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61 WARD ST - BUILDING INSPECTION Apr 16 09 08:22a p' 1 r f The Commonwealth of Massachusetts r�One- Board of Building Regulations and Standards Townof Massachusetts State Building Code, 780 CMR, edition 81:16 g Depi Building Pemtit Application To Construct„Repair.Renovate Or Demolish a 11111:16"110111111611111:16"1101111116 or 7'uo-Fun tt ly1 Dwelling a➢I11111111111. This Section For Of cial yse Only Building Permit Numbe . f ate+A lied: �+ 1 Signature: ` l '� q1 c)�/Q 1 Building Commissioner/Insoefter of "Icings Datc SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numben i // Ly a/1,CJ 5T/L4':C� 5s7 Lb,.vs1 G 3y 39°{ L 1 a Is this an accepted street?yes ✓ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ,.. LAMlISCrlf7.e- 9 fis TRJtA�.241-£ �l�QrL. Zoning District Proposed use Lot Area(sit it) '—� Frontage(fl) 1.5 Building Setbacks(ft) ` Front Yard Side Yards Rear Yard I 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: WblicbC Private❑ Zone: Outside Flood Zone? Municipal 0 On site disposal system D _ Check if s3( SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner of Record: NAI r L'r- S.41-)-Mall 1"11/4 ! i tG'<id/J 5r.t T Name(—�) Address for Service: Signature Telephone SECTION 3:DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 1 Alterations) 0 Addition 0 Demolition * Accessory Bldg,Cl Number of Units_ I Other 0 Specify: Brief Description of Proposed Workz: C�tz= iYk pLt 1'ir<;,,f. /71= YJt t/Lb4ajL& -- SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials y 1. Building S I. Building Permit Fee:S Indicate how fee is determined: 0 Standard City/Town Application Fee 2. Electrical S 0 Total Project Cost'(Item 6)x multiplier x 3.Plumbing T 2. Other Fees: S , 4.Mechanical (HVAC) S List 5. Mechanical (Fire S Su ression Total All Fees:S Check No._Check Amount: Cash Amount:_ 6.Total Project Cost: S 0 Paid in Full 13 Outstanding Balance Due: L2009-04-16 07:26 ECO,EWIRONMENT Page 1 Rpr 16 09 08: 22a p, 3 CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT N'll /All(•nl \I a:a Ml 12^WA•d II\aaalN SIXUl • SAWN4,1f.a11.\a 111 Q I to W)7e I cI. '17x.7 t i'616 • f cx v711.74.'rx46 Workers' Cumpensation Insurance fif6dusiC Builders/Contractors/Electricians/Plumbers \plilicaat Information Please Print LEjjbl NameIUu•nwavllrganlraunl><tndn \tldrcss: 1� �r2r'i'i.t�tJC-I%I'? �i�/i6i— CIty,Staic.%ip 111 v-7-(4tj "_1—i 61, 4 (719*y Thune '•': � ��' �3�' UJ �L' .at,art:gnu at can ployer7 Cheek the appropriate box: Type of project(required): I.mt a cm le, er with � ° .,W I 4- Q I :tin a general coulractor alld I lai P y CJi �I b. C] New cunstrucuun cutplo)ccs(full.md'ur pen-time)-• have hired the suh-contractors 2.❑ 1.nn a sole prnprietlt or panncr- :islcd un rhe attached sheet Z 2' ❑Remudeline ship anal have no etrtploycea Thcse sub-contnctors have tf. Q Demolition working tit me in any capacity. akorkera' comp. Insurance. g, C]Oudding addition INo workers'comp. insurance 5. [1 We are a corporation and its I required.] officers have exercised their 10.Q Electrical repairs oradditions 3.Q 1 ant a homcuwner doing all work right of exemption per MCL ME].Q Plumbing repairs or additinnes I myscir.(No aaoritcry comp. C. 152, i_l't).a'>;!eva!:::ve ro 12,Q Rwfaetn16a uuuranec required.) t employees. tNo workers' 13.Q Other comp. insurance required.) tn. .y+phuur IoW ascka boa It moat alw fill we,the v:cuan I+cluw slwwwy+t4u wwkui cumpen m iult Iwhcy ulhntnutwn '1 wa.n+.wrcn who v.bmit this atndav it inJiuling ata)a.e doing alt.+ark aW then him autvale char.<ton mual.utwnit a naw Ar.Javir mdiwmg uah. f,.ntrxuN.row dwxk mit tits mazer ntxhtd.m uedatiurl,l..Ilact ahowiny rho umuC of IM mbiontrxtalta afM thea ouhen'comp.pllhcy mrnn tarnm /oar on eatployrr Thur it pruvinline nurRrrs'rtanpe,rrntiurr inrsudutreJur try corp/uyrrx. Below is floe pulicy and job vile injortrtnrints Ir..orance Company Name: volicv a or Scif-ins.Lic. n: i? Expirahon Dace: )ub site -Xildress: 61 i.C',�1 f2(� .S"(")ZIi.F_T _ City:Slate,Zip: .%ttach u copy of the workers'emnpcmation policy declaration page(showing the policy number and esplratiun date). iraflurc to accurc cuvcrage as required under Scl.tiun 25A of\IGL c. 152 can lead to the imposition of criminal penalties of a tine op hr SI,50o.OQ undlur use-year imprisonment•n well as eic d penaltocs in the farm of a STOP WORK ORDER and a fine •�f up m 52io.o0 a J.ry againal+he violator. lie advl.Nzd that a copy of the,,latcineut may be forwarded to the 011icc of Ina;>n yau•nn til :,tit UL\ :or ut.w.usc caura�c iartitaton. /du beri by a.r _ oder floe n'un penolliec of perjury that the hforrnal/on provided above is true mo!a'arrect .P. _ WtJ�/v ll �l.lt �-._�I- 1('I I j/iris!uneonly. 1)e,nor n'rir[in obi.+arra.to be ctnpltleJ by airyurtown•t//iaiaL ity ur 1'nwn: Ycrmiul.iccrney.uinl;.foudtufily (circle noe): ll....rd .If Ilv,dth '-. ISulldiu., Ilcpanomnl 1-Cilh.7unu Clerk 4. L•'lectric.d Inipertor i. Plumbing Imyccior Othernnuct Tenon: .. I'hmc nc 2009-04-16 07:27 ECO,ENVIRONMENT Page 3 __ — — Apr 16 09 08; 22a P. 2 .,.�� n...n<wd cnununmen�ai 603 642$179 p2 AccoladeEnviromwnlal Coni racting, Corp. PO Box 1256, Plaistow,NK 03865 Telepkone(603) 40"545 Fay 603) 645-4179 Ms.Paul Philliou .ECO Environmental Services,Inc. 24 Arrow Wood Sheet Methuen,MA 01844 RE: Asbestos Abatement 0 61 Ward Street Dear Mr.Phillion, AEC,Corp., a licensed MA asbestos abatemenf contractor(license# ACOOO-584)has removed all identifiedasbes s ma erials(tool flashing) at the above referenced facility.This ork was performed in complete compliance with all State,Federal an I Local Regulations. All waste has been removed from site. AsbestA 6 shall be transported by Service Transport Group for proper disposa at Minerva Enterprises, Waynesburg,Ohio. Waste Shipment Records upon receipt from Minerva Enterprises will be provi led to your office. Thank you for choosing Accolade Enviro for your environmental needs. Sincerely, Frank Kasabian. Vice President. AEC, Corp. Page 2 2009-04-16 07:27 ECO.ENVIRONMENT Apr 16 09 08: 22a p, 4 CITY OF SALEM t pp ' PUBLIC PROPRERTY DEPAR I'MENT 'I •, c I:: SIs. H-�:...`C;Si3t-Ii� 4,tii ti. YLl�+te �; I , .[`F . Construction Debris Disposal Allidav�it (required Ibr all demolition and renovation work) In accurdance ah the sixth edition of the State Building Code, 780 CR'IR section I I L5 Debris,and the provisions of�1GL c 40, S 54; Building Permit it is issued with the condition that the debris resulting from this work shall he disposed of in a pruperly licensed waste disposal facility as defined by IMGL c I 11. S 150A. The debris will be transported by: QL C o. t t•— t4i I I nanac of haultr) i her—cbris will be disposed of in t h 2fL'>a{ it1 n1T�9C_ _LtkrfL.C' 6i,Lw� L4 (OamC ui raCllllyl 4 7 L4 w i:=z L 1LCtA P) n-/r l %tr If �'' 'srTl i taddses�of Aaedity) )Qc�t"Y signaluw ill permit applicant c/_`Ll-�'�f — ,late 2009-04-16 07:28 EMENVIR©NMENT Page 4 RPR.23.2009 1:51PM NEES COMPANIES NO.087 P.1i1 April 23, 2009 New Hampshire Demolition 792 Londonderry Turnpike RE: Service Removal for Building Demolition. Dear Richard Robitaille This letter is to confirm that `per your request,Nation Grid has removed the electrical Service and meter(s)from 61 'Ward St, Salem Ma April 23, 2009. If you have any questions or need further assistance,please feel free to contact me at 508=389-4641 Sincerely, u ixA D.I.Aguiar Customer Order Fulfillment p. l Spr 23 09 03:06p f'ationaitgf'K4 April 23,2W NH Demolition 742 Londoodetry Turnpike Auburn,NH 03432 Attn: Rick Robitailte Subject—Gas Service Line Cut off verification Rick, This letter is to notify you that the gas service line located at 61 Ward St, Salem,MA has been cat off. if you have any questions.please contact me Q 781466-5316. Best regards, Steve DeRosa Sr.Field Coordinator Support Services 781.466-5316 page 1 20Qg-04-23 14:04 Unavailable