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150 LAFAYETTE STREET - BUILDING INSPECTION . 150 LAFAYETTE STREET_ Plans must be filed and approved by the Inspector before a permit will be granted. No 7 r93 City of Salem Ward Is Property Located in the Historical District? Yes_ No iq s. Home Phone#�SoJ)h7 y-SS3o Is Property Located ma r J y' Conservation Area? Yes_ No Bus.Phone$ 'yam APPLICATION FOR PERMIT TO CONSTRUCT POOL DECKS AND SHEDS Salem,Mass., TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's name and address `TOSf-/" `fzJ LrZ /O 1A llVP� S. Architect's name Mechanic's name and address Location of building, No. ycTTTE s What is the purpose of building? Material of building? tt]OO A If a dwelling, for how many families? T///ZA,�E Will the building conform to the requirements of the law? f/.tr.5 Estimated costOO ntractors Lic. No. 11A V 03-25/8 ; 5-44Z r1 '*//a0 Signature of applicant Signed Under the Penalty of Perjury REMARKS Z- /5'7-/.0 S 3 " /B Two 7- Coo s7-Xuc7- vX'u/ iu06 STRChT /B UPOJfC>4� /U <oogT/oy N a-,3 Ward APPLICATION FOR PERMIT TO CONSTRUCT SWIMMING POOL Location/-50 40. rc yo-t4t / PERMIT GRANTED`" S� v lG ism Ap rove !oc uilding I pector In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: (Locaoon of Facility) Signature of Permit Applicant -��/t� ............ _,,. 4.�yyJ N'G 1...• a ?, / CO. .:z lor 14cabf engineering and Survef� CO.II J�nc 15 CHESTNUT STREET, PEABODY. MASSACHUSETTS 01960 F (617) 532-0028 w SANITARY SYSTEMS REAL ESTATE DESIGN ENVIRONMENTAL STUDIES UTILITY&HIGHWAY DESIGN CONSTRUCTION MANAGEMENT _RVEYSERVICE 1 ,< . . /J` �OUrflJSP,S OHI/ s % D , �. i ' I LAFAYETTE STREET x , Tothe -F;, hereby certify ' at I have examined the premises and all easements, en. . roaehments and buildings are located on the ground as shown. I fuqher .`.'�, A t certify that the b0ildings shown conformed to the zoning laws of�_ r ^:,i, �4� _when constructed. I further certify that this propert� /Sif/oT located in the established flood hazard area. r r JOB eA19 3—o5EPA/ ZZ44.4lo— ISO 4Ar,,4y,-TTt'Sr James M. Kieran SHEET NO. OF 2 Building and Remodeling Contractor 7 Burley Farm Road CALCULATED BY DATE DANVERS, MASSACHUSETTS 01923 23 1.93 (508) 774-5530 CHECKED BY DATE SCALE To .R FMA ).N � MLI ,' M yY� PT Pas= o,0, �EXLSTPV� CGItI�', I I �i STE TD J?E/J�,/�✓ / 4'-o I I II I I I L -- FRONT FLEVATIaN xooua Eo -mEEi-Em:2-67 doB CJS' So sgPH �'�.uo -/S6 .lAFAyk'rT�' ST, James M. Kieran SHEET NO. 2 of 2- Building Building and Remodeling Contractor 7 Burley Farm Road CALCULATED BY DATE DANVERS, MASSACHUSETTS 01923 7 13 93 (508) 774-5530 CHECKED BY DATE SCALE ----------- -- - -zx�; - - - f/RST FL, FRA M t MG ALF, N - .1 I VOTE : /ALL C01v-),E-C-T ioti)" To ,del E ,`l TA, S6Is7Tf/AMIIA-s E COMMONWEALTH OF MASSACHUSETTS E=e DEI`AIr:MENTOFINDUSTRIAL ACCIDENTS �._ 600 WASHINGTON STREET fames., Garrmooeo BOSTON, MASSACHUSETTS 02111 -c, n ss,one- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (I icensee/permi nee) with a principal place of business/residence at: aPD b4Wk1,7-TS moi% (City/Sntc/Zip) do hereby certify, under the pains and penalties of perjury, that: [%]dam an employer providing the following workers' compensation coverage for my employees working on this job. C 23.3 6aga9 CiA Insurance Company Policy Number [ ] I 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. 10)), application by a homeowner for a license or permit may evidence the legal status of an employer under the Workers' Compensation Act 1 understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' Office of Insurance for cnvenge 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 51500.00 and/or imprisonment of up to one yew and civil penalties in the form of a Stop Work Order and a fine of 5100.00 a day against me. Signed this �-3 x� day of --T-0 V 19 15P�3 ensee/Perminec Licensor/Permittor wY 1 wi\J Patti , . I We F Sr" tiltre 3nB11er#or - E�af=, -lass. 01970 c\ren ( abe 517 745-5300 October 2G , 1980 Mr. Robert Gauthier , Building Inspector 1 Salem Green Salem, Ma . 