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21 VICTORY ROAD - BUILDING INSPECTION oil VrC a�� .�o�..� MORTGAGE INSPECTION BAY STATE SURVEYING ASSOCIATES INC. JOB #,IS-Cf 100 CUMMINGS CENTER, SUITE#316J, BEVERLY,MA., 01915 I LOCATION : G ........M�1............... NOTES: 1)This is a mortgage inspection survey and not an SCALE : 1" = I �j—Z'/0 instrument survey,therefore this plot plan is for 3� DATE :................................. mortgage inspection purposes only.It is NOT to .BKS Z3�gg be used to establish boundaries or for the REFERENCE : .......9 I construction of any type of improvements. '�" ..�G"" " " •••••• • 2)This survey is based on survey marks of others. •��+ rX... .� p•,M1DL ) T.1T 3)Bushes,shrubs,fences and tree lines do not } EGI S1Y QF v � necessarily indicate property lines. 4)Whenever an offset is V+_or less,an instrument TO:,J.1!: LK T..... I n�Gl•{ survey is recommended to determine property The location of the buildings)as shown,either lines,and any possible encroachments. compiled with the local zoning setbacks at the time.of 5)Offsets shown are approximate,and are to be construction or is exempt from violation enforcement used-only-for the determination of zoning,Not to action under Mass.G.L Title VII Chapter 40A Section 7 b 6)Ine used to establish property lines, y professional opinion the building(s)are not located in the special flood hazard zone,as defined by H.U.D.MAP# -SDI�Z x 01 o t / cn Z 00 3�j r IF THE SURVEYOR'S SEAL IS NOT EMBOSSED.THE PLAN IS A COPY �� ���� THAT SHOULD ATIONC ASSUMED CONTAINED E CONTAIN UNAUTHORIZED ALTERATIONS. THE CERTIFICATION CONTAINED ON THIS DOCUMENT SHALL NOT APPLY TO COPIES. A CITY OF SALEM9 MASSACHUSETTS DEPARTMENT OF PUBLIC SERVICES z 120 WASHINGTON STREET, 4TH FLOOR y p' SALEM, MASSACHUSETTS 01970 BRUCE D. THIBODEAU, P.E. DIRECTOR OF PUBLIC SERVICES/CITY ENGINEER STANLEY J. USOVICZ, JR. TEL: 978-745-9595 EXT. 321 MAYOR FAX: 978-745-0349 MMOf D M To: Tom St .Pierrr From: Linda White Date: June 10, 2004 Re: 21 Victory Rd. Joe asked me to forward the enclosed to you. Please put in your file for 21 Victory Rd. (Double D Const.) Thank you. �.� CITY OF SALEM9 MASSACHUSETTS DEPARTMENT OF PUBLIC SERVICES 120 WASHINGTON STREET, 4TH FLOOR O' SALEM, MASSACHUSETTS 01970 BRUCE D. THIBODEAU, P.E. DIRECTOR OF PUBLIC SERVICES/CITY ENGINEER STANLEY J. USOVICZ, JR. TEL: 978-745-9595 EXT. 321 MAYOR FAX: 978-745-0349 .lune I, 2004 Mr. Douglas Dubin Double-D Construction 126 Eastman Avenue Swampscott, MA 01907 Tel. No. 781.598.88 10 Cell No. 781.844.8758 Re: Unfinished &Noncompliant Site Work at 21 Victory Road Dear Mr. Dubin: This letter is a follow-up to our meeting with you on November 26, 2003 regarding the uncompleted work associated with your construction of a single-family home at 21 Victory Road. Present at that meeting Tom St. Pierre, City Building Inspector, Bruce Thibodeau, City Engineer & Director of Public Services, Joe Nerden, Assistant City Engineer & Assistant Director DPW and Douglas Dubin, Builder. The purpose of the meeting was to discuss a resolution of Double-D Construction's unfinished site work associated extending the paved roadway in order to access and build the house at 21 Victory Road. Also discussed were issues regarding Double-D's construction impacts to the abutting property owners with single-family homes. Currently, the roadway surface, sidewalks and the adjacent rock/earthen embankment are unfinished. The approved site plan included all water, sewer, road, sidewalk and site grading to be completed as part of Double-D's project to build the new single family home at 21 Victory Road. Because you have known of these issues for some time now, we are forced to take another step in bringing Double-D's project into compliance. The following issues must be addressed and resolved, to the satisfaction of the City, by July 15, 2004 or further legal action will be taken. 