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61 CONGRESS STREET - BUILDING JACKET Vill 6 r CONGRESS STREET ' t TO: Grant Barnum FROM: Marcia Kirkpatrick Clerk, Building Dept. DATE April 25, 2017 SUBJECT CERTIFICATE OF OCCUPANCY PERMITS The fees for rendering CO's on properties is$30.00 each. To date we have generated permits for: 1 Ward Street Rear 2 Ward Street Rear 3 Ward Street Rear 61 Congress St/4 Lynch St Unit 1 61 Congress St/4 Lynch St Unit 2 61 Congress St/4 Lynch St Unit 3 105 Congress St Unit 2 105 Congress St Unit 3 105 Congress St Unit 4 For a total of nine permits#$30.00 each= $270.00 due Certificate Number: B-16-473 Permit Number: B-16-473 Commonwealth of Massachusetts City of Salem This is to Certify that the ... ............................. ....... Multifamily 3+ Building located at Building Type 105 CONGRESS STREET................................................................... in the .....................................City,of 5alem............................................... ......................................... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #4 cdc: 105 Congress St/56 Palmer St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ...............................Not Applicable unless sooner suspended or revoked. Expiration Date Issued On: Thursday, December 15, 2016 Certificate Number: B-16-473 Permit Number: B-16-473 Commonwealth of Massachusetts City of Salem This is to Certify that theMultifamily 3+ Building..................................................... located at Building Type 105 CONGRESS STREET................................................................... in the .....................................City_of kT............................................... ......................................... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #3 cdc: 105 Congress St/56 Palmer St This Pennit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ...............................YotAPPAcqNe ................. ... unless sooner suspended or revoked. Expiration Date S Issued On: Thursday, December 15, 2016 Certificate Number: B-16-473 Permit Number: B-16.473 Commonwealth of Massachusetts City of Salem This is to Certify that the Multifamily 3+ Building..................................................... located at Building Type ...................................................................105 CONGRESS STREET......................................... ................................................................... in the .....................................City_of Salem............................................... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #2 cdc: 105 Congress St/56 Palmer St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ...............................Not Applicable .. unless sooner suspended or revoked. Expiration Date Issued On: Thursday, December 15, 2016 Certificate Number: B-16-470 Permit Number: B-16-470 Commonwealth of Massachusetts City of Salem This is to Certify that the Multi,Family 5+ Building located at Building Type .....................................................................61 CONGRESS STREET..................................................................... in the .....................................City_of Salem ......................................... ................................................. Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #1 CDC @ 61 CONGRESS ST& 4 LYNCH ST This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ...............................Not Appllcable............................. unless sooner suspended or revoked. Expiration Date V i Issued On: Thursday, March 09, 2017 Certificate Number: B-16-470 Permit Number: B-16-470 Commonwealth of Massachusetts City of Salem This is to Certify that the Multi Family S+ Building - located at ........................ ........................................................... Building Type .....................................................................61 CONGRESS STREET..................................................................... in the .....................................City,of Salem............................................... ......................................... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #2 CDC @ 61 CONGRESS ST& 4 LYNCH ST This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ...............................Not Applicable.. .......,..._........... unless sooner suspended or revoked. Expiration Date Issued On: Thursday, March 09, 2017 Certificate Number: B-76-470 Permit Number: B-16-470 Commonwealth of Massachusetts City of Salem This is to Certify that the Multi Family. 5+ Building located at ......... .... ..................... ... .............................................................. Building Type 61 CONGRESS STREET in the City of Salem ............................................................................................ .................................................................................................... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #3 CDC @ 61 CONGRESS ST& 4 LYNCH ST This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ...............................Not Applicable ......--........_... unless sooner suspended or revoked. E)Viration Date Issued on: Thursday, March 09, 2017 Certificate Number: B-16-474 Permit Number: B-16-474 Commonwealth of Massachusetts City of Salem This is to Certify that the Multifamily 3+ Building located at ---------------------- Building Type 105_b14g2 CONGRESS STREET in the City of Salem ------------------------- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #2 cdc: 107-109 Congress St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ----------.-Not Appt qNa _--------- unless sooner suspended or revoked. Expiration Date Issued On: Wednesday, November 16, 2016 Certificate Number: B-16-474 Permit Number: B-16-474 Commonwealth of Massachusetts City of Salem This is to Certify that the Multifamily 3+ Building located at Building Type 105-bldg2 CONGRESS STREET____ _ in the --City of Salem Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #3 cdc: 107-109 Congress St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires .--.-..--..-Not Ayplicable ---- unless sooner suspended or revoked. Expiration Date Issued On: Wednesday, November 16, 2016 Certificate Number: B-16-474 Permit Number: B-16-474 Commonwealth of Massachusetts City of Salem This is to Certify that the Multifamily 3+ Building located at Building •- Type 105_bldg2 CONGRESS STREET in the City of Salem ---------• ------------•---- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #4 cdc: 107-109 Congress St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ------------NotApOlicable unless sooner suspended or revoked. Expiration Date Issued On: Wednesday, November 16, 2016 Certificate Number: B-16-474 Permit Number: B-16474 Commonwealth of Massachusetts City of Salem This is to Certify that the Multifamily 3+ Building located at Building Type 105_-bldg2 CONGRESS STREET in the City of Salem ---------------------------------- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #4 cdc: 107-109 Congress St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires -------.----Not Applicable - unless sooner suspended or revoked. Expiration Date Issued On: Wednesday, November 16, 2016 Certificate Number: B-16-474 Permit Number: B-16-474 Commonwealth of Massachusetts City of.Salem This is to Certify that the Multifamily 3+ Building located at ----------------------------------------------------------------------- Building Type 105-b1gg2 CONGRESS STREET in the City of Salem -•-------- ------------------- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #3 cdc: 107-109 Congress St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ----------_-Not Apvlicabl - unless sooner suspended or revoked. Expiration Date Issued On: Wednesday, November 16, 2016 � ,�� Certificate Number: B-16-474 Permit Number: B-76-474 Commonwealth of Massachusetts City of Salem This is to Certify that the Multifamily 3+ Building located at Building Type 105_bldg2 CONGRESS STREET in the Cityof Salem ---------- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY Unit #2 cdc: 107-109 Congress St This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ------------Not 4PV!icgbk unless sooner suspended or revoked. Expiration Date Issued On: Wednesday, November 16, 2016 ; �e :;'� vq _¢ ,t4+.[3 k"y 1eMA�.�''A.x aA� �5+ '`r4w"�' * N, l tw A t x S aS•1::. s DAt .y. v t &a i 't4•k? dG+` '}n f rK,f` zYa.&ayvYk ri -"a. t's4' . aY y h b� T ,�,� ^. Go- ma s .+;i. F d iA 4Y..e! SY "uf •�",- r;Ci a Px „�v ` • il u y�i _ ' , w� ?a sa, ,. #` Y.i _ _ " �eaEe Number:',. 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" e,ir, , - ^f�r Commonwealth of Massachusetts Citv of Salem - 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5841 Return card to Building Division for Certificate of Occupancy Permit : $1 8-17.127 PERMIT TO BUILD EE PAID: $?47.00 - F DATE ISSUED`. 3/6/2017. .. This certifies that CRAIN'JANE R T � has permission to erect, alter,.or demolish a building-x,_,14 TURNEWSTREET,_ Map/Lot: 410019-0 as follows:" Other` Building Permit REPLACE ROOF, EXTERIOR TRIM RaPAIR; MINOR ELEC. &PLUMB. V. REPAIRS; PAINT 3RD FL. Contractor Name: WILLIAM J. PERRY — 4 DBA: PERRY BROTHERS CONSTRUCTION, INC Contractor License No:.CS-022631 3/6/2017 Buildi c '" Date This permit shall be deemed abandoned and invalidunless the work authorized by this permit is commenced within siW months after issuance.The Building Official may grant one or more extensions not to exceed six months each upon written request. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any.buliding and structures shall be in compliance with the local zoning by-laws and codes. s This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for pubtl6inspection for the entire duration of the work until the completion of the same. - The Certificate of Occupancy will notoe issued until all applicable signatures by the Building and Fire OKcialsrare provided on this perk. "Persons contracdn with unregistered contractors do not have access to the guaranty fund" as set forth In MGL c,142A T HIC#: 108282 r, 9 � 9 !dY ( ) Restrictions:, Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. Commonwealth of Massachusetts City of Salem ti t 120 Washington Sl,3rd Floor Salem,MA 01970(978)745.9595 x5641 Return card to Building Division for CerlI icate of Occupancy - Structure CITY OF SALEM BUILDING PERMIT