01970 Dear Mr. Gauthier, Emergency lights- have been installed at : Bertram Home - Permit 10-20-80 Bowditch School on the leftside stairway - 10-20-80 The probl em ate] 5:1 a_f_ay--e Street has been resolved. Yours truly, Paul Tuttle " Wire Inspector PT/na * CEn,TIFIPT) TLnIT �.` 67S228 `a; r�UIt.�1NG DR. ISRAEL KAP AN PUBLIC UEAL'TH CENTER XT:31 9 BOARD & HEALTH: 4 4178 Off Jefferson Avenue v RECEI'VL`O - CITY OF SALCI4,M SS. Salem; Massachusetts 01970 le ROBERT E. BLENKHOR:Y ISRAEL KAPLA N, M. D. JOSEPH R. RICHARD HEALTH AGENT x:(3D�W¢XS7LDx1tYP[G[3ffi9�C•at7taC October 30, 1978 (617) 745-9000 na.ax>�Vrx��rlslxxbx�c,:xxxxxl M. MARCIA COUNTIE, R. N. MILDRED C. MOULTON, R. N. EFFIE MACDONALD - Philip H. Saindon Robert C. Bonin Mrs. Ann Szczuka Re: 150 Lafayette Street Wilson Apartment 4 Cypress Street Salem, MA 01970 Salem, MA 01970 Dear Sir/Madam: During an inspection .of your property at 150 Lafayette Street, Salem, Mass. tenant(s) Wilson - —(on) October 26, 1978 > at. 10:30 a.m. the following violations have been noted: Bathroom 1. Water backs up in bathtub drain from the sink. Exterior 2. Back porch on first floor has no railing. " 3. Back stairs on first floor has no handrails. General 4. Rodent problem exists exterminator needed. Page 1 of 2 Pages - � CITY OF SALEM HEALTH DEPARTMENT <�. DR. ISRAEL KAPLAN PUBLIC HEALTH CENTER OFF JEFFERSON AVENUE Page 2 of 2 Pages �.,T. SALEM, MA 0,970 Date October. 30, 1978 kI LC�TS.� To: Mrs. Ann Szczuka Re: 150 Lafayette Street 4 Cypress Street Wilson Apartment Salem, MA 01970 Salem, MA You are hereby ORDERED. to make a good faith effort to correct these violations; said correction of these violations shall be commenced 7 days after receipt of this letter and shall be completed no later than 30 days Also, please notify the Health Department immediately by letter of your intention to make these repairs. You are hereby advised of your right to a Hearing before the Board of Health by filing a written petition within 7 days. Procedures for filing of said petition are enclosed. You are also hereby advised. that the conditions which exist may permit the occupant.(S) to exercise one or more statutory remedies which can include rent withholding. You are further advised that failure on your part to comply within the specified time can result in a complaint in the Salem District Court. FOR THE BOARD OF HEALTH REPLY TO: ROBERT E. BLE ddH L" —Lc _ PETER GRADY Health Agent Sanitarian REB/ m Certified Mail # 678228 En cls: (1) Procedure for filing Petition (2) Three-Page Inspection Report cc: xN uilding Inspector, One Salem Green Electrical Inspector, 44 Lafayette St. Fire Prevention, 48 Lafayette St. Plumbing Inspector, One Salem Green Gas Inspector, One Salem Green xTenant(s), Wilson, 150 Lafayette Street, Salem, MA Ward Councillor Attorney xManager, Ann Szczuka, 4 Cypress Street, Salem, MA ~ Plans must be filed and approved by the Inspector before a permit will be granted. No.,Vi--193 City of Salem Ward_ I x T3 IS PROPERTY LOCATED IN THE ; HISTORIC DISTRICT? Yes No 1/ a IF SIDING, HAS ELECTRICAL '4c�aRaa*'' PERMIT BEEN OBTAINED? Yes No Home Phone # 5--/3 zz APPLICATION Bus. Phone # FOR PERMIT TO ROOF, REROOF O INSTALL SIDING Salem,Mass., TO THE INSPECTOR OF BUILDINGS: The undersigned herebv applies for a per it to build according to the following specifications: 1i r) Owner's name and address _7'yse.pti Z01,&Nd _ ID hyla -'* bw"i-e< MA-ss 0/9?.4 Architect's name /V/,?