120 CANAL STREET - BUILDING JACKET 120 CANAL STREET
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Metropolitan Boston—Northeast Regional Office
JANE SWIFT
Governor BOB DURAND
Secretary
�� LAUREN A.LISS
2gof Commissioner
Arthur Freeman Re: Salem— 120 Canal St.
120 Canal St. RTN 3-12326
Salem, MA 01970 Response Action Outcome
Activity and Use Limitation
Interim Deadline
RAO SCREENING REVIEW
AUL SUMMARY COMPLIANCE REVIEW
AUL FIELD INSPECTION AUDIT FINDING
Dear Mr. Freeman:
On March 21, 1995, the Department of Environmental Protection(the Department)received a
Class B-2 Response Action Outcome (RAO) Statement and Activity and Use Limitation (AUL)
for the above-referenced site. On August 5, 1998,the Legislature enacted the `Brownfields Act"
which called on the Department to conduct a targeted audit of all sites at which AULs have been
implemented in order to ensure that these actions are meeting the requirements of Massachusetts'
laws and regulations, including Massachusetts General Law chapter 21 E and the Massachusetts
Contingency Plan (MCP). The Department's audit of this site consisted of an RAO Screening
Review, an AUL Summary Compliance Review, and an AUL Field Inspection to observe the
condition of the area subject to the AUL.
AUL FIELD INSPECTION AUDIT FINDING
On August 12, 1999, the Department conducted an AUL Field Inspection at the location
identified above to observe conditions related to an area subject to a Notice of Activity and Use
Limitation. In particular, the AUL field inspection focused on activities and uses consistent with
the terms and conditions of the AUL and whether obligations and conditions required to maintain
a condition of No Significant Risk were being met.
As a result of the AUL Field Inspection, the Department has identified a violation of the
requirements applicable to the AUL at the site that is outlined below along with corrective
requirements. A copy of the AUL Field Screening Form is also enclosed.
This information is available in alternate format by calling our ADA Coordinator at(617)5746872.
205A Lowell St. Wilmington,MA 01887 . Phone(978)661-7600 . Fax(978)661-7615 . TTD#(978)661-7679
Co Printed on Recycled Paper
Salem,RTN 3-12326 2
Violation of 310 CMR 40.1070(2): Failure of owners, holders of interest,RPs,PRPs, or
Other Persons conducting response actions at a site to comply with the terms of an AUL
(Class 1)
The Notice of AUL recorded for the site requires the maintenance of pavement in the area of the
AUL to prevent access to underlying contaminated soil. The August 12, 1999 inspection
observed that pavement in the area of the AUL was moderately cracked and surface soil was
exposed along the southern boundary of the AUL area.
Corrective Action:
In order to return to compliance with the MCP, within 60 days of the date of this Notice:
1. Submit a written description and photographic documentation to DEP that explains and
verifies that the AUL area has been repaired and is in compliance with the maintenance
requirements of the AUL. Your submittal must include a statement describing the
condition of the entire AUL area and must, at a minimum, answer the following
questions:
a. Were any other paved areas within the AUL in disrepair prior to or at the time.of your
receipt of this Notice? If yes, verify that such areas are now repaired and in
compliance with the AUL;
b. Has the use of the AUL area changed? If yes, describe such change(s)and the
measures you have taken to ensure that such use(s) comply with the AUL; or
2. Provide a statement of activities and schedule for repair of the pavement in accordance
with the requirement of the AUL that also addresses any additional areas of concern as
identified in items La. & Lb. above.
The deadline for submittal of your response to this Notice is an enforceable Interim Deadline
issued pursuant to M.G.L. c. 21E, 310 CMR 40.0167 and 310 CMR 40.1140. If you fail to fully
and properly respond by the Interim Deadline,you could be subject to legal action including
criminal prosecution,court-imposed civil penalties,and/or civil administrative penalties assessed by
DEP.
RESPONSE ACTION OUTCOME (RAO) SCREENING REVIEW
A screening review of the RAO was performed using a standard Department checklist.
Examples of the Department's checklists are available on the Internet at
http://www.state.ma.us/dep/bwsc/audits.htm. The Department is not directing you to undertake
further response actions at this time. Please note,however, that the review conducted by the
Department was not a comprehensive audit, and the Department reserves the right to conduct a
comprehensive audit of the RAO at any time in the future. It is possible that a future audit, if one
occurs,may identify deficiencies and/or violations of applicable laws and regulations, and may
require you to undertake further response actions at the site.
Salem,RTN 3-12326 3
C�
AUL SUMMARY COMPLIANCE REVIEW
Chapter 206 of the Acts of 1998 (The Brownfields Act) requires that the Department conduct an
audit of all sites with AULs. In carrying out this mandate, the Department has established
special procedures for reviewing AULs recorded on or before October 29, 1999, including the
AUL submitted as part of the RAO for your site. Please note that these procedures do not apply
to AULs recorded on or after October 30, 1999, and this Summary of AUL Compliance Review
should not be relied upon to predict audit results for such AULs.
Applying the procedures described above,the Department has identified an error in the AUL that
requires correction. Specifically:
• The AUL does not adequately define what uses and activities are permitted at the site,
what uses and activities are restricted, or what obligations and conditions must be
maintained at the site.
(a) The AUL permits adult residential use of the disposal site while prohibiting
residential use with children. Residential use of the disposal site must also include
use by children.-The AUL must either prohibit all residential uses, or permit all
residential uses,while maintaining a condition of No Significant Risk.
(b) The AUL requires maintenance of the asphalt paving in the AUL area, but does not
delineate the boundaries of the paved areas. To assist with compliance of the
obligations of the AUL, the sketch plan must delineate areas that must be covered by
pavement to maintain a condition of No Significant Risk. The language describing
the obligation to maintain the pavement must refer to an attached sketch plan for
delineation of these areas. If the entire AUL area is completely paved (no landscaped
or gravel areas), then the obligation language in the AUL may state that the entire
AUL area is paved, and no sketch plan is required.
To correct this error, an Amendment and Ratification of Notice of Activity and Use Limitation
must be implemented within 180 days of the date of this Notice, using the enclosed form and
instructions. A revised sketch plan may be attached as Exhibit C to the Amendment and
Ratification Form. Please note that the AUL Opinion must be prepared and attached to the
Amendment and Ratification Form using Form 114S. Alternatively, you may submit a new
RAO Statement within 180 days of the date of this Notice, documenting the achievement of a
Class A-1, A-2, or B-1 RAO at the site (i.e. an RAO that does not rely on an AUL to maintain a
level of No Significant Risk). This is an enforceable interim Deadline issued pursuant to M.G.L.
c.21 E, 310 CMR 40.0167 and 310 CMR 40.1140. If you do not meet this deadline you will be
subject to enforcement action by the Department. Please note that this deadline relates ody to
AUL"corrections. Additional response actions required by this Notice of Audit Findings may be
subject to shorter or longer deadlines.
The Department has prepared forms and detailed instructions for implementing the required
AUL corrections. Copies of the forms and instructions are attached, and are available on the
Department's AUL Audit Project web page,http://www.state.ma.us./det)/bwsc/files/audits/
aulfrx.htm. This web page will be updated periodically to address any commonly asked
questions that arise as a result of AUL audits.
