8 WINTER ST - BUILDING INSPECTION (3) low-
'PL*NS1WVST13Ef#L-E ID APPROVED By 774E
ASPW DR PRIDR TD A PERMIT BEWG GRANTED
CITY OF SALEM
N\�
Date -a —0
Y7 �. arc Ward
Zoning DIStAct
IS Properly Located in Location of W ` S1
the Historic District? Yes No_ tff6 , 1_ �J
Is Property Located In _T�` S
the Conservation Area? Yes No
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Dock, Sf�ad, Pool,
Repair/Replace, Other: lf�kken QO ntv 2
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '
The undersigned hereby applies for a permit to build accor&ng.to the following
specifications:
Owner's Name /Y) 1I'�Q, 1,4W[ICAcP✓
Address & Phone c�� r,n� (176) 70—�N'l Q
Architect's Name w —
Address & Phone f
Mechanics Name mcft6j l 'don
Address & Phone ici tt FSK st f a ( - �ta3-R►a3
What Is the purpose of building? HoM Q /
Materiel of buAdlrg? L^bA B a dwelling,for how many lemmas?
Will building conform to law? Asbestos?
Estimated cold 0 Do state License N _L$ Q-A i 4q
Home Lepraveammat
Signature of Applicant
SIGNED UNDER THE PENALTY`
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
NCl-J D(r�,vlL 4 P lea <�� Df�z uxi 11 "d
--
C''�b��.P;FS
MAIL PERMIT TO: l `BOA
1.
NO.
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
S LD 19
AP AbVFD
� �BUILDING
OF S
o
�JJdp.daadal a1.7ndaidfriaf Md"-
600 Wain;.#.Saint
Janw 1 Caxwel 8-glo., M.dasdlt.aA 0211/
Caaaasaaen
Workers' Comperwt m Imurance Affidavit
a• in AyJ d A eS�o�
.. with.a prbatipal passe of boshaes ac
k(ooceSk ?►�4
do hereby'ceri* under the pains and peniides of pw*y, than
() Iaan employer providing workers, compensation covera fe for my ceaplerea workbg M
IDL
Insurance Company Poliq Number
1 am a sole no one w an any eapacky.
I am a sole proprietor. general coeaacsor or homeowner (circle one) sad how his ehs
contractors listed below who•have thi following workers' compensation poiladeta
Contractor Insuran" Company/Pol{q Numbw
Contractor Insurance Company/Po Number
Contractor Insurance Company/Polley Number
() I am a homeowner performing all the work myseB.
•I rnpyand Ina!a""of"A"Vem WE be ferwarged b ow OB[e if M.edaaeao of dw WA ley co drato ew4r8e54 aM ton lira r tune
a9101811 Al tern once Secdon 2fA of r1GL 152 can was r we iroaieisn of- - - osaade consoont N a he of de 04I.st O delve►em
teaea•:aoroonrrnt a vs a"ommw in the 1.nn of a STOP WORK ORDER arse a f r of f Joe=a an Miew ML r1
Signed this • day of
.iccnseti'Fcrmiued ouildfn Department
jctnsinf Eosre
Seleamens Office
^eslth Geparmer:
ece epc ece ��c
PU®UC„PROPERT DEPARTMENT
120 WAfM1NOTON STREET, 9RD FLOOR '
,� SALEM,MA 01970
//J TEL (976)74"593 EXT.360�
( FAX (976) 740-9646
STANU:Y J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the Provisions of MOL c 40,S34,I acknowledge that as s conM=
of Building Permit 0 all debris resulting from the construction activity
governed by this Building Permit sball be disposed of in a properly licensed sokid-waste
disposal facility,as defined by MOL c III,SS1n50A.