- Mechanic's name and address w008H'S )4,We =7niagrye rw�, l' 9Soz /110 C✓�frY U` Location of building,No. What is the purpose of building? _ Material of building? �.f II 6 O' -ifAsbestos? If a dwelling,for how many families?_ Will the building conform to the requirements of the Is%,? `p- i 6 Eatimaied cost Contractors Lie.No. Signature of applicant R MARKS SIGNED UNDER THE SiVS7*1/ 'J"Ny/ s ,ru L,efi teLr�scd!e PENALTY OF PERJURY. N 3-gg Ward APPLICATION FOR PERMIT TO ROOF REROOF OR INSTALL SIDING Location 15 d 4 at,Y�= Q PERMIT GRANTED (, - 9 19 / Approved _ 10c0-(0§u,! ng lnsp, at� 11nn lam' 11 n c E COMMONWEALTH OF MASSACHUSETTS R Ec DEFAIrTMENT OF INDUSTRIAL ACCIDENTS ��„ ,%' 600 WASHINGTON STREET aures �anooei, BOSTON, MASSACHUSETTS 02111 n•ssone WORKERS' COMPENSATION INSURANCE AFFIDAVIT (I icenseet permittee) with a principal place of business/residence at: 93e /mow SF GlPnhx� A*S3 G�FS-Sz (Gry/Sure/Zip) do hereby certify, under the pains and penalties of perjury, that: [ ] 1 am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company Policy Number kl­am a sole proprietor and have no one working for me. ( J 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 (J I am a homeowner performing all the work myself. NOTE Please be aware that wbile homeowners who employ persons to do maintenance,construction or repair work on ■ 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,sea. 1(5)),application by a homeowner for a license or permit may evidence the legal sums of zn 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 S 100.00 a day again',me. Signed this day of 19 Licenseei Permiaee Licensor/Permiaor ISSUE A�`i RIL CERTIFICATE OF INSURANCE 08/09/93 PRODUCER - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE E A STEVENS CO INC POLICIES BELOW. 389 MAIN ST BOX 188 COMPANIES AFFORDING COVERAGE MALDEN MA 02148-5076, COMPANY LETTER A TRAVELERS INDEMNITY CO ___. .............. _............. : COMPANY B INSURED -. LETTER WOODY'S HOME IMPROVEMENT COMPANY C PHILIP A BLANCHETTE 93R PLEASANT ST COMPANY WENHAM MA 01984 LETTER D COMPANY E LETTER COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COTYPE OF INSURANCE POLICY NUMBER -'POLICY EFFECTIVE :POLICY EXPIRATION' LTi,'. DATE(MM/DDM) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY TO BE ISSUED 08/09/93 '08/09/94 GENERAL AGGREGATE $21, 000f000 X COMMERCIAL GENERALUABIUTY PRODUCTSCOMP/OP AGO. S2, 000, 000 CLAIMS MADE :OCCUR.: PER &ADV INJURY $11000( 000 OWNER'S&CONTRACTOR'S PROT.: EACH OCCURRENCE $1 y 000, 00o FIRE DAMAGE(Any One fire) S 50 y 000 MED.EXPENSE(Any one person)!$ 5, 000 AUTOMOBILE UABIUTY - COMBINED SINGLE ANY AUTO LIMIT $ ......._........ _.._.. ............. .__..... ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS : :(Per person) -$ HIRED AUTOS __. ._............... $ ..... ....._......... BODILY INJURY NON-OWNED AUTOS - (Per eooidenp .........:_GARAGE LIABILITY ._..__ ................ _..._. ................. 'PROPERTY DAMAGE :$ EXCESS LIABILITY EACH OCCURRENCE $ ' IUMBRELLA FORM AGGREGATE I$ '.OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS AND EACH ACCIDENT $ DISEASE-POLICY LIMIT $ EMPLOYERS'UABLLJTY ._._.......... __. :DISEASE-EACH EMPLOYEE :$ OTHER DESCRIPTION OF OPERATIONSA.00ATIONSNEMCLES/SPECIAL ITEMS CERTIFICATE HOLDER :CANCELLATION '.'.: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO CITY OF SALEM MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE BUILDING INSPECTOR LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR WASHINGTON ST LIABILITY OF ANY KIND U HE COMPANY ITS AGENT-W REPRESENTATIVES. SALEM MA01970 AUTHORDXiD REPRE$ENTATIV B Marion Ballou MB A ACORD 25-5 (7/90) 'i OACORD'CORPORATION 1990".