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0000 WINTER IS ROAD - Street Files i Winter Is . Rd. c . e Form No. 31 4 N-V CITY OF SALEM FEE DUE: $,®.00 FIRE PREVENTION BUREAU Recd by; f m 48 Lafayette Street Cash o•02 Ck Salem, Massachusetts 01970 BLASTING MAT(S) REQUIRED APPLICATION FOR PERMIT CALL 744-1235 To: THE HEAD OF THE FIRE DEPARTMENT 15 MINUTES BEFORE SHOT(S) In accordance with the provisions of Chapter 148, G.L. as provided in Section 10A, application is hereby made for permission to use explosives in the blasting of rock or any other substance. Name E L1J� hZ �- 1 .�'v may—--- - -- --- ------- -- ---- - --- -- - - ----- -- - --------------------------- (Full name of person,firm or corporation granted permit) at----- -----ES L%7� ------- --------------==------------------------------------------------------------------- (Give location by street and number or describe in such a manner as to provide adequate identification of location. Name of Bonding Company -- Dig Safe No. _7 � �_�,_�____ RESTRICTIONS: ONLY ONE DAY'S SUPPLY DELIVERED TO THE SITE OF OPERATIONS AS PROVIDED BY THE DEPARTMENT OF PUBLIC SAFETY 527CMR13.00 AS PROVIDED BY THE SALEM FIRE CODE. Date issued: ____>_a__` ___l___- 7 � ----- ------------------------- Company --CR�-�f-L......-j3-.....-�--��--��y`l�-`'-------- 7. p 1 !/ 31 -g ---------------- Address4( o�v�1`r-Er-- �j�� > �QVS1� f Date of Expiration: Certificate of Competency No. __ _6 2.2.1___J-�__________________ The following are the conditions setforth in the issuance of this permit: 1- Pre-blast survey of all buildings within�_feet of the boundries of the bi area. 2- Matting shall be required: yes:_L,,' no-, modification of: 3- A written report of the driller's findings shall be filed with this office within two(-_ days°of the issuance of this permit. Failure to file will result in the revocation of the perm; 4- Location of seismographs shall be at: 1- L[d 147 -49a� f : P.(CR 3- 24: . 5: 6: 5- A Police Officer for traffic shall be required: yes: no: J_' 6- A conference with the blaster shall be required if any questions or problems come up with the neighbors. 7- If there are any conflicts between the blaster and the contractor or the land owner, which or may threaten the safety of the public, the blaster is to file a written report immediately with this office. 8- Call 744-1235, to log in with Fire Alarm, 1/2 hour before the blasting. ` 9- A firm (24) hour notification for the firefighter detail will be adhered to. 1: Q D 13FfykDA-1Sk1 understand, acknowledge and agree with these conditions. Signature: Date: :5/ Form No. FEE DUE '>a10 00 ' � CITY OF SALEM A� r Y d b FIRE PREVENTION BUREAU ss Cash •o Ck 5 a ,48 Lafayette Street ''��• Salem, Massachusetts 01970 BLASTING MAT(S) REQUIRED x APPLICATION FOR-PERMIT CALL 744-1235 To: THE HEAD OF THE FIRE DEPARTMENT 15 MINUTES BEFORE SHOT(S) In accordance with the provisions of Chapter 148, G.L. as provided in Section 10A, application is hereby made for permission to use explosives in the blasting of rock or any other substance *r Name 4Ep211z g �__: _ ! w �--------------------------- - ,y / r (F/uulll name of person, /firm /oorr�corporation granted permit) x z r,z w } (Give location by street and number or describe In such a manner as to provide adequate.Identiflcation of location.) Name of Bonding Company � �Dig Sa a No RESTRICTIONS: ONLY ONE DAY'S SUPPLY DELIVERED TO THE SITE OF OPERATIONS }` 4 AS PROVIDED BY THE DEPARTMENT OF PUBLIC SAFETY 527CMR13 00 _ � r r AS PROVIDED BY THE SALEM FIRE CODE Rnii�.bt. a } r err Date issued: 14 `3� 1 7 --------- Company � �L ''7—ifOJ`I S Calili '7•. . --- ------- --- -- --- .. t By-----%----- !�. ------3_ p liJ Date of Expiration:_____!/ 3! QZ ____ ,'Address 2Q�_� �N�!'�_EfvT _i_/�'HAiVShel- ttt ------- --------- Certificate of-Competency No CITY OF SALEM r FEE PAID: r`S10 00 FIRE PREVENTION BUREAU 48 Lafayette Street .+ 3 BLASTING MATS REQUIRED- Salem, Massachusetts 01970 (: � ."CALL 744-1235 , PERMIT 15 MINUTES BEFORE SHOT(S) S In accordance with the provisions of Chapter 148, G.L. as provided';in Section 10A, this permit is granted to: Name __ ___ _ -- Certificate of Com etenc No. 0_4_Z /_ -- ----- -- - - ----- --------- ------------- P Y - -----1---`--------- (Full name of person,firm or corporation granted permit) to use explosives in the blasting of rock or an other substance. A. Name of Bonding Company _10� ___ ----------------------- Dig Safe RESTRICTIONS: ONLY ONE DAY'S SUPPLY DELIVERED TO THE SITE OF OPERATIONS ' AS PROVIDED BY THE DEPARTMENT OF PUBLIC SAFETY 527CMR13.00 AS PROVIDED BY THE SALEM FIRE CODE. at.------1�1 d�� 8 ---- ----- ---- -----�-)G ---------- ----------= --------- --------------------------- ----------------------------- (Give location by street and number or describe In such a manner as to provide adequate Identification of location.) This permit will expire--__//�C Permit issued by----�- �- --- � ��iwt�en..- --- a'%I ---- ------ ------------------- ----- - -------------- (C Ief df Fire Department) THIS PERMIT MUST BE CON PICUOUSLY POSTED UPON THE PREMISES. Form 31 SFPB (Rev. 7/84) ?Fie Cono wnweakh of Massadzusetts * Department of the State Treasurer One Ashburton Place,12th Floor Boston,MA 02108 Expires: 08-Jan-98 Date: 08-Jan-97 To Want 31t Aap Concern 31 berebp certifp that Thomas, Carl B. Construction of Spofford, NH bag on file at tblifs office on tbig bate a boob in the penal oum of 4r tlZL9"OV&SAB WIMI , ($20,000), in accorbance luitb the probitiong of rbapter 148 of the General TAW ag amenbeb by chapter 501 of the Acts of 1946. The bond is dated 1/1/90 and provides for cancellation - upon 30 days notice to the State Treasurer from the SSlstant S e easu principal or surety company. for the State Treasurer DEPARTHSNT OF PUBLIC SAFSTI' BLASTING.CERTIFICATE OF COMPETENCY Number Expires: 9irthdate: , BL 002919 06 2i1'_998 -'6121 19z Restricted'To: 00 t EDNARD 5SNI(OGS7,I 206 MONUMSNT HINSDA.LS, ';N •a2cG1 FM F.P. 84 (rev. 3/80) • �l�r �Ianmtianwr�ltl� of llga�c�eetts ;{ DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COrroNW[ALTM Avgmua.�OlTON EXPLOSIVES USER CERTIFICATE (Own and Possess) This is to Certify that in accordance with the provisions of Chapter 527 CMR 13.04 (10) , an EXPLOSIVES USER CERTIFICATE is hereby issued to: Carl B . Thomas Construction Co P .O . Box 200 Spofford , NH 0346.2 Issued 1/8/97 Certificate # 1919 1 Expires 01/01/98 (State Fire Marshal) This Certificate Must Accompany Each Application For Permit To Blast. ci Of Salem, Massachusetts Fire Department M Lafayette Street Robert`W.Turner Ste,Massachusetts 01970-3695 Fire Prevention C f TeL 97&-7441235 Bureau 978-744-6990 FaX 97&-745-4646 97&-745-7777 TO: Applicants for Blasting Permits BLASTING MAT(S) REQUIRED FROM: Fire Prevention Bureau CALL 744-1235 RE: Blasting Watch Detail Requirement 15 MINUTES BEFORE SHOT(S) Effective this date, all blasting operations conducted in the City of Salem shall require a blasting watch from the Salem Fire Department as per the provisions of Section 12-71. 1 of the Salem Code of Ordinances. As a condition of obtaining such permit to blast, the blasting technician applying for. the permit shall provide the Fire Prevention Bureau with at least twenty-four (24) hour notice • prior to conducting blasting operations. No operations shall be conducted without a detail from the Fire Department present, or without written permission from the Head of the Fire Department . The blasting technician shall be responsible for securing payment for the detail . The hourly rate is currently $25 . 00 per hour, with a four hour minimum. Forms will be provided for payment and copies will be available as a receipt . Signed, Blasting Technician/Company/General Contractor Date Certificate. of Competency No. • Form #31A 9/97 p' 'Trw Comrrronweakh Of gf=achusetts Department of the State Treasurer One Ashburton Place, 12th Floor Boston,MA 02108 Expires: 08-Jan-98 Date: 08-Jan-97 �D f�hDllt.�t tap �DnLEL'TI ..3 herebp certifp Oat Thomas, Carl B. Construction of Spofford, NH hag on file at this office on tbi5 Date a bonb in the penal Sum of aW(1jjZj9 Z-�bQDWW[933 : ®11 , ($20,000), in arrorbanre bjith the probi5ion5 of chapter 148 of the general latn5 a5 antenbeb by chapter 501 of the Acts of 1946. The bond is dated 1/1/90 and provides for cancellation upon 30 days notice to the State Treasurer from the SlStant S e T Uea96�e, principal or surety company. tr the State Trea FLSE3l F.P. 84 (rev. 3/89) TO MMMM I Mraft4 of 9lUSU* us i� DEPARTMENT OF PUBLIC SAFETY—DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH Avatma.Sawro" lug EXPLOSIVES USER CERTIFICATE (Own and Possess) This is to Certify that in accordance with the provisions of Chapter 527 CYR 13.04 (10) , an EXPLOSIVES USER CERTIFICATE is hereby issued to: Carl B . Thomas Construction Co P .O . Box 200 Spofford , NH 03462 ,r Issued 1/= Certificate 191 Expires 01/01/98~ (State Fire Marshal ) This Certificate Must Accompany Each Application For Permit To Blast. 'E�WANSU RANCE'- °^'��' '°°^^�'IFICA ams+snt.aa�s:—•foods'''''°"....'.:. c'^'�,�r�Y^�'l:s'�zi`�. t'�.'�.�.•'•*�-fe:,r_._.v1d....�.„s:... .ea� Yn'a - �. �. /97 PROCiCEhY/ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE'CERTIFlCATE CLirtia Ins. Agency,Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 725 Concord AVe. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cambridge,MA 02138 COMPANIES AFFORDING COVERAGE COMPANY A CNA '. INSURED COMPANY Carl B Thomas Construction Co. e P.O. Box 200. COMPANY' Spofford,N.H. 03469_ C COMPANY 1 D COVERAGES ..-. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00 INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECT CO TYPE OF INSURANCE POLICY NUMBER LIMITS POLICY EXPIRATION LIMITS ! L R DATE(MWDD/YY) DATE(MWOO/YY) GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERALUA13MM C00586345Q. -01/G1-/97" 0'1/0r/9B PFTOoucTs-c6MP/OP AGG7 s CLAIMS MADE a OCCUR PERSONAL&AOV INJURY sinannno OWNER'S 6 CONT PROT EACH OCCURRENCE slmn000nf n �'r PrOdflC"—ao� ''�i11eS FIRE DAMAGE(Arty one fire) S00 MED EXP(Any one person) S n AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS 130DILY INJURY SCHEDULED AUTOS (Per person) S c. HIRED AUTOS BODILY INJURY S NON-O MED AUTOS (Per accident) ' PROPERTY DAMAGE I$ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT IS . ANY AUTO OTHER THAN AUTO ON EACH ACCIDENT 1$ AGGREGATE IS EXCESS LABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM S WORKERS COMPENSATION AND STATUTORY LIMITS A EMPLOYERS*LIABILITY WC 123 5 2 2 2 7 0 01/01/9 7 O 1/O 1/9 8 EACH ACCIDENT $ THE PROPRIETOR/ n INCL DISEASE-POLICY LIMIT S liomOOO PARTNERSIEXECUTIVE _ :. _.:�.;,__:._. .. _ _. :...:......-... _ _ _. _-r- --- --- OFFICERS ARE: I I'EXCL r DISEASE-EACH EMPLOYEE Is 5000000 OTHER DESCRIPTION OF OPERATIONSILOCATXONSIVEHICLES/SPECIAL ITEMS , Operations of the iNsured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Co=onwealtr. OI Z--ass. ,Dept. of Public Works EXPIRATION DATE THEREOF, THE ISSUING. COMPANY WILL ENDEAVOR TO MAIL AC to: Steve Viola j Fire P recenti-on Of L i—ce 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 1010 Co=onwealth Ave. BUT FAILURE TO MAIL SUCH NOTICErSILL IMPOSE NO OBLIGATION OR LIABILITYBOStOn,L SA OI LS ANY KIND PON C ITS AGENTS OR REPRESENTATIVES LITHO RE RE I I ACORD 25-S(3/93) ; =m ACORD CORPORATION 1993 THOMAS ` DRILLING AND BLASTING SPECIALIST ROUTE 9. P.O. BOX 200; SPOFFORD. NEW HAMPSHIRE 03462 TELEPHONE 603-363-4706 363-8837 TRUCK MAINTENANCE REPORT Date To Truck number Milage Make Color FUEL SUN -MON TUE. WED THU FRI SAT M T W TH F S Oil changed Oil filter changed Fuel filter changed Plugs changed Points changed Air cleaner changed Air cleaner cleaned Truck greased Battery checked for water Battery terminal condition Fan belts checked Radiator fluid checked Transmission checked Rear case checked Wheel bearings checked Generator checked Hydraulic pump fluid checked Brakes checked Service brakes including trailer brake connections Parking (hand) brakes Steering mechanism _ Horn _ Windshield wipers Rear vision mirrors Coupling devices Wheels & rims Emergency equipment Tires REMARKS Tires rotated All lights & reflectors checked Does truck use oil Cleaned inside Cleaned outside General appearance List all dents or damage List any repairs done or to be done and any comments NAME PPP 6228 J �t Lv/,Jc, ko t-&-; All�L6P- OCT-28-97 TUE 04 :44 PM "CONTI.NENTAL. PLACER 603 524 7476 P. 02 Of CONTINENTAL PLACER INC. . P.O.Box 825 L,iCON1A.r4 w HAMPBHIRE W247 rt17.1 1 W.WHUN5(602)524-OB 11 FAX(60M MA-7476 MEMORANDUM Mc. Rua Hickcy Caul Thoxxxas Cunstruc;tiuxt Coxp. 1 rnm: Brent T4rdrif 1)ate, October 29, 1997 Subject_ Pre-1 last Survey at Wtxllcr IalWld Park -- S dt:ii4 MA. War,tr+FieatY��+rt-t,r,i.y.a..ao..r.uwMr�kkyljFdudeie3ed2aaaai.q.r�LAAA�i�•mr.dr�rJr�1r�MJrJrvb�Y�4btk6A4A%'.Ah4,4 AAA ,G;..t,�+..a.k Continental Placer rer.sononal conducted a px•e-blast survey at dic subicct lucatiuxi uxi OtAubA r 23, 1997. Continental Placer rapt with the foreman of the Sener;'al,coutkactlnA cu' wpwxy "Aid cslrllliucd the protocol for conducting flip .survey. Continental Placer was uxstxuetcd by tlic gcncral contractor to survey the light hniise, the new pica, thrz uew boat ramp, tlxc e,x,lcriur of tllc old US Coast Guard building and the exterior ofthc snia.11 cafe. All of these stxuA:.tutas were surveyed using a video camera with audio recording c.apabi.tities_ Continental Placer also rnct with Mr. Roborf Hollows, Construction and Diw0upaAcxAt Coordinator for the Masvachugctts 1)erartnaP.at of Fishcrics, Wildlife and Exxvirow-nexxtal Law Enforcement Public Accesq 'Board. Mr. ljoltows inspected the new boat ramp with CvatuAcalkd Placer. He has also requested, and will r cei,ve,, a copy ofthe video tape. AttaA:hed is Pre-Blast Survey form provided by the. Sateini.:l`ire Department. Continental Placcr cuutac:ted Inspector Frank Preczcwski, Jr. to verify that the video tape could be used to rcVlmc:c the liardbound notebook, still photographs and audin re.rordinp requested by the Fire Dc.paruncia. ZusPc:elur Preczewski authorized the use of the ti7dco tare. A. ropy of tlu tape will also l,Ar autdc lux• the Fire Department. '11.1c original copy of the video tape will be kept on file in rnir office tox- sins niontlis unless uthcr arra.rxSements arc xtiade. At the end of the six months the survey will he destroyed. GEOLOGIC,AND ENVIRONMENTAL SERVICES Y OCT-28-97 TUE 04 :44 PrT'-CONTINENTRL. PLRCER 603 524 7476 P. a 1©-a7-I yy/ 1 1 ;f'M11 FRom P. 2 ciu v^f a y Mas�sac_hmge_�% Tire Depamizent Ski Lafatyettc.street JR,obvT q•V Trrng> Sakm.Ma3sacfiusetts ni..i7o-.3F95 jtre Prez4 nrion C/iie1 `le-C 978-74443V5 'Furwu 975-741-69.9U `fux 976-740 46d6 978-71s;7 7 7 PAX 978-74%-9Gn2 PRE-RUAST SURV.EY IN ACCORDANCE A.177''''';•'E PROVISda1d13 OF CYAPMR 12, SEC7 ON 70, AS A119ENDED, OF THE RBl/1sED ORDINANCES OF 3ALF-m(Y952), DATED MAY 21, 1996- Chanter 12, sectlon 70 (c); TnO survey data shall be recorded in a perimanent manner. In approved hardbound notebooks_ The survey dogs WWI included photographs showing the building o8hetfuctien su".yird, referenced to the notebook pepays. Also, a tripe recording of all data.pertinent to&he survey shall be made. the scope and format of the record survey shall be satisfactory To than Fan Marsh;oi. Before commencing any blasting or ledge excava- tion, a copy of the surday rnust be on filo in the Offfoe of the Fire Marshal, in accordance with the Board Of Fire Peeventlon Regyletlons, 527CMR13.09(10)(e-). The filing fee for the Wrvey shell ba`525.00 (twenty-five doilars), payable to the"Glty Of Salem", and shall .2ccO npeny the copy tiled with the Fire Marshal. (City of Salem) .w•�rrr++.�.rrrr....+.^�Ir�4�a�wwwwf*rfr+:rr.rrw►.ref.see*j-rieww��.wr+++��.?�j�.�...+►.wwww+rww..Qr�.. LOCATION (STRRET)OF THE BLASTING: W IV, K✓ r��,�y��. 'i4f V NCW b•trr Ra-wr? DATE OF THE FILING' 10 29 14- SURVEYING COMPANY:l_MA }NWI A-IA A lltkEcil ADDRFS3:�Q_ C, CITY: . ��C_otn tt STATE; N zlP: a4 TELEPHONE NU.rABER:�(k)3 ' O191 FAX: &03= S ACf- 71{7 SURVEYORS NAME(print)• v^eh uT J � J SURVEYOR.'.<.t $iGNATURE: /^ /� C.4 I NAME Or, PROPOSED BLASTING COMPANY: Czkr') � w14 6 .5 &AS'� CO 1OrI BLASTING COMPANY CONTACT PGRFdON, &-crr`f L r.,� C, BLASTING COMPANY PHONE A &�J&3-00(o FAXAt &63.7 30- �Z`f`i AA^^^^^A^AA AA AAAAAAAA^AAA^^AA^AAA^AA A A A A&A,A.AAA A A AA AAA^^AAA^AAAAA^AAA SUF^lvEY RECEIVEp BY;_. DATE; ITEMS RECEIVED: (1)=HARDBOUND NOTEBOOK. (2)=PC7LAROID PICTURES:_ _ (3)=AUDIO TAPE RECORDING: FEE: rASH:_ AAA^A AA AAA A AAAAA^^^AA^^^A^^A^A A^^^AA AA A.A.A.AAA^AAAAA^^A^AAA^^^^AA^A^^A FOFrt #7n RF.V 10/97 City of Salem, Massachusetts Fire Department 48 Lafayette Street 29 Fort Ave. Robert Turner Safem, Massachusetts 01970-3695 Fire Prevention Chief Tel 978-744-1235 Bureau 978-744-6990 Fax 978-745-4646 978-745-7777 FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE Y AND THE SALEM FIRE CODE, APPLICATION IS HEREBY MADE FOR THE APPROVAL OF PLANS w w AND THE ISSUANCE OF A CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT BY THE U_ Co w 8 SALEM FIRE DEPARTMENT. ( Ref. Section 113.3 of the Mass. Bldg. Code) Z O c~j� O JOB LOCATION: �Sr W tNT�� CSc,g�a P-0A-ram O w Z w OWNER/OCCUPANT: O !- E- ELECTRICAL CONTRACTOR: Z w � n' O FIRE SUPPRESSION CONTRACTOR: � � Q2 �B SIGNATURE OF APPLICANT: q / PHONE �.g/l�'.. 7 7-4 ADDRESS OF APPLICANT: .3"{ �N r NT /L =4 h%JA 9-a CITY OT TOWN: APPROVAL DATE: l U Certificate of approval is hereby granted, on approved plans or submittal of project details, by the SALEM FIRE DEPARTMENT. All plans are approved solely for identification of type and location of fire protection devices and equipment All plans are subject to approval of any other authority having jurisdiction. Upon completion, the applicant or installer(s) shall request an inspection and/or test of the fire protection devices and equipment. (ADDITTIONAL REQUIREMENTS, SEE REVERSE SIDE ***) NEW CONSTRUCTION. PROPERTY LOCATION HAS NO COMPLIANCE WITH THE PROVISIONS OF CHAPTER 148, SECTION 26 C/E, M.G.L. , RELATIVE TO THE INSTALA- TION OF APPROVED FIRE ALARM DEVICES. THE OWNER OF THIS PRO- PERTY IS REQUIRED TO OBTAIN COMPLIANCE AS A CONDITION r OBTAINING A BUILDING PERMIT. / d D PROPERTY LOCATION IS IN COMPLIACNE WITH THE PROVISION OF CHAPTER 148, SECTION 26 C/E, M.G.L. EXPIRATION DATE: S GNATURE OF MIRE qFFICIAL FEE DUE: UNDER 7,500 $ .SQ FT. - 10.00 7,500 SQ. FT. OR LARGER- 0 FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT In compliance with the provision .of Section 113.5 of the Massachusetts State Building Code, and under guidelines agreed upon by the Salem Bldg. Inspector and the Salem Fire Chief, the applicant fir a building permit shall obtain the Certificate of approval (see .reverse side) and stamped plan approval from the Salem Fire Prevention Bureau. Said application and approval is required before a building permit may be issued. The Massachusetts State Building Code requires compliance approval of the Salem Fire Department, with reference to provisions of Articles 4 and 12 of the Building Code, the Salem Fire Code, Massachusetts General Laws, and 527 Code of Massachusetts Regulations. The applicant shall submit this application with three (3) sets of plans, drawn in sufficient clarity, to obtain stamped approval of the Salem Fire Department. This applies for all new construction, substantial alterations, change of use and/or occupancy, and any other approvals required by the Massachusetts General Laws, and. the Salem Fire Code. Exception,: ' 'Plans will not be "required for structural work when the proposed work to be performed under the building permit will not, in the opinion of the Building Inspector, require a plan to show the nature and character of the wort: to be performed. Notice: Plans are normally required for 'fire suppression systems, fire alarm systems, tank installations, and Fire Code requirements. Under the provisions of Article 22 of the Massachusetts State Building Code, certain proposed projects may not require submission of plans or .;:ef complete compliance with new construction requirements. In these cases, provisions of Article 22, appendix T, and Tables applicable .__shall apply. This section shall not, however, supersede the provisions outlined in the Salem Fire Prevention Regulations, Chapter 148, MGL, or 527 Code of Massachusetts Regulations. All permits for fire code use and/or occupancy shall apply for the entire structure; fire alarm and/or smoke detector installation shall apply to the entire structure based upon current requirements as per Laws and/or Codes, but the existing structure may comply with regulations applicable for existing structures. Notice: Sub-contractors may also be required to file individual applications for a Fire Department Certificate of :approval for the area of their work. Such sub-contractors shall file an Application to Install with the Fire prevention Bureau prior to commencing any work for those areas applicable. FORM #81 REV. 10/97 Fee Due$10.00 City of Salem, Massachusetts Ck.# 7 Cash FIRE DEPARTMENT-FIRE PREVENTION BUREAU Rec'd by 29 Fort Avenue Salem, Massachusetts 01970-5232 2. APPLICATION FOR PERMIT (Dae) To:HEAD OF FIRE DEPARTMENT In accordance with the provisions of the Mass.General Laws and/or the Salem Fire Code,application is hereby made for a permit to install approved fire alarm devices. Location: --ris>e / S ILAV.—P le—,4 Owner: A4,R /:7.q 41" = W Installer: �'D wto/0-P ele2 Gs9—r Tel# Installer's Address: $3 _ != `-rv,,, . S!T- A-fC--&4b-et7 Zip: O 6LI S 5 License* �' b D '71 O Z Type of Occupancy: a -LIST TYPE AND LOCATIONS OF DEVICES ON REVERSE SIDE,OR PROVIDE PLANS.- Installation subject to final inspection and filling of Certificate of Completion,by installer.Installer must be present. Date of approval: 2 2,4 Cl 4e=t (Signa;joeof Applicant) Date of expiration: -7 Z Z (Address) Form*81F(Rev.04/92) DO NOT WRITE BELOW THIS LINE a I 1 • i 5TUDY DINING ROOM REPLACE WINDOW I GARAGE 5 q p o ° I.f•' I 'I r Ii -1FI1I1IIIII —_LIIIIIIIIIIR1IIIIII IIIIIIIIIIIIIIIII-------J-RIIIIiIIIIIIIIIII -----------1RIiIIIIIIIIIIIIIII-D1II1IIiIIIIIIIIIIIIIiI-III1IIIIIII-----------I►IIfIRII1IIIIIIII1 1IIIlIIIIIIIIIIII1—- -_- - - ALI GN FIN. FLOOR — Ii - — ---- �-- rQ n_--IT--- f11___IT II1 ill � -D N If 11 11 111 11 D ILY EAT NG IDW' JP KITCHEN P.M.Z..Z. STORAGE</D EL ON ti © J—LJ u u u W u PORCH PATIO FO rr n n ————————————————————————H——ii--t --i i— , 1II ��Nt9ppNl / a♦��'.�'r'' I/ ^7 - ' f I 1� • I I l • i II II III I li /--____.-/---- 1I I I III �`� i I � / • II II III � Q I � / •� it II III G ,T ROOM / / /• It II II I ----- II II II TI__ tT_ I ��\�� lllj�iii' \��\ /�i • / wj ZOO 21-0= 25,-0= f el lie / � _-� � i /III i ��------ � / IJ `t• 0..� I 1 . I j � I / � I � ��'. 'bad��.,Z' -, � •��'•.'�• / FIRST FLOOR PLAN 1/4" = 1'-0" / PAPICH RE►SDENCE 35 WN'ER ISLAND ROAD SALEX MASSACHUSET'TS PRELIMINARY DESIGN / salley associates / REGMERED ARC 4=CT OCTOBER 24, 1917 i aa� I BEDROOM I BEDROOM rc v �@ o 5 � I i LINEN Q I S C/ I BEDROOM ( lb L r nN S � 11 I !1 ,. ail I 5 ' STORAGE GEILIN6) I - _ -I- 2'-II' HI&H w'°a-I- UMN 4 !:j '� �� 1111YYJII V-11' HI6H --- --------- ---KATL-------- -- W.I.G.------------ esamsasaoa aaaee®eam®= I (10'-0* HI&H GEILIN6P S c �— II MA5TER EDROOM SUITE /N - - ---- -� I ----------- -----------_ t LIJ SEGONID FLOOR PLAN I/4It = I'—O" RARdCH RESIDENCE 35 W1N TER ISLAND ROAD SALEM, MASSACHUSE77S PRELIMINARY DESIGN salley associates REGISTERED ARCHITECT OCTOBER 24, (QQ1 r y v �-4-_ 1 'IN Ll L" , L J I ILI , U11 Uji ILLJI I LI-Ji IILJIJ i i t Lj �___-__--.__ 0 F-1 FTT1Lj H' 'Lj 4 � 4 � _^ — - -- - NEST ELEVATION NORTH ELEVATION I/411 _ I,_oil 1/411 _ 11_011 ,1 LLJA LJ i i EAST ELE\yVATI ON 11 PAPICH RESIDENCE 35 WIN'TER ISLAND ROAD PRELIMINARY DESIGN Salley associates REGL=RED ARCHITECT OCTOBER 24, lel -7 ptA lit 1,1 Z110,01011(firl III m fL t)1vislon of Fire and APPI.-IM1014 FOR PMUT, AMA PWIM.I.T, fQH RMOVAI, AND THAI ISPORTMON 10 4'VIIOVW lAtJl( YAHO Salem (lit—Y. Town Of 01011191 634 piq 4 d 25.00 N/A 140, UP! IUA, & S Tank Cleaning, Inc.— !i27 coll 9 . 00 uppl-lipotipl) 14 havot4y 41000 tw-- 10111 Foster S- ee, Y. MA 01 AlsoplawrQ of OPPIW414; App)l(,afIt!4 "AIR@ printudl- Ann Bash vor- 0111lat:; Mr. Conway 25 Winter & S Tank Cleaning Inc Stql-q 1,1c. MA326 N/A E, P.A. #—.---N/A--- Appt-Pvecl tank y,5t-j.14 11149 Turner Salvage 20 Cormprrial St.- TVnn-,MA 'I'Ypa or 1114vt q4ql N/A tjj. tallk It N/A--- fuel oil Mto or lap"Q;— 19 519ilature/Title of OrliflOr granting vqpplt,,— KEEP ORIGINAL AS APPLICATION AND ISSUE 1)UPUCATE AS PEHM11- -IWV fv)clll gov (9/90) Sa,eem Ft-te Department Ft.,Le Pteventton Bureau • 48 Labaye#te St.- eet ' C� Satem, Ma 01970 (617 ) 745-7777 FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT In accordance w.t th the pn.ovt,6ton,6 o4 the Ma,6-6achu 6e t-6 State Bu itdi ng Code and the Sa.eem FiAe Code, appt cation 4,6 hereby made .6on appnovat ob ptean6 and the .i,6.6ua.nce o4 a cen tZ-6,i,ca to o-6 appnovat -6o., a bu.i ed Lng penm-i t by the Satem Ft to Depar tment. (Re4. Sec 4-on 1 13. 3, Mazz. State Btdg. Code) Job Location: f Owner./Occupant: <-- `� Etec tn,i.aa a Contra.cto., : Ft,te Supp�re-6-"on Cont-ra.c to-c: 1< S-i.gna tune ob Appt4x,ant: Phone # _ Addrezz 0,6 C.c ty on A p pt-Zca.nt: G �� L T own: Appn.ovat date: � r Cen -Z,6,c-ate of appnovat -i.6 heteby gna.nted, on app.,Loved p.2a.n6 o-,L .6ubm-ittat ob project de to itz, by the Satem F.vice Department. Att pta n.6 ate approved aote.ey 4o., tdent i 4tca t i.on o4 type and .eoca t i.on ob J4.,Xe pnotec ti.on devtcea and eq"pment. A-et p-ean,6 are 6ubjec-t to appnova.e o.,6 any other, auth.on,i ty having juai,4dZc�ti.on. Upon comptet-ion, the appttca.nt o., tn,6taZZe- .(4) 4hatt .,eque6t an tn,6pecti,on anal./or, te-6t ob the 4Z.,Le pr.otecti.on devtce.6 and eq"pment. ( ** FOR ADDITIONAL REQUIREMENTS, SEE REVERSE SIDE ** ) 0 New co"tr.uct4.on. Property tocatton ha-6 no compttanee with the pr.ovt4.Zon.6 o4 Chapter. 148, Sec�ti.on 26 C/E, M.G. L. , neeati.ve to the Ln,6tat ti,on o4 approved it-te a ea�rm devtc". The ownea o4 thus property t4 %equt., ed to obta in compZ i.ance a-6 a Bond it-i.on o,6 obtatni.ng a Buttd i.ng Pe-.,un-it. Property Coca t i.on t-6 i.n comp-P,i.a.nce wi th, the pr.ov4,-6ton.6 of Chapter. 148, Sectti,on 26 C/E, M.G. L. y xp4Aat i,on date: Stgna t o f FtAe 044.i.ei,a e Fee due: under 7 , 500 Sq. Ft. - $10. 00 a 7 , 500 Sq. Ft. on taAger. - $25. 00 Form # 1 .(Rev. 9/87 ) ' � • - i. a �� RBI///.//�/��I� �M �� a�� 4L'•y �f� M1� 3 1r �3 O J11K..I _ ALA"T Ir lid sa-o l (LCOLOT Z& p D �slol�!s r J tit . FISTas:+ 7 � ct ! . s tv aR ,. 2a7 Z A MST 3 ll• . tii.et �'. >fr _ 0 1 �.'+�-.'Y ]* ..-'d- -••"\„_Lm..:� {' 4s:Xl�a•'rlfw{G�i 2 S�?'.;�t9 �� ijr .•1 �3,•-� � ••� � LOY 1T ,T . . �p�� /. F.X�ST'G k Ayov-n o t-J - r-t o A4vHALT by any ther _ Cr1v�4lAY. +i�>S ec. si " j:GT a Subject to approval 'TGTAt. [( ❑. authority having Jurisdiction. xa�T� z STot«+(.. aCs - CITY ofSALEM, S. L.oT tov�_sACt~ c� !r *' I< RETIE 0 AU Sc�:AL_E t : ZO BY s U�-c?'r PLAPIS ARE AP »1 OVED SOLELY FOR IDENTIFICATION OF 1�A � TYPE AND L ATION OF FIRE PROTECTION DEVICES- AND l VY � � � j �j�I[r ( 'ts?�GS� ALL FIR PROTECTION DEVICES ARE SUBIEC7 TO I_ ___. ! _ _.M,.._.. _.._,. FOR COMPLETE GOMPL!- ,;a�'r�a sa SU kTV ^7 b`? >^' ,: c a 4•l t� FINALT S.TANOINSPECTION, Mot wVTH THE FIRE CQDE. Lt F-S I+ ' OAA uLJa.ir: tt+ 1`9S-' t - - - - .. "� �t�i t"'� '�`t�:.t..�f+%1 1 Fa F''�`.'.a�,�;�a:'h ?-c�;r•.: �4.",:;r,F;��.cr I 1<16 ., , k�f�$'� �{�r•?�' t.is I'e ��r�y�,' . IE- 2: IO tS3/J~,.•f'tE' , I- / ir ANC taOT EA V- i y -� C"Ll J, ' -as CA V t—E?- r tti 'f'p1�r TOC. I'I. 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C.•.>\. t- �'- '!,!r '-!L 1.S'- t'_ a -F t Z:. zL x; T: _ _ —1_=. -: 1 1 f ' t I,` I ✓` � "r�. st..:,i:- . . -. -. � .Tiec- a a :s --_ —._Y.. - _�__��.._. t r' I .'9 ri i •t/ j ;'�:, E• � ,r.� +I r:. .n_`�.,,._._.....,�-..,,. .+.•..� y 'f 1: I f. i� ,;a "a4.. i,1..f�''.•.4+ • 0 L-7 t. , < A• '. = II FA MI ' � I I ! I I t I I ! I r •r i j (� f f I � � i ! I I , _-� — _ ,i ai ,�i ^I s� ``..+ ';i'4�1 i t' i A C Ug Fluaeon E—L L Boston, MA 02109 Street C A C t� •- f r l ICE , a t SALEM FIRE DEPARTMENT r Fire Prevention Bureau RECOMMMEENDATION Name tvl '. J.- Merrk� '1 -f Date ... 19...-..74 ♦a Address-------. 1 ...W ter Island Roads Salerrl� ---------- -- .,--- - . As a result of an inspection this date of the premises owned and/or occupied by you, the following recom- mendations are submitted which should receive serious consideration. These recommendations are made in the interest of fire prevention and to correct conditions that are or may become dangerous as a fire hazard or are in violation of law. you are hereo __r-q#fied- that the -three unregistered go toy~--t'ehicles used for storage of combustible debris on your prom§ses- shad _ire rem©ved- as.- they or`eate a fire hazard, This is a violation of Chapter 148, Section 28;0 .of---the..Geneml...Laws---o-t---tile_._ 0 4nWealth---t?f_Xaz.0ac-huzoUS----- ---------------------------------------- Reinspection date: ?stay ?9,*-- 1g7 cc a He t Ire `t. � - Form 25 SFPB F`�j -(--P t _ rat ii-- �.d ------------------Ins Inspector Bux ding Uspector - p SALEM FIRE DEPARTMENT Fire Prevention Bureau RECOMMENDATION Name..........-LaINVence L. LeBoeuf ------ ............................. .................. -------------------------------------- Date-----XMY---15A...............................19... 12 Winter Island Road# Salem Address--- --- ---------------------------------------------------------- ---------- --------------------- As a result of an inspection this date of the premises owned and/or occupied by you, the following recom- mendations are submitted which should receive serious consideration. These recommendations are made in the interest of fire prevention and to correct conditions that are or may become dangerous as a fire hazard or are in violation of law. It appears that you have been operating a painting business from your -------------------------------------------------------------------------------------------------------------------------------------------------------m..................................... ............... iome at 12 Winter Island Road, Salem in violation of Salem Zoning ordin- --------------------------------------------------------- ----------------------- ------------------ ------------------......-------------------------------------------------- .....-1------------------------ ances. Upon. complaMt from an interested CitiZer. I find upon inspection -----that i appears --------------------------- ------------------------------------------------------------------- ---upon ............... ...... at th- s appears-,to be the condition You are hereby notified 'to remove --all----fj:=Mabj:e ---grid---thy---d6hVA*d---fr'64.------------------------------------------------------------------------------------ YQ�r !operty and a copy Reinspection date:-----0 f----th-is---notice---has-been---fo-m,-wjd d--7.. .... ......................... SFPB Tvc., P^" —_1 /Z-� Form 2S ........................6-------=n_x"----------------- -------'.Inspector my �'rA'rG ADJu�t'M1rN'r ;�taitViCt IlslaliN j0 i a BOX 338 r Meld►utwl ,h a�nua� ANDOVER, MA9SWI IUSE118 01810 0338 Mu1v"111 FAX 1608.414-03304 0 �e1, 1,owd: 468-2642 V Andover: 476.8111 Lynn: 686-6050 leverhll: 314-0262 / CITY WINN DEPARTMENT "fior,m) or 11SAisTI U11I1,0I11t3 COIIMISSIoNER ,or OAi1Q. OF 691,RCTMEN SPECTOR OF RUI CIT CITY OF STT L'M CITY HALL SALEM, MA 01970 SALEM, MA n197n - BOB INSIIRBf1 t PAUL C. Q' SHEA PROPERTY ADQRBSS1 15 WINTER IS POi.ICY 110. t TP14an45'1 t:OHPAIIY i MERRIMnru MTiTTiAT. 1.0011 OV i WATER PATS i JANUARY As 1 99 5 FIT'B OR CLAIN NO- 1 5-029-w liAQB INVOi�VINti i3Ot1H . 11A114(10 OR DESTRUCT-toll OF TUR ABOVE CI,AXN 11A0 BBC" 000. 00 OR CA11HB HASS . . dAPTIONEO PROPBRTY, WHICH HAY BITUSR EXCEED � 1 , SBTTO_KNERAL LAW1�CIIAPT�C At as T1OOI.i APTER 1 i9 NCCTIOII i3R is� ANY NOTICB UNDOR "houbcol18�TT B,NS A� iCll��._ �_�__ INCLUDE APPROPRIATE, YI�EASB 11IRECT IT TO T11B ATTOCATIONOFp01.ICYRNUMBSol DATE OF A REFERENCE TO A CAPTIONED INSURRIIs i. t L000 . A14D CLAIM Of FILE NU"Dl3R, WILLIAM .J. MCGETTRICK T$�,. — ADJ. TITLE ON TI1I0 DhTflg I CAUSED coele.q., Of TWO NOTICE TO QB RBUT TO THE 81100118 . MAIL- NAMED ATIOVRg AT THE ADDRESSiTi'f"INDICATCU AIIOVRt NY FIRHT t . BIGt_��g ATB r ' • B 'CON p� ; � of %1PriY, massMC IIsP Fee Due$10.00 ., . � FIRE DEPARTMENT• FIRE PREVENTION BUREAU Ck.# 4.37 Cash 48 Lafayette Street Rec'd by: nTl Salem, Massachusetts 01970 APPLICATION FOR PERMIT gate) To: HEAD OF FIRE DEPARTMENT In accordance with the provisions of the Mass.General Laws and/or the Salem Fire Code,application is hereby made for a permit to install approved fire alarm devices. Location: !2— IV 7 �;�� /�o� Owner: Installer: E,ei c. L o Tel# Installer's Address / � o License# ,19-�2 919<'— Type of Occupancy: �C f of 2Gt, — LIST TYPE AND LOCATIONS OF DEVICES ON REVERSE SIDE, OR PROVIDE PLANS. — Installation subject to final inspection and filing of Certificate of Completion, by installer. Installer must be present. Date of approval: flPCPmhpr. 