55 BUTLER STREET - BUILDING JACKET
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Lo
�a STREET PERMIT
Cftp of *arem
(Office of Nopector of jluilbino
Gi(-N.W( Sip l ZO ,
.`Permission is Siere6y yiuen to TDE.l..d>v,O S P (n c-)-T . V-) v o
!o occupyf°r �� r Z — D tel. 2D1`1 �Uf� S}� purposes
infronlofeslale 5 =, 2 Q f L_ F-XZ, cJT �d
ofsidema� ofslreel.
-7Srs permi!is lmiledlo QC-T. ppIT su6'ecl to ISie
provisions of lSe or�nances andslalules in re lion to c5freels andlSie.Jnspeclion
and Construction of-Zur/dinys in ISe G. of c$alem.
Direc/aro!'h6/ie cSalvice� //�.�'' J//,� 9nrpaelo�0l',:7fuilJinys
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Western Surety Company
LICENSE AND PERMIT BOND
KNIO '' ALL PERSONS BY THESE. PRESENTS: Bond No. -63 52537 -_
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That we, 55 i;utlai Street viC,
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State of vlassachuse v. a.. Principal
of .S�i�m o , 0
and WESTERN SURETY CMIPANY, a corporation duly licensed to do surety business in the State of
_Massachusetts __� , as Surety: are held and firml) bound unto the
city of Saiecn State of ,+ _3ach?, ett_�__,_,-„ as Obligee. in the penal
sum of One 'housand anci 00Z10G ___ - — - -- -- _ DOLLARS
lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made,
we bind ourselves and our legal representatives, firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas; the Principal has been
licensed 0unuster
by the Obligee.
NOW THEREFORE. if the Principal shall faithfully perform the duties and in all things comply
with the laws and ordinances, including all amendments thereto. pertaining to the license or permit
applied for, then this obligation to be void, otherwise to remain in full force and effect until
Sep<e neer 25th _2.01unless renewed by Continuation Certificate.
This bond may be terminated at any time by the Surety upon sending notice in writing. by First Class
U.S. .Y•lail, to the Obligee andtothe Principal at the address last known to the Surety, and at the expiration
of thirty-five'(35),days from the mailing of said notice. this bond shall ipso facto tern wite and the Surety
shall thereuponr.he-relieved from any liability for any acts or omissions of the Principal. sul?sequent, to said
date .,'Regardless,`of.the number of years this bond shall continue in force. the number of claims made
tg•tmst;this bend` and=the.. number of premiums which shall be payable or paid; the Surety's total limit of
lia6Iliiy shall not be cumulative from year to year or period to period, and in no event shall the Surety's total
d a:
liabilitn�;for all clann_�exceed the amount. =et. forth above. 1n�� revisipn of the bend aunuunt shall not, be
ulati>e.
P yi`
` Dated thin - 25-L _ dans of
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-- Principal
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W G S 'f I S [.i R E: `[5�PA N 1`
Paul T. 131. Flat. Vice President °
Form 532-t2-2015
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ACINOWLEDGMENf OF SURETY
STATE OF SOUTH DAKOTA j+ ss (CorporateOfficer)
COUNTY OF A4IVNEHAHA J
On this _.�25"i: . day of _ Se� ember 2Gi:c , before tire_the undersigned officer.
1
personally appeared �� _ Pau . t 3 u ]@t _,who acknowledged himself to be the aforesaid
officer of WESTERN,SURETY CONVANY. a co poratton. and that he as such officer, being authorized so to do. executed
the foregoing instrumentfor the purposes therein contained, by signing the nameof the corporation by hinrsolf as such
officer.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
}4YYh4554hh4hh4Yh4444hhhh�
f M. BENT $
1l/^�+^,�NOTARY PUBLIC .'"", f
SEL SOUTH DAKOTA $FAI. i Nom rr l'uhlis—$nodi Dakota
M4.5YY445hYYY4Yh445VYY4Y}
Jviv Commission Expires I4arch 2, 2020 ACKNOWLEDGMENT OF PRINCIPAL
(Individual or Partners)
STATE OF _ �,._.._.__._.. `;ss
COUNTY OF ._._ ...,.
On thisday of �. _ . before nre personally appeared
known to true to be the individual_,.,, described in anti who executed the foregoing instrument and acknowledged to me
That...._lie__ executed the same.
My commission expires
ACKNOWLGOGMENT OFPRINCIPAL
(Corporate Officer)
STATE 01"— ------ (>ss
COUNTY OF
On thus _ day of before nre personally appeared
who acknowledged himself,'herselfto be the
of _--- a corporation. and that he/she as
such officer being authorized so to do. executed the foregoing instrument for the purposes therein contained by signing
the name of the corporation by, himself/herself as such officer.
My commission expires
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a Western Surety Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and
authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado. Connecticut,
Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine,
Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey,
New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island. South Carolina.
South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United
States of America,does hereby make,constitute and appoint
_ Paui. i. Bruflat of ,_--_ .5ioux F—1s _
State ofS.outn._.Dakota its regularly elected V.yce Prasine:l.t �,
as Attorney-in-Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on
its behalf as Surety and as its act and deed,the following bond:
One
bond with bond number63362'037
for 55 Butler Street LLC ._..,....__
as Principal in the penalty amount not to exceed
Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company
duly adopted and now in force.to-wit:
Section 7. All bonds, policies, undertakings. Powers of Attorney, or other obligations of the corporation shall be executed in the corporate
name of the Company by the President, Secretary, any Assistant Secretary, Treasurer. or any Vice President, or by such other officers as the
Board of Directors may authorize. The President, any Vice President. Secretary. any Assistant Secretary, or the Treasurer may appoint
Attorneys-in-Fad or agents who shall have authority to issue bonds, policies,or undertakings in the name of the Company. The corporate seal is
not necessary for the validity of any bonds,policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any
such officer and the corporate seal may be printed by facsimile.
In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its
Vim ,i deft_-,. with the corporate seal affixed this __2 the day of
.,2017_ -
ATTEST WESTEENN URETCOMPANY
L.Nelson,Assistant Secretary Paul T 8ruflat,Vice President
t(Y
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STATE OF SOUTH DAKOTA ! #^
ss
COUNTY OF MINNEHAHA }
On this . „?64t6 day ofSe0-_ember before me, a Notary Public, personally appeared
Paul T. Bruflat and T__„, L. i\2=} =on
who,being by me duly sworn, acknowledged that they signed the above Power of Attorney as _.._—_ 'i;_e__?_sicienn=_^_,
and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the
voluntary act and deed of said Corporation.
X444444444444444444444444�
d J. MOHR s
? sEAu NOTARY PUBLIC
ias^Eni i
SOUTH DAKOTAir,
♦44444444444444444444444 Hy Co,RT ssion Exoires June 11, 2021 Notary Public
To validate bond authenticity,go to www.entisui-etN,.coni >Owner/Oblique Services>Validate Bond Coverage.
