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35 CEDAR ST - BUILDING INSPECTION 9lfPSidliiSi 9Ef}LfD�ddD 11P?ROVED BY T44E IAISJ'}F.L7L i 1D13 7p PEAI IT BEIr NO GRANTED CITY OF SA"LEM No. 00' Dale Cf 3 M Is Property Located In Location of /�nn A the Historic District? Yes_No Building a!; CDdO P Si Is Property Located In the Conservation Area? Yes_No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) R Reroof, Install Siding, Construct Deck, Shed, Pool, epair eplace, Other:Siding, S PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's Name C O HN Address & Phone ' t IA- i Architect's Name Address & Phone 1 1 Mechanics Name s Address & Phone L What is the purpose of building? RehTsiL fi+ra�7MZ&J 7S 2 Material of building? If a dwelling, for how many families? 3 , yCS S�c�A WIII building conform to law?_T Asbestos? � tulle/ Esfimated cost n O-City license K N A State license a ZOOk( Home Improvement v l� ZOO ' ` / EG 8igrVature of Applicant 7_I Le I SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE l;eety' z chi /- 01 �iia,�hgs ucQ 6A �s rgadis as 1wP_e2a1j �n (�Y' An/L�nPO. /17o/rllivr/i MAIL PERMIT TO: Un I-Im el4sr=�/ or �-la di97d No c.pAtOS, 00 v pl iZ' APPLICATION FOR PERMIT TO LOCATIOfJ: PERMIT GRANTED • I 7 ! a 03 APPROVED �le� � INSPECTOR OF BUILDINGS 0035 CEDAR STREET 140-2004 saaz COMMONWEALTH OF MASSACHUSETTS Map: 34 CITY OF SALEM Block: — Lot: 0053 Caren: REREPAng BUILDING PERMIT Category: :. PAIR/REPLACE Permit# 140-2004 Project JS-2004-0237 Est Cost: 1$2,000.00 Fee: $20.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: _ jContractor: License: ;Use Group: I R. Konarski Construction Home Improvement Contractor- 138089 'Lot Size(sq. ft.): 14200 (Owner: CASEY JOHN H Zoning: R2 Applicant: CASEY JOHN H tl Units Gained: ;AT: 0035 CEDAR STREET Units Lost: :, ISSUED ON. 13-Aug-2003 AMMENDED ON: EXPIRES ON: 31-Jan-2043 TO PERFORM THE FOLLOWING WORK: 140-2004 REPAIR WORK ON ESTERIOR PORCHES, RAILINGS& BALISTRADES AND DECKING. FRD POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Buildin Underground: Underground: Underground: Excavation: Service: Meter: Footings: Rough: Rough: - Rough: Foundation: Final: Final: Final: Rough Frame: Fireplace/Chimney: D.P.W. Fire Health Insulation: Meter: Oil: Final: House# Smoke: Water: Alarm: Treasury: Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2004-000251 30-Jul-03 7761 $20.00 GeaTMS®2003 Des Lauriers Municipal Solutions,Inc. (fOrnmonumaUh of M6.iackwaht JePdrlrrsa,sl OJ9r�r,lriaf ,4 C c.1 rij i 600 WUny"Sireal nn games J.Camooea i A.., /!/aasaahuaai4 02111 Corrmrssroaa Workers' Compensation Insurance Affidavit f tia...ger.it.e) wich.a principal place of business at: ab' F1zlz6-sie7L Stg of r Qr�i�6 ' Kiwis warah) do hereby certify under the pairs and penalties of ptdiry, that: 1 am an employer providing workers' compensation coverage for my employees working on this job. // // e JU CPS /// lssae- See ISTIC�e�. Insurance Company Policy Number I am a sole proprietor and have no one working for me in any capacity. () 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Polity Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number O 1 am a homeowner performing all the work myself. I vndentand mat,copy of this sute t WE be ion aroed to the Orke el Imestieaoons of the DIA IM co.erate.eri8neion and spat Wure to tewre coveratr at rePaaeo under Section 2SA of MGL 1 52 can lead to the:noortion of crvrinat oenartes corweint of a fine of do toi 1.50000 and/or one years'imwworrnedt x Kra as citi xnaiacs in the loan at a STOP WORK ORDER 3no//a fine of S 100.00 a on aPirat ne. Signed this . 30�11 day of tJCe /y_ d 4 4 3 Li ense /Permittee Building Department Licensing Board Selectmen Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 517-727-4900 X403, 404, 405, 409, 375 m: marym At:John J Walsh Ins To: Fax*:(978)745-4827 Date:7,130/03 04:14 PM Page 2&3 ACORD_ - CERTIFICATE OF LIABILITY INSURANCE CS R Ml4 DATE iMWDDIYY, 9KONA02 07130/03 rea°uccR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE John J Walsh Ins Agency, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P 0 Sox 4407 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Salem MA 01970-6407 Phone: 978-745-3300 Fax: 978-745-9557 INSURERS AFFORDING COVERAGE INSURED INSURERA Lloyds NSURER a R Konarski Construction INSURER 28 Forrester Street wsuaeR o' Salem MA 01970 INSURER E'. COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAI D CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY DATE MNIXIY LIMITS GENERAL LIABILITY EACH OCCURRENCE �51000000 $ COMMERCIAL GENERAL UASLIIY IN ISSUE 07/30/02 0 Py 7/30/03 'REDAMAGE(Aamnrel 1, 100000 cLaNs w.DE ®OCCUR xEC EulAny ene person) '$5000 PERsoIwLxnevnaul�. E 1000000 DENERAI_AGGREaTE $1000000 GEN LACGP£GATEIIMBAPPLES DER'. PCTCUCTS-COMPAPaGG IE 1000000 —1 oRO. POLICY LOC AUTOMOBILE LABILITY CCW8INED3G0LE LINK E 4-AUTO E29RtlP01) A_LOV.MEUAUTOS BOrpDNLURf E SCHEDULED AUTOS (Per pelsc) -- --- HIREDALI NON ONNED ALTOS IPer SPC e¢R) PROPERTY DAMAGE �$ GARAGE LIABILITY AUTOONLY EAACCOENT 5 ANYAUTO OT-ER THAN EA ACT E AUTO ONLY. AGG $ EXCESS LIABILITY EACHOCCURRENCE $ OCCUR El CLAMS_ AGGREGATE $ $ DEDUCTIBLE 4 RETENTION EWORKER $ WC STAiLL OTH- C°MP ON MID EMPLOYERS'LIABILITY TDRY_OMIL$ ER _ EL EACH ACCIDHUT S E.L.WEASE-EAEMPLOYFE £ E1.DISEASE POLICYUMIT $ OTHER CoEnaercial Applica QUOTING 07/30/02 07/30/03 DESCRIOTION OF OPEMTMNSILOCATIONSNEHICLESRXCLUSIONS ADDED BY ENDORSEMENTRPECIAL PROVISIONS Carpentry renovations CERTIFICATE HOLDER N ADDITIONAL INSURED,INSURER LETTER: _ CANCELLATION 0001003 SHOULD MY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENCEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAhURE TO OD SO SHALL Salem Interiors 11 Flint Street IMPOSE NO OBLIGATION OR LIABILITY OF A14Y FIND UPON THE INSURER,ITS AGENTS OR .Sale1R MA 01970 REPRESENTATIVES. AUTHORISED REPRESENTATIVE John J. Walsh Ins. AqI Inc. ACORD 25•S(7/97) ©ACORD CORPORATION 1988 L