2n, 1985 (Signature of Applicant) Date of expiration: January 20, 1986 (Address) Form#81F(Rev. 1/83) DO NOT WRITE BELOW THIS LINE ADDRESS: TYPE; OF OCCUPA C : 1 2 3 4 5 6+ Condo MercItl TIME: _ 4th—FLOOR PUBLIC WAY: 4th-FLOOR APARTMENT 4th—FLCOR APARTMENT ZOIJE CORRIDOR: ; FRONT: REAR: 3rd—FLOOR PUBLIC WAY: 3rd—FLOOR APARTMENT 3rd—FLOOR APARTMENT Z�fd:: CORRIDOR: #; FRONT: REAR: 2nd-FLOOR PUBLIC WAY: 2nd-FLOOR APARTMENT 2nd-FLOOR APARTMENT ZONE0 RE CORRIDOR: 1st-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 1st-FLOOR APART14E,NT ZONL CORRIDOR: 'RONT: REAR: 3ASEMENT: BASEMENT SPECIAL KEY KEEPER: 'ANEL L �OCATION: HORN AND LIGHT: SILENCE SWITCH : SPECIAL LOCATION: SPECIAL EQUIPMENT: SYSTEM VOLTAGE;: AC DC BATT. SD- Smoke detector RR-HD=Rate of rise HD IC= Inter-connected HD- Heat detector FT-HD--Fixed temp. SS- Single station cam �itp of 6a lem, AnoacbU00t.5 Fee Due $10.00 per unit FIRE DEPARTMENT•FIRE PREVENTION BUR! AV Inspection date: r�s 48 Lafayette Street $ Salem, Massachusetts / APPLICATION FOR CERTIFICATE OF COMPLIANCE n XOne Family Dwelling < = - 61 P"k To: HEAD OF FIRE DEPARTMENT ❑ Two Family Dwelling ❑ Condominium Unit # In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application is hereby made For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. 'lope of Detectors: A. Monitored Battery Units B. Permanantly Wired Units Owner j ij v6 ��+► rfw4-3y^ Address: (Give location by street and number,or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Detectors Require Annual Maintainence. (Signature of Applicant) Date of Certification: (Address) By: L�� (Phone) ADDRESS: TYPE OF OCCUPANCY: DATE: 1 2 3 4 5 6+ CONDO. MERC'TL TIME: 4th-FLOOR PUBLIC WAY: 4th-FLOOR APARTMENT 4th-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 3rd-FLOOR PUBLIC WAY: 3rd-FLOOR APARTMENT 3rd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 2nd-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 2nd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 1st-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 1st-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: BASEMENT: BASEMENT SPECIAL: KEY KEEPER: ZONE #: PANEL LOCATION: HORN AND LIGHT: SILENCE SWITCH: ZONE #: SPECIAL LOCATION: SPECIAL EQUIPMENT: SYSTEM VOLTAGE: AC DC BATT. SD=Smoke detector RR-HD=Rate of rise HD IC=Inter-connected HD=Heat detector FT-HD=Fixed temp. SS=Single station SALEM FIRE DEPARTMENT eje Fire Prevention Bureau 48 LAFAYETTE STREET, SALEM, MASS. 01970 'Cuo•�.a°'� Date . . . ./V jV. . �.j. . . . . . . . . . . . Certificate of Completion - Installation or Alteration of Oil Burning Equipment The undersigned hereby certifie hat the ins Ratio (or alteration) of fuel oil burning equipment and/or storage tank and applying to the installation for (Name of Owner) ..............(/r....�/r�.'!1.�.�................. .......... Floor he....................... / bysystem...................t........................... at(Address) .................. ..... .e`?1.�� ....Tv./`I .. ....t........................... (1st,2nd,all) has been made in accordance with provisions of the Salem Fire Prevention Code,of Chapter 148,G.L.,and regulations made under authority thereof now currently in effect and pertaining thereto.(Ref.527CMR4.00) Furthermore,this installation has been tested in accordance with such requirements,is now in proper operating condition and complete instructions as to its use and maintenance have been furnished to the person(or persons)for whom the installation(or alterations)was made. BURNER Name................... e?c r',/ ................................ Mfg.b ff:`C ,t! . Type......... ............... .1V.'')................................... Mass.Approval No. ......../..�j ............................... To use not heavier than......... .......fuel oil....................... Kind of heat................. ........................ (D.H.W.;F.H.W.;STEAM;F.H.A.) { STORAGE TANK Type tJ IZl// ............ .............................. [ ]New Tank of Tank........... �.................... No. of Tanks.......... ..!.................Total Capacity..........9�7.Jr ........... [ -j'Existing Tank �'✓ ✓.�.!'1 .( .. [ ]No additional storage,using same tank as another unit. Location............... ............................................ Note: New underground tank installations,require a plan and Form 81G to be filed. Type(automatic or manual)control......... Location of automatic shutoff valve................................................. Location and type of manual shut-off valve.....................................ELECTRICAt16 CON ,RACTO/R:�n.,9.4/ ...... . . . r...... Special requirements........................................... Company.. ......;_.. . .h� .. ...... . t.C...:.C.f7..�'L:�............ By. .... .... .. �/ ( n sign ... Cert.offgmp.Rec'd....12-b.-.83............ ........ . 7 6r1, ® L1.2 ..................... Permit issued..... `/.� .a......I,... Address...../ 4 .............!E./..... /.. .................. Issued By..�✓.` .... �.eS��../�.dJ� Installer's Certificate of Competency No............(�ffP. ................. DO NOT WRITE BELOW THIS LINE �.covnrr�, SALEM FIRE DEPARTMENT Fee Due$10.00 Received b Dan.sraau Fire Prevention Bureau y 48 LAFAYETTE STREET, SALEM, MASS. 01970 Ck.# x Cash Excerpt from 527CMR4.02(2)(g),NO PERSON shall install or alter any fuel oil burner without FIRST. making application to the head of the fire department and obtaining a permit therefor. Application for Permit to Install/Alter Oil Burning Equipment Application is hereby made in accordance with the provisions of Chapter 148,G.L.and Regulations made under authority thereof by the undersigned for per- mit to install/alter,for the person or persons and at the location named herein,certain equipment for the keeping,storage or use of fuel oil or flammable liquid pro- ducts used for fuel as described below. a Nameof Owner..................../•!•.... ..'l.1.J./........................................... Date......�l � .3........ ]_A �� / Floor heated Address......................... ........................................... by system............................ ' (1st,2nd,all) BURNER //��I J0t TL Name.............. �t. .ajt vA L:.` .! . /� Mfg.by............ 4" Type..........................l:l.� ................................... .Mass.Approval No........./..�y................................ Type of heat.................�L.............................. (D.H.W.;F.H.W.;STEAM;F.H.A.) /� STORAGE TANK ( )New Tank Location of Tank....!k/!J .L: ....................No.of Tanks.................. [ I/Existing Tank Type of Tank.........../. .................Capacity....a.7.).......gals. //Type offffuel.../..�:.................. [ )No additional storage,using same tank as another unit. ELECTRICAL CONTRACTOR....eG.✓./.e4.�.C►......�% ss..l.!�.(................... This application is made with full knowledge of the current requirements of the regulations governing such installation, which will be made in compliance therewith. Company... El l� .. ..�....�Q! ............. Appl. Rec'd....12-.6-8 3................ By..... C ..6'................ 12—(7-8 J (writ,/ ignature) Premit Issued............................... Address.... .... '1G!.... /.'...:.... �/....................... Permit No....D8....3-..2..84.................. Installer's Certificate of Competency No.........p�yj 4.y................. i A self-addressed(installer's name and address)stamped envelope must accompany this application. Note: New Underground tank installations,require a plan and Form 81G to be filed. Form No.22(Rev. 1 1/82) DO NOT WRITE BELOW THIS LINE flit# of Oalrm; Massar4usetis S� Cog ,James A. Premmn qie£ June 2, 1970 James F, Brennan, Chief Salem Fire Department Sir: An ins tion was conducted this morning of the real estate, located at 3 � ,* er s a ti ad Salem, and owned by Cahill's Boat Yard. Conditions were found to be proper for boat yard oper- ations and the yard is now fairly free of the stored boats . The complaint about excess storage of boat stowage racks, left out in the water of the cove adjacent to the *boat yard, appears to be a result of a neighbors opinion of legal rights to the cove. The racks, being left afloat and secured to the ramp, apparently create an eyesore and may block a portion of the cove, but are not creating a fire hazard in their present state. This matter will require a legal determination as to the ripar- ian rights of Mr. - Cahill, and does not seem to be a fire prevention problem at this time . A tI submitted, , David J. G gin Fire Prevention Officer cc : Mayor Zoll "I lilt 4 D } s 1 - - - •� t �,. t } 5 'tom# Y} ' t k A �I.. • f�' $ ' SALEM POLICE DEPARTMENT Nl t r, OFFICER'S REPORT 44 'CASE OF Tom DATE:White 8/8/78 t; _ 19 Wiater. Island Road, Salem Tel;, 4 0 2 f ti'ADDRESS' 7 5_� 7f `. .,NATURE OF CASE boat fire, e � TIME• 211:C) . ' "REPORTED BY marine radio r d ADDRESS_ OF k � , DETAILS OF CASE - a �' * <µ' .° Received radio report of boat fire: off Peache ' s 'J?oint Marblehead. �4i om;- � t tr 'pro -p _d .d. t iscene, boat complete)1y involved. Tide boat -was,, a P i ei: Al burg gea Cprit°m sloop, game "Moonralcer11 no, MS' numbers. — _ F g The boat wa.i_--under tow from Salem Willows to Gxa Ires Boat .Yard by r` f. the r,wner luLd—Rverett Dawkins of 122 Bad View kvimue, Salem. k Tre i:Qwing )i at wsab opsi by Pater Fallon MS 46,LG . N, f The lia.rblegtad, Police buat arrived and acsiste:d ivith their fire fighling equipment, Mr. W41te reported that ttie: posriibla .cause ' k k r„ov1 d have 'neon fro m the gasoline fumes thatA :lged :from 'thy 'out- hn&I rn moto r and aa_a.. tank in the Cabin. Prey1o1 114 thi s aft ernoon bcant r r, n a of the el a et ri gg d,. wirin HavirLa the runninm lights on, could have caused a short { � nirrault ignitink the remaining gasoline fumes w1,1ch in turn ignited a the hull .._,_f herg1—asa). %at sank off Peache.° :olnt Marb] ehoad. ;•;, ti --!.here w;as no rennrted injuries. All the ahoge wa.g reported to the 11,R. Cnaot Guard, Gloucester Ilia NO OFFICER ' is . of 'Salem, r amen - �rcnitxn Date October 12, 1977 thief - iTame• City Engineer Fletcher Re . CETA Project Address: One Salem Green, Salem, Mass. Winter Island Road As a result of an -inspection this date of the premises , structure , open land area or vehicle owned, occupied or otherwise under your control, the followi nc, recommendations are submitted and shall serve as a notice of violation of fire laws . These recommendations are -ma-de in the inter- est of fire :prevention and to correct conditions that are or ma- become d.an erous _as a fire hazard or are in- violation of the laPT. You are hereby_ notified. to remedy said v:Lolations named :elo�,J wi thi.n immediately -- - of the above date . Such fu.rthur action will be taken as the law requires , for failure to comely with the above requirements within the stipulated tima . (Reference : General Laws of Commonwealth of Massachusetts, Chapter 14d, Section 30; and the Salem Fire 'Code Article 1. ) le Open burning at the CETA project located at the former Coast Guard base shall cease immediately. Open burning of debris is .prohibited by the General Laws of the Commonwealth of Massachusetts. cc: Mr. Bevins ...Inspector, Salem ire Pr /enti.on' Bureau SALEM FIRE DEPARTMENT INSPECTION REPORT BUSINESS: CIZ/ 11,4 S T3o 7- i/MPADDRESS: /Vf1'y0 EL: 7qy- 9416� P.T.N. : P111 _/P .C/f/1(/4 k _ ADDRESS: TEL: BLDG. OWNER: ADDRESS: TEL: ANSWER ALL QUESTIONS EITHER "YES" . ttNO", OR ttNONEtt. 1. Are the approches to the building free and clear-? 2. Does the area adjacent to the building appear to be free from rubbish accumulations, ary vegetation or anything of . a combustible nature tending to create a fire hazard? 3. Are facilities provided for the safe disposal of rubbish? . YES 4. Are all- outside means of egress free from any obstructionb that may interfere with the safe exit of the occupants? ✓ G 5. Do porches and fire escapes appear to be in a safe condi- t-ion, and free of obstructions? 6. Do outside sprinklers and standpipe connections appear to e be. in good and usable condition? 7. Are the entrances and' hallways clear. from any obstructions that may interfere with emergency exit of occupants? S 8. Are all interior spaces consistant with good housekeeping �� S practices? 9. Are necessary lic. & permits posted, & currently dated? —Y 10. Are the occupants complying with all regulations and con- ditions as prescribed on the licenses or permits? yG S 11. Are all vertical shafts and stairwells properly safe guarded and provided with self-closing devices? 12. Are all fire extinguishing appliances readily accessable, and have they been inspected, weighed or recharged? �S 13 . Does this occupancy have an interior alarm system? 1V0 14. Has the interior alarm system been tested recently? ��L1 15. Is an emergency lighting system provided? 1V0 , if so , is it in good operable condition? -- 16. Does this occupancy have Vany manufacturing process which would constitute a fire hazard? AZO , if so, are the pro- per fire extinguishers provided? lh- 17. Is this occupancy protected by a . sprinkler system? 'V0 i 18. Are sprinkler gauges showing proper pressures? _ J ed. in 19. in Are anlapproavedbstoragerarea? ,proper containers and kept y� s 20. Are all areas used, for lstorage or piling of products ` d maintained in a safe and orderly manner'? 21. Is the basement free of any rubbish accumulation and maintained in .a, safe manner and- consistant with good housekeeping practices?. . 22. Does the heating system, including the chimney, appear ,q v� s to be in a safe operating` dondition? 23. Does this occupancy have ,a current fuel oil permit posted, and the storage appear. in .good .condition? ''vim 24. Does the premises appear to be free of any electrical �✓G—S hazards? 25. Does the occupancy -appear to have ,any structural defects? .fie 26. Has a Form #17 complaint form follow-up been made for this inspection? - Write a brief description of any violations discovered during this inspection?? iVatne of person to whom verbal recommendations .were made: Date.: ? -.- r 7 7 , Inspected by: . - Approved by: ._oZtc/" RoD:o4�_ Company Vficer FORM 16 (Rev. 2/70) i July 26, 1976 Chief James F. Brennan Salem Fire Department Sir: Officer Czarnecki of the Salem Police came into the office this afternoon to report that he had been isntructed by Judge Zoll and the prosecutor to inform the chief of the fire department that a case involving the burning of a building by juveniles had been dismissed by Judge Zoll for lack of fire department appearance. The case was that of the two juveniles who set a building on fire at the old Coast Guard station. Officer Czarnecki said that he had given Deputy Sosnowski a written notice to appear in court as a witness today and that he failed to appear. Officer Czarnecki expressed his reluctance to be bringing this message but he was following instructions. He said Judge Zoll lectured the boys very sternly and told them they were getting off on a technicality because of the failure of a witness to appear. - - , I called Deputy Sosnowski who was not at home at the time of the call . He returned the call in the late afternoon. He said he thought he was susposed to appear on the 28th. He later checked the card he had been given and found that he was in error and was to appear today. In talking with Deputy Sosnowski I felt that an honest mistake had been made but that this did not relieve me of the responsibility of forwarding the judge' s information. Res ectfully submitted, Robert J. C owley, D p ty Chief !/1 • - -SALEM FIRE DEPAHTYIENT INSPECTION REPORT BUSINESS ,�• S. Q is,1� �JcWd _ ADDRESS; TEL: X_1d11,4-- S P.T.N. : ( �7�„}�. ' o S�. .f-1 ._ ADDRESS .TEL: BLDG. OWNER: S A L ADDRESS: • TEL: ANSWER ALL OUESTIONS EITHER "YES", "NOft OR "NONE". � 1. Are the approches to the building free and clear? , 2. Does the - area adjacent to th.e. building appear to be free from rubbish accumulations, ary vegetation or anything of a combustible nature tending to create a fire hazard? �_ 3. Are facilities provided for the safe disposal of rubbish? -- 4.- Are all outside means of egress free from any obstruction6 that may interfere with the safe exit of the occupants? 5. Do porches and fire escapes appear to be in a safe condi- tion, and free of obstructions? 6. Do outside sprinklers and standpipe -connections appear to =- be in good and usable condition? • 7. Are the entrances and hallways clear from any obstructions that may interfere with emergency exit of occupants? $. Are all interior spaces consistant with good housekeeping practices?: 9. Are necessary lic. &permits posted,' & currently dated? 10. Are the occupants complying with all regulations and con- ditions as .prescribed on the licenses or permits? /� 11. Are all vertical shafts and stairwells properly safe guarded and provided with self-closing devices? �. r 12. Are all fire extinguishing appliances readily accessable, and have they been inspected, weighed or recharged? 13 . Does this occupancy have an interior.,alarm system? 14. Has the interior alarm system ,bebn tested recently? 15. Is an emergency lighting system provided?,-- � 0 , if so, is it in good operable condition? 16. Does this occupancy have any manuf cturing process which would constitute a fire hazard? , if so, are the pro- per fire extinguishers' provided? rF 17. Is this occupancy pi-otected by a . sprinkler system? 18. Are sprinkler gauges showing proper pressures? _ 19. Are all flammables stored in proper containers and",kept in an approved storage area? " 20. Are all areas used for storage, or pilini., of products,, maintained in a safe and orderly manner'? _ 21. .Is the basement free of any rubbish accumulation and maintained in' a safe manner and consistant with good housekeeping practices? 22. Does the heating system, including the chimney, appear to be in a safe operating condition? 23. Does this occupancy have a current fuel oil permit posted, and the F n.: . ge appear in good condition. 24. Does. the premises appear to be free of any electrical hazards? a S' 25. Does the occupancy appear to have any structural defects? L 26. Has a Form #17 complaint form follow-up been made for this inspection? Write a. brief description of any violations discovered during this inspectio#? rig 7ZI Name of person to whom verbal . recommendations were made: Date: .10 7S` --- Inspected by: :z�_ `.� y .�� L . Approved by: ,,rya �- c' `� Company Officer FORM 16 (Rev. 2/70) t� SALEM FIRE DEPARTMENT INSPECTION REPORT BUSINESS: , t3z) AY Y400 ADDRESS: 1VWr40 /s4A&4 RD TEL: ? �� 3 P.T.N. : ADDRESS: f3A U Al, _ _J(__.TEL. BLDG. OWNER: Pay,�, ,�/�, -lu h r-16 V, R3�r� // ADDRESS.: ,��f3��K� �� TEL ANSWER ALL OUESTIONS EITHER "YES", "NO", OR "NONE". A 4 — 1. Are the approches to the b ee and clear? 2. Does the area adjacent to the. building appear to be free from rubbish accumulations, ary vegetation or anything of �, a combustible nature tending to create a fire hazard? 3. Are facilities provided for the safe disposal of rubbish? . 4. Are all outside means of egress free from any obstructions that may interfere with the safe exit of the occupants. 5. Do porches and fire escapes appear to be in a safe condi- tion, and free of obstructions? 6. Do outside sprinklers and standpipe connections appear to be in good and usable condition? ��- " 7. Are the entrances and hallways clear from any obstructions • that may interfere with emergency exit of occupants? 8. Are all interior spaces consistant with good housekeeping practices? a 9. Are necessary lic. & permits posted, & currently dated? 10. Are the occupants complying with all regulations and con- ditions as prescribed on the licenses or permits? 11. Are all vertical shafts and stairwells properly safe guarded and provided with self-closing devices? 12. Are all fire extinguishing appliances readily accessable, and have they been inspected, weighed or recharged? ---f-- 13 . Does this occupancy have an interior alarm system? 14. Has the interior alarm system been tested recently? i 15. Is an emergency lighting system provided? ...J/0 , if so, is :, it in good operable condition? ` 16. Does this occupancy have any manufacturing process which would constitute a fire hazard? 0f. if so, are the pro- per fire extinguishers provided? 17. Is this occupancy protected by a . sprinkler system? 18. Are sprinkler gauges showing proper pressures? / r 19. Are all flammables stored in proper containers and kept in an approved storage area? 20. Are all ''areas used for storage, or pilin,., of rrodu.,ts maintained in a safe and orderly manner'? 21. Is the basement free of any rubbish accumulation and maintained in` a safe manner and consistant with good housekeeping practices? 22. Does the heating system, including the chimney, appear to be in a safe operating condition? .23. Does this occupancy have a current fuel oil permit posted, and the `n,:,ge appear in good condition? 24. Does. the premises appear to be free of any electrical t� " hazards? ` 25. Does the occupancy appear to have any structural defects? AVO 26. Has a Form #17 complaint form follow-up been made for this inspection? r7 Write a brief description of any violations discovered during this, inspection.;? y NaMe of person to whom verbal . recommendations were made: Date: —/�� __ Inspected by: ;�7v_re � „�Q, �t'� LcJ o A—„� Approved by: ` /�_ u I e Company Officer • FORM 16 (Rev. 2/70) • V SALEM FIRE DEPARTMENT INSPECTION REPORT BUSINESS: ef4Ef1LL_5 Soar o ADDRESS:._ •'Za• TEL: 2 `«— 9VSS3 P.T.N. :_1h ti I C,+A E-i1 L L ._ ADDRESS: W;N rrK Er. 20 TEL: �N_s vs".3 BLDG. OWNER: SP" 03 06oye. ,ADDRESS: TEL: ANSWER ALL QUESTIONS EITHER "YES"-, "NO". OR "NONE". 1. , Are the approaches to the building free and clear? Y e S 2. Does the area adjacent to the building appear to be free from rubbish accumulations, ary vegetation or anything of yes a combustible nature tending to create a fire hazard? v 3. Are facilities provided for the safe disposal of rubbish? / e 4. Are all outside means of egress free from any obstructionb ye-5 that may interfere with the safe exit of the occupants. 5. Do porches and fire escapes appear to be in a safe condi- tion, and free of obstructions? 6. Do outside sprinklers and standpipe connections appear to N.A be in- good and usable condition? 7. Are the entrances and hallways clear from any obstructions that may interfere with emergency exit. of occupants? 8. Are all interior spaces consistant with good housekeeping ��s practices? 9. Are necessary lic. & permits posted, & currently dated. Al D 10. Are the occupants complying with all regulations and con- _ ditions as prescribed on the licenses or permits? 11. Are all vertical shafts and stairwells properly safe N A guarded and provided with self-closing devices? 12. Are all fire extinguishing appliances readily accessable, and have they been inspected, weighed or recharged? N A ' �- 13 . lines this occupancy have an interior alarm system? a 14. Has the interior alarm system been tested recently? 15. Is an -emergency lighting system provided? NO , if so , is it in good operable condition? 16. Does this occupancy have any manufacturing process which would constitute a fire hazard?�_, if so, are the pro- per fire extinguishers provided? 17. Is this occupancy protected by a sprinkler system? N D 18. Are sprinkler gauges showing proper pressures? J i va 19. *Are all flammables stored in proper containers . and kept i in an approved storage area? 20. Are all areas used for storage or piling of products maintained in a safe and orderly manner'? 21. Is the basement free of any rubbish accumulation and maintained in a safe manner and consistant with good /Y•1} , housekeeping practices? i 22. Does the heating system, including the chimney, appear a to T g to be in a safe operating condition? o I� eH P g 23. Does this occupancy have a current fuel oil permit posted, ' and the storage appear in good condition. 24. Does the premises appear to be free of any electrical Ye s hazards. 25. Does the occupancy appear. to have any structural defects? Mo 26. Has ,a Form #17 complaint form- follow-up been made for this inspection? Write a brief description of any violations discovered during this - , inspection? - r�r� �e 2 wi 17 Fa 9- l e i ycQ ti,e cu p-—i A) 5Sv,,�7 lS Name of person to whom verbal recommendations were made: Cr4k; ( Date. Ight _ Inspected by: ._- JA Approved by: Company Officer FORM 16 (Rev. 2/70) dOWODNOEM OF kk§SAC11USErrS • OFFICE FOR CHILDREN aiRpUP GRE MD kACE�T •LICENSING AND CONSULTATION. ION REP W t _,P,lummer Home for Boys 1�liis is ,1apy. r y that Y. NAft of Facility iocated <al�t :4. 37 Winter Island: Road, Salem, Mass. 01970 Addy was inepaQte¢' :on Jan.: 23,. 1980 by Lt.. David J. Goggn ti tr., Dtie. -.Name of Inspecto' I certitys-oat the above group care facility complies with the rules hd �regulati i 1` 'the- Hoard .off Sire Prevention. Yee X" NO i .,i Viola any) t t R,e,co=16 Q S (kf any i ` S.ee reverse side 'fgr recommendations. `All other conditions found satisfactory .at time, of inspection. ,fs • i Fire. Chief `k [latiie and '�i t:1e Please xt" this report- Joyce Harding Office for .Children Group Care and Placen►ent Licensioa and Consultation- ' � G�e9'mY Sfis+eet — Mi+�dl eton,'MA 01949 S. F. P.B. #41C. (1/80 f he Mass State Building Code Based on the third edition o t g , effective July 1, 1979i ` the following recommendations are made for group care, residences, existing at the time of adoption. Reference Section. 424,0 . an automatic fire warning system -be recommended that 1 I is reco g t installed. for :the protection of occupants. This shall be a minimum of a Type III system. Ref, Sec. 424 6. 2. & Sec. 1216 2.Fire drills- are required to be held at least quarterly. A form shall be filed with the Salem Fire . Prevention Bureau office, with details of the .drill as conducted.. (Sample form attached) The Fire Department shiM. witness one fire drill per.. year. Sec. 424. 8..1 3.Manual fire alarm pull stations should be provided. At least one station per .floor. , Sec. 1216. 3. 2.4 4. Zoning- by floor is,.recommended, but is- not required. Sec. 1216. 3. 2.5 II 5. Installation. of a Master Fire A'larm 'Box, with direct Fire Alarm connection is recommer de'd,' but not required. Sec. 1216:3...2.6 6. If the. .system is revamped, the use of audible~-and. visual',Alarm devicea:would be required to -provide at least 85 dec.ible of- sound— by fire. horns throughout all :areas. Bells are no longer acceptable. Notes All the, above are ;r.ecommendations for: your class of occupancy. These are not mandatory at this time, but would be required- if sub,-tantal alterations -were made. However, it is necessary to advise .you that no expense.` should .be spared when life safety is involved. Early wirriing devices have proven to be a life saver in many 'cases. Smoke detectors have been the most reliable early warning device .now available on the market. Heat detectors are ,limited to the .actual_ heat build-up in the immediate area, being relied upon to sound the alarms. Smoke detectors will tend. to .alarm approx, ninety percent earlier. and also cover a greater quare , footage. for, protection. JIL rat ie Mwam1 v Iffiz1o,a?M csnn- alweo.an clmalb II�n��m�n��fl®an�o Il, IIanc. NEW ENGLAND UNIT i Howard M. Knight — 2nd Vice.,President 17 Haley Road, Marblehead, MA 01945 Telephone (617) 631-2624 August 6, 1980 Chief James Brennan Salem Fire Department 48 Lafayette Street Salem; MA. 01.970 Dear Chief Brennan; Th-e members of the Wally B,yam. Caravan Club (, or Airstream trailer owners ) are expected to .arrive in Salem on Wednesday the 1 th. of August for a five day stay at Winter Island ( or the Coast Guard Base ) . For your departments information each. trail_er is required to install a fire extinguisher for the pro- tection of their trailer and a fire code is in effect at all times . Our problems in the past have been at a minimum; with. these adquate measures that are constan= ly in effect stressing to each owner as to their indiv- idual responsibility for safety and a means of handling any emergency . The members are planning to take in. the events of the famed Heritage Days in Salem and many plans have been made for their arrival and safety while in town. We hope that you and your department members will take the time to come and visit the members at this most historic site while in Salem. V truly our,. H A M„ NI H HMK/k COMMONWEALTH OF MASSACHUSETTS OFFICE FOR CHILDREN GROUP CARE AND PLACEMENT LICENSING AND CONSULTATION FIRE INSPECTION REPORT This is to certify that Plummer Home For Boys _ ,Name of Facility located at 38 Winter Island Rd.Salem Mass 01970 Address was inspected on 03-30-82 by Raymond T Dansreau Date Name of Inspector I certify that the above group care facility complies with the rules and regulations of the Board of Fire Prevention. Yes No g Violations (if any) : Conditions satisfactory at time of inspection. Recommendations (if any) : Name an4j Title Please return this report: Joyce Harding Office for Children Group Care and Placement Licensing and Consultation Gregory Street Middleton, MA 01949 For inspection of Group Residence (Regulated by Office for Children) per Section 424.0 of Mass . State Building Code. 2 COMMONWEALTH OF MASSACHUSErTS OFFICE FOR CHILDREN GROUP CARE AND PLACEMENT LICENSING AND CONSULTATION FIRE INSPECTION REPOVr This is to certify that Plummer Home For Boy' s . Name of Facility located at 38 Winter Island Rd.Salem_Mass 01970 Address was inspected on 11-29-82 by. Raymond T Dansreau Date Name of Inspector I certify that the above group care facility complies with the rules and regulations of the Board of Fire Prevention. Yes X No Report of Inspection: Conditions satisfactory at time of inspection. Fire Chief Name and .Title Please return this report: cc: Building Insp. Joyce Harding Office for Children Health Dept: Group Care and Placement Licensinu and Consultation Occupant Gregory Street file Middleton, MA 01949 Salem. Fire Dept. Form #41A (1/82) OLIi J f �5� alcul AR attiree� cttttettt {ea��tt�rtcrs 4S r fauette —�>trut tl;h,EeE , a er►i, -Ulu_ ats7B INSPECTION REPORT 1 - Building Inspectors ectors Certificate Of Occup_ ancY Posted Date of Issue: 2. Age Group of Occupants: M Number f r ce e• Maximumo e Li ns . 36ccu ants P P 4. Fire Alarm: `` Date Most Recent Drill. Switch provided ; Drill. Conducted: Full System with panel provided; Battery Power:er: Local. Ylanual Pull Station on A. C. Power only: 5 Fire Extinguishers. g - Properly placed : r. Date last tested: 6.` Exits clear and unobstructed: 1 7. Emergency lighting tested: 8. Housekeeping conditions: 9. Fire Drill procedure posted: 10. Emergency shelter agreement available: Lgcation .of Emergency Shelter: 11. Boiler Room enclosed: Spri kler System City Pressur-e at 12,: AVa-Ir$bl® Pressure Top of 3ystein Remarks: Date: Inspector. Company or`°ar.P. B. (OVER) T �s 19 Corm; of #aIrm, Masoar4usrtto ,Tire Department 31rab quartrro �f xmes �_ �rennan Qlfiie# 1OVt ,4 1'979, , Smog E : zoll,r City or . 0% MY r Washin tree Ulm, xaoa . Dear, t*t on aw'or, Fire 0 � . 40 4t, tbe t a loil wAS ed0-te " tom . We found Me. b r' 'Ound roz� feet In d1- eter- d yet .e �,: t tted 8- �. het the 9� on t t :�: t roes � T i c equal 0 fis-:._ k �d �� " � e'Pell e4 1� �r ��: s�� an the to V44Y, tom 0004041.: and teal s .1 Tvo oUa U fo r bye &Mr,,, a ,. ease. ter " Mw 4lil! 'P,'• "4Y� ourfC3 iY d A;ViVw' 3WM ' � � but, 0a � ap tc degree; ve 'No lw$ck-one ire Id w d A �, e� i ; eonta �: pro appr'�*X- 30 gallons Of regular sasoll- A. di elk is .:eve � nta ed car to gasp , eA S. , OrdtIn AA 4.Ad Ono �.4 � d er, Vie" . t ,, ' Wise. A� I1 , The Coast 04 d rcNged t O pmOly WItUeve t � � tidy at ' l t t o � 'd .t � e� , theref €� t t :, je t e ire'. r1 e d out. a e . . of de s b Used Vo drill s cab otbarbe. faa 0 " ro- ex at this time i, It is bereby noted tY t while we were QA t# Pr?aQe, t7- � ^farmy vao Past Pasti L=S 14 igns o Res, '"t ; 11 MiWt... a trues ed jiP + € ' Te FORM FP 6. 40M-10 71-050515 - `1-. 4 W DEPARTMENT OF PUBLIC SAFETY DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON '12-24 1976 (Date) APPLICATION FOR PERMIT To: HEAD OF FIRE DEPARTMENT . Salmi, Ia e City Sr Town In accordance with the provisions of Chapter 148, G.L. as provided in Sec._ 19 n , application is hereby made Remove 1000 Gal. L.P. Gas Tank for permission to _ -- State clearly Remove tank froxi. the Former Coast Guard-,Base purpose for _ - - -- - - which permit Tank no 1®ner in use, is requested — --- Restrictions: at [►inter Island, Salem, TIa. at (Give locati(a by sheet and no., or describe in such a manner as to provide adequate tdentiHoation of location) Date issued—reps 12/2 8 19 76 By P,yrofax(signatures o papplicont) Date of"expiratio*+ 1/2 8 197 6 Fee $ n i 1Paid—Due - 23 5 Boman-St,--Ta .— (Rddresa �;j'` �",-�).i r•5r`"F�,i> v,.A.s.3 ,. p.; rP: A.;, P a Y:'} �y +r n rr r .�.: r t+r�tr,,f., lt., .�{�r�yr .,� Ir �}i'*�^`r +re�,�.f to i;.,�.a. } ar r'' a r T a .t f° � +�.'3aT j � � ,}r k 5 1i S� j t• } St }}f'!'� �i tits t�+t _ ify _,j µ .i• "-may ♦ n.. )hT?�'}')'S� FbRM PP 6:40M-10-7 1-050515 J 1 S vu�4 �. , �•�, �. ,. `, ��p t�niri�nntu�e �i► i�' �� i 'sk '' ,��;`� jF,s�� t�¢ yq ,o,pk¢a'.'� _ DEPARTMENT OF PUBL.I1t SAFETY D IIVISI�i�Pd�' OF FQIi�E .PREW( I.}Oy N� ;;1' i... ,. dS ®6�d1.8 1C,HFit, = r > 1♦fi 1010 C ®A.•1 EAib! �rGdVVL'I ®17�Olrpq'rttfRyy" r+I •r 1,`,+iP I.7,. F '` �a'� wA O 3 r •;w t � +F>:�, t. x 1., .}♦ 12-'24 , �I��`��i.(t�ivY�'.. �{ d APPLICATION FOR PERMIT: `� ��t � �° }��:riq t� "�•..t ,� - f,♦t,)s; My{t �y +t �;1y FyTo ' HEAD OF FIRE DEPARTMENTIt t �151;' fry tr f Ffi t t y� Sa en Tfa• q r f a ,l, 1 4 1, F F k j r` '+•�' 5y'Jhif'�x 'I; �' ,t y .City or Town - •,� - } -F' *1 v,rs t •! f+ t '�' In accordance with the provisions of-Chapter 148, G.L. ,ts'provided in."Sec: t zF•rs. t ; .,9 t�;1', 6 r , &?' S t,f w I "+dl t ! a. application is hereby made t'' T;; ' )� �� 1;ry{1 - �. t ,x. r - r Y,� 21 �t t Remove 1000 Gal. L.P. Gas Tarlr1 Xf Ft i' for permission to-' t,G'k•y,t�elJ dY"sP kfit .. J r ' a tr r �m � c r. ry f y4 're r t1. z td +/f w`�'►State Ciearl� }l R t, ..� �7` , +�ttr,da`j� I:.F� + ,4 RptiloVe tank from the.Foamier Coast, chlard sae' 4ry l 1 idd! for dwh�ch Tank no 18n�er'.in use, ,. r } i`� �,'��e'.fjk t s)t�.,�"+ � t a g t F• t. f` .Y.;{. X 'k. /t .+' ti F• w4 r' r.}' ' , y'rWinter Island1 Salem,; rfa `� M I y; r r,y J l � 1 Yt � t (GIWV location by street and no., or describe in such 'a moaner as to provuis adequate ldtsntllioutlon oil lacattoW'i, 1 Y 4 V I�ate;issued-rej 12/2 8 7 6 ;} By b. . ,of ax'Gan Corgi (Signature at iWocant) { `• , , :,,,a �i t�':tx} ,aF. Date iof?expiratsori' 1/28 197,6 ,Fee $ :nil,Puid Due s ptk� `i Y�th 1tt`¢�FZIwl t y� syr'•t LL �t 'i' .' 1 .,{ a•i.y`f '1 I�Y -1d it i� •',q {f } i + -.� tE flf• `� ,P t t rit f r it 6 r ? k5 �"�wrFr ,s'rP4r41 d C j �a �fl � �3r � tIIYi1It1Yt1' �;; 1f �& � �� r��' r� �e " rr� dip ' FoyY,. t' ° j t< , i•«.,. st Ire `.DEPARTMENT OF PUBLIC SAFETY `� DIVISION OF FIRE 'PREVENTION >t, 1010 COMMONV{1E1I,` H AVEM, BOSTON. 0 Salem , Dec i28 , 1�3�`i � l'` t ,J. ) S6.i ft tr{ r t I t 3 E e(CitY aT lows) ! Gee? k F 2 q t 1 a}, ' d u� #j F t PERMIT r`{4111.$tD1r� d 1 il j 1 P1 Y In"accordnce with the provisions of ehapter`;14f3, G:L. provided in 3 :; ( b 4 FRirrtFle, a l b a �� tYa.,thisJII$t 13 granted t0 iJ� i' fS�rt# J I rut;°' r4ro r' ,yrofax Gas'. Corn.,-,Topstie.ld, `Ma`ss. j aa{ a f 1�QII19 �.. s t (Full name of�.rpoA urm ar corpomflon Owntdxi fwrmlt) + } ;,r a "; (F 4 f+ • �Fi+l��,l�dpni7i til ��;aF(F{'x yp i l,�i.Fl r.:. �• q :rT_� `-�. �♦ ',, ,. 1, �i ,1, � ''It 2. i '�F r t : ��II,, 1•,+.t tt�,�trt.r,t5�� ,._ i+ •,s,�+ r' >°.Remove one .1,000 gallon LPG tank from .Winterl Tslar>�c ;fix, , i' ,,. . "JS"v`" )a'i�•�°u!� t'l�', ,'Z �S'y*,•t't �y�prj�ixn�ltv�f to -_>�—',,,." ,+ il,, ",,! n, ;yMrti,.i' .0 .;..,,..I;.,.'._+-.I.'T.i t;n,.+ rw .i R+;,n, lAu "., �StateF_rclec�rlyk �r iRoa&, �Fq�?mer �:Coast'}-Gu rd ;;Station ' to Tops f iel�,' } s: ,.- ,g�.t�f d'. }t fOr-Et h ,� s y.,as , r sd r ;,'-r rn: ,. 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Fynto� a4?-N tq�l,.i<-; .i L..,1�•+r 'MAT +. t i. �r .-.y F�lJCi[+a„ t s.,, i }r F r3:.r.,, r: •t+s �;r,,,f �: 1+ :�l �(,,�+"r: t fir,} .:• t; wpI Salem=,Ffib :l�arsihal _l. �, + ,,r t,�l t 'r. + • i. �� ,tv,' _ - x ', y, e ', itI� .. a a r .y". }}• f•F "! 1% ,ix�< � i' f �1,'. 1rt'u^ '.� `V , `' .]t�:." t '{:`.n`<.�7.{S +`A! :ay.5}dLr�Iti'l•� ��it�.;rP;P+r l��;..i}d1 yw � i,-1 t r'1_'t'.r d}�� fe��'� Jrr. tT !C. ♦d +: G � t; sdt��? .q.).�,.+._.!�.7� b S ..r,• r rt '4.,ij>'t,.. ..tr,r,, , �n -.}t� AJQ �..7h N ��°v:;,� t�,�'�filr". Y"t., t1itN`r',`tr ari 1 F{ }�! �1''�� Sr��rl,.�'t��kl +z1)•'.4,'rirs.'^9{.I��n� ,;s �, :F. df�;•v�,. 'ia`t.,,?r� � t .'n nl#t,�,��r,�� ,^, +.« rt '..� ';.{'�_�:' ':'„4. (�� 'P'�"r', Y1 BE�� TCtTOQ�.7B;1f►031��y�tdPrON�7�,�11!�.) '-� � tU, tt vJ. •„Y,, r¢¢�',i. tt kt y ✓•'.i+ :V r .� �- Ir f I # .F' X j}# P,f'"t �,i SY, t• , ' .; 1 l i yQ. ! 1 1,tl t Y t'l i a t n r�+,. a i 'h +-,- { f' r . \ t�' t {, , ,, t 1 •, as ya sr 'S 3t . .iM t,�l.�a� '..»-�.«,j,�`a.r :.�•...}_ i' FS, '�._r !` 4 �,r��l{�F ,t.`+�.°v...'¢t y'". 1 �'iY:.f1+�,`',t•.. ,.-,'� � ,<:4,,r. r.?i-^ri�.t;a*'XY''.1" +..t�lr.:'. a1 tFk`�`u;�rrlullkw.F#>�dM,G raFila V-;:d,t,stw. ,iJ tt..1,..M,..r.afdS..z..r a.�l..,t_sJX.e,1LY: ,� �:3La J!• CASH CHECK # Oft lif'%ktn' fts'sar4usft Fee Due $10.00 per unit e ti1 f� 9 F o FIRE DEPARTMENT-FIRE PREVENTION DIVISION Inspection date.. 48 Lafayette Street / Salem, Massachusetts APPLICATION FOR CERTIFICATE OF COMPLIANCE Time: L�Qt5- One Family Dwelling To: HEAD OF FIRE DEPARTMENT FILE COPY ❑Two Family Dwelling ❑Condominium Unit # In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application is hereby made For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. Type of Detectors: A. Monitored Battery Units B. Permanently Wired Units Owner: - r Zia�' �/ Address: r V (Give location by street an4 number,or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Real Estate Agent Date of Pprtification: B y (Address) 3 y ��—� (Phone) Layout of Smoke/Heat Detectors: Basement: 1st Floor: 2nd Floor 3rd Floor: Special Requirements: Cite of 6a tem, 01azoacbUotto Fee Due$10.00 per unit Is FIRE DEPARTMENT-FIRE PREVENTION BUREAU Inspection date: 48 Lafayette Street /0� 2 a `"IINE Salem,Massachusetts APPLICATION FOR CERTIFICATE OF COMPLIANCE B-One Family Dwelling Tb: HEAD OF FIRE DEPARTMENT ❑ Two Family Dwelling ❑ Condominium Unit In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application is hereby made For an inspection of smoke detectors installed per Salem Fire Prevention Regulations.The under- signed owner of record or authorized agent,requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. ape of Detectors: A. Monitored Battery Units B. Permanantly Wired Units Owner: //�7 94, Z o h / Address: IV->L� 1r 411 1z (Give location by street and number,or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Detectors Require Annual Maintainence. C (signature of Applicant) Date of Certification: (Address) By: — Co / 7 ' .72y' '�i 7/s (Phone) A ADDRESS: TYPE OF OCCUPANCY: DATE: 1 2 3 4 5 6+ CONDO. MERC'TL TIME: 4th-FLOOR PUBLIC WAY: 4th-FLOOR APARTMENT 4th-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 3rd-FLOOR PUBLIC WAY: 3rd-FLOOR APARTMENT 3rd-FLOOR APARTMENT ZONE N: CORRIDOR: FRONT: REAR: 2nd-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 2nd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 1st-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 1st-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: BASEMENT: BASEMENT SPECIAL: KEY KEEPER: ZONE #: PANEL LOCATION: HORN AND LIGHT: SILENCE SWITCH: ZONE #: SPECIAL LOCATION: SPECIAL EQUIPMENT: SYSTEM VOLTAGE: AC DC BATT. SD=Smoke detector RR-HD=Rate of rise HD IC=Inter-connected HD=Heat detector FT-HD=Fixed temp. SS=Single station RECEIPT OF DISPOSAL OF UNDERGROUND STEEL STORAGE TANK NAME AND ADDRESS OFRNER TRUCKING & - -APPROVED TANK YARD APPROVED TANK YARD NO. 10 Tank Yard Ledger 502 CMR 3.031110 tuber: I certify under penalty of law I have personally examined the underground steel storage tank delivered to this "approved tank yard" by firm, corporation or partnership and accepted same in conformance with Massachusetts Fire Prevention Regulation 502 CMR 3.00 Provisions for Approving Underground Steel Storage Tank dismantling yards. A valid permit was issued by LOCAL Head of Fire Department FDID# d 1�� to transport this tank to this yard. Name and official title of approved tank yard owner or owners authorized representative: S cow& 0On/ Ci—3� —9 � SIGNATURE TITLE DATE SIGNED This signed receipt of disposal must be returned to the local head of the fire department FDIDI _____ pursuant to 502 CMR 3:00. (EACH TAM MUST HAVE A RFXEIPT OF DISPOSAL) FORM F.P. 291 (rev. 9/88) (OVER) MASSACHUSETTS STATE FIRE MARSHAL'S OFFICE DIMENSIONS Tank Removed From Width Length -- �-_--- ----- � '--------- '- --- i (no. street) Tank 1 - X a — 5 A ^ Tank 2 ----- X ----- (city or town) Tank 3 ----- X ----- Fire Department -- Tank 4 X Permit # ------ -��-- -------- (if applicable) Tank 5 ----- X ----- (feet) (feet) #i q Citp of *altm, ; faggacbU!5ettg Fee Du $1 er unit ' FIRE DEPARTMENT-FIRE PREVENTION BUREAU Inspection date: 48 Lafayette Street Salem, Massachusetts APPLICATION FOR CERTIFICATE OF COMPLIANCE M One Family Dwelling Th: HEAD OF FIRE DEPARTMENT ❑ Two Family Dwelling ❑ Condominium Unit M In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application js .hereby made For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. Type of Detectors: A. Monitored Battery Units B. Permanantly Wired Units sj Owner: CS�° 6*- D4Y 1 S &4,1 Address: X1 (Give location by street and number,or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Detectors Require Annual Maintainence. (Signature of Applicant) Date of Certification: ®��/93 (Address) By: /e/Q4L, (Phone) ADDRESS: TYPE OF OCCUPANCY: DATE: 1 2 3 4 6 6+ CONDO. MERC TL TIME: 4th-FLOOR PUBLIC WAY: 4th-FLOOR APARTMENT 4th-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 3rd-FLOOR PUBLIC WAY: 3rd-FLOOR APARTMENT 3rd-FLOOR APARTMENT ZONE N: CORRIDOR: FRONT: REAR: 2nd-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 2nd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 1st-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 1st-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: BASEMENT: BASEMENT SPECIAL: KEY KEEPER: ZONE #: PANEL LOCATION: HORN AND LIGHT: SILENCE SWITCH: ZONE #: SPECIAL LOCATION: SPECIAL EQUIPMENT: SYSTEM VOLTAGE: AC DC BATT. SD=Smoke detector RR-HD:�iRate of rise HD IC=Inter-connected HD=Heat detector FT-HD=Fixed temp. SS=Single station Salem Fire� Department, Fire Prevention Bureau * * * * * Fire Certificate of Inspection Date: 02/22/88 Occupancy type : Group Home Distribution: Office for Children (C) Inspection type : Quarterly This is to certify that Plummer Home for Boys located at 38 Winter Island Road was inspected by the Salem Fire .Department on 10/19/87 by A/LT. G. CARON r . _ Inspection status : Approved The inspection of hospitals , clinics, and dispensaries are in accordance with the requirements of Massachusetts General Laws , Chapter 111 , Section 51 .. This fire certificate of inspection issued by the head of the Salem Fire Department certifying . compliance with local ordinances in a prerequisite for an original or renewal license . -# The inspgction. of convalescent and nursing homes , rest homes, hospitals , and public mental institutions are in accordance with the requirements of Massachusetts General Laws , Chapter 111 , Section 71 . This fire certificate of inspection issued by the Head of the Salem Fire Department is the result of an inspection con- ducted by the Salem Fire Department on the date indicated. Inspections conducted by the Salem Fire Department are in accordance with the provisions of Massachusetts General Laws , Chapter 148 , Section 4 . -------------------------------------------------------------------- Report of Inspection: Emergency light in 2nd floor north hallway out of order. J seph F. Sullivan, Chief Salem Fire Department. Form 44D (Rev. 8/87) Salem Fire Department Fire Prevention Bureau * * * * * Fire Certificate of Inspection Date: 10/08/87 Occupancy type: Group Home Distribution: Office for Children (C ) Inspection type: Quarterly This is to certify that Plummer Home for Boys located at 38 Winter Island Road was inspected by the Salem Fire Department on 08/06/87 by A/LT. CODY Inspection status : Approved The inspection of hospitals , clinics , and dispensaries are in accordance with the requirements of Massachusetts General Laws , Chapter 111 , Section 51 . This fire certificate of inspection issued by the head of the Salem Fire Department certifying compliance with local ordinances in a prerequisite for an original or renewal license. The inspection of convalescent and nursing homes , rest homes , hospitals , and public mental institutions are in accordance with the requirements of Massachusetts General Laws , Chapter 111 , Section 71 . This fire certificate of inspection issued by the Head of the Salem Fire Department is the result of an inspection con- ducted by the Salem Fire Department on the date indicated. Inspections conducted by the Salem Fire Department are in accordance with the provisions of Massachusetts General Laws , Chapter 148 , Section 4 . -------------------------------------------------------------------- -------------------------------------------------------------------- Report of Inspection: Jo eph F. Sullivan, Chief Salem Fire Department. Form 44D (Rev. 8/87 ) SALEM FIRE DEPARTMENT - INSPECTION REPORT POSTED ADDRESS: TYPE OF .NAME OF OCCUPANCY: - C OCCUPANCY P.T.N. � ` ADDRESS TEL. BLDG. OWNER ADDRESS TEL. -------------------------------------------------------------------- ANSWER ALL_QUESTIONS : EITHER "YES"1__'NO_.4_OR__'NONE_'___ ----------------- -------------- ------ 1 . Are the approaches to the building free and clear? 2. Does the area adjacent to the building, appear to be free of rubbish accumulations , or other fire hazards? �_ 3 . Are facilities provided for the safe disposal of rubbish? 4. Are all outside egress paths free from any obstructions that may interfere with the safe exit of the occupants? j. 5. Do porches and fire escapes, appear to be in a safe condition and 'free of obstructions? 6. Do outside sprinkler and standpipe F.D. connections appear to be in good and usable condition? 7 . Are entrances and hallways clear of any obstructions that may interfere with the emergency exit of occupants? y-e 8. Are all interior occupied spaces clean and consistant with good housekeeping practices? f/ 9. Are all necessary Licenses and Permits posted & dated? /� - 10. Are the occupants complying with all regulations and —� conditions , as prescribed on the Licenses and Permits? 11. Are all vertical shafts and stairwells properly safe- guarded and provided with self closing devices? 12. Are all portable fire extinguishers readily accessable and have they been inspected and properly tagged? 13. Does this occupancy have a fixed fire extinguishing system? I Date of last inspection? LgA"u, (;k-� 14 . Does this occupancy have a standpine system? V_t) Are all pressures satisfactory? Are standpipe hoses provided? Is a gauge provided at top of system? 15. Does this occupancy have a sprinkler system? Are all pressure gauges showing satisfactory readings? Are all O.S. &Y. valves open and padlocked? Is a gauge provided at the top of the system? 16 . Is this a "WET" or "DRY" system? `— Form #16 (Rev. 1/79) / T 17 .. Does this occupancy have an interior fire alarm system? 18 . Date of last test of the interior fire alarm system? �`- 19. Does this occupancy have a direct Fire Alarm connection? Master Instant . Type :Box # ADTO Alarm # - AFAR 3M* Other 20 . Is emergency lighting system or units provided? 21 . Are all emergency lighting units in good operating condition? v � 22 . Does the occupancy have any unusual condition which would constitute a special fire hazard? V.-O 23. Are all flammables stored in proper containers and/or stored in an approved storage area? 24 . Are all areas used for storage maintained in a safe manner?_ " 25 . Are basement areas free of any rubbish accumulation? 26 . roes the heatinc system, including the chimney, appear to be in 'a safe operating condition? 27 . 7s a current fuel oil permit posted and storage proper? 29 . Pre there any electrical hazards? —� 20 . Ines the occupancy appear to have any structural defects? 30 . Has a Form 25D ( Inspection Recommendation Form) , been made and issued for this inspection? Write a brief description of any violations discovered during this inspection . If the violation requires an early Fire Prevention Bureau notification , file a Form #58 (Complaint Form) If the violation appears to require immediate action , notify the Deputy Chief on duty. List each remark with item number for identification. Name -)f person to whom Form #25D was issued: Date : G - Inspected by: Approved by : _ Approved by Comp Any Officer D.C. in charge of Insp. Date : Form #16 ( Rev. 1/79) P.T.N. checked by F.A. i TELEPHONE BOSTON FIRE, SYSTEMS, INC. TEL. (617) 592-FIRE Engineers of Protective Systems 172 COMMERCIAL STREET • LYNN, MASS. 01905 CERTIFICATE OF INSPECTION PLUMMER HOME FOR BOYS 37 WINTER ISLAND RD . SALEM, MA. 01970 PROTECTED AREA : KITCHEN RANGE HOOD PLENUM AREA DUCT AND RANGE GRILL & BROILER TYPE OF SYSTEM : SYSTEM MANUFACTURER : RANGE GUARD I I THIS IS TO CERTIFY THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSPECTED FOR PROPER OPERATION ' AND COMPLIANCE WITH THE APPROPRIATE GOVERNING, REGULATIONS AND WAS FOUND TO BE : IN PROPER WORKING ORDER AND IN APPARENT COMPLIANCE WITH CURRENT CODES COVERING THIS EQUIPMENT REMARKS : Hl INSPECTION DATE : JULY 14, 1987 I' INSPECTED BY : PHILIP HOCTER SEMI-ANNUAL FREQUENCY OF INSPECTION. 2-LINKS REPLACED MWON TON FIRE SUPPRESSION SYSTEMS ASSOCIATION I;. SALEM FIRE DEPARTMENT - N REPORT POSTED INSPECTIO 0 T ADDRESS:3i, J >/ NAME OF OCCUPANCY:j �,m�.,� i�� 2 / ` TYPE OF OCCUPANCY 3 m ) )I�R ADDRESS TEL�2?r4/(pZ� BLDG. OWNER�)r-fnu 7V S" ADDRESS T E L. 2Vel-16 5',q -------------------------------------------------------------------- --------ANSWER_ALL_QUESTIONS_-EITHER "YES"1_"NO_.L_OR__'NONE_'__ ------------ -cc-//----- 1 . Are the approaches to the building free and clear? 7C S 2. Does the area adjacent to the building, appear to be free of rubbish accumulations , or other fire hazards? 7C's 3 . Are facilities provided for the safe disposal of rubbish? 7 4. Are all outside egress paths free from any obstructions ((�� that may interfere with the safe exit of the occupants? 5 . Do porches and fire escapes , appear to be in a safe YES condition and 'free of obstructions? 6. Do outside sprinkler and standpipe F.D. connections y / appear to be in good and usable condition? / d 7 . Are entrances and hallways clear of any obstructions that may interfere with the emergency exit of occupants? 8. Are all interior occupied spaces clean and consistent y with good housekeeping practices? 9 . Are all necessary Licenses and Permits posted & dated? 10. Are the occupants complying with all regulations and VC� conditions , as prescribed on the Licenses and Permits? 11 . Are all vertical shafts and stairwells properly safe- guarded and provided with self closing devices? 12. Are all portable fire extinguishers readily accessable and have they been inspected and properly tagged? 13. Does this occupancy have a fixed fire extinguishing system? Date of last inspection? 14 . Does this occupancy have a standpipe system? Are all pressures satisfactory? Are standpipe hoses provided? _ Is a gauge provided at top of system? 15. Does this occupancy have a sprinkler system? 1),6 Are all pressure gauges showing satisfactory readings? Are a11' 0.S. &Y. valves open and padlocked? Is a gauge provided at theltop of the system? �— 16 . Is this a "WET or "DRY" system? Form #16 (Rev. 1/79) F4 17.. Does this occupancy have an interior fire alarm system? 7� 18 .'• Date of last test of the interior fire alarm system? 19. Does this occupancy have a direct Fire Alarm connection? /�g Master Instant Type :Box # ADT# Alarm # AFA# 3M4 Other 20 . Is emergency lighting system or units provided? yEs 21 . Are all emergency lighting units in good operating condition? 22 . Does the occupancy have any unusual condition which would A f constitute a special fire hazard? 23. Are all flammables stored in proper containers and/or n ' stored in an approved storage area? /Vd AM' 24 . Are all areas used for storage maintained in a safe manner? Vkf— 25 . Are basement areas free of any rubbish accumulation? 26 . Does the heatinc system, including the chimney, appear to be in •a safe operating condition? 27 . 7s a current fuel oil permit posted and storage proper? VAT 28 . Tre there any electrical hazards? 2Q . roes the occupancy appear to have any structural defects? 30 . Has a Form 25D ( Inspection Recommendation Form) , been made ✓ and issued for this inspection? Write a brief description of any violations discovered during this inspection. If the violation requires an early Fire Prevention Bureau notification , file a Form #58 (Complaint Form) . If the violation appears to require immediate action , notify the Deputy Chief on duty. List each remark with item number for identification. TiaAjiL' 22ag, 'Se"A)d 4chic A A, tnu lU62-140 s IA)S.06r �0 F ►n,� ��yarn �i �e n�G� J��f Name of person to whom Form 425D was issued: Date : 7 Inspected by ,� ,� Approved byc _ Approved by Company 0 facer D.C. in charge of Insp.' Date : P.T.N. checked by F.A. Form #16 (Rev. 1/79) ON SA �. aJ. 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'g''lfc`.„c. -;,s ,i`$.+rtt,4„ "k :-k t ;- t A;4gL,n,ayl�.:+r' .d`.,4�!"`+1•'.a��•,, "9 ,, Pr ,: � r F:'' $J:";' f a�IC.!.� .,.'�"-' ' + tr,x: �`7: u^ ,t`' J / ,• i�F ? + r, x P �kry .n 7+_ t- ' •, e I. ihL 1 .u.,>�e 1 r�+ f'✓i �r�}.:c✓rr� �4e�r l�,*�r." 4h+�e 3,1 :.. �L� jT Named�of4'person nrith =whom 'recommendation ,fo�lo.�w up,�wasr9ydiscu�sed.A,��„,£; � .� ,k� };��fg'I; E j { }zy',R p r � f�+• •�_r} r :1 t -: r � J. �x r : '�g'. >} i "�'a � '�7,S d v1 t �r�.� � ��s...„` '�}t >'+,N :: p.`^ �•��{}refs c �:�� I _.a>}lu Sxja�' --i�. s `+ t ,.�:�, $ ,�Di�� t i r 4'{.s �L;xs ! 7 ti ii } :i + S� J�hi.;; r 2'.s�# r±dk - fiR+e/vli.it)� `JiAR ��?{�1�.r +tt�� ,�.c � �,�n.�1 �f1,-ft"T r't' �lrt'i`Vl"'1x '3 t' FYfit"S'F'e r'.At� i 'i �rf 7 •`•r.,,ri ,,, ' i1 ,�}+f, �y,Ur>c `•x $f ARM ,._d •?j1'4�u+ A•-i'°'f7F hS v'�L".1 f`i' Tb,.`D4'Mf+''^r• eIp i'16i s �4'�li'ti,Y7�.i. .`� <:xi'Y •1`�!7'f"Evi+:/ rs•G'',AYµ. .:'.�< r'Y .''t ''f'. .iE'� $41.xi.,, Reasons cif ;a ford f alureo . comP1 ,�vhi=thorgia °rpec¢om�end'ation:� � gk;, , �ia.63..v tepeL/Ls },�'�t�a,L�4 ` e"i��inskj5 L,�" 'Y..dGt i a.?'�'t ICJ.VZ',�` }S'dS�:��a+r�rt'e��`fL1{ )c✓X i.,�'Q.?.d ��.�i..t4'{'�s�i b¢�J.�'��r,}..�� pC! s,'.d5'i:(S�.r .�s5 S %?�,Lr�#R@�x a ;�f„s r � ' I# Pi��.�'��`vy.t�e,..*iY �, :f.ad � ..A,.Y"/.�� a$i'�kE�h.�??s .. `.+ ,.'� `�:'�r`�f"f`d'�.�'� ?Q.��l.'`.`e?Xi:f`S�t .�F�-.� ��i ♦-Ss�s� i t; F's ti' � y '?., _ .� A 4,:� Complaint has been corrected' ti r. ° Forvrard °this'. form to'` Fire --Prev. Bureau for follow-=up. i S - F En �,#C • j• ,�_ - _� � �`�:�' ,�„��In :ec for, { 'a�".f. ,'�.. ��:�.�t�r�nar-._�+v��`4^'rt1.:fL:iavr'�'�q�.y r.zi,�, "A'�.f�a"�`'"�°.;,.�-� cr-�r't..,�..�".'"TS`.-t;�q-S'q"'°"a3+j"^e.^•,^. r ,«�y�=..?s�:Ash.�I"} �'S�y,.«:�1�„�y�Y,►,d7ti,r .-+•-.-••:� SALEM FIRE DEPARTMENT 1 t, IN=SERVICE' INSPECTION COMPLAINT RECOMMENDATION r f Name.o lL Y 0,........ ��4_e...............................................-:..... Date:..�:�..7 3..-.::....--------..-.-.......-...-.19� . Address---< -----IVA .....��: �'-..................................... As a result of an inspection this date of the premises owned s and/or occupied by you, the.-following recommendations are submitted which should receive serious-consideration. These recommendations are made in the interest of fire prevention and to correct conditions that.are or maybecome dangerous as a fire.hazard, maybe required for legal occupancy of the premises or otherwise are in violation of the law. zwz..... m............... . !A- .. ..- y .:............._..-..-.....-.--...-...-.. ---------------- c! %: '^ ------..,.e r l -.r/o.:--...... 1 ...--..-.-. X,a .......................... ,,tea ---- ------------ ----_...................................................................................................................................................... .................................... Reinspection date- --------- .......................................... --------d/' � Z1/79) �.,t�c•�.�.. � W,4�� Inspector Form 25D (Rev. j- ... .-..,- p (Fire Deptr-_ opy�-_ ----- U In-Service Re-Inspection Report: Date: p , Conditions found to exist at time 'of Re-Inspection:� Ti2�l7IIV CrCc� fTLye-d Name of person with whom recommendation follow-up was discussed. Reasons, if arty, for failure to complj with original recommendation. Complaint has been corrected. Forward this form to Fire Prev. Bureau for follow-up. - En C Co.#� In ector SALEM FIRE: DEPARTMENT IN-SERVICE INSPECTION COMPLAINT RECOM MENDATION Name.................C-Uy ..." ---.........�Dh��...-... 1-04.........,_�`Y.,S.. Date...--.... !..'.... :.............................19.. E Address..-!2........ As a .result of an inspection this date lof the premises owned and/or occupied by you, the following recommendations are submitted which should receive serious consideration. These recommendations are made in the interest of fire prevention and to correct conditions that are or may become dangerous as a fire hazard, may be required for legal occupancy of the premises or otherwise are in violation of the law. ------------------------------------------------------------------- ------------........-----------.......--------------.....------......................... ................ . ... ...................--..........---------------- ----.....-----......................--------........... ----------------...........---------............................----= --.......... .... . ................. .................................................................................---------------.......----.........----------------- � Reinspection date: ...�� ,' �(� . . Form 25D (Rev. 1/79) ! -..Inspector (Fire Dept: -copy G- In-Service Re-Inspection Report: Date: 7 ��7 Conditions found to exist at time of Re-Inspection: ,J K Name of person with whom recommendation follow-up was discussed. Reasons, if any, for failure . to comply with original recommendation. Complaint has been corrected. Forward this form to Fire Prev. Bureau for follow-up. Inspecto . q SALEM FIRE DEPARTnNT -;. INSPECTION REPORT 6 ADDRESS: 2 Ord' TYPE OF --NAME OF OCCUPANCY: OCCUPANC P.T.N. ADDRESS TEL. . epp BLDG. OWNER ADDRESS TEL. -------------------------------------------------------------------- ANSWER ALL UESTIONS - EITHER "YES" "NO OR "NONE" i-------------------Q------ -------------1-----1------------- ----- 1 . Are the approaches to the building free and clear? 4 F ` 2 . Does the area adjacent to the building, appear to be free of rubbish accumulations , or other fire hazards? 3 . Are facilities provided for the safe disposal of rubbish? � 4 . Are all outside egress paths free from any obstructions that may interfere with the safe exit of the occupants? 5 . Do porches and fire escapes, appear to be in a safe 4 condition and 'free of obstructions? _ �6 . Do outside sprinkler and standpipe F.D. connections # kappear to be in good and usable condition? (1! 7 . Are entrances and hallways clear of any obstructions '-that may interfere with the emergency exit of occupants? G 8.. Are all interior occupied spaces clean and consistant with good housekeeping practices? ► 9 . Are all necessary Licenses and Permits posted & dated? -tom 10. Are the occupants complying with all regulations and C conditions, as prescribed on the Licenses and Permits? - 11, Are all vertical shafts and stairwells properly safe- guarded and provided with self closing devices? IV 12 . Are all portable fire extinguishers readily accessable and have they been inspected and properly tagged? �5 13 . Does this occupancy have a fixed fire extinguishing system? At Date of last inspection? -7) 14 . Does this occupancy have a standpipe system? IkIO A,� Are all pressures satisfactory? Are standpipe hoses provided? Is a gauge provided at top of system? 15. Does this occupancy have a sprinkler system? DA16 Are all pressure gauges showing satisfactory readings? Are all O.S. &Y. valves open and padlocked? Is a gauge provided at the top of the system? 16 . Is this a "WET" or "DRY" system? Form #16 (Rev. 1/79) 17v*ft*oXs this occupancy have do interior fire alarm system? 1,U8. Date of last test of the interior fire alarm` system? 19. Does this occupancy have a direct -Fire Alarm connection? Master Instant Type :Box ADT# • Alarm # AFA# 3M#- Other 20. Is emergency lighting system or units provided? 21. Are all emergency lighting units in good operating condition? 22 . Does the occupancy have 'any unusual condition which would Aconstitute a special fire hazard? 23. Are all flammables stored in proper containers and/or � stored in an approved storage area? _ 24 . Are all areas used for storage maintained in a safe manner? klIC9 25. Are basement areas free of any rubbish accumulation? 26 . Does the heating system, including the chimney, appear to be ,in a safe operating condition? � '27. Is a current fuel oil permit posted and storage proper? 28. Are there any electrical hazards? 29. Does the occupancy appear to have any structural defects? 30. .Has a Form 25D (Inspection Recommendation Form) , been made .and issued for this inspection? Write a brief description of any violations discovered during this inspection. If the violation requires an early Fire Prevention Bureau notification, file a Form #58 (Complaint Form) . If the violation aPPears to require immediate action, notify the Deputy Chief on duty. List each remark with item number for identification. Name of person to whom Form #25D was issued: Date : 3 l/Qlr� Inspected by: Approved by Approved by Company Officer D.C. in charge of Insp. Date : Form #16 (Rev. 1/79) P.T.N. checked by F.A. CIof Oatem, ftias;!44"ju eU LLD Fee Due $10.00 per unit(l p „ FIRE DEPARTMENT-FIRE PREVENTION BUREAU Inspection'date: 48 Lafayette Street `'0NE Salem,Massachusetts APPLICATION FOR CERTIFICATE OF COMPLIANCE One Family Dwelling To: HEAD OF FIRE DEPARTMENT ❑ Two Family Dwelling ElCondominium Unit N In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application is hereby made For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. Type of Detectors: A. Monitored Battery Units B. Permanantly Wired Units Owner: 1 Address: v (Give location by street and number,or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Detectors Require Annual Maintainence. (Signature of Applicant) 4� Date of Certification: (Address) By. ,,- (Phone) ADDRESS: TYPE OF OCCUPANCY: DATE: 1 2 3 4 5 6+ CONDO. MERC'TL TIME: 4th-FLOOR PUBLIC WAY: 4th-FLOOR APARTMENT 4th-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 3rd-FLOOR PUBLIC WAY: 3rd-FLOOR APARTMENT 3rd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 2nd-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 2nd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 1st-FLOOR PUBLIC WAY: 1st-FLOOR APARTMENT 1st-FLOOR AP ARTMENT ZONE #: CORRIDOR: FRONT: REAR: BASEMENT: BASEMENT SPECIAL: KEY KEEPER: ZONE #: PANEL LOCATION: HORN AND LIGHT: SILENCE SWITCH: ZONE #: SPECIAL LOCATION: SPECIAL EQUIPMENT: SYSTEM VOLTAGE: AC DC BATT. SD=Smoke detector RR-HD=Rate of rise HD IC=Inter-connected HD=Heat detector FT-HD=Fixed temp. SS=Single station v FO s f LI I t t ' PA 1 2 Ol 1 _ , i, i ... '.. _ I G? w I ifs i I I • , _ o, 1. � • � ICI I _ , f .. , - I n 0 0 e �N(r�14U0N) poeK A f701,r'21►,JU Srt. t,-rIuj A 4 utW &OHrf U4;;Us r2o�t'�iNCr, rl,�r��,�,z rr�'uc.0 o,� i V N L 0 ;�Hr) 1 p / — ------ - # ------ - - y t --- _ --- - -_� — - I ,N It6l �6fL CL�l��u�11J1� i ' L rts r � ��L -7 r4�W 6a4(- U-ro - � j Ct� f7,.�Crli SL,c�S• �; � -T NKvi ¢" vnH rc I tL v/4 volt- r2.- r7A I ►r 2 A. 49 0 �.i��>IN�t �fG�IU►� v GK rL SN1N4t"1 A r DvrlHr rtt -i ��- 19� SR i ( i H sUL,, G I%.� "L-1,,/�► i tl oA r? i 1 Qw Qe S S. No.6028 N B VERLY. O Ga�h- f jh ©)aq iemasko,I 2)c M■ • UM Lf) C ` ® N ftk � cc o 4� � r2 T- A v f° Q w LLJ +� F- 2 Z z Drawing Number A Robert Turner ow 978-7446M City of Salem, Massachusetts � ire Department 48 Lafayette Street Sa&% Massachusetts o197a3695 TeL 978-744-1235 jax 978-745-4646 PAID FIRE DEPARTMENT BLASTING DETAIL FORM Yuh Prevention Bureau 978.745-7777 Blasting operations conducted in the City of Salem require a blasting watch as per the provisions of Section 12-71.1 of the Salem Code of Ordinances. The technician shall be responsible for the securing payment for the Fire Department personnel assigned. The current hourly rate is $25.00 per hour, with a.four hour minimum and is payable directly to the employee on SITE. NAME OF FIRE FIGHTER BRIAN HARRINGTON SOC. SEC. # 027-46-6700 HOME ADDRESS 19 MIDDLEBURY LANE BEVERLY, MA. 01915 LOCATION OF JOB WINTER ISLAND PARK DATE OF JOB NOV. 13, 1997 STARTING TIME / AM ENDING TIME AMOUNT WAD02 S BLASTING COMPANY CARL B. THOMAS CONSTRUCTION CO. ADDRESS 206 MONUMENT ROAD HINSDALE, NH 03451 BILL TO PAYMENT DUE ON SITE ADDRESS JOB AUTHORIZED BY INSPECTOR PRECZEWS.KI, LT. LATULIPPE HIRING OFFICER INSPECTOR PRECZEWSKI PAYMENT METHOD TO BE BILLED ( ) PAYMENT ON SITE ( ) I HEREBY CERTIFY THAT THE ABOVE TIME IS CORRECT AND THAT THE ASSIGNMENT WAS COMPLETED AS DIRECTED. OFFICE USE ONLY FORM REC'D IN OFFICE BILL MAILED PAYMENT RECEIVED CHECK # FORM 31B 9/97 SIGNATURE OF EMPLOYEE DETAIL CHECKLIST COMPLETE ( ) r' Address3A WINTER ISLAND ROAD Eng Name WINTER ISLAND YACHT CLUB Phone Owner ? PTN N/A 1 Lad 2 ? N/A N/A ? N/A AL. Co. N/A N/Mone Knox Box FALSE Permits Required # 32 Fire Alarm System Y N Extinguishers Y N Master Box Sprinklers Y N Nearest Hydrant Standpipe Y N Type of Bldg. F.D. Connection Y N Type of Occupancy Emergency Lighting Y N Central Station Special Hazards Insp. Form Company I Name Remarks & Complaints 17 '7/�� I e'- - / I.2f I I i SALEM FIRE DEPARTMENT nspec. Date., ,7r Insp. Number 7 INSPECTION AND VIOLATION REPORT Reinsp. Date: • Occupancy Name Occupancy Tape 0.T1mc-fl, r ie i ( Address 4 ws Bldg. Ws Yes No ❑ Floor/Section Phone y S 31 q Ins for Name Com ny # Notifications 6 LiD ��rQ ❑Health ❑ Bldg. ❑Electrical ❑Police 16 1. Exterior 6. Heating Systems ❑ N/A fire escapes/decks 0 Pass ❑ Fail ❑ Warn N/A combustibles Pass ❑ Fail ❑ Warn ❑ N/A proper storage proper access ❑ Pass ❑ Pass ❑Fail ❑ Fail ❑ Warn ❑ Warn N/A N/A within 5'feet defective chimney Pass ❑ Fail ❑ Warn ❑ N/A KNOX BOX ❑ Pass ❑ Fail ❑ Warn N/A defective system other Pass Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A 2. Exits 7. Electrical open property ❑ Pass ❑ Fail ❑ Warn N/A exit blocked ❑ Pass ❑ Fail ❑ Warn N/A defective wiring ❑ Pass ❑ Fail ❑ Warn ❑ N/A exit signs working ❑ Pass ❑ Fail ❑ Warn N/A panels accessible ❑ Pass ❑ Fail ❑ Warn ❑ N/A adequate lighting ❑ Pass ❑ Fail ❑ Warn N/A extension cords: door(s) locked ❑ Pass ❑ Fail 0 Warn N/A proper use • ❑ Pass ❑ Fail ❑ Warn ❑ N/A signs needed ❑ Pass ❑ Fail ❑ Warn N/A cover plate missing ❑ Pass .❑ Fail ❑ Warn ❑ N/A in need of repair ❑ Pass ❑ Fail ❑ Warn N/A proper fusing ❑ Pass ❑ Fail O Warn ❑ N/A emergency lights ❑ Pass ❑ Fail ❑ Warn N/A other ❑ Pass ❑ Fail Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn N/A 8. signs needed Fire Extinguishers ❑ Pass ❑ Fail ❑ ❑ Warn N/A N/A 3. Fire Alarm System f� N/A operative ❑ Pass ❑Fail ❑ Warn ❑ N/A properly mounted ❑ Pass ❑ Fail ❑ Warn N/A properly labeled ❑ Pass ❑ Fail ❑ Warn ❑ N/A proper type .❑ Pass ❑ Fail ❑ Warn. N/A accessible. ❑ Pass ❑ Fail ❑ Warn ❑ N/A obstructed ❑ Pass O Fail ❑ Warn N/A trouble indication ❑ Pass ❑ Fail ❑ Warn ❑ N/A need recharging ❑ Pass ❑ Fail ❑ Warn N/A defective devices ❑ Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn N/A missing devices ❑ Pass ❑ Fail ❑ Warn ❑ N/A 9. Sprinkler &Standpipe System other ❑ Pass ❑ Fail ❑ Warn ❑ N/A valves labled valves accessible ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ ❑ Warn ❑ Warn N/A ❑ N/A ❑ N/A 4. Kitchens . 10 lb. ABC extinguisher ❑ Pass ❑ Fail '❑ Warn �%N/A at hazard pressure reading ❑ Pass ❑ Fail ❑ Warn ❑ N/A ext. system operat. ❑ Pass ❑ Fail ❑ Warn ❑ N/A FDC clear/capped ❑ Pass ❑ Fail ❑ Warn ❑ N/A roof collect. clean ❑ Pass ❑ Fail ❑ Warn ❑ N/A Valves open ❑ Pass ❑ Fail ❑ Warn ❑ N/A system inspected ❑ Pass ❑ Fail ❑ Warn ❑ N/A valves secured ❑ Pass ❑ Fail ❑ Warn ❑ N/A hood/duct clean ❑ Pass ❑ Fail '❑ Warn ❑ N/A spare head avail ❑ Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A heads obstructed ❑ Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A 5. Storage proper labeling Pass ❑ Fail ❑ Warn ❑ N/A proper storage Pass ❑ Fail ❑ Warn ❑ N/A PTN Form *84 - Completed Yes ❑ No ❑ legal storage other Pass Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A Form *58 - Filed Yes ❑ No ❑ 10. Violations Found 4# 0 LG iU rllra guo 4,xjr- Form #16 - (Rev. 11/93) Copies: White,- Fire Prevention Yellow- Inspecting Company Pink -Building Owner/Manager J?0l7ETt VV. JLLT/2ET t_guf 50a-744-6990 61ty of,--S-afF-n2, 4::::;flaiiaAuietts 9i.zE 1T5F-#a%tm.Enf 4.9 -L2fayEttE <S- he t SaCEm,-JMassaciausEtts 01g70-3695 ad 508-744-1235 Sax 508-745-4646 9LTE((��P- Ev 12tio12 1JLLTEau '_- 50S-745-7777 PARTY TO NOTIFY (PTN) INFORMATION/AUTHORIZATION PLEASE PRINT ALL INFORMATION DATE: ? 1 '1 � Q -7 ADDRESS OF OCCUPANCY: 31 ' W t P(i&e- SCE `-Q�FLOOR: NAME. OF OCCUPANPHONE: 'r2 q 6- 3°-1 `t % PERSON TO CONTACT IN THE EVENT OF AN EMERGENCY: NAME:PHONE: c{ 3 ? HOME ADDRESS: Cc l U WL6 CITY: 54-I e--t ZIP: O i ' `Z 0 NAME: HOME ADDRESS: PHONE: CITY: ZIP: IF THIS BUILDING HAS A FIRE ALARM, PLEASE LIST THE ELECTRICIAN/ALARM COMPANY THAT IS AUTHORIZED TO RESET THE SYSTEM WITHIN (3) THREE HOURS FOR DWELLINGS AND (6) SIX FOR COMMERCIAL BUILDINGS, CALLS TO ANSWERING MACHINES NOT ACCEPTABLE. NAME OF AUTHORIZED PERSON/COMPANY: NAME OF PERSON AUTHORIZING: (PRINT) OWNER OF BUILDING: HOME ADDRESS: PHONE: SIGNATURE: PHONE: CITY: ZIP: BUILDING KEYS LOCATED IN A KEY KEEPER: YES: NO.0- OTHER: DOES THIS BUILDING HAVE A GUARD DOG: kINSURANCE CO. ON BLDG. ADDITIONAL INFORMATIONAL OR INSTRUCTIONS FOR THE BUILDING AND/OR OCCUPANCY: PLEASE RETURN THIS INFORMATION TO FORM #84 (REV. 2/96) SALEM FIRE PREVENTION BUREAU 29 FORT AVENUE SALEM, MA 01970 Tito of 16alt t, fiRassac4ustns Fee D0 u Ck.� Ca e � # � FIRE DEPARTMENT • FIRE PREVENTION BUREAU Ck. b 48 Lafayette Street y Salem, Massachusetts 01970 To: HEAD OF FIRE DEPARTMENT (bate) Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location med herein: (�(� ,� I,, ^ .� , f Name of Owner: ' ' ` F— ��- Address: 1t�� t,� Number of Tanks: ` Capacity of Each Tank: a— Total Storage: U Company: Address: I tx" `�"'' `% Installer: (Written signature) Issued by: Date: //�9 67 Form #90L (Rev. 1/83) DO NOT WRITE BELOW THIS LINE - To: HEAD OF FIRE DEPARTMENT Ti#g of #81em, Aussar4use#ts Fee Due$ 0 Ck. # ��' Ca FIRE DEPARTMENT - FIRE PREVENTION BUREAU 48 Lafayette Street Rec'd by: Salem, Massachusetts 01970 ate) Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to Install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location med herein: (1(� .� 1 Name of Owner. t ' ` r �-- Address: W I �1 ; I n n Number of Tanks: Capacity of Each Tank: - c% Total Storage: 17 1 rv. Company: �� vI�^� �Q Address: I� ��`�^"t S Installer. (Written Signature) Issued by: Date: Form #901- (Rev. 1183) DO NOT WRITE BELOW THIS LINE ------------------------------------------------------------------.----------------------------------.----------------------------------------------------------------------------------------- MUM L E FIRE DEPARTMENT Fee Paid $10.00 a FIRE PREVENTION BUREAU PERMIT Date: FOR STORAGE OF LIQUIFIED PETROLEUM GAS In accordance with prTisions of Chapter 148, G.L., and Regulations made under authority thereof. Name: Name: (Ow or cupant) / /, (I& talle Address: Address: ( vl/ L PERMIT is hereby granted to store UiJ gallons of Liquified Petroleum Gas, for use in an approved appliance. Subject to approval of Salem Gas Inspector, for piping and equipment. Date Permit Iss d. Inspector. (Chief of Fire Department THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES Form #901- (Rev. 1 /83) This permit will expire on a change of ownership, burner or storage. ---------- --------------------------------------------------------------------- ------------------------------- SALEM FIRE DEPARTMENT LEGAL RELEASE LOCKOUTAN I hereby acknowledge that I requested assistance from the Salem Fire Department and requested, of said department, forcible entry into such premises or vehicle. If damage is incurred in the performance of this action, I will assume complete responsiblity. . I also release the Salem Fire Department and all its personnel and the Cityof Salem from any demand, action, causes of action, suits, accounts, contracts, agreements, damages, and any and all claims, demands and liabilities whatsoever of every name and nature in LAW and EQUITY as a result of such action. SIGNATURE DATE --7 //c� �F INCIDENT LOCATION (�10 w n _4 Id INCIDENT NO. 9 l 6 O HOME OCCUPANT NAME SOCIAL SECURITY NO. . APARTMENT NO. FLOOR NO. OWNER'S NAME OWNER'S ADDRESS CITY & STATE ENTRY POINT DAMAGEINCURRED AUTOMOBILE DRIVER'S NAME DRIVER'S ADDRESS CITY & STATE SOCIAL SECURITY NO. OWNER'S NAME C am.Aag4z OWNER'S ADDRESS CITY & STATE REGISTRATION NO. t;5;'e YEAR & MAKE l DAMAGE INCURRED a OFFICER'S SIGNATURE COMPANY No FORM 27 (Rev. 6i88) Al Chi of alenT, Fee $-Wo90 �� ?Firr �r�arfmrnt �raDrjuarirrs . 48 Tafgcttr 4trrri Cash: Ck#� Salem, fflu. Q1070 Rec' d by - 0 APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN TH CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.# 20 APPLICANT: P `verso -c C-&VLA*Nr ADDRESS: /3 j print 01990 CITY: STATE:a2►q— ZIP: t PHONE: 7-V -J�25 '�606 LOCATION OF TENTAGE: OWNER OF PROPERTY : C (�-� cx ADDRESS: CITY: Sl.(.STATE: 04 ZIP: 61Y PHONE:: INSTALLER/RENTAL CO. OF TENTAGE: fAriv PHONE: s4�e ADDRESS: SAme CITY: STATE: ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE:►° MANUFACTURER: 4 P �d r i SIZE OF TENTAGE: Zy' NAME OF TESTING AGENCY: AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: F 2 1 CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PE"MIT NUMBER: SITE INSPECTION DATE: '%�7 ,DATE OF ISSUE: 7,cs-EF,EXPIRATION DATE: `7 Zo�y APPROVED BY: �� ' TITLE: Form #80B ( Rev. 5/87 ) IMPORTANT DOCUMENT Certificate REGISTERED APPLICATION �. NUMBER F121.4 of ffamle'.�em"5tance ISSUED BY _. CHOR. Date of Manufacture INDUSTRIES INC. 3/06/98 EVANSVILLE, INDIANA 47711 Orde XI b MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have (or are inherently noninflammable) and were supplied to: PETERSON PARTY CENTER INC 139 SWANSON ST WINCHESTER MA 01890 r um er 183326 been flame-retardant treated Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 10g. The method of the FR chemical analication is - Serial #: 8002100 Description of item certified: FI TOP 20W X 40 VL W W Flame Retardant Process Used Will Not (0001) Remnupri Rv vvasriirig And is trtective For The Life Of The Fabric [F Signed: Name of Applicator of Flame Resistant Finish TENT DEPARTMENT —ANCHOR INDUSTRIES INC. �C f�LI�CPLnLI�Lf�Lf�C�C.nC..Pr-pr-onr 0Oonr,nm 7r7nnnr�r_,r_,r,�-, , _------ +0c U To: HEAD OF FIRE DEPARTMENT FIRE DEPARTMENT • FIRE PREVENTION BUREAU 29 Fort Avenue Salem, Massachusetts 01970-5232 Fee Due $30,0 Ck. # �� Rec'dbyi (Date) Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location named herein: Name of Owner. Address: 1611 AV IV 9 S �'� /� �'� 4,15 Number of Tanks: 3 Capacity of Each Tank: aQ Total Storage: Company: Address: Installer n en Signature) Issued .by: Date: 3 Form #901 (Rev. M7) act 2�7V f,"� Gti �rn� DO NOT WRITE BELOW THIS LINE ,�•'Co SALEM FIRE DEPARTMENT Fee Paid $30.00 ------ — FIRE PREVENTION BUREAU Lam," PERMIT Date: FOR STORAGE OF LIQUIFIED PETROLEUM GAS In accordance with provisions of Chapter 148, G.L, and Regulations made under authority thereof. Name: Name: '''',�� _(owner or Occupant) pnstalleq '[[S Address:f� , t e - r �Q %> ,6 i 8161 Address: PERMIT is hereby granted to store gallons of Liquified Petroleum Gas, for use in an approved appliance. Subject to approval of Salem Gas Inspector, for piping and equipment. Date Permit Issued: Inspector. (Chief of Fire Department) THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES Fan., a90l_ (Rev. Wn This permit will expire on a change of ownership, burner or storage. SALEM FIRE DEPARTMENT Fee Paid $30.00 FIRE PREVENTION BUREAU �(,� PERMIT 3 Date: TO INSTALL LIQUIFIED PETROLEUM GAS STORAGE TANKS In accordance with provisions of Chapter 148, G.L:, and Regulations made under authority thereof. Name: 1, t-' C_ LoC)o ce Name: (Owner or Occupant) (Installer) Address: Address: PERMIT is hereby granted to above listed installer, to install LP.G. tanks on the premises of the above listed owner or occupant. Number of Tanks: Capacity of Each Tank: Total Storage: Date Permit Issued: Inspector: (Chief of Fire Department) Form M901. (Rev. 9l97) (OVER) ® Dej� t uuct o6 570 SMA&W - 6F#= 4 de State 579W 7&UAd RECEIPT OF DISPOSAL OF UNDERGROUND STEEL STORAGE TANK Fam"291 Turner Inc . NAME AND ADDRESS OF APPROVED TANK YARD 225 Commercial St. Lynn, MA 01805 APPROVED TANK YARD NO. 010 Tank Yard Ledger 502 CMR 3.03 (4) Number: I certify under penalty of law I have personally examined the underground steel storage tank delivered to this "approved tank yard" by firm. corporation or partnership and accepted same in conformance with Massachusetts Fire Prevention Regulation 502 CMR 3.0%RroyKi-Ons f0rA pmjfhg-EIn4"round Steel Storage Tank dismantling yards. A valid permit was issued by LOCAL Head of Fire Department. FDIDrtC_a_ ,�tT to transport this tank to this yard. Name offival title of approved tank yard owner or owners au� rep sentative: IGNATURE TITLE DATE SIGNED This signed receipt of disposal must be returned to the local head of the fire depa ent FDID# pursuant to 502 CMR 3.00. EACH TANK MUST HAVE A RECEIPT OF DISPOSAL TANK DATA TANK REMOVED FROM Gallonsa&�z (No. and street) Previous Contents Diameter Length �+ (City or Town) Date Received hc:� 1 6/c Fire Department Permit # � /� `�8 Serial # (if available) Tank I.D. # (Form FP-290) Owner/Operator to mail revised copy of Notification Form (FP290, or FP290R) to : UST Compliance, Office of the State Fire Marshal, P.O. Box 1025 State Road, Stow, MA 01775. Make application to local Fire Department. . ' Fire Department retains original sppllcatlon and issues duplicate as Permit. �� efia�u%�n�2G` �� c�l �xv+,ced — �c acr�x� a�� e ✓"��2�'7i� o� ,. APPLICATION and PERMIT Fee: $30.00 for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.C.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: Tank Owner Name (please print) Doug Karam t X - -Signature Address 25 Winter Island Road rap ring for permit) - Salem, MA 01970 &treat city state Zip _ . Contamination Assessment: Company Name N & S Tank Cleaning, Inc. Co. or Individual Print Print Address" 101 Foster St!..Peabody 01960 Address YMA (978)531.-6433 print Print Signature (if applying for permit WA Signature (if applying for permit) ❑ IFCI Certified Other 0 IFCI Certified 0 LSP # Other AR Tank Location 25 WINTER ISLAND ROAD t SALEM, MA 01970 Steet Address City .'rank Capacity (gallons) (1) 275 above ground Substance Last Stored #2 fuel oil �. rank Dimensions (diameter x length) Remarks: To be removed on 1/19/05 —,' tank located , in basement Firm transporting waste & S 'rank C1 P! - n; ng, T»c State Lic. MA326 Hazardous waste manifest# NHJ0002645i E.P.A. # MP9787412179 Approved tank disposal yard Turner Salvage Tank yard # 002 Type of inert gas N%A Tank yard address 225 Commercial Street Lynn, MA 01905 City or Town Salem FDID# 09258 Permit# Date of issue _ /-? 6 s- Date of expiration Dig safe approval number: Dig Safe Toll Free Tel. Number -: 800-322-4844 Signature I Title of Officer granting permit 0,e—t��.._- I t_ After remova(s) send Form FP-29OR signed by Local Fire Dept. to UST Regulatory Compliance Unit, One Ashburton Place, Room 1310, Boston, MA 02108-1618. '-292 (revised 9/96) SALEM FIRE DEPARTMENT Fire Prevention Division 29 Fort Avenue Salem, Ma 01970 (978) 745-7777 * * * * * ANNUAL PERMIT RENEWAL NOTICE WINTER ISLAND YACHT YARD 3A WINTER ISLAND ROAD SALEM, MA 01970 Active 02/03/2003 Bus. Location: 3A WINTER ISLAND ROAD Annual renewable permits -issued by the Salem Fire Department during 2002 will expire on April 30, 2003. Records in the Fire Prevention Bureau in- dicate the following permit to be active: Permit type: Cutting and/or welding operations. File number: 468 Last renewal: 05/03/2001 Telephone: (978)745-3797 This notice shall serve as an application for renewal. Please return this form together with a check in the amount of $25.00 for each permit to be renewed. If you hold multiple permits, a renewal application must be returned for each permit being renewed. If this permit is for Cutting and/or Welding, and is for a unit being carried on a motor vehicle,"pi-ease -complete :the following: Veh Lcle make: r _ f Vehicle year: Vehicle Reg. #: Upon completion of the renewal process, permits will be mailed to you at the above address. If you no longer require this permit for any reason, please mark NO LONGER REQUIRED on the form and your file will be deleted. Please make any corrections to the. above information if necessary in order to update the files. PLEASE INCLUDE YOUR PHONE NUMBER IF IT IS NOT PRINTED ABOVE. If you have any questions, please call the Fire Prevention Division during normal business hours at (978) 745-7777. DavidW.. Cody Chief 978-744-6990 dcody@safem.com City ofSafem, 9Vassachusetts Fire Department 48 Gaffayette Street 1 iY�,� K SaCem, `.Massachusetts 01970-3695 Fire Prevention Bureau 29 Fort Avenue rIeC978-744-1235 7e[978-745-7777 rF 978 74S 4646 'Fa.Z978-745-9402 PERMIT BILLING STATEMENT Primary Contact: Occupancy: Winter Island Yacht Yard, Inc. Winter Island Yacht Yard, Inc. Heywood, Peter 003 Winter Island Road 3 Winter Island Road Salem, MA 01970 Salem, MA 01970 Permit # Type Issued Effective Expires 070439 Welding and/or Cutting (Annual 05/01/2007 05/01/2007 04/30/2008 Renewable) Total Fee Fee $25.00 $25.00 1 0 6/21 /2007 16:24 Page 1 Cif of eSaIem,Mmsachusett� "`` y Fee Due FIRE DEPARTMENT - FIRE PREVENTION DIVISION Inspection date- 29 Fort Avenue - >o -i Salem, Massachusetts 01970-5232 Time //.gyp Q APPLICATION FOR CERTIFICATE OF COMPLIANCE Closing Date: One Family Dwelling To: HEAD OF FIRE DEPARTMENT ❑ Two Famlily Dwelling ❑ Condominium Unit # Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by Massachusetts General Law, Chapter 148 Sections 26F, 26H/2 and 527 CMR 31. et seq. Type of Smoke Detector Battery Hardwire Type of Carbon Monoxide Detectors Battery Hardwire w/Bat. back-up Heat Combination Plug-in W/ Bat. Back-up Combination Location of Property / 6J21J_Te r TS1i9,od I l c-yId Owner of Property i� % �.� e y 'Date of Certification: � � - ��' = le,u Owner or Agent By Phone Note Any certificate issued in accordance with provisions of M.G.L. Chapter 148 Sections 26F. 26F1/2 expires sixty (60) days after issuance by head of the Fire Department. 527 CMR: BOARD OF FIRE PREVENTION REGULATIONS MASSACHUSETTS FIRE SAFETY CODE 4.03: continued =� ?Fee Comnwnwwftk of Mmsae&utetts Department of Tub& Safety 527 CMR 4.00 VA' Form 1 Application for Permit, Permit, and Certificate of completion for the Installation or Alteration of Fuel Oil Burning Equipment and the Storage of Fuel Oil &JP,m IoIalgs (City or Town) (Date) 96 Permit #'s: FD Elec. FDID#: UR. PS& Fee Paid: 2 O Owner/Occupant Name: Tk ei rna— W t Q 2,cf Tel #: 1 y `i — NS 4 7 Installation Address:`a Serviced Floor or Unit #: Heating Unit ❑ Domestic Water Heater ❑ Power Vent ❑ Other Burner: ❑ New IM Existing Location: Trade Name: EXISTING Mfg: Type: Model # or Size: Location: $1 Fuel Oil ❑ Kerosene ❑Waste FUEL OIL TAN REP NT INSTALLATION ONLY Storage Tank: ❑ New Existing Location: 8agpAyAagnt Type: PI yaz Capacity: i 3 F gals. No. of Tanks: Special requirements (or additional safety devices) IQ fee_ ci�tzrm;nec� Ia�tL ❑ OSV Valve ❑ Oil line protected ❑ Sheet Rock ❑ Sprinkler AFUE: ❑ yes ❑ no Combustion Test: Nozzle Size N/A Gross Stack Temp.: N/A New Stack Temp.: CO2 Test N/A Breech Draft: NSA Smoke: NIA Overfire Draft: N/A Efficiency rating %: N/A L the undersitned certify that the installation of fuel burning equipment has ban made in accords= with M.G.L. e. 148 and 527 CMR 4.00 cwnndy in effect Furthermom this installation has been tested in accordance with such requirements. is now in proper operating condition and complete instructions as to its use and maintenance have been furnished to the person for whom the insta0ation (or alteration) was made. Co. Name: Gill Services, Inc. (800) 852-6o67 Address: 381 Warwick Avenue City: Warwick, RI Zip: 02888-1393 Installer: Z � d-nt / 4Z Print Name Signaturt (no Sramp) Li . #Q ]• 7145 Once signed by the fire department, this is a PERMIT for the storage and use of oil burning equipment. Inspected by: (. 141t,--- Date: -3Z-Tl� Keep Original as application. Issue duplicate as permit. This form may be photocopied.. 4/21/95 (Effective 5/1/95) 527 CMR - 45 L'ify Of --SafFn2, �as:iacfiuiF-tti 9izE 1rbE#aEEr 2f-nt 4S Lafayette S-tteet pp Sa%m, JV(assachusetts 01970-3695 ,- � &tt "IV '3utnet '3c15oS-744-1235 "bite J teVention hie f -Jar 508-745-4646 %'3uteau 50S-744-699c 50S-745-7777 RECORD OF COMPLAINT DATE: %d/y o RECEIVED BY: SUBJECT: LOCATION: COMPLAINT BY: �/'lC IC—n ADDRESS :f? Of NARRATIVE: SITE INSPECTED BY: DATE: 10 2p COMMENTS: G/Q, /L� ' L ` Iyi✓ //iT A&� REFERRED TO: SIGNED: Form #58 (revised 3/97) HAND DELIVER COPIES OF THE FOLLOWING: MASSACHUSETTS GENERAL LAWS: SALEM FIRE PREVENTION CODE: I have received on this date from of the Salem Fire Prevention Bureau and witnessed by Officer 0 of the Salem Police Dept., copies of laws and regulations relative to Side C��11C� Addition./ Renovation Four Winter Island Road Salem, Massachusetts 01970 Modified Window Back I Fro, A 0 I 0 O N I io UP 0 Existing House Scope of Renovation: -� Replace all exterior wall shingles. Replace all existing windows. Additional Window Scope of New Construction 5 New Porch and Steps N Side Site Plan AO Scale: ill = 1'—o" Schedule of Drawings: AO Cover Sheet, Site Plan Al First Floor Plan, Second Floor Plan A2 Foundation Plan, Framing Plans A3 Building Elevations A4 Building Sections 0 z' `ATM to bv► � aLiRcr .M go ofL&7 + T� AL team nim cmt Architect: 978-7�s 9Yi7 �- Winter Street Architects, Inc. 209 Essex Street; Suite 300; Salem, MA 01970 (978) 744-7379 FAX (978) 741-0240 wsa@wsarchitects.com i 1 First Floor Plan Al Scale: 1/4" = 1'-0" M 0 I 0 N 00 I Setba k chimney at second floor, provide slopec stone at transition, see elevation. New Fireplace with exterior brick cladding, see detail. Construction Specifications Foundation: 1. Excavate to lines and grades required to properly install the foundations on undisturbed soil or controlled structural backfill. Remove all silty topsoil or objectionable materials from under footings on grade. All excavations shall be dry before placing any concrete. 2. Exterior wall footings are to be placed at a minimum depth of 4 feet below the lowest adjacent ground surface exposed to freezing. 3. Typical Footing: 1'-0" deep by 2'-0" wide poured concrete with 2x4 key. 4. Typical Concrete Foundation Wall: 10" wide with (2) #5 Rebar top and bottom. 5. Provide sill sealer between sill plate and top of foundation wall. 6. All foundation walls to be waterproofed with Tuff-n-Dri as manufactured by Koch Materials, Co. Provide 3/" Warm-n-Dri board as protection and insulation at all membrane areas. 7. Backfilling against walls or piers to be done only after the first floor deck has been installed or after walls or piers are otherwise braced. Walls: 1. Exterior wall framing consists of 2x6 wood stud structure at 16" centers. Typical interior framing consists of 2x4 studs at 16" centers. 2. Wall sheathing shall be exterior grade CDX plywood 19/32" actual thickness x 4' x 8' and back stamped with American Plywood Association span rating 32/16 for rated sheathing. Provide 1/8" mimimum spacing between all panel edges. 3. For exterior wall insulation, provide unfaced R19 fiberglass batt insulation with 6 mil poly vapor barrier. Tape all joints. Floors: 1. Floor Construction consists of 2x10 joists at 16" centers. Provide cross -bridging at mid -spans at spans equal to or less than 12', and at third spans at spans greater than 12'. The subfloor panels 2. Subfloor panels shall be CDX T&G Plywood APA rated 'Sturd-i-floor'. Panels shall be nominal 3/4" x4'x8'. Glue and screw all panels. 3. Provide Kraft -faced R-19 batt insulation in floor over crawl space with faced side against underside of sub -floor. 4. Tile flooring at Foyer to be selected by owner and installed as per manufacturers specifications. 5. Tongue and Groove Hardwood flooring at Living Room to be selected by Owner. 6. Carpet at second floor to be selected by Owner. Stairs: 1. 13 risers at +- 8 %" each, treads at 9". Treads to be hardwood to match Living Room flooring w/ 3/" bullnose projecting %" beyond riser below. Risers to be painted. Roof: 1. Roof to be Fiberglass asphalt shingles (to be selected by owner) on 15# asphalt saturated felt over 1/2" CDX plywood sheathing. No OSB sheathing is permitted on roof. Provide Cedar Shingle starter at eaves only with one inch overhang, no metal drip edge. All valley roof shingles are to be Canadian lapped : lower course placed in valley with top course cut along line of valley. 2. Provide Bituthene Ice and Water Shield as manufactured by W.R. Grace at all eave, valley, and dormer roof intersections, 3'-0" coverage minimum. Provide Bituthene Ice and Water Sheild over entire roof area at slopes shallower than 4:12. 3. Flash with lead -coated copper at dormer roof intersections, cheek wall intersections, and lead flashing at existing and new masonry. 4. At cathedral ceilings, provide R-30 Kraft -faced fiberglass batt insulation with continuous venting above. Provide venting at soffit and ridge for free air circulation below all roof sheathing. Exterior Finishes: 1. Apply all exterior siding and trim materials over Tyvek on sheathing. Tape joints and wrap wall openings. 2. Shingles to be cementitious paintable shingle product. Consult owner for manufacturer. 3. All soffits consist of 1 x6 beaded board, fir wn❑ !owg❑ !r cedar. All exterior trim consists of 4/4 or 5/4 clear vertical grain red cedar, Grade C or better, at rakes, eaves, casings, or as otherwise notedwII❑!. 4. Use only stainless steel siding nails aligned vertically and/or horizontally in straight rows. Interior Finishes: 1. All interior walls and ceilings are'/" blueboard with one coat system skim coat, smooth finish only. 2. All interior trim, including window and door casings, is clear poplar. 3. Cathedral ceilings to be 1x6 beaded board. 4. Floor finishes as indicated on plans. Doors and Windows: 1. Exterior Doors and Windows to be Pella aluminum -clad wood. Consult owner for Pella Series selection, color, and glazing type. 2. Interior doors to be solid core doors with 1 1/2 pair hinges each. Consult owner for panelling and hardware selection. 2'-4 3/4" Prowide inlel at combustion air side \I i in New Fireplace #RD42 by Superior Fireplace. Confirm clearances with manufacturers specifications. Brick Cladding around wood frame enclosure. See elevation for setback at second floor. Brick to overhang foundation by 1/2" Enlarged Fireplace Plan Al Scale: 1/2" = 1'-0" r2� First Floor Framing Plan AZ Scale: 1/4" = 1'-0" </ J \ I I h O\ I �` 4. L--� I e J �p ooc\o� \��' I I Jt`a ------ -� Qo e\o �--- IDot I I I F -1 L — — — — — — — — — — — — - J I I I I I _J I------------------J Foundation Plan A2 Scale: 1/4" = 1'-0" 4 Roof Framing Plan A2 Scale: 1/4" = 1'-0" r3 Second Floor Framing Plan A2 Scale: 1/4" = 1'-0" �ame cricket imney Post Schedule P1 Double 2x6 or 2x4 P2 4x4 or 3-2x4 P3 4x6 or 3-24 P4 6x6 or 4-2x6 P5 3 1/" dia. Concrete filled lally column, see section P6 10" dia. Concrete Sonotube Pier, see section M O N 4 U� E F-+ V a - wv - o o V 0 M u O r N E I O rW I W a d � r � 00 r o rn o, E--4 X zW z 0 Q ~ L� ' _ O n N O ca O O ._ Boom .O 'O a C� �E ■_ V, 0 M0 cl o c v N d- N O O N c 'N Or Q o v �- c E c c v v v v rn a. U- 0 c c L- 2 0 0 U-v c U` c ., , 0 •+- o a�i o UiZV)w Window Schedule KEY WINDOW TYPE MANUFACTURER # ROUGH OPENING NOTES Width I Height Aluminum Clad Replacement Match existing A 3—Wide Composite adjacent sizes Clad French In —Swing Door Left 3781/ 3'-1 1/4" 6'-8 5/8" 3 1/2" Trim 8 & Transom Unit 3614 3'-1 1/4" 1'-2 3/4" C (CUSTOM) Clad Oval Picture 2'-4 3/4" 3'-2 3/4" 3 1/2" Trim D (CUSTOM) Clad Fixed 8'-0" Radius Arch„ �� 7'-3 3/4" 5'-11 3/4" 3—Wide Composite width to match type E E Clad Casement 2971-3 7'-3 3/4" 5'-11 3/4" 3—Wide Composite F Clad Awning 2121 1'-9 3/4" 1'-9 3/4" Venting Unit G (CUSTOM) Clad Awning Width to match type "H" 5'-6 3/4" 1'-9 3/4" 2—Wide Composite H Clad Double Hung 3353-2 5'-6 3/4" 4'-5 3/4" 2—Wide Composite New Width: Match I Aluminum Clad Replacement 2'-1 3/4" Existing Ht. J Clad Arch —top Casement 3571-2 (Arched) 5'-10 3/4" 5'-1 1 3/4" 2—Wide Composite K Clad Casement 3571-2 5'-10 3/4" 5'-1 1 3/4" 2—Wide Composite L Clad Casement 2541 2'-1 3/4" 3'-5 3/4" Venting Unit General Notes: 1. Exterior doors and windows to be Pella aluminum — clad wood. Consult owner for Pella Series selection, color and glazing type. 2. Muntin bars (custom) for all new and replacement windows to be configured as shown on elevations. 3. All existing windows to receive new Pella aluminum clad wood replacement windows. All new and replacement windows to receive new 5 Y2" trim, unless otherwise specified on window schedule. Note: Eaves and rakes to match existing roof details, provide venting at all eaves. Future Work: matching replacement window as shown. Center under windows. Augment header as needed for new . Front Elevation opening size. Verify with Architect. A3 j Scale: 1/4" = 1'-0" ..,,.. - - - - - Center and windows. , Rear Elevation A3 J Scale: 1/4" = 1'-0" _2 Side Elevation A3 Scale: 1/4" = 1'-0" C+...,e ..hi.Y,.,o.. ...,.. H W Z 0 H a TT �l V u - Wo N H M W o o �' o u rn 0 r d N � N 0 W � n r- IN, N ro n OD " rn ►� O� W E4 V, H w Z X Q ~ W o 0 = LL N d O ■MEN O C O ■_ ■ o= 13 a �Q C� �E �W v M0 rY 14- 'v c v o N L c 'Q d- N O O CV c Lr 0 ++ U) '> N Cr c 0 0 w L 0 Qi r.IJ rx A3 Double sill plate, P.T. 2x6 with sill seal, typical. Anchor bolts, -5/8" dia. x 12"-ems C. maxi-m-.- Typical concrete foundation wall, 10" wide with (2) #5 rebc top and bottom. Typical Footing 1'-0" deep by 2'-0" wide poured concrete with 2x4 key 2 Section B—B A4 Scale: 3/8" = 1'-0" Sec( First to m Subflo� 3� Section C—C Scale: 3/8„ = 1 '-0„ Simpson —standoff po base at Sonotube pi Section A —A A4 j Scale: 3/8" = 1'-0" 10" dia. Sonotube concrete pier on 2'- square by 1'-0" dee footing with continue #5 rebar 1 ') into beam above. J 0 n a p, ryw l r � u W o 1--1 - 0 O O rn u W O �1 n M N � N O W \ 00 r x u O r rW W N t'! Z x Z W 0 Q ~ O N d O .... O ■i MWAM 4� v N � ° oc ° ° N C Q a d- N O O N c to 2 ++ U) =3 *> (1) W Q c O U N U) rn c m A4 CASH CHECK N of **Ut t,0J5-r1Lutuo 2- Fee Due $10.00 per unit 4 fro FIRE DEPARTMENT - FIRE PREVENTION DIVISION Inspection date: m � °•° �`'' 48 Lafayette Street Salem, Massachusetts APPLICATION FOR CERTIFICATE OF -COMPLIANCE Time: 4 : -3 O ILEj�$(C�WVVu One Family Dwelling To: HEAD OF FIRE DEPARTMENT, p ❑ Two Family Dwelling ❑ Condominium Unit // In accordance with the provisions of Chapter.148, G.L. as provided in Section 26E and/or 26F application is hereby made Type of Detectors: For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. B. Permanently Wired Units ' Address: 3� location by street and number, or describe in such a manner as to provide adequate identification of location)` LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Real Estate Agent Date of Certification: (Address) By: (Phone) Layout of Smoke/Heat Detectors: Basement: 1st Floor: 2nd Floor: % 3rd Floor: Special Requirements: Robbert w. Turner Tito of '�3' tt1Pm, Massur#uadto 29 Fort Avenue Salem,. MA 0.1970 Fee Due: $10,00. ,/ Ck# Cash v Rec-d by: &/R9 1 Fire Prevention Chief Bureau _ FAX=(508)-745-9402 508-745-7777 * * * * * * APPLICATIC N/PERMIT FOR OONTA=RS/t)LWSTERS * * * * * * TO: HEAD OF FIRE DEPA MMiT DATE OF APPLICATION: In accordance with the provisions of the Massachusetts General Laws, Chapter 148, Section 10, Massachusetts Board of Fire Prevention Regulations, 521CMFL34.00, and the Salem Fire Preven- tion Code, Article 38, application is hereby made for a permit to store a dunpster/container for rubbish handling: LOCATION OF CONTAINER: MM OF BUILDING/SITE : HOME ADDRESS: 3o ti st�,h 7 �1 CITY:. ZIP: 01IF7 U HOME PHONE: %04$t _3 ZG CONTAINER PRDVIMR ( company) : CE0 OF CONTAINER COMPANY: F 'RGENCY PHONE# (no answering device: ZIP: BUSINESS PHONE: o - EMERGENCY PHONE#(no answering device: SMJ CONTAINER SIZE IN CUBIC YARDS: jQ DURATION CN SITE:DAYS 66 PEMANENT: GIVE LOCATION (site plan) OF CONTAINER CST BACK OF APPLICATION: DATE ISSUED: DATE OF EXPIRATION:If temp. %I/ 9G PERMANENT:April 30, 199 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SIGNATURE/TITZE OF OFFICER GRANTING PERMIT: OTHER CITY DEPARTMENTS NOTIFIED: BUILDING: HEALTH: POLICE: 1/ OARS: RESTRICTIONS IF ANY: (THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES) 90M (9/92) • � ` �' �, �i��`� cn�l rv� � `�� i c t ry,®f s�tkfit *iQ 4-- Xo. Ir,�,� SALEM FIRE DEPARTMENT Fire Prevention Bureau 48 LAFAYETTE STREET, SALEM, MASS. 01970 Date ../......J/................. Certificate of Completion - Installation or Alteration of Oil Burning Equipment The undersigned hereby certifies that the installation (or alteration) of fuel oil burning equipment and/or storage tank and applying to the installation for (Name of Owner) ..�(.�. S ... O ........ I .. y y................................................ Floor heated at (Address) ..d�.Jr..w/1YT.i'r�{.. Z.rL N. U...�/t.l�%....r*10A N-d- . %YS' ��o � by system .......................................... ..... (lst,2nd,all) has been made in accordance_ with provisions of the Salem Fire Prevention Code, of Chapter 148, G.L., and regulations made under authority thereof now currently'in effect and pertaining thereto. (Ref. 527CMR4.00) Furthermore, this installation has been tested in accordance with such requirements, is now in proper operating condition and complete instructions as to its use and maintenance have been furnished to the person (or persons) for whom the installation (or alterations) was made. BURNER Name .......................�j. X /5.%'/ j:. G ...................... .. ........ Mfg. by .......................................................... Type.... ....... ...... :..... ........ ................. ...:...:. ... ...... Mass. Approval No........:....................................... To use not heavier than ....................... fuel oil....................... Kind of heat....................................................... (D.H.W.; F.H.W.; STEAM; F.H.A.) STORAGE TANK _V oy f nsr+. r ✓ av :,.? �, s :.;rx w .c fix: )irlxrsPng:�ta•r1KGtia Location..L'...A.X I I No additional storage, using same tank as another unit. Note: New underground tank installations, require a plan and Form 81G to be filed. Type (automatic or manual) control.... D .S..U..v�} G v (p ...................................................................................... Location of automatic shut-off valve........................................................................................................... . Location and type of manual shut-off valve. a#174 .41. - Or. d- F ELECTRICAL CONTRACTOR:.... . . .................1........... Special requirements .......................................... Company. (r /4 i�✓yG�� ...3 L C O J O .SO/ P� Le9 P Y...... By .. 's�c�*��... �1 ".,v Y ('.................................. (wKritten signature) Cart. of0pmp. Rec'd.. fQ . S /c/ -/ ............. ...... 7-.�1. L[ .fY C G G !k..Q �0................................... . Permit issued ....... ...a�?..��r/l.�. Address. /t�i. O1.9.