Form F1975-1-2016
Of!)O
CITY OF SALEM � t ire
BUILDING DEPARTMENT
Id k�b1 MAY 23 A 4�1
120 Washington Street, 3Floor, Salem, M 1970
ABANDONED AND FORCLOSED PROPERTIES REGISTRATION FORM
PROPERTY INFORMATION
Address: 55 Butler St, Salem, MA 01970 Parcel ID # 16-0096
Square Footage of Building: 21558 Number of Stories: 3
Sprinkler System: o❑(Operational yes/no) Unknown
Pipe System: YesV (Operational yes/no) unknown
Fire Detection System: es —1 yes/no) unknown
OWNER(S) *OF RECORD ('attach additional sheets I necessary)
Owner: Juan C Espinal Sr C/O Wells Fargo Bank, N.A. as Mortgage Loan Servicer
Address: 1 Home Campus, MAC N0012-01G, Des Moines, IA 50328
Tel. No.: (877) 617-5274 E-mail: codeviolations@wellsfargo.com
CONTACT PERSON/REGISTERED PROPERTY MANAGER
Name: Wells Fargo Bank, N.A.
Primary Address (No P.O. Box) 1 Home Campus, MAC N0012-01 G, Des Moines, IA 50328
Business Tel. #: (877) 617-5274 Non-Business Tel. #: (877) 617-5274
E-Mail address: codeviolations@wellsfargo.com
Emergency Telephone # - 24hr/day (877) 617-5274
IS THE PROPERTY LISTED FOR SALE? YesEINoR
If yes, Real Estate Agency N/A
Address: N/A Tel. No. N/A
VACANT BUILDING PLAN: Please check which applies.
1. The building is to be demolished.
2. The building is to remain vacant.
3. ✓ The building is to be returned to appropriate occupancy or use.
B^; � Brttani 0 Coleman.Research/ .D,gnany signed ey l9i o oaemnn
l.• Remetlia[ion Analyst L Wells Fargo Reeen�mw.me°'ends Anew i.wens
SIGNATURE OF AGENT: a.2017 sen,".A
Bemedfl A. Fegs'=N.A itis-.igasao
DATE: 05/04/2017
REGISTRATION FEE $300', $900.00 Cash/Money Order/Cert. Bank Check
-- -- ----
REGISTRATION:
All owners, including banks and mortgage companies, must register abandoned and/or
foreclosing residential and commercial properties with the Director of Inspectional
Services.
"All property registrations are valid for one year. An annual registration fee of three-
hundred ($300.00) dollars must accompany the registration form. The fee and
registration are valid for the calendar year, or remaining portion of the calendar year, in
which the registration was initially required. Subsequent registrations and fees are due
January 15`of each year and must certify whether the foreclosing and/or foreclosed
property remains abandoned or not.
Once the property is no longer abandoned or is sold, the owner must provide proof of
sale or written notice of occupancy to the Director of the Inspectional Services.
ENFORCEMENT & PENALTIES
Failure to initially register with the Director of Inspectional Services is punishable by a
fine of three hundred dollars ($300.00), each day being a separate offense.
Failure to maintain the property is punishable by a fine up to three hundred dollars
($300.00) for each month the property is not maintained.
MAINTENANCE REQUIREMENTS
Properties subject to this section must be maintained in accordance with all applicable
Sanitary Codes, Building Codes, and local regulations. The local owner or local.property
Management Company must inspect and maintain the property on a monthly basis for
the duration of the abandonment.
The property must contain a posting with the name and 24-hour contact phone number
of the local individual or property management company responsible for the
maintenance. This sign must be posted on the front of the property so it is clearly visible
from the street.
Adherence to this section does not relieve the property owner of any applicable
obligations set forth in Code regulations, Covenant Conditions and Restrictions andlor
Home owners Association rules and regulations
The complete Ordinance can be viewed on our website at:
http://salem.com/Pages/SalemMA Clerk/ordinances
W IN E CE OF T•i 00 UME�T H A 00_On�EO 9A`CK OLt yLWiA F'(�� VOi FxEAyT�URE�
HOME WELLS FARGO BANK NA 17'1
MOR.•1'�a•1�Gg WELLS FARGO BANK N 910
ESCROW DISE CLRNG/4W CHECK NO, MOtDAYtYR
FDM G09 UTIL-CM970 9018183344 I)$/12l2p17
P.O.Box 10335 0476043257 _
Des Moines,IA 50308-0335 1.800 234.6271
_
FOR PAYMENT OF STATUTORY, AMOUNTEXPENSES _ - $900.00
PAY TO CITY of SALEM
.THE ORDER 3RD FLOOR _
OF 120 WASHINGTON S7
-SALEM,MA.07970
Nine Hundred and 001100 Dollars AUTH7,�FIGNQIURE _
11.9018183344115 1:0910000191: 564639347911'
ORt6t Ai. UOEUM R£ LEFTY AT R O E B EK. H L AT A A L TO IEW WHEN G EKiN THE £N OR MEN .
Disbursement Check Voucher
PAYEE NAME CITY OF SALEM CHECK NUMBER: 9018183344
&ADDRESS 3RD FLOOR
120 WASHINGTON ST CHECK DATE: 0511212017
SALEM,MA 01970 PAYEE CODE: UTIL-CM970
BATCH: FDM PAGE 1 OF 1
SNORT NAME/
INITNAME/ TRAN AMOUNT
LOAN NUMBER PROPERTYADDRESS DESCRIPTION - CODE DATE DUE
0498643257 JC ESPINAL 55 BUTLER ST 632 900.00
Check Totals: 1 Item $900.00
CITY OF SALEM
,� fi/"�,CHEDULLEE OF DEPARTMENTAL PAYMENTS TO TREASURER /
Department Name 1 l I,_ _ OA�F4 Date�� 'f /
Department# � Fiscal Year Cqz 9/10 Form#
FROM WHOM ACCOUNT NUMBER&DESCRIPTION AMOUNT TOTAL
i966
— A�, kodld4b-
Total 9/10 Comprised of:
Cash:
Checks:
TOTAL DEPOSIT 6b
THE COMMONWEALTH OF MASSACHUSETTS,DEPARTMENT OF CORPORATIONS AND TAXATION,BUREAU OF ACCOUNTS
No. Lao 1 1� 20-1-2
To the Department Officer aking the Payment:
Received of t the sum of
�if� i� T 7'/�Gt�Gk CL Q h �AY Dollars,
for the collections from / ' CCL/?/ l / to for
collections as per schedule of this date,filed in my office.
Treasurer Treasurer
' ROL No:G 22]6D1Y30
CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
KIMBERLEY DRISCOLL
MAYOR
120 WASHINGiY)N S'IREE'f♦ SALEM,MASSAQ-I[.15E'ITS 01970
'nu.:978-745-9595 ♦PAx:978-740.9846
March 8, 2011
By fax to:
Jim Tracy @781-477-0220
To Whom it May Concern:
RE: 55 Butler Street, Salem
Copied below is a section from the Zoning Ordinance regarding rebuilding of non-
conforming structures in the event of a catastrophe.
