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20 WILLIAMS STREET - BUILDING INSPECTION r� _ - � I J 3 S-- 0 Plans must be filed and approved by the Inspector prior to a permit being granted CITY OF SALEM ;: No. (./ `7�f Ward k HISTORIC DISTRICT? Y 1� 9 Date-A, .,, IF FOR SIDING, HAS ELECTRIC Home Phone PERMIT BEEN OBTAINED? Yom% Bus. Phone APPLICATION ` FOR r PEBMIT TO ,,4-QC SG�iWI rYS TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to:the following specifications: Owner's name and address A4 As -77 sfi<it2u�/��idrirY Architect's name Builder's name A nn,r Location of building, No. ' �� JG 1/<Cii9�J5 Ste. What is the purpose of building? _ If dwelling, # of units? Material of bldng? Will building conform to law? Asbestos? / "+ Estimated cost �� City Lia# State Lic.# Goy G6 Signature of Applicant sW SIGNED UNDER THE P SALTY OF PERJURY DESCRIPTION OF WORE TO BE DONE * .:i'Ai..._, ya. Mail Permit to: AVS �� C� le) d�d r� s � t y: Yy � Try R�p2#Y °t� o` �i�' t I t� t I3 tis f 3�' , I , F 1 �' a�•: j� T Yjs I No. I APPLICATION FOR PERMIT TO ROOF Lif REROOF OR INSTALL 816 NG I PERMIT GRANTED 9/a� 189 Avp yea .� l'� 1 Inspec 4 Citp of harem, 01agga boettg e,l �r Public Propertp department F. �3uilbing 3®epartment One &Salem green 745-9595 tlxt. 380 Director of Public Property Inspector of Buildings DEPARTMENT POLICY - Zoning Enforcement Officer COVERING OF ASBESTOS SIDING All permit applications to cover asbestos sided homes must be accompained by a statement from the licensed siding contractor as to how this will be accomplished without disturbing the siding. The City of Salem Board of Health must, be consulted prior to start of the work and must notify this office of notice. Every effort must be made to avoid disturbing and dislodging the asbestos siding and any siding dislodged must be disposed of under the direction of the Salem Board of Health. Both the property owner and contractor must sign this policy indicating that they are aware of the policy and will abide by it. OWNER .Se) dev-f- 6?0 nOU111 i avms CONTRACTOR Roliald �knzeyr 14aC Sea'-P' hosS 0 �- �o✓ P(rSf ya5S U Lyman S-l-• S3 SALEM LICENSING H /000& ? �5-fafe for the BOARD OF HEALTH �f S y 4 11[1"14 Or, THE SEAMLESS PEOPLE ABC SEAMLESS OF NORTHEAST MASSACHUSETTS 96 LYNN STREET, PEABODY, MA 01960•(508)531-4931 WATS LINE 1-800-675-4931 To ; City of Salem September 26 , 1994 Building Inspector Health Inspector Re ; Coverage of asbestos siding . Location ; 20 Williams St . Owners ; Sharon & Douglas Seivert . Procedure ; bottom edge where siding meets foundation will be covered by 2 "x2 " L aluminum to prevent dropping of asbestos onto ground . First course of 4"x50" fanfold insulating board will be attached to wall with Liquid Nail . Remaining courses will be nailed . Seamless siding will be nailed over insulating board . In the event of asbestos siding being removed or becoming detached from wall material will be wetted down and bagged in 6 mill plastic and removed in accordance with State and Federal regulations ACM Corp . of Peabody , Lic . #000273 . 41 on Tanzer Pres . ABC Seamless "4f/onld'y 1'�ayeel S'ecixle4d. �'rdug. Cony�cuy„ City of Salem, Mass. ELECTRICAL DEPARTMENT s 44 Lafayette Street PAUL M. TUTTLE ,CITY ELECTRICIAN DATE . . . . . . . . . . . . . . . . . . . . . . . . To: INSPECTOR OF BUILDINGS Salem, Mass Electrical Contractor -------------------------------------------- --------•- ----------- (Signature of Applicant) / .ci y'Oct ./------r�-�-----•--=---lJ f ----------------------------------------- has signified their intention of performing the required electrical work, viz: removing and later replacing all electrical wires, fixtures, receptacles, etc., on outside of building located at: j'.s r . /A .�. ----------------------- ------------I... '...... --- ------------------ Street in conjunction with a wall siding installation to be made by: .:..................... Siding Contractor `fif�r_irJ .