30 COLUMBUS AVENUE - BUILDING JACKET jug , Ot,
The Commonwealth of Massachusetts CITY Board of Building Regulations and Standards
Massachusetts State Building Code,780 CMR, 7`' edition OF SALEM
Revised January
Building Permit Application To Construct,Repair,Renovate Or Demolish a I,2008
One-or Two-Fam' Dwelling
This Secti For Official Use Only
Building Permit Numb a !,r lied: 1
Signature: '"`'a"'o �'�/o'�/�
Building Commissioner/ItEpector of Bud ' Daze
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
50 COL(AMBuS l4vE. 4q- 1.5720
L l a Is this an accepted street?yes '>t no Map Number Parcel Number -
13 Zoning Informatio : 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq i) Frontage(11)
1.5 Building Setbacks(ft) J
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
6-" 76 , /a ` ITS 1/0, 30' 775'r
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Private❑ Zone: y�, Outside Flood Zone?Check if yes❑ Municipal ZJ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
O ' t if AN-me AU45,
Name dnt) ® Address for Service:
K Signature [ / Telephone
SECTION 3:DESCRIPTION OF PROPOSES WORK2(check all that apply)
New Construction 1Z' Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition I$' Accessory Bldg.❑ Number of Units Other ❑ Specify:
Brief Description of ProposedWork2: DbMOr.trHq fi�e. Siro6i6FAmarO✓.+rLc-irul $
-��.47r•vv ConSS't`Lu�t M1re..5 ror��/Ytc o-u al icJcw S'e arcr-c'. r-/�.w��
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ saw,ad 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 1 L,a�-e ❑ Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ ZSw 2. Other Fees: $
4.Mechanical (HVAC) $ /5�,,, List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
6.Total Project Cost: $ �6t ocb. Check No. Check Amount: Cash Amount:
i ❑Paid in Full ❑Outstanding Balance Due:
-2 ��
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
4'L4`Y3 � zarl
'Falk k G_ License Number Expiration Date
Name of CSL-Holder List CSL Type(see below) �(
61 Z /'F Q'Y!/ktN S 1. ��Xfpsm�r,-w a77-1
Addres T e Description
G, C Unrestricted(up to 35,000 Cu.Ft.
R Restricted 1&2 Family Dwelling
Signature M MasonryOnly
�Z Y�•-3 Si. RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D I Residential Demolition
5.2 Registered Home Improvement Contractor(HIC)
11 A,C"t flCt,rpt/tp Cbi ;!Zt C.0=r 7 6 7lF/
HIC Company Name or HIC Registrant Name Registration Number
r/yR MRriS Sf /duxFoYo .kut cst4z/ Sfty�za/2
Addm
;
75T 3J -7(�y! Eacpva n Date
Signature Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 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 ..........6-' No...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, Roark T -j- Scr✓ as Owner of the subject property hereby
authorize �At to act on my behalf,in all matters
relative wo audio ' d by this building permit application.
� /d ll8�io
Si ature of Owne Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
I, FKAA& Apw04td as Owner orAuhorAn ereby declare
that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and
behalf.
rem-i(c l4at�rwzetD
Print Name !c // n /e /6S(!O
Signature of Owner or uthorized Agent` Lea.-`••c.•••� Date 6
Si ed under the pains an m— es of petjury)
NOTES:
1. 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 fiord under M.G.L.c. 142A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 1 IO.R6 and I IO.R5,respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq.Ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(Sq.Ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
r`
TINTI, QUINN, GROVER & FREY, P.C.
