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B-20-690 - 0014 UNION STREET - Building Permit I The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Revised Mar 2011 Building Permit Application To Construct,Repair,Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Building Officia (Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers LIa Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard uPrIt Required Provided Required Provided Required Provided ILL 1.6 Water Supply:(M.G.L c.40,§54) .1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1��jjwner'of Record: ///%CfjAC/ .�/57�P.-t /17-4 0/lid Name(Print) City,State,ZIP /y 11,4110- 14-�k Z72 / C 0 3a17 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work2: /*:12o SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. QAher_Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Su ression Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 0 Paid in Full 13 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES. 5.1 Construction Supervisor License(CSL) / --VV Z4 u/2-e✓A'�Yr��j'�,�'` License Number Expiration Date Name of CSL Holder p�-- �® List CSL Type(see below) t/ No.and Street Type Description U Unrestricted(Buildings u. to 35,000 cu.ft. R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Mason ry RC Roofing Covering WS Window and idin 711 SF Solid Fuel Burning Appliances 91fe rIve 0I I Insulation Telephone Email address D Demolition 5.2 Re istered Home Improvement Contractor(HIC) f y� 7 c/, 40 HIC Company N e or H C Registrant Name HIC Registration Number Ex cation Date No.and Street ,^ ee Vi,A---" !p� ��/��f�X1 Email address City/Town,State,ZIP !0 Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will"result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN• OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT . I,as Owner of the subject property,hereby authorize 1,4ay ,-yee' to act on my behalf,in all matters relative to work authorized by this building permit application. �GXi,,e///11//p�� Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION ` By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Lal le,6w e X/11 Prn�wner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass. ov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: TotaLfloor area(scl.;ft:) (inciudinggarage,;finished basement/attics,�decks or.:porch) Gross living area(sq.ft.) Habitable room count ` Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Commonwealth of Massachusetts a p ® Division of Professional Licen sure Board of Building Regulations and standards S Office of Consumer Affairs 8"Business Regulation COri5tr1W , " HOMEIMPRVEMENT CONTRACTOR rvisor �. q, Re �o E n ati n CS-090389 � EXt ires:Oe/24/2020 o9/24/2021 i � i t LAWRENCE H� -�- • LAWRENCE M LDEBRAND g; <, 30 SHERIDAN S+T � # LAW REhfCE'hftLQ 30 SIiERIDAN WOBIJ MA 01801. Undersecretary $: Comrnissionei V. g = 14 n� F _ S. j x�a� J I • � ._ b =Licensee Details ' _ T„ Demographic Information Full Name: LAWRENCE HILDEBRANp Ownec.Name: " a ` I:icense Ad&�&S Irifar nation City. .r WOBURN tate: MA� ipcode; 01801 ` Count United States = r .. k License Information f x s tense l�IQ GS-Q� $9 �1iyRef+cttRil ✓tsf z P:.r®fission 8>xliaa`g ltceases taste of't ast,teauu 6/4/2020~ Issue Date , M 5/2472 0 1 0 ` Expiration"Date: •`°5/24"/2022.k' _ , m License°Status: Active Today s Date 7/10/2020 p a Secondary License`Type: Doing Business As:, tatus'Chan a Reason:s License Re`' • y . t „ k t' Areregtus>tte Information :-T r _No Prerequisite Information } - I{ [ 4 [,tip rQ x ,h . 