1. The rubble rock embankment at the edge of the road must be reworked and moved back to provide for a buffer between the edge of road pavement and the base of the wall. The wall must also be constructed to be structurally sound and maintainable by abutting 1'A,INciAe,A3I A'iciort Hd Oouhlc U Cones 01 I JIW.Aoc i' June 1, 2004 Mr. Douglas Dubin Page 2 of 2 property owners for aesthetic reasons e.g. cutting vegetation, preventing soil erosion, etc. Currently there are unsightly weeds, soil erosion and unstable rocks. The wall as constructed is unsafe, as rocks have been dislodged and fallen since its construction by Double-D. This is of particular concern as there are young children living at this end of the street. If an appropriate gravity wall is not possible than a more structurally sound wall, built by a mason with mortar may be needed. 2. Asphalt berms are to be installed to define the edges of the roadway on both sides. 3. Final top course paving is needed, both on the sidewalk and roadway. The final paving is to be installed so that it blends smoothly with the existing roadway limits and addressed suitable driveway access for all property owners adjacent to the site. The final pavement must be at least 1.5 inches thick in all locations. Final pavement grades are to be such that stormwater runoff will not puddle. 4. Loam, grass seed and maintain impacted yards of abutting property owners and the plan mow-strip between the roadway and sidewalk, until such time as a sufficient grass has taken root to thrive. 5. Resolve all impacts to the property at 20 Victory Road caused by Double-D Construction during construction: a. The driveway for 20 Victory Road as well as the retaining wall issue must be made accessible and safe. b. Replace or repair to the homeowner's satisfaction the four punctures to the exterior vinyl siding caused by breaking up the roadway rock bed. c. Repair or replace to the homeowner's satisfaction dents to the front door also caused by rock removal. d. Repair or replace five window screens, to the homeowner's satisfaction, also caused during rock removal. Please contact us immediately should you have any questions regarding this directive. Regardless of any questions, the deadline above must be met. \ VA uly yours, Nerdei� Thomas St. Pierre nt City Engineer Acting Building Commissioner stant Director DPW "Zoning officer 1 w�m�y Rd u�„�ni�o c�,�i of uoa ao� J 1 CITY OF SALEM n + DEPARTMENT OF PUBLIC SERVICES ' 120 Washington St.,4th Floor 04 Salem, MA 019701;t-.' • r9• r1 ' r o.. 0 h44,SF�C��S F�tf til A g ME ERPOSTAGE t o to/?�,��D � i r ', y _ .� _ � L6ertificate No: 60-2003 Building Permit No.: 60-2003 r Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at -- - . - ........ . . - - Dwelling Type 0021 VICTORY ROAD in the CITY OF SALEM Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY SINGLE FAMILY HOME This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires unless sooner suspended or revoked. -------------------------------------------- Expiration Date Issued On: Thu Mar 6, 2003 - ------------------------------ GeoTMS®2003 Des Lauriers Municipal Solutions,Inc. ...----..... -------- - - - --- -- -- ---- - --- -- -- Certificate No: 60-2003 Building Permit No.: 60-2003 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0021 VICTORY ROAD in the CITY OF SALEM - - - --------------- - --.._......... -.. . ------ - - - Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY SINGLE FAMILY HOME This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires unless sooner suspended or revoked. Expiration Date ------------ ............ Issued On: Thu Mar 6, 2003 .... ------------------ --- - - GeoTMS®2003 Des Launers Municipal Solutions,Inc. ---------------- - ---------- ------- -- --------- -- ----- - - 0021 VICTORY ROAD 60-2003 ills#: 16316 COMMONWEALTH OF MASSACHUSETTS Map: 42 Block: CITY OF SALEM Lot: 0066 Permit: Building Category: 101 Nein single famil BUILDING PERMIT Permit# 60-2003 Project If JS-2003-0071 Est. Cost: $150,000.00 Fee: $905.