3.3.7 Reconstruction after Catastrophe. Any nonconforming structure may be
reconstructed after a catastrophe in accordance with the following provisions:
1. Reconstruction of said premises shall commence within two years after such
catastrophe.
2. Building(s) as reconstructed shall be located on the same footprint as the original
nonconforming structure, and shall be only as great in volume or area as the original
nonconforming structure.
3. In the event that the proposed reconstruction would (a) cause the structure to exceed
the volume or area of the original nonconforming structure or (b) exceed applicable
requirements for yards, setback, and/or height, a special permit shall be required from
the Board of Appeals.
7
8�
Si r 1 �►
T oma cGrath
Assistant Building Inspector
cc: file
APPLICATION FOR APPLICATION NO.(COURT USE ONLY) PAGE
Trial Court of Massachusetts
CRIMINAL COMPLAINT of District Court Department
I;1he undersigned complainant, request that a criminal complaint issue against the accused charging the
offense(s)listed below. If the accused HAS NOT BEEN ARRESTED and the charges involve: - - Salem DlstrIct,,COUrt
❑ONLY MISDEMEANOR(S), I request a hearing ❑ WITHOUT NOTICE because of an imminent threat of 435 WaShIngtor Street
L1BODILY INJURY/6 COMMISSION OFA CRIME ElFLIGHTA WITH NOTICE to accused. 8u13m' MX 01970
❑ONE OR MORE FELONIES, I request a hearing ❑ WITHOUT NOTICE ❑ WITH NOTICE to accused.
ARREST STRATUS OF ACCUSED
❑WARRANT is requested because prosecutor represents that accused may not appear unless arrested. ❑ HAS r HAS NOT been arrested
NAME(FIRST MI LAST)AND ADDRESS BIRTH�OATV SOCIAL SECURITY NUMBER
/ PCF NO. MARITAL STATUS
DRIVERS LICENSE NO. STATE
GENDEJ HEIGHT WEIGHT EYES
:+tIn/!
HAIR RACE COMPLEXION SCARSIMARKS/TATTOOS BIRTH STATE OR COUNTRY DAY PHONE
EMPLg,YER/SCHOOL MOTHER'S MAIDEN NAME(FIRST MI LAST) FATHER'S NAME(FIRST MI LAST)
/t-tt�j�,.�✓ice .,
COMPLAINANT NAME.(FIRST MI LAST). COMPLAINANT TYPE PD
✓• S�` f 'f'Z '
El POLICE ❑ CITIZEN,40 OTHER f
ADDRESS h" v �� � PLACEOFOFFENSE) )
INCIDENT REPORT NO. OBTN
Jt l ry.• �•f/t �f ,.'1 `/() CITATION NO(S).
OFFENSE CODE > DES�RIPyyIIO�y: r .} r </ OFFENSE DATE
V1."/,� li,.^.v �: / �ti?� (r11 "✓ F:o,. �I✓, F ,;>. s .✓
t VARIABLES( g. victim name,controlled subst nce,".a and value of property other variable information;see Complaint Language Man 1)
�! ..� / ,�`.✓ ,/��,;� f l;,r. /'.r �' i ! :Jr . x, . � sem'•.,!/, . ,i ° ..a ��'"' ..� t`—
OFFENej f1 <'ft /�.•'C_14.J s"/ ts fav a� .J:
OFFENS�E:.DATE
/,/
7
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IP
2 VARABLES Z '
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/ f � G' 6/ /
<.oJ !. f/ef•st !.•L' /:? .✓ /C ' Z—
OFFENSE CODE DESCRIPTION OFFENSE DATE
3 VARIABLES
REMARKS COM?, IAN SSI} RDATEFI D
- '
COURT USE ONLY A HEARING UPON THIS COMPLAINT APPLICATION l j• W OF HEARING TIME OF HEARING OUR7 USE ONLY
WILL BE HELD AT THE ABOVE COURT ADDRESS ON J / Y AT E
DCCR-z(08/04) COMPLAINANT'S COPY/
CITY OF SALEM
i�
PUBLIC PROPERLY
DEPARTMENT '
I:IAIIII'Ji Lll1'DRI$f;f ry.l,
AYPH
120 AA �,i 1ING I ON ti i R1.111 * Sni A.+i A1AssAci iU,uTIS 0I970
�n Iid,:978-7-15-9595 ♦ 1 978-740-9846
REQUIRED INSPECTION 0®RP "PROPERTY LOCATION 55 BUTLER STREET
January 15, 2008
Juan Espinal
55 Butler Street
Salem, MA 01970
Dear Mr. Espinal;
The above referenced property has come to the attention of this department for the
following reason(s):
Multiple reports have come to this office from this neighborhood regarding
the existence of an illegal apartment at this address.
Under the provisions of 780 CMR, Section 115.6, State Building Code, access to this
property must be granted for the purposes of inspection. Please call this office upon
receipt of this letter to schedule this required inspection. If this property has rental units,
these tenants must be notified in advance of this inspection, so that access to these spaces
may also be accomplished.
This inspection must be completed on or before January 29, 2008; failure to respond to
this notification will be construed as non-compliance, and as such an Administrative
Search Warrant will besought, so as to allow the lawful inspection of this property.
If you have any further questions regarding this letter, please call this office at
(978) 745-9595, extension 5643.
Sincerely,
y,
G ,1�
I
)Assistant
oseph E. Barbeau, Jr.
Building Inspector/ Local Inspector
CC: file, Mayor's Office, Fire Prevention, Health Dept., Councilor Ryan
a
CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
KIMBERLrY DRISCOLL
MAYOR
120 WASHINGTON STREET*SALEM,M/\tiSACHU5E;1'1'S 01970
TEL:978-745-9595 1 F'Ax:978-740-9846
VIOLATION NOTICE
PROPERTY LOCATION 55 Butler Street
April 9, 2008
Jaun Espinal
55 Butler Street
Salem, MA 01970
Dear Mr. Espinal;
The above listed property has been found to be in violation of the following State
Codes and/or City Ordinances:
780 CMR, State Building Code, Section 118, states that no structure can be
built, altered, or renovated without a Permit to do so.
City of Salem, Code of Ordinances, Chapter 12, Section 1, adopts the State
Building Code, which allows for the imposition of 21D fines for non-compliance which
can be assessed at$50 per day with each day being a separate offense.
This use must Cease and Desist, and this unit must be dismantled with the
required permits and by licensed tradesmen.
Said violations must begin to be corrected, repaired, and/or brought into
compliance within 7 days of your receipt of this notice. Failure to do so may result in
further actions being brought against you, up to and including the filing of complaints at
District Court.
If you have any questions regarding this letter, please contact the Building
Inspectors Office at (978) 745-9595, extension 5643.
Since ely,
Jos ph E. Barbeau. J .
Assistant Building Inspector/ Local Inspector
CC: file, Mayor's Office, Fire Prevention, Health Dept., Councilor Ryan
Daleffime Primed:IM9-200010:1946 Verson RO-11N6
CRIMINAL COMPLAINT DOCKET NUMBER NO.OF COUNTS Trial Court of Massachusetts
POLICE COPY 0836CR003357 2 District Court Department '
DEFENDANT NAME&ADDRESS COURT NAME&ADDRESS
Juan C Espinal Salem District Court
55 Butler St. 65 Washington Street
Salem, MA 01970 Salem, MA 01970
(978)744-1167
DEFENDANT DOB COMPLAINT ISSUED DATE OF OFFENSE ARREST DATE
08/07/1977 10/09/2008 07/24/2008
OFFENSE CITY/TOWN OFFENSE ADDRESS NEXT EVENT DATE&TIME
Salem 55 Butler St. 11/13/2008 9:00 ANSU A 1A1
-4-000e DEPARTMENT POLICE INCIDENT NUMBER NEXT SCHEDULED EVENT r
Arraignment
OBTN �,"p°� y",,; �5+:n i� �1°m Fed ROOM/SESSION
-;� it �.'' Arraignment Session
fiflN N"!i," v id d u `X
The undersigned complainant, on behalf of the Commonwealth, on oath complains that on the date(s)indicated below the
defendant committed the offense(s)listed below and on any attached pages.
'..COUNT CODE DESCRIPTION
1 666666 MISCELLANEOUS MUNIC ORDINANCEIBYLAW VIOL
.On 07/24/2008 did illegal apartmant,in violation of 143/94 of the City or Town of Salem.
2 666666 MISCELLANEOUS MUNIC ORDINANCE(BYLAW VIOL
.On 07/24/2008 did violation of City zoning,in violation of 40/218 of the City or Town of Salem.
SIGNATURE OF COMPLAINANT SWORN TO BEFORE CLERK-MAGISTRATE/ASST.CLERK/DEP.ASST.CLERK DATE
X X
NAME OF COMPLAINANT ATRUE M.. CLERK-MAGISTRATE/ASST.CLERK DATE
COPS X
ATTEST
Notice to Defendant:42 U.S.C.§3796gg-4(e)requires this notice:If you are convicted of a misdemeanor crime of domestic violence you
may be prohibited permanently from purchasing and/or possessing a firearm and/or ammunition pursuant to 18 U.S.C.§922(g)(9)and
other applicable related Federal, State, or local laws.
APPLICATION FOR APPLICATION NO. (COURT USE ONLY) PAGE Trial Court of Massachusetts
_CRIMINAL COMPLAINT L/ nr Z District Court Department
I,the undersigned complainant, request that a criminal complaint issue against the accused charging the
offense(s) listed below. If the accused HAS NOT BEEN ARRESTED and the charges involve. Salem District Court
❑ONLY MISDEMEANOR(S), I request a hearing D WITHOUT NOTICE because of an imminent threat of 65 Washington Street
❑ BODILY INJURY/?000MMISSION OF A CRIME ❑ FLIGHT '_ WITH NOTICE to accused. - Salem, MA, 01970
❑ONE OR MORE FE(ONIES, I request a hearing p WITHOUT CE D WITH NOTICE to accused.
ARREST STATUS OF ACCUSED
❑WARRANT is requested because prosecutor represents that accused may not appear unless arrested. I] HAS AAS NOT been arrested
INFORmAtIdN�AEQUTACCUSED' r
NAME(FIRST MI LAST)AND ADDRESS BIRTH DATE SOCIAL SECURITY NUMBER
F C. l d8 D7 l97
!T, _ / fxeDRIVERS
/!✓.q-/ �rr PCF N MARITAL STATUS
JLICENSE NO. STATE
l O/�A0 GENDER HEIGHT WEIGHT EYES
HAIR RACE COMPLEXION SCARS/MARKSITATTOOS J ,i/'BBIIIR%THH STATE OR COUNTRY DAY PHONE
j i I
EMPLO R/SCHOOL MOTHER'S MAIDEN NAME(FIRST MI LAST) FATHER'S NAME(FIRST MI LAST)
INFORMATIONCASE
COMPLAINANT NAME(FIRST MI LAST//) •� COMPLAINANT TYPE 07 •/i/C/44-e— PD
❑ POLICE ❑ CITIZEN OTHER G
ADDRESS �}!� �. /`m PLACE OF OFFENS
INCIDENT REPORT NO. OfITN
L r •fn r 4 �D CITATION NO(S).
OFFENSE CODE DES IPT N OFFENSE DATE
Mel- /A/3 9 �s�� �7,0 ,A 78o Gm,< -r" ��. /al. Lod/' C� a '
VARIABLESS(e. . victim name,controlled substance, type and value of property.other variable information;see Complaint Language Manual)
fr/eao tJ /9ein i .10-
OFFnEENNn�SE CODE DES PT)ON/ % / � � OFFENSE DATE
r2 er
VARIABLES
OFFENSE CODE DESCRIPTION OFFENSE DATE
3 VARIABLES
REMARKS COMP INA T'$�IG E DATE FIL
X GJ� eO
COURT USE ONLY A HEARING UPON THIS COMPLAINT APPLICATION 1 D F HEARINGTIME OF HEARING URT USE ONLY
N WILL BE HELD AT THE ABOVE COURT ADDRESS ON J AT -K
NOTICE SENT OF CLERK'S HEARING SCHEDULED ON:
NOTICE SENT OF JUDGE'S HEARING SCHEDULED ON:
HEARING CONTINUED TO:
APPLICATION DECIDED WITHOUT NOTICE TO ACCUSED BECAUSE.
❑ IMMINENT THREAT OF ❑ BODILY INJURY [I CRIME I] FLIGHT BY ACCUSED
❑ FELONY CHARGED AND POLICE DO NOT REQUEST NOTICE
❑ FELONY CHARGED BY CIVILIAN;NO NOTICE AT CLERK'S DISCRETION
❑ PROBABLE CAUSE FOUND FOR ABOVE OFFENSE(S) D NO PROBABLE CAUSE FOUND
NO(S). ❑ 1. ❑ 2. ❑ 3. BASED ON ❑ REQUEST OF COMPLAINANT
❑ FACTS SET FORTH IN ATTACHED STATEMENTS) ❑ FAILURE TO PROSECUTE
❑ TESTIMONY RECORDED:TAPE NO. ❑ AGREEMENT OF BOTH PARTIES
START NO. END NO. ❑ OTHER'
❑ WARRANT ❑ SUMMONS TO ISSUE COMMENT
ARRAIGNMENT DATE:
DCCR-2 leN041 nnr in•r l nnaa
STATEMENT OF FACTS APPLICATION NO.(court use only) PAGE -.
Trial Court of Massachusetts I'
IN SUPPORT OF Z of Z District Court Departments
APPLICATION FOR CRIMINAL COMPLAINT
COURT DIVISION
The undersigned alleges the following as a r_1full or n partial statement
of the factual basis for the offense(s)for which a criminal complaint is sought.