JExcava„on. - - ,:PERMIT TO BE POSTED IN THE WINDOW Footing INSPECTION RECORD Foundation I Framing, Mechanical Insulation INSPECTION: BY DATE CChimney/SmokeC amber :Final 0 / Plumbing/Gas f kRough:Plumbing .. Rough:Gas t Final - Electrical 'Service a Final d Fire Department � r< `Preliminary M a Final ,a Health Department reliminerY .. r Final- c+. ; e: •. - - -> - ” '�, ^ CONO(p,,N �t Commonwealth of Massachusetts lcx Citv of Salem m 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 y Y O Return card to Building Division for Certificate of Occupancy "1Permit No. 8-16-470 l ' BUIL D Ii=FE PAID: $15,317.50 DATE ISSUED: 5/12/2016 This certifies that CONGRESS &WARD LLC l� has permission to erect, alter, or demolish a building 61 CONGRESS STREET/4 L-`1NC-" ST.Map/lot: 340192-0 as follows: Repair/Replace WORK INCLUDES REHABILITATION OF 64 OCCUPIED UNITS IN 8 BLDGS. TO INCLUDE: RECONFIGURATIONS OF SELECT UNITS, STAIR UPGRADES, KITCHEN & BATH RENOSL, INTERIOR FINISHES, NEW DOORS/SIDELIGHTS, EXTERIOR MASONARY REPAIRS; WINDOW & ROOF REPAIR/REPLACEMENTS; MECH., ELEC., & PLUMBING UPGRADES, NEW FIRE ALARM & SPRINKLER SYSTEMS IN SELECT BLDGS. SITE/UTILITY EXTERIOR UPGRADES. Contractor Name: DOUGLAS GRANT BARNUM DBA: NEI GENERAL CONTRACTING Contractor License No: CS-069714 5/12/2016 Buildin6"Official Date This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official may grant one or more extensions not to exceed six months each upon written request. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. HIC#: 'Persons contracting with unregistered contractors do not have access to the guarantyfund'(as set forth in MGL c.142A). Restrictions: City of Salem lug r � 120 Washington St.3rd Floor Salem,MA 01970(978)745-9595 x5841 0 Return card to Building D'c-r!^ion for Certificate of Occupancy Structure CITY OF SALEM BUILDING PERMIT i I' xcavation - PERMIT TO BE POSTED "iN THE WINDOW Doting 1 INSPECTION �R�rE�-CORD oundation .,L yi w 2 ranting !Tti J echanicat ulatiorl INSPECTION: BY DATE himney/Smoke Chamber final ,r Plumbing/Gas g jg11 ough:Plumbing ough:Gas inal Electricals ✓l'� L G�rci,2�E�r / c�<� Cif v,� �r / J �� 1f Service f ��G" G%L--Gr••'i?rte G - .ucr.,� ;'r;./..�,%i.1 -. 2 - ovgh final . .�. ._ �..r,��.� v-�-� � ��'� fk%C•,d�,o•..�.¢� �`r��7� Fire Department minary r< 01 ina) '213NM0 A1213d021d aye;o RNadoid ay;aye spJeD;ltuJ1ad Ilt/ Health Department a;ls uo algeilene eq o;eje sueld Sulpl!ne douedn000 jo ao1 five ,`��tu!Piing c;pea un;es Preliminary ,/„5 ' ��y'�(^t let/�t1�"'PjE 7S#uol6ulyseM OZLn Ftnai ./�U✓^'/cG s;}esnyoessew jo y}ieaMuo wok P�'yran Certificate Number: B-16-470 Permit Number: B-16-470 Commonwealth of Massachusetts City of Salem This is to Certify that the Multi Family 5+ Building located at .................................................................... .... .................................................. Buitding Type 61 CONGRESS STREET..................................................................... in the ..................................._City,of Salem.........,..................................... ................................................................-...... . AddresshY Town/C Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY 61 Congress Street (4 Lynch Street) Unit#1. CDC @ 61 CONGRESS ST& 4 LYNCH ST This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ............................Not Applicable.........._........__,... Mess sooner suspended or revoked. Expiration Date Issued On. Thursday, March 09, 2017 Certificate Number: B-16-470 Permit Number: B-16-470 Commonwealth of Massachusetts City of Salem This is to Certify that the .....................................................Mufti Family S+ Building..................................... ........ located at Budding Type 61 CONGRESS.STREET..........._... ......................_......._............ in the ...................._....._....,..City.of Salem..._.......__............................... ................................._. Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY 61 Congress (4 Lynch Street #2 ) CDC @ 61 CONGRESS ST& 4 LYNCH ST This Permit is granted in conformity with the Statutes and ordinances relating thereto, and expires ............................Not gppiicable.............................. unless sooner suspended or revoked. EVIrabon Date 60� /A Issued on: Thursday, March 09, 2017 Certificate Number: B-16-470 Permit Number: B-16-470 Commonwealth of Massachusetts City of Salem This is to Certify that the ........................................................Multi Family S+ Building located at Building Type 61 CONGRESS STREET ....._................................ in the .....................................ezt!_of Salem _.._......_.................._........_.........._................._.............................._._................................................ ...........................-.........,...... Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY 61 Congress Street (4 Lynch Street) #3 CDC @ 61 CONGRESS ST& 4 LYNCH ST This Permit is granted in conformity with the Statutes and Ordinances relating thereto, and expires ...........................Not 4PPAcable............................ unless sooner suspended or revoked. Expiration Date Issued On: Thursday, March 09, 2017 �--" Commonwealth of Massachusetts City ref Salem • 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5641 Return card to Building Division for Certificate of Occupancy - Permit No. -16-47 PERMIT TO BUILD �rFE PAID: $15,317.50 Y 'DATE ISSUED: §1112/2011 This certifies that CONGRESS &WARD LLC ! - has permission to erect, alter, or demolish a'building- 61.CONGRESS STREET/H t-` NC." SxWapti_ot 340192-0 as follows: Repair/Replace WORK INCLUDES REHABILITATION OF 64 OCCUPIED UNITS IN 8 BLDGS. TO INCLUDE: RECONFIGURATIONS OPSELECT UNITS, STAIR UPGRADES, KITCHEN &BATH RENOSL, INTERIOR FINISHES, NEW DOORS/SIDELIGHTS, EXTERIORMASONARY REPAIRS; WINDOW& ROOF REPARVREPLACEMENTS; MECH., ELEC., & PLUMBING UPGRADES, NEW FIRE ALARM & SPRINKLER SYSTEMS IN SELECT BLDGS:SITE/UTILITY,EXTERIOR UPGRADES. t Contractor Name: DOUGLAS GRANT BARNUM - DBA: m NEI GENERAL CONTRACTING ` Contractor License No: CS-089714 r " 5/12/2018 Buildin6lofficial X Date w; This permit shellbe deemed abandoned and invalid unless the work authorized by this permit is commencedwithin six months after issuance.,The Building Official may grant one or more extensions not to exceed six months each upon written request.All work authorized by this permit-shall conform to the approved application and the approved construction documents for which the permit has been granted. - Allconstruction,alterations and changes of use of anybunding and structures shall be_kr compliance with the local zoning by-laws and codes:- ` �- This permit shall be displayed in a location cleady,visibte from access street or road and shalt be maintained open for public Inspection for the+entire duration o fthe work until the completion of the same, The certificate of occupancy win not be issued until all applicable signatures by the Building and Fina Officials are provided on this permit:" N H IC#: "Persona contracting with unregistered contractors do not,havaaccess to the guaranty fund"(as set forth in MGL c.142A). a Restrictions: J Citv of Salem 120 Washington St,3rd Floor Salem,MA 01970(978)745.9695 x5641 ' - Return card to Building DIJ!^.lon for Certificate of Occupancy - -Structure CITY OF SALEM BUILDING PERMIT xcavation PERMIT TO BE"POSTED IN THE WINDOW ooling �'[- 11w- CZ-/� INSPECTION RECORD tion ounda - ✓- 3�7�{ / y (y�jl. fZ fa'` echanical sulatlon INSPECTION: By �, _ DATE himney/Smoke Chamber r1nalPlumbing/Gaslumbing ` f as inal Electrical ervice ghl ug Incl Fire Department rellminary - e�` incl - - "4j, 7r• V rS 113NMO A1113dO21d eta jo f4aedoid aqt e,e SPJe3 il►wed Iro Health Department -e;ls uo elgellene eq o3 eje sueld Sulpling. Preliminary - .- -."'..,. - RouednooO to eleogilleo J%U0191AJO Bullolne of pie'wlnlea . 1b99x 9696-94L(SM OL61,0 VV4'weleS J001d MIS UMOU14SOM OZI, Final - UJaIeS 10 AJ!0 G " J s;iesnwessew ;o yijeaMuowwoo , Commonwealth of Massachusetts City of Salem 120 Washington St,3rd Floor Salem.MA 01970(976)745.9595 x5641 Return card to Building Division for certificate of Occupancy „t Permit No, 816-468 PERMIT TO, 8U,ILD . FEE PAID: $15,317.50 DATE ISSUED: 5/12/2016 This certifies that CONGRESS &WARD LLC M has permission to erect, after, or demotish a building _ -6 WARD STREET ; Map/Lot:-340363-0 3: as follows: Repair/Replace WORK INCLUDES REHABILITATION OF 64 OCCUPIED UNITS IN 8 BLDGS. { TO INCLUDE: RECONFIGURATIONS OF SELECT UNITS, STAIR UPGRADES, KITCHEN&BATH RENOS, INTERIOR FINISHES, NEW DOORS/SIDELIGHTS, EXTERIOR MASONARY REPAIRS; :«` WINDOW& ROOF REPAIR/REPLACEMENTS; MECH., ELEC., & PLUMBING UPGRADES, NEW t FIRE ALARM & SPRINKLER SYSTEMS IN SELECT BLDGS.,SITE/UTILITY& EXTERIOR UPGRADES' Contractor Name: DOUGLAS GRANT BARNUM DBA: NEI GENERAL CONTRACTING Contractor License No: CS-069714 t a 5/12/20.16 Building Official/t' 4 Date l This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months aftai issuance.The Building Official may grant one or more extensions not to exceed six months each upon written request All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the kcal zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street o road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. .` 7, The certificate of Occupancy will riot be issued until all applicabta signahzes by the Building and Fire Officials are provided on this permit. .HIC#: *Person contracting with unregistered contractors do Trot he"access to the guaranty fund'las set Porth in MGL cA 42A). . Restrictions: 4' wealth of Massachusetts Common city of Salem fO'1970(978)74519595 41 n . M W ash"ton 9t 3rd fl D{vlaio�CertYBoate of Qcu+Pady Return card to Building aYall&ble On Site. Bulldln9 pi are to of the PROPERTY OWNER. ,( p� Permit C A11 ards are the PrePe "J } r, SENDER Complete items 1 and/or 2 for additional services. I also wish to receive the • complete items 3,and 4a a o following services(for an extra fee): • Print your name and address on the reverse of this form so that we can return this card to vou. 1. ❑ Addressee's Address • Attach this form to the front of the mailpiece,or on the back if space does not permit. • Write"Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery • TheReturn Receipt Fee will provide you the signature of the person delivered to and the date of derver,. Consult postmaster for fee. 3.Article Addressed to: 4a.Article Number - P 921 991 689 5anr�i Trust; c/o No"innt�c>alty Houle 4b.Service Type 2 Dearborn Lane Salem, Mass. 01WO CERTIFIED 7.Date of Delivery 5.Signature—(Addressee) 8.Addressee's Address (ONLY if requested and fee paid.) 6.Signature—(Agent) PS Form 3811,November 1990 DOMESTIC RETURN RECEIPT United States Postal Service II I I II Official Business PENALTY FOR PRIVATE USE,$300 Illu�u�lll�luIII lll1uu1INImIII IIII IIII IBig II INSPECTOR OF BUILDINGS ONE SALEM GREEN SALEM MA 01970-3724 >� ' 1 d ' ..-!`3N� s.'"� h _ .... \ � �. .... 4: . , -- CITY OF SALEM I �' BUILDING DEPARTMENT E R ' "`� �, CITY HALL ANNEX 5 L ONE SALEM GREEN 02.52u FES 1 '45 - SALEM, MASSACHUSETTS 01974 ` MA rte" *+ '+ M Al H METER d 12 154 �94 / ,r&$3; Sanai Reaity Trus t _ : \ riO %' o C/o Normand Houie F*nx G C.f!¢ q 2 Dearborn Lane r.9a�q�ty � fld �10tiE LPii!riC.7 tr:N FU...c 3 Tito of tWem, massac4usetts Public Propertg Bepnrtment Nuilbing ]Department (One #idem (6reen 500-745-9595 ;Ext. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer February 17, 1995 Sanai Realty Trust c/o Normand-Houle 2 Dearborn Lane Salem, Mass. 01970 RE: 61 Congress Street Dear Mr. Houle: Due to a complaint received through the Neighborhood Improvement Committee hot line, I conducted an inspection of the above mentioned property and the following violations were found: 1. Basement windows are boarded up, and may prohibit sufficient make-up air to boilers. 2. Front and rear entry doors missing glass portion. 3. Holes in masonry left by removal of porches must be patched in front and rear of building. 4. Concrete lintel over window opening on Lynch Street side must be repaired (exposed re-bar) . 5. Stairwell lighting must be repaired. 6. Railings completly missing in rear stairwell. 7. Smoke detectors disconnected must be repaired through all stairwells. 8. Mail boxes must be secured properly. 9. Remove all debris from halls in stairwells. 10. Must obtain Certificate of Fitness from Health Department before rental of unit. 11. Exterior light at rear door must be repaired. 12. Unregistered vehicle must be removed 13. Graffiti must be removed from rear of yard. Sanai Realty Trust c/o Normand Houle 2 Dearborn Lane Salem, Mass. 01970 page two Please notify this department upon receipt of this letter as to your course of action to rectify these violations. Failure to do so will result in legal action being taken against you. Thank you in advance for your anticipated cooperation in this matter. Sincerely, z � Leo E. Tremblay Inspector of Buildings LET: scm cc: Councillor Ahmed, Ward 1 Health Department Fire Prevention Certified Mail # P 921 991 689 APPLICATION ❑ ADULT NUMBER Trial Court of Massachusetts FOR COMPLAINT ❑ JUVENILE District Court Department ❑ ARREST LX HEARING ❑ SUMMONS ❑ WARRANT COURT DIVISION The within named complainant requests that a complaint issue against the within Want TDAwmt�`+out named defendant, charging said defendant with the offense(s) listed below. 65 Washington Street DATE OF APPLICATION DATE OF OFFENSE PLACE OF OFFENSE SBtdYRr MA.DIM 3/29/95 1 2/95 61 Congress Street NAME OF COMPLAINANT City of Salem Building Department NO. OFFENSE G.L. Ch. and Sec ADDRESS AND ZIP CODE OF COMPLAINANT Massachusetts State Section One Salem Green t Building Code 104.1 Salem, Mass. 01970 2. NAME,ADDRESS AND ZIP CODE OF DEFENDANT a' Sanai Realty Trust c!o Norman Houle 3. 2 Dearborn Sbueet Salem, Mass. 01970 4. COURT USE I A hearing upon this complaint applicationi� DATEOFHEARING TIME OF HEARING COURT USE ONLY will be held at the above court address on /f C.P /S AT /(i V f4- 4---ONLY CASE PARTICULARS QBE SPECIFIC NAME OF VICTIM DESCRIPTION OF PROPERTY VALUE OR PROPERTY _ TYPE OF CONTROLLED .. NO. Owner of property, Goods stolen,what Over or under SUBSTANCE OR WEAPON person assaulted,etc. destroyed,etc. $250. Marijuana,gun,etc. 1 2 3 4 OTHER REMARKS: Failure to respond to coorespondence from Building Department. SIGNATURE OF COMPLAIN N DEFENDANT IDENTIFICATION INFORMATION — Complete data below if known. DATE OF BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER SEX RACE HEIGHT WEIGHT EYES HAIR OCCUPATION EMPLOYER/SCHOOL MOTHER'S NAME(MAIDEN) FATHER'S NAME V 3 2 D W y8 DC-CR2(3/88) Tito of 1$ttl>em, massac4usletts ? f'o Public Prnpertg i9epartment 1Suilbing Department (One Salm (6rem 508-745-9595 Fxt. 380 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer February 17, 1995 Sanai Realty Trust c/o Normand Houle 2 Dearborn Lane Salem, Mass. 01970 RE: 61 Congress Street Dear Mr. Houle: Due to a complaint received through the Neighborhood Improvement Committee hot line, I conducted an inspection of the above mentioned property and the following violations were found: 1. Basement windows are boarded up, and may prohibit sufficient make-up air to boilers. 2. Front and rear entry doors missing glass portion. 3. Holes in masonry left by removal of porches must be patched in front and rear of building. 4. Concrete lintel over window opening on Lynch Street side must be repaired (exposed re-bar) . 5. Stairwell lighting must be repaired. 6. Railings completly missing in rear stairwell. 7. Smoke detectors disconnected must be repaired through all stairwells. 8. Mail boxes must be secured properly. 9. Remove all debris from halls in stairwells . 