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Use Group: Double D Construction General Contractor-Salem#1383 LotSize(sq.ft.): 10234 Owner: HOMEOWNER Zoning: RI Applicant: HOMEOWNER Units Gained: —SAT: 0021 VICTORY ROAD Units Lost: ISSUED ON: 25-Jul-2002 AMMENDED ON: EXPIRES ON. 17-Jan-2003 TO PERFORM THE FOLLOWING WORK. 60-2003 CONSTRUCT NEW SINGLE FAMILY HOME. TSP POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Buildin Underground: Underground: Underground: Excavation: Service: Meter: Footings: Rough: Foundation: Final:/Q� � ���' Rough Frame: Fireplace/Chimney: D.P.W. Fire Health Insulation: Meter%/7&);1 J 7O/_/ Oil:KJ C/ Final• House# � Smoke: Treasury: Water: Alarm: Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPRJ- VTION OF ANY QF ITS RULES AND REGULATIONS. (/ Signature: d Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2003-000083 17-Jul-02 13343 $905.00 GeoTMS®2002 Des Lauriers Municipal Solutions,Inc. 0021 VICTORY ROA_ D 60-2003 GI-Q#: 6316 COMMONWEALTH OF MASSACHUSETTS Map: 42 Block: CITY OF SALEM Lot: 0066 Pernat: Building Category: 101 New Single falnilBUILDING PERMIT ermit# 60-2003 Project# JS-2003-0071 „ Est. Cost: $150,000.00 Fee ; � $905.00 ,., PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Double D Construction General Contractor-Salem#1383 Lot Size(sq.ft.): 10234 =' 's Owner: HOMEOWNER Zoning: RL, Applicant: HOMEOWNER Units Gained: _ Units Lost: AT: 0021 VICTORY ROAD t ISSUED ON: 25-Jul-2002 AMMENDED ON: EXPIRES ON: 17-Jan-2003 TO PERFORM THE FOLLOWING WORK: 60-2003 CONSTRUCT NEW SINGLE FAMILY HOME. TSP POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing - Buildin Underground: Underground: Underground: Excavation: Service: Meter: _ Footings: Rough: Foundation: Qk� Gam. Final: 3/Q2,,/�/ yq • Rough Frame: M0/11V ®` Fireplace/Chimney: D.P.W. Fire 1Health 1 Insulation: Meter: On: `f 0� 1 G1/ // '�a�I Final: 0P � 3/ 3/ted IIause# Smoke: ✓ '""'���/// Treasury: Water: Alarm:eq Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UP�6R VIOLATION OF ANY QF ITS RULES AND REGULATIONS. lV,J y Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2003-000083 17-Jul-02 13343 $905.00 GeoTMS®2002 Des Lauriers Municipal Solutions,Inc. e f YSeve AO CITY OF SALEM BUILDING PERMIT Proposal ATLANTIC PAVING, INC. 61 R Jefferson Ave. SALEM, MA 01970 No 4111111111111111111 6.--AM* E-Mail: atlpaving@gis.net TEL (978)-745-2890 FAX (978)-745-2200 PROPOSAL SUBMITTED TO PHONE DATE Double D Construction 781-740-9979 3/6/03 STREET JOB NAME 21 Elm P1. CITY,STATE and ZIP CODE JOB LOCATION Swampscott, MA 01907 ARCHITECT DATE OF PLANS Att: Doug JOB PHONE We hereby submit specifications and estimates for: 1. .Inst?1l 1 1/2" finish course over existing bindered road, drivevray, and, sidewalk(approx 620 yds.)._ ---- ---- - --- - - ------------------ ----------' Cost: $3575.00 I Install 1-1/2"-finish course over-old_pavement and trench (approx 360-yds). Cost: $1300.00 - ----------- -------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------- * Cleanlevel, and repair existing binder: $800.00 * Widen road for berm? $5.00 per foot ? * Berm $5.00 per foot ? * Replace water gate. $100.00 * Raise 2 sewer covers. $400.00 ------------------------------------------------------------------------- * Concern of grade at house with garage under. -------------------------------------------------------------------- * Not responsible for 100% water drainage for-job with less than 2% pitch. We Propose hereby to furnish material and labor complete in accordance with above specifications, for the sum of: Payment to be made as follows: Upon completion. Interest of 1 1/2% will be charged monthly after 30 days on all unpaid balances. Ail material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to Standard practices.Any alteration or deviation from above specifications Authorized j involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be 