- rt ---------------------------- ISSUED BY /.�+-F. % c-y. --------------- This-is a requirement, preliminary to the issuance of a permit for the sidewall installation by the Inspector of Buildings. ORIGINAL-SIDEWALL INSTALLER PtW COPY-BLDG. INSP. YELLOW COPY-ELEC. FILE r �� �� i I _e_ RSG SCR�IIeCdd MA REG.# 100069 CONTRACT# THE SEAMLESS PEOPLE Seamless Steel Siding "World's Finest Siding" 96 Lynn Street A00` PEABODY,MA 01960 Seamless Gutters m "Proven in the (508)531-4931 N A R I Metal Soffit& Fascia North Country" (800)675-4931 m L M 11 ' K "World's Largest Seamless Steel Siding Co." i THIS CONTRACT made the 30th day of June 19 94 bRtween Ae Gouglas R Sharon Spdvert (5ns 1744 _(1'101 ( � (Home Owners) (Home Phone) (Business Phone) of 20 Williams St . Salem Me . 01970 (Street Address) (City) (State) (Zip Code) herein called Owner(s) and abc Seamless Co., Peabody, Massachusetts, hereinafter called the Contractor, WITNESSETH: The Contractor hereby agrees that,for the consideration hereinafter mentioned,It will furnish all labor and materials necessary to install the following described work at the premises located at: ;4s above JOBDESCRIPTION: Cover exterior walls of dwelling with 3/8" Amocor fanfold insulating board . Cover Amocor with ABC Seamless Sidin4 System in customers choice of color and style , Deluxe cap all window and door casings . d rnlor - Install ABC center vent soffet system on all oypr1hanQ- and Pavpq with PVC coated metal in sustomers choice of color . Remove existing utter( left side of house only ) and replace all elbows and downsoputs in customers choice f Furnish and install 4 vinyl replarpinpint window-(z tn matrh Pxi ,�ting windows - fppc, - Remove all debris from re o Tn the event of any breakageSTART DATE SEE BACK siding ACM Co . ( Lic . #000273 ) will remove from premis COMPLETION DATE SIDE and dispose of according to re ulations . PAYMENT SCHEDULE TOTAL PRICE 3 ; s DEPOSIT i i SIDING COLOR,Crn/,n' STYLE Q -.5— C. TRIM COLOR_141wi7c' GUTTERS I-V//, "e: SHUTTER COLOR STORM DOOR STYLE COLOR i ATTENTION:Above specifications and price must be accepted by both the contractor and property owner.If accepted by both parties,property owner j must allow contractor a reasonable time to start the above work taking into consideration weather factors. Interest at 11/2%per month(18%Annual Percentage Rate)will accrue on any payment not made hereunder on the due date.If contract is for cash on completion,due date is the date of completion. Should it be necessary to obtain an attorney,customer agrees to pay interest as above stipulated and any reasonable legal fees to collect balance due plus interest. The Contractor and/or his subcontractors represents that itwill provide Workers Compensation and Public Liability Insurance in the amount of$100,000 .$500,000.The Contractor reserves the right to accept or reject this Contract and may do so at any time prior to ordering especially if it is determined that structural or other building deficiencies exist.This Contract is subject to review to determine feasibility of doing work as contracted for hereunder. IfOwner(s) refuse(s)to permit the Contractor to proceed with the work herein,or in the event of any breach by the Owner(s)for any reason whatsoever, then such refusal and/or breach shall cause the Owner(s)to pay the Contractor a sum of money equal to two thirds(2/3)of the total rash price agreed to be paid,as fixed,liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage.Contractor shall not be held liable j in damages for delays in the performance of this Contract due to causes beyond its reasonable control.Any damage for which Contractor may be liable i to Owner(s)shall in no event exceed the total cash price of this agreement. Owner(s)warrants to be the Owner(s)of the property on which is to be performed or is otherwise authorized on behalf of the Owner(s)to enter into and bind this