Loading...
113 WEATHERLY DR - BUILDING INSPECTION I ldtSTeE fiL-E - APPROVED 13Y T44E ,WS,PIx1DR ,P=B Tp:A.PERMIT.B,JWG GRANTED CITY OF SALEM 2 u�: ✓No. �O 2.(7d`{ , -t. ..�_ ��\ Date Z Is Property Located in Location of G/�/� Tu the Historic District? Yes_No A Building ��3 n,1 y9 'L/ ��• 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, epair/Replac Other: 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 o,� 67C>uc L40/YJh91Ji(//T/ 5 V11WJA1 �Q�� ' Address & Phone / C /9eDL.,,�NAI-LK 11/�i 744- "&70 Architect's Name At Z Oo /�,ecfllrC- 7ZJOL�,eo��? AfC . Address & Phone .99A10A/7i/44C !/Lx (78h 979-4444P Sroro�are Mechanics Name �E Z/�DE CoN)0111 W Address & Phone 140 Bf�r �I- 4 What is the purpose of building? -- avlst Material of building? If a dwelling, for how many families? 46 Will building conform to law? Asbestos? N® Estimated-cost s01000 City License# N A State License # ©505Y / DSO S 00 Home Improvement Lic. # I/�, LK j3l23h Signature of Applicant -- �Co (�3��jf� SIGNED UNDER THE PENALTY OF DESCRIPTION OF WORK TO BE DONE ? /PERJURYj 3� I A.►rof�� i pPC✓iINC Z MAIL PERMIT T0: .ao /�li9�- 4657Z�7V, NI-1 031408-443a �l t r No. 2- -ZcdO 1 APPLICATION FOR {� PERMIT TO fC .e� C�is74° LOCATION. PERMIT GRANTED INSPECTOR OF BUILDI GS Ron Sandmann —Project Manager 603-623-8811,ext247• Fox 603-623-7250 Finad:rsandmann@proconconstruction.com PAVUW .e�1qry� CGOSTRUC7100 www.proconconstruction.com PRO CON INCORPORATED P.O.Box 4430•Manchester,NH 03108 Pro Con construction is a building contracting company providing responsible construction services in a competitive, timely,profitable manner,resulting in pride `and. satisfaction for its clients and employees. I I - 1 OF $ALEM. PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR SALEM,MA 01970 TEL. (978)745-9595 EXT.380 p Gpy� FAX (976) 740-9846 5TANLEY J. USOVICZ, JR. MAYOR DISPOSAL OF DEBRIS AFFIDAVIT In accordance with the provisions of MGL c 40,SA I aclmowledge that as a condition of Building Permit# all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid-waste. disposal facility,as defined by MGL c IIl,S150A. C /� The debris will be disposed of at: f Location of Facility Signature of Permit Applicant Date FULLY complete the following information: (PLEASE PRINT CLEARLY) - Name of Permit Applicant Firm Name,if any Address, City &State The above statute requires that debris from the demolition,renovation,rehab or other alteration of building or structure be disposed in a properly-licensed solid-waste disposal facility as defined by MGL cIIl S 150A, and the building permits or licenses are to indicate the location of the facility. PRO CON, INC. City of Salem, MA L';-DATE WiNfIJINVOICEN0'd OB i i-INAVWJOB,DESCRIPTION„�t�P DESCRIPT10N 5m�i m . ;IFi;INVOICE AMOUNT' ' 9-04-03 PERMIT 20-3419 Vinnin-Sprinkl 505.00 DATE 7—ll'k-G3 NUMBER 13723'7 TOTAL> 505 . 00 PLEASE DETACH AND RETAIN FOR YOUR RECORDS -ft I OfIll TleEfil.{9 AIO;APPROVEO BY T44E IAI otm Piwa TP:A PEH0i1UT 1fmr. GRANTED CITY OF SALEM No. Date s:f Is Property Located In Location of �1 (r the Historic District? Yes_No Building 1�3 �jl/ j �Q. Is Property Located in the Conservation Area? Yes_No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof eroof Install Siding, Construct Deck, Shed, Pool, (IlepaidR plac Other: 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: Owners Name /7. TO,A—re L/O/ylN1A61-T/E cSQ;5 6) VIA11AMAI #46- Address & Phone C. //'c5'I&,L V)W (24 744-&760 Architect's Name .Z TEG L VP, RUC . c*7/i9M �r o-3 aS. 44l Address & Phone Q,Q/16AtTT I 44.E Mechanics Name E z; 9%7E Co �1�, �jo5'7b Address & Phone /40 5!I0�1 What is the purpose of building? ✓ Material of building? If a dwelling,for how many families? Will building confgnn to law? �� Asbestos?_ N© nC Estimated cost :501000 city license k N o' State License a ©5'�✓�� Rome Improvement AIKO Lic. 1 1 Signature of Applicant SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF.WORK TO BE DONE �pP,t,/�illC� MAIL PERMIT TO: �.� �C�N Co/U�iTRl�T/Dr(r �� NI-1 03108.4436 �� �:Jepailmanl o,/I..7n�lriaf./+cc+a.u+G nn 600 ,,y W��u�fan m �t...t Jaes J.Camooell f�oalon, ///uaa:(uwllt 0:21 It Coa:mrssorw Workers' Compensation Insurance Affidavit with•a principal place of business at: do hereby certify under the pains and penalties of pesitny, that: (ZI am an employer providing workers' compensation coverage for my employees working on this job. >�RJQ� Tio,4v/ � ��a �75aaz 3 Insurance Company Policy Number I am a sole proprietor and have no one working for me in any opacity. O I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Polity Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number O I am a homeowner performing all the work myself. I undergo"mat a cony of this suc m l. 11 be ion aroco to the Office of Inrettitaaom of the DIA la coecratc•erlIcadon am trot failure w severe co. att v raourea unoer Section I$A of MGL I S 2 on lead w the irwosttion of crir i l oe"O t tor:fadnt of a (M of 00 o04 1.500.00 arbor one can irnaruonmtnt v.v_o as cir3 oenaldu in the loan of a STOP WORK OR no a 6"of S I oo.00 a am starlit mm.�y� Signed his , day of Liccnsee/Fermlttee Building Depa ent Licensing Board Seiecccmens Office Health Department 0 VERIFY COVERAGE INFOR'�,ATION CALL: 6 i 7.7`17 4900 X4C 404, 405, 409, 275 au i CONSTRUCT � U : B�°'der �4ONSUPERV4 pR 'u�eTe per, ttll RONALD A <00 Tr.no: 7 L AE MANC �.' R6 ESTEqV NH c /_ r02 , Aurreo�fw