The debris will be disposed of at: OiT Si �d vt(J SfQ�
Location of Facility
6-2 —o�F
Signature Of Permit licaot Date
FULLY complete the following in�
(PLEASE PRINT CLEARLY)
/Vl,a eW ti cd n
Name ofPer'/mrt Applicant
vlv\Key ('GFf� �Cy/
Firm Iflune,if any
�a0ee51�
Ass,city&state
The above statute requires that debris from the demolition,renovation,rrhab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by M(Z CM S 150A, and the building permits or kieensea are to
indicate the location of the facility,
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
5A- L�7✓1 , Mass. Date z Q y
City, Town / �� permit #
a Building ry W J owner 's / o
AT: Location D Name M( _I,(=4uyel)cC
Type of occupancy: M ) Feiml
New ❑ Renovation IvJ Replacement ❑ vim'
Plans
FIXTURES Submitted. Yes No ❑
z
Z N Q
Z Y '
W W W O Z z ¢
W w
W Y J W Y U Q W 7 a ¢
W _Z W Q ¢ Q ~ Z O _Z W a
¢ = W Z Z
O W W W W S R I- O W W Y m m W G a a 3 X
O Z ¢ m W W !� Q F U) z G Q N O ¢ a ¢ O W
¢ W t- F, W Q U) C � Q J W ¢ ¢ J Z G-C se ¢ O —1 ¢
_ WG Z O
O a Y
S 0 W Q Q O Q J J Q ¢ ¢ W Q O Q F
�• Y J at in p p J 3 = f W W U' O O .4 3 ¢ m O
SUB—BSMT.
BASEMENT
IST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
6TH FLOOR
(Print or Type) Check One: Certificate
Installing Company Name /'—t f�1J�}L) ❑ Corp.
Address l!�112 S AQJ5:�F,�110(c - t( El Partnership
-Xl. /�c=m1,/ 7f1 mh" 0/0, kp`)) 0 Firm/Company
Business Telephone 17 Name of Licensed Plumber or Gasfitter
�Sr�'I r y'�IG.7S�••?
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code,and Chapter 142 of the General Laws.
I have informed the owner or his agent that 1 do not have liability insurance including completed operations coverage.
Signature of Owner/Agent
I have a current liability insurance policy to include completed operations coverage.
By igna[ure of Licensed Plumber
Title
City/Town
�/— _ Type of Plumbing License
Z�a s
❑ Master ® Journeyman
APPROVED (OFFICE USE ONLY) License Number
FORM 1240 A.M.SULKIN CO.
BELOW FOR OFFICE USE ONLY
a FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME h TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE
PLUMBING INSPECTOR
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
Mass. Date �.L —Oy
City, Town / Permit #
Building Owner 's
AT: Location NName 1YLXQ- LcwK)/Enc.e�
Type of Occupancy: Mt��
GNewE] Renovation ® Replacement ❑ (�i
Plans Submitted Yes ❑ No ❑
N
N W
W N
N N U Z ¢ N
q S N G 0 y =
W W 2 O O m f ~
0 0: PW F f 2 N
z
J
Q ea 41 N Q C O O C Z
W W
W F. y 6 R W Q
N 2 W Z U W Y 0 W Q G F0+ C > W
O F Z J F Z F• W W O O > U. F W J N 2
Q W > W n Z Q at NqQ a O O W O W F-
2 = O U' Y W 7 3 0 C'J J 0 R > 0 6 1— O
SUB—BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RDFLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
STH FLOOR
(Print or Type) Check One: Certificate
Installing Company Name 14(h osan e ❑ Corp.
Address 11 S 1 `��e��1U�� d�It�C ❑ Partnership
So A(a,,ry194f � tl i )e C/ C/"V°1 ® Firm/Company
Business Telephone q u � r2��, '� Name of Licensed Plumber or Gasfitter
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent
provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that 1 do not have liability insurance including completed operations coverage.
Si,.t...f Owneq Agent y
0 OR
I have a current liability insurance policy to include completed operations coverage. ey
By TYPE LICENSE:
❑ Plumber Signature of Licensed
Title Plumber or Gasfitter
City/Town ❑ Gasfitter _
❑ Master ^�
APPROVED (OFFICE USE ONLY) Journeyman License Number
(�
FORM 1243 AM.SULKIN CO. 1989
BELOW FOR OFFICE USE ONLY
~ FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
e
NAME d TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER OR GASFITTER
LIC. NO.
PERMIT GRANTED
DATE
GASINSPECTOR
i