20 ESSEX STREET - BUILDING JACKET 20 ESSEX STREET
1
City of Salem, .Massachusetts
Fire Department
�G 48 Lafayette Street
Robert 9N.Turner Salem, Massachusetts 01970-3695 Fire Prevention
Chief Tel.978-744-12.35 Bureau
978-744-6990 Fax 978-745-4646 978-745-7777
NAME: Pradeep Madan RE : Jeffrey Craig
ADDRESS: 24 Essex Street Illegal Spray Booth
CITY/STATE/ZIP: Salem, MA 01970
AS THE RESULT OF AN INSPECTION OF THE PREMESIS, STRUCTURE, OPEN LAND AREA, OR
VEHICLE OWNED, O.CCUPIED, . OR OTHERWISE UNDER YOUR CONTROL, THE FOLLOWING RECOM-
MENDATIONS ARE MADE AND SHALL SERVE AS A NOTICE OF VIOLATION OF. THE LAWS,
ORDINANCES, OR REGULATIONS PERTAINING TO 'THE PREVENTION OF FIRE' AND THE. PRO—
TECTION OF LIFE AND PROPERTY.
On Friday March 8, 2002 we received a complaint from the owner of 24
Essex Street. Upon the investigation of this property we found improperly
stored flam able liquids in the basement. It is required that flamables are
to be stored ina metal cabinet at a minimum of 10 feet from any open flame
ie (furnace) . We also found illegal spray operations. Both of the above
are in violation of Massachusetts General Laws Chapter 148 Sec. 23, 24.
It is advised that this operation cease immediately. A follow up inves-
tigation will occur to see that all flamables are properly stored and all
spray operations have ceased.
cc: Building Dept.
Per Order, _
SALEM FIRE PREVENTION DIVISION
Form 25A ( 1/24) DATE :�� ,S /� „"
�o T CITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MA 01 970
TEL. (978) 745-9595 EXT. 380
FAX (978) 740-9846
STANLEY J. USOVICZ, JR. PETER STROUT, DIRECTOR OF PUBLIC PROPERTY
MAYOR
March 12, 2002 COPY
Pradeep Madon
Waylous Variety
20 Essex Street
Salem, Ma. 01970
RE: 20 Essex Street
Dear Owner:
This department received a complaint about spray painting being performed in the
basement of your residential building. ,
This use violates numerous building codes, fire department regulations and City of Salem
Zoning Ordinance.
You are directed to cease this operation immediately.
Failure to cease this painting will result in Municipal Code Tickets being issued and a
complaint being filed in Salem District Court.
S' cerely,
Thomas St. Pierre
Local Building Inspector
cc: Mayors Office
Tom Phillbin, Chief of Staff
Fire Prevention
of �ttlem, Mttssac4usetts
Public Vropertp Department
iluilbing Department
(One 03alem (5reen
508-745-9595 Ext. 380
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer November 27 , 1995
Joel Foster
43 Forrest Street
Danvers , Mass . 01923
RE : 19-21 Essex Street
Dear Mr. Foster:
Thank you very much for your response to the letter
dated on September 13 , 1995 regarding the above mentioned
property. An inspection was conducted and found all
violations corrected.
This office will notify all the appropriate
departments and the Ward Councillor that this situation
has been brought to a satisfactory conclusion.
Sincerely,
Leo E . Tremblay
Inspector of Building
LET: scm
cc : David Shea
Tom Keough
Councillor Ahmed, Ward 1
of #ttlrtn, ttrl�uortt
Public Vrnlrertg Department
+Nuilbing Department
(9ne *stem (careen
508-745-9595 Ext. 380
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer November 27 , 1995
Joel Foster
43 Forrest Street
Danvers , Mass . 01923
RE: 19-21 Essex Street
Dear Mr. Foster:
Thank you very much for your response to the letter
dated on September 13 , 1995 regarding the above mentioned
property. An inspection was conducted and found all
violations corrected.
