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76 BRIDGE STREET - BUILDING JACKET 76 BRIDGE STREET r L: MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800, Ma Only(800) 392-6108, Fax (617) 557-5675 03/26/01 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139 Sec.313 SALEM BUILDING COMMISSIONER SALEM CITY HALL SALEM MA 01970 c Re: Insured: 76 BRIDGE MCT, SAL & JUDITH VILLAR Property Address: 76 BRIDGE ST, SALEM, MA 01970 Policy Number: 0618161 Type Loss: Theft Date of Loss: 01 18523 Claim Number: 185232 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, chapter 139 Section 3 B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. MPIUA Claims Division CMA00021 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617) 723-3800, Ma Only (800) 392-6108, Fax (617) 557-5675 04/19/01 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws Ch. 139, Sec.313 SALEM BUILDING COMMISSIONER f O� SALEM CITY HALL n f SALEM MA 01970 Re: insured: -NESTOR MGKiNNEY & JuDITH VILLAR Property Address: 76 BRIDGE ST, SALEM, MA 01970 Policy Number: 0618161 Type Loss: Windstorm Date of Loss: 03/23/01 Claim Number: 186048 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws Chapter 143 Section 6 to be applicable. If any notice under Massachusetts General Laws, chapter 139 Section 3 B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. MPIUA Claims Division y 7Zs� CMA00021 r -� S�� � :e�`�° � � ��c� -�� � ��� Business Certificate City of 6aiem, Alassactugetts OYOU R UO �11f��tt DATE FILED o U Type: New Expiration Date 0 Renewal, no change Number �Uo r/ 0 Renewal with change In conformity with the provisions of Chapter one hundred and ten, Section five of the Massachusetts General Laws, as amended, the undersigned hereby declare(s) that a business is conducted under the title of: at Tel .# — type of business by the following named person(s): (Include corporate name and title if corporate officer) /�( Fu Name t j/ R side # n (, Tel C�be ,G11� te)f S -l-s� na, re ----------- --------- ----------------------------------------------------- ------- ----- -----------------,---- ,- - - - - --------------------------------------------*----- on --�� Uthe above named person(s) pemonail a eared before me and made. an oath thai the foregoing ss{tatem'ent is true. -- -- � _eLf -- ------ ---------------------------------- ----------------------------------------------------- CITY CLERK Notary public (seal) Date Commission Expires Identification presented r ry State Tax I.D. # S.S. (if available) In accordance with the provision of Chapter 337 of the Acts of 1985 and Chapter 110, Section 5,of Mass. General Laws, business certificates shall be in effect for four(4) years from the date of issue and shall be renewed each four vears thereafter. A statement under oath must be filed with the town clerk upon discontinuing,retiring, or withdrawing from such business or partnership. Copies of such certificates shall be available at the address at which such business is conducted and shall be furnished on request during regular business hours to any person who has purchased goods or services from such business. Violations are subject to a fine of not more than three hundred dollars (5300.00) for each month durine which such violation continues. �Q Titg of #a1Em, Massar4usPtts Public Propertg Department Nuilbing flepartment (Out dalem (6recn 508-745-9595 Ext. 380 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer 02/03/94 Dear Property Owner: The following notice is in regard to your property located at: 76 Bridge Street, Salem, Mass. It is your responsibility to have snow and ice removed from your sidewalk within six (6) hours after the snow ceases to fall. Failure to do so will result in a fine being posed on your property. Please contact this office upon receipt of this letter as to your course of action. 