30 Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days. Acceptance of Proposal The above prices,specifications and Conditions are satisfactory atisfactoanda he by accepted.You are authorized Signat re _ to do the work as specifierryay ent be made as outlined above. Date of Acceptance O 7 Signature A APPLICATION .X ADULT NUMBER Trial Court of Massachusetts FOR COMPLAINT ❑ JUVENILE District Court Department ❑ ARREST Ex HEARING ❑ SUMMONS ❑ WARRANT COURT DIVISION The within named.complainant requests that a complaiht issue against the within Salem Dwell Court:: named named defendant;-charging said defendant with the offense(s) listed below. DATE OF APPLICATION DATE OF OFFENSE PLACE OF OFFENSE ,t 6-tAfaishtngton Street e: Salem. MA.6tg74 . NA E OF COMPLAINANT ' a NO. OFFENSE G L. Ch. and Sec LIEfit' y ADORES' AND ZIP CODE OF COMPLAINANT 2. NAME,ADDRESS AND ZIP CODE OF DEFENDANT 3 ------------ COURT USE A hearing upon this complaint applic Ion DATE OF HEARING TIMEOF HEARING COVT USE ONLY—* will be held at the above court addre on - G AT 00 hw NLY CASE PARTI LARS — BE SPECIFIC NAME OF VICTIM DESCRIPTION OF PROPERT VALUE OR PROPERTY TYPE OFD NO, Owner of property, Goods stolen,what ,. Over or under SUB NCE OR WEA N person assaulted,etc. destroyed,etc. $250. r} Nana, c. c 0 rJ _ 3 p CJS OTHER REMARKS: / rrn if(n ��3 lD6 740 h e� O f X SIGNATURE OF CO LAINANT DEFENDANT IDENTIFICATION INFORMATION — Complete data below if known. DATE OF BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER SEX RACE HEIGHT WEIGHT EVES HAIR CCU ATI EMPLOYER/SCHOOL MOTHER'S NAME(MAIDEN) FATHER'S NAME T/. K DC-CR2(3/88) Imo\ APPLICATION ❑ ADULT NUMBER Trial Court of Massachusetts FOR COMPLAINT ❑ JUVENILE c District Court Department ❑ ARREST HEARING ❑. SUM NS WA COURT DIVISION The within named complainant requests that a complaint issue against the in ' SEfem015*J1Ct.t'i4ttft. named defendant, charging said defendant with the offense(s)listed below. DATE OF APPLICATION DATE OF OFFENSE PLACE OF OFFENSE y� 65 Wasi%ington Street Salem. MA_07570 NAME OF COMPLAINANT NO. OFFENSE G.L. Ch. and Sec ADDRESS AND ZIP CODE OF COMPLAINANTF ? C zTr ,nom AlAt? rG170 00. /t NAME, DDRESS AND ZIP D OF DEFENDANT 2 �., _ _ 3. 4. COURT USE A hearing upon this complaint application DATE OFHE_ARING TIMEOF HEARING COURT USE ONLY will be held at the above court address ony AT .' � E}7 ONLY CASE PARTICULARS'— BE SPECIFIC; �-t'' NAME OF VICTIM QESCRIPTION OF PROPERTY VALUE OR PROPERTY OF TROLLED NO. Owner of property, Goods stolen,what 4Over or under SCt !$TANC,&QR WEAPON person assaulted,etc. ,� desttbyed,etc. 1, $250.' arijua un,etc. 4p. hJ 3 a OTHER REMARKS: D�+ nG�GIle7�� r tit R x t//�° '��L/p y/ /P/ T't SIGNATURE OF COMPLAINANT DEFENDAN IDENTIFICATION INFORMATION — Complete data below if known. DA7_ OF BIR H PLACEOFBIRTH SOCIAL SECURITY NUMBER SEX RACE HEIGHT WEIGHT EYES HAIR aOF � . OCdUPATt0NP EMPLOYER/SCHOOL SNAME(MAIDEN) FATHER'SNAME r y hn �C DC-CR2(3/88) Certificate No: 60-2003 Building Permit No.: 60-2003 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at ---------------------------------------------------- Dwelling Type 0021 VICTORY ROAD in the CITY OF SALEM ----------------------------------------- ......--------- - - - Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY SINGLE FAMILY HOME. NOTE: 06/25/2003 Ltr to Doug Dubin REVOKES occupancy permit #60-2003 (State Bldg Code 780 CMR, Section This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires Wednesday Jun 25, 2003 unless sooner suspended or revoked. -------------------------------------------- Expiration Date Issued On: Thu Mar 6, 2003 - GeoTMS®2003 Des Launers Municipal Solutions,Inc. ' '- "-""""""""""'-""""""'-.—.... '---'-----'------------ Certificate No: 60-2003 Building Permit No.: 60-2003 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at ......--...... ...--_...... - - -- Dwelling Type 0021 VICTORY ROAD in the CITY OF SALEM ................