This office will notify all the appropriate
departments and the Ward Councillor that this situation
has been brought to a satisfactory conclusion.
Sincer ly,
Leo E. Tremblay
Inspector of Building
LET: scm
cc: David Shea
Tom Keough
Councillor Ahmed, Ward 1
Titg of �tt1Em, fttsliar4usEtts
' f Public Propertp Department
9eG " Nuilbing Department
(One #stem (rireen
508-745-9595 Ext. 380
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer September 13, 1995
Joel Foster
43 Forrest Street
Danvers, Mass. 01923
RE: 19-21 Essex Street
Dear Mr. Foster:
Due to a complaint received through the Neighborhood Improvement
Committee hot line, I conducted an inspection of the above mentioned property
and found the following:
The chain link fence at the above mentioned property must be removed or
repaired at once. It is in hazardous condition.
Please notify this department within fifteen ( 15) days 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,
Leo E. Tremblay l
Inspector of Buildings
LET: scm
cc: David Shea
Larissa Brown
Councillor Ahmed, Ward 1
Certified Mail Il P 921 991 824
CITY OF SALENI
' NEIGHBORHOOD INIPROVE\IENT TASK FORCE Jurisdiction
Hut. Comm. Yes Cl No Cl
REFERRAL. FORM Cons. Comm. Yes Cl No ❑
SRA Yes cl No ❑
Date: �h
Address: :�:SSex S�-
Compiaint:
Compiainant: Phone#:
Address of Complainant:
�i BUILDING INSPECTOR KEVIN HARVEY
FIRE PREVENTION ELECTRICAL DEPARTMENT
HEALTH DEPARTMENT CITY SOLICITOR
ANIMAL CONTROL SALEM HOUSING AUTHORITY
PLANNING DEPARTMENT POLICE DEPARTMENT
TREASURER/COLLECTOR ASSESSOR
i
WARD COUNCILLOR DPW
SHADE TREE DAN GEARY
IF
PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO DAVE SHE.
WITHIN ONE WEEK. THANK YOU FOR YOUR ASSISTANCE.
ACTION:
PosTAGe _ POSTMAAK OA DATE or
RETURN SHOW TO MOM,DATE ANO% RESTRICTED /
RECEIPT ADDRESS OF DEIVERV DELNEW 1
O
CERTIFIED FEE+REIDRN RECEIPT J
SERVICE W N
_ TOWL POSTAGE AND FEES Z N
IL NOI SDRA C COVERAGER - W K
m SENT TO: N T FOR INTERNAT,DNFL MAR LL
In I DIDa
o00Z
" ,v2b Joel Foster
��
I 43 Forrest Street
y W
i DSuvers, Mass. 01923 o
Er N
v W
U
W
<. CL J 2
` PS FORM 3800 z
1 RECEIPT FOR CERTIFIED MAIL
P
01
uw
PoST4SEWICERlILE �_
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front).
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address of the
article,leaving the receipt attached,and present the article at a post office service window or hand
it to your rural carrier(no extra charge).
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address
of the article,date,detach and retain the receipt,and mail the article.
3. If you want a return receipt,write the certified-mail number and year name and address on a return
receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space
permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED
adjacent to the number.
4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee,endorse
RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return 6
receipt is requested,check the applicable blocks in item 1 of Form 3811.
6. Save this receipt and present it if you make inquiry.
I
I
ARTICLE +.
• P 921 991 824
UNE i. Joel Foster NUMBER
43 Forrest Street
DBnvers, Mass. 01923
t FOLD AT PERFORATION
W t , qAla •
INSERT IN STANDARD#10 WINDOW ENVELOPE. [ E A i F I E o
.... M A I E E 6W �CILJ�I�
• Co I also wish to receive the
Complete item 1 and/or 2 for additional services.
• complete items 3,and as a b, 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 you. 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 mi below the article number. 2. El Restricted Delivery
.• The Return Receipt Fee will provide you the signature of the person delivered to and the
date of delivery. Consult postmaster for fee.