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(Use additional sheets d necessary)
PRINTED NAME SIGNATUR TAMA DATE SIGNED
❑ LAW ENF RCEMENT OFFI
X 'CIVILIAN COMPLAINAf7T OR WITNESS
-------------------------------------------------------
REMARKS SIGNATURE OF CLERK-MAGISTRATE I ASS T.CLERK/JUDGE DATE SIGNEU
X
DC-CR 34 (7104)
a
CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
til JII4P.111.10'DR UI;IJLI.
Si,�'ult
12U WMI I IN(�IONSI'RITA ♦ SAIA l,iAInssACI USI;I'fs019%0
riiu 978 745-9,>95 LIANA 978-740-9848
VIOLATION NOTICE
PROPERTY LOCATION_-:Butler Street
CApril,9,_2_tO08
Jaun Espina-j-j
55 Butler Street-7
CSalem, MA 01970
Dear Mr. Espinal;
The above listed property has been found to be in violation of the following State
Codes and/or City Ordinances:
780 CMR,State Building Code, Section 118, states that no structure can be
built, altered, or renovated without a Permit to do so.
City of Salem, Code of Ordinances, Chapter 12, Section 1, adopts the State
Building Code, which allows for the imposition of 21D fines for non-compliance which
can be assessed at $50 per day with each day being a separate offense.
This use must Cease and Desist, and this unit must be dismantled with the
required permits and by licensed tradesmen.
Said violations must begin to be corrected, repaired, and/or brought into
compliance within 7 days of your receipt of this notice. Failure to do so may result in
further actions being brought against you, up to and including the filing of complaints at
District Court.
If you have any questions regarding this letter, please contact the Building
Inspectors Office at (978) 745-9595, extension 5643.
Since ely. / ±,J—k
Jos ph E. Bar
Assistant Building Inspector/ Local Inspector
CC: file, Mayor's Office, Fire Prevention, Health Dept., Councilor Ryan
p i
F /R
:c
STREET PERMIT
-Citp of 6alem
mnsc� Office of 31nopector of 3guilbingt
20
Jermission is Siere6y yioen to
to occupy�or �/� (� purposes
in`ronl o`eslale _ '��✓`-TI/'e� \ —DO(
o`sidea�al�, of slreel.
`7Fiis permi'l is 6mileo/lo I '01 /1 . � q 201 v suo6l to 1 S
prooisions o`l"ie oro(mances andslalules in relation to cSlreels andlnie 7nspechon
and Conslruclion o`✓3uildn9s M I& Ciy Of CSalem. -
�../ 'Oirec/w o�J`�u6/'c cSenwbe.r gmpeclor o`.�vi/dn9s /
c$iyna/ure o�.`App�icari! t 0. i
�DlJul 14, 2003
ffective Date:
Compan YWestern Suretyv :
LICENSE AND PERMIT BOND
F KNOW ALL PERSONS BY THESE PRESENTS: Bond No. 69553703
That we, John F. Mc Kay_, Jr.
of the City of Salem , State of Massachusetts as Principal,
and WESTERN SURETY COMPANY, a corporation duly licensed to do surety business in the State of '
Massachusetts _ as Surety, are held and firmly bound unto the
CitV of Salem , State of Massachusetts , as Obligee, in the penal
sum of One Thousand and 00/100 DOLLARS ( $1, 000.00 ),
lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made,
we bind ourselves and our legal representatives, firmly by these presents.
THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal has been
licensed Sidewalk Contractor
--_ by the Obligee.
NOW THEREFORE, if the Principal shall faithfully perform the duties and in all things comply with the
laws and ordinances, including all amendments thereto, pertaining to the license or permit applied
for, then this obligation to be void, otherwise to remain in full force and effect until
July 14th 2004 , unless renewed by Continuation Certificate.
This bond may be terminated at any time by the Surety upon sending notice in writing, by First Class
U.S. Mail,Ape Obligee and to the Principal at the Pddress last known to the Surety, and at the expiration
of t from the mailing of said notice, this bond shall ipso facto terminate and the Surety
sh . eYeu ori eyed from any liability for any acts or omissions of the Principal subsequent to said
dEitea, e5 ro e number of gears this bond. shall enn±inue in force, the number of claims made
aga n s"this bon 3MdEthe number of premiums which shall be payable or paid, the Surety's total limit of
lra ity gliall not beemulative from year to year or period to period, and in no event shall the Surety's total
lixlity,•+oaA 9i s;exceed the amount set forth abov2. •Any revision of the bond amount shall not be
cu
••�sds�Ift�1`{6•i:fltlld�` '
Dated this 15th day of July 2003 ;
Principal
F --- ——
Principal
Countersigned (where required) W E S T E /S UU R E E T COMPANY
By— --- By- --
Resident Agent Paul T.Bruflat, Setior Vice President
Form 532-5-2002
c
CITY OF SALEM
a
PUBLIC PROPERTY
DEPARTMENT
KI,UBI AKLIO [RIS(I)ILL
Al' It
I20 W,\sul,vGron Sralarf � $ALHAI,�1 r�s5M:�+csP:rn 01970
Ii7 978-745-9595 ♦ I�•�s:978-740-9846
REQUIRED INSPECTIO_ N
PROPERTY LOCATION"55 BUTLER STREET'
J�anuar 5,2008
Juan Espinal
55 Butler Street
Salem, MA 01970
Dear Mr. Espinal;
The above referenced property has come to the attention of this department for the
following reason(s):
Multiple reports have come to this office from this neighborhood regarding
the existence of an illegal apartment at this address.
Under the provisions of 780 CMR, Section 115.6, State Building Code, access to this
property must be granted for the purposes of inspection. Please call this office upon
receipt of this letter to schedule this required inspection. If this property has rental units,
these tenants must be notified in advance of this inspection, so that access to these spaces
may also be accomplished.
This inspection must be completed on or before January 29, 2008; failure to respond to
this notification will be construed as non-compliance, and as such an Administrative
Search Warrant will be sought, so as to allow the lawful inspection of this property.
If you have any further questions regarding this letter, please call this office at
(978) 745-9595, extension 5643.
Sincerely,
L L P—j
i
Joseph E. Barbeau, Jr.
Assistant Building Inspector/ Local Inspector
CC: file, Mayor's Office, Fire Prevention, Health Dept., Councilor Ryan
`e CITY ON SALEM
PUBLIC PROPERTY
Q DEPARTMENT
VIA Yi At
120 WAST HNG rury S rei=sr♦ SAI.N%1,N1XSSAa iUS5P1;9 01970
`C,i.:978-745-9i95 s FAN;978-740-9846
STOP WORK GIRDER IIF
Property Location 33 Boardman Street
January 31, 2007JI+r�
Robert Soloman P Z /Ot
Elisa Castillo
33 Boardman Street
Salem, MA 01970
Dear Mr. Soloman and Ms. Castillo
The above listed property has been posted with a Stop Work Order due to being in
violation of the following State Codes and/or City Ordinances.
