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63 FLINT ST - BUILDING INSPECTION (4) � Thr Commonwealth of Massachusetts of OF SALEM Building Regulations and Standards CITY Massachusetts State Building Code. 780 C'MR, 7'a edition Nrvrsrd Jurnnvy - I)uilding Permit Application To Construct, Repair, Renovate Or Demolish a /. 1fNAY One-or Two-Family Dwelling This Section For ORcial Use Only Building Permit Number: Date Applied: Signature: Building Cummissioned Inspector of Buildings Dare SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map dl Parcel Nom I.la Is this an accepted street?yes no Map Number Parcel Number IJ Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use La Arco(sq 11) Frontage(11) 1.5 Building Setbacks(11) From Yard Side Yards Rev Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.I,c.40,§54) 1.7 Flood Zone Informstion: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if es❑ SECTION 2: PROPERTY OWNERSHIP' �J 2.1 L 0-4 efl of DLt{Record: �L'fl�l /� � �/i�t�� •��X�Jyc Name(Print) Address for Service: ?7k ?414 S raf Signature Telephone SECTION): DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Unit_ Other ❑ Specify: Brief Description of Proposed}vor -: O U / SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: OMCISI Use Only Labor and Materials I. Building S OV 11. Building Permit Fee: S Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Cost'(Item 6)x multiplier x J. Plumbing S 2. Other Fen: S 4. Mechanical (IIVAC) S List: S. Mechanical (Fire S Suppression) Total All Fees:S Check No. _Check Amount: Cash Amount: 6. Total Project Cost: S 0 Paid in Full 0 Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) License Number livpiration lyJle Name of CSI.• I lulder 1.ist CSL Type(see below) t Description :%Jdrcss U Unrestricted(up to)5.000 Cu.Ft. R Restricted Id2 Family D%ellin Signature M M the RC Residential Routine C'overin 1'cicpMme WS Residential Window and Siding SF Residentid Solid Fuel BurningA Tim c Installation D Residemid Demolition 5.2 Registered Home Improvement Contractor(HIC) I TIC Company Namur IIIC Registrant Name Registration Number Address Expiration Dale Sign:aure 'telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. IS2.f 23C(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? Yea ..........It— No...........O SECTION 7n:OWNER AUTHORIZATION TO 8E 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. SlunaturcotOwner Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION �)Ojrl//tzt ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are we and accurate,to the best of my knowledge and be f. /' W Pri Signal '(honer Authori Agent Diet Si nJer Ite inn andpenalties of 'u NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who him an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will gg have access to the arbitration program or guaranty fund under M.G.L. c. M2A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 790 CMR Regulations 1 I0.R6 and I IO.RS,respectively. ?. When substantial work is planned,provide the information below: Tolal Moon area(Sq. Ft.) (including garage, rinished basement/anics,decks or porch) Gross living area(Sq.Ft.) Habitable room count Number o!fireplaces Number of bedrooms LN;mber of bathrooms Number of half/baths of heating system Number of decks/porches peofcoolingsystem Enclosed Open"Total Project Square Footage"may be substituted f'or"Tidal Project Cost" Oct 05 10 08:44p Carol Hedges 978-283-4163 p.1 Certi zcacte o Ft - .f ame ,f Resistan ce REGISTERED . FABRIC ISSUED BY Dam Iti eta NUMBER JOHNSON OUTDOORS IN C. BINGHAMTON, NEW PORK i3902 MAY 2009 F-140.01 TWOProaketff efs of the Fhma e Descliliedheaw This is to certify that the produUs herein have been manufachned{�material frdtererrtfy flame retardant as here after specMd bythe material er. suppli NAME THE EVENT CO. CITY. GL.OUCESIER,MA Certification is hezeb9 made The articles dewnbed m this tlnt wrtflea[e have been maw write an ved flame in Test a Fire Marstal NFPM Cana retardant acted in m wmWrance with Code. 701•. tlMawttars la fro of Cana FederaE - ate' Canada, and have been - I Test McOwd SPedfaaaone and meet m weed the 6�0 tested m aoomdance w+tFt the 4 Military Flame Specifications o!MIL-C-g3pOgC,. TYae.cctor and weight of material 14 OZ W80 Do on Ulf team cerwes EFS 10 MID 30 VdW Flame Retardant Process Used Will Not Be Removed By Washing And IS Effective For The Life.Of The:Fabric . . Sn dor M i y arttrtacUtring, Inc. Maasadore.clRar-RaianaantVinvttamlrvRs T73frDernt:rtet3vi.igFiwsowouno D_tLSPt — was seta Oct 05 10 08:45p Carol Hedges 978-283-4163 p.4 Certt'j'Icate of Flame Resistance REGISTERED ISSUED BY Date of Manufacture FABRIC JOHNSON OUTDOORS INC. NUMBER BINGHAMTON,NEW YORK 13902 MAY 2009 F-T 46.01 Manufacturers of the FArest Tent Froducts Described Herein This is to certify that the products herein have been manufactured from material inherently flame retardant as here after specified by the material supplier. NAME: THE EVENT CO. CITY. GLOUCESTER,h1A Certification is hereby made that: The articles described on this certificate have been manufacbrted with an approved flame retardant chemical in compliance with California State Fire Marshal Code, NFPA-701', Underwriters Laboratory of Canada, and have been tested in accordance with the Federal Test Mettmd Specifications and meet or exceed the Military Flame Specifications of Iv11L-C-43006G- Type,color and weight of material 14 OZ.WEIO Descrio8on of item certifies EFS 10 MID 30 MO Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric , . . Snyder Manufacturing, Inc. r Ma'lnracWfer Df Rame Retardant%nnd Laminates TENT DEPARTMENT.is HNSON OUT ORS IN - 'Large Sple Oct 05 10 08:46p Carol Hedges 978-283-4163 p.6 Certificate of Flame Resistance REGISTERED FABRIC ISSUED BY Date of Manufacture NUMBER JOHNSON OUTDOORS INC. BINGHAMTON.NEW YORK 13902 MAY 2009 F-140.01 Manufacturers of the Firrest Tent Products Described Herein This Is to certify that the products herein have been manufactured from material inherently flame retardant as here after specified by the material supplier. NAME: THE EVENT CO. CRY: GLOUCESTER,MA certification is hereby made that: The articles described on this certificate have been manufactured with an approved flame retardant chemical in compliance with California State Fire btarshat Code, NFPA-701•, Underwriters Laboratory of Canada.and have been tested in accordance with the Federal Test Method Specifications and meet or exceed the Witary Flame Specifications of IIAL-C-43006G_ Type,color and weight of material 14 07 WBO Description of item certifies EFS 15 MID 30 VIM Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric Snyder Manufacturing, Inc. 6lanurechuer of Flame Ralardant vtrvl Laminates TENT DEPARTMENT,JOHNSON OUT W ,. -- ..- - Marge Scale Oct 05 10 08:47p Carol Hedges 978-283-4163 p.7 Certificate of Flame Resistance REGISTERED ISSUED BY Date of Manufacture FABRIC JOHNSON OUTDOORS INC. NUMBER BINGHAMTON, NEW YORK 13902 ALAY 2009 F-140.01 Manufactwers of the Finest Terd Products Desonbed Herein This is to certify that the products herein have been manufactured from material Inherently flame retardant as here after specified by the material supplier. NAME: THE EVENT CO. CITY_ GLOUCESTM ALA Certification is hereby made that: The articles described of this certificate have been manufactured with an approved flame retardant chemical in compliance with Califomia State Fire Marshal Code, NFPA-701*, Underoafters Laboratory of Canada, and have bew tested or accordance with the Federal Test Melhod Specifications and meet or exceed the Military Flame Specifications of MIL-C-43006G. Type,color and weight of material 14 OZ.W80 DeaCrtntlnn Of item certifies EFS 30 X 30 2 PC WB0 Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric Snyder Manufactlaing,Inc. Maquractuw of Flame Retardant Vimi Laminates TEN'DEPARTMENT,JOHNSON OU ORS IN - 'Large Scale ❑ C.I�C.nCPC.TCICJLC.CIJIJ'7LfDC)7r��CrC�I��YI r:.��.�/r$ DOCVMEI��b`r Ij-F3F30-cifIRM=MCJGnL{L�LIrJCI.LjrNE0 0° 5 Certificate cif f hanN (C c%ii sty ?ee J 5 — 5 REGISTRATION Date of Shipment 5 5 APPLICATION ISSUED BY s° �M�R 06/03/04 5 5 NUMBER ND sTPIE 1NC. 5 m i i i Identfcaton l w � fir.. EVANSVILLE, INDIANA 47725 Tent 5 a 5 [1214 MANUFACTURERS OF THE FINISHED D3851234 Inn 5 TENT PRODUCTS DESCRIBED HEREIN 5 v This is to certify that the materials described have been flame-retardant treated 5 (or are inherently noninflammable) and were supplied to: 76556 APEX TENT RENTAL 5 7 COTEVILLE RD 5 5 LONDONDERRY NH 03053 5 5 a 5 5 5 Certification is hereby made that: E The articles described on this Certificate have been treated with a flame-retardant approved 5 5 chemical and that the application of said chemical was done in conformance with California Fire ift%hal Code. All fabric has been tested and passes NFPA 701.99, CPAI 84, ULC 109. 5 serial alua400tul 555 5 Description of item fANI Q9k 22'LAP&SNAP 2 5 W2 CATHEDRAL WINDOW Will'I'E VL 5 5 Flame fleta fila t rneess Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Qf The Fabric 5 5 _ 6IT _OYLE STATESVILLENC Signed: T; 5 SPECIAL EVENTS DIVISION•ANCHOR INDUSTRIES INC. 5 El fiafr op,1i'. I r I�::n2.1 '�1 CAI !l:Jl1'ir'� '_ �r tli r I[�Ir� q lI 1�Ifr�F(>nG�(�litlelf?J��fl�rhfcf�lrllr!IrJcPPJ�cPPP.:frl7cPr.Pcf?rf'rJ'rJu?cPPrJ�i.P1� L°l N Q _ -.__. '. ..:. ": ' '.. ':.' :.. '. I 111f .I..I.•III 1 I .". I! � I�i a 1✓..I ll.i h� r j I":I I 05/12104 .. N _III .1. I .I EI_ld1 IY ICI 1 is ,fir .I: IrI f 1 'rl ....__. J 36 6.191 it,l m I� cu N _, MIA t r I � it !1 i. . i 5123 I fall II u I. 1j (1'F'' a 41Jc [2, O la a'ff. IiF�Fi.,.�'.t]t["� �.i )i'1[lS.r,lka::c1.' i .; I.kit', 1.n1( E s 5 76556 5 APEX TENT RENTAL 5 5 7 COTEVILLE RD 5 5 LONDONDERRY NH03053I 1I 5 5 ry C � i1 ' '. 5 ' i .(.: 1L,.L L.: ".k'. , ..I(., ..`a v ..I . :n(t�� I ... . f .',1 .n'1�:] L,in (ri, R j I rr� r, 8106200(7) 1 Ifal I WALL RI0 X 22'LAP&SNAP 21.4 'I°I ?I WHl'1'E VINYL rn: I JOHN BOYLL SJATLSVILLLNC I;d' 1 (E rLPCJ-E3j-L3jC1n[J"P�jj2PLPLrL3j(qPLjL1 rL3 III licAD10 0 IMPORTANT Li of Flame ;j Cc REGISTRATION ISSUED BY . ....... I Date of Shipment ---'%qmqP 06103/04 APPLICATION NUMBER EVANSVILLE, INDIANA 47725 Tent Identification IVIANUrACTURERS OF THE FINISHED 03851234 TENT PRODUCTS DESCRIBED HEREIN This Is to certify that the materials described have been flame-retavdant treated (or are Inherently noninflammable) and were supplied to: 