3.Article Addressed to: - 4a.Article Number
a
P 921 991 824
cz4 Sr r,_et t 4b.Service Type
CERTIFIED
7.Date of D 've
j
S.Signature—(Ad resseee) 8.Addressee's Ad rens
ty- (ONLY it requested and fee paid.)
6.Sig ure—(Agent) ..
PS Form 3811,November 1990 DOMESTIC RETURN RECEIPT
United States Postal Service II Ig
Official Business F M)
J
p a
PENALTY FOR PRIVATE
USE,$300
Illum�l�l�lnl� III 11un1l11uIloll IIoil III Kill
INSPECTOR OF BUILDINGS
ONE SALEM GREEN
SALEM MA 01970-3724
(fit oft�Ie�tc �ssttcl��zsetts I�
r � � � 1 RF
A s Pourb of tAYVVl �N1i 4y' I1 0e
• CITY t�i.:r,r, : .. .
DECISION ON THE PETITION OF MICHAEL AND DEBRA CARDELLA SALEH, HASSIICE
FOR A SPECIAL PERMIT FOR 20 E`SSEX STP,EET�(R-2) 'I
A hearing on this petition was held on March 25, 1987 and continued until April 15,`,
1987 with the following Board Members present: James Hacker, Chairman; Richard A. 1
Bencal, Secretary; Messrs. Fleming, Strout and Associate Member Dore. Notice
of the original hearing was sent to abutters and others and notices of the original
hearing were properly published in the Salem Evening News in accordance with
Massachusetts General Laws Chapter 40A.
Petitioners, owner of the property, are requesting a Special Permit to extend
nonconforming density, use and side setback to allow construction of a two
story addition in this R-2 zone.
The provision of the Salem Zoning Ordinance which is applicable to this request
for a Soecial Permit is Section V B 10, which provides as follows:
Notwithstanding anything to the contrary appearing in this Ordinance, the Board of
Appeal may, in accordance with Section VIII F and IX D, grant Special Permits
for alterations and reconstruction of nonconforming structures, and for changes,
enlargement, extension or expansion of nonconforming lots', land, structures, and
uses, provided, however, that such change, extension, enlargement or expansion
shall not be substantially more detrimental than the existing nonconforming use
to the neighborhood.
In more general terms, this Board is, when reviewing Special Permit requests,
guided by the rule that a Special Permit request may be granted upon a finding
by the Board that the grant of the Special Permit will promote the public health,
safety, convenience and welfare of the City's inhabitants.
• The Board of Appeal, after careful consideration of the evidence presented at the
hearing and after viewing plans, makes the following findings of fact:
1 . Letters of support from the City Health Officer and Ward 2
Councillor were submitted;
2. A petition signed by neighbors, abutters and others was submitted;
3. A letter of opposition was submitted by one abutters;
4. The bottle deposit law and an increase in business has caused a
lack of storage space;
5• The loading area would be moved off Essex St. thus alleviating a
traffic problem;
6. The plan was approved 9-0 by the Planning Board;
7. An increase in the family has caused the need for more living
space on the second floor.
DECISION ON THE PETITION OF MICHAEL AND DEBRA CARDELLA FOR A
SPECIAL PERMIT FOR 20 ESSEX STREET, SALEM
page two
On the basis of the above findings of fact, and on the evidence presented at the
hearing, the Board of Appeal concludes as follows:
1 . The proposed addition would improve the property;
2. The proposed addition will promote the welfare and
convenience of the City's inhabitants;
3. The enlargement will not be substantially more detrimental than the
existing nonconforming use to the neighborhood.
Therefore, the Zoning Board of Appeal voted unanimously, 5-0, to grant the
Special Permit requested, subject to the following conditions:
1 . All work be done as per the plans submitted;
2. The addition for the first floor be used for storage only;
3. All requirements of the Salem Fire Department in its letter to
the Board regarding this petition be adhered to;
4. All construction be done per all existing State Building Codes;
5. All. delivery trucks must park on Forrester Street while making
deliveries at the store;
6. A legal building permit be obtained;
7. A Certificate of Occupancy for the second floor residential space
be obtained.