1 i Leo E. Tremblay %� Director of Public Yr erty (�itg of t*ttlem, Mttosac4uoetto Ilublic Propertg Bepartment Guilbing Department (Put Belem Orem 588-745-9595 Ext. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer November 15, 1993 Timothy Kelly 76 Bridge St. Salem, MA 01970 RE: 76 Bridge St. Dear Mr. Kelly: Please be advised that it is a violation of the City of Salem Zoning Ordinance to have more than three unrelated persons living in one apartment, it is also unlawful to have continuous overnight guests. This office has received numerous complaints regarding on-going activities at this address. I have contacted the owners and they have guaranteed to cooperate with this office to rectify any and all alleged violations. Should they fail to control this apartment building I will be forced to take the appropriate legal action. I thank you for your anticipated cooperation in this matter. Sincerely, Leo E. Tremblay Zoning Enforcemen fficer Inspector of Buildings LET:bms cc: Councillor Harvey, Ward 2 \76brdg3\ l� �/ �� �� �� � � , , y \?� I �,I � �� � . � � i �� 1 � J � � � u 'ra, 3 � �' ' III I ti ` � � � '' � �a '^�R CV C I I I. � �� � � � IIS ISI f � � I � � �� � I � i -� � � � 'i SII '' '� � I ' ' I , , s r . J IY + t 1 � d L ' \ \ � , SENDER: I also wish to receive the Complete items 1 and/or 2 for additional services. • Complete items 3,and 4a s b. following services(for an extra fee): • Print your name and address on the reverse of this form se that\M can return this card to you. 1. ❑ Addressee's Address • Attach this farm to the front of the mailpiece,or on the back if space does not permit. • Write'Return Receipt Requested'on the mailpiece below the article number, 2. ❑ Restricted Delivery • The Return Receipt Fee will provide you the signature of the person delivered to and the date of delivery. Consult postmaster for fee. 3.Article Addressed to: 4a.Article Number tlaria G atellaa 8011 P 921 991 566 12 WJ10 Fond 4b.Service Type Jarblii*ai HA 01945 M CERTIFIED Milt 76 BridCe St. , Salah ` 7� t a y 5.Sign re Addy V 8.Add r s 's Address (C '<{ (ONLY 2if quested and fee paid.) ignatur (Agent) lalJ� �e bf PS Form 3811,November 1990 STIC RETURN RECEIPT United States Postal Service F-ESS ES Official Business3 \J PENALTY FOR PRIVATE USE,$300 Illuuulll1luluN1Ilu1ull1luiloil IIII III III INSPECTOR OF BUILDINGS ONE SALEM GREEN SALEM MA 01970-3724 i p� ARTICLE 2 P 921 991 566 UNE,. Maria & Stelios Belesis NUMBER 12 Lu@ia Road Marblehead, MA 01945 RE: 76 Bridge St. , Salem it FOLD AT PERFORATION* PIPWALZ INSERT IN STANDARD#10 WINDOW ENVELOPE. , E E Y T I F I E D M A I L E N�,,, °- Titu of #Ulcm, Massar4usPtts Public PrnpertV Department Nuilbing Department (!One Oulem (6rem C D 509.745-9595 E". 390 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer ! c�`✓y October 7, 1993 Maria & Stelios Belesis 12 Lucia Road Marblehead, MA 01945 RE: 76 Bridge St. , Salem Dear Mr. & Mrs. Belesis: I appreciate your prompt response to my letter of September 14, 1993 with regards to alleged violations at the above referenced property. / However, you assured me over the phone that you were not in violation of the City of Salem Zoning Ordinance and that you would forward a list of names of the tenants residing at 76 Bridge St. , Salem. To date, no such list has been received. Please forward said list to me as soon as possible so we may put this matter to rest, failure to do so will force me to take appropriate legal action and 1 am sure that neither one of us wants this to happen. I am anticipating you prompt and courteous response to this request. Sincerely, b Leo E. Tremblay Zoning Enforcement Officer LET:bms cc: councillor Harvey, Ward 2 Certified Mail #P 921 991 566 \76brdg2\ SENDER: I also wish to receive the Complete items 1 and/or 2 for additional services. • Complete items 3,and 4a a o following services(for an extra fee): • Print your name and address on the reverse of tkk!form so that we can return this card to you 1. ❑ Addressee's Address • Auden this form tb.the'lront M'the mailpieoe,or on the back if space does not permit. • Write'Return Receipt Requestedon the mailpiece below the article number. 2. ❑ Restricted Delivery • The Return Receipt Fee will provide you the signature of the person delivered to and the Consult postmaster for fee. di so di 3.Article dressed to: •�6w• 4a.Article Number flaraTz &T.Steiloi Bei,>sia P 921 991 533 12 Lucia Road 41b.Service Type flarblehend, IIA 019il PE: 76 Brii St., 55k6a CERTIFIED 7.Date of Delivery SEPI EnI C 1RR.' 5.Signa ( essee) 8.Addressee%Address_, . . / (ONLY if requested and fee paid.) PS Form 3811,November 1990 DOMESTIC RETURN RECEIPT United States Postal Service Official Business PENALTY FOR PRIVATE . USE,$300 IIL.r.rJlldrrL�rIII,�rr�IlrL„Ir,I,IrIrrlLrJl INSPECTOR OF BUILDINGS ONE SALEM GREEN SALEM MA 01970-3724 Aa9 i .x.00 ARTICLE �.Ot7 r _ P 921 991 533 LINE 1. Maria &OStelios Belesis .. NUMBER 12 Lucia Road j'MarbleheadA MA 0t� RE: 76 Bridge,St., Se t FOLD AT.PERFORATION t �+ WALZ INSERT IN STANDARD#10 WINDOW ENVELOPE. , ( E R 11 F I E A M A I L S A'W of 0$ttlEtn' massar4usetts t1ublic Propertp Department +Nuilbing Bepartment 09ne Ooalem l&reen 508-745-9595 $xt. 300 Leo E. Tremblay Director of Public Property Inspector of Building Zoning Enforcement Officer September 14, 1993 Maria & Stelios Belesis 12 Lucia Road Marblehead, MA 01945 RE: 76 Bridge St. , Salem Dear Mr. & Mrs. Belesis: This office is in receipt of complaints regarding an alleged violation of the City of Salem Zoning Ordinance Section 2-2 at the above referenced property. Section 2-2 of the Ordinance defines family as one (1) or more persons occupying a dwelling unit and living together as a single nonprofit housekeeping unit; provided that a group of three (3) or more persons who are not within some degree of kinship shall not be deemed to constitute a family. You are not allowed any more than three (3) unrelated persons in one dwelling unit. You are hereby requested to contact this office within five (5) days of receipt of this notice to advise us of the current status of this property and your intent in this matter. I thank you in advance for your anticipated courtesy and prompt attention in this matter. Sincerely, Leo E. Tremblay Zoning Enforcement Officer } LET:bms cc: Councillor Harvey, Ward 2 Certified Mail PrP 921 991 533 \76brdg\ 4� CITY OF SALEM HEALTH DEPARTMENT OFFICE OF THE BOARD OF HEALTH Salem, Massachusetts 01970 ROBERT E.BLENKHORN,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740.9705 January 26, 1994 Peter Belesis 12 Lucia Road Marblehead, MA 01945 Dear Sir: In accordance with Chapter III, Sections 127A an 127B, of the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chapter II: Minimum Standards of Fitness for Human Habitation, an inspection was made of your property at 76 Bridge Street,Apt. I Salem, Massachusetts conducted by Virginia Moustakis, Sanitarian of the Salem Health Department, on January 25, 1994. An inspection of the dwelling unit at the above address has revealed that it does not comply with the Massachusetts