76556 APEX TENT RENTAL 7 COTEVILLE RD LONDONDERRY NH 03053 Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant appecwed chemical and that the application of said chemical was done in coi if ormance with California Fire Marshal Code. All fabric has been tested and passes NFrPA 701-99, CPAI 84, ULC 109. W Saris I# 8025000(l) ra U1 Description of Item IqLegfl(I4ANDAHLF TOP 30WX30 i 5 W, WHITE VINYL —Us—ed W-411 h-l'ot-8—e Washing And Is FlAactive For The U.fe Of FFF,-,,Kwic r Cl! SPEC'At.EVENTS DIVISION-ANCHUn INDUS FFI1U3,!NC. 7 fL Q O J�r�ifJuuc iJ;cPcPrlcPrJ�rJr�IPCcJ cfrJ��fc�PrJFT(�lcPu�JDcorarJ�cP 0 1MPOR TAN`T DOCUMENT-- aPLE -- r� Certificate of 'Flalpe Rveststapee Im 5 REGISTRATION % ISSUED BY ------- — 5 t Date of Shipment 5 5 Ai�l'LICATION o N �aNUMBER1iMD' EVANSVILLE, INDIANA 47725 Tent Identification 5 a P121 4 ° MANUFACTURERS OF THE FINISHED 03916744 5 in 5 _--- TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated 5 m (or are inherently noninflammable) and were supplied to: 76556 APEX TENT RENTAL 5 7 COTEVILLE RD 5 LONDONDERRY NH 03053 5 5 5 5 5 5 (� Certification is hereby made that: 5 E 5 The articles described on this Certificate have been treated with a flame-retardant approved 5 chemical and that the application of said chemical was done In conformance with California 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701.99, CPA[ 84, ULC 109. 5 Serial # 8025300f41 5 Description of Item Certified 5 FIESTA EXPANDABLE MIDDLE 5 30WX 10 WHTrF.VINYL 5 5 f Pa �fe �trl I J II ' u r�s; Used Will Not Be Removed By 5 5 WaslAn l od lap E ffeintive For The 1-1-fe Of 'Flie fabric 5 JOHN BOYL6 tiIATP.SVII LE NC SlSned: _.._ SPECIAL.EVENTS DIVISION-ANCHOR INDUSTRIES INC. S Cal (PIrJJ �d i ifrii5Wrll IjKLIF ii f. I '!r,i`I-r'I IIhl h.gr Ir frilrJrJ�(rJrJr�rdJ�IdfcPhPfrP(?J��f�1?fr�,fcf f�fcr?P.Pnhf?G?P f] J. M. Garve 603-425-2999 P. 5 IMPORTANT DOCUMENT Certificate of Flame lssutance ISSUED BY Date of Shipment 08/30/10 NCNOR Registration Number `F-12110 �tNDUSTRIES INC. Tent Identification 14905650 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable)and were supplied to: APEX TENT RENTAL 7 COTEVILLE RD LONDONDERRY, NH 03053 1 � `` Q' F CAL/RSA F- Z FARE N,t;��T' 'yE R E'r Q'4 Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire I'f Marshall Code. All fabric has been tested and passes NFPA 701, CPAI 84. Serial# 8025300(1) Description of item certified: FIESTA EXPANDABLE MIDDLE 30WX10 WHITE VINYL Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric TRI VANTAGE STATESVILLE NC Name of Applicator of Flame Resistant Finish Signed: AN HOR INDUSTRIES INC O7/EHlOB 08:44 FAX 97SE719905 RAPID ILItRO BI09Y91'Fffi5 - , .;� „ ...^ The COMMAKWOOk of assackusars astriuL Acddm& Dpm6u Bart d Ia office oflav 600 W=&b4&m S&eo Rostov,AW103111 ""rm ` ',9,�`t �g� y/planabtas warkew C9mpeeaation bmuranee A �g etealCua p�pa.Fe Ptiait Lteib� A nnli��nt iaf --r� r �j} - q - Aadless: � . are sa eaaNey�'Chaelc app�I- 1 has Type o a ❑ lam aO0�i7°�andl s. �xawm 1. acaaemPbtFerwlha baeemosubaae)a� (tbil®dror�s )- listed onto wed 3 ❑ Lava ncn mam z❑ Iamaa2 °0at 1L,sesab � $ ❑ and hM m employee' deed bave w�toa wdtpan 9. s5ogt - - emP1�9� ❑ w for ma in a�eae�Y- QIo"Odmw CmnFL maw 5-0 we OEM a cmPaXidmand its 10•[]P�uatd or addi d) - offla have amts=W sum 11.0 Y H t�or add mod) a 3_❑ Ima90 "8uwode nof==q6m PCMUL 12.Qltoorn:paias - weI7na ate- I amdwaLmem � t F i43.4 �4). 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