------------.._...-.. --- - - - - - - - - Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY SINGLE FAMILY HOME. NOTE: 06/25/2003 Ltr to Doug Dubin REVOKES occupancy petmtt�#60-2003 (State Bldg Code 780 CMR, Section This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires Wednesday Jun 25, 2003 unless sooner suspended or revoked. Expiration Date Issued On: Thu Mar 6, 2003 --------- -- -- - - - -------------------- GeoTMS®2003 Des Lauders Municipal Solutions,Inc. - - -- ----- -- --- ---- - - --- -- -- ----- ------------ .�o CITY OF SALEM MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR s' IAsq SALEM, MAO1970 TEL. (978)745-9595 EXT. 380 ' s FAX (978) 740-9846 STANLEY J. USOVICZ, JR.' MAYOR June 25, 2003 Cop* Doug Dubin 126 Eastman Avenue Swampscott, Ma. 01907 RE: 21 Victory Road Dear Mr. Dubin: Please be advised,the Occupancy permit issued on building permit#60-2003 has been revoked. You have failed to comply with the plans and specifications submitted to the City of Salem Engineering Department. Your occupancy permit will not be reinstated until all requirements of the Engineering Department have been met. State Building Code 780 CMR, Section 120.1 and 113.3 and 113.4 Sincerely, Thomas St.Pierre Acting Building Commissioner cc: Mayors Office Bruce Thibodeau Joe Nerden Bill Merrill r r` CITY OF SALEM9 MASSACHUSETTS DEPARTMENT OF PUBLIC SERVICES z 120 WASHINGTON STREET, 4TH FLOOR S SALEM, MASSACHUSETTS 01970 BRUCE D. THIBODEAU, P.E. DIRECTOR OF PUBLIC SERVICES/CITY ENGINEER STANLEY J. USOVICZ, JR. TEL: 978-745-9595 EXT. 321 MAYOR FAX: 978-745-0349 June 1, 2004 Mr. Douglas Dubin Double-D Construction 126 Eastman Avenue Swampscott, MA 01907 Tel. No. 781.598.8810 Cell No. 781.844.8758 Re: Unfinished& Noncompliant Site Work at 21 Victory Road Dear Mr. Dubin: This letter is a follow-up to our meeting with you on November 26, 2003 regarding the uncompleted work associated with your construction of a single-family home at 21 Victory Road. Present at that meeting Tom St. Pierre, City Building Inspector, Bruce Thibodeau, City Engineer & Director of Public Services, Joe Nerden, Assistant City Engineer & Assistant Director DPW and Douglas Dubin, Builder. The purpose of the meeting was to discuss a resolution of Double-D Construction's unfinished site work associated extending the paved roadway in order to access and build the house at 21 Victory Road. Also discussed were issues regarding Double-D's construction impacts to the abutting property owners with single-family homes. Currently, the roadway surface, sidewalks and the adjacent rock/earthen embankment are unfinished. The approved site plan included all water, sewer, road, sidewalk and site grading to be completed as part of Double-D's project to build the new single family home at 21 Victory Road. Because you have known of these issues for some time now, we are forced to take another step in bringing Double-D's project into compliance. The following issues must be addressed and resolved, to the satisfaction of the City, by July 15, 2004 or further legal action will be taken. 1. The rubble rock embankment at the edge of the road must be reworked and moved back to provide for a buffer between the edge of road pavement and the base of the wall. The wall must also be constructed to be structurally sound and maintainable by abutting I UNcodenel wnory RAooumcDConsi OII;OJ.doc June 1, 2004 Mr. Douglas Dubin Page 2 of 2 property owners for aesthetic reasons e.g. cutting vegetation, preventing soil erosion, etc. Currently there are unsightly weeds, soil erosion and unstable rocks. The wall as constructed is unsafe, as rocks have been dislodged and fallen since its construction by Double-D. This is of particular concern as there are young children living at this end of the street. If an appropriate gravity wall is not possible than a more structurally sound wall, built by a mason with mortar may be needed. 