780 CMR Massachusetts State Building Code, Section 118.1, regarding violations of
the construction code, states drat it is unlawful to add, alter, or construct any structure
without the proper permit to do so.
No further work may be done until such time as the order is lifted. Any person who shall
continue any work in or about the building or structure after having been served with a
Stop Work Order, except such work as that person is directed to perform to remove a violation
or unsafe condition, shall be liable to a fine of not more than $1000, or by imprisonment for
not more than one year, or both for each violation; with each day constituting a separate
violation.
If you have any questions regarding this letter, please contact the Building Inspectors Office
at (978) 745-9595 ext. 386.
Sin rely,
J eph )e arb� ,
Assistant Building Inspector
CC: file, Mayor's Office, Fire Prevention, Electrical Insp., Plumbing Insp., Councilor
Sosonoski
I - - • trial L;our< or massacnusetts
CRIMINAL COMPLAINT � y� �� of_t_ District Court Department {;�a
I, the undersigned complainant, request that a criminal complaint issue against the c sed charging the
offense(s)listed below. If the accused HAS NOT BEEN ARRESTED and the chvLfd /��, Salem District Court
ONLY MISDEMEANOR(S), I request a hearing i] WITHOUT NOTICE because of a i t at of Sa Washington Street
1-1 Q� A. 01970
BODILY INJURY El COMMISSION OF A CRIME �_� FLIGHT ;4'WITH NOTICE t d.
D ONE OR MORE FELONIES, I request a hearing 'D WITHOUT NOTICE D WITH 1 accused.
ARREST STATUS OF ACCUSED
D WARRANT is requested because prosecutor represents that accused may not appear unless arrested. D HAS HAS NOT been arrested
NAME(FIRST MI LAST)AND ADDRESS BIRTH DA SOCIAL SECURITY NUMBER
/977
/;q,/ E,S�/'�/p/'4/ PCF NO. MARITAL STATUS
SS x3L/ /ere Sf2eef
DRIVERS LICENSE NO. STATE
GENDER HEIGHT WEIGHT EYES
HAIR 1 RACE COMPLEXION SCARS/MARKS/TATTOOS J BIRTH STATE OR COUNTRY DAY PHONE
EMPLOYER,'SCHOOL MOTHER'S MAIDEN NAME(FIRST MI LAST) !I FATHER'S NAME(FIRST MI LAST)
COMPLAINANT NAME(FIRST MI LAST) •� COMPLAINANT TYPE �L�/(//['//�qL PD
7 Jos fpf� �, �A/�[�f//J ,//e; ❑ POLICE ❑ CITIZEN VOTHER
ADDRESS PLACE OF OFFENSE
ec141OAI.9/crexL1iCef PDelf ,sS >5'."A/e 'c
/n/J� 5
/Z-05J �tJgj�J/�/}+ /c,/ S�/�'Er� / INCIDENT REPORT NO. OBTN
/ CITATION NO(S).
OFFENSE CODE DESCRIPTION OFF NSE ATE
1 A96'L /%3 . 9`/ tea%/��c ,4//� /Leg Jo�e�✓/..t c ✓s� rim /�s eX-e,l
VARIABLES(e.g.victim name,controlled substance, type and value of property o4ffer variable Informatio ,see Complaint Lantluage Manual)
OFFENSE CODE DESCRIPTION OFFENSE DATE
2 VARIABLES
OFFENSE CODE DESCRIPTION OFFENSE DATE
3 VARIABLES
REMARKS COMPL NANT'S SIGI HE DATE FI D
X
COURT USE ONLY A HEARING UPON THIS COMPLAINT APPLICATION F HEARING TIME DFI- ARING COURT USE ONLY
WILL BE HELD AT THE ABOVE COURT ADDRESS ON �� AT / S �
NOTICE SENT OF CLERKS HEARING SCHEDULED ON: �`� —1G
NOTICE SENT OF JUDGE'S HEARING SCHEDULED ON:
HEARING CONTINUED TO:
APPLICATION DECIDED WITHOUT NOTICE TO ACCUSED BECAUSE:
IMMINENT THREAT OF D BODILYINJURY D CRIME IJ FLIGHT BYACCUSED
D FELONY CHARGED AND POLICE DO NOT REQUEST NOTICE -
D FELONY CHARGED BYRieCIVILIAN:NO NOTICE AT CLERK'S DISCRETION
_ i L.... .. s ^ 4.�f\L '..�'��I� (:'AEi .._ ...,� ..n....9 K•� 1 J.�.hAMY � I" F� � i; x..•, t... B
D PROBABLE CAUSE FOUND FOR ABOVE OFFENSE(S) D NO PROBABLE CAUSE FOUND
NO(S). D 1. D 2, D 3. BASED ON D REQUEST OF COMPLAINANT
D FACTS SET FORTH IN ATTACHED STATEMENT(S) D FAILURE TO PROSECUTE
D 'TESTIMONY RECORDED:TAP[NO. _ D AGREEMENT OF BOTH PARTIES
START NO. END NO. D OTHER:
D WARRANT C SUMMONS TO ISSUE COMMENT
ARRAIGNMENT DATE:
DCCR-2(08101) .____--____ —.___..-------
APPLICATION FOR APPLICATION NO. (COURT USE ONLY) PAGE Trial Court of Massachusetts
CRIMINAL COMPLAINT / of 2 District Court Department
I,the undersigned complainant, request that a criminal complaint issue against the accused charging the
offense(s)listed below.If the accused HAS NOT BEEN ARRESTED and the charges involve: Salem DistrictCourt
65 Washington, Street
I P(ONLY MISDEMEANOR(S),I request a hearing El WITHOUT NOTICE because of an imminent threat of Sai.,m MA 07970
❑ BODILY INJURY 0 COMMISSION OF A CRIME 0 FLIGHT WITH NOTICE to accused.
0 ONE OR MORE FELONIES, I request a hearing 0 WITHOUT NOTICE 0 WITH NOTICE to accused.
ARREST STATUS OF ACCUSED
0 WARRANT is requestedbecause prosecutor represents that accused may not appear unless arrested. 0 HAS 1K:HAS NOT,been arrested
NAME(FIRST MI LAST)
)AAND ADDRESS/' /
.✓ Ll/I"/ .C .S /�✓A/
SS ����z Sfrrr-e f
-------------------------------------------
COMPLAINANT NAME(FIRST MI LAST) -7 COMPLAINANT TYPE 1J;I& le- PD
JAS Iii/'F �/1/��F�`�✓� / J/�'. ❑ POLICE ❑ CITIZEN 29 OTHER �6f/t/nG
PLACE OF O7-1 E,/ /� C.
INCIDENT REPORT NO. OBTN
- CITATION NO(S).
OFFENSE CODE DESCRIPTION // OFF NSE DATE
t /��� �L�.3��tpr". �� %n/�rrrc y� ,/j�fcJ /{� ✓.�ec�in�1, c./ry„ifJf�yrrl�l3.'I is i)1_ �i,:ic.,,,l.