agreement.This Contract represents the entire agreement between the Owner(s)and the Contractor and no representation or warranty shall be binding upon either party,unless included herein,exclusive of written change order(s). Any additional items or unforeseen repairs which may be necessary to complete the terns of this contract will be considered"extra"and charged to the customer accordingly. You may cancel this agreement if It has been signed by a party thereto at a place other than an address of the seller,which may be his main office or branch thereof,provided you notify seller in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not laterthan midnight of the third business day following the signing of this agreement.See the attached notice of cancellation form for an explanation of this right. READ OTHER SIDE BEFORE SIGNING.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. IN WITNESS WHEREOF,the parties have hereunto signed their names this Zr,T6day of .Tr 1� � 199� Rescission expiration date �Lo c Signed 414 ------ Designated Agent Owner Acceptt d: ab—c a,mless'Co.`O4'3122143 I Y �(�,ate: 9 B G` s,'ail r �;' /%.rc=s" Si ned Auth razed Si nature Title Owner Any reference to Seller or Company refers to abc Seamless of Northeast Massachusetts. PERMITS: It is the obligation of the Contractor, as the Homeowners agent,to obtain all necessary construction related permits as required by state of Mass. or local authority. Owners who secure their own construction related permits or deal with unregistered contrators will be excluded from the Guarantee Fund provision of MGL c142A-780CMR-6. WARRANTIES AND LIMITATIONS: Seller warrants to Buyer that the materials provided by it will conform to these terms and conditions and/or to approved shop drawings and will be free of defects in materials and workmanship. Seller specifically disclaims responsibility for design and engineering. The sole and exclusive remedies for breach of this warranty shall be, at the Seller's discretion,correction of the materials, replacement of the materials, replacement of the materials F.O.B. point of shipment, refund of the amount by which the value of the materials is diminished by the breach of warranty,or any combination of these alternatives; provided the nonconformity or defect is due to Sellers fault and is not the result of abuse, misuse, mishandling, accident or other event outside Seller's control and provided the Buyer gives written notice of any nonconformity or defect within seventy-two(72)hours after Buyer learns of the breach of ninety (90) days after the specific materials involved are delivered,whichever is earlier. Buyer accepts the above conditions as reasonable limitations of any right of recovery. IN THE EVENT OF BREACH OF THIS CONTRACT BY SELLER, BUYER SHALL NOT BE ENTITLED TO RECOVER CONSEQUENTIAL OR LIQUIDATED DAMAGES.The warranty provisions set forth in this paragraph are in lieu of all other remedies against Seller for consequential, incidental or other damages, notwithstanding anything to the contrary in the Contract documents. BUYER WILL RECEIVE WRITTEN WARRANTIES ONLY WHEN FULL PAYMENT HAS BEEN MADE TO SELLER, WARRANTIES SHALL CONFORM TO ABC SEAMLESS, INC. NATIONAL FRANCHISE AGREEMENTS. INDEMNIFICATION: If Buyer is not the project owner and does not ensure that these warranty limitations are accepted by,and made a part of the Contract with the owner and any other party with whom the Buyer has a contract relating to the project for which the materials hereunder are provided, then Buyer shall indemnify and hold Seller harmless from any and all claims, demands, loss or liability in excess of the obligation Seller would have had under its limitations. BACK CHARGES: Buyer agrees that it shall have neither the right of offset against the Contract price nor the right to back charge the Contract unless Buyer has given prompt written notice and Seller has given its