5 21 s a [ �.. '' & r I I CITY OF SALEM, MASSACHUSETTS BUILDING DEPARTMENT 98 WASHINGTON STREET,2ND FLOOR TEL: 978-745-9595 KIMBERLEY DRISCOLL MAYOR THOMAS ST.PIERRE DIRECTOR OF PUBLIC PROPERTIES/BUILDING COMMISSIONER I Construction Debris Disposal Affidavit (required for all demolition & renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR,Section 111.5 Debris, and the provisions of MGL c40,S54; Building Permit# is issued with the, condition that the debris resulting from this work shall be disposed of in a properly licenses waste deposit facility as defined by MGL c 111,S150A. The debris will be transported by: 1-54 (name of hauler The debris will be disposed of in: (name of facility) (address of facility) Signature of applicant (today's date) ACC>R& CERTIFICATE OF LIABILITY INSURANCE DATE(rAM DD1YYYY) `� 1 07/16/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policypes)must be endorsed. If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the cerpilcafla Froiifer In Iteu of saaG PRODUCER N CONTACT Claudia Victoria AL POIVTE INSURANCE AGENCY INC �'' @.IT)49217600:< AooRE CVIOTOR�PONTEINSURANCE•COM 819 CAMBRIDGE ST INSURER a AFFORDING COVERAGE NAK:O CAMBRIDGE MA 02141 INSURER A; TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B: US HOME IMPROVEMENT LLC INSURER C: .INSURERD: } 31 JOHN STREET INSURER E: TEWKSBURY MA 01876 INSURER P: COVERAGES CERTIFICATE NUMBER: 554562 REVISION NUMBER:. .; .THIS IS TO CERTlF1'l'HAT.THE POLICIES OF INSURANCE LISTED,BELOW HAVE BEEN ISSUED TO T.E 04SUf;RD NAME ABOVE,FOR THE POLICY PERIOD INDlCJITED. -"meTWrrHSTAND"IkG ANN`REQUIREMENT.'TERAY:+OR.COM,r1�N.oO �AW.bONTRACT:�R OTHER DOCI.IMI! "WITH RESPECT TO WHICH THIS CERTIFICATE MAY ISSUED OR'MAY PERTAIN,'THE INSURANCE AFFORDED BY�YHE POLICIES DESCRIBED HEREIN'IS"SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER MM yr MM O LIMITS "(Y —"j I EACHOCCURRENCE S AIMSMADE u OCCUR PREMISES Ea oaunenra $ MED EXP(A one person) S NIA PERSONAL S ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ POLICY❑PRO- ❑JECT LOC PRODUCTS-COMPIOP AGG S OTHER: $ meuurndir-CJ)itllClrY. I:: :• c: - ;.. .:. SINGLE- IT. ,5.: ;,: BOO(LY1WURfY Pe .;.. ALL OWNED SCHEDULED NIA BODILY INJURY(Per accW"AUTOS AUTOS ,) $ HIRED AUTOS NON-OWNED .PROPERTY DAMAGE S AUTOS (Per aWdoWl S UMBRELLA UAB OCCUR I EACH OCCURRENCE S EXCESS LIAR CLAIMS•MADEI NIA AGGREGATE S DED RETENTION S WORKERS COMPENSATION j AND EMPLOYERS'UA13LM YIN; STATCIUUTE ER A A�YVROPR&TOWPART" ...EFXECUTIVE E,L EACH AC W S 100000. 1CCEER�&fA06EERREACLIL.QQJD Dr 'NSA WA �7PJl'64307P1:88,20 07/13/2020 -�071430T021�. .(Mandatory In NN) E.L.DISEASE-EA EMPLOYE $ 100,000. 1 l61yaSqCRIPTtON'0F:of .:.DESGRIPI'ION'OF�OPERATIONS`Lekw �:..E.L.DISEASE.=PGUCYA{MR':5 ;SDD,DOO NIA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddMant!RerneHn Schedule,may be anached If mom space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 D6 B,no authorization Is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was Issued(unless the eKplrallon date on the above policy precedes the issue date of this certificate of Insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/kvdtworkers-oompensabonfiinvestlgations/. "CERTIFICATE-HOLDER" CANCELLATION'' SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN QUAMY ROICtFW BY LAY ACCORDANCE WITH THE POLICY PROVISIONS. 30 SHERIDAN AVENUE AUTNORQED REP RESE WATP/E WOBURN MA 01801 --'+ C Daniel M.Crow y,CPCU,Vice President—Residual Market—WCRIBMA ®1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I AC" c CERTIFICATE OF LIABILITY INSURANCE °ATE`MM,D°"YYY) 07/08/20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder 1s an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. if SUBROGATION IS.WAIVED,subject to the,terms and conditions of the policy,,certain pohcles may,require an endorse)n ITI nn, this certificate does not corer rights to the certificate holder iri`heD of such•dndorsement(s). PRODUCER GUN 1AU1 NAME: CLAUDIA VICTORIA Al Ponte Insurance Agency A/C. o Ext: 617-492-7600 A/c No: 819 Cambridge St ADDRESS:0 AIL Cambridge,MA2141 SS: CVICTORIA@PONTEINSURANCE.