health Department
contact person: phone#; ❑Other
(,e m d Sept 2003)