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54 TURNER ST - BUILDING INSPECTION CITrO-rSALEn— _ _ ` PUBLIC PROPERTY DEPARTMENT KI?BEB.EY D83SCOLL MAYOR 220 WASHUSCM 3 STKEEr♦S AcE,u,MAssAcxGsrris 02910 TFL 978.745-9595 0 FAx:978.740.9846 \ APPLICATION FOR THE REPAIR, RENOVATION, CONSTRUCTION. DEMOLITION. OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUILDING 1.0 SITE INFORMATION Location Name: koose rjF eve;l &61el Building: Property Address: �" 'rite ire S'f' Property is located in a;Conservation Area Y/N Historic District Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land f Name: cro 3P cs"F .S e ve!1_ Address: ,Sz/ /c, tZ maet S y- o � Telephone: ?-2s - 7' Y- 099/ 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use New Demolition Existing Approximate year of Area per floor (sn Renovated i construction or renovation of existing building New Brief Description of Proposed Work: ??,")001zq&y 74- dY1, Mai! Permit to: S�?T 01 �� What is the current use of the Building? Material of Building? If dwelling, how many units? Will the Building Conform to Law? Asbestos? Architect's Name Address and Phone ( } Mechanic's Name Address and Phone Construction Supervisors License#.ceozz t g HIC Registration# Estimated Cost of Project$ SO Permit Fee Calculation Permit Fee$ Estimated Cost X$71$1000 Residential Estimated Cost X$111$1000 Commercial An Additional$5.00 is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the abovestated specifications. Signed under penalty of perjury X-29 Date C � O N r` 00 4 V '.: ,. . .. .... .;:l:..._. _ .: -.-.X•r 4i S .:.,.. ...._. vr.,i,_✓....;'d'i/'hay'o xS�a.'�2'��"X4;""''a�srdiiZ:a�a.��•:^..s.�tiu. a1a»d��1`A`+.:_ c�PcPC I�CPCPC I�rJ�[PrJ�rJ�cPrPcPrJ@PcP ❑° IMPORTANT DOCUIVIENT 5 Certuleate of Flame Resistapee 5 5 REGISTRATION ISSUED ttBY Date of Shipment 5 APPLICATION a �� 09/14/04 55 NUMBER E iNousraie we® 5 EVANSVILLE, INDIANA 47725 Tent Identification 5 SF140.1 !N� °r MANUFACTURERS OF THE FINISHED 03938764 5 5 TENT PRODUCTS DESCRIBED HEREIN 5 This is to certify that the materials described have been flame-retardant treated 5 5 (or are inherently noninflammable) and were supplied to:657150 5 5 5 PETERSON PARTY CENTER INC 5 139 SWANTON ST 5 SWINCHESTER MA01890 5 5 5 5 5 Certification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 5 chemical and that the application of said chemical was done in conformance with California 5 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. C5 5 Serial u 8108975(2) 5 5 55 Description of item certified: 5 5 CENTURY MAIL EXPANDABLE MIDDLE 5 40WX20 SNYDER WHITE VINYL 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric 5 5 �SNYDER MFG NEW PHILADELPHIA,OH Signed: '" ' r'+=• 5 5 "SPECIAL EVENTS DIVISION•ANCHOR INDUSTRIES INC. 5 O r_:.^..lcPcPcPrJ�S.J�PPcJ�srJc-lc:Jn;..��rlr�P�'�J�rJ?J�J�r�rJ�J�J"cP�cPrJ�rJ�r�r�rJ�r�rJ�r..Pc..f��.��.��T�nrJ�rJ�LP�r?ncJ��n�ncPc.P[�'��n�n�nrJ�Lf3�.n[P�nrJ�rJ�cPcPcPcPcJ� 91 .:;. v .4x ='11��"i4rCiY l >d�,..,.r:�:„?'$�N+'{'x% e^./di%.W:' '�itk�'1�iffi�.'tT.`.F.chi';`u�&i'•R+Ww+�`IAhF��,.4�' r LG�4.:z .;cY K^y seWBVGnwYtt:�:\.