�.0 Issued B �� G�"........... Installer's Certificate of Competency No... Q. �.g. y.......... pe y ...........I ............... DO NOT WRITE BELOW THIS LINE WINTER ISLAND PARK City of Salem, Massachusetts 50 Winter Island Road Salem, MA. 01970 (508) 745-9430 FAx 9y(>- 9;V % SPECIAL EVENT APPLICATION AND PERMIT NAME OF EVENT PZves� Gary M. Moore Manager TYPE OF EVENT: CONCERTFAMILY , BUSINESS , ORG. DATE(S) OF EVENT: Sy mdA `")9 Y 16 TIME OF EVENT: )QairLTO WE SCOPE OF EVENT: EST. # PEOPLE S70e2j-- # OF VEHICLES /3-00 PERSON RESPONSIBLE FOR EVENT: TELEPHONE ACCESS: DAY to/'7 6 39 yo yo EVE. E4 ?A BEEPER # ORGANIZATION RESPONSIBLE: kv.4n. MAILING ADDRESS: C1 P,14c / 1110 X L .,9y1 aeS )I. A'P 'd Z'— '( e-.)W &/g ZIP PROCEDURAL MILESTONES: DATE BY WHOM ACTION COMPLETE APPLICATION RECEIVED la IS"" - G 6r--r _ DATES APPROVED 1 --A A t wL /s " TIMES APPROVED - POLICE DETAIL ESTAB. FIRE SAFETY PLAN OK i INSURANCE BINDER REC'D SECURITY PLAN OK _ PARKING PLAN OK RUBBISH REMOVAL PLAN Container /Su. d SANITARY WASTE PLAN # Chem. Toilets PUBLIC HEALTH PERMIT ALCOHOL PERMIT OK - Lic Bd OTHER APPLICATION APPROVED NU I tN: co at Fix Otis- y�o z Tests z 30 3/�y e '7q l- 0/7I D.= TAIL ,'1 7W.?j 3G /J..,r TS .X FORM e-r- zvz (rov.9/90) Ville (90111nuulwV104 ,af Department of Public Safety i� Pivision of Fire Prevention and Regulation APPLICATION FOR PERMIT, AND PERMIT, FOR REMOVAL. AND TRANSPORTATION TO APPROVED TANK, YARD FDID# permit I a 1 d Date 11/16/ 1995 Salem my. 70W"orPlOw c.p i.40 M.G.L. 017S-S - PIG SAFE NUMBER Fee paid: S 15.00 N/A start date in accordance with the provisions of chapter 140, Sec. 38A, M.G.L., 527 CMR 9. oo appilcotlon is hereby made by; H & S Tank Cleaning Inc. Street Address 6 city or Town.- 101R Foster St. Peabody, MA 01960 Signature of applicant: Applicants name printed: Ann Bash For permission tp remove and transport one %QI atprags tank from. Owner: Tim Zack Otreet Address; 30 Winter Island Rd.. Firm transporting Waste; H & S Tank Cleaning Inc. StOta Lic.I MA326 Hazardous Waste manifest IN/A Approved tank yard; Turner Salvage # 002 Tank yard Address: Commercial St Lynn, MA Type of inert gas: N/A UI# tank 1; N/A Tank capacity: 275 gallon $uhstailgs last etpred; fuel oil Date of issue; �/ �� l� �� Rate of e:Kpjtgtjgn; Signature/Title of officer granting permits ` KEEP ORIGINAL. AS APPLICATION AND ISSUE DUPLICATE AS PERMIT Form 90V (9/90) a K RECEIPT OF DISPOSAL OF Ufawr1fr' lking &ESayage NAME AND ADDRESS �iT�' 1 R Co-, OF 225 Commercial St _ _ APPROVED TANK YARD Lynn MA 01nn5 _ APPROVED TANK YARD NO. _ Tank Yard Ledger 502 CMR 3.03(4) Qom_ Number'-�`—!( I certify under penalty of law I have personally examined the underground steel storage tank delivered to this "approved tank yard" by firm, corporation or partnership and accepted same in conformance with Massachusetts Fire Prevention Regulation 502 CMR 3.00 Provisions for Approving Underground Steel S tling yards. A valid permit was issued by LOCAL Head of Fire Department FDID1� to transport this tank to this yard. Name oofficial title of approved Z,,rdZer or owners autho'ized re resentative: U SIGNATURE t TIT12 J IWE 1S:rGNEb This signed receipt of disposal mist be returned to the local L of the fire department FDI1# _ _ _ _ _ pursuant to 502 CMR 3:00. (EACH TW MUST HAVE A RECEIPT OF DIS110SPL) FORM F.P. 291 (rev. 9/88) (OVER) MASSALHUSElYS STATE FIRE MARSHAL'S OFFICC ; k?IMENSIONS Width Length Tank 1 -- X� - Tank 2 ----- X ----- Tank 3 ----- X ----- Tank 4 ----- X ----- Tank 5 ----- X ----- (feet) (feet) Tank Removed From - ------ (no. street ___ _ - (city or town) Fire Department Permit # -- �c)- ---------- (if applicable) Robert W. Turner 0:11HU of Salem, �fflassarhusrfts Fee $10.00 3Ftrr wepartmrnf �ruDquartrrs 48 Tfgcffr ;Ebfrrrf Cash: V Ck# ,5alrm, , Hzz. 91370 Rec' d by: Cv2 Chief APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULAITION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.# 20 APPLICANT: ADDRESS: --�S- print CITY: fi U-9--A.S STATE: ZIP: 6/923 PHONE: 777-0 3 3 LOCATION OWNER OF CITY: OF TENTAGE • PROPERTY: ADDRESS: STA ZIP: PHONE - INSTALLER/ RENTAL CO. OF T c"r L � ADDRESS: CITY:/A)(kicit STATkk (A ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: 1/' MANUFACTURER: `To A 'm A SIZE OF TENTAGE: 36 x 3 o a NAME OF TESTING AGENCY: !_Jt) Co AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: 9 SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: ,DATE OF ISSUE: 8/-O4.r , EXPIRATION OATS: L/a7 q APPROVED BY: TITLE:-- S Form#80B (Rev. 5/87) Of 7 4'Pr* Lrk C. lop 4. Ile Joe of Alat REGISTERED ISSUED BYs. APPLICATION -: ANCHORIND NUMBER tMTRIIES' INC.Date of manufacill EVANSVILLE, IN DIANA 47711 kIN, MANUFACTuRrERS OFTHE FINISIJEI) 75095 --.141191.- -TENT PRODUCTS DESCRIBED KEREIN'-�' Thls'is,'to certify that the'rnaterials 'described *have'been flamO-retardiant inherently nonintlammabile) and treated '(or were supplied to:,' NAME:CST PrrP171j Qn 7k rrmw TR WINCRESTER STATE' Certification is h a ereby, made that:: .Ir-v7!Thwarticleq described on this C mrfificatehave.6 chemical"ind'that the -�applicatio een'treated ' wfth.a flame-retardant approved Mof said -chemical was d "FirwMairshall Code,-_ecjug�to or exceedwNFPA71D one'in conformartmwfth"Cafffornlw�, 1XPAl'441 GOVERMENT CERTIFIED IAR #6360 ... 7.,� 'LMINATED;,2 -Method of application,.,-, -TYPe, color and weight Of canvasivi nyl; 15 VINY� Log WHITE 'DeacrlplJon. ot item cerfltied: 301X309 -2 :'PC'. SQUARE ND PARTY 'TENT. ,.RaMe Retard1int proyP cess Will, Not B Re M6V-ed By WaShiRg And [S� Effect- :,/1C, - . I f Thi Fabric ive For �Tlhe''Lal FType, color 7r,, 7ana of _Aqp[[Lt0 F of 45 Ill ! nY 7!Z1117: on Finish . Signed:. . Ti: DAR&1l 1111 11111111!!!,! 11 11,1111 All A TRIES Iffa.- Robert W. Chief Cat of Salem, �fflassarhusrftEi Fee $10.00 Prr Urpartntmt �Dlzahquartrrz 48 Txfgcttr !ttrrrt Lash: k# Turner U1970 Rec' d by: v✓Ikl� APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.# 20 APPLICANT: V,1 tnn —7� CITY: I� 5L VI v-QA STATE: M61— ZIP: Q 1 27-7 PHONE: ? 6 LOCATION OF TENTAGE: t V� t7" T S (c�i•� CQ �' OWNER OF PROPERTY: C 0 ADDRESS: CITY: STATE: ZIP: PHONE:: INSTALLER/RENTAL CO. OF TENTAGE: PHONE: ADDRESS: - CITY: STATEAQ ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: v I rvCS " i � c�k MANUFACTURER:--- N h r�sn IC +. Co SIZE OF TENTAGE: k 3 6 4-PL NAME OF TESTING AGENCY: AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PE/P.MIT NUMBER: SITE INSPECTION DATE: F4Zl R3 ,DATE OF ISSUE: as� EXPIRATION DATE: a74S APPROVED BY: �� %� 14.04, TITLE: c/Lf 4111&'� Form #80B (Rev. 5/87) KARAW '739M Z:� Rt` ,a t tot4:. V&Wart* t t AwAA � 4 :; REGISTERED. 4- "ISSIX0 BY Date of Manufacture APPLICATION -,-,`,•ANCH0R to .""NUMBER CUAKIQUIN I r- 1KIMALUA A INDUSTRIM INC` F 'SERIAL ANUFACTURERS ORTME FINISHED 1: W1. .121. stET f-TENT 'PRODUCTS DESCRIBED HEREIN s 2591 -3/8/93 his he' materials described have,been flame-retardant treated " 7jS 'to certify that t inherently noninfiammableland,were,supplie -d,to, -', NAMIZ",•PIETRASON'PA 'CIEKTKR7� INC 'WINCHE HAi�� STER v,g STATE-'- ificad W hereby. made that: T, Wes descriF oTi``this-Certificate.ba4e been treated with- alane-retardant ' a P0 rpie .,,chemical- and that.the application of said-chemicalwas done in- Qonformance'with California. -'Fire Marshall Code, equal to or exceeds'NFPA 701 CPA] 84 GOVERNMENT CERTIFIED LAB #305&. % , of'app Icatiow ?Mthod N LAMINATED 214- .-t,,t,-_),0,M1LG'_43006D NYC-.374 65 -SM ro 7 T, 71 F:: Type ,,, color and weight of canvaslvinyl, ,-`ry�e'BOYLES BIG TORVINYU7,LAMINAT E rrppn/jY f_rb -Description of item certified: 7 flTr 'r 3n iLpc np RaMeR64ardam. Process, Used. Wilk ot"Be'-- Removed-'B T Th i Of TheF6b WashingAnd Is Effective For 1'ft he �i JOHN BOYLE & CO. Name of Applicator of Flame Resistant Finish RTMENT—ANCHOR iff_D_USTFllz�� 3r4t;. \_TENT,*g STATESVILLE NC W WN LOUIS R. BRO k ga Xi% MA Ail Va ga &-I gam Robert W. Turner CQlif of � �iafcm, �,Hassarhusrfts Prr ;Urpartimnt '�ttfzc�cffr �rahquarfrrs Fee $10. 00 48 'itrrrt Cash: +/ Ck# - Miem, jRtt. 01970 Rec' d by: c�vg Chief APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION JJ 527CMR19.0 AND THE SALEM FIRE PREVENTION CODE, ART.# 20 APPLICANT: i t m LO &V IL V� D ADDRESS: 20 CPneci � 5 print L CITY: f STATE: ZIP: D l Z HONE: 77 7-0 333 LOCATION OF TENTAGE: (,yc v1ttA 5 �� y�0( 7s�q Lf:_ -i OWNER OF PROPERTY: e(iyi ADDRESS: CITY: STATE: ZIP: PHONR:: INSTALLER/RENTAL CO. OF TENTAGE: 7LteA So,,-, 2U-�j j-y-PHONE: ADDRESS: 111 - CITY: STAT4,-1_4 Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: I�I4 F) CJ La mI MANUFACTURER: h r, ROV ICj SIZE OF TENTAGE: o25 Xad V L Gt-J NAME OF TESTING AGENCY: AvtC_ 't' �Tv'dus�� AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: av i ,DATE OF ISSUE: 9 4' q� , EXPIRATION DATE: APPROVED BY: TITLE:',�/CQ Form #80B (Rev. 5/87) 5 S Lip tit., P t ` i$ESafS?Ei3E® -' 15SUED ` APPLICAMON 'ANCHOR-INDUSTRIES�� UNl�Eg'i" EVANSVIL�E, iNDIAr4A47711 asrc y sy ,r. ti � .+�a, w ,"':..; - ..�v. i, 4 k..� t : MANUFACTUR6S OF THE FINISHED Order f5umher ? x a �^< r r • TENT PAODUCIS QESGR[BED HEAEi�E 45 5 92 8, Y z" v c l�w� lt;T A is F T.., ,x y y " ;. .� 4 ty �'� r.• y This is to bertffi h.l 't 01 materials described have beery fiame-re4ardaa,lt treated a �� r inherengiy a�oa�Ir #I,�IrlrtRlr>riaible arad were su' „ lied M _ `PETERSON PARTY MWER SYNC Rt9 to: * ; �� 1irr#t�t.;.T vS' sd �.J JeS P✓��VI1�J.'ST ,YeP`"�' � ':9 6�3(4 y r -_ Y� '�: i tF �• '� FAQ Zy-.', s {TW' ,, ✓�;:y 1 �� .. �, i,. � { f 4;a1 `3-. 1 s { as ,}.`n Nis, i + � :SF a - �,' s:. .ii t f, •r:, s a%J.,,n-. �'j '?I�.,,*� '-r 41 4 k . `t' �td , jj- ,� a w r w x ax s ,y �" r{<Y=,.:.Cel'tification ishereby'maketha$ The ;articles described; on a;this„Certificate have been treated with a fEarvte-e-etardant ME approved chemical-and.that theapplication of said chemical was done in conformance wtth'::Caflffor-nia .Fire Marshall °, Code, equal to . 'or exceeds NFP 749, , CPA] - 84 < k { x #Meth®d of a li ' o P7 T�Ry ' . A.N -. ^F •T i�P Ca't�l�t'tE - ' � vas Type, color and weight of canJvEnyl .. ,. sRg, 8Q23Q4Q. CQ001?. , Description of item certified ; XP :=TOP Z OW X 20 VL G W °: Flame. art Process Used Will Not Be RemoveBy d Washing And ,1�C� '�'�" } � Fabric JOHN BOYLE & , co � "`� �Cr /I .�r�� 1a cif l iVame of Ap�ticator of Flame Resistant Finish ��' ►� Jh ' ' b TENT DEPARTMENT —ANCHOR INDUSTRIEs rNC. S. , 8 •, '�O/MD6 TPr r To: HEAD OF FIRE DEPARTMENT Titg of %lerim, fllaosar4usetts FIRE DEPARTMENT • FIRE PREVENTION BUREAU 48 Lafayette Street ' Salem, Massachusetts 01970 /t/6' � Fee Due $10.00 Ck. # Cash Rec'd by: q-gl—ql (Date) Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location named herein: Name of Owner: _ Number of Tanks: G Company: Issued by: Form #901- (Rev. 1/83) Address:40 W,q &A � 7 - �i�� U(J) S - a Capacity of Each Tank: � 32 M-5 - Total Storage: 0 ress: Installer: / (Written Signature) Date: y 4-1/ DO NOT WRITE BELOW THIS LINE `°ON SALEM FIRE DEPARTMENT Fee Paid $10.00 6 FIRE PREVENTION BUREAU PERMIT Date: TO INSTALL LIQUIFIED PETROLEUM GAS STORAGE "TANKS In accordance with provisions of Chapter 148, G.L., and Regulations made under authority thereof. Name: Name: t (Owner or Occupant) (Installer) Address: Address: PERMIT is hereby granted to above listed installer, to install L.P.G. tanks on the premises of the above listed owner or occupant. Number of Tanks: Capacity of Each Tank: ' Total Storage: Date Permit Issued: Inspector (Chief of Fire Department) Form #901- (Rev. 1/83) (OVER) NOTICE TO INSTALLER: RESTRICTIONS: 1. Installer certifies that the installation shall be made in accordance with all provisions of 527 CMR 6.00. 2. An installation of an underground tank, shall require the submittal of a plan for stamped approval, with an application. (Form #81G) Separate fee of $10.00 for each underground tank, with application. 3. Application shall be made to the Salem Gas Inspector for approval of piping and appliances. f 4. All tanks installed in an area where damage may occur due to motor vehicle traffic conditions, shall require such additional protection as the Head of the Fire Dept. may require. Any tank or tanks, with a total of 1,000 gallons capacity or more, or which may be subject to vandalism, shall require a chain link fence to be provided. 5. NO L.P.G. SHALL BE PUMPED INTO ANY TANK OVER 499 GALLONS CAPACITY, UNTIL THE SUPPLIER HAS KNOWLEDGE OF A PERMIT BEING ISSUED, AND SAID PERMIT SHALL BE POSTED ON THE PREMISES. 6. DISPENSING OF L.P.G. FOR RE -SALE, REQUIRES ISSUANCE OF A SERVICE STATION PERMIT. Joseph F. Sullivan Chief Fee $10.00 Dire Pepnrtmrnf �irnbqunrirrs 48 `Cnfri�cffrfrccf Cash: Ck# rzLem,tt. 01970 Rec' d .by: APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO. THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.00. APPLICANT: ADDRESS:G�0 CnAAb - pri nt CITYZIP: C. /9 PHONE: LOCATION OF TENTAGE: U—DoltEL- =(Iqk' d " OWNER OF PROPERTY: C(4Q r-)P ADDRESS: C J'�C-j CITY: STATE: M ZIP: 0 Iq PHON@I, . INSTALLER/RENTAL CO. OF TENTAGE: �� 2��j�) A4441 Gift PHONE: —)(,39-VOOC> ADDRESS: ) >-} CITY: L3(n( h6SSTATE: i6/MP: C"'/ Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: 7k-6-k6*.ozdywd �)Y-i2o/l) " MANUFACTURER: A A)ChoL SIZE OF TENTAGE: ,?Lj X hO NAME OF TESTING AGENCY: Z0,,k) AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: ,DATE OF ISSUE: F'291-C' 1, EXPIRATION DATE: - —,P-6—?/ a APPROVED BY: TITLE: Joseph F. Sullivan Chief Fee $10.00 Jirr jDrpnrtnuent �gc2ia9unrtcr53 48 TGzif:t�icffc �frcct Cash: CkTIT ,:$aLm, 01970 Rec' d .by: APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO. THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19:00 AND THE SALEM FIRE PREVENTION CODE, ART.#30. APPLICANT: M_DI f) ADDRESS: ( C(_Inf) S t print CITY: ::�3ftf)o m <, STATE: / � A- ZIP: O�)'- PHONE: LOCATION OF TENTAGE: ,L'4'� fiie_�_' = OWNER OF PROPERTY: i OP '5CL- _ADDRESS: O CITY: Ct STATE: - nZIPQJ �Q PHONEI: INSTALLER/RENTAL CO. OF TENTAGE:eSUttr I'}IQ PHONE: —_)J--(-1GO6 ADDRESS: 1 j"i � ft+00 Sf CITYSTATE: /DftZIP: Ol� Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: �� :�`il��C�1:w ��CR •� !`� MANUFACTURER: SIZE OF TENTAGE: NAME OF TESTING .AGENCY: AGENCY APPROVAL NUMBER: L%' CERTIFICATE. OF FLAME RESISTANCE:. CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: ,DATE OF ISSUE: a?/-CP EXPIRATION DATE: -fib APPROVED BY: TITLE: r—,, Ionn (on%, (�N7) Joseph F. Sullivan Chief 01, laf 'alem suchu5�tta.-_ F ee $10.00 fire Dcpnrfi rn1 �icnbquarfcrs 48 �Cxzfncifc ;frcrf Cash: Ck,'� ttlem, �i3�tz. 0I970 Rec'd.by: APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO. THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.0 0. APPLICANT:_ ADDRESS:() ccoq/)� Sr print M _ CITY: STATE: ' 1jq ZIP: CS/j PHONE: LOCATION OF TENTAGE:I/lJ �nIUC� _L_I19�/�cY C OWNER OF PROPERTY:nj�—jj ADDRESS : / `�hl/ CITY: cC�(1L� STATE: ZIP: PHONEI: INSTALLER/RENTAL CO. OF TENTAGE: l� C4 ° PHONE:` _VboO ADDRESS: � % �(�A�l }j� CITY:`�►>'1�llr�Sf��. STATE:�)/'-ZIP: OJ�Cjb Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: Artd2., 1'� D MANUFACTURER: SIZE OF TENTAGE: NAME OF TESTING AGENCY: AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE°"INSPECTION DATE: ,DATE OF ISSUE:aJ��ll, EXPIRATION DATE: APPROVED BY: r d� TITLE: Joseph F. Sullivan OLTii of �5nlelll a5-,q .r11U�i ii Fee $10.00 ire �cpztrttzuttl �-�cua9uttricra 48 CZzfnieffc 5-trcct Cash: Ck" rzlem,zz. 0I970 Rec' d .by: Chief APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19:00 AND THE SALEM FIRE PREVENTION ' CODE, ART.0 0. APPLICANT: �i�l I ADDRESS: �C UO (q)q-/] �- S� print M CITY: 010E 5 STATE: l� '`� ZIP: �/G PHONE: LOCATION OF TENTAGE: 1. 3,o+Ek, OWNER OF PROPERTY: E/j�__,ADDRESS: Cc 4'j 46--t I CITY: � i STATE : PHONNI- INSTALLER/RENTAL CO. OF TENTAGE:/V �� `��, PHONE:�9�_y�� ADDRESS: r3q 'CITY: L.D,A z(�:S t TATE: %�IP: 6/Ko Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: INNSW MANUFACTURER: ��C r� --4✓ du.5.7��/�S' SIZE OF TENTAGE: NAME OF TESTING AGENCY: 6py/e Cd AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTtfENT PE;:MIT NUMBER: SITE INSPECTION DATE: ,DATE OF ISSUE: �021 ° EXPIRATION DATE: APPROVED BY: I TITLE: r ter„ Yfann (Qr)w R/R7) Joseph F. Sullivan Fee $10.00 ire �rpnrinuttt �`iena9unricrs 48 Cash: Ckn 5aLrin, z:. 01970 Rec' d .by: Chief APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO. THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19:00 AND THE SALEM FIRE PREVENTION CODE; ART.00. APPLICANT: ADDRESS: c D Cow�- print CITY:/1l)�IZ-J STATE: ZIP: �ICJ�_ PHONE: LOCATION OF TENTAGE: L"�) �mfk_�`>�4i)d OWNER OF PROPERTY:R (,rn /ADDRESS: . 0),� OCO I c CITY: C ,l�tr}� STATE: l /iInn' ' G_ZIP: O I 76 RHONEI:. INSTALLER/RENTAL CO. OF TENTAGE:at_'La/) PW� C—tt, PHONE: ADDRESS: �j� �i► P� CITY: �(/�1��5} 2 STATE:�ZIP: .G Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: MANUF SIZE OF TENTAGE: > x 40 ' 0 NAME OF TESTING AGENCY: AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: .SALEM BUILDING• DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: ,DATE OF ISSUE: EXPIRATION DATE:-�-1 APPROVED BY: Q0 TITLE: (llertificttte of Ntamic Xtsistan.rje REGISTERED APPLICATION NUMBER F031.02 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 75095 — 1/1/91 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify -that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON PARTY CENTRR CITY WINCHESTER STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 GOVERNMENT CERTIFIED LAB #6360 Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . VINYL LAMINATE WHITE Description of item certified: (1) 30' X30' 2 PC. SQUARE END PARTY TENT Flame Retardant Process Used Washing And Is Effective For DUBACOTE Name of Applicator of Flame Resistant Finish RAVENNA, OR Will Not Be Removed By The Lif Of The Fabric Signed:. TENT DE AR MENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN (11'ertiftratt of Niame TRiest-stance REGISTERED APPLICATION NUMBER F121.4 ISSUED BY ANCHOR INDUSTRIES INC. EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN Date of Manufacture T6855 6/20/89 This is to certify that the materials described_ have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME' PETERSON CHAIR INC. CITY WINCHESTER STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 GOVERNMENT CERTIFIED LAB #3056 Method of application: LAMINATED Type, -color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP VINYL LAMINATE WHITE Description of item certified: 20 X 40 4 PC FIESTA EXPANDABLE TOP Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Lif Of The Fabric JOHN BOYLE & CO. Name of Applicator of Flame Resistant Finish igned: rL STATESVILLE, NC TENT DE RTMENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN Trrfiftratr Tarr REGISTERED �,ASSIF/E• ISSUED RY D� of Man�faoure APPLICATION �' `� ANCHOR INDUSTRIES, INC. NUMBER EVANSVI`9.E, IND!anPlA 47711 T 212 3 MANUFACTURERS OF THE FINISHED 4— 2 8— 8 7 0 TENT PRODUCTS DESCRIZED HERINK U L This is to certify that the materials described have been 'flame-retardant treated (or are in- herently noninflammable) and were supplied to:) NAME: PETERSON CHAIR CENTER WINCHESTER MASS CITY STATE Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chem- ical and that the application of said chemical was done in conformance with California Fire Mar- shall Code, equal to or exceeds Federal Specification MIL—C-43006D Method of application: LAMINATED _ Type, color and weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 20 x 20 Fiesta Top _ Marne Retardant Process Used Will Not Be Removed By Washing And 1s Effective For The Life Of The (Fabric JOHN BOYLE & CO.� Signed: Name of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCINDUSTRIES, INC. STATESVIL E. NC GLENN SEGER (11'ertifirate of fflamic TRest-stancie REGISTERED APPLICATION NUMBER F-121.4 ISSUED BY ANCHOR INDUSTRIES INC. EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN Date of Manufacture T3540 6/3/88 This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR, INC. CITY WINCHESTER, STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in confor a with California Fire Marshall Code, equal to ormel %�s NFPA 701, CPAI 84 MIL-c�co06D Method of application: Type, color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP WHITE DACRON Description of Item certified: 6 X 10 FIESTA MARQUEE MIDDLES Flame Retardant Process Used Washing And Is Effective For JOHN BOYLE & CO. Name of Applicator of Flame Resistant Finish STATESVILLE, NC Will Not Be Removed By The Life Of The Fabric Signed: C5 L " — TENT DEPARTMENT —ANCHOR INDUSTRIES INC. LOUIS R. BROWN Cnertifirttte of Ntame TRest-stanve REGISTERED APPLICATION NUMBER F.121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED T8931 9/13/88 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR INC CITY WINCHESTER STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 MTT-c-4-lnntin Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP WHITE DACRON ' Description of Item certified: 9 X 10 FIESTA MARQUEE Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric JOHN BOYLE & CO. C�+ " _ Signed: v5 Name of Applicator of Flame Resistant Finish TENT DEPARTMENT —ANCHOR INDUSTRIES INC. STATESVILLE, NC Louis R. Brown Cnertificttte of Niame Ties t""'stance REGISTERED APPLICATION NUMBER F031.02 ISSUED BY Date of Manufacture ANCHOR INDUSTRIES INC. EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED T5063 5-16-89 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials inherently noninflammable) and were NAME: PETERSON CHAIR CITY WINCHESTER, described have been flame-retardant treated (or are supplied to: STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 GOVERNMENT CERTIFIED LAB #6360 Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . VINYL LAMINATE WHITE Description of item certified: 30X60 4 PC SQ END PARTY TENT Flame Retardant Process Used Washing And Is Effective For DTRACOTE Name of Applicator of Flame Resistant Finish RAVENNA, OH Will Not Be Removed By The Life Of The Fabric :�2 Signed �.I TE T D AR MENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN ON 0tv of ftem, Assagr4untts Fee Due o o a � � FIRE DEPARTMENT - FIRE PREVENTION BUREAU Ck. ti C 48 Lafayette Street Rec'd by: Salem, Massachusetts 01970 Nov. 22, 1989 To: HEAD OF FIRE DEPARTMENT (Date). Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location named herein: �%%6nP e S WC-S O� t__M c. Address: Qn,c 'V21-1 P6 , N +11 Name of Owner. ,, w 1 o 3,?o Number of Tanks: Capacity of EaA Tank: / UO 1 Total Storage: f Company: IU: Address: Installer. tl X.7/ �" I / n _ n igna ure Issued by: Form R90L (Rev. 1/83) Ck , C *tu of $alenl 9 Fee $10.00 Wire Drpartntent lica6guarters 48 3:afavettr itrrct Cash : Ck# 23 Joseph F. Sullivan $ lrm, , Ea. II1970 Rec' d by: %�, Chief APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.# 20 APPLICANT: uscoL-2,�STRa?►4 J fiSSCICIPTJord ADDRESS: ®ZC> (fo,1IgNT Sl print CITY:_1 ,9dvC-kS STATE: V4SS ZIP: 0/913 PHONE: GB - %77-0333 LOCATION OF TENTAGE: W /N TC- R -7-SLp/�j D S/4L &M AA A OWNER OF PROPERTY: F _Sp LGAI ADDRESS: CITY: STATE: &ASS ZIP: 019-70 PHONE:: INSTALLER/RENTAL CO. OF TENTAGE: __P5-rGR56A1 �i3,QTy C 0TX PHONE: ADDRESS: CITY: 4(J)AICf/ESTE2 STATE ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: ^ A�{, 4 MATERIAL USED: TYPE: MANUFACTURER: SIZE OF TENTAGE: NAME OF TESTING AGENCY:. AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: 1 SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: ,DATE Of ISSUE: 7/3/ a, EXPIRATION DATE: APPROVED BY: // /.%.c� ti TITLE: ��yC.e 1)4 Form MOB (Rev. 5/87) ` tNtatnt Kes-s tance Ike.rti c SST Q REGISTERED CATION �,�' � ANCHOR INDUSTRIES BY Date of Manufacture INC. NUMBER ,* F EVANSVILLE, INDIANA 47711 ? Z 75095 — 1/1/91 AMME N,t OQ' MANUFACTURERS OF THE FINISHED F031.02 'yF RETpa TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PRTRRSnN PARTY CENTER CITY WINCHESTER STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done inGOVERMENT conformance with CaERTIFIED lifornia Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 Method of application: LAMINATED Description of item certified: (1) 30' X30' 2 PC. SQUARE END PARTY TENT Flame Retardant Washing And Is Process Used Effective For OU$ACOTE Name of Applicator of Flame Resistant Finish RAVENNA, OH Will Not Be Removed By The Life Of The Fabric Signed:. TE `DE AR MENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN 0 (11'ertift-rate of fftamt West-stancie REGISTERED APPLICATION NUMBER F121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED T6855 6/20/89 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR INC. CITY WINCHESTER STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 GOVERM49NT CERTIFIED LAB #3056 Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP VINYL LAMINATE WHITE Description of item certified: 20 X 40 4 PC FIESTA EXPANDABLE TOP Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Lif Of The Fabric JOHN BOYLE & CO. iZ Name of Applicator of Flame Resistant Finish , igned: STATESVILLE, NC TENT DE RTMENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN 0 is Tntifiratr of 34tamr TKo,,. st"Staurr REGISTERED G�,aSSIU0 ISSUED 8Y Deft of Manufacture APPLICATION 11CI f01 9l'� DIITIIES, 111, NUMBER EVANSVILLE, IND!A!!A 47711 T�12 MANUFACTURERS OF THE FINISHED 4— 2 8— 8 7 QQ TENT PRODUCTS DUZC2IIIFD HEREIN This is to certify that the materials described have been flame-retardant treated (or are in- herently noninflammable) and were supplied to:) NAME: PETERSON CHAIR CENTER — MASS CITY STATE ___ -- Certification is hereby made that: The articles described on this Certificate have been treated with a fiame-retardant approved chem- ical and that the application of said chemical was done in conformance with California Fire Mar- shall Code, equal to or exceeds Federal Specification _MIL-C-43006D Method of application: LAMINATED Type, color and weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 20 X 20 Fiesta Top _ Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric OHN BOYLE & CO. Si J Signed: g Name of Applicator of Flame Resistant Finish TENT DEPARTMENT —ANCHOR INDUSTRIES, INC. STATESVILLE. NC GLENN SEGER ,. (IIertifirttte of Ntamie Xtst-stanct REGISTERED APPLICATION NUMBER F-121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 T3540 MANUFACTURERS OF THE FINISHED 6/3/88 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR, INC. CITY WINCHESTER, STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in co1n Lori ilq(" Dwith California Fire Marshall Code, equal to 2rmel�r%jgs NFPA 701, CPAI 84 Method of application: Type, color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP WHITE DACRON Description of Item certified: 6 X 10 FIESTA MARQUEE MIDDLES Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric JOHN BOYLE & CO. (`.dots.. /� Signed: Name of Applicator of Flame Resistant Finish TENT DEPARTMENT —ANCHOR INDUSTRIES INC. STATESVILLE, NC LOUIS R. BROWN 0 0 0 w (11'ertificate of Ntatne Kes-stance REGISTERED APPLICATION NUMBER F.121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED T8931 9/13/88 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR INC WINCHESTER STATE MA CITY Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 MTT 0-41nn6n Method of application: LAMINATED Description of item certified: 9 X 10 FIESTA MARQUEE Flame Retardant Process Used Will Not tie Hemovea ray Washing And Is Effective For The Life Of The Fabric JOHN BOYLE & CO. Signed: . Name of Applicator of Flame Resistant Finish TENT DEPARTMENT —ANCHOR INDUSTRIES INC. STATESVILLE, NC Louis R. Brown Tertifirate of .34tame %STF ISSUED BY REGISTERED Q �tiF G Date of Manufacture APPLICATION ��s ANCHOR INDUSTRIES INC. y NUMBER EVANSVILLE, INDIANA 47711 � � t, p' MANUFACTURERS OF THE FINISHED T5063 5-16-89 F031.02 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR MA CITY WINCHESTER, STATE Certification is hereby made that: The articles described on this Certificate have been treated with aflame -retardant approved chemical and that the application of said I was econformance in California GOV RNrzNT CERTIFIED #6360 Fire Marshall Code, equal to i or NA�d NFPA 701, CPAI 84 Method of application: Type, color and weight of canvas/vinyl Description of item certified: 15 OZ. VINYL LAMINATE WHITE 30X60 4 PC S4 END PARTY TENT Flame Retardant Process Used Washing And Is Effective For ��BACOTE Name of Applicator of Flame Resistant Finish RAVENNA, OH Will Not Be Removed By The Life Of The Fabric Signed TE T D ARTMENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN 0 (�lertifirate of 341ame West -stance REGISTERED APPLICATION NUMBER F121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED T6855 6/20/89 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are Inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR INC. CITY' WINCHESTER STATE IAA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 GOVERRIENT CERTIFIED LAB #3056 Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP VINYL LAMINATE WHITE Description of Item certified: 20 X 40 4 PC FIESTA EXPANDABLE TOP Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Lif Of The Fabric JOHN BOYLE & CO. Name of Applicator of Flame Resistant Finish Igned: Z_ STATESVILLE, NC ',"TENT DE RTMENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN i Vassar use##s Fee ue $1O:OU § FIRE DEPARTMENT - FIRE PREVENTION BUREAU Ck. # Cash 48 Lafayette Street Rec'd by: Zl7 Salem, Massachusetts 01970 / yZ To: HEAD OF FIRE DEPARTMENT _ ) Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under Authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location named herein: //��,,��,, nnA� Name of Owner: /� e-09pi Address: Number of Tanks: Capacity of Each Tank: 02 — Total Stora e:� Company: d ss: %'�: Installer: n en Signatu Issued by: Date: Form #90L (Rev. 1/83) DO NOT WRITE BELOW THIS LINE Joseph F. Sullivan Fee $10.00 fire jUrPnrinunt �icabqunrfrrz 48�zfacftcfrcct Cash t Ck# %Vc &Lem, JUtt. 01970 Rec d b �L( y: Chief APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO. THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.#30. APPLICANT: ��`��-��{S�izbR�Q �SS ADDRESS: C O/I df S print CITY: Il�)E!1_5 STATE: A ZIP: PHONE: ? 03, 3 LOCATION OF TENTAGE: OWNER OF PROPERTY: ADDRESS: 5� �(�., CITY: STATE: f l l ZIP: d lPHON@I:' INSTALLER/RENTAL CO. OF TENTAGE:— PGRf PHONE:y'yc�C� ADDRESS: j� �1��(� St CITY: i� �S�STATE:�ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: MANUFACTURER: hi+t' �icd�-4 SIZE OF TENTAGE: \� �� NAME 0 F TESTING AGENCY: In A nu 1 0-0 AGENCY APPROVAL NUMBER:4��'SV CERTIFICATE OF FLAME RESISTANCE: - 6 X f () CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS- SALEM BUILDING DEPARTMENT PERMIT NUMBER: p, Q SITE INSPECTION DATE: (�/,DATE OF ISSUE: 0. 2 EXPIRATION DATE: o APPROVED BY: TITLE: Joseph F. Sullivan Chief of " Fee $10.00 Jire Uq*z1HnU11t jgcnbqunr1m5 48 Tzifinutfc -�-_Irccl Cash:" " C k # " Salem, ii. 01970 Rec' d by:yr.,,�� " APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.#30. APPLICANT: �I005CO10.P—:1�54ec)Mq ASS ADDRESS: CO/1 of print _Ij CITYSTATE: ZIP: Oq 5 PHONE: %7 LOCATION OF TENTAGE: wl(1�1� �CIUI PRE K_ OWNER OF PROPERTY:C�CADDRESS: Inf CITY: STATE: ZIP: 019)0 PHONEI: INSTALLER/RENTAL CO. OF TENTAGE: GilCA d _PH ONE:�7'�/0� ADDRESS: � j ,�l y� ilk S� CITY: STATE. ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: \�Z_+f' —T)qCLo) MANUFACTURER: SIZE OF TENTAGE: X; NAME OF TESTING AGENCY: AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PE,RMIT NUMBER: SITE INSPECTION DATE: i�� ,DATE OF ISSUE: EXPIRATION DATE: 2AAPPROVED B Y : ��L�C�,vtc.� TITLE:— Joseph F. Sullivan Chief APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM .FIRE PREVENTION CODE, ART.#30. APPLICANT: (ilk ( ��S a�l�P '�}SScsc ADDRESS: r:Dn C 0/ I'mf SSA print ? -031:�L3 CITYSTATE: ZIP: 01�c25 PHONE: �7 LOCATION OF TENTAGE: OWNER OF PROPERTY: n{ ADDRESS: � 51P�� CITY: � �(L(Y� STATE: rn�— ZIP: a 19)(3 PHONEI: INSTALLER/RENTAL CO. OF TENTAGE: Z4 omQR PHONE: 5'y0o a ADDRESS: j �'�P�� Sfi CITY: �41 �S STATER - ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: MANUFACTURER: SIZE OF TENTAGE: \�� ' NAME OF TESTING AGENCY: C(j AGENCY APPROVAL NUMBER:�'SU ► (� CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PE,;MIT NUMBER: SITE INSPECTION DATE: DATE OF ISSUE: EXPIRATION DATE: APPROVED BY: TITLE:.ti.� Form #80B (Rev. 5/87) Joseph F. Sullivan Chief Chit - of ulezll;lr�e `= ee �10.00 Jirr jDrpnrfnunt j4riibqunrtrrs F 48Cash : Ck# t(! Salem, �Eu: 01970 Rec' d b �^ y: APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO. THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM .FIRE PREVENTION CODE, ART J30. APPLICANT: 3_-{54�WA)q pSSc�-_ ADDRESS: ran C0 41) print _Ij CITY: (l�-05 STATE: lrfl ZIP: Ulf PHONE: �7 LOCATION OF TENTAGE: U--)in-uP_=—,, )Calof Egg OWNER OF PROPERTY: ��-P ;�� ADDRESS: 6--) CITYU STATE: �� ZIP: a 19) PHONRI: INSTALLER/RENTAL CO. OF TENTAGE:— PZ496OR eA PHONE: ADDRESS: 51+r)(D S CITY: 3t'rjl �5 _STATEAn- ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: �� I��_ _ C _ 4 MANUFACTURER: SIZE OF TENTAGE: � a X NAME OF TESTING AGENCY: AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE:'7. CONDITIONS OF APPROVAL OTHER THAN AS PER .THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: ,DATE OF ISSUE: EXPIRATION DATE:-6/2-7— TITLE: APPROVED BY: I �;� (Up of *aletn' 0a2;!5aCbU2;ett!5 Fee Due $10.00 per unit FIRE DEPARTMENT -FIRE PREVENTION BUREAU 48 Lafayette Street Salem, Massachusetts Inspection date: ,�j l— c 7-/lam APPLICATION FOR CERTIFICATE //OF COMPLIANCE �3 Clone Family Dwelling To: HEAD OF FIRE DEPARTMENT ❑ Two Family Dwelling rus ❑ Condominium Unit N In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application is hereby made lype of Detectors: Owner: For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. A. Monitored Battery Units B. Permanantly Wired Units Address: (Give location by/freet and number, or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Detectors Require Annual Maintaiience. Date of Certification: By, (Signature of Applicant) (Address) 00 (Phone) ADDRESS: 4th-FLOOR PUBLIC WAY: CORRIDOR: FRONT: REAR: TYPE OF OCCUPANCY: 1 2 3 4 5 6+ CONDO. MERC'TL 4th-FLOOR APARTMENT DATE: TIME: 4th-FLOOR APARTMENT ZONE #: 3rd-FLOOR PUBLIC WAY: 3rd-FLOOR APARTMENT 3rd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 2nd-FLOOR PUBLIC WAY: 1st -FLOOR APARTMENT 2nd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 1st -FLOOR PUBLIC WAY: 1st -FLOOR APARTMENT 1st -FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: BASEMENT: BASEMENT SPECIAL: KEY KEEPER: ZONE #: PANEL LOCATION: HORN AND LIGHT: SILENCE SWITCH: ZONE #: SPECIAL LOCATION: SPECIAL EQUIPMENT: SYSTEM VOLTAGE: AC DC BATT. SD=Smoke detector RR-HD=Rate of rise HD IC=Inter-connected HD=Heat detector FT-HD=Fixed temp. SS=Single station Joseph F. Sullivan Chief OTHU, Jaf �SUfem, CCudjusefts jirr Drpartmrnt �irnbqunrirra Fee $10.00 48 T'zzf li lcifc frrcf Cash: Ck#; ttlern;�i. 01970 Rec' d .b y: APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO. THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART.#30. APPLICANT: M05C010,L: 5-eo c�,-- • ADDRESS: �() C C/I print 7 7 -033 CITY:—])a(1,)F'25 STATE: IT ZIP: o1q-J5 PHONE: � LOCATION OF TENTAGE: OWNER OF PROPERTY: ADDRESS: 6-'-)��{�� CITY: �CL(Yi STATE: MR- 1 ZIP: d 19)6 PHONGI: INSTALLER/RENTAL CO. OF TENTAGE: Pz1a6OR e(;MONE: ADDRESS: J=vn �1-nA+P)o S-t CITY: ill �S&� STATERn- ZIP: Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: MANUFACTURER: SIZE OF TENTAGE: (� NAME OF TESTING AGENCY: AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT.PE,MIT NUMBER: SITE INSPECTION DATE: Lf- ,DATE OF ISSUE 2 2 EXPIRATION DATE: 91:)— APPROVED BY: TITLE: --.� _1'� rf 11400..S5,0 tan:r �ASS1FjF ISSUED 3Y APPLICA-MCPJ ]art. at .vlanufactere 14UMaiz atiCriC2 ,_y i c lAASY3LL= ENWANA �'771 1 T 21225 AANUFACTUMIS OF THE=iN!SPED 4-28—� 4 "� TENT ?RCDUCT-4 3E5C;t1 EiD :iErt;fN This is to certify that the materials described have besn flame-retardant treated (or are in- herently noninflarr.mable) and were supplied to:) NHiAE'_ PETERSON CHAIR CENTER CITY WINCHESTER STATE MASS Certification is hereby made that: The articles described on this Cartificate have been treated with a flame-retardant approved chem- ical and that the application of said chemical was done in conformance with California Fire Mar - IL Cade, equal to or exceeds Federal Specification MIL—C-43006D _ Mathod of application: LAMINATED Type. color and weight of canvas: 15 oz . BoylesBig Top white Dacron j Description of item certified: 10 ' End Fiame Retardant Process Used Will Not Be Rernaved By Washing And 3s Effective For The Lfe Of The Fabric JOHN BOYLE & CO.I Signed: Name of Applicator of Flame Resistant =inisn I TENT DEPARTMENT --ANCHOR :NJUSTRIES, iNC. GLENN SEGER xEGis—.21ZED G, �cSiF/�., ISSUED 3y APPL.CAT, TCN a&" �4 Aanaracrvro NUMBER ANCHCR J.Nm_US 7"2 ES, iNC. i UL WANSVILL. INDIA:IA 47711 T 2125 MAHUFACTURMS OF THE FINISHED i 4 -2 8 —8 % TENT PRODUCT DESCalUD ijERVII This is to certify that the materials described have been dame -,retardant treated :or are in- herently noninflammable) and wera supplied to:) NAME:_ PETERSON CHAIR CENTER WINCHESTER MASS CITY Certification is hereby made that: The articles described on this Cartiricato have been treated with a :lame -retardant approved chern- icai and that jhe application of said chemical was done ;n conformance with Caiifornia Fire Mar- shall Code, equal to or exceeds Federal Szoecification MIL-C-43006D Method of application: LAMINATED Type. color ind -.,weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 1 0 ' End l:larne Retardant Process Used Will Not Be Removed By gashing And is E!"Jective For The Life 0f The Fabric JOHN BOYLE & CO. I Signed: - Name :f Appticator of dame Resistant =;nisn TENT DEPARTMENT —ANCHOR iNDUSTRIES. ;NC. STATES ILL ., NC GLENN SEGER >?Q'.'CA 71CN _ :m x Asnutscrvn _YANSVILLZ. ;HOLAAA t771 i ^' 2 1 7 3 . M.:irIIFACTMRM, OF : r±E %INISHc: �_��I 4-_7 8-8i m TENT ?Roauc-s 3r✓c2ta�� .�4tr This '.s to certify that the materials described Nava 'lame 3tardant �ITeateu '.Jr are ;n- ner2ntly aoninflammabie and ':yere suCniied to:; yA.l _: PETERSON CHAIR CENTER N C H E ER MASS n.+�, Carti;ication is heraby made that: T;ie articles describes on this Certificate have peen :reared icai and :hat the application of said chemical was done in shall Cade, equal. to or excaeds Federal Specification Method of aaalication: LAMINATED ,vith j `lame -retardant _noroved chem- cvnhormanca with California 'Fire Mar- MIL-C-43006D I Type. ccior and weight of canvas: 15 oz . Boyles . Big Top white Dac-on ' Description of :tern certified: 5 ' End Flame Retardant Process Used Will N-ot Be Removed By Washing And Is E-Iffectave For The L]fe C-' The Fabric �. JOHN BOYLE & CO. i �� ' '�'✓� < G' Name of Applicator of Fiame Resistant =inisn Si�r.ea: i STATESVILLE , NC TE?ITGLENNr�SEGERcHoR ihcuST,tiEs. .nC. r-b" V], 3'tflaz']� !ZEGISTERE® r��pSSlF/F� ISSUED SY APPLICATION 1 Deft Of ManufactureUMM AI` CHCR INDUS7;tIES, INC. � :vawsvlLLE, IrIDaAHA 47711 T 212311 MANUFACTURERS OF THE FIHISHE7 I G TENT PRODUCTS DESCalsE3 ?iERElA1 4 —2 8 —8 7 This is to certify that the materials described have been flame-retardant treated (or are in- herently noninflammable) and were supplied to:) NAME: PETERSON CHAIR CENTER CITY MASS —STATE Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chem- ical and that the application of said chemical was done in conformance with California Fire Mar- shall Code, equal to or exceeds Federal Specification MIL-C-43006D Method of application: LAMINATED - Type, color and weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 1 5 ' End Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric JOHN BOYLE & CO "'� Name of applicator of flame Resistant Finish Signed: STATESVILLE-NC TENT OEPARTPAENT—APNCHOR INDUSTRIES, INC. GLENN SEGER itEGISTEREO n PSJiF/�.0 ISSUED BY Daft of ManViaclaro �►PPLA AT1ON A1�8Ca+]�il 9 DUSTR:ES, INC. j MUMBER EVANSVIU-c, INN A;4A 47711 T 2125 MANUFACTURIERS OF HE FINISHED 4 —2 8 —8 7 �11n ULTENT PRODUCTS DESC2131D iHER24H This is to certify that the materials described have been flame-retardant treated ;or are in- herently noninflammable) and were supplied to:) NAME:_ PETERSON CHAIR CENTER WINCHESTER MASS CITY STA I_ i Certification is hereby made that: The articles described on this Cartificato have been treated with a flame-retardant approved chem- ical and that the application of said chernical was done in conformance with California Fire Mar- shall Code, equal to or exceeds Federal Specification MIL-C-43006D Method of application: LAMINATED Type, color and weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 10 ' End Fiame Retardant Process Used Will Not Be Removed By gashing And is Effective For The Life Of The Fabric JOHN BOYLE & CO. Signed: Name of Applicator of Flame Resistant Finish 1 STAT ,SVTT,L N i TENTGLENNMSEGERCNOR INDUSTRIES, INC. T'Irrtift-1;W-rdr -Vv .' Nlamr BEGIS T ER2D \�ASS1F ISSUED 9Y APPLICATICN " i Deft ,af xnufactur® tVVARS` I IZ, INDIANA -47,711 T 2�15 MANUFACTUrzros OF THE FINISHED � 4 —2 8 —8 7 ! OL TENT PRCDUCrS DESCRIUD HERsiN This is to certify that the materials described have been flame-retardant treated (or are in- herently noninflammable) and were supplied to:) NAME:_ PET_ERSON CHAIR CENTER WINCHESTER MASS CITY ISTATE Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chem- ical and that the application of said chemical was done in copformance with California Fire Mar- shall Code, equal to or exceeds Federal Specification MIL—C-43006D _ Method of application: LAMINATED Type, color and weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 10 ' End Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric _ JOHN BOYLE & O Signed: Name of Applicator of Flame Resistant Finish — TENT DEPARTMENT —ANCHOR INDUSTRIES, INC. GLENN SEGER Tertifirate jaf 3TIamr IK2,6i & !itanrr REGISTERED 'APPLICATION NUMBER F-121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 T3540 MANUFACTURERS OF THE FINISHED 6/3/88 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR, INC. CITY WINCHESTER, STATE MA Certification is hereby made that: The.articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 MIL—C-43006D Method of application: LAMINATED Type. color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP WHITE DACRON Description of item certified: 6 X 10 FIESTA MARQUEE TOP Flame Retardant Process Used Washing And Is Effective For JOHN BOYLE & CO. Name of Appiicator of Flame Resistant Finish STATESVILLE, NC Will Not Be Removed By The Life Of The Fabric Signed: TENT DEPARTMENT —ANCHOR INDUSTRIES INC LOUIS R. BROWN Tnflffirzl_-L I APPLICA-70N NUMBER-,uNNC*i;ciz iz, rVaAJtY1LL:, INDfAEdA 4771 T 21231 MANUFACTURM :7f THE is NISNEC LTENT PRODUCE 3ESC2jZZ D This is to cartify that th � Dx. of .Ll,nu.aetue. i l 4-28-87 I i e ma#erials describes nave een ,`lame -retardant treated ;or are in- herently noninflammable) and we r2 aumilied to:) TAME: CITY PETERSON CHAIR CENTER WINC-HE STER MASS S � .a' Certification is hereby made that: The artic;es described on this Cartificate have been treatea wit` a flame-retardant approved chem- ical and that the application of said chemical was done in conformance with California Fire 'Mar- shall i3ode, equal to or exceeds Federal Specification MIL-C-43006D Method of application: LAMINATED - Type. color and weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 20Middle Flame Retardant Process Used Will And is Effective For The Life Of. The JOHN BOYLE & CO. I Name of applicator of Flame Resistant Finish STATFSVTT T F NC Naot Be Removed By Washing Fabric Signed;""----. 1 • (, TENT CEPARTMENT—ANCHOR INDUSTRIES, INC. GLENN SEGER ClIerfiffirau -of Flamr Etril-'stana REGISTERED APPLICATION NUMBER F-121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 T3540 MANUFACTURERS OF THE FINISHED 6/3/88 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR, INC. CITY WINCHESTER, STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 MIL—C-43006D Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP WHITE DACRON Description of item certified: 6 X 10 FIESTA MARQUEE TOP Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric JOHN BOYLE & CO.� Name of Applicator of Flame Resistant Finish Signed: STATESVILLE, NC TENT DEPARTMENT —ANCHOR INDUSTRIES INC. LOUIS R. BROWN dIT %L"'ertifiraft of -viamt TRuil'o'notancr REGISTERED APPLICATION NUMBER F-121.4 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 T3540 MANUFACTURERS OF THE FINISHED 6/3/88 . TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR, INC. CITY WINCHESTER, STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with aflame -retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal. to or exceeds NFPA 701, CPAI 84 MIL—C-43006D Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . BOYLES BIG TOP WHITE DACRON Description of item certified: 6 X 10 FIESTA MARQUEE TOP Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric JOHN BOYLE & CO. Name of Applicator of Flame Resistant Finish Signed: STATESVILLE, NC TENT DEPARTMENT —ANCHOR INDUSTRIES INC. LOUIS R. BROWN A-EMpSTERED F�►GK IS:�US� 37 PPLI .p�A a ;0N Dam *f manuineurt NUMSE� ANCHOR -VANSVILL/E, INDIANA 47711 T 21231MANUFACTURnnS OF THE F!MJSHED TENT PRO;UCTS DESC210ED ''ieEREIN 4 —2 8 —8 7 This is to certify that the materials described nave been `lame -retardant treater (or are in- herently noninflammabie) and were supplied to:) AIME. PETERSON CHAIR CENTER CITY WINCHESTER MASS SoATE Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chem- ical and that the application of said chemical was done in conformance with California Fire Mar- shall Code, equal to or exceeds Federal Specification MIL-C-43006D Method of application: LAMINATED Type, color and weight of canvas: 15 oz . Boyles Big Top white Dacron I Description of item certified: 20Middle Flame Retardant Process Used Will Not Be Removed By Washing And is Effective For The Life Of The Fabric JOHN BOYLE & CO. Name of A_ p—p I —ic a —to 7 of Flame Resistant Finish Signed;•�: may" I _STATFSVTT T F NC TENT DEPARTMENT —ANCHOR INCUSTRIES, INC. GLENN SEGER rtEGlSTERED UL (qo �,SSiF �aPPe.I�:�i'g'I®N / ISSUED BY INC Date of /Aanu�sefbw NUMBED �al�@�.l*iiOR 6N;�U5'iE�.aCSF ��.. EVANSVILLE, INDW-A 47731 T 212 ETENTUPRODUC'P.�.M OF DESCRIUD FINISHED HREIN 4 — 2 8 — H % This is to certify that the materials described have been flame-retardant treated (or are in- herently noninflammable) and were supplied to:) NAME:_PETERSON CHAIR CENTER WINCHESTER _ MASS CITY ST- Certification is hereby made that: The articles described on this Certificate have bee!i treated with a flame-retardant approved chem- ical and that the application of said chemical gas done it conformance writh California Fire Mar- shall Code, equal to or exceeds Federal Specification MIL-C-43006D Method of application: LAMINATED Type, color and weight of canvas: 15 oz . Boyles Big Top white Dacron Description of item certified: 20 x 20 Fiesta Top Flame Retardant Process Used WIN! Se Renneved By Washing And Is Effective For The Life Of the Fabric JOHN BOYLE & CO. Sig.nec: Name of Applicator of Flame Resistant Finish DEPARTMEN1—j*.fd^H0F MDUSTRIES. IN::. f STATFSVTLLE, NC GLENN SEGER �aft-fYxttte of Ntamr Itsimanve REGISTERED APPLICATION NUMBER F031.02 ISSUED BY ANCHOR INDUSTRIES INC. Date of Manufacture EVANSVILLE, INDIANA 47711 MANUFACTURERS OF THE FINISHED T5063 5-16-89 TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (orare inherently noninflammable) and were supplied to: NAME: PETERSON CHAIR CITY WINCHESTER, STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84 GOVERNMENT CERTIFIED LAB 16360 Method of application: LAMINATED Type, color and weight of canvas/vinyl: 15 OZ . VINYL LAMINATE WHITE Description of item certified: 30X60 4 PC SQ END PARTY TENT Flame Retardant Process Used Washing And Is Effective For DUBACOTE Name of Applicator of Flame Resistant Finish RAVENNA, OH Will Not Be Removed By The Life Of The Fabric J2 Signed- C. c-z TENT D ARTMENT—ANCHOR INDUSTRIES INC. LOUIS R. BROWN Robert W. Turner Chief (11-itU of $alem, Cfflassarhnsrtts .TF rr 13rpartmxnt litaDyuartrrz Fee $ 10. 00 48 T-af Trttr 5trrrt Cash: Ck# 1 -0 'Su1Pm, 'ma. 91970 Rec' d by APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527CMR19.00 AND THE SALEM FIRE PREVENTION CODE, ART. # 20 APPLICANT: U&D ADDRESS: RIR P7b,Sf-A_ print CITY: P20,6" Y STATE: cko& ZIP: 015 6 U PHONE: LOCATION OF TENTAGE: _ _ j %,tJ 1 s v ✓ .� _; - p„ J OWNER OF PROPERTY: C1 Ty Lb !� S f,C ADDRESS: CITY• STATE: ZIP: PHONE: INSTALLER/RENTAL CO. OF TENTAGE: / 6 (p PHONE: 77-- &- ADDRESS: P6 CITY: PKP- P6 . STATE:, O ZIP Indicate with reference to property lines and other buildings the location of the tent- age on the back of this form: MATERIAL USED: TYPE: MANUFACTURER:__ J4cy SIZE OF TENTAGE: /- 0 3/ - 0 `1✓ NAME OF TESTING AGENCY: 113�.BOLL r/2Z -! t A211e-pz:_ AGENCY APPROVAL NUMBER: /_6 'Z-- CERTIFICATE OF FLAME RESISTANCE: A- fC CONDITIONS OF APPROVAL OTHER THAN AS PER THE FIRE PREVENTION REGULATIONS: SALEM BUILDING DEPARTMENT PERMIT NUMBER: SITE INSPECTION DATE: 2J_jzJ- S ,DATE OF ISSUE:.S , EXPIRATION DATE: ,r APPROVED BY: TITLE: Form #80B (Rev. 5/87) , j r� :i t 5 � r �•I f i } C tut�c�e ` .lametst i REGISTERED':,,"Q �oF �uciFo�a h'. ISSUED BY Date of Manufacture APPLICATION ,Q s u ANCHOR INDUSTRIES INC. NUMBER,' • „* � � � I " - EVANSVILLE, INDIANA 47711 Rj KP Q' MANUFACTURERS OF THE FINISHED INV#963085j,1/ 1/90 F031.02 'yF kEfp�O F t TENT PRODUCTS -DESCRIBED HEREIN }( :� �. r.. This'.is to certify that the materials described have been flame-retardant treated�(or: are' �' e" ' inherently rnoninflammable) and were supplied to: � x >•� r brrtl, t NAME::, Hu co'' CITY STATE �. ,ri:V •Certificationis hereby made th'at� ' ' t 3• s :The articles descnbed;onthisCertificate have been treated with aflame -retardant approved t'" ^ } chemical and that the application of said chemical was done in conformance with" California *. r Fire Marshall Code; eq' ual'to'or exceeds NFPA 701; CPAI 84 GOVERNMENT CERTIFIED I.AB "#6360'' Method of application: LAMixATEn ., n Type,, color and weight of canvas/vinyl: 15 oz : VINYL LAMINATE white - Kf t �y Description of `item certified. � 3) 10' Exp . Mids for 20' Fiesta , Flame. Retardant: Process Used Will Not Be Removed Y B Washing And Is Effective for The Life Of The Fabric } 1 { . DURACOTB 1 Signed:. € . }� { Name of Applicator of Flame Resistant Finish C c. - t �. RAVENNA; OH D — TRIES INC. i TENT EPrAR MENT ANCHOR INDUSTRIES # LOUIS R. BROWN , ' w S_:"�y '' y._�.� � 4,{'}fir. �. �'.....:..5 6 ..J .t•[ F :{yfv t ..^..1 ..1' { �h..- Lk 1 -� .-: S:'.: S +Yc., 1 .4. '. k *TWA41, HtEEO13iEREDr • BPS IF'/F ISSUED eY APRLICATION'�' DaN`'oi Maenfaeivee NUMBERy s ANCHO ; NVUST'RIES WWII •_, ," t ,,LL . , EVANSVILLE, INDIANA .47711 10 -14 - 8 7 •• 4 M MANUFACTURERS OF THE FINISHED T7825 l " Id F-121•' 1 R TENT PRODUCTS DESCRIBED' HEREIN , 7 ., ;G This Is to certi that the `materials described have been flame-retardant treated Jor are in '> herently: noninflammable) and: were supplied to) i s; t�'�NAME.� xuBco' _. .' CITY DANVERS STATE MASSACHUSETTS Certification Where that s The .articles described .on this Certificate -have been treated`with aflame -retardant approved Chem- rt ;, Seal 'and., that: the application •o#.said chemical'was:�:done in .conformance .with California Fire.'Mar- t shall Code; equal, to or�exceeds: Federal $ecification' MIL2C-43006D p IV9ethod 'of a Ilcation LAMINATED �. x p:P , 777 Type,=color and weight'of"canvas.,, Green andy white 1.5 oz . viri 1 Bo 1 a + M1 es, Bi To Description of item. certified: �(1)`20x30FIESTA- to ` • ®®F��lppar�e Retardant kProcess Used Will Not Be Removec� ' By 1A/ashing S.PUY�d Is TEffeE;#ive For The yLife ®f The fabric � r t - 2', a T'� -,.� i i4s. z � _ $ ✓r+ s t E C _ Signed: dissa., { Name 'of. Applicator 'of Flame: Resestant Finish, +, $: + � ; ; • TENT ,DEPARTMENT -ANCHOR INDUSTRIES, INC STATEsvi�F NQ LOUIS `R. BROWN' <: • .^ r . r •i- .� r v�.1 •� r .r. r •r^ r •r r •�- r •�-. .i--. r .i-- r .i-- r •s- �-- r •r. r •i- r .r- r .r-. i- �t?iLC: �C.Ci uL-Cs'iCKi iLCC�Ci i�Ci �Lf s cLr iLCi cLC: iLCs cC: Ci tLCi PLC: iLCi PLC: iLCs cC:Ci'�LCi cLCi iC:Ci <<.Ci �LCc: ct:Cs iC:Cs iC:Ci iL�`iLCti iLCs` C�rrttftrat�e oaf ,lttzzt�e,ttllr�e REGISTERED it�sTFq ' `•J FABRIC Q4�o�Ca�F NUMBER A„ Top Tec, Inc. Dale of Manufacture +t�+V.•" i o 1905 N.E. Main Street - ' 0. V �3 r,r, ..••�� o Simpsonville, SC 29681 F-140.01 803-967. 4312 FAX 803.963.7750 _. F. IgO 1 This is to certify tHat the products herein have been fabricated from materials treated for flame retardancy, , as hereafter specified by the materials supplier. - NAME: HUBCO CITY DANVERS STATE MA Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that'the application of.said chemical was done in conformance with California Fire Marshall Code, equal to or exceeds Federal Specification Method of application: Laminated , rTy7pelolcir and weight of material: 12oz. vinylwhite Description of item certified:... Flame Retardant Process Used Will Not Be Re Effective For The Life Of :The Fabric d B� Washing And Is Name o1 Application of Flame Re. slant Finish . TE ; DEPARTMENT, .. ' A�- Form #90M (12/81) CITY OF SALEM Fee Due $10.00 FIRE DEPARTMENT - FIRE PREVENTION BUREAU 48 Lafayette St., Salem, Massachusetts 01970 (Date) �.I'PLICA.T'IO® PE MIT' To: HEAD OF FIRE DEPARTMENT In accordance with the provisions of Chapter 148, G. L. as provided in Sec. 10A application is hereby made State dearly purpose for which permit is requested Name (Give location by street and no., o, Date issued - Date of expiration for permission to use and maintain portable space heating devices and equipment Burin construction Refs 527 CIVIR 20.00 TYPE OF FUEL: L.P. G, Restrictions: As per Fire Prevention Regulations Gas Inspector to issue permit for L.P.G. Units. /Pov to ( flea r'I A c3 d r P Z S : � -&ZI = =14- in such a manner as to CITY OF SALE FIFE DEPARTMENT - FIRE PREVENTION BUREAU Salem, Massachusetts 01970 Date 'S 55 b "L EMFT of location) c%glr' (Address) Fee Paid .... $10:.00.. In accordance with the provisions of Chapter 148, G. L. as provided in 10A , this permit is ed tTo Name � I 'Mil S , e � I I , �Q , (Full name of person, firm or corporation grantedPermit) to use and maintain portable space heating devices and State clearly equipment during construction. purpose peon Ref: 527 CMR 20.00 G 7e m t /je q T eC whicis granted 0 Restrictions: As per Fire Prevention Regulations. Gas inspector to issue permit for L.P.G. Units. �j'c )tip (Give location by street and no., or describe in such manna as to p vide adequate jd�atiitcation of )ovation) - n / This permit will expire- � / 9 0 (Signature of official granting permit) (Title) 'OST.EON tt ° Tito of Sltm, massar4useto Fee Due $10.0 0 o FIRE DEPARTMENT • FIRE PREVENTION BUREAU Ck. # Cash $ 48 Lafayette Street Rec'd by: Salem, Massachusetts 01970 To: HEAD OF FIRE DEPARTMENT (Da /�L/ Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location named herein: C , 7P; Name of Owner. L�r' � Te A- �� /. �c� %�f3��. Address: 4 �% olTe&- _Z _SA"cam Number of Tanks: / . Capacity of Each Tank: /d'U'� Total Storage: Company:,�5�67�N ��'� WSAddress:/f Gv-TK ST Installer- / f )'0V'Vye.A.$, OW/ an ure Issued by: �,�� I-�-— Date: dlj Form #90L (Rev. 1/83) DO NOT WRITE BELOW THIS LINE n e ROBERT J. CROWLEY A/Chief TT ire Dc �rtme( � uarfers 48 `uc gn1&m, tt.01970 Name Mr. William Hanley Address Y36 Jkel'h 1K City/Town Medford, MA 02155 Re: The Old Hanger at Winter Island Date: May 8, 1985 As the result of an inspection of the premesis, structure, open land area, or vehicle owned, occupied, or otherwise under your control, the fol- lowing recommendations are made and shall serve as a notice of a violation of the laws, ordinances, or regulations pertaining to the prevention of fire and the protection of life and property. Based on a complaint and a subsequent inspection of the above listed property and the conditions found therein, the following is ordered by me to be completed within twenty four (24) hours. The complete removal of: All propane containers. '. All oxygen containers All acet Vh n a All 1 acq ` r ner +aers . !LAll ain l er containers. P All welding and cutting equipment Tractor truck Automobile Storage trailer Any and all other equipment and materials owned by you and/or your company. All items in this building are in direct violation of the Salem Fire Code, The Massachusetts Fire Regulations, City of Salem Ordinances, Massachusetts State Building Code, and Massachusetts General Laws, Chapter 148. Signed, cc: )/0 I'm a4? Mr. John L. Hayes—qZ?�dG�(3®(�� Mr. Gary Moore �C'�0' Norman P. LaPointe, Fire Inspector Salem Fire Prevention Bureau Form #25A (10/84) r • G ROBERT J. CROWLEY A/Chlef Name Mr. William Hanley Address V30 s f-i - City/Town Medford, MA 02155 ire Pex a rferz ?g�r48 CttE # gAera, Ma.01970 Re: The Old Hanger at Winter Island Date: May 8, 1985 As the result of an inspection of the premesis, structure, open land area, or vehicle owned, occupied, or otherwise under your control, the fol- lowing recommendations are made and shall serve as a notice of a violation of the laws, ordinances, or regulations pertaining to the prevention of fire and the protection of life and property. Based on a complaint and a subsequent inspection of the above listed property and the conditions found therein, the following is ordered by me to be completed within twenty four (24) hours. The complete removal of: All propane containers. All oxygen containers. All acetylene containers. All lacquer thinner containers. All paint thinner containers. All welding and cutting equipment Tractor truck Automobile Storage trailer Any and all other equipment and materials owned by you and/or your company All items in this building are in direct;.violation of the Salem Fire Code, The Massachusetts Fire Regulations, City of Salem Ordinances, Massachusetts State Building Code, and Massachusetts General Laws, Chapter 148. cc: Mr. John L. Hayes Mr. Gary Moore Signed, 0 ?. 147 k Norman P. LaPointe, Fire Inspector Salem Fire Prevention Bureau Form #25A (10/84) ,- ;;, .� �. A.-� �� `" � - 3 �� ... CITY C - Rr,,.iiF . ► FIRE DEPA ..BENT HE 48 LAFAYETTE S - r SALEM, MASSACHUSEl_. 'S 01970 1 SALEM FIRE PREVENTION BUREAU RFELEPHONE 745-7777 )/l 'iOFFiCE HOURS lYly 18.9 A.M. & 1-2 P.M. /+ I Z�- - )>�/ al*71 1�� 104231.04643 POLAROID09 ' I i rrm;. . AWAW 10423104643 POLAROID®9 i 10423104643 POL A ROIDO 9 rim t- W, polow IF"WIF-P 4M 4a 10423104643 P0LAR01009 10423104643 POLARO10®9 � I I �Aq _ 10423104643 POLAROIDO§ � _ 1 �` � � �� \ � �� ,- t w 10423104643 POLAROIDS 9 j GONDITq,O'�.1 �� N��4♦�� !K�VNK��IV ��lV n Winter Island Commission Office —City Hall 93 Washington Street a�a GATE KEY ASSIGNMENT Salem, Mass. 01970 To: ,.inter Island Commission Re: Assignment of keys to Winter Island Gate. As a tenant, or person conducting Winter Lsland Commission approved activity at Winter Island, I agree to accept the respon- sibility of being a keyholder to the access' road gate. I agree to abide by all conditions of use of the. gate as directed by the Manager of Winter Island. Further, I agree that security of the Island can be best assured by limiting access to persons of demonstrated respon- sibility. Therefore, I agree not to allow any other person to make use of the assigned key, and I will not attempt to" have the key re -produced. In the event that the key is lost, I will contact the Manager of Winter Island immediately for key replace - went at the cost of reproduction. Only the Manager'of Winter " °:Island has writ -ten authorization by the Commission to reproduce the gate key. In the event of an emergency, I understand that I may/should. contact the Salem Police or Fire Department.to access Winter Is- land when I am otherwise unable to do so. In any emergency situation regarding access to Winter Island, the Manager should be notified as soon as possible. All keyholders have been given the work and home telephone numbers of the Manager. Agreed to this date.by affixing my signature., t c date: �D Key s_ issued by the Manager in witness hereto: Gary i Moore, Manager �f tally ]Byars CELravELrr Club Iaiterimati®xanl, lite. NEW ENGLAND UNIT Howard M. Knight 17 Haley Road Marblehead, MA 01945 Tel. # (617) 631-2624 PAST PRESIDENT August 3, 19.83 Chief James Brennan Salem Fire Department 48 Lafayette Street Salem, MA 01970 Dear Chief Brennan: The members of the Wally Byam'Caravan Club (or Air- stream travel trailer -owners) are expected to arrive in Salem on Sunday the 7th of August for fa seven day stay at Winter Island (or the Coast Guard Base). For your departments:information each trailer is required to install a fire extinguisher for th.e protection of their trailer and a.fire code is in effect at all times. Our problems in the past have been,a minimum; with these adequate measures that are constantly in effect str&ssing% to each owner as to their individual responsibility for the safety and a means of handling any emergency. The members are planning to take in the events of the famed Heritage Days in Salem and many:plans have been made for their arrival and safety while in town. In closing, we hope that you and your department members will take the time to come and visit the members at this most historic site while in Salem. Very triul yours, i� Ofr HOWARD M. KNIGHT, re ident HMK/pac Zip Cite of Eaten , ffia2; ;aCb6. 15ett5 Fee Due $10.00 per unit FIRE DEPARTMENT -FIRE PREVENTION BUREAU Inspection date: 48 Lafayette Street / Salem, Massachusetts / APPLICATION FOR CERTIFICATE OF COMPLIANCE ne Family Dwelling To• HEAD OF FIRE DEPARTMENT rO T Family Dwelling ❑ Condominium Unit N In accordance with the provisions of Chapter 1 8, vided in Section 26E and/or 26F application is hereby made For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors. type of Detectors: A. Monitored Battery Units B. Permanantly Wired Units Owner: t�` Address: (Give location by street and number, or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Detectors Require Annual Date of Certification: _ By: (Signature of Applicant) (Phone) ADDRESS: TYPE OF OCCUPANCY: DATE: 1 2 3 4 5 6+ CONDO. MERC'TL TIME: 4th-FLOOR PUBLIC WAY: 4th-FLOOR APARTMENT 4th-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 3rd-FLOOR PUBLIC WAY: 3rd-FLOOR APARTMENT 3rd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR: 2nd-FLOOR PUBLIC WAY: 1st -FLOOR APARTMENT 2nd-FLOOR APARTMENT ZONE #: CORRIDOR: FRONT: REAR::';: 1st -FLOOR PUBLIC WAY: 1st -FLOOR APARTMENT 1st -FLOOR APARTMENT ZONE k: CORRIDOR: _ FRONT: REAR: BASEMENT: BASEMENT SPECIAL: KEY KEEPER: ZONE #: PANEL LOCATION:. HORN AND LIGHT: SILENCE SWITCH: ZONE N: SPECIAL LOCATION: SPECIAL EQUIPMENT: SYSTEM VOLTAGE: AC DC BATT. SD=Smoke detector RR-HD=Rate of rise HD IC=Inter-connected HD=Heat detector FT-HD=Fixed temp. SS=Single station �= f 172 COMMERCIAL STREET - LYNN, MASSACHUSETTS 01905 617-592-FIRE CERTIFICATE OF INSPECTION CUSTOMER: Jillian' s Snack Bar DATE August 20, 1982 Winter Island Road Salem, Mass. 01970 H /Z A R D P R O T E C T I N G Three hood plenum areas, associated ductwork an all surface cooking equipment. SYSTEM EQUIP. MFG. Walter Kidde & Co. DESCRIPTION: 1-HDR50 DRY CHEMICAL WET CHEMICAL TANDEM CARBONDIOXIDE x❑ AUTOMATIC ® MANUAL CONDITION OF EQUIPMENT AS FOUND E] SATISFACTORY El UNSATISFACTORY ALL NECESSARY SYSTEM COMPONENTS CLEANED[:] YESFj NO SYSTEM COMPONENTS TESTED: CONTROL HEAD(S) [E]SATISFACTORY n REPAIRED n REPLACED FUSIBLE LINKS IFt830 3- 3500 2- 5000 OTHER NUMBER OF DETECTORS TESTED ELECTRIC PNEUMATIC LOCAL CONTROL SATISFACTORY n REPLACED REMOTE CONTROL SATISFACTORY ❑ UNSATISFACTORY GAS VALVE OPERATED xx YES n NO REASON: ELECTRICAL EQUIP. SHUT DOWN n YESEj NO REASON: n/a LOCAL ALARM/CITY TIE IN TESTED F1 YES Q NO REASON:n/a CYLINDER(S) : DRY/WET CHEMICAL (PRESSURE) n SATISFACTORY REPLACED CARBONDIOXIDE (WEIGHED) SATISFACTORY n OUT OF TEST s * CYLINDERS REQUIRE TEST AS PER N.F.P.A. # 1 2 1 -9.5.2 AND N.F.P.A. # 17 2- 10.1 .7 PRESSURE SWITCH OPERATED YES NO Kidde SERVING NEW ENGLAND FOR OVER 22 YEARS RESULTS OF INSPECTION SYSTEM WAS FOUND TO BE IN GOOD OPERATING CONDITION, ALL COMPONENTS OPERATED AS REQUIRED SYSTEM MEETS ALL STATE LOCAL NATIONAL FIRE PROTECTION (N.F.P.A.) STANDARDS AND MANUFACTURES REQUIREMENTS, SYSTEM AS LEFT IN FULL OPERATING CONDITION SYSTEM WAS FOUND TO BE INOPERATIVE AND IN NEED OF IMMEDIATE REPAIRS AS LISTED BELOW: SYSTEM WAS FOUND TO BE IN NON-COMPLIANCE WITH ONE OR MORE OF THE ABOVE LISTED AUTHORITIES FOR REASONS LISTED BELOW: N.F.P.A. * 12 1 -8.3.8 / 096 7-3.2 /* 1 7 4-4 REQUIRES COMPLETE FUEL SHUT -DOWN TO ALL COOKING EQUIPMENT N.F.P.A. # 1 2 APPENDIX B /096 7-1 REQUIRES COMPLETE PROTECTION FOR ALL GREASE PRODUCING COOKING EQUIPMENT ❑ N.F.P.A. * 12 1 -8.3.4 /,ODE 17 2-6.3.4 REQUIRES THAT THE MANUAL RELEASE MUST BE LOCATED IN AN EASILY ACCESSIBLE AREA ON THE WAY OF EGRESS FROM THE HAZARD NOT MORE THAN 5' FROM THE FLOOR E] N.F.P.A. *96 9- 1 .2.2 REQUIRES THAT THERE MUST BE AT LEAST 1611 SPACE BETWEEN A SURFACE FLAME AND ADJACENT COOKING EQUIPMENT N.F.P.A. * 1 2 3-3.3.2 REQUIRES THAT WHEN USING CARBONDIOXIDE FOR DEEP FAT FRYERS A DISCHARGE OF THREE MINUTES IS NEEDED nREMARKS: New installation, installed as per manufacturers requirement. INSPECTED BY J.J.Howland 172 COMMERCIAL STREET - LYNN, MASSACHUSETTS 01905 617-592-FIRE CERTIFICATE OF INSPECTION CUSTOMER: Jullian' s Snack Bar D A T EAugust 6-,1984 Winter Island Rd. Semi annual Salem Ma 01970 HAZARD PROTECTING Three hoods fans all appliances SYSTEM EQUIP. MFG. Walter Kidde DESCRIPTION: HDR 59#DRY CHEMICAL WET CHEMICAL F] TANDEM CARBONDIOXIDE ® AUTOMATIC ❑ MANUAL CONDITION OF. EQUIPMENT AS FOUND © SATISFACTORY UNSATISFACTORY ALL NECESSARY SYSTEM COMPONENTS CLEANED R YES,Fj NO SYSTEM COMPONENTS TESTED: CONTROL HEAD(S) D SATISFACTORY REPAIRED REPLACED FUSIBLE LINKS REPLACED 3- 3500 2-5000 OTHER NUMBER OF DETECTORS TESTED n/aELECTRIC PNEUMATIC LOCAL CONTROL [:] SATISFACTORY O REPLACED REMOTE CONTROL [E] SATISFACTORY UNSATISFACTORY GAS VALVE OPERATED a YES R NO REASON: ELECTRICAL EQUIP. SHUT DOWN YES R NO REASON: LOCAL ALARM/CITY TIE IN TESTED Fj YES Q NO REASON: CYLINDER(S) : DRY/WET CHEMICAL (PRESSURE) [] SATISFACTORY [] REPLACED CARBONDIOXIDE (WEIGHED)[:] SATISFACTORY [:] OUT OF TEST s * CYLINDERS .REQUIRE TEST AS PER N..F.P.A. # 12 1 -9.5.2 AND N.F.P.A. # 17 2- 10.1 .7 PRESSURE SWITCH OPERATED [-].YES a NO NONE Kidde SERVING NEW ENGLAND FOR OVER. 22 YEARS RESULTS OF INSPECTION: ❑X SYSTEM WAS FOUND TO 'BE IN GOOD OPERATING CONDITION, ALL COMPONENTS OPERATED AS REQUIRED SYSTEM MEETS ALL STATE LOCAL NATIONAL FIRE PROTECTION CN.F.P.A.) STANDARDS AND MANUFACTURES REQUIREMENTS, SYSTEM WAS LEFT IN FULL OPERATING CONDITION SYSTEM WAS FOUND TO BE INOPERATIVE :AND IN NEED OF IMMEDIATE REPAIRS AS LISTED BELOW: SYSTEM WAS FOUND TO. BE IN NON-COMPLIANCE WITH ONE OR MORE OF THE ABOVE LISTED AUTHORITIES FOR REASONS LISTED BELOW: N.F.P.A. * 12 1 -8.3.8 / *96 7-3.2 / * 1 7 4-4 REQUIRES COMPLETE FUEL SHUT -DOWN TO ALL COOKING EQUIPMENT N.F.P.A. * 1 2 APPENDIX B /*96 7-1 REQUIRES COMPLETE `PROTECTION FOR ALL GREASE PRODUCING COOKING EQUIPMENT N.F.P.A. 0 12 1 -8.3.4 /# 17 2-6.3.4 REQUIRES THAT THE MANUAL RELEASE MUST BE LOCATED IN AN EASILY ACCESSIBLE AREA ON THE WAY OF EGRESS FROM THE HAZARD NOT MORE THAN 5' F,ROM THE FLOOR N.F.P.A. .*96. 9- 1 .2.2 REQUIRES THAT THERE MUST BE AT LEAST 16" SPACE BETWEEN A SURFACE FLAME AND ADJACENT COOKING EQUIPMENT N.F.P.A. 012 3-3.3.2 REQUIRES THAT WHEN USING r,,.,;CARBONDIOXIDE FOR DEEP FAT FRYERS A DISCHARGE OF THREE MINUTES IS NEEDED REMARKS: INSPECTED BY BOB CITY OF SALEMFee Due FIRE DEPARTMENT - FIRE PREVENTION BUREAU 48 Lafayette St., Rec ` d by Salem, Massachusetts 01970 _..c` Aug. 16 l g 2 t� (Date) It APPLICATION FOR APPROVAL OF PLANS: Fire Prot. Equip. -&"F.P.Code Inst. To: HEAD OF FIRE DEPARTMENT Fire Alarm System Fire Extinguishing SystemX In.accordance with the provisions of the Massachusetts State Building Code and the Salem Fire Code, application is hereby made for approval of plans for the install- ation of Fire Protection devices. LOCATION:Jilliants Snack Bar Winter Island Rd. Salem, MA. OWNER OR OCCUPANT: Albert A. Potorski Tel.# 922-2955 INSTALLER: Boston Fire Systems, Inc., LICENSE # INSTALLERS ADDRESS 1 72 Commercial St. Lynn, YIA . TEL. # 592-3473 Plans are approved solely for identification of type and location of devices. Installation subject to final inspection and filing of Certificate of Completion. Date approved: q' 7 (Signature of applicant) Date of expiration 6 !� CblyimE/,'e/h'G S( Mdresa) CIT OF SALE Fee Paid v FIRE DEPARTMENT - FIRE PREVENTION BUREAU r Salem, Massachusetts 01970 PERMIT TO INSTALL: Date _ Aug. 16, 1982 Fire Extinguishing System XX Fire.Protection.Equipment and Fire Prevention Code Fire Alarm System Required Installations. Owner Jillian Is. Snack Bar Nam Installers Name Boston Fire Systems, Inc.. Permit is hereby granted based on approved plans, to install the system designated above. All plans are approved solely for identification of type and location of fire protection devices. All plans are subject to approval of any other authority having jurisdiction and issuance of a permit by said authority. Upon completion, the installer shall reouest a test and file a Certificate of Completion or Inspection. LOCATION: Winter Island Rd. Salem (Give location by street and no., or describe in such manner as prov a ad uat en ion of location) KgmpeyThis permit will expire (Title) (THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON TH} F. PREMISES.) .'%N. Form #81 (Rev. 7/78) _ - . { ' � {}s' _ _ r :: r - } _ ns ref•/ tr i. S.rt • � • t f I -mil ._ 1 Y -.�.� j• t t . 1 ,r�f _ - iS' .N l7 /�#,1 i rt R i"3 Y>� - it { dr al P _ C �t +�{ S _ �...=}/�� "T• -ww r - _ ti' f .? :��...,. . _ r R m l� t ia+.....: ai L ..a i�j�7t �'#yij i..F.Lm.__ � $ii All + - _ .. 's".3 .� F' `{��• }r€ �� s f .'� ''i+ _tr��".w��`'z.R I',r_ r �. {�t 't:,-,irc!.••-n.ir 44 r.1=.`:r ssr _y; -S R IC '{`r' * :'. r - � Y i ' "X". r r �"� .f�g'x1 � .-! ."Y oS` � �t • .1 a • GT. ..^3 r_ aK',+.1..�' . 2'`_ 1 f � __ + _ i ...�...i..= `' r„•.-a,... � r ..3.-y--�- .mot .'••��...1• f .a8•__ - t ' �µ �Y f. a :r •.�-.-•. +w., r . .rr t-t ^r f. �r z: } + .Z-ECHR/► /C/�L n �« _� � t i ( L `_ t # _ i 3 � f ., �> t � i � ;t 1 .7 �' �, i 1 - t • AL - r • c� A. ID J7l 2 Gyrri �•--._ E ' ��e s vo-N .' _./c��-s'� II,�A�F, O � S�[ iT ' FrPvT�crS � .. PtE-414 15 /fir'✓' c S!v'/9 C�• L3�R. TN�..p!'CTS,{ttJALL'FR,vs�' .. '.oF- 'Spti�' :PRo y��rs•' R��. Ha�� `Pc�N�rna ` 4 � '_ LtJiNTCRI JSLA�t/� �D�`�..i� __. _ _ # �- #♦• �jt j � `� F � i f. � i M. _'� S{-. _ f/ f.�/f j /i.. � ' ` f -.•. _) �r-a i�� y� .,.` -D R1 ". i'/`��iYl �77 J DA '0 Vie ' fiP� � l _ i _ 4. >. s ; � '{ '- t`'d..f _ .•�� n � �:_ +y •,i�.�. t �. i�'� I �aE�f - '- ,. ._. �qr �. :y'"�44"� _X..—,.s.- .... .''r��•�. �. i'w+�� '•'1-`4". i s"i�•3''`�,t;-N"^E� �=��`.ar.•�,ty F��`.',f�'•.. T'-:t1ii3 a:`+'.`�y��S'4y'^G-S?+�'-i�:��' • ___-_ -� Form 01(7/82) - Fie Due $10. 00 r Recd by: D_ *_Y�.� - - ` ~`O Ckl o�Cash s - Cyr# Pf ialenl, Aaasarhusetts ire �Exr#meeaDquxrters �ann $ �T- c�rtttnast 4$ TafiWttePPf �t�uf o� II137II �.Y FIRE DEPARTMENT'CERTIFICATE OF.APPROVAL-FOR BUILDING PERMIT 4_ To $ Head of Fire Department,. 'Date: I ► f 8 Application for plan - approval and Certificate In accordance with the 'provisions of the Mass. State Building Code and Salem Fire Code,: application is hereby made for approval of plans and issuance of a certificate of.•approval for a building permit, by the Salem Fire Department. (Ref. Section.113..5, Mass. State Bldg. Code.) Job Location: V r Owner or Occupant:'1bc4� Genera]: Contractor.a��6. a-N� Addres • ss _ Electrical �bw..Ct� Q�z�SR: ..io4S Add•'esss peYalDoo.) Contractors _ Fire Supresson Contractor: os' o iy I%Rc..,. �y�-M-s Address: Corr wwwr;ec; Notice: Prior, to starting work, sub -contractor shall file required form. Final inspection is required,.prior to issuance of Certificate of Occupancy. Inspections are by appointment only.. 'Signature of(� Applicant: �iJe� Phone # ]Address of _City or Applicants 1�t11�e�,,�,. Towns' Vc�-� Approval Date: 98 _11"82- ;�. _ `Certificate of A roval is hereby anted on_a roved' laps or sub- mittal of project details, by the Salem. -Fire Department. All plans are approved solely for identification of type and location of fire protection devices and equipment.. All plans are subject to ,approval of any other authority having jurisdiction. Upon completion_ the applicant or installers shall request a test or inspection, and the installer.shall file a Certificate of Completion, if required. Owner orMr Albert Potorski Occupant: Pro ject Location: Winter Island At Hanger Area gnature of Fire Official This Certificate will Inspector Salem Fire Prevention. expire on 08-24-82 i Applicant shall submit this Certificate of Approval, to Bldg. Insp. Form #81 ( Rev. 7/82) ... ,. . U Cat of Jalt a, s sfa'�'c � F ire �3ppttr#mexi# �eaDquxrLers s" 43 :dgzue rP�t a4 D1J7D r k FIRE DEPARTMENT CERTFICATE OF APPROVAL FOR BUILDING PERMIT Incompliance with provisions of Section 113.5 of the Mass..State Building,Code; and under guidelines agreed upon by the Salem Bldg. Inspector and the Salem Fire Chief;,the applicant for a building permit, shall obtain the Certificate of Approval (see reverse side) and stamped plan approval from the Salem Fire Prevention Bureau._ F.Said application and approval is required before a building permit may be issued. The Mass. State Building Code requires compliance :,;approval of the Salem Fire Department`, with.reference to provisions of Article #4 and Article #12 of the -Building Code, the Salem Fire `.;;.Code, Mass. General Laws and Mass. Fire Prevention.Regulations. _The applicant shall submit this application with three (3) sets of plans, drawn in sufficient clarity and detail,,to obtain stamped approval of the Salem Fire Department. This applies for all new construction; -substantial alterations; change of use and/or occupancy; and any other -approvals required by the Mass. General Laws and the. Fire Codes. Exception: Plans will not be required for structural work,.when the proposed work to be performed under the building permit, will not; -in the opinion of the Building Inspector, require a plan to show the nature, and character of the work to be performed. NOTICE: Plans are normally required for fire supression systems; fire alarm systems; tank installations; and fire code requirements.. NOTICE: = Under provisions of Article #22, of the Mass. State Bldg. Code; certain proposed projects may not require submission of plans,` nor complete compliance with new construction requirements...' In these cases, provisions of Article #22, Appendix T, and Tables applicable shall apply. This section shall not however, super sede the provisions outlined in Salem Fire Prevention Bureau Regulations; Chapter 148, M.G.L.t; or the Mass. Fire Prevention Regulations. i.e. all permits for fire code use and/or occupancy' shall apply.for the entire structure; fire alarm and/or smoke detector.installation, shall apply to the entire structure, based on new A.C. (hardwired) units for all new construction, but the existing structure may comply with regulations applicable for existing structures. NOTICE:.Sub-contractors may also be required to file individual appli- cations for a fire department certificate of approval,, covering -their area of work. Said sub -contractors shall file for Fire Department application to install, prior to,commencing any work. All Ctr of ' �'r� oaTss irerlrpurtmcrrt �ieur�r�rrrters 48 ylaffigette 2-0 ,y. QI isi o�atem,: _ II1J7I1 t`r r Y;�r x tDate �F , Salem Board of Appeal Re: Albert_ City, of Salem, Niassachusetfs. z }Winter`' One Salem. Green . H`earin Salem,.. Va. 01970 15 ;Sirs: ` 4 As a result of notice received concerningthe'Boa: ` hearing„ -for the above l �ste,d name .and address, "4th' Department, requests the following items.. to'be p.l X . 1.; The offiee of the Salem: Fire Marshal is opposed r`j of the petition for a special permit, to constr:u� and occupancy as a . snack bar, -until phans �.aresul clarity and detail, to insure the requirements q; shall be complied with in full.0 _ 2.-This petitioner has operated at his existing loc of current codes and has been extremely non-conf reference to :prov'iding the tests on the fixed fi` Y s eft. system at his `present location The petitioners past:' co-operation with thisn.; off ` . 'the best `interests of ; ;public. safety and:` hasbeeri m k -he feels' this office should not be rbothering him of:re;gu1 ions. r Y4:.�r• It is therefore our, request that until plans;'w the} gro.posed 'op.eration, are ,presented t:o this, of r r sequent report :to, your. Bo-ard'. "is made, that you t .and not grant. 'the Special Permit at this >date. ' u: r c £ry z i Respectfully 'submi qq 'z s: l e :# :ii Captain David J. �;Gc cc: 3uilding' Inspector. Salem Fir- P.'arshal< w ,a z. ;t file j{ �t Form ` 105 8 CITY OF SA,LEi[ �Rec'd by FIRE DEPARTMENT - FIRE PREVENTION BUREAU -Ck.# 125 Cash 48 Lafayette St., "'--"-- Salem, Massachusetts 01970 744-1235 APPLICATION FOR APPROVAL OF PLANS: Form #81: Basin P1an Review To: HEAD..OF FIRE DEPARTMENT In accordance with the provisions of the Massachusetts State Building Code and Salem Fire Code, application is hereby made for approval of plans per Sec. 113.5 LOCATION:' lli i n!'tC-"'a S Z e n 6 a OWNER OR OCCUPANT: i / �L.5A c %3_A �2 GENERAL - -CONTRACTOR: ELECTR I CAL a jN y ADDRESS: 3 I Ce - -- �� w '�1f�1-aSc'• CONTRACTOR: �owCl1 �1-u i-' GY71't CAA)95 ADDRESS: � G %�u�(... 'FIRE SUPPRESSION --�-- CONTRACTOR: Boston Fire Systems ADDRESS: Lynn, Ma.. NOTICE:Prlor to starting work, if checked: Electrical Cont. to file Form # 81 F • ti h&A - .. `i"lyvoofury d vp011oarN) •••��•�•••• X FireSuppression Cont. to file Form#M.81D �psu�ti hog-sS;,_13cEy Gtrn�� Ulddrw) 13 TEA?. ------------- ----- ----- - - Phone # y zz — s'L 4 6 � mi ----------------------- ---- ------------------------- CITY O F SALJEM y FIRE DEPARTMENT - FIRE PREVENTION BUREAU _ Salem, Massachusetts 01970 Approval Date June 5, 1982_. Plans Approved Applicants Albert Potorski Name Approved subject to filing of any other application required, (as checked above), -.,. 4 . applicable to the Mass. Fire Prevention.Regulations or any other code. Permlt Is hereby granted based. on a roved lens, to: procede with the project. All plans area roved solely for: identifi.catlon of t PP Y typeandlocation of fire protection devices. All plans are'sublect t0 approval ofany other authority, Navin urisdiction and Issuance of a permlt b .said•autho:rit U on com let ton, the installer shall request a nest and file a Certificate of Comnlerion or Insnection. LOCATION: Wintar .Island Road, Salem, Mass. - lGl►e l000Uoe by deool mid'no., w d•oo►lb* In such ronn•r to {do od uaf• !d• loq el ►Qe) . IBIOnawn ol►leloi. Hall) Thie'permit will expire August 9, -1982 Salem Fi re Marshal (TWO) Nw- (THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMCS A) ' e ti Form #81 (Rev..8/81/) A. d �9 ��'� au�A ��a � ,dam �'-C�,., �s9� c�-/� �^ �B `,names �_ �rrnn:�n fL[l2ief ATttg of �$s�zlem,Massachusetts Xire Department �HeaD9uarters 48 ` 4afagPtte ,Street ,,5atem, CMu_ 01970 Date: January 18, 1982 Salem Board of Anneal ' e: Peter S. Haywood City of Salem, Massachusetts Winter Island Road One Salem Green Continuance Salem, i%'a. 0197Q Hearing Date 1/20/1?-,---*' Sirs: As a result of notice received concerning the Board of Appeal hearing for the above listed name and address, the Salem Fire Den-irtment, .requests the following items to be placed on record. This occupancy has been addressed in a prior report to the Board. It shall be mandatory for the use of property as a boat yard, to comply with provisions of the Fire Prevention Regulations of the Commonwealth of Massachusetts and the Salem Fire Code. The Petitioner shall be so notified of these conditions which are quite extensive, in reference to fire protection devices and related Fire pre,, ent, i ors requirements. Respectfully -submitted, —�--/,in 0 Captain David J.,Go cc: '2u.ild i.ng Inspector Salem Fire Pr'arshal file lauxe'S rt3Tj(ar( �Ihisf of Aire Uepar =llt ea quarter.5 48 C'"""�Ptte `tzPPt ttlem. Ott: 1313 7ll m lamas 'A. puft" Salem Board of Appeal Re: rester s. xaywood City of Salem, Massachusetts Special Permit One Salem Green Winter'Island Salem, Ma. 01970 Boat' Yard Hearing; Date: 11/its /81 Sirs As a result of notice received concerning the Board of Appeal hearing for the above listed name and.add.ress, the Salem Fire Department, requests the following items to%be place.d..on record, 1. Plans have not been viewed, by this office- as of 'this date._ 2. Fire Protection shall be established and maintained. based on provisions outlined in N.F.P.A. Standard. #303.(Marinas`& Boatyards).. 3. Plans shall be submitted to the Salem -Fire Prevention Bureau for stamped approval, before any work is contemplated. Respectfully submitted WAAA Captain David J. Go in cci Building Inspector Salem Fire Marshal file Form # 105 FORM FP-6. 4014010-71-050515 , ° t��r� f�uutmmvtaptti#�r ,af ��cr�t�e#t� w DEPARTMENT OF PUBLIC SAFETY — DIVISION OF FIRE PREVENTION , � k 1010 COMMONWEALTH AVENUE, BOSTON June 20, 19 77 (Date) APPLICATION FOR PERMIT To: HEAD OF FIRE : DEPARTMENT . ` Salem r` City or Town In accordance with the provisions of Chapter 148, G. L. as provided in Sec. 10A application is hereby made for permission to conduct open burning for the purpose of training or research in fire prevention and or fire protection State clearly purpose for on June 20, June 21, June 22, June 23, and June 240 19774 which permit er Chapter 148 Sec. 13 of the General Laws and Reg. 7.2.3 of is requestedhe Depar en of Pu511c ea . Restrictions: As per, regulations and under the supervision of at -(Winter Island at Salem. Mass. G _ b street no., or describe in such a manner as to ad�ate Idea o! loocd=, Date issued—n4eWn& 6/20/7719 BY Lt. G 6/24/77 nil 48 (Sis��re of applicant) Lafa ette St. Sale Date of expiration_ 19 Fee $ . Paid-4c7 �4 _, Y (Address) I % FORM FP-6. 40M-10-71-050515 f 90 f�mnmmuuptt�#llr ,af tt� ri t i#� DEPARTMENT OF 9 , PUBLIC SAFETY — DIVISION OF* FIRE PREVENTION 1010. COMMONWEALTH AVENUE, BOSTON (bate) 1 APPLICATION. FOR PERMIT To: HEAD OF FIRE DEPARTMENT Salem 4 City. or Town In accordance with the provisions of Chapter 148, G. L. as provided in Sec. 1 OA application is hereby made for permission to conduct open burning for the purpose of training or research in fire prevention and/or fire protection, State clearly on -June 15, June 16, & June 17, 1977; per Chapter 148 Sec. - 13. purpose for which permit of the General Laws and Reg. 7. 2.3 of the Dept. of Pub. Healtr is requested Restrictions: As per regulations and under the supervision of Salem Fire Department Training Officer Burkinshaw. atWinter Island at Salem, Mass. ocatioa by street and ao., or describe J. such a manner ae o pmvidk adequate i of locadm) vl Date issued- j&ffdv& 6/l3 19 77 By (signature of applicmtit) Date of expiration 6/17 1977F� $ ni'Paid—Due 48 Lafayette St. Salem (Address) Form F.Y. 6. 4OM-4-65-939963 i � p T=VtV=rzd* of filassadmiattil 4 W DEPARTMENT OF PUBLIC SAFETY -- DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON Sept. 12 a 19 75 o T1� Oq'M SVBv r _ T ,(Bate) APPLICATION FOR PERMIT To: HEAD OF FIRE DEPARTMENT Salem City, or Town In accordance with the provisions of Chapter 148, G. L. as provided in Sec._ 10A application is hereby made d for permission tom duct open burning for the purpose of Training or research in fire prevention_ and/or fire protection, daily State clearly S d fr om Sept. 16, through Sept. 26 purpose for as required p . _ g p o 1975s per Chapter which permit 148, Sec. 13 of the General Laws and Reg. 7.2.3 Dept. of Public is requested --- Restrictions: As per regulations and under the supervision Health. Salem Fire Dept. Training Officer Purkinshaw. at _ Winter Island" at Salem, Mass. or describe in such a manner as to provide adeq a identification of location) Date issued—noxat C 9/12 0 19 75 By JV (signature of applicant) Date of expiration_9/27 19?5Fee $ n"Paid—Due _ 48.. Lafayette St. Salem (Address) +4 r�, Form F.F..6. 4OM-4-65-939963 ' S Alt (110mmouurrIA of Attoottrlmatto W DEPARTMENT OF PUBLIC SAFETY — DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON Aug. 26, 19 74 °+M — sv0y`oW (Date) APPLICATIOl� FOR PERMIT To: HEAD OF FIRE DEPARTMENT Salem City or Town In accordance with the provisions of Chapter 148, G. L. as provided ins Sec.-10A , application is hereby made for permission to conduct open burning for the purpose of training and/or esearch in prevention or fire protection on 8 7 7 ; State clearly -8/729/74; - ral purpose for Laws _and Rem 7. 2- 3 of the_Ilepartment Of Ruhl ic Heal th. which permit is requested Restrictions: As per regulations and under the direction of Fire Lieut. F. Burkinshaw, Training Officer. Salem Fire Dept. at_ Winter Island at Salem Mass. (Give location by street and no., or describe in such a manner as to provide on 0 1a • Date issued—>oomd 8/26/74 19 gy Lt. Goggin Aw�" - (signature of applicant) Date' ot-c-r3iration_ 9/9/74 19 Fee $nll Paid —Due ____ $ Lafayette St. Salem y�:r (Address) 1 , , , , CITY+ OFr SATi LE! hr-r 11, I� 1RE DE!'.1I�'f'�tEN'L' - )FIRE !'IZEVENTI01' BUREAU SAI,E,M, ItitASSACHUSETTS 01970 C-E-R-T-I-F-I-C-A-T-E Dat e As. an essential Dart-of.Application to the City of Salem, Massachusetts for a Blasting Permit 'to perform blasting T operations at a• in said City of Salem, Massachusetts, it is hereby certified by the owner of record of said property, or his authorized agent: :.. 1. That all blasting for which. applicant_ -seeks, a permit - will occur within the boundaries of the real estate owned by said person, firm or corporation, as shown op a plot plan attac'bed to this Certificate and made a part hereof-hy referer,�e=; ' 2. That there is set forth on the attached plan all the area or areas to be blasted under the Permit herein applied for; 1, 1 0.. 1� 3. That none of the area or areas to bu, blasted are within ij 250 ,feet of any structure or %.-all not owned by said; person, firm or corporation executing this Certificate as shn%J>by a line on said plan setting forth the circumferen&E,e_ 6f 'a circle with radius of 250 feet from the area or areas to be blasted. This Certificate is executed to establish that the Applicant's proposed blasting operations on the property afore- said is.exeuipt from the Pre -Blast Survey provisions of Chapter 35, Section 6, of the Ordinances of the City of Salem, arld to iiiduce the City of Salem to issue a Blasting Permit based upon the reprc:;Serit'ativiio hGrciii Sew forth. Person, Firm or Corporation ner By A ved as to rm ppro 1� (� ` 4k"\\ Assistant i y Solicitor .January 10, 1974 X#r Tammonorralt4 of Aassar#usrtts F DEPARTMENT OF PUBLIC SAFETY — DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON Salemp Sept. 20, tg 73 - (City or Town) (Date) PERMIT In accordance with the provisions of Chapter 148, G. L. as provided in 10A this permit is granted to Name City of Salem Fire Department (Full name of person,: firm or corporation granted permit) to conduct open burning for the puppose of Training or research State clearly in fire prevention or .fire protection during the weekof Sept. purpose for which 'permit 24 to 299 1973 inclusive. Per chapter 48 Sec. 13 General Laws q is granted and Reg. 7.2.3 Department of Public Health. strictions: As per regulations and under the direction of Fire Lievt,. Francis Burkinshawg Training Officer, Salem Fire Dept. at r7winter Island, ialemp Mass. no., or describe in such manner Fee Paid $ ili.i" (Sfgnatu f official permit) This permit will expire 9/29/73 19 Salem Fire Marshal W- (THIS PERMIT MUST BE CONSPICUOUSLY`POSTED UPON THE PMUSES.) -W Form F.P. 6. 4oM-4-65-939963 l Mot (Imnmawtal* of 11mosadmatts F W DEPARTMENT OF PUBLIC SAFETY — DIVISION OF FIRE PREVENTION 1010 COMMONWEALTH AVENUE, BOSTON Aug, 10, 1973 c, (Bate) APPLICATION FOR PERMIT To: HEAD OF FIRE DEPARTMENT Salem City or Town In accordance with the provisions of Chapter 148, G. L. as provided in Sec.— 10A application is hereby made for permission to Conduct open burning for the purpose of Training or Research in _fire proltection or prevention during the weeks State clearly purpose for of August 13 to August 17 and August 27 to August 31, 1973. which permit Per ChApter 48 Sec_. 13 G.L. and Reg. 7. 2. 3 Dept. of Pub. _Health, is requested — Restrictions: As per regulations' and under the direction of Lieut. Francis Burkinshaw, Training officer, Salem Fire Dept. at_ Winter Island at Salem, Mass. (Give location by street and no., or describe in such a manner as to provide adequate idea of loaxam) Date issuedxgectsd1 8/10/73 19 By (signature applicant) Date of expiration_ 8/31/73 19 Fee $ nil Paid —Due ___.y $ Lafayette St. Salem, (Address) SALEM FIRE 4DEPARTMENT INSPECTION REPORT. BUSINESS:��Cj///LL %3�•4T ?lt�ADDRESS:Gr/iaYr2 �SLa:�TEI,: �yY-9ys' P.T.N: `{ADDRESS: 5 'TiiEL • mot ---BLDG.OWNER: ADDRESS: ; •� � `' ^TEL:, AN •'ALL . UESTION"S EITHER; i'ykS '" ^11N0'i - 0R . "'NONE 'I - rew t e approaches to the ' bui ing free and .c.leart5 2. Does- the area adjacent to the building appear to.be freE from rubbish accumuYations;� dry vegatation nor to. of �- - -a-combustible nature `tending to, create a• fire" hazard? VISS 3.. Are facilities provided for the safe disposal of rubbish`s 5 - 4.._Are-all outside moans of egress free from any obstructions that may.interfere with the safe exit of the occupants? Fs 5. Do porches .and fire excapes appear to be in a1.safe condi- tion, and free°of� ob"stiucti`ons?` - � f. i' '`'' �6._..Do._out_side_sprinklers and _standpipe connections.appear to be in good and usibie condition? 7. Are the entrances and hallways clear from any obstructions, that may interfere with emergency exit of oc,cupa-i ts'. 8. Are'all interior spaces consistant with good housekeep..ng practices?- - 9.-•---Are--necessary---lic;-_&-Permits -posted, &_currF-rL-uJy:_d :�ed�_ 10. Are the occupants complying,,wit-h- all �{egu1�t.. � and con- - ditions-as••pre scri-bed--on--•-the: tic.ensas-or-permits? .._-�•�/�-� ll.-- Are -•al•1-•fir_e' extinguishing appliances-res.di.J..y_acce.ssable,_.� and have they been -inspected, weighed or recharged? 12.� Are all vertical shafts and stairwells* properly safe guarded and provided_ -with ..self -closing .devices? .13. Does this occupancy, have an interior alarm system? Ala 14. Has the interior alarm system been tested recently? w NAND_ 15. Is an emergencylighting system provided. „ lVe , if so, is is - it in good operable conditions? 1.6. Does this occupancy have any manufacturing process which would constitute,: a.- fire lbaLrd? .if, .so-, are: the,tprop,er.,fire- i.. extinguishers provided? yes _ 17. Is this occupancy protected-'Ey a -sprinkler system? 'Wo •18.' 'Are sprinkler gugges "showing proper` pressures? IVO.49 " 19. Are all flailima'Olcs stored in aron: r co,tainers and kept in an approved stora.c; area?ems 20. Are all areas" used: for storage_ or Jilin oil products _..,maintained in a sr?ica-ayiclo:rde .lyT i a�1n_rM?�I.w_ .,__. _._ • -� F_ s 21. Is the base_?ont fnJo o.f_,.an,r, rub'oish accumulation and - �- --maintained n-a-sal rr�anne'r., and- consistent •T.,aith••-good--' housekeeping practices? A16^Ili 22. Does t e . hea-ting ;syste:ru, including; - thcT;chirr,rio:, appear , to be' in'':a s'afc opc.r`atiri�; °cof , Rion? � (: 1. - f i r• 7 y :) f ' ! 1 i � � f • '4 ;- 1. 23 Does ,this .'occupancy have ;a- `cur\rcnt',fuel,' oil .6 rwit posited,` - - and •,the store e• aPPean, in . p:oodA cond. ti,:>ri`� ` . NOIVA •i '*' '{ � .. � C1 � C';.. y '`xyY, 'a .;•...Yi• r.,� i''- �r "r •`� "1 .. lJ- 3' 24. Does the pre1t.i"sesa roar to be free of •.arl; elcctr c.al •hazards'.?, h,. - 25. Does' the occupancy appear . to have any. stru:ctual 'd6l ects?1q%i� _ .. n,r r3• .. � 13 A 26. ITas a Form17 corap'laint ;ft�rm; follow*-u.pbeen • -Jade for., t! is _ _ .. - Inspection? y NO ~iit '� ,lir ;`3 `; ' " "".f: r. .`a ,x.•r+,. I', .'� •}..(i t4rite a brief description of apy violations discovered during this inspection. - .. �r .i .:t �K ' Liu r r• _ Name` of the' parson- tp, ail om" verbal _rc c orfunondat ions were made*.* - _..Date Inspected by:_49.V�e .___ __..�...�......_._ •Approved by: Company Officer FORM- 16 (rev. 2/70) v CITY OF S.1LET1 FIRE DEPARTI%ONT - FIRE PRE:V&VTIO` BUREAU SALEAI, MASSACHUSETTS 01970 C-E-R-T-1-F-1-C-A-T-E Date As. an essential. Dart of Application to the City of Salem, Massachusetts for a Bla ' g Permit t _ perform bluz—tilig ►: operations .at T. in said City of Salem, - �etts it i er ified by ,s c. the owner of record of said property, or his authorized agent:. $e _ . 1. That all blasting for which applicant seeks a permit will occur within the boundaries of the real estate owned by i ., said person, firm or corporation, as shown op a plot plan attached to this Certificate and made a part hereof by reference; - 2. That there is set forth on the attached plan all the h area or areas to be blasted under tbe.Permit herein applied for; 30That. none of the area or areas to be blasted are within 250.feet of any structure or wall not owned by said person, firm or corporation executing this Certificate as shown by a �. line on said plan setting forth the -circumference of a circle with radius of 250 feet from the area or areas to be blasted. a.. This Certificate is executed to establish that the Applicant's proposed blasting operations on the property afore said is.cxetapt from the Pre -Blast Survey provisions of Chapter 33, Section 6, of the Ordinances of the City of Salem, and to indute:•the City of Salem to issue a Blasting Permit based upon the representations herein set forth. C ;-i' o-�'•I t Person,/ Firm or orporation ner By:L%- C cSo Approved as to rm: cTz�� Assistant City Solicitor January 102 1974 , , �•• , � �_,a`11l_ DEFENS ,rig i E C TY OF SALEM .GO�Lf�t C L/� f J' SASS. f 4� >Y i �iU(i LJ � tad CITY OF SALEM MASSACHUSETTS JEAN A. LEVESOUE MAYOR - August 20, 1976 Commander 94th Army Reserve Command .666 Summer Street Boston, Massachusetts 02210 Dear Sir: It has come to my attention recently while visiting Winter Island with members of the 94th,. that there is the possibility of having some of the derelict abandoned buildings on that site removed by your Command. There is considerable interest in rehabilitating Winter T11and following its evacuation by the Coast Guard several. years ago. Ona.of our major Bicentennial projects, the restoration of historic Fort Pickering, has dramatized the need to have the ugly and hazardous buildings around it removed. Most of these buildings (marked with parallel -lines on the. enclosed map) are temporary structures built in the early 1940's. Building H'is a corrugated metal Quonset Hut, the others are wood or pre-fab material. Because the City lacks the funds to demolish and remove these buildings and because Winter Island cannot be safely nor adequately used until they are removed, the possibility of the task being done by the 94th is of great interest to us.. If this is a possibility, I would greatly appreciate hearing from you. I could arrange a tour -of the area along with several city officials whose interest and responsibility it is to reopen Winter Island for public use. I look forward to hearing from you. Sincerely, .,J JEAiV A. LEVESQUE Mayor encl: Winter Island, Salem diagram CITY OF SAL`M MASSACHUSETTS W. GREGORY SENKG PLANNING DEPARTMENT CITY PLANNER ONE SALEM GREEN 01970 March 2, 1977 MEMORANDUM RE: Demolition 6tWinter Island, arch 5, 1977 FROM: Dave Lash, Planning Department, 744-4580 On Saturday, March 5th, and Sunday, March 6th, the Army Reserve will.be on Winter Island demolishing the first of nine structures. Demolition will be achieved by controlled charges placed to implode and collapse the building. The Army team will be on the Island at 7:00 A.M. The charges will be set during the morning, with detonation scheduled for early afternoon. The remainder of the weekend will be used to remove debris. The sound of the explosion may carry, however, the charges will not cause physical damage to structures or persons beyond the confines of the Coast Guard base. Security and control of access to the Island is vital and will be handled by the Army. However, it is imperative that this information be treated on .a NEED TO KNOW BASIS ONLY so that we do not attract interested bystanders. DL/pw COPY: Mayor Jean A. Levesque Fire Department Police Department Building Inspector Board of Health City Council Civil Defense Plummer Home LJs`iF Jc ;" 1^ F, ,� •V +�.,'"`1r1 �* ,•rc'i.-�''RAr'+c''�' a`�i.-1`�+••A �°v. 'f • > .. � ,.. �, �+�,v� �"�"" ;F�" � ..r fr! t '""• �Ar+�w 't-��h i � „aR,y �w'�4 'mod' �u.i`• �� i� � ' x �"' �. y ; _ .' �. s '+Y` e ,�" s }..,,�'�`• '!,.c'y+ ...sew -:+ T :�+.-s�.u.. ..: w•.t'k ... �.-. i.x �... .rat.._H-a....3:.",._f �:_r..�'itYs�6�rr�'+i1.rt'Rs�.,«.s�",ait�_,�._-�`.�Jt'4;s�...�i+��.'k'�_�.r�zw�<t] . -- 1 � Y - '.'r.. +art.. s•'i tr � iS# � .,,� ',� '• �y FROM THE DESK T ? Lt. David J. Goggir �• � - Salem Fire Marshal - Deputy Chief Francis Batesw Fire Alarm Office The Arm Corps of Engineers' _ has been y granted permission to..c6nduc'te 'a trainingt drill at the Winter: Island Complex; � ' commencing at 7: 00 A, M, on -Saturday''� March 5, 1977. This drill will consist of demolition of several structures on the land of the °..z former Coast Guard Base. = t ,. Blasting with dynamite will Nbe 'inciud6'd r �-., t` in the drill' program. All necessary. , releases have been placed on file- with FRS' the Fire Prevention Bureau;, sµ a Detonatiori of the charges, is scheduled for earl afternoon of Parch k ' y 5 � ,1977. r" The Army Corps of Engineers will be in ` full charge of the operation. `- t �Respe tfully,; 76 Lf. David J. gi Salem Fire. Marshal a i _ ' ' . ' •...-:..,-,-, `-:ram.-•r.�+.�_ .-.rs..:++, .: - ti I i %I- LIT i t 4) 11 f �Ilellt, fnu�i' tt �V • �'�,��kr`t' �liitre ,�leprtrliuut �'lealt�u;trhts `' µ tl 48 P&v L'... 6treet 3 kFebruar 17 19$2� : i ' , '�' Date Y i F' Salem. Board s , .'� - •. _ , o rd of Appeal Re l �T nter'S=)Island Commiss bnP City of Salem, Massachusetts Winter `.Island ��' One Salem Green Hearing Date Feb. 17,�19$2�,. Salem, Via. 01970 > f Sirs: As a result of notice received 'concerning - the Board oaf Appeah; hearing for the above listed name,, and address, the Salem Department, requests the following items to be placed, on record;,°F .1. No objection by. Salem. Fire Prevention,Bureau to occupancy °;,,t 4 in an orderly fashion' of � recre.dt:ional 'vehicles, for tramping. Fire Alarm -office.- shall be notified' of, .conditionsY �.'-r . which would impede apparatus.,response if said conditions dewelopj's= , t .Responsibility ao rest with Winter .Island, Commission . t 2 No -open camp fires will be permitted... rw >r X. + t: f w � ` Respectfully submitted, u Captain David J. Go in_ y , ec:� Buildings Inspector Salem., Fire Pfarshal ' f ile Form # 105 Tames cal- ?ai=wan (94ief CZ� .af o ez , T�ns'arhusdts Aire Uepartmerd Pea quarters 48 ` Eafagztte ,Street _ alent, dffitz_ 019713 Salem Board of Appeal City of Salem, :Massachusetts One Salem Green Salem, Ma.. 019?0 Date: March 16, 1983 Re: Winter Island Commission Winter Island Hearing Date: 3/16/83 Sirs: As a result of notice received concerning the Board of Appeal hearing for the above listed name and address, the Salem Fire Department, requests the following items to be placed on record. The Salem Fire Department has no objection to the request for a Special Permit,,subject to providing of adequate roadways being maintained, for access of fire apparatus. Respectfully submitted, 0- Captain David J.., Go in cc.: Building Inspector Salem Fire P,'arshal file Form # 105 F, .. � �'T`'�^G%'w„m±^'c"e>t"^'''��RS"q.,r t�4.Y.2'.OJT!,"Prri'^.'wq`?^RR'!e.!burin:.R",qh""!,:_;�'�.nu?n31`F"t''4'Y'nTP'4'Mx'4,xy..w�Sw,t w....1i:]2i �iT!.d`P':G!.:I✓:�:fiP�M+CM'0.:Aa�!'.S�Lf'+D�7'C`?!.)r,.�,^'2�T.'tIL: J^eC'..'rY'e'r.� as*r ,err ��rrm -,r M 0!, 1,j 04 '0. `4 v i 4 Yt:� W", J 4 A tt, Pet 4 t 'it !Y! A Y T ..5 7 Pit if Foo FIRE DEPARTMENT FIRE PREVENTION 1301 ;EA' Salem, Ma%%achUsmu 019*70 11 n + A, * M PERM T, 144W In crcrn'r4ance with thr, provinions of Chaptor 148, G, I... Cie this rx-l-mit Is granted to e t) cirn(* Salom Fir. e Department, (TrRinlng, Offic' (Irm ew rorrowillno grnniatl re conduct open burning I for -, r a. i ni n g' Ur P' of Regulations of thp Dej)n.rm( t,nt of Qti 0..j.j-ty .IS)nirpos,--! for for Arson in con ji.Inc-t.1-01-1 W 11;1-1 the off, fig z1. which permit in grCM tod t h e, N A. t 1. o n a I F Ir f, , kl Mass. StO Fire M,,ixshal and 10A] Apstrictionn: _ks per. P'i.rr Pr'f,-��v,,,,nt.ion R(,rvu1n-tiOns, 1, 1 m i t e (1 1;0 va.can-t structure ,�ituated at fol"Mor., W I s 1,an d-.. Ro.asl o..