consent. PAYMENT TERMS:Purchaser shall pay Company in full, within thirty(30) days from date of invoice for materials shipped and ready for shipment at Company's plant as invoiced by Company until the Price is fully paid. Prompt and timely payments are the essence of this agreement and are a condition precedent to the performance by Company hereunder. Payments hereunder shall not be contingent upon the completion or acceptance of any otherwork in the Project nor upon the failure of Architect of Ownerto authorize or make any payment for cause beyond the control of the Seller. No bond of any kind is included in this agreement. LATE PAYMENTS: Any payment not made when due shall bear a service charge at the rate of one and one-half (1 1/2) percent per month plus all collection costs and attorney fees. In addition,and not in limitation of any remedy it may have a low or under this agreement,if payments are not made when due.Company upon seven(7)days written notice to Purchaser may stop the Work until Purchaser pays the full amount due together with all service charges, collection costs, and attorney fees. SECURITY:Company's lien rights on this Project shall not be impaired in any manner.If Purchaser's financial responsibility becomes unsatisfactory at anytime, Company may require Purchaserto give satisfactory security forpayment.In addition,and not in limitation of any remedy it may have at law or underthis agreement,Company upon seven(7)days'written notice to Purchaser may stop the Work until Purchaser eliminates any impairment of Company's lien rights or provides said satisfactory security. ARBITRATION: In case of disagreement on any matter under this agreement and with respect to any decision of Architect, the question shall be submitted promptly to the American Arbitration Association for arbitration by three(3) arbitrators to be resolved in accordance with AAA Construction Industry Arbitration Rules. Each party hereto agrees to observe said rules and abide by the decision of said arbitrators which decision shall be final. Each party shall pay one-half of the expense of such submission.Arbitration shall be in accordance with MGL cl 42A-780CM R-6. TERMINATION: In the event Purchaser should breach any of the terms or provisions hereof,default in its obligations hereunder or seek for any reason to revoke this agreement, Company at its option, may terminate this agreement forthwith upon the occurence of any of the foregoing events, and, in addition to and not in limitation of any remedy, it may have at law or under this agreement, Company shall be paid by Purchaser in full any and all amounts due and owing from Purchaser and the reasonable value of any and all of the Work in process of fabrication or shipment. LEGAL EFFECTS:The parties hereto agree that this Contract is a Massachusetts Contract and is governed by the Massachusetts Uniform Commercial Code. The terms and conditions set forth above contain Seller terms and conditions and in no way waive or limit Seller's rights under the Massachusetts Uniform Commercial Code and Seller specifically reserves the same. All materials, equipment, and supplies installed or uninstalled remain the exclusive property of abc Seamless Siding and may be removed from the property by authorized abc Seamless Siding personnel at its discretion until full payment is made by the property owner, and furthermore,the property owner or occupants of said property shall not attach, hold,keep,damage, move or otherwise impair the Seller in any way from removing such materials, equipment and supplies from the site. Customer agrees that upon the major portion of installation the full payment will be rendered to abc Seamless Siding - less a percentage, not to exceed 10%of final payment for adjustments, remake or reorders-catagorized by the contractor as -service. Customer agrees that Seller will be allowed to place job signs or advertising signs