10. Must obtain Certificate of Fitness from Health Department before rental of unit. 11. Exterior light at rear door must be repaired. 12. Unregistered vehicle must be removed 13. Graffiti must be removed from rear of yard. Sanai Realty Trust c/o 'Normand Houle 2 Dearborn Lane Salem, Mass. 01970 page two Please notify this department upon receipt of this letter as to your course of action to rectify these violations. Failure to do so will result in legal action being taken against you. Thank you in advance for your anticipated cooperation in this matter. Sincerely, r +�Leo E. Tremblay Inspector of Buildings LET: scm cc: Councillor Ahmed, Ward 1 Health Department Fire Prevention Certified Mail # P 921 991 689 AUIVIINIS I HA I IUN A14U LNFUHULIVILN I Department of Public Safety shall be notified in writing within seven (7) working days of any action taken under this section. 101.4 Referenced Standards: Where differences occur between provisions of this code and referenced standards, the provisions of this code shall apply. SECTION 102.0 ORDINARY REPAIRS 102.1 General: Except as provided in Section 113.1, a permit shall not be required for ordinary repairs to buildings and structures. SECTION 103.0 INSTALLATION OF SERVICE EQUIPMENT 103.1 General: When the installation, extension, alteration or repair of an elevator, moving stairway, mechanical equipment, refrigeration, air conditioning or ventilating apparatus, plumbing, gas piping, electric wiring, heating system or any other equipment is specifically controlled by the provisions of this code or the approved rules, it shall be unlawful to use such equipment until a certificate of approval has been issued therefor by the building official or other agency having jurisdiction. SECTION 104.0 MAINTENANCE 104.1 General: All buildings and structures and all parts thereof, both existing and new, shall be maintained in a safe and sanitary condition. All service equipment, means of egress, devices and safeguards which are required by this code in a building or structure, or which were required by a previous statute in a building or structure, when erected, altered or repaired, shall be maintained in good working order. 104.2 Owner responsibility: The owner, as defined in Article 2, shall be responsible for the safe and sanitary maintenance of the building or structure and its exitway facilities at all times, unless otherwise specifically provided in this code. Corrected 780 CMR - Fifth Edition 1-3 EASTERN ADJUSTMENT COMPANY, INC. 430 BOSTON STREET, UNIT#5 •P.O. BOX 445 •TOPSFIELD, MA 01983 TELEPHONE(508)887.5858 •FAX (508) 887-8081 Multiple Line Adjusters, Surveyors &Appraisers NOTICE OF CASUALTY LOSS TO A BUILDING Under Mass. Gen. Laws, Ch. 139, Sec. 38 TO: Building Commissioner or, Board of Health or Inspector of Buildings Board of Selectmen // /9�7 Addresses ` R OA RE• Insuror: Insured• S(1711' Property Address: 1;� -�rsl .577-. Policy Number: f��OGbZY�I�O// File and/or claim No. :/ /������ Loss by:. I .r.e 7Lr7 {�I On: //- l8 19�_:Z-�. i - *As "representatives of the above captioned Insurance Company, . we hereby notify you, in behalf of said Insurance Company, that claim has been made involving loss, -damage or destruction of the .above captioned property, which may either exceed $1,000.00 or cause Mass. &en. Laws Cha ter 143 section 6 to be applicable. If any no ce 5M ass . n. aws, sec. 30 is appropriate, please direct it to the attention of the writer and include a ref- erence to the captioned Insured, location, policy number, date of loss and file or claim number. o I . Adjuster On this date I caused copies of this notice to be sent to the persons named above, at the addresses_.indica d a ve, by first_ class mail . -- { -- ignature and date \ _ ,-Speed Letter. as-sot Speed Letter To From Subject LIL No 9 o FOLD MESSAGE Date,/,7 - y 1 L Signed REPLY N. Date /+9Z& Signed WYLINEFJOf1eS RECIPIENT—RETAIN NVHITE COPY, P.ETLIRI•; PINK COPi" G1983 INEFORMC US &PPRI C 1909•PRINTED IN LLS P 1 184 s Of IIf "�2SlP1TI, ��iiI��t2t�1:33L'll� h .a �'����jr �u�1it �xa�r2x#g �ettttx#mtn# _ r LIIPT V�'Sr PNilbing Pq114tmnt Richard T. McIntosh One Salem Green 745-0213 May 6, 1983 TO WHOM IT MAY CONCERN: RE: 61 Congress Street The existence of a fire separation wall at the above referenced address designates the structure as two three family dwellings instead of one six family dwelling. ,t Very truly yours, Richard T. McIntosh Inspector of Buildings RTM:bms i 2S G �f�f023 The Commonwealth of Massachusetts Department ofPublW$ 30 P I122 _ 1 Massachusetts State Building Code(780 CMR) C� Building Permit Application for any Building other than a One-or Two-Family Dwelling r (rhis Section For Official Use Only) t Building Permit Number: Date Applied: Budding Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) No.and Street City/Town Zip Code Name of Building(if applicable) SECTION 2•PROPOSED WORK. Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below Existing Building Repair 11 Alteration ❑ I Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ 1 Change of Occupancy ❑ 1 Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Pro used Work: s SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-1 Cl A-5❑ B: Business ❑ E: Educational ❑ - F: Facto F-1 ❑ F2❑ I H: Hi h Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional [-1❑ 1-2❑ I-3❑ 14❑ M: Mercantile❑ R: Residential R-113 R-2❑ R-3❑ R4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ IIA ❑ IIB O HIA ❑ !Till ❑ IV ❑ VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Debris Removal:i Permit:Water Supply: Flood Zone Information: Sewage Disposal: TrenchLicensed Disposal Site❑ Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be P required ❑or trench or specify: Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: ::\I\I li u nc Co'un�s�:m i;".a'v Pro"s: Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ 1 Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: SECTION 9: PROPERTY OWNER AUTHORIZATION Na/meand Address of Property Owner, C K » Name(Print) ,. ,( a o.and Street City/Town Zip Property Owner Contact Information: Title - Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes Name Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this budding permit application. SECTION.10:CONSTRUCTION CONTROL(Pleasefill out Appendix.2) f building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control thencheck here O and slap Section 10.1 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor -All y--n r'— keC}Y'1 c Company Name _ Ll Name of Person Responsible rXo'nstruction License No. and Type if Applicable Street Address City/Town State Zip qA-qrc! n/cam 9 -y7(q_1_!q1 i itpA nn 11 jq✓- eg Jrr Telephone No. business Telephone No. cell e-mail address SECTION 11:WOItKFRS'COKIPENSA"PION INSURANCE AfTIDAVf f M.G.L.c.152.§25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes❑ No ❑ SECTION 12:.CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1. Building $ Building Permit Fee=Total Construction Cost x (Insert here 2. Electrical $ appropriate municipal factor)=$ 3. Plumbing $ d. Mechanical (HVAC) $ Note:Minimum.fee=$ (contact municipality) 5. Mechanical Other S Enclose check payable to 6.Total Cost $ (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Please print and sign"ame Title Telephone.No. Date Street Address City/Town f /J State Zip Municipal Inspector to fill out this section upon application approval: Name Date A� The Commonwealth of Massachuset 3' ( Department of Public Safety 6. - ss,it husrt Is Stale Bu iItIinl;Cady(781)CAIR)Building Permit Application forany Buildingother than a One-orlw Dwelling (This Suction For Official Use Clnh-) Building l'ennit Numbee Date Applied: _ Building Official: SECTION 1: LOCATION(Please indicate Block N and Lot N for locations for which a street addres is not available) No.and Street J City/Town Zip Code Name of Building(if.)pplicabli•) SECHON 2:PROPOSED WORK �i Edilion of ,NI:\State Cade used._C�rl" If New Construction check here❑or check Al that apply in the two rows baluw Existing Building Repair Alteration ❑ AJditian❑ Demolition ❑ (Please fill out and submit Appendix 1) ` Change of Use ❑ Changeof Occupancy ❑ i Other ❑ Specify:__ ...^ ' . Are buitding plans and/urCunstructiun dot:umelus being supplied'as part of Ihis permit application? Yes ❑. No ❑----- _. Is an Independent Structural Engineering Peer Review required? Yes ❑ No ❑ Brief Description of Proposed Work:. /o ar rS-'�� "l".�-B's vlI' 3!-arf •P 1� Sim-Y,-.0 t 'dot . --- SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Cheek here if an Existing Building Investigation and Evaluation is enclosed(See 788 CNIR 34) ❑ Existing Use Gruup(s): Proposed Use Gruup(s): -.-_ SECTION 4:BUILDING IIEIGIIT AND AREA Existing Proposed No.of Flours/Stories(include basement levels)& Area Per Fluor(sq.ft.) I'ukd :Area(sq.ft)and Total Height(It.) SECTION 5:USE GROUP(Check as applicable) r\: Assembly A-I ❑ A-2❑ Nightclub ❑ A-1 ❑ A 4❑ A-5❑ B: Business ❑ E: Educational ❑ F: Facto F-I ❑ F2❑ 1 If: High Hazed H-1 ❑ H-2❑ 11-1 ❑ li-a❑ 11.5❑ I: Institutional 1-1 ❑ 1-2❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-10 R 2❑ R-3❑ R-a❑ S: Storage 5-1 ❑ S'_❑ U: Utility❑ Special Use❑and please describe below' Special Use SECTION 6:CONS"rRUCrION TYPE(Check as applicable) 1,1 ❑ - Itl ❑ II:k ❑ IIB ❑ IIIA ❑ IIIB ❑ IV ❑ 1 VA ❑ VII ❑ SECTION 7:SITE INFORMATION(refer to 7HB CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Reuwv al: / Public .\ Ircmh leill not be Licvnsrd Dkposal Sitt,El ly Cheek if outside hood Zone T� Indicole municipal rryulrvd l��r trench or specify Private❑ or indcntliv Tone: . at nn site sv41011 ❑ ",not is rnclnsrd❑ Nei�1.,y Railroad right-of-way: Ha/arils it):Air Navigation: \I \ 1. J,�i . � ���.�. �.. . . �.• I Not :Applicable❑ Is Strurlure lc ilhill airport approach area? Is their rvv iris con1p10vot or Gonsrot to Iludd ruclosrtt ❑ 1 rs ❑ or.No Cl 1'vs❑ No ❑ Sl:C1lON 8:CON I'EN'r OF C R I IIICA'I'E OF OCCUPANCY � 111111111 t 1 C de ._ L w Gr141p(s). _ - I cia of Construction: _ OCcul+•u11 Load per blur n': 11 rs the 1;prmkh r 9c.lrm -----`,I A Not -- SECTION 4: PROPER]Y OWNER A UI'11OR IZA'IION N - ,unr.uul �\ddress of PnrpertY Owner N,une(Print) No.and Street City/Town -----Zip Prrperty Owner Contact Information: p 11 1441 \ 1 b...r---✓ -7.a .9 S D. 7 Title relephone No. (business) relephone No. (cell) n-mail address 0 If applicable, the property owner herebv authorizes - - Name Street Address --- -City/Town State Zip In act oo the property owner's behalf, in all matters relative to work authorized by this building wrinit a + licatiun. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) r if ling is less than 33,00()cu.ft.of enclosed space and/or not under Constnuction Control then check here O and skip Section 10.1 111.1 Re istered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town Slate Zip Discipline Expiration Date 10.2 General Contractor Company anne f E)7 -- CS - 16 I 3 7 Name of Person Responsible for Construction License No. and Type if Applicable 20 Ab �a( I- �9i vZ�FS3 Street Address City/Town State Zip Tole phone No. business Telephone No. cell a-mail address SECTION 11:t\t li ti 1:,,( (IM 11,1,A110X 1N'11JItA.\c'I All n r,\\'t t M.G.L.c.152. 25C 6 A Workers'Compensation Insurance Affidavit from the NIA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this a lication? Yes O No ❑ SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Nlatcrials) Total Construction Cost(from Item 6)-S_ 1. Building S 51 O O O Building Permit Fee-Total Construction Cost x_(Insert here 2. Electrical $ appropriate municipal factor)=S 3. Plumbing S 4. Mechanical (HVAC) S Note: Nlininumt fee-S__(Contact nnmiCipalih•) 3. Mechanical Other S Enclose ihcck payable to 6 To tal otal Cost $ (contact n1nni6palit<')and write check nuniber here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 14v entering my n•umc below, I hercbv attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the hest of ntv knuwled m and underetonding. 11vase print and sign name 'I"ille frlcphane No. Dole Mq titrecl Address C.ih'i Ibwn State /ip I .Municipal Inspector to fill out this section upon application approval: -----_----------_--_----- ..- ..._ . _ -- Nance Dale CITY OF S:u. 111 NWSACHUSETTS BuILDINNG DEP.kamENT 120 WASHLYGTON STREET, 30 FLOOR TEL '978 74 -9505 F.��c(978) 11498-16 .,�j.\I134nf FY DEUSCOL Ttt �L�YO Z O1NS ST. i P1ERRl DIRECTOR OF PILBLIC PROPEitTY/OCR.DNG CONNISSIONER Workers' Cumpensatlon Insurance AflTdavit: guilders/Contractors/E(ectrlcians/Plumbers Apolleant information (� Please Print Lea_ihi NamClHusilu..rUrgamvalian Individual(: ✓a.... `\�a�`^" w•� Address: City/Stare/Zip: diva ,MP oa`ISl hone N: o `!� — 7 S ( g Are yttu ao employer?Check the appropriate best Type of project(required): 1.❑ tam a employer with 4. ❑ I am a general contractor and I 6. ❑New construction s;nlploytes(Nil and/or part-time).' have hired the subcontractor 2. 1 am a sole proprietor or partner• listed on the anachod.shect, t 7. ❑ Remodeling .,hip and have no employees These subcontractors have 8. ❑Demolition working tisr me in any capacity. workers'camp.insurance. 9. O Building addition [No workcW comp.insurance 5. ❑ We are a corporation and its rcquired.j officers have exercised their 10.❑Electrical repairs or additions J,❑ I am a homeowner doing all work right of exelnptiun per MGL 110 Plumbing mptdn or additions myself.(\o workers'camp. c. 152,11(4),and we have no 12.❑ Roof repairs insurance required.)t ampluydcs. [No workers' comp, insurance required.] 11.❑Other n• ay eppllcan dwt Omits boa$I mist aim rill uul the wctloa below Aawine their ranks'Compensation Pettey mMtmueon. '1 hvneuwncve who mhmit this rMdavil Indiealne they m dairy ant work and then hits outside contractors mint mhmit a new a111davit indicuing itch 4%.mnwton that chuck ibis box most attached an additlunal abed ahuwlns the mine orthe tubeuntmbi and Ihalr woAtro'Bump.pulley Intervene". I ran an employer that&pruvlding nvorkdrs'cumpatradun losuranae jar my empluyerst Below Is the polley andJob site irrjornrution, lnanr3IIC9 Company Name: _.... laolicy.4 ur Self-ins. Lic, /P Expiration Date: Job Site Address: Cityistatr/2ip: uucb a copy of the tvorkdra'componsailott policy declaration page(showing the policy number and expiration data} F'.iilura to uxuru cuvdrage as required under Section 21A ul'btGL c. 152 an lead to the imposition of criminal penalties of s tire up to 51,500.00 and/or mu-year impri.mnmen4 as wall as.civil penallids in the form of a STOP WORK ORDER and a ilia afup to 52i0000 r day against the violator. Ile advlxed that'a copy of this.,talcment may ba furwarded to the Ofticu of lavc,nigutiunv ut'dte MA llor insurance atvcmgc vcriticliuri. /do hereby certify❑nder,the paherr n�ienukles a erjury rhut the provided abuvr 'r true•raid correct If rr •,r 4 S ( FS Ul/iciu!rut Andy. Do not veils 6r rlu:r urea,ru he emuyltldJ by riry ur town n�flriaL Ciryorl'own:. _. .. __.. I'crmWr.icemei__ Iutioy.\ulhurily (circla uac): I. I;uard of Ilcallh I Iluildlnq lyrpartlncnl 1. ('ilylTown Cicrk 1. Electried Inspector i. 111uinhin4 Inspector G. Onhcr l .,n l.ecl Nr I,it t: 1 hoar t: CITY OF SIVZ%f, NEUSACHUSETTS JuLmG DEP.tAnwir I'a W-UHNGTON STXW, 1'O FZCC A M ;973) 145-959f 'UMAIPAI Y DRLSCOLL P,,.x N(AYOA 1komuf ST.PM&U 01"aC4 all PLSLIC PROPItiTY/at:mnom CosolISSIOm!< Can$tructlon Debris 013pa531 Affidavit (required for ill demolition and renovation work) In accordance with the sixth edition ON*State Building Code, ISO CUR section I I I Debris, and the provisions of UCL o 40, S 54; .1 Building Permit At this work shall be is issued with the condition that the debris resulting rmm dis 11, $ I JOA. posed of in--ins licensed waste dispose! facility as defined by NICE c 1 The debris will be transported by: N 10-+f- s A r (name ut hauler) The debris will be disposed of in : (name o—dray) I j1drm a/Ac 6iy) u(naNro u(permir ipphcml 2 , a J