Salem,RTN 3-12326 4
The Department is also offering several training workshops in the next few months. The
Department recommends that you(and/or the Licensed Site Professional (LSP)/attorney
preparing your AUL corrections) attend one of these workshops if you have questions on how to
proceed. The training schedule is also available on the Department's AUL Audit Project web
page. To obtain a schedule and/or register for the workshops, contact Thomas Potter,DEP's
Statewide Audit Coordinator at(617) 292-5628.
POST AUDIT COMPLETION STATEMENT REQUIRED
When the AUL Violation and AUL Error are corrected, you should submit to the Department
(attention: BWSC Audit Section)a Post-Audit Completion Statement in accordance with 310 .
CMR 40.1170, a copy of which is attached.
LICENSED SITE PROFESSIONAL
A copy of this letter has been sent to Hugh Mulligan, LSP #3490,the LSP-of-Record for the
Disposal site.
LIMITATIONS & RESERVATION OF RIGHTS
Please note that,the screening review conducted by the Department on the RAO was not a
comprehensive audit, and the Department reserves the right to conduct a comprehensive audit of
the RAO at any time in the future. It is possible that a future comprehensive audit, if one occurs,
may identify deficiencies and/or violations of applicable laws and regulations, may require you
to undertake further response actions at the site; and may invalidate the AUL. The screening
review is not a representation by the Department that the RAO complies with M.G.L. c. 21E, 310
CMR 40.0000, or any other laws,regulations, or requirements.
The Department's findings were based upon the accuracy and certainty of the information
reviewed during the audit. These findings do not: (1)preclude future audits of past, current, or
future actions at the site; (2)apply to actions or other aspects of the site that were not reviewed in
the audit; (3)in any way constitute a release from any liability,obligation, action or penalty under
M.G.L. c. 21E, 310 CMR 40.0000,or any other laws,regulations,or requirements. The
Department retains authority to take or arrange, or to require any Responsible Party or Potentially
Responsible Party to perform any response action authorized by M.G.L. c. 21E,which the
Department deems necessary to protect health, safety,public welfare,or the environment.
Sincerely,
f�
Patricia M. Donahue
Chief,Audit Section
Bureau of Waste Site Cleanup
Salem,RTN 3-12326 5
1
Filename: Nlhowes/P:/Letters/scnnot3-12326
Scnoafv6_105_31_01]
Enclosures: AUL Field Screening Form
AUL Amendment and Ratification Form and Instructions
AUL Opinion Form(BWSC 1145)
Audit Follow-up Plan Transmittal Form &Post-Audit Completion Statement
(BWSC-111)
cc: Salem Chief Municipal Officer
Salem Health Department
Salem Zoning Code Enforcement Official
Salem Building Inspector
Hugh Mulligan, LSP-of-Record(LSP#3490)Gulf of Maine Research Center
204 LaFayette St., Salem, MA 01970
Thomas M. Potter;Audit Coordinator,DEP-Boston
NERO/Data Entry: RAO/TSAUD
AUDINS/NAFVIO
GULF OF MAINE RESEARCH CENTER INC.
ENVIRONMENTAL CONSULTING SERVICES
204 LAFAYETTE STREET
SALEM, MA 01970
May 15, 1995 (508) 745-6618
FAX (508)741-8648
Building Department
Attn.: Zoning Official
One Salem Green
Salem,MA 01970
Re: 120 Canal Street, Salem, MA
Dear Sir/Madam:
A release of oil and/or hazardous material has occurred at the above-referenced
property. Gulf of Maine Research Center Inc. (GMRC)had been contracted to respond to
this release in accordance with 310 CMR 40.0000, the Massachusetts Contingency Plan.
In accordance with 310 CMR 40.1403(7)(a), GMRC hereby submits to you a copy
of the Activity and Use Limitation imposed upon this property as related to this release.
If you have any questions,please contact Jeffrey Kelly or myself at(508) 745-
6618.
Sincerely,
A+_
James M. Colbert
Associate Environmental Scientist
attachment
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-' 'GULF OF MAINE RESEARCH CENTER INC.
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Disposal Site Name: 120 Canal Street, Salem, Massachusetts Page 1 of 4
DEP Release Tracking No(s). Not Applicable
NOTICE OF ACTIVITY AND USE LIMITATION
M.G.L. c. 21E, §6 and 310 CMR 40.0000
PURSUANT TO CHAPTER 21E OF THE MASSACHUSETTS GENERAL
LAWS,AS AMENDED("Chapter 210)and THE MASSACHUSETTS
CONTINGENCY PLAN, 310 CMR 40.0000,AS AMENDED("MCP"),NOTICE is
hereby given by Arthur B. Freedman, of Salem Essex County, Massachusetts,
being the owners)in fee simple of that certain land located in,gym Esm County,
Massachusetts,with the buildings and improvements thereon,pursuant to a deed recorded
with the Eccex South District Registry of Deeds in Book$&41.Page M said land being
-. more particularly bounded and described in Exhibit A,attached hereto and made a part
hereof, and being shown on a plan entitled, "Land of Julius Polansky and Hyman
Freedberg in Salem. Mass",dated AV 1943.prepared by Thomas A.
Appleton,recorded with E&Ux County Registry of Deeds as plan no. &2 of 12 and
on a plan entitiled "Land in Salem Macs" Boston and Maine Railroad to
Monarch Packing Co. Inc.. dated March 1961 prepared by Charles H. Bowker
recorded with&=South District Registry of Deeds as plan no.4U of M
('property")
THAT A PORTION OF SAID PROPERTY IS A DISPOSAL SITE AT WHICH
THERE HAS OCCURRED A RELEASE TO THE ENVIRONMENT OF OIL AND/OR
HAZARDOUS MATERIAL,SAID DISPOSAL SITE BEING DESCRIBED IN EXHIBIT
B,ATTACHED HERETO AND MADE A PART HEREOF, [AND BEING SHOWN ON
A PLAN DATED FEBRUARY 23, 1995, ENTITLED, "PLAN OF LAND 120
CANAL STREET SALEM MA", PREPARED BY OTTE & DWYER, INC., TO
BE RECORDED HEREWITH] ("DISPOSAL SITE")AND THAT A RESPONSE
ACTION HAS BEEN UNDERTAKEN AT THE DISPOSAL SITE.
Said response action is based upon the limitation on human access to and contact
with oil and/or hazardous material in soil and the limitation on certain activities occurring
in,on,upon,through,over or under the Disposal Site as set forth in an Activity and Use
Limitation Opinion ("AUL Opinion") dated February 28. 1995 prepared by the
undersigned, Hugh F. Mulligan. PhD. , holder of a valid license issued by the Board
of Registration of Waste Site Cleanup Professionals pursuant to M.G.L. c. 21A, §§19
through 19J(any holder of such a license hereinafter referred to as an"LSP"),said AUL
Opinion filed with the Massachusetts Department of Environmental Protection ("DEP"),at
its Northeast Regional Office. The activity and use limitations set forth in said AUL
Opinion are as follows:
1.Activities and Uses Inconsistent with the AUL Opinion. Y
Activities and uses which are inconsistent with the AUL OpiniWruubli,�FUISTM' DISTPiCTI
implemented at the Disposal Site,may result in a significant risk o � 21iLt; ' etyhcTFF 0F pis,
public welfare or the environment, are as follows:
y
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GULFOF MAINE RESEARCH CENTER INC.
Notice of Activity & Use Limitation
120 Canal Street Salem, MA Page 2 of 4
1 . Activities which result in the removal or degradation of the
asphalt pavement and subsequently provide a means for
prolonged access and potential human contact with the
underlying soil; and,
2. Excavation of subsurface materials, as well as installation
and/or repair of subsurface utilities unless such activities are
reviewed in advance by an LSP, and, in the opinion of the
LSP, will not result in a condition of significant risk to human
health and/or the environment.
3 . Use of the disposal site by children for residence, attendance
of school or attendance of day care.
2.permitted Activities and Uses Set Forth in the AUL Opinion.
The AUL Opinion provides that there exists for any foreseeable period of time a
condition of No Significant Risk to health, safety,public welfare or the environment(such
condition being defined in 310 CMR 40.0000) so long as any of the following activities
and uses occur on the Disposal Site:
1. The disposal Site may be utilized for all non-residential uses
which do not cause the structural integrity of the asphalt
pavement to be compromised;
2. The disposal site may be utilized for residential uses restricted
to persons over the age of eighteen (18) which do not cause
the structural integrity of the asphalt to be compromised; and
3. Such other activities or uses which,in the Opinion of the LSP, shall present
no greater risk of harm to health,safety,public welfare or the environment
than the activities and uses set forth in this paragraph. Any such Opinion
shall be set forth in writing, signed and sealed by an ISP, a copy of which
is to be filed with DEP at its Northeast Regional Office within 30 days of
its date of execution.
3.Obligations and Conditions Set Forth in the AUL Opinion.
If applicable,obligations and/or conditions,to be undertaken and/or maintained at the
Disposal Site as set forth in the AUL Opinion in order that a condition of No Significant
Risk may be maintained, shall include the following:
1. The asphalt paving in the Disposal Site shall be maintained in a
condition such that cracks, voids, holes, and/or degradation of
the pavement which would provide a potential route of
' GULF OF MAINE RESEARCH CENTER INC.
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exposure for human receptors to the underlying soil do/does
not occur.
I
4. Proposed Chanas in Activities and Uses.
I
Any proposed changes in activities and uses at the Disposal Site which may result in
higher levels of exposure to oil and/or hazardous material shall be evaluated by an LSP
Notice of Activity & Use Limitation
120 Canal Street Salem, MA Page 3 of 4
who shall render an Opinion,in accordance with 310 CMR 40.0000, as to whether the
proposed changes will present a significant risk of harm to health,safety,public welfare or
the environment. Any and all requirements set forth in the Opinion to ensure a condition of
No Significant Risk in the implementation of the proposed activity or use shall be satisfied
before any such activity or use is commenced.
5.Violation of a Rgponse Action Outcome.
If the activities,uses and/or exposures upon which an Activity and Use Limitation filed
with DEP is based change at any time to cause a significant risk of harm to health, safety,
public welfare or the environment due to exposure to oil and/or hazardous material without
the prior evaluation by an LSP in accordance with 310 CMR 40.0000,and without
additional response actions,if necessary,to achieve or maintain a condition of No
Siguficant Risk the owner or operator of the Disposal Site subject to such Activity and
Use Limitation at the time that the activities,uses and/or exposures change,shall comply
with the requirements set forth in 310 CMR 40.0000.
6. Incorporation into Deeds Mort&ages Leases and Instruments of Transfer
In accordance with the requirements set forth in 310 CMR 40.0000, this Notice of
Activity and Use Limitation shall be-
(ii)incorporated either in full or by reference into all deeds,easements,mortgages,
leases,licenses,occupancy agreements or any other instrument of transfer,
whereby an interest in and/or right to use the Property or a portion thereof is
conveyed
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'• GULF OF MAINE RESEARCH CENTER INC.
Notice of Activity & Use Limitation
120 Canal Street Salem, MA Page 4 of 4
Owner hereby authorizes and consents to the filing and recordation and/or registration
of this Notice of Activity and Use Limitation to become effective when executed and sealed
by the undersigned LSP,and recorded with the appropriate Registry of Deeds.
,,,_'_ i
WITNESS the execution hereof under seal this _day of►�/1Vnl 19g5
Owner
COMMONWEALTH OF MASSACHUSETTS
ZQ 1995
Then personally appeared the above namedA(* d acknowledged the foregoing
to be— AI:� free act and deed before me,
ANotaryPu"blic:
My Commission Expires:I-j G-01V
The undersigned LSP hereby certifies that he/she executed the aforesaid Activity and
Use Limitation Opinion attached hereto as Exhibit C and made a part hereof and that in
his/her Opinion this Notice of Activity and Use Limitation is consistent with the terms set
forth in said Activity and Use Limitation Opinion.
Date: -S 9
LSP
[LSP$ w(NGF>;iqa�
o
UGH y�
F.
o RaI,LLIGA?! ig
3490
�''�t. ��/ter✓fgrK.
COMMONWEALTH OF MASSACHUSETTS \ll
Fj �
§§ 1 7, 195/
Then personally appeared the above named { and'acknowledged the foregoing
to be L`; free act and deed before me,
Notary Puh�c:
My Commission Expires: i"II.", Y
GULF OF MAINE RESEARCH CENTER INC.
EXHIBIT A
I
PARCEL 1. The land with the buildings thereon in said Salem,also known as and numbered
120 Canal Street, in said Salem,bounded and described as follows:
Beginning at the Southeasterly corner of the granted premises at a point which is on the center
line of a common way twenty (20) feet in width as shown on plan hereinafter referred to and.
thence running Southwesterly by said center line of said way one hundred fifty-six and 15/100
(156.15)feet to land now or formerly of the Boston&Maine Railroad; thence running Northerly
by said Railroad land two hundred sixty-six and 20/100 (266.20)feet to a point; thence running
Easterly sixteen and 22/100 (16.22) feet to Canal Street; thence running Southerly by Canal
Street by two courses,two hundred twelve and 49/100 (212.49)feet and forty-one and 51/100
(41.51)feet,respectively,to the point of beginning.
Together with a right of way ten (10)feet in width over the Southerly half of said common way,
and subject to a right of way ten(10)feet in width over the Northerly half of said common way.
Being Lot B as shown on plan entitled "Land of Julius Polansky and Hyman Freedberg in Salem
Mass. Scale 1 in. =40 ft.April 1943,"recorded with Essex South District Registry of Deeds,as
plan no. 82 of 1943.
PARCEL 2. A parcel of land in said Salem bounded and described as follows:
Beginning at a point on the most northwesterly corner of land now or formerly of Saul Goldberg;
thence running along land now or formerly of the Boston and Maine Railroad on the following
four(4) courses: North 070 13' 20" West seventy-two and ninety-five hundredths (72.95) feet;
North 040 51' 40" West ninety-six and fifty-seven hundredths (96.57) feet; North 060 55' 10"
West one hundred one and twenty-seven hundredths (101.27) feet to a point; thence turning and
running South 800 43' 03" East Eighteen and ninety-six hundredths (18.96) feet to a point; thence
turning and running along land now or formerly of Monarch Packing Co., Inc. South 020 20' 10"
East two hundred sixty-six and twenty hundredths (266.20) feet to the point of beginning, be all
�I GULF OF MAINE RESEARCH.CENTER INC.
of said measurements more or less, said parcel containing about two thousand four hundred
sixty-one(2,461)square feet and being shown upon plan marked; "Land in Salem,Mass. Boston
and Maine Railroad to Monarch Packing Co.,Inc.J.F.Kerwin Asst. Chief Ener. kale V =40 ft.
i
Mar. 1961,"recorded with Essex South District Registry of Deeds as Plan 494 of 1962, to which
reference is hereby made for further description of the premise hereby conveyed.