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: ATAIN SPECIALTY INS CO. INSURED INSURER B: i US HOME IMPROVEMENT LLC INSURER C: 3-1 JORN STREET <tEWKSBURY,-MA 01876 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. INSR AIJULSUBK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD LIMITS COMMERCIAL GEffERAr CrABIErfY:: EACH a+CIJRRENCE $ 1,000:AOU DAMAGE TO RENTED CLAIMS-MADE 'OCCUR PREMISES Ea occurrence $ 100,000 -. MED EXP(Any oneperson) $ 5,000 A CIP353982 07/12/20 07/12/21 PERSONAL&ADV INJURY $ 1,000,000 r1EN1':LA1GREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ICY PRO ❑JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 ER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO J J BODILY.TNJURY(Per,persora)4.$ OWNEd S AUTOS ONLY AUTOS CHEDULED BODILY INJURY(Per accident) $ HIRED NON-OWNED I PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acc dent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STAT YIN.., UTE ER ANY.PROPRIETOR/PARTNERIEXECUTIVEa - E.C.EACH ACCIDENT -$-- 'OFFICERYMEMBER EXCLUDED?': . (Mandatory In NH) E.L.DISEASE EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Pll(,.�CY I'ROV1$R QUALITY' ROOFIN_�BY-LARRY.. ACCURDANI:EWLTH THE ION9: 30 SHERIDAN STREET WOBURN,MA 01801 AUTHORIZED REPRESENTATIVE ALPONTE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Pririt Form Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lep-ibiy Name (Business/Organization/Individual): `— Address: City/State/Zip: s,��,�� .g- G/ Phone#: 2el 7f1!?7Z Are you an employer? Check the appropriate box: Type of project(required): 1.El am a employer with 4. m a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance . comp. insurance.$ 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. No workers' comp right of exemption per MGL y � p 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeownemwho submitthis affidavit-indicating:they are doing all work and then hire outside contractorsmnst submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. f4o.herehy.cer#fy.un.der the. .ains and e a ies of per'urythat the in ormation;:provided above is true and correct. C Si nature: . Date: . f(� Phone#: l �( ( ��g Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: ..---_------ Phone#: List of Subcontractors: Us Home Improvement Tewksbury Ma. 617-719-2465 LAWRENCE HILDEBRAND LLC CONSTRUCTION CONTRACT DBA QUALITY ROOFING By Larry www.QualityR*ofingByLarry.com 30 Sheridan street Woburn, MA 01801 Ow Ws Name ems. 781.789. 711 `Mlchael Navarro 14 Union t CS 0389 ownewscey Owmr'sZ-PCod$ owWaMmePhww ornursWomP11" larryhildebrand@ e ' on.net Salem Ma 01970 Proiset Address Prof Cdy Project Zap code Project Rw" Oats UW E.the Owner(s)of the premises described above authorize Lawrence I lildebrmd LLC dba Quality Roofing By Larry, hereinafter referred to as"Contractor".to rumish ail mataiaL9&labornecessarytoconstructWarimprovethesepremisesinagoodworkmanlike&substantialmanneraccordingtothefollowingtenms,speeiricatiomand visions: a.Desc riptlon of the work and the materials to be used: GAF Factory Certified Master Elite Roof Installation ID#90389 1)Use Tarps to protect property from shingle removal& installation. Dispose of in a dumpster we will provide. Homeowner may wish to cover attic with plastic to capture any debris that may find it's way into attic during removal of old roofing materials. We will make.minor repairs to roof deck up to of plywood.Additianil repairs$65.00 per/sheet of plywood. 