�:w'.w`w ".,::; D �rcncJ��nct�rc nc P�rLnJ�c r�cPLncPr�ct 1 M P Q R TA N T DOCUMENT 60 0 O ri r Certlneate of lane .esistapee 5 5 REGISTRATION ISSUED BY Date of Shipment 5 APPLICATION � 06108104 5 NUMBER o > ousTaiE R!!wc. 5 EVANSVILLE, INDIANA 47725 Tent Identification J FI44.1 c ,r 9t MANUFACTURERS OF THE FINISHED 03850284 5 TENT PRODUCTS DESCRIBED HEREIN 5 SThis is to certify that the materials described have been flame-retardant treated 5 {or are inherently noninflammable} and were supplied to:657150 5 PETERSON PARTY CENTER INC 5 139 SWANSON ST 5 5 WINCHESTER MA01890 5 5 5 5 5 SCertification is hereby made that: 5 The articles described on this Certificate have been treated with aflame-retardant approved 5 T chemical and that the application of said chemical was done in conformance with California 5 Fire Marshal Code. Ail fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. 5 SSerial # 8108985(2) 5 5 5 Description of item certified: (5 L5'a CENTURY MATE EXPANDABLEEND 5 40WX20 SNYDER WHITE VINYL 5 Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For ThLe fe Of The Fabric 5 5 SNYDERMFG NEW PHILADELPHIA,OH Signed � ' u' 15r 5 "ESPECIAL EVENTS DIVISION•ANCHOR INDUSTRIES INC. 5 l�cJc1rPccPPJ��cPrcPrPCZF1l1:: PL3pdPLQmPrpcPP�LPLPJ@tc=(rlc!c1�c rrJ�cJ�cS� , o Qug@QQgKggQgKn��g 1 M P Q R TA N T DOCUMENT s Cerm ieate of Flame 'Reslsta12ee SREGISTRATION t �IS�SUED BY Date of Shipment APPLICATION a `s T7��'�9` rIR® 06/08104 5 5 NUMBER '`��j ��i s Tent Identification Ej EVANSVILLE, INDIANA 47725 C5 MANUFACTURERS OF THE FINISHED 03850284 r 5 Ft4Q.l 5 TENT PRODUCTS DESCRIBED HEREIN 5 SThis is to certify that the materials described have been flame-retardant treated 5 (or are inherently noninflammable) and were supplied to:657150 5 PETERSON PARTY CENTER INC 139 SWANSON ST 5 SWINCHESTER MA01890 5 5 5 5 5 5 5 Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved 5 5 chemical and that the application of said chemical was done in conformance with California 5 SFire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. Serial # 8108985(2) 5 5 5 Description of item certified: 5 CENTURY MATE EXPANDABLEEND 0+ 40WX20 SNYDER WHITE VINYL ? l Not Be 5 Flame Washing And Is Eff ct ve For / iriBy The Life Of The Fabric5 SNYDER MFG NEW PHILADELPHIA,OH Signed: 5 "SPECIAL EVENTS DIVISION•ANCHOR INDUSTRIES INC. 5 @] �cTr�cf�cPt.fry'r�cPc1-cPcPrJ-[_I�cJ�LfrS[P�rJ7r�cic.l�€.t3cfr�rncPc.frJ��c.11"c�PcJ"c1��3��.l�ct�.Tc!'cPclcf}cJc!'r�c.tcf�.fcf@Pc.(c.fcSrtrPr�r1'�Pr�cPE.fcJcPr�cJ�cl[PrJ-lcicJr�ci� Q T'his cenifese is by Li Manal I...Gro as is.1n,usnrzsxcas m.frool by those connietnes, BMG068 Certificate of Insurance This ceuificat<is issued as a rtuner of infomation only and wnlers lies ngMs upon die eenificatc holden.This eMi6calc is not an imwanc<poliey and does xt alLrmatively or negatively amend,extend,or ohm die eoverege afforded by die policies EiRed below. Policy omits arc rro 3essthanthosc)isftd,althauhfi paticies may inL7ude additiwsal suhlimitr not tilted below.Policylieniumaybereducedbyclaims or other yunts.s. This is to certify that(Name and address of Insured) Peterson Party Center Inc j 139 Swanton St 1.i1b.