27 CONGRESS STREET, SUITE 414 _
SALEM, MASSACHUSETTS 01970
WILLIAM J.TINTI WILLIAM B.ARDIFF(1965- 1995)
tinti@tintilaw.com TELEPHONE
WILLIAM F. QUINN (978)745.8065 • (978)744-2948 MARCIA MULFORD CINI
OF COUNSEL
WilliamFQuinn@aol.com
TELECOPIER JOHN D. KEENAN
SCOTT M.GROVER
smgrover@tintilaw.com w.Gin it w of COUNSEL xom
MARC P. FREY
mpfrey@tintilaw.com
JONATHAN M.OFILOS
jofilos@tintilaw.com
10/10/10
Henry A. Lucas, Jr., Esq
133 Washington Street
Salem, MA 01970
RE: Jackson Construction at 30 Columbus Ave., Salem, MA
Dear Henry:
As represented in the attached letter from Stephen Saltzman, M.D., my client Jean Paul
Dionne of 26 Columbus Avenue, Salem, the next door neighbor to the Jacksons, suffers from
severe COPD. Because of Mr. Dionne's breathing problems, we hereby request that the
Jacksons agree to adhere to the following conditions if we cease our opposition to their building
permit and proposed construction:
1. For any asbestos removal, use only a licensed asbestos removal contractor
2. Notify the Dionnes at least 48 hours in advance of any demolition work beginning
3. Jackson's contractors to confer with Building Inspector as to means to control dust
arising from demolition, construction work or street sweeping associated with the
project, and
4. For any exterminations or pesticide applications, use only contractors licensed to
perform such work.
Please review this with the Jacksons and let me know whether they are willing to
cooperate in these regards.
Very truly yours,
William F. Quinn
Harvard Vanguard Lynnfield Medical Associates
Medical Associates 2 Essex Center Drive
Peabody,MA 01960
Atrius Health 978-532-2800 tel
w .harvardvanguard.org
August 11, 2010
Re: Jean Paul Dionne
26 Columbus Ave
Salem, MA 01970
To Whom It May Concern:
Mr. Dionne is currently a patient under my care for severe COPD. For this reason it is necessary
that dust be contained when tearing down the house next to him.
Should you need additional information, please feel free to contact my office.
Sincerel
Step en J. Saltzman, M.D.
SJS/tab
An affiliate of Harvard Medical School
�r
TINTI, QUINN, GROVER & FREY, P.C.
27 CONGRESS STREET, SUITE 414
SALEM, MASSACHUSETTS 01970
WILLIAM J.TINTI WILLIAM B.ARDIFF(1965• 1995)
tinti@tintilaw.com TELEPHONE
WILLIAM F.QUINN (978)745�8065 • (978)744-2948 MARCIA MULFORD CINI
OF COUNSEL
WilliamFQuinn@aol.com
SCOTT M.GROVER TELECOPIER JOH F D. KEENAN
COUNSEL
smgrover@tintilaw.com w.dn4i wxo9m OF COUNSEL
MARC P. FREY
mpfrey@tintilaw.com
JONATHAN M.OFILOS
jofilos@tintilaw.com
10/10/10
Henry A. Lucas, Jr., Esq
133 Washington Street
Salem, MA 01970
RE: Jackson Construction at 30 Columbus Ave., Salem, MA
Dear Henry:
As represented in the attached letter from Stephen Saltzman, M.D., my client Jean Paul
Dionne of 26 Columbus Avenue, Salem, the next door neighbor to the Jacksons, suffers from
severe COPD. Because of Mr. Dionne's breathing problems, we hereby request that the
Jacksons agree to adhere to the following conditions if we cease our opposition to their building
permit and proposed construction:
1. For any asbestos removal, use only a licensed asbestos removal contractor
2. Notify the Dionnes at least 48 hours in advance of any demolition work beginning
3. Jackson's contractors to confer with Building Inspector as to means to control dust
arising from demolition, construction work or street sweeping associated with the
project, and
4. For any exterminations or pesticide applications, use only contractors licensed to
perform such work.
Please review this with the Jacksons and let me know whether they are willing to
cooperate in these regards.
Very truly yours,
William F. Quinn
TINTI, QUINN, GROVER & FREY, P.C.