__Sr,0_cai I _M, (Olva lo-oflo" by Pirool and no., or doas7ril- In aticls moaner r n I P,nvW Thin t-Y!rmit will oxp.irn,..5/24/Y_F3 ti,a.J or)i Fie mpirdh"A�].._, 00 T1. M. tii "N T IMON vn!::)�08) (11-n. MMTT MUST PC CONSPIMTOUSLY PO,,,1 .r) J0. R PJi ev7"eY4 .Zsl�nf,P 4, O 's as S'CG 41 II N_EO�H* P CITY OF SALEM MASSACHUSETT S W. GREGORY SENKC CITY PLANNER Lt. Col. Hall 94th U.S. Army Reserve Command 666 Summer Street Boston, Massachusetts 02210 Dear Colonel Hall: PLANNING DEPARTMENT ONE SALEM GREEN 01970 January 31, 1977 I must apologize for not writing you sooner, but I must reiterate that the City of Salem is still extremely interested in having you and your people do demolition work on Winter Island. As stated at our meeting of November_16, 1976 there are certain conditions and controls which will have to be observed by your group during these training sessions on Winter Island. In addition, information has been requested by -Al Durocher of the 368th Engineering Battalion. 1. Permits. Please sign the enclosed application form and return it to me so that I may forward it to John Powers, the Salem Building Inspector. (This is in addition to the explosives permit which has already been granted.) My office has filed for clearance from the Conservation Commission. 2. Work Hours. Entrance and exit to and from Winter Island will occur not before 7 A.M. Saturdays, and not after 4 P.M. on Sundays. The use of explosives on Winter Island will not occur before 12 noon or after 2 P.M. on Saturdays, and will not occur before 12 noon or after 2 P.M. on Sundays. 3. Access. Authorized personnel from the Police Department, Fire Department, or other appropriate local departments may have to be on Winter Island during your training sessions; however, only those persons authorized mutually by you and me in advance, and having proper identification when entering the site, shall be allowed to enter. These people will be on the site at their own risk, and under no circumstances will the U.S. Army be responsible for these people when they are on Winter Island.. T Lt. Col. Hall January 31,`1977 -2- 4. Demolition. Al Durocher has received a listing of the nine (9) buildings slated for demolition. These include a pyro magazine and electrical generating shack which are both disconnected and inactive. Water is currently shut off at the main gate and electric current will be turned off on 48 hour notice. Our present thinking is that the largest, debris will be dumped in the earthworks area and buried. In other cases, debris should be transported to the regional dump. 5. Extermination. Prior to demolition by the Army, the buildings must be exterminated by the Salem Board of Health and certified as such. This should not interfere with your scheduling. 6. Timber Pier. We are also anxious to have the derelict pier removed. In its current condition, it is a severe hazard to anyone wandering onto it. It may be that this. demolition is not conducive to explosives. We do not wish to see the debris cast into the harbor and furthermore, we are hopeful that salvagable timber might be stockpiled. 7. Reconstruction Work. We are interested in discussing with you certain reconstruction work which would be appropriate when the demolition is completed. Specifically, these are the repair of the concrete launching ramp and the construc- tion of a footbridge to the lighthouse. If you have any questions in reviewing these matters, kindly contact me. Otherwise, if they meet with your approval, I will be anxious to hear from you when your schedule is prepared. At that time, we can arrange for authorization of city personnel, storage of explosives, debris disposal, etc. .Thank you again for this valuable gesture toward the goal of renovating and improving Winter Island. Sincerely yours, W. Gregory Senko City Planner WGS/kms cc 368th Engineering Battalion Mayor Jean A. Levesque William J. Tinti, Esquire Marshal Connolly Chief Brennan John Powers Anthony V. Fletcher John Smedile Ralph Hobbs Dr. John J. Toomey. Conservation Commission. David TV Cody Chief 978-744-6990 dcody@satem.com Oy of Salem, Massachusetts .dire Department (fe 9f�o2�� i 48 Lafayette Street ?7 Salem, .ti(assacfiusetts 01970-3695 Tcl 978-744-12-35 FaX 978-745-4646 Fire Prevention Bureau 978-745-7777 APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION REGULATION 527—CMR 19.00, AND THE SALEM FIRE CODE, ART. # 20 FEE $30.00 CHECK ii- APPLICANT: ADDRESS: l�U jL CITY: �OZVC�;S (Z STATE: f _ ZIP:O' f4 3d PHONE: �'%& 29� �(d z( LOCATION OF TENTAGE:�c�,� OWNER OF PROPERTY C_ ADDRESS: CITY: STATE: ZIP: PHONE: INSTALLER/RENTAL CO. OF TENTAGE: ) PHONE: ADDRESS: CITY: STATE: ZIP: INDICATE WITH REFERENCE TO PROPERTY LINES AND OTHER BUILDINGS THE LOCATION OF THE TENTAGE ON THE BACK OF THIS FORM: MATERIAL USED: MANUFACTURER: SIZE OF TENTAGE: 3o NAME OF TESTING AGENCY: SclLr AGENCY APPROVAL NUMBER: CERTIFICATE OF FLAME RESISTANCE: CONDITIONS OF APPROVAL OTHER THAN AS PER FIRE PREVENTION REGULATION: !i n 40, G � SALEM BUILDING DEPARTMENT PERMIT NUMBER: —r/ DATE OF ISSUE: _ SITE SITE INSPECTION DATI::�f�� EXPIRATION DATE: APPROVED BIZ. TITLE: •'� f� FORM eDB (Rev. 8/99) 80B ✓1. (f/I'�i�/r�//r� �l'i r�'-��i<r /r'f:; — (��//irrre% ///E '^/%rI RECEIPT OF DISPOSAL OF UNDERGROUND STEEL STORAGE TANK FORMERLY CONTAINING MOTOR FUEL NAME AND ADDRESS OF APPROVED TANK YARD: T V 1. LAWRFNaE, MA OIS41 Approved tank yard no. �/� Tank Yard Ledger 502 CMR 3.03(4) Number I certify under penalty of law I have personally examined the under round teel sto �eliver�dthis "approved tank yard" by (firm, corporation or partnership)S ' sand accepted same in conformance with Office of the State Fire Marshal Regulation Provisions for Approving Underground Steel Storage Tank Dismantling Yards. A valid permit was issued by the head of the LOCAL fire department FDID# to transport this tank to this yard. Name and official title of a proved tank yard owner or owners uthorized representative: Signature : Title . ei .1e,! Date signed: ! Z TANK DATA: TANK REMOVED FROM: Gallons: S 7f" No. and Street: lv Previous contents: City and Town:_ ��(%� r� �_ Diameter: Gda.0 , Fire Dept. Permit Length: s' Notes: Date Received: Serial # (if available): _ Tank I.D. # (Form FP-290). EACH TANK MUST HAVE A RECEIPT OF DISPOSAL Owner/Operator to mail revised copy of Notification Form (FP290, or FP290R) to local fire department and: Department of Environmental Protection Bureau of Waste Prevention - UST Program P.O. Box 120-0165 Boston, MA 02112-0165 This signed receipt of disposal must be returned to the head of the local fire department. Form FP 291 (Rev. 11/2009) ,CON (mg of'381Pm, Asssar4usPfto Fee Due $10.00 $ FIRE DEPARTMENT • FIRE PREVENTION BUREAU Ck. # 3 I Cash 48 Lafayette Street Rec'd by: Salem, Massachusetts 01970 g- �( -mil To: HEAD OF FIRE DEPARTMENT (Date) Application is hereby made in accordance with the provisions of Chapter 148, Mass. General Laws; and 527CMR6.00 made under authority thereof, by the undersigned, for permit to install Liquified Petroleum Gas storage tank or tanks, for the person or persons and at the location named herein: Name of Owner. C Address:y ^ 'e di R cA � to�s��.ggsl Number of Tanks: a Capacity of Each Tank: Total Stof4ge: .0 L4 5 a- 16 9 //— S Company: `��S+e.h i< 01j'a,0a_�Q CrCS Address: 1-3 1 "'-z4ed S� Installer. �!! ✓ f6'�� J rlxfen Signature) Issued by: rLn .. Ic T(-,p Cze.W 4 � Date: Form #90L (Rev. 1/83) DO NOT WRITE BELOW THIS LINE • FIRE DEPARTMENT - FIRE PREVENTION DIVISION 29 Fort Avenue Salem, Massachusetts 01970-5232 APPLICATION FOR CERTIFICATE OF COMPLIANCE One Family Dwelling To: HEAD OF FIRE DEPARTMENT O'Two Family Dwelling O Condominium Unit #. CHECK # I Fee Due $20.00 ptr unit Inspection date:] �4 �I Time: D 3 0 In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application is hereby made For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. `The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors Type of Detectors: A. Monitored Battery Units B. Permanently Wired Units Owner: 7 L e ,Q n or Con UJ q Li Address: W i n I-e r 1 S 1g1d K® 4G( (Give location by street and number, or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Date of Cer44ation.rA 2 _% /0 Real Estate Agent By: .� ) — 0 0 S (Phone) Layout of Smoke/Heat Detectors: Basement: 1st Floor: 2nd Floor: 3rd Floor:. Special Requirements: --- � )Ilia::a : FIRE DEPARTMENT - FIRE PREVENTION DIVISION 29 Fort Avenue Salem, Massachusetts 01970-5232 APPLICATION FOR CERTIFICATE OF COMPLIANCE To: HEAD OF FIRE DEPARTMENT 666ne Family Dwelling ❑ Two Family Dwelling ❑ Condominium Unit M CHECK #-1 20 Fee Due $20.00 per unit Inspection date: Ll Time: In accordance with the provisions of Chapter 148, G.L. as, provided in Section 26E and/or 26F application is hereby made For an inspection of smoke detectors in: The under- signed owner of record or authorized agent. reauests the issuance of a Certificate of Comnliance Type of Detectors: A. Monitored Battery Units B. Units (Give location by streee /and rber, or describe in such a manner as to provide adequate identification of location) LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Date of Cert' cation: �^ By: Real Estate Agent '773" may" -�7.6 / (Phone) Layout of Smoke/Heat Detectors: Basement: 1st Floor: 2nd Floor: 3rd Floor: Special Requirements: application to local Fire Department. � Make aj pP Fire Department retains original application and issues duplicate as Permit. D� M APPLICATION and PERMIT Fee: $50.00 for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application is hereby made by: ' Tanke (please print) 11 1/2 R Winter Realty Trust X :111/2 Signature (if applying for permit) AddrWinter Inland Rd. Salem Ma. 01970 Street City State Zip Company Name H & S Tank Cleaning, Inc. (978) 531-6433 Co. or Individual Print Print Address P.O. Box 2 Amesbury, MA 01913 Address Print Print Signatur�(ifplying for permit) Signature (if applying for permit) , F OAF-Cr6erfified Other ❑ IFCI* Certified ❑ LSP # Other Tank Location 11 1/2 R Winter Wand RD. SAlem Ma. 01970 Steel Address City Tank Capacity (gallons) 275 Gal. Aboveground Substance Last Stored Fuel Oil Tank Dimensions (diameter x length) Remarks: Firm transporting waste H & S Tank Cleaning, Inc. State Lic. # MA326 Hazardous waste manifest# E.P.A. # Approved tank disposal yard Winfield Alloy Inc Tank yard # 014 Type of inert gas N/A Tank yard address 1-15 Medford St., Lawrence, MA 01841 CiForwn1��' `� I # fJ �'1 S� Permit# Date issue �' Z l r of D e of expiration Dig safe approval number: Dig Safe Toll Free Tel. Number - 800-322-4844 Dr A, Signature / Title of Officer granting permit After removal(s) ("Consumptive Use" fuel oil tanks exempted) send ,!!orm FP-296R s gned by Local Fire Dept. to UST Regulatory Compliance,Unit, Department of Fire Services, P.O. Box 1025, Staf2 Road, Stow;rMA 01775. *International Fire Code Institute FP-292 (revised 4/97), , C!T,Yot- r, atcm,i-..ds,�sac9-.u8C,'(, FIRL-D'PARTMENT - F1RE P'P.EVEN T iON DiViS!ON 29 Fort Avenue Salem MassachUSettS 0 i 970-5232 Fee Die S 0.00 Ck YD = �i lI el"K il-JA�Llz l AIVN Temporary Stomp Propane To: 1MfiD OF FU'� DEPA—RTNMNT - Date APpiication is hereby made in accordance with the Provisions of Ciiapter 148, Mass. Get erai maws aid 527 CPf Sec. 6.00 Made under au hori.y thereof, by the undersigned, for permit, to store Liquefied Petoleum Gas on a :ems porany basis for speci`c event(s) use. Name of A ppi:caAFE / T aak(s) Owner: V lAJ 1 Ito's aQgh _ Address Phone 'Numbef Location of to k'(s) visage a� �� i` a��_(sy dJsage �✓ "s( �� ` /� '•. v I u:i`ber oT Ta�Etc : _ _ iap ity o�eac x a�� )r Tot i Storage Date cf Approvai,. �( andDate qr E %QZl a or: '1- ' * r (K (Address)s�� 6s�40 'i C Cy �,� �J bJ 4 U 9 I I C.it. '��.' V aN P �. l..J iRE'DEPFRTMENT - FIRE PR.E,VFN T i)N DEVsSf( N "9 Fort Avcnue Sa!e.,,. Massachusetts s 1970-5232 pE�� UT A P PLICA. -l'0 Pee sue S50.00 Appiication is hereby made m accordance with the provisions ofCiiapter'L48, Mass. Ceae-_i maws and 527 CW--R Sec. 6.00 Made i:nder a nhor2- tt ereof, by the mdeisis jed, for pemit 'Co S=QSe r iqueued Petro?eL?_Ti CYa. s on a ECG p 7 j C?S:S for S�eC!f's events; use. cv Name Of A p-i?cant / T ank(s;D Owner : J� . b , V"Gae lV 3.iF '�ei_' .ocatiou Otank(s) Usage : � � Dam(s) of Ta?k(Sj Usage : Tti u- 7 ` � j r Number OT �?a?�Cs : i� iac'D.2C's� Of each 5'�k t 4•�� Y b% Dot SCOrace Date of i;xi)?ranion : � / (Address) t p (•j G11 r _ .-ccer Paid _ Saienn, i assachuseus 01970-5232 11-2 (0)78;745-7777 PER R ME T Name of A to-pEcail-t /'Fam- k(s) Owner o:,a�ie- c<<>-_•��s; ;'sage � D?La(s) c_ La_==+'_,,$) Usage . Con' dtLo s Or -;7erma'A Date Ef eaive Ca—acij of eaCha-ns` : ota: ram JLo CjC (Siguat e of ('sr^ O—'5C3a 3 i Address100 WINTER ISLAND ROAD Eng 1 Lad 2 Name WIlVTER ISLAND GRILL Phone ? Owner ? - 9 9 9 9 PTN N/A N/A N/A ? N/A AL. Co. N/A N/kone Knox Box FALSE Permits Required # N/A Fire Alarm System Y N Extinguishers Y N Master Box Sprinklers Y N Nearest Hydrant Standpipe Y N Type of Bldg. F.D. Connection Y N Type of Occupancy Emergency Lighting Y N Central Station Special Hazards Insp. Form Date Company Name Remarks & Complaints 17 zK"— / �� y 1 - 44 SALEM FIRE DEPARTMENT Inspec. ate# 7 9% Insp. Number7�j0�/ INSPECTION AND VIOLATION REPORT Reinsp. Date: Occupancy Name td �� D r ` Occupancy Type e Address /' Bldg. #'s Yes €30 ❑ Floor/Section Phone2//_® 7� D O f✓�e:A I� Inspector Name,, Company # Notifications ❑ Health ❑ Bldg. ❑ Electrical ❑ Police 1. Exterior 6. Heat g-Systems ❑ N/A fire escapes/decks proper storage proper access Gass CrPass C�Pass ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A combustibles within 5 feet defective chimney ss 3 ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A B-N/A KNOX BOX ❑ Pass ❑ Fail ❑ Warn A defective system 311ass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A 2. Exits defective wiring 7. Electrical 1515ss ❑ Fail ❑ Warn ❑ N/A open property Kass ❑ Fail ❑ Warn ❑ N/A exit blocked Cass 0 Fail ❑ Warn ❑ N/A exit signs working 9-Pass ❑ Fail ❑ Warn ❑ N/A panels accessible ®-Pass ❑ Fail ❑ Warn ❑ N/A adequate lighting bass ❑ Fail ❑ Warn ❑ N/A extension cords: door(s) locked signs needed in need of repair Liss 3'1ass ❑ Fail ❑ Fail ❑ Fail 0 Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A proper use cover plate missing proper fusing Q-Pass C31:5 s 0-a-ss ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn 0 Warn ❑ N/A ❑ N/A ❑ N/A emerge ncy.li s ; ss giGFail ❑ Warn ❑ N/A other � ❑ Fail ❑ Warn ❑ N/A other T� ❑ Pass ❑ Fail ❑ Warn ❑ N/A -- 8. signs needed Fire Extinguishers B-6ss ❑ Fail ❑ ❑ Warn N/A ❑ N/A 3. Fire Alarm System N/A operative ❑ Pass ❑ Fail ❑ Warn ❑ N/A properly mounted ®'Vass ❑ Fail ❑ Warn ❑ N/A properly labeled accessible. ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A proper type obstructed 211�_s_s dss ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A trouble indication ❑ Pass ❑ Fail ❑ Warn - ❑ N/A need recharging ❑ Pass Ef Fail ❑ Warn ❑ N/A ..defective devices ❑ Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A missing devices ❑ Pass ❑ Fail ❑ Warn ❑ N/A 9. Sprinkler & Standpipe System other ❑ Pass ❑ Fail ❑ Warn ❑ N/A valves labled ❑ Pass ❑ Fail ❑ Warn /A ❑ N/A 4. Kitchens 10 lb. ABC extinguisher ❑ Pass ❑ Fail O Warn ❑ N/A valves accessible ❑ Pass ❑ Fail ❑ Warn ❑ N/A at hazard ext. system operat. roof collect. clean system inspected ❑ Pass Cass Os ❑ Fail 0 Fail ❑ Fail C9'Warn ❑ Warn C~}-Wa—rn ❑ N/A ❑ N/A ❑ N/A pressure reading FDC clear/capped Valves open valves secured ❑ Pass ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ Warn ❑ Warn ❑ N/A D N/A ❑ N/A ❑ N/A hood/duct clean Er Pass ❑ Fail ❑ Warn ❑ N/A spare head avail. ❑ Pass ❑ Fail ❑ Warn ❑ N/A other 0 Pass 1 ❑ Fail ❑ Warn ❑ N/A heads obstructed other ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A S. Storage proper labeling BAss ❑ Fail ❑ Warn ❑ N/A . proper storage ❑ Fail ❑ Warn ❑ N/A PTN Form *84 - Completed Yes ❑ No ❑ legal storage other Gass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A Form #58 -Filed Yes ❑ No ❑ 10. Violations Found i MI-4-43 QUE f ur o;� awiz ) Form *16 - (Rev. 11/93) Copies: White - Fire Prevention Yellow - Inspecting Company Pink -Building Owner/Manager '�?OVEtt (M JU%nZ% 508-744-6990 nty o f eSaf m, �asiacfiu:iEtt:i 9i,EF- S�F-#attmF-nt 4b infay£ttE �tt£Et .SafEm, _Massac%us£tts 01g7L 3695 \�l4£ �Azvr/Ltlolz �ci 5oS-744-1235 9az 5oS-745-4646 jl3ut£au 50S-745-7777 PARTY TO NOTIFY (PTN) INFORMATION/AUTHORIZATION PLEASE PRINT ALL INFORMATION DATE: oc)4 /% % ADDRESS OF OCCUPANCY: 90 0 NTf/2 7;� Z4)fal /(FLOOR: I S 7 NAME OF OCCUPANCY: O/ wT,-/L ZLZd2r�( Sh PHONE: S2* hqV - 9y 3 PERSON TO CONTACT IN THE EVENT OF AN EMERGENCY: NAME: AR "e PHONE: HOME ADDRESS: / 3 al- U 4 4 S'T�" CITY: 3 ,/7Ze )f/ ZIP: Ol P ? 1 NAME: HOME ADDRESS: PHONE: CITY: ZIP: IF THIS BUILDING HAS A FIRE ALARM, PLEASE LIST THE ELECTRICIAN/ALARM COMPANY THAT IS AUTHORIZED TO RESET THE SYSTEM WITHIN (3) THREE HOURS FOR DWELLINGS AND (6) SIX FOR COMMERCIAL BUILDINGS, CALLS TO ANSWERING MACHINES NOT ACCEPTABLE. NAME OF AUTHORIZED PERSON/COMPANY: PHONE: NAME OF PERSON AUTHORIZING: (PRINT) SIGNATURE: OWNER OF BUILDING: �, / 7 d/ v� �,9L2 Yf�, PHONE: HOME ADDRESS: CITY: ZIP: BUILDING KEYS LOCATED IN A KEY KEEPER: YES: k NO: OTHER: DOES THIS BUILDING HAVE A GUARD DOG: /�lo INSURANCE CO. ON BLDG. ADDITIONAL INFORMATIONAL OR INSTRUCTIONS FOR THE BUILDING AND/OR OCCUPANCY: A PLEASE RETURN THIS INFORMATION TO: SALEM FIRE PREVENTION BUREAU 29 FORT AVENUE FORM #84 (REV. 2/96) SALEM, MA 01970 �k4 r Salem Fire Department Fire Prevention Bureau 48 Lafayette Street Salem, Ma 01970 Group Home Inspection Name of facility F:-O ilz- 4,0 S-1' Address Name of licensee Address 7 ✓1N'i�/�- i' City J'q C-(,- State lln4 Zip c S -2 o Telephone Date of inspection 7 27-'S7 Inspector: C l"e4I VW/ 5 Company E-/ Responsible parties to notify in the event of an emergency: Name Address Telephone 4r 6--v 4- -?7 41W-fhti /ICE N� �� °7�f ►- b Z % o Reference : Massachusetts State Building Code, Section 424.0 NFiPA 101, Life Safety Code Form *41K"(06/88 Salem Fire Department Fire Prevention Bureau 48 Lafayette Street Salem, Ma .01970 Group Home Inspection (Circle one) N 1 Is the Building Inspector's Certificate of Occupancy posted? 2. 'Maximum occupancy allowed: / 6 Number` of . residents between the ages of ven (7) and fifteen (15) years of age inclusive. (12 max) Number of esidents sixteen (16) years of age or _ . older. (25 max.) - N 3. Is one (1) means of egress and one (1) escape route serving each floor, remote as possible from each other and leading to grade provided? N 4. Are all exits properly.marked? /Y� N 5. Are all egresses clear of obstruction? 0 N 6. Is a full fire alarm system with panel provided? N 7. Is a drill switch provided? N �f 8. c Date most recent drill conducted: N 9. Is a fire drill procedure conspicuously posted? N 10. Do all interior stairways have smoke detectors connected to alarms audible throughout? N (2 11. Has an emergency shelter agreement been formulated for the shelter of occupants in the event of an emergency? �--� Y �N ) 12. Are there any conditions which would constitute a fire or safety hazard to the occupants? Note: Fire Drill Criteria: Occupants of group homes must egress the building within two and one-half minutes (2-1/2 min). The person initiating the drill shall cause to be blocked any one point in the principal egress route to simulate a hazardous condition and the internal alarm system shall be activated for two and one-half minutes. 4 f SALEM FIRE DEPARTMENT Insp4 Date: Insp. Number 111INSPECTION AND VIOLATION REPORT Reinsp. Date: Occupancy Name Occupancy Type L v /goer.( -F O J o U P e Address Bldg. #'s Floor/Section Phone 37 (' e� F l . Yes O�No ❑ 4Le- y /0 Ins for Name Comr�ppaany # Notifications er ./2'&",,.,�'l �_i ❑ Health ❑ Bldg. ❑ Electrical ❑ Police 1. Exterior 6. Heating Systems ❑ N/A fire escapes/decks 121"Pass ❑Fail ❑ Warn - ❑ N/A combustibles Bass ❑ Fail ❑ Warn ❑ N/A proper storage proper access 2"Pass 16ass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A within 5 feet defective chimney ss ❑ Fail ❑ Warn ❑ N/A KNOX BOX ❑ Pass ❑ Fail ❑ Warn I�/A defective system Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A 2. Exits defective wiring panels accessible 7. Electrical 13rPass ❑ Fail ET%ss ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A open property ta'Pass ❑ Fail ❑ Warn ❑ N/A exit blocked VPass ❑ Fail ❑ Warn ❑ N/A exit signs working Pass ❑ Fail ❑ Warn ❑ N/A adequate lighting door(s) locked signs needed in need of repair VPass VPass OXPass pass ❑ Fail ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A ❑ N/A extension cords: proper use cover plate missing proper fusing ePass VPass C IPass ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A emergency lights . ®'Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A 8. signs needed Fire Extinguishers 011ass ElFail ❑ ❑ Warn N/A ❑ N/A 3. FireIarm System ❑ N/A operative properly labeled accessible. trouble indication EZPass Pass Pass ss PPass ❑ Fail ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A ❑ N/A properly mounted proper type obstructed need.recharging M#Pass Pass EfPass 'ass ❑ Fail ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn._ ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A ❑ N/A defective devices ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A missing devices Pass ❑ Fail ❑ Warn ❑ N/A 9. Sprinkler & Standpipe System A valves labled ❑ Pass ❑ Fail ❑ Warn ❑ N/A valves accessible ❑ Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A 4. Kitchens 10 lb. ABC extinguisher ZPass ❑ Fail 0 Warn ❑ N/A at hazard ext. system operat. roof collect. clean system inspected hood/duct clean Pass VPass VPass -dPass ❑ Fail ❑ Fail ❑ Fail ❑ Fail ❑ Warn O Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A ❑ N/A pressure reading FDC clear/capped _ Valves open ' � valves secured spare head avail. ❑ Pass ❑ Pass ❑ Pass ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A ❑ N/A ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A heads obstructed other ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A S. torage proper labeling ss ❑ Fail ❑ Warn 0 N/A proper storage legal storage other PIPass 'Pass ¢amass ❑ Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ Warn ❑ N/A ❑ N/A ❑ N/A PTN Form *84 - Completed Form #58 -Filed Yes ❑ Yes ❑ No No 10. Violations Found Form *16 - (Rev. 11/93) Copies: White - Fire Prevention Yellow • Inspecting Company Pink -Building Owner/Manager SALEM FIRE DEPARTMENT Inspec. Datey, Insp. Number F7160S_1 INSPECTION AND VIOLATION REPORT Reinsp. Date: Occupancy Name IUD tie" O"A to, Occupancy Type s 0/711, Address 7 ILe 14a Bldg. Ws YesV No O Floor/Section 2 Phone Inspector Name Ilow Company* 1 Notifications J D Health • O Bldg. ❑Electrical ❑Police 1. Exterior 6. Heating Systems ❑ N/A fire escapes/decks Pass ❑ Fail ❑ Warn ❑ N/A combustibles N Pass D Fail ❑ Warn ❑ N/A proper storage 'fist Pass ❑ Fail D Warn ❑ N/A within 5 feet proper access Pass D Fail ❑ Warn ❑ N/A defective chimney Pass ❑ Fail ❑ Warn ❑ N/A KNOX BOX O Pass D Fail ❑ Warn tkN/A defective system 1K Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail O Warn ❑ N/A 2. Exits 7. Electrical open property Pass q Fail ❑ Warn ❑ N/A exit blocked Pass ❑ Fail O Warn ❑ N/A defective wiring Q Pass ❑ Fail ❑ Warn ❑ N/A exit signs working IR Pass ❑ Fail ❑ Warn ❑ N/A panels accessible W Pass ❑ Fail ❑ Warn ❑ N/A adequate lighting DR Pass ❑ Fail ❑ Warn ❑ N/A extension cords: door(s) locked signs needed Q Pass 9 Pass ❑ Fail ❑ Fail 0 Warn ❑ Warn ❑ N/A ❑ N/A proper use cover plate missing k, Pass � Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A in need of repair V3 Pass ❑ Fail ❑. Warn O N/A proper fusing 6L Pass ❑ Fail O Warn ❑ N/A emergency lights '7 Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A 8. signs needed properly mounted Fire Extinguishers U Pass W Pass ❑ Fail ❑ Fail ❑ ❑ Warn ❑ Warn N/A ❑ N/A ❑ N/A 3. Fire Alarm System ❑ N/A operative [9 Pass ❑ Fail ❑ Warn . ❑ N/A properly labeled 5 Pass ❑ Fail D Warn ❑ N/A proper type N Pass ❑ Fail ❑ Warn ❑ N/A accessible. q Pass ❑ Fail ❑ Warn ❑ N/A obstructed CKPass ❑ Fail ❑ Warn ❑ N/A trouble indication defective devices 0 Pass t5 Pass D Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A need recharging other KPass O Pass D Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A missing devices ®' Pass ❑ Fail ❑ Warn ❑ N/A 9. Sprinkler & Standpipe System other ❑ Pass ❑ Fail ❑ Warn ❑ N/A valves labled valves accessible ❑ Pass ❑ Pass ❑ Fail ❑ Fail X N/A ❑ Warn ❑ N/A ❑ Warn ❑ N/A 4. Kitchens 10 lb. ABC extinguisher Pass ❑ Fail ❑ Warn D N/A at hazard ext. system operat. roof collect. clean 15d Pass M Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A pressure reading FDC clear/capped Valves open O Pass ❑ Pass ❑ Pass D Fail ❑ Fail ❑ Fail ❑ Warn ❑ Warn O Warn ❑ N/A ❑ N/A ❑ N/A system inspected ®. Pass O Fail O Warn ❑ N/A valves secured ❑ Pass ❑ Fail ❑ Warn ❑ N/A hood/duct clean IPass [I Fail ❑ Warn ❑ N/A spare head avail. ❑ Pass ❑ Fail ❑ Warn O N/A other ❑ Pass ❑ Fail ❑ Warn ❑ N/A heads obstructed other ❑ Pass ❑ Pass ❑ Fail ❑ Fail ❑ Warn D Warn ❑ N/A ❑ N/A 5. Storage proper labeling IV Pass ❑ Fail ❑ Warn ❑ N/A proper storage ® Pass ❑ _Fail ❑ Warn O N/A PTN Form *84 - Completed Yes ❑ No ❑ legal storage other (Pass ❑ Pass ❑ Fail ❑ Fail ❑ Warn ❑ Warn ❑ N/A ❑ N/A Form #58 -Filed Yes ❑ No ❑ 10. Violations Found Form *16 - (Rev. 11/93) Copies: White - Fire Prevention Yellow - Inspecting Company Pink -Building Owner/Manager �1 �1 �464 @qiTM'tM' FIRE DEPARTMENT - FIRE PREVENTION DIVISION 48 Lafayette Street Salem, Massachusetts APPLI f JLER I TE OF COMPLIANCE To: HEAD OF FIRE DEPARTMENT ne Family Dwelling ❑ Two Family Dwelling ❑ Condominium Unit N. SH HCHECK N O Fee Due $10.00 per unit Inspection date: In accordance with the provisions of Chapter 148, G.L. as provided in Section 26E and/or 26F application is hereby made Type of Detectors: Owner: Date of Certification: By: �- For an inspection of smoke detectors installed per Salem Fire Prevention Regulations. The under- signed owner of record or authorized agent, requests the issuance of a Certificate of Compliance for approved installation of smoke detectors A. Monitored Battery Units B. Permanently Wired Units Address: (Give location by street ancPfumber, or describe in such a manner as to provide adequate identification of LIST LOCATION OF DETECTORS ON BACK OF APPLICATION Real Estate Agent (Address) (Phone) Layout of Smoke/Heat Detectors: Basement: 1st Floor: 2nd Floor: 3rd Floor: Special Requirements: Fee Due $10.00 City of Salem, Massachusetts Ck. # i Cash t % FIRE DEPARTMENT - FIRE PREVENTION BUREAU Rec'd by. 3,y 29 Fort Avenue a„a„t Salem, Massachusetts 01970-5232 ELEC. - -) `q I f' APPLICATION FOR PERMIT (Date) To: HEAD OF FIRE DEPARTMENT In accordance with the provisions of the Mass. General Laws and/or the Salem Fire Code, application is hereby made for a permit to install approved fire alarm devices. pp o�d p Location: 'p C : � S G \ V Ot. FOwner: Installer: Kam- l't, Al - "u-Zi Tel * ` 8 3 a. Installer's Address: t ( �C v"` P Zip: ® (5 5 License * IS- 2 a Type of Occupancy: - LIST TYPE AND LOCATIONS OF DEVICES ON REVERSE SIDE, OR PROVIDE PLANS. - Installation subject to final in pec�oq n and filling of Certificate of Completion, by i ler. Installer must//be esent. Date of approval: �' `'""� 7' "A. = ' f \ (Sigrffure of Applicant) Date of expiration: ` t ( �� < <v 0- 1� SA l (9 (Address) Form #81 F (Rev. 04/92) . DO NOT WRITE BELOW THIS LINE Fee Due $10.00 « City of Salem, Massachusetts ck. # i3cash FIRE DEPARTMENT - FIRE PREVENTION BUREAU Rec'd by. _�. 29 Fort Avenue Salem, Massachusetts 01970-5232 ELIC. Fj APPLICATION FOR PERMIT (Date) E To: HEAD OF FIRE DEPARTMENT In accordance with the provisions of the Mass. General Laws and/or the Salem Fire Code, application is hereby made for a permit to install approved fire alarm devices. nn --'' p Location: G� S (n v )�'l Owner Installer. �� « �� Q A Q -V ` Tel # -I LI Lt ` 13 (i l Installer's Address: t �'� C v v-• �'� S7 Zip: a (4 1 b License # iP ZS Z d �- Type of Occupancy. e-C' - LIST TYPE AND LOCATIONS OF DEVICES ON REVERSE SIDE, OR PROVIDE PLANS. - Installation subject to final in pect'on and filling of Certificate of Completion, by i ler. Installer must be esent Date of approval: 9 C �- / 17 (Sig re of Applicant) Date of expiration: (- 8� y ( �4 C ,�- w+ 2, -;i '�A ( Form#81 F (Rev. 04/92) (Address) DO NOT WRITE BELOW THIS LINE Fee Due $10.00 ca ° City of Salem, Massachusetts 11 * 10 31 x FIRE DEPARTMENT - FIRE PREVENTION BUREAU Rec'd by. / `C ',1 9 [tic. 29 Fort Avenue Salem, Massachusetts 01970-5232 (508) 745-7777 . 'l —g Office Hours: (8-9 A.M.) and (1-2 P.M.) - (Date) PERMIT TO INSTALL • FIRE ALARM DEVICES Permit is hereby granted to�install /approved fire alarm devices. All equipment and wiring are subject to approval of Sale Electrical Dept Location: 30 (,!%�+,-ti t� r�/�/> /( Owner. D5?,f� Installer. 4121142 Llt2l� License Installer shall note special equipment required, as listed on reverse side. UPON COMPLETION, THE INSTALLER SHALL REQUEST AN APPOINTMENT AT LEAST ONE WEEK PRIOR TO TEST, BE PRESENT FOR THE TEST, ,AND SIGN A CERTIFICATE OF COMPLETION. Cat/ U41zee��- (9gnature of F ) Date of expiration: (THIS PERMIT MUST BE CONSPICUOUSLY POSTED UPON THE PREMISES) Form #81 F (Rev. 04/92) (OVER) APPOINTMENT FOR FINAL INSPECTION MUST BE MADE AT LEAST ONE WEEK AHEAD ............ ___ Faye P,z ventton Su,teau 4 8, Pa ,x.Vette Street SZerr� Ma 01970 (50�) 745-7777 APPOINTMENT FOR FINAL INSPECTIONMUSTBE MADE AT,��I 4 ONE WEEDY AHEAD____ FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR EUILDING PERMIT In acc v :do ncc w-i.th the pyv i,s ivn.s o 6 a.;Zd the Sa Zcm T.i✓ G Code, appZtcattcn arzd the 06 a v6 SaCe;n F-_;.e Dc:pa-ttmer_t. (P.e�,. Sect.i.vn the Ma-s �achtL,set+_s S-tate F3u�'Xt_4 .ny Cod= -us he-teb y made ;op, app--tv vaL o � pLa.r�s a.ppyvvaL boy a bu.,edirtg per'n-vt by the 113.3. Ma,,-.,. S-tate RLdg. Code) I�-j L VN 4.,Iel wN C yi?atLL"e c, s Ap ! '_cant: -6 (AJiY'/MZ- 4: LL~(D QD Appyvva.°_ date: Phone # : -� y y-� 3 a-� 7 Town: S¢1 C �'y,-� /Ij✓f vL appfcvvae he�rehy y moaned, vn app-zvvEd ptarZ-s vh - r_N;;:-mot. deta•i L , by the SaZem F-vr.e De par tment . ACC pZcz n-s aye app 7 v _ l vCe'c o-: Zderzti,(Zca _i.on o� type and Location o6 and AZt plan aye -hub jec-t to appnvvae v6 any vthe-Z au21_v-��ty Upon cvmpLex ion, the appZicant v-z i n-sta iL ( size r an -ir�specctton and/oy te-st o� .the 6-i,-ce protect-i.on iev-i ce .,id F_qu-pment. ( ** FOR ADDITIONAL REQUIREMENTS, SEE REVERSE SIDE ** ! New con-StyLLGtZon. Pyoper.ty .Coca - vn ha-5 no evmpt i,ance :v-i,t{_ the o Chapter 148, Sect.i.un 26 C/E, M.G.L. , yeLz,:t_i.ve to the .tn,.,t.aZ.at^'_on v4 app-zoved 6,v e aLa-zm dev� ce The viJne-a, v�j tht-s pyopeyty •vs ,LequiAed to obtain a cvnd- ,tton o 6 vbtatn-inq a Su-r Cdtny P un'i_t. P-7 v pe.n,t y £.vca,�on in cvmjoi :.ance the p,+ vv i c'in- Chapter 74,q.. Sec t i.on 26 C/E, M.G.L. date. l3 4s"qnaz:cu.,-Le o Fi _ ! 500 Sq i .. 0 0 S Ci F t. O-_ ew ` a ...JI FIRE DEPARTMENT CERTIFICATE OF APPRii'V;4L FOR BUILDING PERMIT In compliance with the provision of Section 113.5 of the Massachusetts State Building Code, and under guidelines agreed upon by the Salem Bldg. Inspector and the Salem Fire Chief, the applicant for a building permit shall obtain the Certificate of Approval (see reverse side) and stamped plan approval from the Salem Fire Prevention Bureau. Said application and approval is required before a building permit may be issued. The Massachusetts State Building Code requires compliance approval of the Salem Fire Department, with reference to provisions of Articles 4 and 12 of the Building Code, the Salem Fire Code, Massachusetts General Laws, and 527 Code of Massachusetts Regulations. The applicant shall submit this application with three (3) sets of plans, drawn in sufficient clarity, to obtain stamped approval of the Salem Fire Department. This applies for all new construction, substantial alterations, change of use and/or occupancy, and any other approvals required by the Massachusetts General Laws, and the Salem Fire Code. Exception: Plans will not be required for structural work when the proposed work to be performed under the building permit will not, in the opinion of the Building Inspector, require a plan to show the nature and character of the work to be performed. Notice: Plans are normally required for fire suppression systems, fire alarm systems, tank installations, and Fire Code requirements. Under the provisions of Article 22 of the Massachusetts State Building Code, certain proposed projects may not require submission of plans or complete compliance with new construction requirements. In these cases, provisions of Article 22, Appendix T, and Tables applicable shall apply. This section shall not, however, supersede the provisions outlined in the Salem Fire Prevention Regulations, Chapter 148, MGL, or 527 Code of Massachusetts Regulations. All permits for fire code use and/or occupancy shall apply for the entire structure; fire alarm and/or smoke detector installation shall apply to the entire structure based upon current requirements as per Laws and/or Codes, but the existing structure may comply with regulations applicable for existing structures. ?Notice: Sub -contractors may also be required to file individual applications for a Fire Department -Certificate of Approval for the area of their work. Such sub -contractors shall file an Application to Install with the Fire prevention Bureau prior to commencing any work for those areas applicable. Form 81X (10/90) FOR F,NPL PPP�1N ZMON M�SONr� �� E CPS ENS ..�/ .,NEFO ."• FAR F`NPL Jj\ONE