VARIABLES(e.g.victim name,controlled substance,type and value of property.other variable information;see Complaint Language Manual)
OFFENSE CODE DESCRIPTION OFFENSE DATE
2 VARIABLES
OFFENSE CODE DESCRIPTION OFFENSE DATE
3 VARIABLES
REMARKS COMP INAN?S ICryAyi1RE DATE FI D
X TA/C/
COURT USE ONLY A HEARING UPON THIS COMPLAINT APPLICATION F HEARING / TIMEE F/W�/ AA�RqING COURT USE ONLY
WILL BE HELD AT THE ABOVE COURT ADDRESS ON} lz .-1-2 S_� AT
TO THE ACCUSED NAMED ABOVE
You are hereby notified that an application for a criminal complaint to issue against you for the offense(s) listed above has
been made in this courtby the complainant named above.This notice is to inform you that a hearing will be held at this court
by a Magistrate to determine whether criminal proceedings will be commenced against you in this matter. The hearing will be
held at the time and date shown above. You may appear at this time to present your side of the case. You may bring witness-
es with you and you may also bring a lawyer, although it is not required that you be represented by counsel.
Please bring this notice and report to the Clerk-Magistrate's office upon your arrival at the court.The court house address is
listed above.
If you do not appear for your hearing at the time and date noted, the criminal complaint may issue against you on that date.
DCCR-2(011104) ACCUSED COPT
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
t
ti Massachusetts State Building Code, 780 CMR, 7m OF SALEM edition RevisedJunuary
Building Permit Application To Construct, Repair, Renovate Or Demolish a 1. .ou8
One-or T vo-Jramily Dwelling
This,Sectioril For Official Pic Only
Building Permit Num er::: Dat pplied:
Signature: �/^�� -'� ` V /0
Building Commissioner/Thspectorol Hu"Ass hate
11
SECT IO 1:.,5ITE'1 N FORMATION
I.I.rope A dress: // 1.2 Asses ors Map& Parcel Numbers
41, / i fi/Qr S-I r e / I . 0
L l a Is this an accepted street?yes no Map Number---------- Parcel Number
13 ning Information: 1.4 Property Dlmensloos:
_ 512s� / C/92
Zoning District Proposed Use Lot Area(sq 11) Fromage(it) -
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? Municipal On site disposal system ❑
Public Private❑ Check if es❑ p po y
SECTION 2: PROPERTY OWNERSHIP'
2.4 Owner of Record: -
ef>ptv,a
Name( ) Address for Service:
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) �{` Alleration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units r+ Other Cl Specify:
Brief Description of Proposed Work: S
S ^
o r O
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: OMclal Use Only
Labor and Materials
I. Building S I. Building Permit Fee:S Indicate how tee is Determined:
❑Standard City/Town Application Fee
2. Electrical S ❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: S
4. Mechanical (IIVAC) S List:
5. Mechanical (Fire S Total All Fees: S
Su ression
t�r� vo Check No. Check Amount: Cash Amount:
6.Total Project Cost: S S\!V1�) - ❑Paid in Full ❑Outstanding Balance Due:
{i
f
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
License Number Expiration Dute
Name of C'SL-I folder
List CSL 7*ype(see below)
Address T' Description
U Unrestricted(up to 35,000 Ca Ft.
R Restricted IR2 Family Dwellin
Signature M Masonry Only
RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Registered Home Improvement Contractor(HIC)
I IIC Company Name or HIC Registrant Name Registration Number
Address
Expiration Date
Signature Telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 2SC(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 ..........O 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 to act on my behalf, in all matters
relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
1, /�kp &w /*(- ,as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and
behalf.
Print NamS
Signat of-owner or Authorized Agent Date
(Signed under the vains and penalties ofperjury)
NOTES:
Ll
I. 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 WJ have access to the arbitration
program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 110.116 and I IO.RS,respectively.
? When substantial work is planned,provide the information below:
Total floors area(Sq. Ft.) (including garage, finished basemenUattics,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"
t
,
CITY OF SM.E.M
PUBLIC PROPERTY
DEPARMMENT
KIfOklliY DY/1'n
.�rA710e -30wA911N4WW 3r1ff•ULEK NAMACHLSWM 0197e
74.L 979.745-7ssS• r-..u.9'5.7+oeaw
HOMEOWNER LICENSE EXE.r MON
Please Print
Date
Job I.oc-tkm
Home Owner Address SS--
Home Owner Telephone
Prescott Mailing Address �-p nn Ma-
-The current exemption of"Homeowners"was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who.does not possess a license.provided that the owner acts as supervisor.
DEFINMON OF HOMEOWNER
Persons) who owns a parcel of land on which he/she resides or intends to reside, on
which there is, or is intended to be.a one or two family dwelling, attached or detached
structures accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official,on a form acceptable to the Building
Official. that he/she be responsible for all such work performed under the Building
Permit
The undersigned "homeowner"assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations.
The undersigned "homeowne"certifies that he/she understands the City of Salem
Building Department minimum inspection procedures and requirements and that he/she
will comply with said procedures and requirements.
HOMEOWNERS SIGNATURE
,APPROVAL OF BUILDING [INSPECTOR �
See other side for state code
AZI The Commonwealth of Massachusetts
Board of Building Regulations and Standards Town of
It, Massachusetts State Building Code, 780 CMR, 7"edition on
Builth—ng pepai
Building Permit Application To Construct, Repair,Renovate Or Demolish a
One- or Ttvo-Fumi&Duelling aloftThis ton For ffhcial Use Only
Building Permit Number:, ate Applied:
Signature:
Building Com issi a Inspector 1 in Date
S 10 :SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
1.1 a 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(it) j
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard j
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:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0
Check if yesO
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ow
neS'of Record:
Name(Print) Address for Service:
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ 1 Owner-Occupied Repairs(s) ❑ Alteration(s) Addition ❑
Demolition ❑ Acoessory Btdg.❑ Number of Units Z* I Other ❑ Specify:
Brief Description of Proposed Work':
c0A461A F- WwND ANP nirm> z.
TO GtfE StAI[a.f.E {IiIICt'
r_
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Building S 1. Building Permit Fee: 5 Indicate how fee is determined:
2. Electrical ; - E3 Standard City/Town Application Fee
O Tota!Project Cost'(Item 6)x multiplier x
3. Plumbing S 2. Other Fees: $
4. Mechanical (HVAC) S List
5. .Mechanical (Fire S
Suppression) Total All Fees: S
Check No. Check Amount Cash Amount:
6. Total project Cost: 5
0Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
License Number ExpirationDate
Ngmc of CSL-Hplder
List CSL Type(see below)
Address VDResidential
Deser—tion
tricted u to 35,000 Cu. Ft.)