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GULF OF MAINE RESEARCH CENTER INC.
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EXHIBIT B
Description of Disposal Site
120 Canal Street,Salem,MA
Beginning at the south easterly corner of the property at 120 Canal Street,thence northerly by a
curved line twenty five(25')feet,thence S88-48-54 W,one hundred forty four and 84/100
(144.84')feet,thence S07-13-20E, seventy two and 95/100 (72.95") feet, thence N70-10-46E,
one hundred fifty six and 16/100 (156.16)feet to the point of beginning.
4"
GULF OF MAINE RESEARCH CENTER INC.
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EXHIBIT C
Activity and Use Limitation Opinion
120 Canal Street,Salem
i
Gulf of Maine Research Center,Inc. (GMRC)of Salem,Massachusetts has completed an
environmental investigation at the above referenced property (Disposal Site). This investigation .
was performed in order to determine what,if any,effect past uses of the property may have had
on the environmental quality of subsurface materials (soil and groundwater). This investigation
has been fully documented in a report entitled"Limited Environmental Investigation For
Compliance with MGL Ch. 21E for property at 120 Canal Street Salein,
MA" dated February,
1995 which is available for review at the Northeast Regional Office of the Massachusetts
Department of Environmental Protection(HERO-DEP)currently located at 10 Commerce Way
in Woburn,Massachusetts. Because a Release Notification Form for this property was submitted
concurrently with a Response Action Outcome Statement,the environmental report and
supporting documentation are filed under the property address and NOT under a Release
Tracking Number at NERO-DEP.
Results of the investigation indicated that reportable releases of lead and petroleum
hydrocarbons to subsurface soil had occurred at the subject property. It is likely that the source
of the lead was fill material historically used to level the Site and the source of the petroleum
hydrocarbons was underground petroleum storage tanks previously located at the Site. Each of
these sources are not continuing.
A condition of no significant risk to human health and the environment exists at the
Disposal Site under current conditions. However,to ensure that this condition of no significant
risk is maintained for any foreseeable time,certain limitations must be placed on activities and
uses which occur at the Disposal Site.
Permitted activities and uses shall include all non-residential activities and uses and
residential activities and uses restricted to persons over the age of eighteen which do not cause
the structural integrity of the asphalt pavement to be compromised in any way. All other
activities and uses which, in the opinion of a Licensed State Professional (LSP)do not pose an
excess risk of harm to health, safety,public welfare,or the environment are also permitted. Any
such LSP opinion shall be set forth in writing, signed and sealed by the ISP and shall be filed
with NERO-DEP within 30 days of its date of execution.
Activities and uses which are not permitted at the Disposal Site include those which result
in the removal or degradation of the asphalt pavement subsequently providing a means for
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GULF OF MAINE RESEARCH CENTER INC.
i,
prolonged access and potential human contact with the underlying soil. Use of children for
residence,attendance of school or attendance of day care is not permitted. Excavation of
subsurface materials as well as installation and/or repair of subsurface utilities are also not.
permitted unless such activities are reviewed in advance by an LSP and a written opinion is
produced and filed as described above.
To further ensure that the present condition of no significant risk exists for any
foreseeable period of time,the asphalt pavement in the disposal Site shall be maintained in a
condition such that cracks,voids,holes and or degradation of the asphalt which would provide a
potential route of exposure for human or environmental receptors do/does not occur.
It is the opinion of Gulf of Maine Research Center,Inc. that if the conditions required by
this Notice of Activity and Use Limitation are met,a condition of no significant risk will
continue to exist at the Disposal Site for any foreseeable period of time.
I attest that I have personally examined and am familiar with the information contained in
this submittal,including any and all documents accompanying the opinions expressed herein, and
in my professional judgment, this Activity and Use Limitation complies with the provisions of
M.G.L.c.S. 19-19 J, 309 CMR 40.0000,and all other laws,regulations,orders,permits, and
approvals applicable to but not limited to possible fines and imprisonment,if I willfully submit
information which I know to be false,inaccurate,or incomplete.
ani
Name: 1 �0 � t "l U l l i1
Signature: Seal:-
w Iii
Date:
License Number. 3490 �E
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ho B PLAN BOOK P_Ai�
C 10'53'24' 278.40 41.51 47.45 S29'23'S0'E Esau <wa-+. o• o.C,'7
I HEREBY CERTIFY THAT s:._E,,. (...
L1 _ THIS PLAN WAS PREPARED IN f
Ll S80'4303•E 78.96' RemwceC ,,F � 9 v
ACCORDANCE WITH THE 1976 -j�
L2 S80'43'03'E 18.22' -ti -
RULES FOR RECORDING ADOPTED . .
BY THE REGISTERS OF DEEDS. +"
AMENDED JANUARY 12, 19988. —
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1 HEREBY CERTIFY THAT THE PROPERTY- -
B.M.= PK NAIL _ LINES SHOWN ON THIS PLAN ARE THE LINES
IN POLE DIVIDING EXISTING OWNERSHIPS, AND THE
'� �ELEV.=100.00 (ASSUMED) - LINES OF THE STREETS AND WAYS SHOWN
> 2� ARE THOSE OF PUBLIC OR PRIVATE STREETS
'p c' - OR WAYS ALREADY ESTABLISHED, AND THAT -
NO NEW LINES FOR SUBDIVISION OF EXISTING
r a,; OWNERSHIP. OR FOR NEW WAYS ARE SHOWN.
_ REGISTERED LAND SURVEYOR
FOR OTTE & DWYER, INC. -
P�
s RELEASE AREA AS DESIGNATED
$ BY GULF OF MAINE RESEARCH PLAN OF LAND
Locus CENTER, INC.
120 CANAL STREET
0
Z 24,234.63 s.f.
SALEM , MASS .
................ N 88'48'54" E 744.84'
... . . . . . . . .--. . — . .--. .— - .-,r. . . . . ` � - r PREPARED FOR
. . . . . . . . . . . . . . . , POLAR BEAR REALTY TRUST
BY.
�. . . . . _ ... . P�
LAND SURVEYORS
05 i 196 CENTRAL STREET SAUGUS, MASS.
i . . . . . . �@. . . -CIO . i +�' P.O. BOX 982. (617) 233-8155
i�o Pay " 4s"w i ' - SCALE 1'=20 FEB. 23, 1995
�. . . Boyd �
S
0.
i
® BORING
i SCALE
® MONITORING WELL (5) NOTE: �_TM-'OFp"�sry-`�
BORING LOCATIONS FROM 19� MAY �SO .
CTI) UTILITY POLE GOF MAINE RESEARCH CENTERFIELDD�a�W�
GULF �S
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F= SKETCHES. FLMW7HSCfF4H
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GULF OF MAINE RESEARCH CENTER INC.
ENVIRONMENTAL CONSULTING SERVICES
204 LAFAYETTE STREET
SALEM, MA 01970
May 15, 1995 (508) 745-6618
FAX (508)741-8648
Building Department
Atm.: Building Inspector
One Salem Green
Salem,MA 01970
Re: 120 Canal Street, Salem, MA
Dear Sir/Madam:
A release of oil and/or hazardous material has occurred at the above-referenced
property. Gulf of Maine Research Center Inc. (GMRC)had been contracted to respond to
this release in accordance with 310 CMR 40.0000, the Massachusetts Contingency Plan.
In accordance with 310 CMR 40.1403(7)(a), GMRC hereby submits to you a copy
of the Activity and Use Limitation imposed upon this property as related to this release.
If you have any questions,please contact Jeffrey Kelly or myself at(508) 745-
6618.
Sincerely,
James M. Colbert
Associate Environmental Scientist
attachment
'GULF Of MAINE RESEARCH CENTER INC.
i
Disposal Site Name: 120 Canal Street, Salem, Massachusetts Page 1 of 4
DEP Release Tracking No(s). Not Applicable
NOTICE OF ACTIVITY AND USE LIMITATION
M.G.L. c. 21E, §6 and 310 CMR 40.0000
PURSUANT TO CHAPTER 21E OF THE MASSACHUSETTS GENERAL
LAWS,AS AMENDED("Chapter 210) and THE MASSACHUSETTS
CONTINGENCY PLAN,310 CMR 40.0000,AS AMENDED ("MCP"),NOTICE is
hereby given by Arthur B. Freedman. of Salem Essex County, Massachusetts,
being the owner(s)in fee simple of that certain land located in Salem Ewa County,
Massachusetts,with the buildings and improvements thereon,pursuant to a deed recorded
= with the Eccex South District Registry of Deeds in Book$&41.Page�„'}5 said land being
more particularly bounded and described in Exhibit A,attached hereto and made a part
hereof, and being shown on a plan entitled, "Land of Julius Polansky and Hyman
Freedberg in Salem. Mass",dated April 1943,prepared by Thomas A.
Appleton,recorded with Essex County Registry of Deeds as plan no. B2_of 1943 and
on a plan entitiled "Land in Salem Mass" Boston and Maine Railroad to
Monarch Packing_Co. Inc., dated March 1961 prepared by Charles H. Bowker
recorded with E,S,EIig South District Registry of Deeds as plan no.454 of JM
("Property")
THAT A PORTION OF SAID PROPERTY IS A DISPOSAL SITE AT WHICH
THERE HAS OCCURRED A RELEASE TO THE ENVIRONMENT OF OIL AND/OR
HAZARDOUS MATERIAL, SAID DISPOSAL SITE BEING DESCRIBED IN EXHIBIT
B,ATTACHID HERETO AND MADE A PART HEREOF, [AND BEING SHOWN ON
A PLAN DATED FEBRUARY 23, 1995, ENTITLED, "PLAN OF LAND 120
CANAL STREET, SALEM, MA", PREPARED BY OTTE & DWYER, INC., TO
BE RECORDED HEREWITH] ("DISPOSAL SITE")AND THAT A RESPONSE
ACTION HAS BEEN UNDERTAKEN AT THE DISPOSAL SITE.
Said response action is based upon the limitation on human access to and contact
with oil and/or hazardous material in soil and the limitation on certain activities occurring
in,on,upon,through,over or under the Disposal Site as set forth in an Activity and Use
Limitation Opinion ("AUL Opinion") dated February 28. 1995 prepared by the
undersigned, Hugh F. Mulligan. PhD. , holder of a valid license issued by the Board
of Registration of Waste Site Cleanup Professionals pursuant to M.G.L.c.21A, §§19
through 19J(any holder of such a license hereinafter referred to as an"LSP"),said AUL
Opinion filed with the Massachusetts Department of Environmental Protection("DEP"), at
its Northeast Regional Office. The activity and use limitations set forth in said AUL
Opinion are as follows:
1.Activities and Uses Inconsistent with the AUL Opinion.
Activities and uses which are inconsistent with the AUL Opini %ffiibU, t? �BTR'r" DiSThrCT`
implemented at the Disposal Site,may result in a significant risk o dtltl±alth" 'Istlrk 0F 0FEVS!
public welfare or the environment, are as follows: {
GULPOF MAINE RESEARCH CENTER INC.
Notice of Activity & Use Limitation
120 Canal Street Salem, MA Page 2 of 4
1. Activities which result in the removal or degradation of the
asphalt pavement and subsequently provide a means for
prolonged access and potential human contact with the
underlying soil; and,
2. Excavation of subsurface materials, as well as installation
and/or repair of subsurface utilities unless such activities are
reviewed in advance by an LSP, and, in the opinion of the
LSP, will not result in a condition of significant risk to human
health and/or the environment.
3 . Use of the disposal site by children for residence, attendance
of school or attendance of day care.
2.Permitted Activities and Uses Set Forth in the AUL Opinion.
The AUL Opinion provides that there exists for any foreseeable period of time a
condition of No Significant Risk to health,safety,public welfare or the environment(such
condition being defined in 310 CMR 40.0000) so long as any of the following activities
and uses occur on the Disposal Site:
1. The disposal Site may be utilized for all non-residential uses
which do not cause the structural integrity of the asphalt
pavement to be compromised;
2. The disposal site may be utilized for residential uses restricted
to persons over the age of eighteen (18) which do not cause
the structural integrity of the asphalt to be compromised; and
3. Such other activities or uses which,in the Opinion of the LSP, shall present
no greater risk of harm to health,safety,public welfare or the environment
than the activities and uses set forth in this paragraph. Any such Opinion
shall be set forth in writing, signed and sealed by an LSP, a copy of which
is to be filed with DEP at its Northeast Regional Office within 30 days of
its date of execution.
3.Obli gations and Conditions Set Forth in the AUL Opinion.
If applicable,obligations and/or conditions,to be undertaken and/or maintained at the
Disposal Site as set forth in the AUL Opinion in order that a condition of No Significant
Risk may be maintained,shall include the following:
1. The asphalt paving in the Disposal Site shall be maintained in a
condition such that cracks, voids, holes, and/or degradation of
the pavement which would provide a potential route of
GULF OF MAINE RESEARCH CENTER INC.
exposure for human receptors to the underlying soil do/does
not occur.
4.Eroposed Changes in Activities and Uses.
Any proposed changes in activities and uses at the Disposal Site which may result in
higher levels of exposure to oil and/or hazardous material shall be evaluated by an LSP
Notice of Activity & Use Limitation
120 Canal Street Salem, MA Page 3 of 4
who shall render an Opinion,in accordance with 310 CMR 40.0000,as to whether the
proposed changes will present a significant risk of harm to health, safety,public welfare or
the environment. Any and all requirements set forth in the Opinion to ensure a condition of
No Significant Risk in the implementation of the proposed activity or use shall be satisfied
. before any such activity or use is commenced.
5.Violation of a Recnonse Action Outcome.
If the activities,uses and/or exposures upon which an Activity and Use Limitation filed
with DEP is based change at any time to cause a significant risk of harm to health, safety,
public welfare or the environment due to exposure to oil and/or hazardous material without
the prior evaluation by an LSP in accordance with 310 CMR 40.0000, and without
additional response actions,if necessary,to achieve or maintain a condition of No
Significant Risk the owner or operator of the Disposal Site subject to such Acdviry and
Use Limitation at the time that the activities,uses and/or exposures change, shall comply
with the requirements set forth in 310 CMR 40.0000.