2. Asphalt berms are to be installed to define the edges of the roadway on both sides. 3. Final top course paving is needed, both on the sidewalk and roadway. The final paving is to be installed so that it blends smoothly with the existing roadway limits and addressed suitable driveway access for all property owners adjacent to the site. The final pavement must be at least 1.5 inches thick in all locations. Final pavemeht grades are to be such that stormwater runoff will not puddle. 4. Loam, grass seed and maintain impacted yards of abutting property owners and the plan mow-strip between the roadway and sidewalk, until such time as a sufficient grass has taken root to thrive. 5. Resolve all impacts to the property at 20 Victory Road caused by Double-D Construction during construction: a. The driveway for 20 Victory Road as well as the retaining wall issue must be made accessible and safe. b. Replace or repair to the homeowner's satisfaction the four punctures to the exterior vinyl siding caused by breaking up the roadway rock bed. c. Repair or replace to the homeowner's satisfaction dents to the front door also caused by rock removal. d. Repair or replace five window screens, to the homeowner's satisfaction, also caused during rock removal. Please contact us immediately should you have any questions regarding this directive. Regardless of any questions, the deadline above must be met. \ VAg ulrs, e Thomas St. Pierre Engineer Acting Building Commissioner irector DPW Zoning officer auble U Const 01 004.d« i i i CITY OF SALIBM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT a 120 WASHINGTON STREET, 3RD FLOOR SALEM, MA 01970 _ p.l TEL. (978)745-9595 EXT, 360 FAX (978) 740-9846 STANLEY J. USOVICZ, JR. MAYOR I June 25, 2003 Copy I Doug Dubin 126 Eastman Avenue Swampscott, Ma. 01907 RE: 21 Victory Road Dear Mr. Dubin: i . Please be advised, the Occupancy permit issued on building permit#60-2003 has been revoked. You have failed to comply with the plans and specifications submitted to the City of Salem Engineering Department. Your occupancy permit will not be reinstated until all requirements of the Engineering j Department have been met. State Building Code 780 CMR, Section 120.1 and 113.3 and 113.4 Sincerely, Thomas St.Pierre Acting Building Commissioner cc: Mayors Office Bruce Thibodeau Joe Nerden Bill Merrill 0 i I Commonwealth of Massachusetts Board of Building Regulations and Standards Manufactured Buildings Program LABEL REQUEST FORM This Section for State Use Only Date Received 20/0-x I Label Numbers Issued: Fee Received $ 26o.00 (_p 8((p 8 (pa, Check Number Date Issued: Issued by: This Section to be Completed bv Manufacturer . PLEASE PRINT OR TWE SECTION 1 -MANUFACTURER INFORMATION BBRS\DPS I.D. # /V5,30 Manufacturer Name PEX pdY1 ES MC # rj Street 2/4 -1 Us bl wY 5 2z N City/State/Zip InlQuEtSULG , A bT Z Manufacturer Telephone Number: (570) 837-A 33 lFax Number: (57p) $E5 7 & Manufacturer-Plant Inspector . jp qD E iZ lC N6155lL S a2P0 t Third Party Agency ' TPIA# Number of Labels 1( Total Amount Attached $ 2—oc).c5D Manufacturer's Serial Manufacturer's Model (Do- to 379 Number53Designation NIQ C SECTION 2- LOCATION OF BUILDING Street City/State/Zip S-qt ". ..= . -C)(- - (7- SECTION 3 - BUILDER/DEALER/CERTIFIED INSTALLER INFORMATION Builder/Dealer LAND 1-tome 8uruneRS `/o S6- Street t?�:eAu+ -mob• Ural -1-11> City/State/Zip 12E,�t M1+ oZt s� Certified Installer Rte uT Licensed Construction License Number: C S 0 2 1022 Supervisor �aL S'. boMuRA Expiration Date: 9/1 /03 This form shall be completed by the manufacturer when requesting manufactured building labels. All information shall be clearly indicated. Incomplete forms will be returned to the manufacturer unprocessed. This request shall be forwarded to the State Board of Building Regulations and Standards-CERC Building, Paul A. Dever School-1380 Bay Street,Taunton,MA 02780 Bbrs\Forrns2\amfgLabe1Request lune 15,2001 .. . - - - . .. ..