27 CONGRESS STREET, SUITE 414
SALEM,MASSACHUSETTS 01970
WILLIAM J.TINTI WILLIAM B.ARDIFF(1965- 1995)
tinti@tintilaw.com TELEPHONE
WILLIAM F.QUINN (978)745.8065 • (978)744.2948 MARCIA MULFORD CINI
WilliamFQuinn@aol.com OF COUNSEL
SCOTT M.GROVER TELECOPIER JOHN D. KEENAN
smgrover@tintilaw.com (978) tila,.co of COUNSEL
www.tintilaw.com
MARC P. FREY
mpfrey@tintilaw.com
JONATHAN M.OFILOS
jofilos@tintilaw.com
10/10/10
Henry A. Lucas, Jr., Esq
133 Washington Street
Salem, MA 01970
RE: Jackson Construction at 30 Columbus Ave., Salem, MA
Dear Henry:
As represented in the attached letter from Stephen Saltzman, M.D., my client Jean Paul
Dionne of 26 Columbus Avenue, Salem, the next door neighbor to the Jacksons, suffers from
severe COPD. Because of Mr. Dionne's breathing problems, we hereby request that the
Jacksons agree to adhere to the following conditions if we cease our opposition to their building
permit and proposed construction:
1. For any asbestos removal, use only a licensed asbestos removal contractor
2. Notify the Dionnes at least 48 hours in advance of any demolition work beginning
3. Jackson's contractors to confer with Building Inspector as to means to control dust
arising from demolition, construction work or street sweeping associated with the
project, and
4. For any exterminations or pesticide applications, use only contractors licensed to
perform such work.
Please review this with the Jacksons and let me know whether they are willing to
cooperate in these regards.
Very truly yours,
William F. Quinn
t .t
CITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
ce
R
SALEM. MASSACHUSETTS 01970
TELEPHONE: 978-745-9595 EXT. 380
FAX: 978-740-9846
Cc)L,WAA ck$ AcfCE_
Thomas J. St.Pierre
Director of Public Property
Zoning Enforcement Officer
Section 116.0
Demolition of Structures
Structures over fifty.(50) tears old must have approval of the
Salem Historical Society
UTILITY DISCONNECTIONS REOUIRED
Authorized Agent Date of Disconnection
Water:
(see attached requirements) 1 �{
Electrical:
Fire: cr
Sewer: W
Salem Historical Commission:
Dig Safe Number: 2oto4goe2- e. Z_
ZLAZ' 7, "W
Pest Control: (-)Ri -16
***DOCUNIIENTATION OF ALL THE ABOVE MUST BE ATTACHED BEFORE PERMIT CAN
BE ISSUED***
Fee for Demolition: $5.00 for application plus$2.00 per 100 square ft. gross area,minimum$15.00
k•
CiTy or. S.U.EM AkSSACHUSETTS
e Bt.ILDLNG DEP'<R MF—NT
<8 o 120 WASHr4GTON STREET, r FL oo
' E1- (97®) 745-9595
Fla(978) 74G-9845
KIiESERL L I3tiISCOT-L
MAY011 ZTiOR9hS�'e.
DIRECTOR OF PUBLIC PROPER-rV/I9I:II.AING COS.LtIISSIONER
Dern olition Permit Sigli-off
(Supplement to permit application)
4ck--e � hereby supply the following rcicases as part of the
application fora permit to demolish the structure located at SO CoL Lc.-,c PUS AJ
and shown on the Assessor's Maps
of .__ as being on Map # . Block # — . 1.ot # .
f�(,�
The sixth cd i.tion of the Massachusetts State Building Code, 780 CMR, states in part: " A
permit to demolish or remove a building or structure shall not he issued until a release is
obtained troth the utilities, stating that their respective seroice connections and appurtenant
equipment, sudr as ffleh!rS arrd regulators, have been removed or settled ar111 plugged in a safe
mariner.,,
j Utilit v to be Notified Notice Received.by Date Received
i Gas
"1 ele hone.
Clectric
Public Utilities (Municipal)
I Iealth Department
Fire Department I j
Other - PIA n n N
Othor _ D bIL.
Duinoiition debris hauler:
1 .ovation of licensed
demolition debris Inndtill-
Si rnaturc of Applicant Date: leli7 f18
Signature or Owner Date
This sheet must be returned to th nspections Department along with a completed
application for a permit, a site plan, and any other applicable information and fees.
�),muiprrm.iiu:
From:National Grid 17815221067 1U2812010 11 :40 #701 P.001!001
i 4 4
natiOnalgrid
40 Sylvan Rd
Waltham MA 02451
October 28. 20 10
Frank Howard
30 Columbus St.
Salem, MA
RE: Service Removal for Building Demolition.
Dear Mr. Howard,
This letter is to confirm that, per your request, National Grid has confirmed
electrical service and meters have been removed from 30 Columbus Ave.
Salem. MA on 1027 10.
If you have any questions or need further assistance, please feel free to
contact me at {50.8) 357-4565
Sincerer,
lose E. Correa
Customer Order Fulfillment
nationalgrid
Nov 0l 10 08: 38a National =rid 1401.46'70473 p. 1
nationalgri
November 1, 2010
Frank Howard Construction LLC
& 30 golumbus Av® Salem. Ma
This letter is to notify you that the gas service located at 30 Columbus Avenue, Salem, Ma was cut off at
the gate box in the sidewalk on 10129MO.
If you have any questions, please feel free to contact ine @ 781,-907-2930
Sincerely,
Diane L. Stever;�n
Customer Driven Construction
diane.stevenin@2s.ngrid.corn
79?-907-2933
781-522-?05Efax
40 Sylvan Road E-2
VValthwn. h1a 02451
I
Ir
,i
CITY OF SALEM, MASSACHUSETTS
3 BOARD OF APPEAL
h
2.?t
120WASEEN;TONSTREET♦ SALEM,MASSACnl7$ETTS01970
-.
'FELE:978-619-5685 s FAx:978-740-0404
KLW3ERLEY DRTSCOLL
MAYOR
City of Salem
Zoning Board of Appeals
978-619-5685
Will hold a public hearing for all persons interested in the W 'tion of ROBERT JACKSON
requesting a Special permit to demolish construct a nonconfoimmg le family
residential structure, pursuant to sec n 3.3.3 of the Salem Zoning Ordinance, the single
family home on the property loca d at 36 C LUMBUS AVENUE [R-1].
Said hearing will be held on WEDNESDAY August 18, 201 at p.m. 3`d floor conference
room 120 WASHINGTON STREET, ROOM 313.
Robin Stein
Chair
August 4, 2010 and August 11, 2010
Remit bill to:
Robert Jackson
13 Highland Rd.
Boxford, MA 01921
508-843-3211
V-
ZONING BOARD OF APPEALS
S,\I PETMON F69
4 -f:M, MASSMA IUSEM
XONING BOARD ()I-',\PPF.',\Is
T
120 A AM IIN(;T()N .STRI;I:1".3811 1;1.()()R -i c
M\SSACM SI:1'1*.S()197()
Z 0 --"
> -J,,t, 1) 1
1111c Ic McKim,li
z Thomas St. Pierre, HL111ding In,pect'
t. 978-619-568i/f. 9'8-'411-11;tµ t 978 619-3641/f 1)78--
0 -W-9846
a,
j LL
LU D rO THE BOARD OF APPEALS: >
Ul 0:E The Undersigned represent that he/she is/are the owners ora certain Parcel of land located at:
Address:
3oO U Zoning District:
An application Is being submitted to the Board of Appeal for the following resson(s):
descrihe it-hat o on p,,IN).,e it,brild. This statement Must
the dinienvi(nys. the:one properri,is in,and the zoning requirements. Er..nple.
"m proposing to t-Misim,I a 10'.r /0-onestory"'filition to in
Distric-t TIreZoning 011lil,,,-e,-,qi,ire.,Ilyetpyi.ninium lleplh,?Y home located /3 Stilen;Lune, in the R-2 Zoning
rear ffhe,eariardtobeJtOleet. The current ileoth(ffinv
i,,ir(ii.v32.1�et,.Ilyepropo.yet(,,IditioIylt'()Iilelrechiellie,leptIl(?I.11e'rear.i-itrilto22.feet.
Pq
LQ6�j
L
In
For this reason I am requesting:
( ) Variance(s) from provisions ofSecuo of the Zoning Ordinance,specifically from
,:"Pec"41 t C3 3.3
What is allowed is —(i.e. minimum 11ePthqfrtv-yotrd).
0"sq fl?.stories? Y.?), and what I
am proposing is lug (10 sq.10stories?
XA Special Permit under Section
—ofthe Zoning Ordinance in order to
po.v" 41h6� -
( )Appeal of the Decision of the Budding Inspector(described below):
the Current Use of the Property Is. Are the lot dimensions included on the plan?
I e.runytle: Tiro Family//note) )40 I�Mj1 ) YC, ( )Non/abecause ya's
Thr Undersigned hereby Petitions the Board of Appeals to vary the terms of the Salem Zoning Ordinanceand allow
[lie project to be constructed its per the plans submitted,as the ent'orcement of said Zoning Hy-LaWs would involve
practical difficulty or unnecessary hardship to the Undersigned and relief may be granted without substantially
derogating from the intent and purpose of the Zoning Ordinance.
ZONING BOARD OF APPEALS
PETITION FORM
rhe following written statement has been submitted with this application:
t
) For ail Variance requests a written Statement of Hardship demonstrating the following must be attached:
a) Special conditions and circumstances that especially affect the land,building,or structure involved,
generally not affecting other lands,buildings,and structures in the same district;
b) Literal enforcement of the provisions of the Ordinance would involved substantial hardship to the
applicant; and
cl Desirable relief may be granted without substantial detriment to the public good,and without nullifying or
substantially derogating from the intent of the district or the purpose of the ordinance.
( ) For all Special Permit requests a Statement of Grounds must be attached. An application for a special permit for
a nonconforming use or structure shall include a statement demonstrating how the proposed change shall not be
substantially more detrimental than the existing nonconforming use to the neighborhood in accordance with Art. V,
y< 5-3. Such a statement should include reference to the following criteria:
a) Social,economic,or community needs served by the proposal;
b) Traffic flow and safety, including parking and loading;
c) Adequacy of utilities and other public services;
d) Impacts on the natural environment, including drainage;
e) Neighborhood character; and
f) Potential fiscal impact, including impact on City tax base and employment.
Previous applications to the Board of Appeals involving this property have been submitted with this petition
form. The Building Commissioner can provide documentation it/previous applications to the petitioner or his
representative.
nn � If
N differentfrom petitioner:Petitioner. (�iR/ —1 HC&5a fj Property Owner:
Address: �'3{�S� -hwD �� IJJX.��-1 Address:
Teleph ne: Telephone:
Signature Signature(Attached consent letter is also required)
`7 - ly - lu
Date Date
If differentfrom petitioner:
A TRUE Representative:
ATTEST,
Address:
Telephone:
Signature
Dale
DATE SUBMITTED TO
BOARD OF APPEALS:
CITY CLERK
I/ov original application must he filed rcith the City Clerk.
i
Certificate No: 365-11 Building Permit No.: 365-11
Commonwealth of Massachusetts
City of Salem
Building Electrical Mechanical Permits
This is to Certify that the RESIDENCE located at
Dwelling Type
30 COLUMBUS AVENUE in the CITY OF SALEM
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFTCATE OF
OCCUPANCY
I
I
This pernut is granted in conformity with the Statutes and ordinances relating thereto, and
expires unless sooner suspended or revoked.
Expiration Date
lasnvd On: -File Sep 13, 2011
GaiTMSA 201 1 Des Laurimm PAmicipal Solutions,Inc.
