68 SUMMER STREET - BUILDING INSPECTION 68 Serer
�) 17
s�
a�
68 Summer Street
North Elevation
. . .��.
68 Summer sle
North Elevation
� CQMMQIYWEAZ.TH OF MASSACHUS£ZTS
e� DEMIM, ENT OF INDUSTRUL ACCIDENTS
^� _ > 640 WASHINGTON STREET
amen a-ooe,: BOSTON. MASSACHUSETTS 02111
WORKERS' COMPENSATION INSURANCE AFFIDAVIT
Zalzrz�e ZD/�e�k
�I tCCA3Kt OCrr[SIR[[)
wieh�a�nnncipai place of businessiresidence at
(Cary/StararZio)
do hereby cernry, under the pains and penalties of perjury, that:
j i am an cmpiover providing the following workers compensation coverage for my employees working on this
+00.
Insurance Company Policy Number
�m a soleproricror and have no one working tar me.
( j I am a sole proprietor. general contactor or homeowner(circle one) and have hired the contactors lisped bolo
who have the following work�erss' compo/ruarion insurance polici=
Name of Conrn or Insurance CompanyiPolicy Number
<ame or Contractor Insurance CompanyiPoliev Number
Name of Contactor In=mn=Company/Policy Number
[j lama homeowner performing aU rhe work myself.
NOTE Plesm be aware that while homeowners woo tmpioy persons to do maintenance.construction or repair work on s
awei(ine of not more than torte units to Which the homeowner Liao resters or on tot groumis sopurtenaot thereto are not gensraily
consrdereo to be emtsioyen under the WeritertComptusstron Act(GL G 152.tees 1(5)),appiiutson by a homtarwear for a iicta
or permit may ev,dence toe legal aunts of an empsoverunasr the Workers' Comtxnsation Acs
unoerstma that a copy of this statement will be forwarded to the Dcoarmtent of Inciustrisi Accioend Office of insurance for coverts
+rnnuuon rano coat faiiurc to secure coverage as reoutreo unary Secuon 15A of MGL 152 can xad to the imposition of criminal vena
-onstsnnt of a fine of uv to$1500.00 anoior imprisonment of uv to one vew and civil oensitia to the form of a Stoo Work Order an
inc or S 100.00 a Lav against mc. q
Signed _ W to day or 19 5 -_
:i sect t'crmttree 'LiCeSS vPermsrtor
No. City of Salem Ward
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all itemX.
AT(LOCATION) r S
is in sections:1, It, 111, IV, and I
l
S U VN rn ` ZONING
I. DISTRICT
LOCATION ("o.) (SIREET) t ' ` t ,
OF BETWEEN S V FVV✓V�{r S-`-, AND W t h`T \y_0 P
BUILDING (CROWSTREET) tCROW LSTR OT TI
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(It residential,enter number of new 12 ❑ One family 18 ❑ Amusement,recreational
housing units added,it any,in part D,13) 19 E] Chruch,other religious
13 � Two or more family-Enter number
3 Alteration(See 2 above) of units .................. 20 ❑ Industrial
21 ❑ Parking garage
4 ❑ Repair replacement 14 ❑ Transient hotel,motel,or dormitory- 22 ❑ Service station,repair garage
Enter number of units ...........................
5 ❑ Wrecking(It multifamily residential,enter number ❑ 23 ❑ Hospital,institutional
of units in building in Part D,13) 15 Garage
24 ❑ Office,Dank,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
institution,etc.) 29 ❑ Other-Specify
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,
�l
parochial school,parking garage for department store,rental office building,office building
10. Cost of improvement ......................................................... $ oU U at industrial plant.If use of existing building is being changed,enter proposed use.
To be installed but not included
in the above cost
aElectrical...........................................................................
b. Plumbing..........................................................................
c. Heating,air conditioning.............................................
d. Other(elevator,etc.).....................................................
U,
11. TOTAL COST OF IMPROVEMENT $ GG
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) 351B Gas 40 ® Public or private company Will there be central air
31 ® Wood frame 36 ❑ Oil 41 ❑ Private(septic tank etc.) conditioning?