SPECIAL PERMIT GRANTED
Richard A. Bencal, Secretary
A COPY OF THIS DECISION HAS BEEN FILED WITH THE PLANNING BOARD AND THE CITY CLERK
APPEAL FROM THIS DEti ISIbi;, IF ANY. SHALL BE LADE PURSUANT TO SECTION 17 OF THE MASS.
GENERAL LAV;S, CE12TER EOE, AND SHALL BE FILED V.1THIN 20 DAYS AMM THE DATE OF FILING
OF THIS DECIS:3N IN THE OFFICE OF THE CITY CLERK.
PURS=.NT TO V;ES. CEJER.AL LA.7S. CH AAT ER 303. SECT13N 11. THE V,-IANCE OR SPECIAL PER an
GP,AKTED HEREIN, SHALL N37 1AKE EFFECT UNTIL A COPT OF THE CECISI 7:'i. D'::_R ClS THE CERT
FICATI.:i OF THE CITY CLERK MAT 20 DAYS HAVE ELAPSED AN-) NO A?FAL HAS BEEN FILED,
OR THSI. IF SUCH AN A°PEA! HAS BEEN FILE. THAT IT HAS C:c':i C:0':1:SCED OR DENIED U
RECORDED IN THE SOUTH ESSEX REGISTRY CF DEEDS AND N:DEXED C-17E3 THE NA:..E OF THE OWNER
OF RECORD OR IS RECORDED AND NOTED ON THE OWNER'S CERTIFICATE OF TITLE.
BOARD OF APPEAL
ATTORNEYS AT LAW
BAHNY D. B.RKAL MAN'1`IN BERKAI.
LEONAHL A.BERKAL 26 LYNDE STREET
Q599-19541
MICHAEL N.STEWIAN SALEM.MASSACHUSETTS 61976 M"SE31.S14"N
'1'IMO9'HY J.DAVERN TEI.:MIT 7454010 0905-195.51
JKFF6F.Y N.SHRIDNIAN OY COUN.IKI,
ALBERT R. PI'1'CUNF
September 2, 1986
Mr. William H. Munroe
Building Inspector 7
City of Salem c <=
One Salem Green 11.7
Salem, MA 01970 -'
r�"G
,:gip G7 C7
Re: Michael J. Cardella
Dear Mr. Munroe:
In accordance with our conversation, this is to confirm that my client, Michael J.
Cardella, 20 Essex Street, Salem, has agreed that he will remove the ice storage
cooler on his premises so that it will comply with set-back requirements.
Mr. Cardella will accomplish this move not later than November 7, 1986.
Yours very truly,
BERKAL, STELMAN & DOAV�E,RNn
Leonar6LA. Berkal �
LAB/ak
cc: Mr. Michael J. Cardella
20 Essex Street
Salem, MA 01970
---
-
— - ----- - ' -¢a_--�a�-�-t�- v-•-z -nth_ JJ4rJ�`
- --- -- i+- - - - To 7` _ _ _- - O-
- - -- - -
YLA70
-- --- ttILL
-
'' C�_
!
! I I I I I l
� I
i
i
I I I I I I I I I
t-
I !
i !
SENDER: Complete items 1,2,3 and 4.
Put your address in the"RETURN TO"space on the
reverse side.Failure to do this will prevent this card from
�+ being returned to you.The return receipt fee will provide
+ you the name of the person delivered to and the dace of
+ tlallverv.For etlditionel few the followln8 services am
available.Consult postmaster for few and check box(w)
< for service(s)requested.
1. El Show to whom,date and BQQras of delivery.
2. El Restricted Delivery. 1
jj 3. Article Addressed to:
0
Mr. Fred. Cardella
Mr. Michael Cardella
20 Essex St.
Salem Ma. 07.970
4. Type of Service: Article Number
❑ Registered ❑ Insured p 445 292 022
K1 Certified ❑ COD
❑ Express Mail
Always obtain signature of addressee or agent and
DATE DELIVERED.
