27 SALEM STREET - BUILDING JACKECT 27 SALEM STREET
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♦ CERTIFICATE ISSUED-
e ! _ DATE December 16, 1993
!' CITY OF SALEM
SALEM, MASSACHUSETTS 01970 BUILDING PERMIT r
a*�[DmLL CERTIFICATE OF OCCUPANCY
DATE. August 16 93' 340-93 ..
john D®yle . ''9£—c=F-V `l8l!"U9re ,As9
APPLICANT ADDRESS
INO.I (f TP[L TI ICON(R'SL(CENSE.
Renovations Dvelliis NUMBER OF 6
PERMIT TO - (_I STORY
' 1.•F[ Or wRPOv[Mf NEI N0. VPOFOf[0 Of[I DWELLING UNITS
AT (LOCATION) 27 Salem at . Ward I ZONING -.
DISTR ICT_
IN0.1 ISTP[[ll
BETWEEN AND
iC11 qf$ fER[[il (CROSS STREETI
SUBDIVISION LOT T_LOT" BLOC[ SIZE
BUILDING 15. '0 BE � ET, WIDE P.• � FT, LONG BY FT. IN NEIGNT AND S„ALL CONFORM IN CONSTRUCTION
TO TYPE VSE GROUP BASEMENT WALLS OR FOUNGAT ON
n rRn
AEMARNS: ,.os-lete R�!Qoviations
AREA OR
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SMW,9D1Y�1'RNNI.�Wy
VOLUMEjw2mffTlgnglfA
J('Ihn Doyle swo[swsrwsrwee�Is'slrrnse'nlvdloe[(o.wsvlse•rlsan s. a=4
OW NF�i TO BE POSTED ON PREMISES
ADDRESS.V . DiIA ! ,co c.:cpor t , ;a ♦ SEC"E R&E.SIDtjTe%tOI10ZT4ONS OF CERTIFICATE
DEPARTMENT4L PPROV LvFOP CERTIFICATE .,
of OCCOP NCY and C�IMPLIAN`-
N
� ? .�' n F
;- filled m;b e5ich div siifn rndicategd heteon i
comoletrgn iofaits fin I inspection.
340, 93
Bq GS Pe MIA No
Approved by Ohn. nn' % Date /93
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Rerks _
FTNBING ! Pefmit No.
I i
A roved b Dlenni's IRo s I" i Date2/793
I
PP y
I
Rer arks
ELOCTRICAL i Permit No.
Approved by 1 Fi Ikowski I Date '12/8/93
i Remarlts ` I I
OTHER Fir w iPermit No.
I`r 'Appove'd byNorman aPoin[e I Date `12/ 15/93 �;r x�,1
E F�S
Remarks,
v 0 HER �' = Permit No.
('Approved by I i ( Date fi
ir
1 ' :J�.
Remarks
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SA EMS MASS�ICHUSETTS 0.1910 RMIT = LIDAAIO
APPLIAV L`5
CANT
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{ r ' iYP9: MBER. t�
PERMIT TO T} '+. ' I w ° ( 'v''' IZ8(�Y - •"DNEI"' O+ANI S"". � i
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'TOJtYP! {IS G OVA A N W l5 DR,ff OUNDATI N'- -
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R[MARKB
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.FROM THE • L S
AF:.ANY APPLICABLE SUBDIVISION RE ST,RICTIONS. :>' tT.iy z..k::_ 3fi } �^;?: K cep x[s.'..;�T w' 1g �ba4, r.�,V-,
MINIMUM OF 'THREE CALL �� APPROVED PLANS MUST BE RETAINED ON•JOB AND'THIS wMERE APPLICABLE SEPARATE F'?'^:?
INSPECTIONS REQUIRED FOR ,.a CARP KEPT POSTED UNTIL FINAL INSPECTION DT.IDN HAS BEEN PFRMOTS_ ARE-2.REQUIRED FOR AUL'CONSTRUCTIOK«WORN
q ..,;. ELECTRICAL .PLUMBING ANOf
I.:f OUNDATIONS;OR'FOOTINGS MADE WHERE A CERTIFICATE OF R
OCCUPANCY IS E MECHANICAL INSTALLATIONS',
72.-PPIOR TO R
COVERING TUCTURAL c -
iR OUIR D $UCH BUILO(NG SHALL NOTteE CCUPIED UN.T II
MEMB E'RS(REAOr TO LATH) : ECT
FINAL INSPION HAS BEEN MADE •',, 1 t
S. FINAL IN4PE.CTISN BEFORE
-OCCUPANCY. !:. �#
P.OST`THIS pCARM SO IT_ IS"VISIBLE -FROM STREET -
BUILDING INSPECTION APPROVALSP DUMBING•INSPECT ION APPROVALS ELECTRICAL INSPECTION+ARF ROVALS
,• L
- -POq Rp'!"F HEALTH GAS INSPECTION APPROVALS F OfePT. INSP TING APPROVALS
to-�=F3 D x _ • _
t
OTHER CITY ENGINEER 2 2
WOR" SMALL NOT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION ' INSPECTIONS INDICATED ON THIS CARD-'
., MSPE'P. ]R HAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN.SIX MONTHS OF DATE THE CAN SHE ARRANGBD'FOR BY TELEPHONE,' -'
STAGES OF CONSTRUCTION. PERMIT IS ISSUED A$NOTED ABOVE. OR WRITTEN NOTIFICATION._' - - _
No. 7 City of Salem Ward
A $
X
•
4cusrrt
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, ll, Ill, IV, and IX.
nn
I. A7(LOCATION) P 7 S9/e ST ZONING DISTRICT
LOCATION NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS LOTET)
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING -All applicants complete Parts A -D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION"USE MOST RECENT USE
1 ❑ New building Residential Nonresidential
2 ❑ Addition(I/residential,enter number of new 12 ❑ One family 18 ❑ Amusement,recreational
(rousing units added,it any,in part D,13) 19 E] Chmch,other religious
13 Two or more family-Enter number
3 ❑ Alteration(See 2 above) of units....Z20 E] Industrial
...................................... .
21 E] Parking garage
4 Repair replacement 14 ❑ Transient hotel,motel,or dormitory- 22 E] Service station,repair garage -
Enter number of units ...........................
5 ❑ Wrecking(1/multifamily residential,enter number 23 ❑ Hospital,institutional
o/units in building in Part D, 13) 15 ❑ Garage
24 ❑ Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School,library,other educational
17 ❑ Other-Specify 27 ❑ Stores,mercantile
B.OWNERSHIP 28 ❑ Tanks,towers
8 Private(individual,corporation,nonprofit
29 ❑ Other-Specify
institution,eta)
9 ❑ Public(Federal,State,or local government
C.COST (Omit cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
machine shop,laundry building at hospital,elementary school,secondary school,college,
10. Cost of improvement ........................................... $ •0 uU parochial school,parking garage for department store,rental office building,office building
............. . at industrial plant.If use of existmg. uilding is being changed,enter proposed use.
To be installed but not included
in the above cost
000
a. Electrical........................................................................... —Z
o�U
uuu
c. Heating,air conditioning ...................
d. Other(elevator,etc.).....................................................
11. TOTAL COST OF IMPROVEMENT $ G oo p
III. SELECTED CHARACTERISTICS OF BUILDING •For new buildings and additions, complete Parts E-L;demolition,
complete only Parts J&M, all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ❑ Gas 40 I'dVil Public or private company Will there be central air
31 Wood frame 36 JR Oil 41 C] Private(septic tank,etc.) (��I
conditioning?
32 Structural steel 37 ❑ Electricity 44 ❑ Yes 45 0 No
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
34 ❑ Other-Specify 39 ❑ Other-Specify 42 Public or private company 46 ❑ Yes 47 irovil No
43 ❑ Private(well,cistern)
J.DIMENSIONS /I�� M. DEMOLITION OF STRUCTURES:
48. Number of stories ..........1...........................................
49. Total square feet of floor area, Approval all floors,based on exterior Has oval from Historical Commission been received
dimensions ......................................................................... for any structure over fifty(50)years? Yes_ No
50. Total land area,sq.it....................................................... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed.............................................................................
sz. outdoors............................................................................. HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed............................................................................. Electric:
Gas:
Full..... Sewer:
54. Number of
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
partial BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No—X (If yes, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ No X (If yes, please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No
Is property located in the S.R.A.district? Yes_ No_
Comply with Zoning? Yes—X No_ (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No (If yes,submit documentation/if no,submit Board peal decision)
If new construction, has the proper Routing Slip been enclosed? Yes
Is Architectural Access Board approval required? Yes_ Nov(If yes,submit documentation)
Massachusetts State Contractor License # Salem License #
Home Improvement Contractor # Homeowners Exempt form (if applicable) Yes_ No
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6) MONTHS OF ISSUANCE OF BUILDING PERMIT
If an extension is necessary,please submit
CONSTRUCTION IS TO BE COMPLETED BY: in writing to the Inspector of Buildings.
V. IDENTIFICATION • To be completed by all applicants
Name Mailing address-Number,street,city,and state ZIP Code Tel.No.
Owner or 207
Lessee
2.
Contractor
p f o Builder's
License No.
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building [/
Permit number FOR DEPARTMENT USE ONLY
��yd
Building e Group
Permit issued u r-e • 6 19
Buildin ,, ///� ! Fire Grading
Permit Fee $V � C�z�C� Live Loading
Certificate of Occupancy $ upancy Load
Approved by
Drain Tile $
s
Plan Review Fee $
TLE
NOTES AND Data. (For department use)
PERMIT TO BE MAILED TO: p
DATE MAILED: � 16 0 2
Construction to be started by: V Completed by:
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
SITE OR PLOT PLAN -For Applicant Use
O N
INFORMATION PAGE-AR
54 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY
14z HARTFORD FIRE INSURANCE COMPANY 1.326;'
HARTFORD PLAZAv HARTFORD CONNECTICUT 06111;
POLICY NO: 77 W7. ZCE426 00 Rl-.,NC14Ai .
i . NAMED INSURED AND JAMES DOYLE DBA J DOYL.E a SON
MAILING ADDRESS: BACKHOE SERVICE=
P.O. BOX 7Z7 %
7HK NAMED INSURED IS: ROCKPORTr MA. 01966
INDIVIDUAL
r 3:N Pdr,-,:. c 494000000
oTHF.R WORKPLACES NOT SHOWN ABOVE:
? M_INR(lE DRIVEv ROCKPORTv MA 07466-IZZ:3
POLICY PERIOD: FROM 11-17-92 TO"11 17-43i 1001 .AdM.
STANDARD TIME AT THE INSUREDS MAILING ADDRESS
PRODUCER 'S CODE: 083475
PRODUCER'S NAME: MASS.WORKERS COMP REINS `POOL
CARROLL K STEELE INS AGCY': I'NC
31 BROADWAY PO BOX 4041,.';`+•''�
ROCKPORT a MA. i 01.7446
P=REVIOUS POLICY NO. 09 -WZ` '6F6T5SY
POLICY PROVISIONS FORM NDc 1�W43Q131100i&0711;hGr.n
MUSINFNS OF NAMED INSUREDC EXCAVATION
AUDIT PERIOD: ANNUAL. "611?A; I''" k 61:9,
_- --. ...._- _- __._...._ _ -__----------- --------------•-- -
TOTAL ESTIMATED ANNUAL PREMIUM $3150P
- --
POLICY MINIMUM PREMIUM $500 MA
COUNTERSIGNED BY
AUTHORIZED AGENT
FORM WC 00 00 01 T (PRINTED IN U.S.A.)