100sf 2)At all edges of your roof we will install 8 inch premium drip edge. Color white 3) Install 6 feet of GAF Weather Watch leak barrier at all eves and 3 feet on valleys va leys 4) Install GAF Prostart Starter Strip at all edges of your roof to protect your home from high winds 5)Install GAF Shingle-Mate Roof Deck Protection A breathable water resistant membrane 6)Install GAF High Definition Architectural Shingles. Color Pewter 7) I and GAF Life Time Ridge Cap Shingles exclude ridge vent deduct$150 8) Re-Flash chimney unless flashing is in like new condition 9)Cost of Roof S 8710.00 Calculated 1742 square feet x$5.00 per/ft 10) Cost of Golden Pledge Warranty if desired$ 153.00 for a 1 family home and$204 for a multifamily home. include warranty This list of spselfleations may be continued on subsequent pages(see page number below). c.Payment:Contractor proposes to perform the above work,(subject to any additions and/or deductions pursuant to authorized change orders),for he Total Sum of$ 8,764.00 Down Payment(If any)a 2,700 Balance Due on Completion-6 ,064 Quote: $8,710 Deduct Ridge Vent: ($150) Add Warranty: $204 'Contract'total: `$8,764 d.Commencement and Compteden of Work:Commencemcm of work shall"'the physical delivery of materials onto the pnmises and/or the perform of any labor and commencement shall be subject to permissible delays as described in provision(6)on the reverse side. Approximate Start Data: Approximate Completion Date: e.Acceptance: 'rhis wntract is approved and accepted.I(we)understand there are no oral agreements or understandings between the parties of this agreement.Tic written rams.provisions,plans(if any)and specifications in this contract is the entire agreement between the parties.Changes in this agreement shall be dtute by written chm ge order only and with the express approval of both particw.Changes may incur addirional charges. Addi' ions Of This ContractAre On The Reverse Side And May Be Continued On Subse*mt Pages(see page number below. W14 eirri ) date OWNERIAGENT, see the "Arbitration of 01 putes �1dBC0 tlj�""�" ' date provision on page two (provision 14) and the NOTICE following this provision. If you agree to arbitration initial on the line below the NOTICE where indicated. Also initial In the same place onEACH COPY of this contract. NOTE: This contract maybe withdrawn after days from If rtot approved artZt 37I illy tt6tlt p�Ftt✓NP. I Page one of_Tob a Pages CITY OF SALEM., MASSACHUSETTS i BUILDING DEPARTMENT• 98 WASHINGTON STREET,2ND FLOOR TEL: 978-745-9595 KIMBERLEY DRISCOLL MAYOR THOMAS STYIERRE DIRECTOR OF PUBLIC PROPERTIES/BUILDING COMMISSIONER Date: L- - 2- R 2-0 2 0 Dear: �\ • 1 L •,., Ll g 1� B 1 C Re: { �l N t 0 Src�(� 4 Your application is being returned to you,without processing,for one(1)or more of the following Reasons: 5'T No approval from the Condo Association (letter needs to be provided with the application). Needs an approval letter from the Salem Historical Association. Owner does not live on site. Needs proof of insurance (Worker's Comp.Affidavit) Not all paperwork needed was submitted with application. Needs copies of valid Massachusetts licenses pr'T'ETD L4 c-AE't%,3tT_ ��•c.. 0'ho �e odc. f ra me Signature missing r� O 4 i ccjjso T-L Check not included (payment needs to be included with application). td g 6LV Other reason: �1=�a )_a� +�C,0 N)� Z—At t O(2-S. V Q h1 *(idT c+a tE--p S"ts-t,--C" y N b T" Q 11 C. -u D tsD _ This office will no longer hold applications while we wait to get missing information from you and/or your clients. Sinc y, Thomas J.St. Pierre ✓c Building Commissioner& Zoning Officer,City of Salem MA I _ Lawrence Hildebrand LLC Quality Rooring 30 Sheridan Street Woburn,Ma 01801 City of Salem Building Department 98 Washington Street 2"d Floor Salem, Ma 01970