State Sanitary Code Chapter II: Minimum Standards of Fitness for Human Habitation. Therefore, a Certificate of Fitness cannot be granted from the Code Enforcement Division of the Salem Health Department and the unit may not be rented or occupied until the noted violations have been corrected and a reinspection has been made. VIOLATIONS: SEE ENCLOSURE: ONE OR MORE OF THE NOTED VIOLATIONS MAY ENDANGER OR MATERIALLY IMPAIR THE HEALTH, SAFETY AND WELL-BEING OF THE OCCUPANTS. Failure on your part to comply within the time specified will result in a complaint being sought against you in Salem District Court. Please note that some of the necessary repairs may require permits from the Building, Plumbing, Electrical, Fire or other City Departments. These must be obtained before the work is commenced. Should you be aggrieved by this Order,you have the right to request a hearing before the Board of Health. A request for said hearing must be received in writing in the office of the Board of Health within seven (7)days of receipt of this Order. At said hearing, you will be given an opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You maybe represented by an attoreny. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection or investigation reports, Orders and other documentary information in the posession of this Board, and that any adverse party has the right to be present at the hearing. Please be advised that the conditions noted may enable the occupant(s)to use one or more of the statutory remedies available to them as outlined in the enclosed inspection report form. SALEM HEALTH DEPARTMENT ( ; 9 North Street Salem,MA 01970 trv1� 410.810: Access for Repairs and Alterations Every occupant of a dwelling,dwelling unit,or rooming unit shall give the owner thereof, or his agent or employees, upon reasonable notice, reasonable access, if possible by appointment,to the dwelling, dwelling unit, or rooming unit for the purpose of making such repairs or alterations as are necessary to effect compliance with the provisions of these minimum standards. FOR THE BOARD OF HEALTH REPLY TO ROBERT E. BLENKHORN, C.H.O. VIRGINIA MOUSTAKIS HEALTH AGENT SANITARIAN CERTIFIED MAIL P 871581459 Este es un documento legal importante. Puede que afecte sus derechos. cc: Fire Prevention John Jennings, Building Inspector Enclosure bye SALEM HEALTH DEPARTMENT 9 North Street e ,. Salem, MA 01970 Enclosure 76 Bridge Street Salem, MA 01970 BACK HALLWAY Main entry door to outside has gap at threshhold and no door handle or lock. Window does not meet to lock or fit properly and is not weathertight. Back door to apartment is broken and must be replaced with appropriate weather tight door to primary operating locking device. MIDDLE BEDROOM No cover plates on electrical outlets. No smoke detectors on ceiling as mandated. FRONTBEDROOM No ceiling light fixture and wiring is exposed. No smoke detector. Holes in floor around pipes. Closet door does not have operating door knob. LIVING ROOM Door missing operating locking device. REAR BEDROOM Baseboard heating unit is in disrepair and must be restored to original condition. Electrical wall outlet is missing cover plate. BATHROOM Ceiling is in disrepair. Grouting around tub and sink is cracked and stained. Toilet handle is broken and must be replaced. If this medicine cabinet is to be used, the light bulbs must have protective cover. BACK HALLWAY No hand rail between Ist and 2nd floor. No smoke detectors on either floor. FRONT HALLWAY No operating smoke detector. Cellar stairwell is missing handrail. Door to cellar does not close. There is no smoke detector on the ceiling directly above the last stairtread into cellar. Miscellaneous items and debris. • NOTE: YOU MUST CONTACT FIRE PREVENTION AT 745-7777 FOR INFORMATION REGARDING TYPE AND MANDATED LOCATIONS OF ALL SMOKE DETECTORS. Please note: The matter of the cooking stove appearing to be somewhat in a passageway between the rooms is being referred to the Building Department. Contact Mr. John Jennings at 745-9595 Extension 389 to arrange for his inspection. ..ob-wV bt . SALEM HEALTH DEPARTMENT r�,yy 9 North Street Salem. MA 01970 Our records indicate that you did not obtain a Certificate of Fitness prior to renting to the tenants that just vacated. This is creating a violation of Chapter II of the State Sanitary Code and Article XIII of the City of Salem Code of Ordinances. BE ADVISED THAT THIS APARTMENT CANNOT BE RENTED UNTIL ALL VIOLATIONS CITED HAVE BEEN CORRECTED. I Tt t Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 311 Tot Building Commissioner or Board of Health or Inspector of Buildings Board of Selectmen - Town of Salem ) ( Town of Salem addresses Salem, MA 01970 ) ( Salem, MA 01970 1 1 REt Insured: Stelios & Maria Belesis Property address: r-76'BdQ--Tria St eet A Salem, MA Policy No. H3f7-90012 Loss of 7/17/92 19 File or Claim Not WAP14657 Water Claim has been made involving loss, damage or destruction of the above-enptioned property, which may either exceed $1,000.00 or cause MASS. GEN. LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASS. GEN. LAWS, CH. 139, SEC. 39 in appropriate please direct it to the attention of the writer and include n reference to the captioned insured, location, policy number, date of loss and claim or file number. Adjuster Titles On this dote, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. PATRICK J. DONOVAN ASSOCIATES, INC. tof - 7/30/92 P.O. BOX 110 Signature and,dale WAKEFIELD, MA 01880 Speed Lettere 44-902 Speed Letter., To From v Subject 9 L 10 FOOD MESSAGf D a t e S i g n e REPLY Date Signed WilsonJones �4AYL I ME FORM 44-W?3 PAR REC',IPIF�t�--RFTAtr4VVHITECOP'i 1%3-PRINTED INV 5 Ll P.I 1184 it of "`�afinn, tt �zrZTn yet# f a a �!�Ltblic �rnpEr#� �s��rtlneltt °"<c'�;n 'tloat. ��uillilc� �L�pMrtmenf . ;4u(in i1. �laturrs One adrm (6rern 741-11213 - August 30, 1978 Mr. & Mrs. Stelios Belesis 4 Lathrop Street Salem, Massachusetts 01970 RE: 76 Bridge Street Salem, Massachusetts 01970 Bear Mr. & Mrs. Belesis: Please be advised that this Office is in receipt of a complaint in regards to your property located at 76 Bridge Street. The complaint is in regards to a possible zoning violation at that address. Please contact this Office within seven (7) days of receipt of this letter. Your failure to respond will result in further action being taken by this Department and the City of Salem. Very truly yours, JOHN B. POWERS Zoning Enforcement Officer JBP/mlr Certified Mail #945329 1ph AO to 71rs-V7b Paul & Ann LaBonte 78 Bridge Street 6U�1-0044 �E�'T Salem, Mass . 01970 August 28, 1978 Dear Sir, This letter co qeag the house at 76 Bridge Street. Y flf SAIEW'NASS. Last spring, or your office regarding repairs on the third floor. Your response was that the work being done was for the second. floor apartment (Q bedrooms & bath) . It is now being rented, out to some young men. My concern for this letter is that I was not notified. by my bank about a .permit for such apartment. I do not want to cause any problems between the landlord, and. ourselves, but he does, not understand. any english and. I have not other alternative but to inquire about it. The .problems we are having about this third, floor apartment is that the right of way driveway being used by us is being blocked so we have to wait until they move their car out of our way or if they move it.it is as if it is our fault that we have to use the driveway. Also, I have two small child.reh that play in the back of our yard. and. God forbid. any one of them is struck by their entrance into the driveway which is usually very fast without regard. to ?