32 ❑ Stmctuml steel 37 ❑ Electricity 44 ❑ Yes 45 [yNo
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator7
34 ❑ Other-Specify 39 ❑ Other-Specify 42 0 Public or private company
46 ❑ Yes 47 No
43 ❑ Private(well,cistern)
' . J.DIMENSIONS 3 M. DEMOLITION OF STRUCTURES:
48. Number of stories ............................................................
as. rola) feet f floor
all floors, Has Approval from Historical Commission been received
ors,babased onexterior
dimensions ......._................................................................ for any structure over fifty(50)years? Yes_ No_
50. Total land area,sq.ft. ............................. Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed .....................-..........I.................................
.........
�j
52. 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_ Nom (If yes, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ No (If yes,please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No X
Is property located in the S.R.A. district? Yes_ Nou
Comply with Zoning? Yes-)L No (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes-)L No (If yes,submit documentation/if no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ Nb_ /U q
Is Architectural Access Board approval required? Yes_ No X (If yes,submit documentation)
Massachusetts State Contractor License # Salem License # 3 3
Home Improvement Contractor# Homeowners Exempt form (if applicable) Yes_ No-K
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: Ll') in writing to the Inspector of Buildings.
V. IDENTIFICATION • To be completed by all applicants
Nattm��e Mailing address-Number,street,city,and state ZIP Code Tel.No.
1. KAlr, Ut0. r Sv rS+ SeL(km {11A- C44-40D(9lo SO�-
Owner or ' l
Lessee l
z �crl 'r`s 2 O 1^e c� le
Contractor
Builder's 3 2
License No. J
3.
ArchNect 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 pylic t /fls_ Address �7tS C '� Application date
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number C1 a Use Group
Building /l� r/
Permit Issued ' ! b �g Fire Grading
Building �1JJ ° / Live Loading
Permit Fee $ (�
Occupancy Load
Certificate of Occupancy $ Approved by:
Drain Tile $
Plan Review Fee $
TITLE
NOTES AND Data• (For department use)
kkvy\.cv'i✓\ Lu t atiJ fi ut5�aJ o
► r~
-e5 5, Also lr�,Lj Iiq S 1,
S atr (0.S2 QS .0.r1S O -erf 5
SAL
5 �
MA-
PERMIT TO BE MAILED T0:
DATE MAILED:
Construction to be started by: 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
oN
(�ONU1t� 1.
a� }, CERTIFICATE ISSUED
DATE November 24, 1993
CITY OF
9 SALEM. MASS SALEM 01970 BUILDING. PERMIT -
CERTIFICATE OF OCCUPANCY
DATE November 16 19 93 PERMIT NO. 5IJ6-93
APPLICANT `.oring 11-lackey ADDRESS 7 Forest Ave. Salem,Mass. 3333
(ND.) (STREETI (CONTA'S.LICENSE
PERMIT 70 dlt•erations I_) STORY DwellinE
NUMBER OF-
ILPE Of INPROVEMENTI 'N0. )PROPOSED USE)- DWELLING UNITS 2
AT (LOCATION) 68 Summer Street WArd ZONING
DISTRICT 1��2
(N0.1 ISTAEETI
BETWEEN 5uu-mer' St_ AND wint irnp St.
. - IfR04S STREET) ICROSS STREET)
SIIBOIVISION" LOT BLOCK ¢ 'S T 1
BUILDING IS TO BE FT. WIDE)P.,' FT. LONG BY ?FTaN HE[GNT AND SRAUL''.CONFORM 4N CONSTRUCTION'
TO TYPE USE GROUP ! BASEMENT WALLS OR FOUNDATION {
REMARKS.. 'itiLG::L2 J.InC�W T 138`811 `Inn - ,' -,,U,,Oncj p,,q of egrasah-z ^t^ jpirnl faircasp
AREA OR Ila. Weswas
VOLUME
C'iBIC SOUL AE;FEET, 131 a
1 .
pn1 Of71pf11 pATpf110'Elp!„b!!tIbCF1pC/\pf�l"._Ipf.TlblAplTlp�Ilp
OWNER Hal- S rianne idll_er
pA
. -
F 1 r' - SEE REt"AE SIDE f IJQ 01
NjJONS PREMISES
CERTIFICATE
ADDRESS IJ �Jr�,er SLrea.t Ja1eP. 1a89.. . �1
Y, T_DEPARTMENTA 'APPRPV L FOR CERTIRICATE =,
4 of 000'U)IANCY'anh tOMALIANCE
To be tilled in by each division indicated hereon i
t,UJ V 4 completinnof its ; 4al I inspection.