(: ONTINUED ON NEXT PAGE
i'1 -1"!. -4'2: 77 WZ ZC54Z6 (11-17-13)
1 PRODUCER PRODUCER PROPIIIJ I
CERTIFICATE OF INSURANCE 08/09/93
T-PR06OLER--- _—__-- —__T- TRIS'-LgRiIFICATE-T5-IggM6-R.5-R-MATTER-OF-IRFOtb4fT WOAC4-WM FES-T
I I NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT ANEND, I
I Gray, Gave & Gave, Inc. I EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I
I Isinglass P1, 13 Railroad Ave I I
I Rockport,MA I COMPANIES AFFORDING COVERAGE I
1 01966- I I
I INSPIRED I COMPANY LETTER A Commercial Union Insurance Co. I
I James Doyle DBA Backhoe Serv. I COMPANY LETTER B I
I P.O. Box 727 1 COMPANY LETTER C I
I RockPort,MA I - --I
101966- I COMM LETTER D I
I I COMPANY LETTER E I
1) COVERAGES (---------__----------�_� �� ___----_-----
1 THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY I
I PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 1
I WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIA THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO I
I ALL TERNS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. 1
I C01 TYPE OF INSURANCE I POLICY NUMBER I POLICY EFF I POLICY EXP I ALL LIMITS IN THOUSANDS I
ILTRI I I DATE I DATE I I
I I GENERAL LIABILITY I I 1 I GENERAL AGGREGATE 1600 1
1 1 1 1 I 1-- —I----I
I AI DO COMMERCIAL GEM LIABILITY I ABR408666 04/24/93 04/24/94 1 PRODS-COMP/OPS M. 1600 1
I I I I i i---------I------I
I I I I I I CUTINS MADE 6{I OC. I I / / I / / I PERS. & ADVS. INJURY1300 I
I I I I OWNER'S & CONTRACTORS 1 I / / I / / I EACH OCCURRENCE 1300 1
1 1 PROTECTIVE 1 I I I —I----I
I I 1 I I I FIRE DAMAGE 1 I
I I I I I I / / I / / I (ANY ONE FIRE) 150 1
1 1
I I I I I I / / I / / I MEDICAL EXPENSE I I
I I I I I I (ANY ONE PERSON) 15 1
I I AUTOMOBILE LIAR I I I I CSL I I
I I I I ANY RUM I I / / I / / I BODILY INJURY I 1
I I I I ALL OWNED AUTOS I I / / I / / I (PER PERSON) I I
I I I I SCHEDULED AUTOS I I / / I / / I---- -I---- --I
I I I I HIRED AUTOS I I / / I / / I BODILY INJURY I I
I I I I NON-OWNED AUTOS I I / / I / / 1 (PER ACCIDENT) I I
I I L I GARAGE LIABILITY I 1 / / I / / I-- -----I-------I
I I [ 7 I I / / I / / I PROPERTY I I
I 1 EXCESS LIABILITY I I I I I EACH OCC I AGGREGATE I
I I I I UMBRELLA FORM I I / / I / / I I I 1
I I I I OTHER THAN UMBRELLA FORM I i / / I / / 1 I I I
I I I I I I STATUTORY I
I I WORKERS' COMP I I / / I / / I EACH ACC I
I I AND I 1 I I DISEASE-POLICY LIMIT I
I I EMPLOYERS' LIAB I I / / I / / I DISEASE-EAC{ EMPLOYED
I I OTHER I I I I I
I DESCRIPTION OF OPERATIONS/LDCATIONS/VEHICLES/SPECIRL ITEMS I
I I
I I
I I
1) CERTIFICATE HOLDER l--=------_-=> CANCELLATION
I = SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- I
I City of Salem = PIRRTION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 1
I = DAYS WRITTEN NOTICE Tb THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT I
I = FAILURE TO PAIL SUCH NOTICE SHALL IME NO OBLIGATION OR LIABILITY OF I
I Sal em,MA = ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I
1 01970- ----------------------------------- -------I
= AUTHORIZED REPRESENTATIVE GRAY,GOVE&GOVE,INC.
1ACORD 25-S (11/85) --- --- -- �� L" `� -- 1
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WilsonJones
FOOM44M RECIPIENT—RETAIN WHITE COPY, RETURN PINK COPY
t 1953 PE NTED«992 3MRi
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1181
SENDER—DETACH AND RETAIN YELLOW COPY. SEND WHITE AND PINK COPIES WITH CARBON INTACT
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F
EASTERN ADJUSTMENT COMPANY, INC.
P.O. Box 446
Brockton, MA 02403
(508) 584-2343
NOTICE OF CASUALTY LOSS TO A BUILDING
Under Mass. Gen. Laws, Ch. 139, Sec. 3B
To: Inspector of Buildings
C/O City Hall
Salem, MA 01970
To: Board of Selectmen
C/O City Hall
Salem, MA 01970
Re: Insuror: Great American
Insured: Osier, Lawrence
Property Address: 27 Salem St., Salem, MA
File Number: E 18255
Claim Number: 506-50041
As representatives of the above captioned Insurance Company,we hereby notify you,in behalf
of said Insurance Company, that claim has been made involving loss, damage, or destruction
of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen.
Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws. Chapter
139, Section 3B is appropriate, please direct it to the attention of the writer and include a
reference to the captioned Insured, location, policy number, date of loss and file or claim
number.
Richard L. Cornetta
Adjuster
On this date I caused copies of this notice to be sent to the persons named above, at the
addresses indicated above, by first class mail.
Patricia Brown Date August 31. 1993