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54 TURNER ST - BUILDING INSPECTION (13) p Hie Commonwealth of Massachusetts ra''I Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Building Permit Application To Construct, Repair. Renovate Or Demolish a One-or Two-Fandl,v Dwelling This Section For Offici Use Only Building Permit Number: Dat Applied: 9 � Building Official(Print Nwne) Signature Dale SECTION I:SITE INFORRIA ION Li Property Address: 1.2 Assessor Map arc tiers I.In Is this an accepted street?yes no Map Number arcel Number 1.3 Zoning Information: 1.4 Property D mens ns: Zoning District Proposed Use Lot Area(sq 11) Frontage(11) 1.5 Building Setbacks(R) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.I.c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Check ifycs❑ Municipal❑ On site disposal system ❑ SECTION2: PROPERTY OWNERSHIP' 2.1 Own�ert of R�sor�9 t °.,p 7` L�iV—s-9 /,, 4/ N:mie(Print) City. ZIP 4:;q 'emu f ns+" M Wf 0 9& No.and Street 'telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ I Other ❑ Specify: Brief Descri tion of P oposed Work': SECTION a: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only I. Building S I. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing S '. Other Fees: S „Mech:mical IHVAC) S List: 5, \fcchanical (Fire S Suppression) Total :III Fees: S _ I Check No. Check Amount: __Cash Amount:_ G. Total Project Cost: S �f 0paid in Full ❑Outstanding l3al:umce Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Limnw Number lispiradon Date Name of CS]. I folder List C'SI-Typc(.ice helow) No. and Street - --- fype Description U Unrestricted Buildin gS Up to 35,000 cu. 11.) R Restricted 1&2 FamilyDwellin g Cilg/IUwn,State.ZIP M Nlasonry RC Roofing Covering W'S Window and Siding SF Solid Fuel Burning Appliances I Insulation Neithone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) I III' Registration Number Expiration Date I IIC'Company Name or I IIC Registrant Name , No.and Street Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.it. 152.1 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... ❑ No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application i rue and accurate to the best of my knowledge and understanding. Print Oaa ner's nr Audurtize Agri 's anac I lilectnmic.Signature) Dale NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC) Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at oca Information on the Construction Supervisor License can be found at t�n�q.inas;.gm.'Jp, 2. When substantial work is planned,provide the information below: Total fluor area(sq. ft.) _(including garage, finished besenaent'atties,decks or porch) Gross living area(sq, It.) Habitable room count Number of fit replaces Number of bedrooms Number of bathrooms Number of half;baths ------------------- ------------------ I'y pe of heating S�stem --- Number of decks, porches 1)peot'cool ingSysten___. Enclosed t "rolal Project Square Footage-ma) be Substituted tin"focal Project Cost' 07/29/06 08:44 FAX 97SE719905 RAPID HICRo SIOSYSYElIS � 771e ConusOK Offwe of ZKYOdwakem 600 wffA&g9M S&cw gosinw,A 02111 wwrkalease"av/d�a lecUidanTlumbers workers' Compensation lmsurance Ate' Annlirant Isfolmal� ue��Us;�do :T�`g— Andiess: et City/state/zip; Zf ��Z-- F2.0 aa�a' appropriatebas �> ( r�k wa i a.❑IamaEi "cs�c ❑r`tarv000e�aon � >ssua oa�armed�a�m� �= � lM.,a & pne�i�nahip,odbzvem ❑WMIft fox mate ter- aedhavewaalxa' 9. as �: 30�F10CUM9tepam ar addtioasNa saOdtets'cook i s_0 we sna a cotpo�mnd is eri have asncirad ar addiUM �] tL� 1L�1?Lm>t>loB�P® 3_� I,M&kmwowacedoh%aUw0de ri8Kof arMCtt. goof mpolt 0!40 worbM'eaaaw_ 15-4§1(4 �pc Larsm lZ0 Rpm val�am ]t Wo 33Odstr m®p.ie�xcqWrcQ .N,� LaetoRz�ayn�Le®�>b.,.eua�aowme 'mw mWS&.eam0 him M,6emaeeooe� {u�saot�edc�Lm[m7rt�mldiemltLaotebar�C��fiwa4� - :-; . a'oleten.ffOmmDeunamos>uree9legaooZt � . Ieasaa r,rogd0� �a�a.nr„samacelbrmyaV►OM B�trmep�,dlota w . hammnoeCmvpanYNM= pe , use Ur. .�1 � UJ3 ��9�9 �y9�a9 rob site A uch a copy of the worimn'pomp Pe1K1 dedaratica page(dXMIng&a pAcy mmfbe&W aapuatian Failsemsen¢a cawaa9e as tayoiadumder Section 25A of 192 rae3am3 m go 3WoaiHm ofctio>�P�g Of swupm$13 .00 00 =&InVa Ycw dl aswm�PeashiesmetifaemafaSropWOMORDEE aSae ofapw3250Madapagate[tovWWw Beadvisodtbw acopgofftHgrztaatitmaybefarum edtoft Oft,of tweztgga oa g1d,D fo'' ec rerifir^ - I do I 63 a+ Y undarihepads aad penalties ofPaju "fike hu pro �frne®d r�n1Y ,se ear wade it air; armaw a�idaf My or Town; reem�+'I'eaoa°d Issalag Atdhorlw(cuele me): I.Somd ofBmMh Z.Bw7d+'uSDq�rttitant 3.Gkjlrotm ClerS d-Slechteal inspedo'• 5.Ylamb�gl . 6 Other l'oatael Yerms Pkcw . 