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20 DOW STREET - BUILDING JACKET 20 ;DOW:.STREET i I MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION 2 CENTER PLAZA BOSTON, MASSACHUSETTS 02108-1904 800-392-6108 617-723-3800 DATE 05/02/96 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B TO: SALEM BUILDING COMMISSIONER SALEM CITY HALL SALEM MA 01970 RE: Insured: ANTOINETTE C. THERIAULT Property Address: 20 DOW STREET SALEM MA 01970 Policy Number: 20-2-381638-01 Type of Loss: PROPERTY DAMAGE Date of Loss: 04/23/96 Claim Number: 20-2-0149697 Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000. 00 or cause Massachusetts General Laws Cha ter 143 Section 6 to be applicable. If any notice under Massac usetts Genera Laws Chapter 1395 Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. MPIUA Claims Division I MUA-CL-21 MASSACHUSETTS PROPERTY INSURANCE FAIR PLAN UNDERWRITING ASSOCIATION Claims Division Two Center Plaza Boston,Massachusetts 02108-1904 (617) 723-3800,MA Only (800) 392-6108,FAX (617)723-8424 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B TO: Building Commissioner or Board of Health or Fire Department or Inspector of Buildings Board of Selectmen Arson Squad RE: Insured• Property Address: Policy Number: Loss of: � �� 19 File or Claim Number(s) : Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. i (Si ature) - i U Title: on this date, I caused copies of this notice to be sent to the person. named above at the addresses indicated above by first class mail. Signature and Date MUA-CL-21 Did you check your smoke detectors today! MASSACHUSETTS PROPERTY INSURANCE FAIR PLAN UNDERWRITING ASSOCIATION Claims Division Two Center Plaza Boston,Massachusetts 02108-1904 (617) 723-3800,MA Only (800) 392-6108, FAX (617) 723-8424 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B TO: Building Commissioner or Board of Health br Fire Department or Inspector of Buildings Board of Selectmen Arson Squad RE: Insured: f//Z��/IZ��rU' ( .� � ✓� Property Address: _�70 Policy Number: Loss of• �� 02� 19 File or Claim Numbers) : /,j�71 7o Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws Chapter 139 Section 3B is appropriate, please direct t to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. �t (Si ature) Title: on this date, I caused copies of this notice to be sent to the person named above at the addresses indicated above by first class mail. Signature and Date MUA-CL-21 Did you check your smoke detectors todayl y (Gita of ttlem, Aussachusetts �nttrD of �upeal � _ r aR1Z 3 'fTY '!: . DECISION--ON—THE PETITION OF PAUL TREMBLAY FOR VARIANCES & a SPECIAL PERMIT SAT -9DOW STREET'(R=3) A hearing on this petition was held January 31 , 1990 and continued until March 7, 1990 with the following Board Members present: James Fleming, Chairman; Messrs. , Bencal , Luzinski , Febonio and Associate Member Dore. Notice of the hearing was sent to abutters and others and notices of the hearing were properly published in the Salem Evening News in accordance with Massachusetts General Laws Chapter 40A. Petitioner is requesting a Special Permit to construct an addition and Variances from density and parking to allow four unit building in this R-3 district. Petitioner is the owner of the property. The Board of Appeal , after hearing the evidence, and after continuing the petitioner, at the request of the petitioner voted unanimously to allow the petition to be withdrawn without prejudice. WITHDRAWN rl�r I g, cam°) ichard A. Bencal ,r Vice Chairman A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY CLERK situ of ' ttMem, f assar4usQtts �zhlit xu ext a ttxtment U 's .... .' �uilain� �e�ttxtrterct William H. Munroe One Salem Green 745=0213 - October 17 , 1985 Mr. Paul Tremblay 20 Dow St . Salem, MA 01970 RE: Building Permit Extension Dear Mr . Tremblay : As per your request , and as provided under Section 113 . 9 of the Massachusetts State Building Code , your Permit #142 , for work at 20 Dow St . is extended for an additional period of ninety ( 90 ) days , commencing this date . Sincerely , William H . Munroe Inspector of Buildings WHM : bms 77 : /V2. I �0& 1—�Zf ev,e- / -T, rte, s yam' ��!' Zo ��w S?'• it �-x ��?j`� r=�rL iii . •... i .16 CITY OF Sk1ASS. i i , Citu of "Salem, aA Public Vniperig Uepartineut William H. Munroe One Salem Green 745-0213 May 31,1985 Mr. Paul Tremblay 20 Dow Street Salem,Ma 01970 Re: 20 Dow Street Dear Mr. Tremblay: I have reviewed your request to add an additional dwelling unit at your property, located at 20 Dow Street with the following findings: 1. The Lot is presently non-conforming by reason of Lot Area. 2. Based on the Plan provided, the necessary additional parking cannot be provided. In view of the above any increase in units would require a Special Permit, from the Zoning Board of Appeals. ° very truly yours, WIDI:mo's William H. Munroe i 4 - ,;,, :M.. �""�- F-- ;x .3 n ._ �- _ _ .. ,� . _ __... ._- - z . '.`ti ,.`0'1 l�p.h � • � -� /,f� �S Delo��'I/ �, lv � � / - �-• � `� . I . �= �, a� 1 �s t � -- In �l� �'.b / . . v Q,� C.. //jj Y � �� � `- L/ � v . _. �� . � � .r � �- � Cp l .,�.,. v � . �. -f� a / / . m The Commonwealth of Massachusetts CITY OF Board of Building Regulations and Standards SALEM Massachusetts State Building Code, 780 CMR Revised,Char 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Tivo-Family Dwelling This Section For Official Use Onl. Building Permit Number: Date Applied: (� Building Otlicial(Print Name). .: Signature- '- - ate SECTION t:SITE INFORMATION LI oper ddress: 1.2 Assessors Alap&Parcel Numbers aIs t ul 5 T L I a Is this an accepted street?yes_ no hlap Number 'Parcel Number 1.3 'Zoning Information: 1.4 Property Dimensions: 'Coning District Proposed Use Lot Area(sq It) Frontage(It) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Reyuired Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§5d) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Public❑ Private❑ Check If es❑ pa Po y SECTION2: PROPERTYOWNERSHIPI' 2. ,()wneRecord: o G� NN me(Print) City,State,ZIP 'a t'� Gtc S' No.end Stmet Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ Alterntion(s) ❑. Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify: Brief Description ot'ProposedWorV: =� o SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials I. Building $ i,u v. o I. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cose(Item 6)z multiplier s 3. Plumbing $ 17,(pher Fees: S a.Nlechmtical (hIVAC) S List: S.Mechanical (Fire S Total All Fees:$ Su ressiun) Check No._Check Amount: Cash Amount:_ G. otal Project Cust S �u u o , cv ❑Paid in Full ❑Outstanding Balance Due: St�w-r GONT • i I I S SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 0 License Number Expiry n Unt Name of CSL Holder �— � List CSL Type(see below) V fi/1 o O t,cJ Type,,-- - Description No. and Street � k1l Unrestricted(Buildings up l0 35,000 cu. ItJ L R Restricted 1&2 Family Dwellin CIt uwn,State,ZIP M Nfasomy r/�j)ofr4 L/-�m to � � y� RC Rooting Covering WS Window and Siding SF Solid Fuel Burning Appliances 1 Insulation 'rule hone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) © HIC Registration Number Expiration Date HIC Comp:ay Name or HIC Registrant Name No.atnd Street Email address City/Town,State ZIP 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 ..........❑ No...........❑ SECTION 7a:OWNER AUTHORIZATION:TO BE COMPLETED WHEN.: ' OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT` 1 � I,as Owner of the subject property,hereby authorize 6 Vt ' !� ZZ- )u� t9 act on my behalf,in all matters relative to work authorized by this building permit application. l5r nt Owner's Name(Electronic Signature) Dale SECTION 7b:OWNEW ORAUTHORIZED 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 is true and accurate to the best of my knowledge and understanding. lJ (,4 6T-OD ?,/ S Print Owner's orAudArizcd Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do hislher own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC) Program),will rrnr 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 www.m;ss.. (Woca Information on the Construction Supervisor License can be found at www.mass.�ov'Jns _ 2. When substantial work is planned, provide the information below: 'rota) floor area(sq. R.) 4 1(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 rype of heating system Number of decks/porches ` Type orcooling System Enclosed Open_ i. Total Project Square Footage"may be substituted for"'rota) Project Cost' I NOT�E RECEIPT DATE NO:k 42b783`0 �9. RECEIVED FROM ���TOIZ`ra'��iZO � Cr�J.�� .'n'C� wiK/,R�f+f v •r'r � u �r'��1fl1 ' ���ZT��-�T- ACCOUyV/NTH <! HOW PAID i'� ti � �m ACCOUNT � %'f� Jn +'• �- - > h. . r �F, eeeVVV�y �r�l(�i PAID r dh 1`�•�� t ' BALANCE MONEY Yv.,.i l�✓✓tlt rr/��yp fiti 4'4,� DUE � � '�hvJ"�. ORDER BY p eyaoB�T' _ f I' I ICI .I II III �I) —t--r�— ► y — l ct l S The Commonwealth of Massachusetutscp RECEIVED Board of Building Regulations and Stat HUfCTIDNAI SER ICETITY OF SALEM W Massachusetts State Building Code, 780 CMR ed Shir �^ /LtWsed a/err 2011 Building Permit Application To Construct, Repair, Renoer{IdlislOd LJ One-or Tivo-Fmnily Dwelling This Section For Official Use Only Building Permit Number: Date ppiied 1 Duiiding Official(Print Name). . . ' Sign at Date v SECTION 1:SITE INFORMATION' t 1.1 Property Address*?- ddress S+ `�n 1.2 Assessors Alap& Parcel Numbers 0W rl - I.1 a Is this an accepted street9 yes no Map Number Parcel Number 1.3 'Zoning Information: 1.4 Property Dimensions: "Zoning District Proposed Use Lot Area(sq If) Frontage(11) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard ReyuireJ Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Munici al O On site disposal s stem O Public O Private O Check if esO p Po y SECTION2: PROPERTY OWNERSHIP" 2.1 Ownerl of Record: uer_�6r M6ran �a- SpA` r-'. I144rne(Print) City,state,ZIP Lo Lool C( 71 - Z /6 - �01 _4 ' No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction O Existing Building 0 Owner-Occupied O Repairs(s) 61 Alteration(s) ❑ 1 Addition O Demolition O Accessory Bldg.❑ Number ofUnits Z I Other C3 Specify: Brief Description of Proposed Work-: C. Q G I ..Z OO N1 . G )/ a SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated CostVUst: 0 Official Use Only Labor and Mater I. Building S ermit Fee:S indicate how fee is determined: ity/Town Application Fee I. Electrical S t Costs(item 6)x multiplier s 3. Plumbing S : S d. Mechanical (IIVAC) S 5. iMechanical (Fire S Total All Fees:3 Su ression) vo Check No. Check Amount: Cash Amount: 6. Tutal Project Cost: S I g pp _ ❑Paid in Full ❑Outstanding Balance Due: J �N-7 TU M4c<z L(D �2 �11 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) a _S License Number Expiration Dale Name of CSL Holder a �(y q L List CSL'fype(see below) 9 b�6Y)�t R 1 AIA `S I -Type Description No.and:uect --- y Unrestricted(Buildings Lip to 35,000 cu. It.) hQ l a f. m 2 5 a R Restricted I&2 FamilyDwelling City/town,Stale,ZIP M Mason RC Rooting Covering WS Window and Siding SF Solid Fuel Burning Appliances Tele hone Eniail address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) 2 � I (�_'Lo_ Q r�l Q �,�,c Y1 '�'C.no HIC Registration Number Expiration Date HIC um :my Name or 111C Regist at Nmne , O 4 -3 IIiIGWtt n °t cialo 3 - Marti 5 9 m tail • awe No and Street �_(�., �">t S 4�-3 - Email address cti,/ S�14 WI /�4S `�"� City/Town,State ZIP Tel e hone 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 Ishuance of the building permit. Signed Affidavit Attached? Yes .......... ❑ No........... ❑ SECTION 7a:OWNER AUTHORIZATION:TO BE COMPLETED WHEN. OWNER'S AGENT OR CONTRAC'T/OR APPLIES FOR BUILDING PERMIT 1, as Owner of the subject property,hereby authorize t9 act on my behalf,in all matters relative to work authorized by this building permit application. fi lafs<) � 12- 11- zG 14- P tr nt Ohmer's Name(Electronic Signature) Dale SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below, 1 hereby attest under the pains and penalties of perjury that all of die information contained in this application is true and accurate to the best of my knowledge and understanding. �nar'I l� J (uc7p4�s14- Print Owner's or Authorized Agent's Name(Electronic Signature) Date 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 Lira'have access to the arbitration program or guaranty fund under I.G.L.c. 142A.Other important information on the HIC Program can be found at www mass uov:'oca Information on the Construction Supervisor License can be found at wcvw.musssov'das 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) ' .(including garage, finished basement/alfics,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 healing system Number of decks/porches 'rype of cooling system Enclosed Open 3. `Total Project Square Footage"may be.substituted for"rot;d Project Cost" PROPOSAL PROPOSAL NO. r/y SHEET NO. - ti DATE PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT NAME �] t' ADDRESS ADDRESS 4-0 Vim' � `7•� r v ry E DATE OF PANS � A- 'i-14 i PHONE NO. -LLL��I����'� I ARCHITECT \� ^ We hereby propose to,€t+-F ah ', perform the labor necessary for the completion of X' A x� — ac ,6 mimp-io _+bk VVIAl oulwo, �. f6c ico be w'I �b -L' tw 1 N e s r E' u < 1� QPu� o R , 6 1�b ooe.a� �xl. All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings ands ecifi- cationnss+submitted for above work and completed in a substantial workmanlike manner for the sum of U e 6C e3 Dollars ($ [606 • 00 ) with payments to be made as follows. CT Respectfully submitted Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents,or delays beyond our control. Note—This proposal may be It drawn by us if not accepted within N days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Signature Date l o4dol Signature NC 3818-50 PROPOSAL µ CITY OF &XL.EM ~ PUBLIC PROPERTY DEPARTMENT �ldi� N Nlb'N 1 ywroa 130 WAaa a rem STRuzr* sALM W&-%Aon:s5R501970 71=i 972-745-959S• FAiL 978-740-984 HOMEOWNER LICENSE EXEIMMON Please t Date v� Job Location O Home Owner Address Home Owner Telephone �2 z��'—44 o � Present Mailing Address� � Z)- iZel The current exemption of"Homeowners"was extended to include owner-occupied dwellings of two Units or less and to allow such homeowners to engage an individual for hire who,does not possess a license,provided that the owner acts as supervisor. DEFBMION OF HOMEOWNER Person(s) who owns s parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling. attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official, on a form acceptable to the Building Official, that he/she be responsible for all such work performed under the Building Permit. The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable by-laws and regulations. The undersigned "homeowner"certifies that he/she understands the City of Salem Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures an equreent . aHOMEIGYATUREdm OWNERS S r APPROVAL OF BUILDING INSPECTOR See other side for state code CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT ..u1u■t ANALL 13C *41b:.i. Tn.%Owdam •Fv%WW4&04 r- Coastrucdon Debris Dhp"af Affidavit (ragwmd fW all demolition and rawvadm work) In=ankms w idt dw lode ad doe otl'dw Sam Suddios Coda 710 CUR soetias 111.! Darig.gad dw ptovislam of N(GL c 406 S Jt 9uildiq pw"d _ is issued wilt dw eood[dom dw dw debris rca+ltin/ dos this wedt shall be disposed of in a popssty Ikansed waste disposal &dUty as doflned by WL c !l1. ! 15" The debris will be transported by: �r�� tna�w a(harts � rhodcbris will be disposed of in : tu.aw.,i rid�q)- --- - CITY-OF8-CLETN - - -- PUBLIC PROPERTY DEPARTNIE►NT AI]OWjU-&Y DRWAA l WAYDI 130 WMMD1GrON hlZ • "U*Jk SlAssAcrLst1-rs 01970 71•L 971-74S•9S% • FAr 976-740.9/4 APPLICATION FOR THE REPAIR, RENOVATION. CONSTRUCTION, DEMOLITION. OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUILDING 1A SITE INFORMATION Location Name. Building: Property Address: Property Is located in a;Conservation Area Y/N Historic District Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land Name: / Address: 19 � � �i 5 2 ell, Telephone: 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use New Demolition Existing Approximate year of Area per floor, (sf) Renovated construction or renovation of existing building New Descri'pticnn of Proposed Work: Mail Permit to: What is the current use of the Building? Material of Building? )W,e f If dwelling. how many units?_ Will the Building Conform to Law? Asbestos? u Architect's Name Address and Phone ( 1 Mechanic's Name Address and Phone Construction Supervisors License# HIC Registration 0 Estimated Cost of Project 5 /G Ov Permt Fee Calailatlin Permit Fee:A'si Estimated Cost X$7/$1000 Residential Estimated Cost X$11/51000 Commercial An Additional $5.00 is added as an Administrative charge. and legibly Make sure that all fields are properly eg ly written to avoid delays In processing. The undersigned does hereby apply for a Building Permit to er mitto build to the above stated specifications. Signed under penalty of perjury Date J d� -2- d N d � as a N xc o v c v