O."BUILDINGS ! Permit No. 508-93
E �
Approved by Leo E1' Tremblay! Date 11/23/93'
Remarks { 1 I
j PLUMBING _ f Permit No.
Appioved by; I Date
Remarks
^ I �
ELECTRICAL' Pejmit No. `
APProved by 1 1 Date .,
j Remarks i F
� � i � •:fit
I I J I
OTHER' Perm
Permit Na
a ` APProved by 'II Date
. Remarks '
OTHER ! Permit No.
jApprond by' 1 i + Date !
i I
Remarks 1 i i
BUILDING
PERMIT
JOB WEATHER CARD
DATE �i4'• . t,s Til 19 } PERMIT NO.
APPLICANT ADDRESS
1`40.1 (STREET) MONTR'S LICENSE!
:iib 1.`a:'i, 1.tCi NUMBER OF
PERMIT TO ) STORY DWELLING UNITS
(TYPE OF IMPROVEMENtI N0. (PROPOSED USEf
..::¢.i" C2i .ab._G ZONING
AT (LOCATIONI DISTRICT
{NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET) -
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP 'I BASEMENT WALLS OR FOUNDATION
ITYPEJ
REMARKS: ' f.d I door :1- ..0!';61:30 "':F:_la,t .YVlf REA OR
'3 f ,j. ��i n
!!j ,oI i 4Ix (fi
Ilt. i to t ccu py
yy.. PERMIT
V {OLUME ESTIMATED COST O I "� FEF S
:CaO(C/SQUARE FEET)
OWNER Y.ir tI j
I � BUILDING.DEPT
ADDRESS rf.r „ L.R. BY :d91.
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY. NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE. MUST BE.AP-
-
PROVED BY THE JURISDICTION, STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY LH-a aT na..c o'
FROM THE DEPARTMENT OF PUBLIC WORKS, THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
S.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED F.O R CARD KEPT POSTED UNTIL FINALINSPECTION HAS BEEN PFRMITS ARE REQUIRED FOR
All CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
1, FOUNDATIONS OR fOOT5NG5. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE. MECHANICAL INSTALLATIONS.
Z. PRIOR TO COVERING STRUCTURAL OUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERSIREADY TO LATH(. FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET s.
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS f
A)14
2 z z
86ARD OF HEALTH GAS IN PECTION APPROVALS FIRE DEPT,INSPECTING APPROVALS -
1 1
H
OTHER CITY ENGINEER 2 2
i
RORK SHALL NOT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD
INSPECTOR HAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN ARRANGED FOR BY TELEPHONE
OR WRRITTEN NOTIFICATION. j
srAG£s of coNSTRucrtoR• PERMIT 15 ISSUED AS NOTED ABOVE.
FIELD COPY
~ CITY OF SALEM BUILDING
,a
s
SALEM. MASSACHUSETTS 01970 PERMIT
4COONE
t�
DATE November 16 IB 93 PERMIT NO.
APPLICANT Loring Mackey ADDRESS 7 Foresr. Ave. 13K]em.Mass_ 3331. _
INO.) (STREET) '(CORTN'S LICENSE)
Alterations NUMBER OF
PERMIT TO iI_I STORY TITTdP. TTI!% DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
6$ Summer Street Ward 3 ZONING N-7
AT (LOCATION) _ DISTRICT
(N0.) (STREET)
BETWEEN Suw!.tr St., AND Fiin�T�n. C+
(CROSS STREET) ACROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIEE
BUILDING IS TO BE FT, WIDE R+ FT. LONG BYFT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: P.,,n ,, .an -r-•i ' A•Tm- Jnr eA T^^^T•^ of 'r^^/r._,,.,. IT
CallforPermit to CCCupy
VOLUME ESTIMATED COST bf V(n PERFEEMIT S
ICUBIC SOUARE FEET)
OWNER Hal h Oiannr •4'11pr .
ADDRESS Al c4r, mor CCr-.r e:,l
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR