1A PARALLEL STREET - BUILDING JACKET
��' `
Plans must be filed and approved by the Inspector before a permit will be granted.
No. . � City of Salem Ward n
IS PROPERTY LOCATED IN THE o q
HISTORIC DISTRICT? Yes_Noo� s
IF SIDING, HAS ELECTRICAL
PERMIT BEEN OBTAINED? Yes No Home Phone #
APPLICATION Bus. Phone
FOR
PERMIT TO ROOF, REROOF OR INSTALL SIDING
Salem, Mass.,
TO THE INSPECTOR OF BUILDINGS:
The undersigned herebv applit5.4or a permit tq.,build accor mg to the followJ�B specifications:
Owner's name and AA
Architect's name
Mechanic's name and address —7
Location of building,No.
What is the purpose of building? ,ng? �f17P2
Material of building? Asbestos?
If a dwelling,for how many families^.
Will the buildin ,confonn to the requirements of the law?
Estimwed cost' Q'C-C2 �jnCractors Lic.No. ,L 31 7
Signature of applicat �) tel—"
REMARKS SIGNED UNDER THE
A40 z�� PENALTY OF PERJURY.
25
No. —9,11Ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location !.5 a `!D +-t k
� /
PERMIT GRANTED
J / (�.✓/��f / (I 191
Approved
o.
Buildi g I sped
COMMONWEALTH OF MASSACHUSETTS
`c DEPAIrI MEN T OF INDUSTRIAL ACCIDENTS
600 WASHINGTON STI=
.: BOSTON, MASSACHUSEM 02111
gamesCanooen
sStone• WORKERS' COMPENSATION INSURANCE AFFIDAVIT
I,
(I iccnscei ocrmineq
with a principal place of business/residence at:
(City/StatdZip)
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 Number
I am 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
vamc of Contractor insurance Company/Policy Number
Name of Contractor insurance Company/Policy Number
[] 1 am a homeowner performing all the work myself.
NOTE: Please be aware that while homeowner,who employ persons to do maintenance.construction or repair work oa a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant tbereto are net generally
considered to be employers under the Workers' Cumperuation Act(GL C 152.sect. 115)),application by a homeowner for a license
or permit may evidence the legal sums 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
�cnncanon and that faiium to secure coverage as reautrcd under Section 25A of MGL 152 can lead to the imposition of criminal Penalties
consisune of a fine of up to $1500.00 and/or imprisonment of up to one yew and civil penaiuu in the form of a Stop Work Order and a
fine of S 100.00 a day against me.
t
Signed i"Fi s //A L day of 3 7 19
Licenseei Permittee LicensoriPermirtor
Itu of ttlPrtt, iHtt� �rliuse#t$ e9
o M � �lxtucutg �nxr� c
�F�s4, ! 009a'
@m Salem 115reen
FORM A - DECISION
Deborah E. Burkinshaw
Ms. JosegMrne-Yu"a
City Clerk
Salem City Hall
Salem, MA 01970
Dear Ms. fhrsca: Burkinshaw
At a regularly scheduled meeting of the Salem Planning Board
held on February 17, 1993 it was voted to endorse "Approval Under
Subdivision Control Law Not Required" on the following described
plan:
1. Applicant:
Stephen F. Coady
2. Location and Description:
1 A Parallel Street
Salem, MA
There is no frontage change on either lot. . No new buildable lot is being
created. This action involves a simple shift of property lines.
City of Salem, Assessors' Ma 1123, Lot 132
Deed of property records in Essex South District Registry.
Sincerely,
�� 1 �g,1,,�
"Walter B. Power, II
Chairman
EX\DH\BPFORMA
i
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SUBDIVISION PLAN OF LAND
APPROVAL UNDER SUBDIVISION SALEM , MASSACHUSETTS
CONTROL LAW T REQUIRED
_ �� �➢� STEPHEN & ELAINE M. EL L IOT
!` *1 �� SCALE : I ° = 20' OCT. 16, 1992
SCALE IN FEET
NOTE : PARCEL 2A TO BE CONVEYED v, '` c r '
rr.� -"• {y !� � +t,- 0 10 20 30 40 60 80
STEPHEN F. COADY AND BECOME
ONE CONTIGUOUS LOT WITH �`-
CARTER a TOWERS ENGINEERING CORP
LAND COURT PARCELS I AND 2. 6 FAIRVIEW AVENUE
_ DATE 3 SWAMPSCOTT, MA 01907
- .
(617) 592- 8386
F jG065
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