_ the children in the yard.. I would, appeeciate this matter looked. into before my children get hurt and. before the winter comes and only causes more problems with the driveway. 1Sincerely yours, J dv�ilt Ann LaBonte SENDER: Complete item, 1.2,and i. y 's Add your address in the "RETURN TO" space on 3 reverse. I. The following service is requested (check one). 8 F1 Show to whom and date delivered. .. .... ... Show to whom,date,and address of delivery, ._¢ RESTRICTED DELIVERY Show to whom and date delivered. .... . . ... ¢ RESTRICTED DELIVERY. Show to whom,date,and address of delivery.ffi (CONSULT POSTMASTER FOR FEES) z 2. ARTICLE ADDRESSED TO: Mr, & Mrs. Stelios Belesis `z 4 Lathrop Street z Salem, Massachusetts 01970 In m 3. ARTICLE DESCRIPTION: REGISTERED NO. CERTIFIED NO. I INSURED NO. m 1945329 y (Always obtain signature of addresses or sgen0 zI have received the article described above. m SIGNATURE ❑ Addressm ❑ Authorizvd agent 2 2 C >4.mDATE OF DELIVERY o�3 '--POST"RK O A cs A 5. ADDRESS (Complete only it roque t Y ti =[ 6. UNABLE TO DELIVER BECAUSE: '�CLE K'S O �� e1NIT ALS D r GM:t9n�23<-337 UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS PENALTY FOR PRIVATE OSE TO AVOID POST GE, $300 ENT Print your name,address,and ZIP Code in the space below. OF POSTAGE, 5300 • Complete items 1, 2, and 3 an the reverse. • Moisten gummed ends and attach front of article U.&MAIL if space permits. Otherwise affix too beck article. • Endorse article "Return Receipt Requested" " adja cent to number. RETURN TO Mr. John B. Powers, Inspector of Buildings (Name of Sender) City Hall Annex, One Salem Green (Street or P.O. Box) Salem, Massachusetts 01970 (City, State, and ZIP Code) August 30, 1978 Mr. b Mrs. Stelioe Belesis 4 Lathrop Street Salem, Massachusetts 01970 RE: 76 Bridge Street Salem, Massachusetts 01970 Dear Mr. & Mrs. Belesis: Please be advised that this Office is in receipt of a complaint in regards to your property located at 76 Bridge Street. The complaint is in regards to a possible zoning violation at that address. please contact this Office within seven (7) days of receipt of this letter. Your failure to respond will result in further action being taken, by this Department and the City of Salem. Very truly yours, JOEIi B. PDMS Zoning Enforcement Officer JBplmlr Certified Mail ##945329 h hIitu of �,$atem, fflaosar4usdts Public PropertU PepttrtmPnt GI.MEu ftrttaxtat 7. Salem Green 745-11213 November 3, 1976 Ms. .Ann LaBonte 78 Bridge Street Salem, MA 01970 RE: T Bridge Street, Salem Dear Ms. LaBonte , In response 'to your complaint an inspection of the property located at 76 Bridge Street was made by this department on November 2 , 1976• The building materials observed by you are to be used on the third floor as an additional bedroom and bath for the second floor apartment the owner has been advised to obtain the necessary permits before commencing the work. In addition a permit has been issued by this department for re-roofing. Sincerely, John B. Powers - Inspector of Buildings. JBP:cc copies : files - ---- -- ----- �8- - - -- -- � '� i �-n�--rv"j-- ---- - - -- _ _ - - - -- - - - ��- - _,� , ,Q- _�� .__ Q.