on the property up to 30 days before the start date and no more than sixty (60) days after completion of work or final payment is made. START AND COMPLETION DATES:Seller will not be held responsible for variations in dates caused by sickness, injury or death, byeilherSellerorBuyer orbyweatherconditionsoractsof God or by delays—bySeller'ssuppliers in shipping materials or equipment breakdown. Seller shall not be held to completion dates it delays occur by property owner or occupants or other contractors engaged by the Buyer are experienced.Completion date may be delayed by as much a 180 days in such cases.Buyerwill be notified in writing by the Seller of extension. Any changes of the work described in this Contract must be written separately on a change order provided by the Seller and signed and dated by both parties. I/we have read, understood and agree with the terms of this Contract. All home improvement contractors and subcontractors shall be registered by the Director of Mass. Board of Signed _Date Building Regulations and Standards.Any inquiries about a contractor or subcontractor relating to registration S.S. # should be directed to: Signed Date Director, Home Improvement Contractor Registration S.S. # One Ashburton Place, Room 1301 Boston, MA 02108 (617) 727-8598 - - _ � ._. i �_ � h .� � ' �' <;ro , . APPLICATION CX ADULT NUMBER Trial Court of Massachusetts FOR COMPLAINT ❑ JUVENILE District Court Department { ❑ ARREST Ll HEARING ❑ SUMMONS ❑ WARRANT COURT DIVISION . The v-Athin named complainant requests that a complaint issue against the within tialeelE>if811111*icourt named defendant, charging said defendant with the offense(s) listed below. as DATE OF APPLICATION DATE OF OFFENSE PLACE OF OFFENSE S 1 .071 _T/27/94 1 6/94 1,20 Williams St., Salem NAME OF COMPLAINANT .. City of Salem, inspector of Buildings NO. OFFENSE G.L. Ch. and Sec ADDRESS AND ZIP CODE OF COMPLAINANT ,Mty_of Salem, Inspector of Buildings Massachusetts State Building Salmi, MA 01970 2. NAME,ADDRESS AND ZIP CODE OF DEFENDANT _Doug Seivert 20 Williams St. 3. _Sal=f__!tA . 01970 f,. 4. __.. COURT USE A hearing upon this complaint application DATE OFHEARING TIME OFHEARING COURT USE ONLY will be held at the above court address on ' ; ' , .it _1 e AT ONLY CASE PARTICULARS — BE'SPECIFIC NAME OF VICTIM DESCRIPTION OF PROPERTY VALUE OR PROPERTY TYPE OF CONTROLLED NO. Owner of property, Goods stolen,what Over or under SUBSTANCE OR WEAPON person assaulted:etc. destroyed,etc. $250. Marijuana,gun,etc. 1 2 3 OTHER REMARKS: Failure to acknowledge correspondence and to comply with the State Building Code. -_ 'SIGNATURE OF COMPL AINAN�� DEFENDANT IDENTIFICATION INFORMATION — Complete data below if known. DATEOF BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER SEX RACE HEIGHT WEIGHT EYES HAIR OCCUPATION EMPLOYER/SCHOOL MOTHER'SNAME(MAIDEN) FATHER'S NAME V � W G DC-CR2(3188) t APPLICATION ❑ ADULT J NUMBER Trial Court of Massachusetts FOR COMPLAINT JUVENILE 1 District Court Department i ._ ARREST HEARING _ SUMMONS _ WARRANT COURT DIVISION The within named complainant requests that a comolaint issue against the within Salem District Court named defendant. Charging said defendant with the oilense(s) listed below, , DATE OF APPLICATION DATE OF FFENSE PLAC OF OF NSE Q co71r, 65 Washington StreetSalem, MA. 01970 NAMEOF CO LAI T 107 NO. OFFENSE G.L. Ch.and SeC LA44. C4 ADDRESS D* CODE OF COMPLAINANT ///� i 2. NAME.ADDRESS AND 21P CODE �OF�DEFENDANT 3. 4. 4/576 COURT USE I A hearing upon this complaint application I DATE OF HEARING TIME OF HEARING COURT USE ONLY will be held at the above court address on I AT *—ONLY CASE PARTICULARS — BE SPECIFIC NAME OF VICTIM DESCRIPTION OF PROPERTY VALUE OR PROPERTY TYPE OF CONTROLLED NO.i Owner of property. Goods stolen.what Over or under SUBSTANCE OR WEAPON person assaulted.eta destroyed.etc. $250. Marijuana.gun.etc. t 2 I 3 4 OTHER REMARKS: SIGNATURE OF COMPLAINANT DEFENDANT IDENTIFICATION INFORMATION — Complete data below if known. DATE OF BIRTH PLACE OF BIRTH SOCIALSECURITY NUMBER SEX RACE HEIGHT WEIGHT EYES HAIR . 