C 5. Suture—Addressee
y 6. Signature—Agent
i
tj X
7. Dateof Deli ry
m
azC
2 8. Addr e' Add (ONLYf
a
m
n
m
ti
i
_,�
UNITED STATES POSTAL SERVICEM -
OPRCUILBUSINESS S F.JG w j
SENDER INSTRUCTIONS �ggb
Print your name,address,,end ZIP Code in tfie. uassesses8
space below.
• Complete items 7,4 3,and 4 on the reverse.
• Attach to front of article R apace Permits, PENALTY FOR PRIVATE
otherwise affix to back of article. USE,$300
• Endorse article"Return Receipt Requested"
adjacent to number.
RETURN
TO Building Inspectors Office
(Name of Sender)
1 Salem Green
(No.and Street,Apt,Suite,P.O.Box or R.D.No.)
Salem, Ma. 01970
(City,State,and ZIP Code)
P l 292 022
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse)
v
f' Set}ored & Michael Cardella
C
Street and No.
20 Essex St.
Ci P C�asla'em;d aco"61970
d
�
rA Postage S
Cedified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt showing
to whom and Date Delivered
rn
rn Return Receipt showing to whom,
Dale.and Address of Delivery
d
C TOTAL Postage and Fees 5
0
O� Postmark or Date
n
E
0
LL
N
a
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front)
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving
the receipt attached and present the article at a post office service window or hand it to your rural carrier.
(no extra charge)
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of
the article, date,detach and retain the receipt,and mail the article.
3. If you want a return receipt,write the certified mail number and your name and address on a return
receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space per-
mits. Otherwise,affix to back of article. Endorse lent of article RETURN RECEIPT REQUESTED
adjacent to the number.
4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee,endorse
RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return
receipt is requested,check the applicable blocks in item 1 of Form 3811.
6. Save this receipt and present it if you make inquiry.
Public Propertg Departutent
s
" ,�
7p
ullNng nepartntent
One Satrm (15reen
795-0213
William H. Munroe
Director of Public Property Maurice M. Martineau, Ass't Inspector
Inspector of Buildings Edgar J. Paquin, Ass't Inspector
Zoning Enforcement Officer John L. LeClerc, Plumbing/Gas Insp.
August 6, 1986
Mr. Fred Cardella
Mr. Michael Cardella:
Dear Sir:
Please be advised that you are now in violation of the Zoning laws of
The City of Salem as that the ICE Storage Cooler, now on your property
fails to meet set back requirements.
A number of visits to your store by our inspectors have to this date
failed to acquire any satisfactory results and. cooperation from you in
relocating this unit.
You are herby ordered to move this unit immediately or face the
possibility of having it removed from your property.
Should you fail to comply with this order, legal action would be
forth coming.
Respectfully,
Maurice Martineau
Asst. Building Inspector
MM/ld
cc: Councilor
City Clerk
File
�� - ' --- I'he C'onunumccuhh of biassarhusens
Board of Building Regulations and Standards CI'I'1'OF
sI Massachusetts State Building Code, 790 LAIRS,\Lli\I
14-1-mr,l Via Jnll
Building Permit Application To Construct. Repair, Renovate Or mulish ❑
One-or Ttru•Fwrnh Duelling
rhis Section For Official Vw X11y
Building Permit Number: Date Ap li• : 059 OF
Building 011ieial(Print N;unc) Signalu O
SECTION I: SITE INFORMATION
1.1 Property Address: 62 Assessurs Ntap d's Parcel Numbers
�s•�.O 1,L �T _
I.In Is this an accepted street? •a no Map Nunsher Purcell Nunstsvr
1.3 Zoning Information: 1.4 Property Dimensions:
Lining District Proposed ilia Lot Area(sq II) Frontage III)
1.5 Building Setbacks(Il)
Fruit(Yard Side Yams Rear Yard
Required I'ruvidcd Required Provided Required Provided
1.6 Water Supply:(M.G.I.c.40.134) 1.7 Flood Zone Informallont 1.3 Sewage Disposal System:
141blic 0 Private Cl zone: _ Outside Flood Zone? Municipal 0 On site disposal s)stem 0
Check if es0
SECTION2. PROPERTY OWNERSHIP'
2.1 Ownerl of Record:
Rhc_k✓ MAD S -4L ,$),
N;wsa(Print) City.Stine,ZIP
'a d Es-e r S- SC? 8 �;;)/�S 17 17
No,and Street relephune Email Address
SECTION J: DESCRIPTION OF PROPOSED WORK'(cheek all that apply)
New Construction 0 Existing Buildin Ovvner-Occupie Repairs(s Alterollon(s) O I Addition 0
Demolition 0 Accessory Bldg.❑ Number of Units_ I Other ❑ Speedy:
Brief Description of Proposed Work': r u
SECTION J: ESTIMATED CONSTRUCTION COSTS
hem Estimated Costs: Official Use Only
I Labor and\laterials)
I. Building S )c 5 0® 1. Building Permit Fee: S Indicate how fee is determined:
❑Standard City!Tussn Application Fee
L'Icclrical S
O Total Project C'osll(hem 6)x muhiplier _,--x
1 I'Iunlhing S 2. Other Fees: S_
1, \Iech,mieol ill\- \(•) S List:
Vechanic,d Irve S -------- -- ---
\;u, rvssion) r,aal .\Il Fees: S_..__-----
) ('hcck No. _('hock:\mount —Ca h \mount:
l alai Project Cuvl: S l l ��] 5 p`—' O Riid in Full ❑Outstanding Dal.mce Due:
L—
SEC HONS: CONSI'll1licriONSF.RVU'ES
1 Icetee Numb I:Nptnition Mile
N un—w i 0"IL-S-1 I 1—o-M-c-r, lit 01. Il Ile Iwe
I%PC
No and.Strect
It -I figs lit)11)35.000 ol. II.)
it , 11) I)%%VIIillA
01)il'oml. M Nlasmiry
R,
SF Ilurnills APPlia"M_�ts)IJL IlFllu:iL
I clevllvlle I mail addmss D Demolition
5.1 Registered Home Improvement Contractor(HIQ
L' 1s C I 6-,e)—V—C'D I K Rq6tration Nual Evirillivil UJII
I 11 C Co Name;
.N n— I&T— I
bohK MA 41 ,1 R S 318 :;X3R [:mail address
City/Town,State,ZIP roc hone
SECTION 61 WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L e. 153.§ 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 .......... 0 No...........0
SECTION 7a,OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print O%mvr's Nuints(Elvorunic Signature) oute
SECTION 7b:OWNER' OR AUTHORIZED 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.
7,J !�k�fog q --2-C? - /2--
NOTES:
I. \n O%sntf who obtains a building permit to do his her own work,or an owner who hires an unregistered cuntrxtor
(nut registered in the Hume Iiiiproveiticiit Contractor lHIC) Program),will no have access to the arbitration
program or guaranty fund under.M.G.L. c. 142A.Other impuriant inliarniation on the HIC Progra:ii can be l'ound at
11\%1% 11,V., ." 1 Inrarmation on the Curistrwitin Supen isor License can be round at
lien substantial work is planned, provide the hilbrinatiun below:
rotai flour area(44. 11 ) —1 including garage. 11misfied basement attics, decks or porch)
Croii li%ing,irca 1 S4. 11 Hobilatilt room count
Number ot'hedruilms
\m0crol'bathrounis \kl1l)bQr lit lialf Klilli
I lwof liv,11ilig ')i1vill Numher of Jecki. liordws
I
I ProjwSkIllarl: Fool�lgc-ma% t,c uhinitjted I'or folal 1'roim CoNt"