0l,d £9l4 £SZ 8L6 se6peH Ioae0 d8b:80 0l 90 p0 Certificate of Flame Resistance REGISTERED ISSUED BY FABRIC JOHNS IS OUTDOORS INC. Date of Manufacture NUMBER BINGHAMTON, NEW YORK 13902 MAY 2006 F-140.01 Manufacturers of the Finest Tent Products Described Herein This is to certify that the products herein have been manufactured from material inherently flame retardant as here after specified by the material supplier. NAME: THE EVENT CO CITY: GLOUCESTER, MA Certification is hereby made that: The articles described on this certificate have been manufactured with an approved flame retardant chemical in compliance with California State Fire Marshal Code, NFPA-701', Underwriters Laboratory of Canada, and have been tested in accordance with the Federal Test Method Specifications and meet or exceed the Military Flame Specifications of MIL-C-43006G. Type, color and weight of material 14 OZ Description of item certifies 40 X40 2PC WBO GENESIS ame Ketardant Process Used Willo e Kemoved By Washing And Is Effective For The Life Of The Fabric Snyder Manufacturing, Inc. Manufacturer of Flame Retardant Vinvl Laminates TENT DEPARTMENT,JOHNSON OUTDO QRS7FC' \ 'Large Scale Certificate of Flame Resistance REGISTERED FABRIC ISSUED BY Date of Manufacture NUMBER JOHNSON OUTDOORS INC. BINGHAMTON, NEW YORK 13902 MAY 2006 F-140.01 Manufacturers of the Finest Tent Products Described Herein This is to certify that the products herein have been manufactured from material inherently flame retardant as here after specified by the material supplier. NAME: THE EVENT CO CITY: GLOUCESTER, MA Certification is hereby made that: The articles described on this certificate have been manufactured with an approved flame retardant chemical in compliance with California State Fire Marshal Code, NFPA-701', Underwriters Laboratory of Canada, and have been tested in accordance with the Federal Test Method Specifications and meet or exceed the Military Flame Specifications of MIL-C-43006G. Type,color and weight of material 14 OZ Description of item certifies 20 MID 40 WBO GENESIS artte Ketardant Process Used Willo e KeMoved By Washing And Is Effective For The Life Of The Fabric Snyder Manufacturing, Inc. Manufacturer of Flame Retardant Vinvl Laminates TENT DEPARTMENT,JOHNSON OUTDO t�STRC" \ 'Large Scale Sep 13 10 05:42p Carol Hedges 978-283-4163 p.7 Certificate of Flame Resistance REGISTERED FABRIC ISSUED BY Date of Manufacture NUMBER JOHNSON OUTDOORS INC. i BINGHAMTON,NEW YORK 13902 F-140.01 Manufacturers at 2008urers ofthe Finest i Tent Products Described Herein This is to certify that the products herein have been manufactured from material inherently flame retardant as here after specified by the material supplier. Made in the USA. NAME: THE EVENT CO CITY: GLOUSTER, MA - I Certification Is hereby made that: The articles described on this certificate have been manufactured with an approved flame fa ant rhenricaI in compliance with Califomia State Fire Marshal Code: NFPA-701•,A-A-55308,FMVSS-302,CANIULCSf09 Mare CPAI-B4, Underwriters Laboratory of Canada, and have been tested in accordance with the Federal Test Metncd Specifications and meet or exceed the Military Flame Specifications of MIL-C-43006G. Type, color, &weight of material: 14 OZ Vinyl: WHITE BLOCK OUT Description of item certified' EFS 20' MID 20' Flame Retardant Process Will Not Be Removed By Washing. Eurelal rent tops that are designed to meet Temporary Building codes are supported with a Registered Architect Stamp. For that stamp to remain valid,the tent top must be installed with 100%Eureka!Manufactured fabric components. Snyder Manufacturing,Inc. rnamBarLnermFlame RetarCant VinvF Laminates TENT DEPARTMENT,JOHNSON OU ORS gJ •Large Scare r Sep 13 10 05:42p Carol Hedges 978-2834163 p.8 Certificate of Flame Resistance REGISTERED ISSUED BY FABRIC JOHNSON OUTDOORS INC. Date of Manufacture NUMBER BINGHAMTON,NEW YORK 13902 ' F-140.01 Manufacturers of the Finest APR[L2008 'r Tent Products Described Herein This is to certify that the products herein have been manufactured from material inherently flame retardant as here after specified by the material supplier. Made in the USA. NAME: THE EVENT CO CITY: GLOUSTER, MA Certification is hereby made that: The articles described on this certificate have been manufactured with an approved flame retardant chemical in compliance with California State Fire Marshal Code,NFPA-701',A-A-553DS,FM VSS-302 CANll1LCS10l CPAWA,Underwriters Laboratory of Canada, and have been tested in accordance with the Federal Test Method Specifications and meet or exceed the Military Flame Specifications of MIL-C-43006G. Type, color, &weight of material: 14 OZ Vinyl: WHITE BLOCK OUT Description of item certified: EFS 20X20 2PC Flame Retardant Process Will Not Be Removed By Washing. Eureka!Tent tops that are designed to meet Temporary Building codes are supported with a Registered Architect Stamp. For that stamp to remain valid,the tent top must be installed with 100%Eureka! Manufactured fabric components. Snyder Manufacturing,Inc. Manuractureref Flame Retardant%rind Laminates TENT DEPARTMENT,JOHNSON OUT ORS IN . 'Large Style