Signature ctrd I&2 Famd Dwellin
Onl
ntial Roofin Coverin
Telephone ntial Window and Siding
ntial Solid Fuel Burnin A fiance Installation
Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name Registration Number
Address
Expiration Date
Signature Telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.4 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 HE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner of the subject property hereby
authorize to act on my behalf,in all matters
relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION
1, - , as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and
behalf.
PrintYne
Cn� l&�d
Signature of Owner or Authorized Agent Date
(Signed under the pains and penalties ofperjury)
NOTES:
I. 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 and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I I O.R6 and I I O.RS, respectively.
2. When substantial work is planned,provide the information below:
Total floors 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'may be substituted for"Total Project Cost"
CITY OF SALE.vt
PUBLIC PROPERTY
DEPARTMENT
iu�air�irr�,.".•.ti L
WWroa
130w,mw.cnon snFrr•SALM,yn4ApM•SUM 01970
TEL 978-7454S"• Fn7L 978-740.9}46
HOMEOWNER LICENSE C SE EXE.riPTION
Please Print
Date
Job Location CS/'
Home Owner Address P 0• 60,y /Y
Home Owner Telephone -/j-
Present
/s-Present Mailing Address Pa. a=x Le
The current exemption of"Homeowners"was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who does not possess a license,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s) who owns s parcel of land on which he/she resides or intends to reside, on
which there is, or is intended to be, a one or two family dwelling, attached or detached
structures accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official, on a form acceptable to the Building
Official, that he/she be responsible for all such work performed under the Building
Permit.
The undersigned "homeowner"assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations.
The undersigned "homeowner"certifies that he/she understands the City of Salem
Building Department minimum inspection procedures and requirements and that he/she
will comply with said procedures and requirements.
H0IAEOWYERS SIGNATURE
APPROVAL OF BUILDING INS ECTOR
See other side for state code
CITY OF SALEM
j PUBLIC PROPRERTY
� . DEPARTMENT
I I I V'8 'J; '); 1; • I \C ';_8 -4 114,.
Construction Debris Disposal Affidavit
(MILlired li)r all demolition and renovation work)
In accordance n ith the sixth edition of the State Building Code, 780 C•AIR section I 1 1.5
Debris, and the provisions of:b1GL c 40, S 54;
Building Permit K is i59lll'd with the condition that the dcbris resulting front
this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c
I 11. S 150A.
The debris will be transported by:
(name of hauler)
I lie dcbris will be disposed ofin
(name ul I-johly)
IadJrc<. .d I�nIiIVI p
lcnalmc f p:unit apphunl
,lalr
(p 1-7 q
- - - MillcialUiconly
nonwealth of Massachusells
ding Regulations and Standards CITY OF
t State Building Code, 780 C-NIR •SALEL, Rerise).l far_Till
Building Pero Construct, Repair, Renovate Or Demolish a
r Tiro-Foutilt•Du ellinl;
s Section For Olrciul Use Onl
Building Permit Number: Date Applied:
Building offloal(Print Nwne) Signature
SECTION I: SITE INFORMATION
L l f
1.2 Assasan Slap& Parcel Numbers
LlaIsthiseet?yes no Ntap Nun,her Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed tine Lot Area(sq It) Frontage(It)
1.5 Building Setbacks(R)
Front Yard Side Yards Rear Yard
Reyuircd Provided Required Provided Required Provided
1.6 Water Supply:(M.G.I.c.40.§Sy) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Munici al❑ On site disposal Check it' es0 P posal system ❑
SECTION2: PROPERTY OWNERSHIP
2.1 Ownerl f Re rd:
N;une(Pnn�l , U •.Statc,/.IP
No.and Street Telephone Finail Address
SECTION J: DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction❑ Existing Buildingo Owner-Occupied A I Repairs(s) ❑ Aiteration(s) ❑ Addition Cl
Demolition ❑ Accessory Bldg.❑ Number of Units ? I Other LK Specify:
Brief Description of Proposed Work-:
--- '-1-p✓u cite
SECTION 4: ESTIMATED CONSTRUCTION COSTS
item Estimated Costs:
(Labor and.Materials) Ofllclal Use Only
1. Building S I. Building Permit Fee: S Indicate how ree is determined:
'. Electrical S ❑Standard City/Town Application Fee
❑Total Project Cush(Item 6)x multi her _ - x _ _
1, Plumbing S / P - - -
_. Other Fees: S
4. .Vxhanic•ll III\'.1('I S List:-- -- -
i ?. \lechanical IFirc S .-__- - .--.—=-•t-1
Su„ressionl Todd .\ll FCC$:
fn 3 Check No. _('heck amount: l'uih ,\mount:
h. Total Project Cost: ) 3!1 r ❑Paid in Full ❑Outstanding Ilakmce Due:
r
SECTION 5: CONS"I'RIiC'riON SERVI('F.S
5.1 Construction Supen'isor License(CSIJ
rsr I.ictnsc Numhcr F\lirallon Dow
N attic of CIT. I Folder
I ist CS I. i)pe Isce helow) -
3 `--- ---- ---- 1)PC Description
Mi. and Street/' l I Inrestriacd I I)uildin o ti n/ 13,1)(A)eu. It
ry e_ _—".----- R Restricted 1-2 Ivn nlil M%elli
Cinit") Slatc, II \I Mason
RC Rlxlfin C'overin
._.—. W'S Window and Siding
SF Solid Fuel Burning Appliances
ek
g2�' 67q 4P OLbC� C/d(tC1'61r 1 Insulation
T hone Fntnil nd ress D Demolition
5.2 Registered Home Improvement Contractorl(HIC)
/A a-S9 V"'Ar4�-fiejLwO d IIIC llegistr;niun Numhcr E pinn' m Uulc
I IIC'3un ly Nm_11Q 11r�I IIC R�--A r Ill NJlile
No.;md V•ck•t�J/Y %YM✓A- O&2`0 Email address
City/—Town.State,ZIP relc hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.,c. 152.4 2SC(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...........O
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 12,ar(Ar y 0 C�
to act on Ay behalf,in all matters relative to work authorized by this building per it application.
Print \\ner's Nan (Elect is Signature) Date
SECTION 7b:OWNEW 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.
Prins Ullncr'i or:\uthoriicd Agcnt's Name ENctronic Signature) Dute
NOTES:
I. :\n 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 I have access to the arbitration
program or guaranty fund under\I.G.L.c. I42A.Other important information on the HIC Program can be linnd at
\Hilt 1111111 �%,s I,,.1 Information on the Construction Supervisor License can be found at nl.ls: lils
�. \%'lien substantial work is planned,provide the information below:
Total fluor area Isy. R.) _ 1 including garage. finished basement'attics,decks or porclu
Gross li%ing area(sq. 11.1 _ _ Habitable room count
\umbcrof fireplaces . Numberof'bedroonts
\umherol'bathrooms - - — Number ofh:dYhaths
I)pe of heating sy'lent _ Number of Jecks, porches _
I
i
Itpcof ioollll_g i(elit Fllcloscd _ . .-011en
1, "Total Project Square Footage"nun he substituted for l'oua Project Cost"