00CUPATION EMPLOYER/SCHOOL MOTHER'S NAME(MAIOENI FATHER'S NAME II COURT USE ONLY DATE DISPOSITION AUTHORIZED BY NO PROCESS TO ISSUE At request of complainant Complainant failed to prosecute - Insufficient evidence havinc been presented PROCESS TO ISSUE TYPE OF PROCESS Sufficient evidence presented Warrant - Defendant failed to appear - Summons returnable Continued to COMMENTS i DC-CR2(3188) 0(9,q�Dw) Titg of ihiPm, Mttoottc4uoptto Public Propertg i9epartment iguilbing Department (One #alem /preen 508-745-9595 Fd. 380 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer June 23, 1994 Doug Seivert 20 Williams St. Salem, MA 01970 RE: 20 Williams Street Dear Mr. Seivert: In response to complaints received regarding the above referenced property an inspection was conducted and the following violations have been noted and must be corrected: 1. New windows were placed in openings without completing exterior trim. 2. Exterior siding shingles are missing. 3. Exposed tarpaper around doors and windows. 4. General peeling of paint. The property is rundown and an eyesore. You are requested to contact this office upon receipt of this notice so as to inform us of your intentions to correct said violations. Failure to comply will result in the appropriate legal action being taken. I thank you in advance for your anticipated cooperation and prompt attention in this matter. Sincerely, Leo E. Tremblay Inspector of Buildi gs LET:bms cc: David Shea Councillor Harvey, Ward 2 \tskvltn\ (situ of *altm, MasstttllusEtts . h Public Prupertq Department � f Nuilaing Department One Ontem (Arcen 500-745-9595 Ext. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer June 23, 1994 Doug Seivert 20 Williams St. Salem, MA 0197 RE: . 20 Williams Street Dear Mr. Seivert: In response to complaints received regarding the above referenced property an inspection was conducted and the following violations have been noted and must be corrected: 1. New windows were placed in openings without completing exterior trim. 2. Exterior siding shingles are missing. 3. Exposed tarpaper around doors and windows. 4. General peeling of paint. The property is rundown and an eyesore. You are requested to contact this office upon receipt of this notice so as to inform us of your intentions to correct said violations. Failure to comply will result in the appropriate legal action being taken. I thank you in advance for your anticipated cooperation and prompt attention in this matter. Ci'z .' Leo E. Tremblay Inspector of Buildi gs LET:bms cc: David Shea Councillor Harvey, Ward 2 \tskvltn\ Church of the Larger Fellowship ■ ■ .. Unitarian Universalist q.. .. Rev. Scott W.Alexander,Senior Minister 25 Beacon Street, - Boston MA 02108 (home) (617)742-2100 X161 25 Williams Street Salem MA 01970 FAX (617)523-4123 (508)745-6051 June 16, 1994 Building Inspector City of Salem 1 Salem Green Salem, Ma 01970 Dear Sir or Madam, I own the home at 25 Wiliiains St.ett, which I purchased nearly 7 years ago. For that entire period, the dwelling at 24 Williams Street has been in a state of unsightly disrepair and incompleted renovation. I hereby request that your office inspect this property, and force compliance with all City of Salem building code regulations. As you will see when you visit, the property is in general disrepair: exterior siding shingles are missing,tar paper is showing, the finishing around the"new" windows has not been completed, the trim paint is peeling and the property is generally a run-down eyesore. A number of neighbors have verbally expressed concern to me about how the condition of this property affects their property value. I have these concerns myself, being afraid that if I had to sell my property at 25 Williams, the condition of this house across the