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'� CERTIFICATE OF,OCCUPANCY
CITY OF SALEM
Issued. ao Permit A:
SALEM, MASSACHUSETTS 01970 •�-�=L
Cit of Salem Buildin Dept:'
DATE OC MEER c1..J ;5-1.999
F(aFF1RD DEV C O12F'. PERMIT NO. 71.
APPLICANT ADDRESS '"'�� F.::I-T 99 T.O�T STI?Ef=T 1562
(NO.) (STREET) (CONTR'S LICENSE)
CITY ASHL._AND I'+IA 071c::1.
STATE_ZIP CODE TEL.NO.- 5QO f)O.L' .I.E.i L11I1
PERMITTO NEW DIAL.-DTWO OR MORE FAI'4I I.._Y NUMBEROF
( ) STORY DWELLING UNITS I
(TYPE
.'IMPROVEMENT) NO. (PROPOSEDUSE)
AT(LOCATION) 00i'-' EOLJ:PSE LAIVE U.1.8jfi ZONING h�S
(NO.) (STREET) DISTRICT
BETWEEN
(CROSS STREET) AND
(CROSS STREET)
SUBDIVISION MAID 1717 LOT 1081 BLOCK 8.95 LOT 1.5. 79 ACRE':,
— SIZE
BUILDING IS TO BE FT.WIDE BV FT.LONG BV FT.IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: BUILD /I. 1..1N:I:T CCINDOMIN:I:Lill 1S PER FLANS. PL-DG 101, UNIT A, (:-'OAC)..I 57.YI_..E., I OF /I
AREA OR
VOLUME ESTIMATED COST$ 130, 01710 PERMIT 9171.1. ;271(CUBICISOUARE FEET) FEE $
OWNER F AFARID IR. ::. D. C.
ADDRESS 290 EL.:1:0'1' SSTfdEI::::T BUILDING DEPT. -r•, tC
BY 1 J J
Commonwealth of Massachusetts RSPECRECEI SERVICES
r p Sheet Metal Permit 10lb _ I Ail: 25
K) Date: Permit #
I Estimated Job Cost: $ �g ��� Permit Fee: A. G� (p 4 l�
Plans Submitted: YES NO X Plans Reviewed: YES NO
Business License# Applicant License#
Business Information: t � Property Owner/Job Location Information:
00)m ll
Name: Name: r�
Street: D���� W �,� Street: \
City/Town L'y{IJ� City/"Gown: Sft�yM q
Telephone: �� I'S�J '1��� Telephone:
Photo 1.D. required/ Copy of Photo I.D. attached: YES NO
J-l '�'��, \lurr IIIIII:II
unrestricted license
J-2 / NI-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. / 2-stories or less
Residential- 1-2 family Multi-family Condo/ Townhouses Other
Commercial: Office Retai( Industrial Educational
Institutional Other
Square Footage: under 10,000 sq. ft. x over 10,000 sq. ft. Number of Stories: 3
Sheet metal work to be completed: New Work: _ Renovation:
I IVAC Metal Watershed Rooting_ Kitchen Exhaust System
Metal Chimney/ Vents Air Balancing
Provide detaileddescription of work to be done:
t Z ILL �X1 S�11s p- S �VfM�c@ Cot) () VNW- \OWIA
su �� �� d ee jN,f du �t of
6oOVDo L-TWI
-t I INSURANCE COVERAGE:
�� .11 cqa .�1z"
I have a-current Ilabili inibrance'policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes No❑
If you have checked Yes, indicate the type of coverage by checking the appropriate box below:
A liability insurance policy R Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
cqOwner ❑ Agent
Signature of Owner or Owner's Agent
By checking this boxl],I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit Issued for this application will be
In compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to Insulation installation: YES_ NO_
Progress Inspections
Date Comments
Final Inspection
Date Comments
Type of License:
By WMaster
Title ❑ Master-Restricted '
i
City/Town ❑Journeyperson
Signature of Licensee
Permit# ){S 2
❑Journeyperson-Restricted License Number: 1
Fee 5
Check at www.mass.rlovldpl
Inspector Signature of Permit Approval