1
Certificate No: 365-11 Building Permit No.: 365-11
Commonwealth of Massachusetts
City of Salem
Building Electrical Mechanical Pemuts
This is to Certify that the RESIDENCE located at �
-----------------------------------------------------
Dwelling Type
30 COLUMBUS AVENUE in theCITY OF SALEM
---------------------------------- - -- --------------------------------------
Address Town/City Name
IS HEREBY GRANTED A TEMPORARY CERTIFICATE OF
OCCUPANCY
TEMPORARY OCCUPANCY PERMIT TO EXPIRE (JULY 3, 2011)
This pemnit is granted in conformity with the Statutes and ordinances relating thereto, and
expires Sunday Jul 3, 2011- - unless sooner suspended or revoked.
Expiration Date
------------------------
-
-----------
Issued On:Fri Jun 3,2011 --------------------
- - -
GeoTMS®2011 Des Lauriers Municipal Solutions,Ina -------------
�•CONur��,�
rscre •o
CITY OF SALEM
BUILDING PERMIT
30 COLUMBUS AVENUE 36;-11
Glsa 6ao6 COMMONWEALTH OF MASSACHUSETTS
_ ._ __
Map. 44
Mock: I. .___.__..-- --- _; CITY OF SALEM
;Lot: 10150
Categoly: - ,101.NewSinglefanuly,
permit%r 136511 BUILDING PERMIT
project lr 1JS 2011-000359 j
Est. Cost 1$566;000.00
Fee Charged: �S3,96-7 00
Balance Due: A.00 PERAIIISSION IS HEREBY GRANTED TO:
Const Class_ _ _ -!Contractor: License: Expires
Use Group. __ ,Frank Howard Construction LL,C
LotSvc(sq. Ft_) ,9374.9332
UnnsGa - - RI
--- - ,Owner Robert Jackson
zoning: __
Applicant: Prank Howard Construction LLC
Units Lost: IAT: 30 COLUXIBUS AVENUE
Dig Sale#:
ISSUED ON 25-Oct-2010 AMENDED ON: EXPIRES ON: 25-Mar-2011
TO PERFORM THE FOLLOWING WORK:
DEMOLISH &REMOVE SINGLE FAMILY DWELLING&FOUNDATHON, CONSTRUCT NEW FOUNDATION & IN W
SINGLE FAMILY DWELLING jbh
POST THIS CARD SO IT IS "ISIBLE FROM THE STREET
Electric as Plumbing Building
Underground: .)41 Underground: Underground: Excavation: ',J
�1
Scrwu: e[cr: Footings:
� . 7 ... � �
Rough �i -1^�„ Rough:cll 144Q% Rough( ' w3
Foundation: ✓` " p�+ar�J °fir ��o1Zl . .
Final: maIQP 6� Final: . _ _ I Rough Frame. In Y�
7 /� (4 /
d
������ � .• �� ��� �
�D.PChimvey:.NV. Fire Health 4-�
Insulaunn: S?7r��+� hl`C
"Ouse ft
Final: l M 6
S o � �
71'ensu ry: a
Water: p✓n. Assessor
A Final:
Sewer:
.t
THIS PERMIT MAYBE REVOKED BY THE CITY OF SALEM UPON VIOL. TION OF ANY OF ITS
RULES AND REGULATIONS.
Signature:
Fee Type: Receipt Nn: Date Paid: Check No: Amur.nl:
BUILDING REC-2011-000457 25-Oct-10 15423 :;3,967.00
IMPORTANT:OWNER OR CONTRACTOR MUST dT11 g, �4r14
ARRANGE FOR PERIODIC INSPECTIONS DURING J �w7vt�.,
CONSTRUCTION.SEE CURRENT BUILDING CODE
py
CHAPTER t FOR LIST OF REQUIRED INSPECTIONS.
CALL 978-619-5641 TO SCHEDULE AN INSPECTION
Cco"rMSOO 2010 Des Lanriers Municipal Solutions,Inc.