street would very negatively impact the price I might receive. I would prefer, if possible, that this complaint remain confidential. If that is not possible, and the owners of the above mentioned property request to know who formally complained,you have my permission to tell them who filed it. If you need any more information, please don't hesitate to contact me. My address and ' phones are: 25 Williams St., Salem, MA, 01970; (0) 617) 742-2100 X161; (H) (508) 745-6051. Thank you for your prompt attention to this matter. Sincerely. !c'C� Scott W.Alexander SWA AUIVIINI51 HA I IUN A14U 1:141-UHULIV LN 1 Department of Public Safety shall be notified in writing within seven (7) working days of any action taken under this section. 101.4 Referenced Standards: Where differences occur between provisions of this code and referenced standards, the provisions of this code shall apply. SECTION 102.0 ORDINARY REPAIRS 102.1 General: Except as provided in Section 113.1, a permit shall not be required for ordinary repairs to buildings and structures. SECTION 103.0 INSTALLATION OF SERVICE EQUIPMENT 103.1 General: When the installation, extension, alteration or repair of an elevator, moving stairway, mechanical equipment, refrigeration, air conditioning or ventilating apparatus, plumbing, gas piping, electric wiring, heating system or any other equipment is specifically controlled by the provisions of this code or the approved rules, it shall be unlawful to use such equipment until a certificate of approval has been issued therefor by the building official or other agency having jurisdiction. SECTION 104.0 MAINTENANCE 104.1 General: All buildings and structures and all parts thereof, both existing and new, shall be maintained in a safe and sanitary condition. All service equipment, means of egress, devices and safeguards which are required by this code in a building or structure, or which were required by a previous statute in a building or structure, when erected, altered or repaired, shall be maintained in good working order. 104.2 Owner responsibility: The owner, as defined in Article 2, shall be responsible for the safe and sanitary maintenance of the building or structure and its exitway facilities at all times, unless otherwise specifically provided in this code. Corrected 780 CMR - Fifth Edition 1-3 APPLICATION El ADULTNUMBER Trial Court of Massachusetts FOR COMPLAINT ❑ JUVENILE District Court Department ❑ ARREST HEARING ❑ SUMMONS ❑ WARRANT COURT DIVISION The wJthin named complainant requests that a complaint issue against the within Salem tl' tCourt named defendant, charging said defendant with the offense(s) listed below. 65 iAfiaslfinCjtoen Street DATE OF APPLICATION DATE OF OFFENSE PLACE OF OFFENSE Salem,STA.01976 7/27/94 6/94 X20 Williams St., Salem NAME OF COMPLAINANT City of Salem, Inspector of Buildings NO. OFFENSE T.L. Ch. and Sec ADDRESS AND ZIP CODE OF COMPLAINANT „pity-of Salem,-inspector of Buildings Massachusetts State Building Salem,_ MA 01970 I 2. NAME,ADDRESS AND 21P CODE OF DEFENDANT 'r _Doug_Seivert�, 20 Williams St. 3. t Salemi, MA__01970 T4 COURT USE A hearing upon this complaint application DATE OFHEARING TI ME OFHEARING COURT USE ONLY—♦ will be held at the above court address on f ,t C C`a ttia /-) AT 5 ONLY CASE PARTICULARS B )SPECIFIC - NAME OF VICTIM DESCRIPTION OF PROPERTY VALUE OR PROPERTY TYPE OF CONTROLLED NO. Owner of property, Goods stolen,what Over or under SUBSTANCE OR WEAPON person assaulted,etc. destroyed,etc. $250. Marijuana,gun,etc. t 2 3 4 OTHER REMARKS: s> Failure to acknowledge correspondence and to comply with the State Building Code. r X �U �" (%i Lw� '4-6 r SIGNATURE OF COMPLAINANr/ DEFENDANT IDENTIFICATION INFORMATION — Complete data below if known. DATE OF BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER SEX RACE HEIGHT WEIGHT EYES HAIR OCCUPATION EMPLOYERISCHOOL MOTHER'S NAME(MAIDEN) FATHER'S NAME 8 9 2 D 8 DC-CR2(3188) J