(air 4 V Winchester,MA 01890-1918 7{,r u 4uaJJJj su is,al Ne issue date of this comficate,;elated by the Company under the pdicy(ies)]sled blow. The insurance afforded by Ne listed po]icq(ies)is subject to all their teens,exclussiionnss and conditions and 1 is not alteeed b an re uircment,termor condition o(anv comract or other d«urvrent wish res ct to which Nis eertificam ma be usueC. Ex ;ration T e EIT✓E% .boots) Policy Number(s) Limits of Liability Continuous` 1010912008/10/09/2009 WC7-111-259617-028 Coverage afforded under WC law of Employers Liability Extended the fonowingstates: Bodily Injury By Accident X Policy Terre MA $500,000 Each Accident Bodily Injury By Disease $500,000 Policy Limit Workers Compensation Bodily Injury By Disease $500,000 Each Person 10/03/2008/10/03/2009 TB7-1 1 1.259617-038 General Aggregate-Other than Prod/Completed Operations General Liability $2,000,000 _ Products/Completed Operations Aggregate Claims Made $2000000 X Occurrence Bodily Injury and Property Damage Liability Per S1,000,000 Occurrence Retro Date Personal and Advertising injury Per Person 1 $1000000 Or anizalion Other Liability Other Liability 101031-1008/10103/-1009 AS2-111-259617.018 Each Accident-Single Limit-B.1.and P.D.Combined Automobile Liability $1,000,000 Each Person X Owned X Non-Owned Each Accident or Occurrence X H'led Each Accident or Occurrence Excess 10/03/2008/10/03/2009 T]32611-259617-068 $5,000,000 BI/PD $5,000,000 ProdieWCornplchel Ops $5,000,000 General Aggregate C O M M E N T S IMPORTANT If ds«nif tate holo u an ADDITIONAL MSURM,the seniors)man be endmed A stmrnxnt on this cutifi Wit dons ms eamet ligbas n the mtifn:ate hDWn in lien of such atdmsmys)enif SUWAIVED, SUBROGATION IS subjectma to the Jiand caudaiwcs of the policy,«rwn policies may tWm uiM an dutsemrnt A satemmt an this ceni f « ate ds in ounia lights the conficso Mlder in lieu cinch cndnrsomcna. The following apPlins only with rzapect b;tiro.c<[ur mdw carriers regisfaed in FWri<k As provided far in Fla.Sut§320.81(Sxe}.de luted insurance p+licy maY nw be ca+aaliadon kss Nan 54 days»riaenagiaby ac inswn w dx Oepemm�afnwy Safwy&Mwm Vahieies,sm'h 3ndoys mti«+nmmmmee aamdne mut«u re«iwd bYUe Depaztme+rt. Nod«efwnallaUm:(lid eppliublc unless anumbn ofdaysuut«N helot) B<forc Ue stated npimtion doe cite«mpanY will uxcl orrWmcthe insurenu anoNm under Nc aMtve policies will atlues JO days.wi«of " mhcuxxNnion tots barn mn'kdw: Naii«MCrcciietimd«s�sypty wbmlulicifio)arzcmcNN duew len-paYmcnl otpemium. i Office: Glastodbtay CT Phone: 860652-0404 Certificate Holder: AVIV SHAW Peterson Party Centex ' Authorized Representative. 1.39 Swanton Street Winchester, MA 01890 Date Issued 10/14/2008 Prepared By: EH I - i I s� �la.�aaa:.ut+citw - Depm-tinew of Public w.A'ctd Board of Buitdin" Re-uiations and `.^standards Construction Supervisor License License: CS 60219 Restricted to: 00 «: e MARK TRAINA 33 HANFORD RD STONEHAM, MA 02180 i --'— -� fes` Expiration: 4/27/2011 t'onun issioncr Tr#: 14425 l