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94 WASHINGTON STREET - BUILDING INSPECTION �s 94 Washington St.ri ` _ _ Bay Contracting, Inc. Exterior Restoration Specialists Caroline Rooney Office Administrator camline.rooney@bayconuacting.com ' Masonry Waterproofing 56 Felton sweet Waltham,MA 02453 General Contracting oft'ice.617.779.8811 fn.617.779.0888 1 www.baycontmcting.com 1 � � , � t �\ � � � `� �� ` � �� �� . , � , � � , � • � S-�EE�(' PEg,Iv1IT �ffit� of�n�pe�r of�uitAfnS$ Gify Yfa.ff �¢rmission Ile is6'l9iuen to purposes to occupyh1' -^- in fronf of estate s1reel. of'sidewaJ%, -- sub 8cf fo fie `gsjs p�'�!is fin ite�!!o in in relation fo ($!reels anal foie ffnsPection provisions of&,�nancfilin�in!�a t'iify o� artc5alem. �lCianslruclion of g r y, ���ja.�,z3ai(diags x -n rn s n � H�7 orn NA > ._- � �o N M m cn �o STREET PERMIT 8 Cttp of *aiem Office of 3noVeacr of jBuiCDino Coiry.7{aff ./ " /� 20 4 0 Armrssion rs 6ere6y yruen to 6t to occupy for �qm, purposes rnfronl of eslale �7 (N CS�f/�f' Jul l �� Wd J � ofsrdeoa _ofslreel. .`7Srspermilislmiledlo 0 . su6ecll tFie proomrons of 1Se ordinances andstalules rn rekn(ron to cslreels ands e gnspeclron and C'ionslruclron of-TuiYo6kys rn!6e Cirly of cSakm. � `3� Durcloro``R6lro c$v�roiesr � _ 9lxrpac%af'.2fui/din�r c$iyna/urc o`.Applican/ v�:� ��'� Z . e Bay Contracting incorporated CEPA. 2 ...protecting your investment , s. 0 NAT-24395-1 April 28th 2015 Please find enclosed a check for the renewal of a street permit at 94 Washington St, Salem Ma to have staging occupying the sidewalk. If you have any questions or need any more information please feel free to call me Regard Q P tt rlJ� (;� CAROLINE ROONEY Caroline.rooney@bavcontracting.com BG ♦ 56 Felton St♦ Waltham ♦ Massachusetts ♦ 02453 Telephone 617-779-8811 ♦ Facsimile 617-779-0888 i . Architecture Planning Interior Design 16 June 1992 Building Department One Salem Green Salem, MA 01970 Att: Building Commissioner RE: Red Lyon Smoke Shop Washington Street Salem, MA Gentlemen: A final inspection was made by CSS Architects Incorporated on 10 June 1992 , at that time the gas, plumbing and electrical services had been inspected and approved by the respective city officials. The only work remaining to be completed was the exit lighting and on 15 June 1992 that work was completed and the fire department has inspected and approved the work. The project has been built in accordance with drawings prepared by CSS Architects dated 17 April 1992 , with the exception of the changes identified in items 6, 7, 8, 9 and 10 in the attached field report No. 2 dated 10 June 1992 . The changes made in the field have no affect on Code compliances. We feel the project is ready for occupancy as of the date of this letter. Very Truly Yours: CSS Architec Incorporated John J. Savasta, AIA Principal Attachment cc Roger Bresnahan CSS Architects Incorporated Corporate Place 128 Audubon Road,Building 2 Post Office Box 1460 Wakefield, Massachusetts 01880 617 245 8400 CSS Architects Incorporated Corporate Place 128 ARCHITECT'S Audubon Road, Building 2 FIELD Post Office Box 1460 Wakefield,Massachusetts 01880 (617)245-8400 REPORT PROJECT: RED LYON SMOKE SHOP FIELD REPORT NO. : 2 CONTRACT: INTERIOR CONSTRUCTION ARCHITECT'S PROJ. NO. : 706 DATE: 10 June 1992 TIME: 4: 30 pm Weather: N/A TEMP RANGE: N/A EST. °% of COMPLETION: 100% CONFORMANCE WITH SCHEDULE(+, -) : On Schedule WORK IN PROGRESS: PRESENT AT SITE: Store Fixture Installation Roger Bresnahan Dick Anderson John Savasta OBSERVATIONS: 1. Aluminum store front exterior entry system is installed at the front and rear of the Red Lyon Smoke Shop space. 