� . - _ , _ C 1 j I i i I I I I 1 j I I I I I I i i I i i i I I i I I _r I 1 � ...J`*'. � � �� � �G c'i � �p r �'` c-' �� o�'r� � O 4 � s� F,�cO ��� N y0. `� CITY OF SALEM NEIGHBORHOOD IMPROVEMENT TASK FORCE REFERRAL FORM Date: Address: e Complaint: r7 14 oe 4 e- LI ;3, 1- j e�Z, Cq c Complainant: 41y Ph'one#: Address of Complainant: DAVID SHEA, CHAIRMAN KEVIN HARVEY -BUILDING INSPECTOR ELECTRICAL DEPARTMENT tz FIRE PREVENTION CITY SOLICITOR HEALTH DEPARTMENT SALEM HOUSING AUTHORITY ANIMAL CONTROL POLICE DEPARIMENT PLANNING DEPARTMENT ASSESSOR TREASURER/COLLECTOR DPW WARD COUNCILLOR DAN GEARY SHADE TREE PLEASE CHECK THE ABOVE REFERENCED COMPLAINT AND RESPOND TO DAVE SHEA WITHIN ONE WEEK. THANK YOU FOR YOUR ASSISTANCE. 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CeL4- _"&L- Jho`TorcVCoIS � (J nr t3IKEs .��s-c,. p�-/tppe_ .� a,a.�. .2mu�,�a.. �u-c--. �/�--°-c.�"e_ .��•-acs-�/�/tr�..a�=a-L:'.t�t.Q.c"Q�- � t-LhLG.{L_g.t/ G0.-t�.,fz.. ;tic r_�,s'L-(V.� �•FptL(y/" tt Ul+u..e� t�.•aL�s<..-1 .{ t .�Lt.£-Lr.a cz�.-:!4._ �Y/J�',{�7rcr� .. J 22tt,Lc a MLeL.a_ /ht c+2 r U2� G<. 1 L3 Lc C2 t0. ... '2t. /t1,"a....e_kk— O-Lt2 ,&.0_ (. .), La Q-Gc G.s, �c st�L,z B-uA- �1 t`- ��A..,[_y //Q t/I.�QI � -.U.•2.G/.7� I �e.-iA7L�O..?h.d� �pL��EtiO'Ql�L.���',✓--0'� �-� a et .J ".t'ar'va.•.. .�5"Q'A•f',u-� D'� -.La ., �'l:.e!f tt Gt S� G.[+T1L..r �r.t C.Gf_) ,�`�i,L•- LL?2.G.2t.C-Ccft�7/,,,�^' !G.•,/1.4'-ct���tt.,C_R..o"._ , ,+ L� (/" _ / eec-t.a1 Clf _ p l g A 6 ) _-fL1�A�/14c.n aC /LQ.f� '�) �iLLC�Ii" "" !�s✓rc�c".L�-„�"-��C'•�7L.F..i,....24 �(f-P_,.�y7 s d— p = fln.v-rrt�r c tr R r�LT. f 1"T9E f 04AD APPROVED BY 774E NAPFC=PWR TD- PERMIT BEING GRANTED CITY OF_SALEM Nok -u� . Date ward z«+w DftM Is PMPWty Located in Location of dro Hidoric District? Yes—No Building -7 Co E ST Is Pic"iy Located In Bn ConwrA Ion Ann? Yes No Permit to: BUILDING PERMIT APPLICATION FOR: (Circle whichever apply) R , Reroof, Install Siding, Construct Dedc, Shed, Pool, Repair/Replace, Other: PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: ' '• The undersigned hereby applies for a permit to build accortLig.to the.following specifications: t Owner's Name o h+ �l t LL.4R Address & Phone Ce Architect's Name Address & Phone Mechanics Name Address & Phone 2jLf S G-2E�t aw o vp �3—i (4-7g i S19 9-C�(L °2CE S1 2,AAA- Otcecr WIW b ata quposa of �� � D RN'r1.4 t_ Lamm of buildlnp? A 5R Eta.L:r- M a dwaft ,for how Wy fambss? I WN t ukkq cordam to 'W'7 NC'L�s ASOastos? Ellwal d cod (a.2 Clty License Ir steer License r Lie. It3 Signaturo of Applica I SIGNED UNDER THE PENALTY, OF PERJURY DESCRIPTION OF WORK TO BE DONE I I SCR S-irL�P ? Moor MAIL PERMIT TO: BUNROEUN CHHOUY HOME DEPOT a4 COBURN RD. jI TYNOSBORO,MA. 01879. 19--7(? APPLICATION FOR PEfM/T TO LOCATION PERMIT GRANTED 19 APPROVFD INSPECTOA OF BUILDINGS / The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SA Mar Revised Mar 2011 Building Permit Application To Construct, Repair,Renovate Or Demolish a One-or Two-Family Dwe 'ng This Section For O cial Use Only Building Permit Number: D Appfed: ' Building Official(Print Name) Signature 1z Date SECTION 1:SITE INFORMATION 1.1 Psp rt:edr ssa� / 1.2 Assessors Map&Parcel Numbers L l a Is this an accepte street?yes v no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq It) Frontage(11) 1.5 Building Setbacks(it) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Public❑ Private❑ Check if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' N a of e ��' Name(P ' t) City,State,ZI No.and Street Telephone Email Address SECTION 3:DESCRIPTION,OF F PROPOSED WORK2(check all that apply) New Construction❑ Existing Building Owner-Occupied ❑ Repairs(s) ❑ A ration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other p,city: /�7 Brief Description of Proposed Wor ?: VI& ew —05 SECTION 4:ESTIMATED 06NSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ Q t7 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cose(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: S.Mechanical (Fire $ Su ression Total All Fees:$ Check No. Check Amount: 'Cash Amount: 6.Total Project Cost: $ 141 Q 0 0 ❑Paid in Full r❑�Outstlanding Balance Due: /� ApArle SECTION 5: CONSTRUCTION SERVICES 5.1 Cons" ction Supervisor Li rise(CSL) D ZO/3 icense N� xpiration Date Name of CSL Holder , _ / List CSL Type(see below)_ /,/__ No.and St Type Description tr 1 U Unrestricted(Buildings up to 35,000 cu.ft. �C R Restricted I&2 Family Dwelling Ci /Town, IP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 RegW' eyed Home Im r ement Contractor(HIC) Zl /' /- u !� Z.J HIC Registration Number Expiration Date HIC Comp y Name r HICReps>fit Name a � / e ✓J n'J,r ay/� /[�. Email address Ci'/Town,State, 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 th building permit. Signed Affidavit Attached? Yes ........... No...........Cl SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING ERMIT I,as Owner of the subject property,hereby authorize to act on my behay,in al matters r l4bve to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNERi 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 applic 3 iiis true!=othe best of my knowledge understanding. PRR;MMer's or orized Agent's ame(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.eov/oca Information on the Construction Supervisor License can be found at www.mass. og v/dos 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,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"maybe substituted for"Total Project Cost" Z�e .000 . e kf y y11 uti o yy . ,fSrlSrl. ,;h 7�« j "., =eNi' JF .tt'tiG n;'•y i s.hS -,gsr,N ;sif(,�t8 ns r�. . yl1�« Sri :. 'ltlr« r.:!3i1➢I I I° .��4ir .ti'... . . y ay. .. ;),r tt.. ryvh.F '.rd,� iEt',R��q a9+,1 .: , - t'zlirl.: . -. «kt .'nt; �'`!��• � ,. lz -Fqs r�:r6..,,b ei•1 . 7vF s3L1:,'vi 1'•'4 ::ic'26G!^' .'e^rsytidx:F '9: CY �'.Ai4 N14�::Ax;"! pc,n� rW.^+.i«IA'.?F. i a i}'.(' r,iy`Q1� =? +M1x! ript`! ' ... . .. ,;:.,... .. .,...:.,.... ., •.,:r.w .. .:.._._ ....,. .. ....,_...,.,..,-... .. ,_ ..., Awl 1SR1Ny4'11 .: i i d'r;-,• Mir ".4t##�1` • ( 7 {hl�j. ;,l 3lt.;z•:". (Fft..... -'1( ,51:)tF'/kilvriN'••'`{C5i 444�n � r QWW §e!j A 7ef C7 ._ N o ... :. a�M UIL \ 1 U z-. - � a- a + DATE: IO O I O S.' 4 Cit p of arQm, �aS�aL�U�Ett� PLANS MUST BE FILED AND APPROVED BY THE INSPECTOR PRIOR TO A PERMIT BEING GRANTED Location of Building 76 6R,be£ T Building Permit Application For: '(Circle whichever applies) Roof,Reroof, Install Siding, Construct Deck, Shed, Pool Addition. Alteration, Repair/Replace,Foundation Only, Wrecking Other. ' 7-.4�!izMA.0— 0 t/.� PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING To the Inspector of Buildings: The undersigned hereby applies for aI permit to build according to the following specifications: Owners Name: V) �(,� {�' Contractor: Street 7b AGE city,]t6ler-, street city State. mG Phone (9 A yl-ll'aoleC/ State Phone Architect: City of Salem Lici[ Street City State Uc/!_��HIP O State - Phone ( ) Homeowners Exempt Form _yes no Structure: (please circle) Single Family, Multi Family N Other 6 i/j Estimated Cost of job S 7 7 / Will building confirm to law?_yes no Asbestos?_yes✓o —� Description of work to be done: II ,Z Drawings obitted:_yes no Mail Permit to: X Signature f Application,S NED UNDER THE PENALTY OF PERJURY ;w CONSTRUCTION TO BU,OMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE Department use only: Perini(% Zoning Map/I of T Permit fee S COW EMS: