12 HAWTHORNE BLVD - BUILDING INSPECTION (002) -Ko tzRe-
UPC 10330
No. 153L
HASTINGS, MN
QTY OF SALEM, MASSACHUSETTS
�J BUILDING DEPARTMENT
n �
120 WASHINGTON STREET,3m FLOOR
e „s TEL. (978) 745-9595
FAX(978) 740-9846
KIMBERLEY DRISCOLL
MAYOR THOMAS STTIERRE
DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER
April 18, 2012
Emmerton House—Ms. Karen Lamarine, Director
Women's Friend Society
12 Hawthone Boulevard
Salem Massachusetts 01970
Ms. Lamarine,
The ensuing communication shall serve as this office's follow-up to our April 10, 2012,\
106 - Periodic Renewal inspection. The purpose of the investigation was to identify any
safety concerns and code violations noted during the visit as required in accordance with
the Massachusetts Building Code 780 CMR.
Thank you in advance for the prompt attention to the lever hardware,non-secured fire extinguisher and
emergency light battery pack corrections listed on my report dated April 10, 2012. As discussed at the
inspection I further reviewed the requirement for lighted"emergency exit" signage in the egress stairs and
corridors as well as the requirement for emergency lighting in the basement. This office's determination is
that both of these life safety equipment components are required in the building. These violations must
be corrected within the thirty-day (30) time period we discussed on April I7th. You are hereby
ordered to begin to rectify these conditions within thirty(30) days of receipt of this notice.
Failure to do so may result in further actions being brought against you,up to and
including the filing of criminal complaints at District Court. You have the right to appeal
this order to the State Board of Building Regulations at One Ashburton Place, Boston,Ma.
If you have any questions regarding this letter,please contact the Building Inspectors
Office at(978) 619-5649, extension 5648.
Respectfully,
Michael E. Lutrzykowski
Building Inspector
Cc: file, Fire Prevention,Jason Silva
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FIELD COPY
!' CITY OF SALEM BUILDING F°
SALEM, MASSACHUSETTS 01970 PERMIT
,A VALIDATION
4EDOHE
DATE November 3 4 93 PERMIT NO 490-93
APPLICANT United Roofing Company ADDRESS 5. Brentwood Road Salem,Mass. - 065 . _
G DWELLI
1x0.1 (STRE[r) NUMBER
IC Oxr R'S CICFx3lI
PERMIT TO ROof (_I STORY Dwelling OF
DWELLING UNITS
n.P[ o• wRR ov[u[xn xo. IRRorosen Nsu '
12 Hawthorne Blvd. Ward I ZONING B_5
AT ILO:PV ION[ DISTRICT
IxO.I I ISTREETI -
BET WEEI. - AND
ICPOS. SrR[Erl [CROSS STREET[
LOT
SUBDIVISION LOT - BLOCK SIZE
x
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
(TIRE)
REMARKS: Reshingle section of roof
Inspected 6 Approved Date
AREA'OL LIME ESTIMATED COSTS 2,000 FEEMIT S 20.00
r:SIa SOU0..R[ F[[TI
aWNER Womans Friend Society
<^D.Ess 12 Hawthorne Blvd. Salem, Mass. John J. Jennings
INSPECTOR OF BUILDINGS
INSPECTION RECORD
DATE NOTE •DOOM!!! CRITICISMS AND REMARKS INSPECTOR
l-Z
COMMONWEALTH OF MASSACHUSETTS
Ems DEFARrMENT OF INDUSTRIAL ACCIDENTS
_ 600 WASHINGTON STREET
games Ganooei, BOSTON, MASSACHUSETTS 02111
Gomnss one• WORKERS' COMPENSATION INSURANCE AFFIDAVIT
(I icenseei perminec)
with a principal place of busi ess/residence at: 1
(City/State/Zip)
do hereby certify, under the pains and penalties of perjury, that:
[ ] I am an employer providing the following workers' compensation coverage for my employees working on this
job. _
Insurance Company Policy N ber
(J /
[ J 1 am a sole proprietor and have no one working for me.
] ] I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below
who have the following workers' compensation insurance policies:
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
[] I am a homeowner performing all the work myself.
NOTE: Please he aware that while homeowners who employ persons to do maintenance,construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally
considered to be employers under the Workers' Compensation Act(GL C. 152,sect. 1(5)),application by a homeowner for a license
or permit may evidence the legal status of an employer under the Workers' Compensation Act.
I understand that a copy of this statement will be Forwarded to the Department of Industrial Accidents' Office of Insurance for coverage
verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to $1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of S100.00 a day against me.
Signed this day of /v �y 19
Licensee/Permittee licensor/Permitror