2 . Acoustic ceiling, lighting and sprinkler heads are installed in the sales area. 3 . All drywall has been installed and painted on the walls scheduled for drywall in the sales area. 4. All vinyl tile and carpet has been installed in the sales area. 5. All interior doors are installed, stained and finish hardware have been installed in the sales area. 6. The rear storage area is complete. All wall finishes have been installed and painted. The gypsum board wall finished schedule for the rear wall shall be left unfinished. The floor shall be left unfinished and no vinyl base shall be installed. 7 . The single leaf door scheduled at the entry to the storage room has been changed to a dutch door. 8 . The Men' s and Women's toilets have gypsum board walls installed and finished. Toilet fixtures, accessories, mirrors, and grab bars have been installed. Lighting, ventilation and ground fault receptacles are installed. The ceiling has been changed from acoustic tile to gypsum board painted. The door to the Women' s room has been shifted to the left of the original location. The water closet and lavatory in the Women's room have been installed with the water closet located adjacent to FIELD REPORT RED LYON SMOKE SHOP Page 2 the wall dividing the Men's and Women's room. The scheduled floor finish and vinyl base have been deleted from the contract. 9 . The hall wall which is perpendicular to the Men's room has been shifted down to the existing chimney. 10 . A door has been added from the office area into the unoccupied space at the rear of Beneficial Finance. DIRECTIVES: 1. Carpet shall be installed around the columns in the sales area. 2 . The gas, plumbing and electrical services have been inspected and approved by the respective city officials. ITEMS TO VERIFY: None INFORMATION OR ACTION REQUIRED: 1. Exit lighting is scheduled to be installed on 11 June 1992. 2 . The fire department has been notified and is scheduled to inspect the work on 12 June 1992. ATTACHMENTS: None REPORTED BY: John Savas cc: Roger Bresnahan Salem Building Commissioner CSS Architects Incorporated Corporate Place 128 ARCHITECT'S Audubon Road, Budding 2 FIELD Post Office Be.1460 Wakefield,Massachusetts 01880 (617)245-8400 REPORT PROJECT: RED LYON SMOKE SHOP, SALEM FIELD REPORT NO. : 1 CONTRACT: CONSTRUCTION ARCHITECT'S PROJ. NO. : 706. 02 DATE: 15 May 1992 TIME: 2 : 30 pm Weather: Clear TEMP RANGE: 50' EST. % of COMPLETION: 40% CONFORMANCE WITH SCHEDULE (+, -) : On Schedule WORK IN PROGRESS: PRESENT AT SITE: Plumbing Work Roger Bresnahan Electrical Work Dick Anderson Drywall Work John Savasta OBSERVATIONS: 1. All demolition work has been completed. 2 . Store front on Washington Street has been installed and rear entry door frames are in place but not complete. 3 . Rough plumbing and domestic water service have been installed in the wet wall at the mens and womens toilet. Plumbing inspector has reviewed the installation and approved the installation without comment. 4 . Rough wiring and the load panel have been installed and inspected by the electrical inspector and he approved the installation without comment. 5. The fire treated gypsum board has been installed to the underside of the floor joists. 6 . Additional floor joists have been sistered-in to increase the floor load capacity for the second floor. FIELD REPORT RED LYON SMOKE SHOP Page 2 DIRECTIVES : 1. HVAC duct work to begin on Tuesday 19 May 1992 . 2 . Sprinkler work to begin on Wednesday 20 May 1992 . ITEMS TO VERIFY: None. cc: Roger Bresnahan Salem Building Department EIIJILDINC DEN C55 Architects Incorporated Corporate Place 128 ARCHITECT'S Audubon Road. Building 2 JLN �a ( [ _ FIELD Post Office Boz 1460 Wakefield.Massachusetts 01880 (617)245.8400 R L"E I I_0 REPORT CITY OF SAL !4,H?lSS. PROJECT: RED LYON SMOKE SHOP FIELD REPORT NO. : 2 CONTRACT: INTERIOR CONSTRUCTION ARCHITECT'S PROJ. NO. : 706 DATE: 10 June 1992 TIME: 4 : 30 pm Weather: N/A TEMP RANGE: N/A EST.% of COMPLETION: 100% CONFORMANCE WITH SCHEDULE(+, -) : On Schedule WORK IN PROGRESS: PRESENT AT SITE: Store Fixture Installation Roger Bresnahan Dick Anderson John Savasta OBSERVATIONS: 1. Aluminum store front exterior entry system is installed at the front and rear of the Red Lyon Smoke Shop space. 2 . Acoustic ceiling, lighting and sprinkler heads are installed in the sales area. 3 . All drywall has been installed and painted on the walls scheduled for drywall in the sales area. 4. All vinyl tile and carpet has been installed in the sales area. 5. All interior doors are installed, stained and finish hardware have been installed in the sales area. 6 . The rear storage area is complete. All wall finishes have been installed and painted. The gypsum board wall finished schedule for the rear wall shall be left unfinished. The floor shall be left unfinished and no vinyl base shall be installed. 7 . The single leaf door scheduled at the entry to the storage room has been changed to a dutch door. 8 . The Men' s and Women's toilets have gypsum board walls installed and finished. Toilet fixtures, accessories, mirrors, and grab bars have been installed. .Lighting, ventilation and ground fault receptacles are installed. The ceiling has been 'changed from acoustic tile to gypsum board painted. The door to the Women' s room has been shifted to the left of the original location. The water closet and lavatory in the Women' s room have been installed with the water closet located adjacent to FIELD REPORT RED. LYON SMOKE SHOP Page 2 the wall dividing the Men' s and Women's room. The scheduled floor finish and vinyl base have been deleted from the contract. 9 . The hall wall which is perpendicular to the Men' s room has been shifted down to the existing chimney. 10. A door has been added from the office area into the unoccupied space at the rear of Beneficial Finance. DIRECTIVES: 1. Carpet shall be installed around the columns in the sales area. 2 . The gas, plumbing and electrical services have been inspected and approved by the respective city officials. ITEMS TO VERIFY: None INFORMATION OR ACTION REQUIRED: 1. Exit lighting is scheduled to be installed on 11 June 1992 . 2 . The fire department has been notified and is scheduled to inspect the work on 12 June 1992 . ATTACHMENTS: None REPORTED BY: John Savas cc: Roger Bresnahan Salem Building Commissioner COMO, CERTIFICA6T yS$}J,E0 N DATE ////yy ll y F'. CITY OF SALEM 3 SALEM. MASSACHUSETTS 01970 BUILDING PERMIT - a� y CERTIFICATE OF pOCnCUPANCY ' Vw. ....L,.... DATE April 29 E9 92 PERMIT NO. 183-92 APPLICANT Bressahan ADDRESS Beverly,14A p�yyy�pTT(�T�� 1.0.1 iCOnTR`S LICENIEI PERMIT TO {-) STORY RETAIL STORE NUMBER OF DWELLING UNITS Ii+#[ 0. IMI,ROVLME NTI MO, E.'_,.,� {yR0#OE[D UE[t AT (LOCATION$ 94 NMbiroM St. Ward L ZONING 1X0.1 iSTPEETI DISTRICT BETWEEN AND 4ROSS SIOEET) ICROSS SIRLETI LOT SUBDIVISION LOT BLOCK SIZE. BUILDING IS 706f FT, WIDE R FT, LONG BV FT, IN MCIGMT AND SMALL CONFORM IN CONSTPUCTION TO TYPE USE GROUP BASEMENT WALL$ OR FOUNDATION {,'�'y� qry /�}��[� I T+vf) REMARKS: RLI1MAAiTIO NS TO OUSTING SPACE, FOR RETAIL STORE CALL FOR PERMIT 7O OCCUPY 745-9595 KK-��� �-��(( AREA pR I$ VOLUME b'BIC SOVARE F[[TI L1}F1f1M'yHT CEIII,{ER 4w14111aFRslVIow14 w1sf114wINO BE POSTED ON REMISE Tl4w.4LTl4 OWNER AiSY�Al11 "`NC lflail TO BE POSTED ON PREMISES ADDRESS 161 Cabot cut•• Beverlv.MB. 01915 SEE REVERSE SIDE FOR CONDITIONS OF CERT�lific ASSISTANT BUILDIING INSPECMR, David Harris BOARD,JOFASSESSORS - n f 93 WASHINGTON STREET,CITY HALL,SALEM,MASSACHUSETTS 01970 3^ a (506)745- tf261::... (508)744-59185918 FAX J�cUaxt�:.n _ April 21 , 1992_ Mrs . Josephine R. Fusco City Clerk - City Hall . Salem MA 019'70 Dear Mrs . Fusco: Please be advised that the new location of the Red Lion Smoke Shop, ,to be moved to the former. Foodland building (Assessors Parcel # 35-0015 ) , has been assigned the mailing address of 94 Washington Street . V tr 1 yours ,, . Peter M. Caron Chairman cc: Postmaster Joseph L . Leccese Chief Joseph F . Si. 11ivan, Fire Department Margaret R. Hagerty, Principal Clerk, Water Dept . - tXilliam H. Munroe, Inspector of Buildings Richard Lis , Engineering Dept . .. Red Lion Smoke Shop Inc . , 99 Washington St . Salem K- 0135rSERYM The Commonwealth of Massachusetts REC Board of Building Regulations and Standards NSPECTI01Massachusetts State Building Code, 780 CMR 2I SMar2011 Building Permit Application To Construct, Repair, Renovate Or t��eYt K2 1 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Ap ied: _S• a I Building Official(Pont Name) Signature Date iS t SECTION 1: SITE INFORMATION PI1.1, Property Address: 1.2 Assessors Map&Parcel Numbers 1.1 a Is this an accepte sOfreeV yes_ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑ Public❑ Private❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'ofRecord: ( Ae O19�h Mt� ern,�-- Name(Print) City, State,Z qL\ Email e,21 e No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed WorkZ: 't1i,.,jXA w\ \ t vv v OY\ ! 4 rz erg kiltqcy nptYE SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Official Use Only Item Labor and Materials 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (14VAC) $ List: 5. Mechanical (Fire $ Total All Fees: $-- Suppression) ( �0O O O Check No. Check Amount: Cash Amount: l 6. Total Project Cost: S � ❑Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 1 'Construction Supervisor License(CSL) O t V.4�YYQi�� GC�nU�0. m nseNuber SExxp_iratitionDate rce Name of Holder ,,H'older V_Q • 1.1 7X S / ' �,7p •`� ` r�V� List CSL Type(see below) No.and Street / Type Description �nt��I N m� oiae5 R Unrestricted(2 Family s u el ing cu.ft. R Restricted 1&2 Famil Dwelling City/Town,Sudd,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances Gm 11 I Insulation 1 cle hone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) C Registration Number Expiration Date C Co any Name or HIC Registm Name LLVand ekStreet mA ^� tr 1 Nv Email addr s Ci /Town, tate,ZIP 'L V' Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. C. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuan of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner o the subject property,hereby authorize��r ce\k CnMrNpn / l ran yuc l�Yl t act_on a alf,in all m re to work authorized by this buildmg'penntt applicafi n. i Print Owner's Name(Electr i Sign re) D to SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Icy. y a015 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L. c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass. og v/dns 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) (including garage, finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" HED LION SMOKE SHOP, INC. 94 WASHINGTON STREET SALEM, MA 01970 978-745-2050 • p oop i i� TI�Yi Poo 1� gof2 c4.0'ig 69 c*.r?4 rn io I.V 2 � y-itrs Awvhr'c pop& 3 � �5�i �c � ' ?•�t'� Pfl�Tin�r. 0 0° o o o o ° a Av,,ti 40o49k 5' DDFiai�v6r "�f�r5 fives pvo The Commonwealth of Massachusetts Department of Public Safety :\fassac huse l is State Building Cade(780 C\IR) Building Permit Application for any Building o Ilan a One-or'I'wo- a»ily Dwelling (Ibis Section For Official LXe Only) Building Permit Number Uale Applied: ______ Bui1 gOfficial ' SECTION l: LOCATION(Please indicate Block R and Lot p fulflocatioefr ich street address is not available) S '_— SA Le,A, P..4_ J Reg L,,,n� .Sr,.ohG Tb"o No aunt Street City /Town Zip Code Name of Built inl;(if.Ipplicable) SECTION 2: I'ROPOSEU ORK Edition of MA State Code used_— If New Cunslrucliun check here❑or check all that apply in the two rows below lixi.vlinl; Building❑ [?,pair❑ 1 Alteration 0-- Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: ;1rc building plans and/or Construction d,k uments being so ppl Jed as part of this permit application? Yes ❑ No O --_ Is an Independent Structural Engineering Peer Review royuired? Yes ❑ Nu ❑ Brief Description of Proposed%Vork:.L� r.JaF /o v-rr 'r 3"C-1 7TL. SECI'ION 3:COMPLETE'Tms SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 C\IR 14) O Existing.Use Group(s): —_ Proposed Use Group(s): _ SECTION 4:'BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area(Ski. ft.)and Total Height(ft.) SECTION S: USE GROUP(('heck as a licable) A: Assembly A.1 ❑ AQ❑ Nightclub ❑ A-1 ❑ A4 ❑ A-i❑ B.- Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: Hi h Fiaz,ud H-I ❑ H-2❑ 1-I-1 ❑ 11-a❑ 11-i❑ I: Institutional I-I ❑ IQ❑ 1-1❑ I-1❑ ,�I: Mercantile❑ R: Residential R-10 R-?❑ R-,\❑ li--{ ❑ S: Storage 5-1 ❑ S-2❑ Ur Utility❑ Special Use❑and please describe below: .. Special Use SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA ❑ IB ❑ tL ❑ JIB ❑ 1111110 FIB ❑ IV ❑ VA ❑ \'11 ❑ SECTION 7:SITE INFORMATION(refer to 780 CJIR 111.0 for details on each item) Water Su p ply: Flood Zone Information: Sewage Disposal: French Permit Debris Rcuuw al: Public❑ Chock if outside(load Zone❑ Indicate municipal ❑ A trench will not be Licensvd Disposal Site❑ I'm ale❑ or iodentik lour: or on silt s\stem❑ reyuir,d ❑or trench or specify:.____. - . permit is CnCl09ell❑ Railroad right-of-way: Ilaiards to Air Navigation: `1 ' i:: 1L , ' . ..:.,,I., :. ,. Not Al'I'licablo❑ Is 91n,c lure within airport approach area? Is lheir r,•y i,•,v,omplclod' ar Con.ent to liudd enc lu.ed ❑ 1 es❑ or.No❑ Yvs❑ .No ❑ SI[CT ION H:CON'ITNT OF CFRl IHCA I E OF OC'CLPANC'Y I dilian A C,nle. _ . ".. l'.r Gn,uplsl: - - 1\pe of Construction: lh cupant Load Par I I.... to,. the building;contain ao pl,rmklvr SN Wm'. - tipeCi,d >Iipulatione: e SEC"IIONY: PROPER I OWN ERA Ul"IIOI4IZA'P[ON Name,md Address of Property(honor RcZ�_ tea t_7--No L U L . _°1`1 `_Si . =-��1 --�� N,ime(Pearl) No and Street Cityj TopGn Zip propertyy�Ow1ner Contact Information: tl l•ML �b� __ �L7S-��1_�' '�a-� M•At /Gi-L.9n I"ills telephone No. (business) -Telephone No. (cell) C-mail address If.applicable, the property owner hercbv authorizes "- ----- Street Address city/town State Zi Name Y/ Pr to act on the property owner's behalf, in all matters relative h)work authorized by this building permit a p plication. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) if building is less than 35,000 cu.ft.of enclosed s pace andl or not under Construction Control then check here O and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control to Name (Registrant) Telephone No e-mail address ,Registr ion Number Street Address City/Town State Zip .Discipline Expiration Date 10.2 General Contractor n2,gF�� SQri'�¢•r Sac Con parry Name 0s4 -f 3 Name of Person Responsible for Construction License No. and Type if Applicable Ss (L p'lA;k-- - QA� - 004 Street Address 1ty/Town State Zip 9L� S3L � 6f ; -sus - 63`ln °�/rs P.t r�aF, C�� Tole phone No. business Telephone No. cell - n& ail address SECTION 11:�)', ytti,i.[:�, ( (_)yrl1 Ni,.\I It p.\_I,NId iq,\_\i r AH 11".1 '1 M.G.L.c.152.§ 25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the is uance of the building permit. Is a signed Affidavit submitted with this a lication? Yes No ❑ SECTION 12 CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and \lateriais) Total Construction Cost(from Item 6) 5_ 1. Building 5 Building Permit Fee-Total Construction Cost x_(Insert here 2. Electrical S- appropriate,municipal factor) -$ 3, Plumbing S 1. \lechanical (HVAC) S Note: \linimum fey 5__(con Lrct mwaicipalily) 3. \Icchanical (Other) I S Enclose ihcck parable hp _ h. rotal Cost $ 'a f 3� Q— (contact municipalih')and write check nundmr here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below, I hercbv attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. -bA✓_L.._r �_�'^ _ Pits I loose pri at ood .ign n.une I itle I Olrphone No. D,alc n �trvct Address nr/ Paton Mate /ip I \tunicipal Inspector to fill out this section upon application approval: --Nome _. .._ 11nd---- What is the current use of the Building? Material of Building? B dwelling,how marry un'ds? Wilt the Building Conform to Law? �`� Asbestos? Architect's Name Address and Phone ( ) Mechanids Name >1 i�k '�d (�tx��h3 fY1C �1Gb� Address and Cons Phone isors License tt ,— L2` HIC Registration X CO Estimated Cost of Project S ��S�� - Permit Fee Calouladon Permit Fee S Estimated Cost X$7/57000 Residential - - Estimated Coat X ill/$1000 C Wnerolal—-—--- An Additional $5.00 is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of perjury Date a5 b 3 � N e u a p # O 9 V loft CITY-OF- PUBLIC PROPERTY DEPARTNIENT �rnvas 130 W&%UNGWW TrUn• &UXK Nnttnall:sti'rIS 01970 TU--97 US•9S"•FAX M740.9W APPLICATION FOR THE REPAIR RENOVATION CONSTRUCTION DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING] STRUCTURE OR BUMDIN 1.0 SITE INFORMATION Locadon Name: p Building: --- Property Address:-- - --- __ -- --- - -- --- b �4- Property Is located In a;Conservatlon Area YIN Historic District YIN 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land ✓t Name: fy1 \b Address: Telephone: 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation LA Renovated Change in Use New Demolition Existing Approximate year of Renovated construction or renovation of existing !wilding New Grief Description of Proposed Work: aeQ,c)me, �-ovcJ�\ 00 b�k rok ceA\ -- — - --Mail Permit to: ,QED LION SWIKE SHOP, INC. D4 WASHINGTON STREET SALEM, MA 019M NO 745-20W �Q o t a1 G, 1 C'AEg al-9 0 s 2 to Cr] N� Co11S'r �C-t- iO I RED UON SW KE SHOP, INC. 84 WASHINGTON STREET &LLEM, MA 019M 008 745-2050 4n o o?/ �11 , 01 1 j c L C'J ctvss S I ! I i %L 0 o HOC '�edh 1 I p COR,ez