6. Incorporation into Deeds Mortgages Leases and Instruments of Transfer
In accordance with the requirements set forth in 310 CMR 40.0000, this Notice of
Activity and Use Limitation shall be-
(ii)incorporated either in full or by reference into all deeds,easements,mortgages,
leases,licenses,occupancy agreements or any other instrument of transfer,
whereby an interest in and/or right to use the Property or a portion thereof is
conveyed.
4
GULF OF MAINE RESEARCH CENTER INC.
Notice of Activity & Use Limitation
120 Canal Street Salem, MA Page 4 of 4
Owner hereby authorizes and consents to the filing and recordation and/or registration
Of this Notice of Activity and Use Limitation to become effective whecrexecuted and sealed
by the undersigned LSP,and recorded with the appropriate Registry of Deeds.
i
WITNESS the execution hereof under seal this j T day of M" 19-T5
O r�
Owner
COMMONWEALTH OF MASSACHUSETTS
Then personally appeared the above namedAA d acknowledged the foregoing
to be Jib-free act and deed before me,
ANotarry&blic:
My Commission Expires:1-11,
The undersigned LSP hereby certifies that he/she executed the aforesaid Activity and
Use Limitation Opinion attached hereto as Exhibit C and made a part hereof and that in
his/her Opinion this Notice of Activity and Use Limitation is consistent with the terms set
forth in said Activity and Use Limitation Opinion.
Date: 3
C
LSP
+a
[LSP S X-Njk;
V
0 oy
;
HUGH N
F.. f
00 WILLIGAN y
COMMONWEALTH OF MASSACHUSETTS
§§ 1 7, 1915
Then personally appeared the above named and`acknowledged the foregoing
to be ! S free act and deed before me,
fL Id
Notary Pu lic:
My Commission Expires: r
i
GULF OF MAINE RESEARCH CENTER INC.
i
EXHIBIT A
PARCEL L The land with the buildings thereon in said Salem, also known as and numbered
120 Canal Street, in said Salem, bounded and described as follows:
Beginning at the Southeasterly corner of the granted premises at a point which is on the center
line of a common way twenty (20)feet in width as shown on plan hereinafter referred to and
thence running Southwesterly by said center line of said way one hundred fifty-six and 15/100
(156.15)feet to land now or formerly of the Boston&Maine Railroad; thence conning Northerly
by said Railroad land two hundred sixty-six and 20/100 (266.20)feet to a point; thence running
Easterly sixteen and 22/100 (16.22)feet to Canal Street; thence running Southerly by Canal
Street by two courses, two hundred twelve and 49/100 (212.49)feet and forty-one and 51/100
(41.51)feet,respectively,to the point of beginning.
Together with a right of way ten (10)feet in width over the Southerly half of said common way,
and subject to a right of way ten(10)feet in width over the Northerly half of said common way.
Being Lot B as shown on plan entitled"Land of Julius Polansky and Hyman Freedberg in Salem
Mass. Scale 1 in. =40 ft. April 1943," recorded with Essex South District Registry of Deeds, as
plan no. 82 of 1943.
PARCEL 2. A parcel of land in said Salem bounded and described as follows:
Beginning at a point on the most northwesterly comer of land now or formerly of Saul Goldberg;
thence running along land now or formerly of the Boston and Maine Railroad on the following
four(4) courses: North 07013' 20"West seventy-two and ninety-five hundredths (72.95) feet;
North 040 51' 40" West ninety-six and fifty-seven hundredths (96.57) feet; North 060 55' 10"
West one hundred one and twenty-seven hundredths (101.27) feet to a point; thence turning and
running South 800 43' 03" East Eighteen and ninety-six hundredths (18.96) feet to a point; thence
turning and running along land now or formerly of Monarch Packing Co., Inc. South 020 20' 10"
East two hundred sixty-six and twenty hundredths (266.20) feet to the point of beginning, be all
i
GULF OF MAINE RESEARCH.CENTER INC.
of said measurements more or less, said parcel containing about two thousand four hundred
sixty-one (2,461) square feet and being shown upon plan marked; "Land in Salem, Mass. Boston
and Maine Railroad to Monarch Packing Co., Inc.J.F. Kerwin Asst. Chief.Eng'r. Scale 1' =40 ft.
Mar. 1961," recorded with Essex South District Registry of Deeds as Plan 494 of 1962, to which
reference is hereby made for further description of the premise hereby conveyed.
GULF OF MAINE RESEARCH CENTER INC.
EXHIBTT B
Description of Disposal Site
120 Canal Street,Salem,MA
Beginning at the south easterly comer of the property at 120 Canal Street, thence northerly by a
curved line twenty five (25')feet,thence S88-48-54 W,one hundred forty four and 84/100
(144.84')feet, thence S07-13-2013, seventy two and 95/100 (72.95") feet, thence N70-10-46E,
one hundred fifty six and 16/100 (156.16)feet to the point of beginning.
GULF OF MAINE RESEARCH CENTER INC
i
EXHIBIT C
Activity and Use Limitation Opinion
120 Canal Street,Salem
Gulf of Maine Research Center,Inc. (GMRC)of Salem,Massachusetts has completed an
environmental investigation at the above referenced property(Disposal Site). This investigation
was performed in order to determine what,if any,effect past uses of the property may have had
on the environmental quality of subsurface materials (soil and groundwater). This investigation
has been fully documented in a report entitled"Limited Environmental Investigation For
Compliance with MGL Ch. 21E for property at 120 Canal Street,Salem,MA" dated February,
1995 which is available for review at the Northeast Regional Office of the Massachusetts
Department of Environmental Protection(HERO-DEP)currently located at 10 Commerce Way
in Woburn,Massachusetts. Because a Release Notification Form for this property was submitted
concurrently with a Response Action Outcome Statement,the environmental report and
supporting documentation are filed under the property address and NOT under a Release
Tracking Number at NERO-DEP.
Results of the investigation indicated that reportable releases of lead and petroleum
hydrocarbons to subsurface soil had occurred at the subject property. It is likely that the source
of the lead was fill material historically used to level the Site and the source of the petroleum
hydrocarbons was underground petroleum storage tanks previously located at the Site. Each of
these sources are not continuing.
A condition of no significant risk to human health and the environment exists at the
Disposal Site under current conditions. However, to ensure that this condition of no significant
risk is maintained for any foreseeable time,certain limitations must be placed on activities and
uses which occur at the Disposal Site.
Permitted activities and uses shall include all non-residential activities and uses and
residential activities and uses restricted to persons over the age of eighteen which do not cause
the structural integrity of the asphalt pavement to be compromised in any way. All other
activities and uses which, in the opinion of a Licensed State Professional (LSP)do not pose an
excess risk of harm to health, safety,public welfare, or the environment are also permitted. Any
such LSP opinion shall be set forth in writing, signed and sealed by the LSP and shall be filed
with NERO-DEP within 30 days of its date of execution.
Activities and uses which are not permitted at the Disposal Site include those which result
in the removal or degradation of the asphalt pavement subsequently providing a means for
i
GULF OF MAINE RESEARCH CENTER INC.
prolonged access and potential human contact with the underlying soil. Use of children for
residence,attendance of school or attendance of day care is not permitted. Excavation of
subsurface materials as-well as installation and/or repair of subsurface utilities are also not.
permitted unless such activities are reviewed in advance by an LSP and a written opinion is1
produced and filed as described above.
To further ensure that the present condition of no significant risk exists for any
foreseeable period of time,the asphalt pavement in the disposal Site shall be maintained in a
condition such that cracks,voids,holes and or degradation of the asphalt which would provide a
potential route of exposure for human or environmental receptors do/does not occur.
It is the opinion of Gulf of Maine Research Center, Inc. that if the conditions required by
this Notice of Activity and Use Limitation are met, a condition of no significant risk will
continue to exist at the Disposal Site for any foreseeable period of time.
I attest that I have personally examined and am familiar with the information contained in
this submittal,including any and all documents accompanying the opinions expressed herein, and
in my professional judgment,this Activity and Use Limitation complies with the provisions of
M.G.L.c.S. 19-191, 309 CMR 40.0000, and all other laws,regulations,orders, permits, and
approvals applicable to but not limited to possible fines and imprisonment, if I willfully submit
information which I know to be false,inaccurate,or incomplete.
00c,
�j
Name: l �0P' U
Signature:. I t Gr. ' _ Seal �t3
.�f"
Date: t 4`s >
License Number: 3490 __; �
Cho d SearIniL. PLAN BOOP, PLAN
Cl 103Y24' 18.. 41.51 41.4.5 ilby.,350E I cssu .wa+.• S.? �`,"
Lt
I HEREBY CER?IFY THAT s,,_E„. .�„ ”
— L2 7H15 PLAN WAS PREPARED IN c�
L1 S80'43 03'E 18.98' zeca�eC !T�iCl\,yp`
ACCORDANCE WITH THE 197E c�--ft- r�f1
L2 sao'43'o3'E 18.2Y - 19
RULES FOR RECORDING ADOPTED - 1 `h../- ,�
BY THE REGISTERS OF DEEDS.
AMENDED JANUARY/12, 1988./
�, - ?•Z1-fJ- AK/'a-o C� Atw#'
P C 1
N - 98.83- k BesiM ELEV.
net a De.ca
o .. .... 97.64
104
99.20
105 --97.69
b
F. 1 HEREBY CERTIFY THAT THE PROPERTY- - - - -
B.M.= PK NAIL LINES SHOWN ON THIS PLAN ARE THE LINES
�o �IN POLE DIVIDING EXISTING OWNERSHIPS, AND THE
ELEV.=100.00 (ASSUMED) - LINES OF THE STREETS AND WAYS SHOWN
ARE THOSE OF PUBLIC OR PRIVATE STREETS
OR WAYS ALREADY ESTABLISHED, AND THAT
-�� ` ;D• NO NEW LINES FOR SUBDIVISION OF EXISTING
t ,r� OWNERSHIP. OR FOR NEW .WAYS ARE SHOWN. -
�Oy
_-
- REGISTERED LAND SURVEYOR
n - /
FOR OTTE & DWYER, INC. - -
e
RELEASE AREA AS DESIGNATED
g BY GULF OF MAINE RESEARCH PLAN OF LAND
LOCUS CENTER, INC.
120 CANAL STREET
o .
24,234.63 s.f.
o�
SALEM , MASS .
.......... N 88'48'54' E 144.84'
. . . . . . . . .-- . . r - - PREPARED FOR
�� POLAR BEAR REALTY TRUST
I%. BY
. .
. . . . . .
.'.o� i /.i . . . wPi / i
/ i LAND SURVEYORS
04 / / 196 CENTRAL STREET SAUGUS, MASS.
1
o / + P.O. BOX 982. (617) 233-8155
. . /+10�. . a. . . 0ydhe•W / / / g' _ SCALE: 1'=20' FEB. 23, 1995
o•• 0' ?, 20' 40' 60'
/ ® BORING f
SCALE
® MONITORING WELL (5) NOTE: >`'" " TM �s"`'�7
BORING LOCATIONS FROM �"'�`'`�TFYSOO$`
�Q UTILITY POLE GULF OF MAINE RESEARCH CENTERFIELD
ATsuecop.m"
FIE},p SKETCHES. Arrwn
n.Enwnuofnce
DWG\6327 I
I
.E•• .IITRr .'' _ ".,r.-."sr.. ."..""x-,+�.,^N'�^ltl'T'�....rin.�';�r °i �,�„".Ki''d"�'Y4Y+�'cH< SIT
FIELD
FIELD COPY
H ° CITY OF SALEM BUILDING
SALEM. MASSACHUSETTS 01970 PERMIT
.� VALIDATION
4E�
DATE dec. 1, 19 92 PERMIT NO. 560-92
APPLICANT A. Freedman ADDRESS Rat Pm, MA 17.
1X0.1 ST°ECTI ICOX1.•S of,.,"
` NUMBER OF
PERMIT TO RTC.M (_I STORY �TEPTR1IET. .DWELLING UNITS
(IVPE O• IMFROVEMCNTI N0. IP�ROPOSE. USEI
120 Canal St. Ward
C ZONING T
AT ILO:PTIOAI Canal Jl. SY61L3 J DISTRICT 1
INO.1 ISTKECTI -
BETWEEN AND
IUOI* STREET) (CROSS STRECTI
LOT _
SUBDIVISION LOT BLOCK SIZE
BUILDING IS.T0 BE FT. WIDE BV FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUPBASEMENT WALLS OR FOUNDATION
ATPD
REMARKS:'REA OR � P D �[Y6.[ CTYC.E CT61
'OL UME ESTIMATED COST 3E 150.00 FEEMIT S 20.00
O:elo so.AR[ F[11TI
Arthur Freedwn
aWNER1:20 Cmial r.,. Salein,ma Ileo E. Tremblay
•^DaEss
INSPECTOR OF BUILDINGS
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICU4f AND REMARKS INSPECTOR
—••,.,•8'•^hsw'4,.++F+^N�^'v,.:,,�TrR,[^Y�"ZiQ.<.,ft..,. .4i,.r'�-.."-9. rywsrrr.p.ese.�Yr.,•,p.�..^ .. a,..,
"EL(O So FIELD COPY
0.
H ° CITY OF SALEM BUILDING ?°
SALEM, MASSACHUSETTS 01970 PERMIT
.� VALIDATION
4E�
DATE notnhe,• R 19 07 PEPMIT No. 459-93
APPLCANT Star Neon Sign ADDRESS 324 Rantoul 'St. Beverly,Ma. 717 _
IHO.I (StR([TI ICONIS•S
PERMIT TO R.T•PL`t ;TORYAnlmal Hospital NUMBER OF
.
ITT.( 0• uLAOVEMC NiI N0. IMOKOSEO USE) DWELLINGUNIT$
AT ILOCA140>1 120 Canal Street Ward 3 ZO6 N cT I
1x0.1 ISTA((TI
BETWEEN - AND
(CPO.. SIIILLTI (CROSS STPE(TI
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING S,TO BE FT. WIDE By FT, LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
G ITIPEI
6
REMARKS: Erect sign 4 X
TLINISPeCLUd & Approved D=—
/GLU-PAME ESTIMATED COST $ 500.00 FEEMIT S 20.00
OWNER Jason Kates
-o Ees 52 Nancy Ave. Peabody, Mass. Leo E. Tremblay
INSPECTOR OF BUILDINGS
INSPECTION RECORD
DATE MOTE •ROORESS CRITICISMS AND REMARKS INSPECTOR
f 4 APPLICATION FOR PERMIT TO ERECT A SIGN
* � Salem, Massachusetts 19 9/
PERMIT MUST BE OBTAINED BEFORE BEGINNING WORK
TO THE BUILDING INSPECTOR:
The undersigned hereby applies for a permit to Erect,
Alter, Repair a sign on the following described
building. r
Location C a't �� Zoning/District _
Name of Property Owner
Name of Sign Owner `t / b ✓/J
Address
If Owner is a corporation, name of responsible /Officer
Name of Licensed
f�Sign, Erector 5- � NToK Il%✓�
Address J� `� t"� ��°�) S� �v License No. �/ 7
Use of Building: Ist Floor 3rd Floor
2Floor 4th Floor
Type of Sign: V Surface Right Angles to Building
Free Standing Other ( ) Height: _
Sign Materials : 1n/00
Sign Dimensions : L't fb Sign Area SF
Existing Signs : Surface: Sign Area SF
Right Angles : Sign Area SF
Free-Standing: 3 — Sign Area ----1,7—SF
Other: _ Sign Area / SF
Signs to be removed: Type Sign Area✓ SF
Frontage: Building 60 FT Property FT
Signature of Owner
Name & Address0f Address ✓�7i/[/
Insurance Company:
E�ehr
Telephone
�i ti �o�eN+e✓� ' \` �
Estimate Cost of New Work: $SVC)
A P S:
APPLICATION TO ERECT, ALTER, OR REPAIR , PLAN OF LOT 1
A SIGN IN THE CITY OF-SALEM -
__________________ w Location of Present Structure i
snd Signs
BUILDING LOCATION: !J 1 �.� '^J st��1 ge-v SiS'l
LO ( piJ �N {�rlfC' t
�'��� <"ok.cQ � • , E � s� . �� awthorne
�� �' s�. Animal ospital = r
BUILDING USE: / -
`Ya1t�
1p
}
---------
------------------------------
� t
CONDITIONS � �� , + a•' "�� �
IE Ani 1
t � -
CAiTftnNt&_
�C 4
___--_- ---_-_-_-- --------- ---- - - sem. / .[/�
- -- PERMIT GRANTED- -__- ' / �r �h j a R( rt
S ( e%r it .�✓Sr�•itft Cir
Iac w.v✓ vV,l( l�
�V` tat
X
SALEM FIRE DEPARTMENT COMPLAINT FORM
FIRE PREVENTION BUREAU _Y pATc . June 13, r�94�Mc A.M.
Location of Complaint or Hazard tom' 120 Canal Street
Complaint by Concerned Citizen Address Unknown
Nature of Complaint,, Illegal_aparttrent nextto the animal hospital at the Salem Ice builds na
r1he citizen saw ads in tha windcws rnlat-sup to an anarFrmnt fnr 1aAgo
Received by Inspector N.P. LaPointe
Investigated by owre t1.„.,,,Time Y.
Action Taken
as �
1. i
i�-tom
T-
z' m
v.
nr�
csm
Other Department Notified Referred to the Building Inspector. Wm. Mwiroe.
Fnrm #58 (Rev.6/87)
NOTES
LE D
1
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tA
FP
SEPL MOPTX RPXOW
IC
ALE — -p
lo..
IN
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CXECEEUYBY
D. F. VALENTM
�6�stFFEo qqC' '
, • ANNA
PROJECT TITLE
11 , 11 0/ re `+,� ��, d,AW OFFICE
c
NO.3597 a 7o CANItL sr
Y. BOSTON.
MNS9.
DRAWING TITLE
WDONENIC i.VPLEMTE,JN..1^D/B
n 1` /o • WI`
• SENDER: -Complete Items 1 and 2 when additional services are desired, and complete items
3 and 4.
Put your address in the"RETURN TO" Space on the reverse side. Failure to d�this will prevent this
card from being returned to Vou.The return receipt fee will Provide oujzhe name of the arson delivered
to so the date of delive .Fore mons ees the o owing services are eve a e. onsu t postmaster
forftybs and check ox es for additional service(s)requested.
1. A Show to whom delivered,date, and addressee's address. 2. ❑ Restricted Delivery
(Extm duwge) (Fara charge)
3. Article Addressed to: 4. Article Number
J0,301? /�.'eej ,_
�J Type of Service:
PO CQ�r/ 1324 r /� ea L&l 1--e. k ❑'Registered ❑ insured
Ala r?C ✓e, ertified El COD
`J / A Q Cj/ Q T❑ Express Mail ❑ Return Receipt
neG hGd y' �. !, for Merchandise
n� //� Always obtain signature of addressee
C:/P 0 10 n0 L�T. SG�Biv /L//a or agent and DATE DELIVERED.
5. Signature— Address 8. Addressee's Address (ONLY if
X requested and fee paid)
6. Sigrlature —A e t
X "e
7. Date 'Delivery
PS Form 3811, Mar. 1988 U.S.O.P.O. 1988-212-866 DOMESTIC RETURN RECEIPT
Sir
UNITED STATES POSTAL SERVICE 5
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OFFICIAL BUSINESS o M - •• ...... _.,. s..f
SENDER INSTRUCTIONS o 19 JUN
Prhrt Your name,address and 21P Code
In the specs below.
• Complete Rema 1,2,3,and 4 on the �
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roversa. O
• Attach to front of article S apace
permits,otherwise aftto back of
article. PENALTY FOR PRIVATE
• Endorse article "Return Receipt USE, 8300
Requested"adjacent to number.
RETURN Print Sender's name,address,and ZIP Code in the spec below.
70
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ane Sol ems:-vn, 6reeK) - Z nY/
P 268 691 686
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse)
Sent to I
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Street�dto.
lO . '"Bear eQlt
R.O an9�P Code
N ahc Aye 3
e bodwM S _
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Certified Fee
Spacial Delivery Fee T
Restricted Delivery Fee
Return Receipt showing
to whom and Date Delivered
N
Return Receipt showing to whom,
Date,and Address of Delivery
d
j TOTAL Postage and Fees S
a.
mPostmark or Date
n
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STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see hem)
1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving
the receipt attached and present the article at a post Dt ice service window or hand it to your rural carrier.
(no extra charge)
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of
the article,date,detach and retain the receipt,and mail the article.
3. It you want a return receipt,write the certified mail number and your name and address on a return
receipt card,Form 3611,and attach It to the front of the article by means of the gummed ends if space per-
mits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED
adjacent to the number.
4. It you want delivery restricted to the addressee,or to an authorized agent of the addressee,endorse
RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested In the appropriate spaces on the front of this receipt.It return
receipt is requested,check the applicable blocks In Item vtR Forr6,3611.
6. Save this receipt and present it if you make inquiry, ous.G.Ao.1569-23a555
r
Citp of *arem, Alaoacb gettg
J)ublic Propertp ;Department
jguilbing IDepartment
One Psalem Oreen
745-9595 ext. 380
William H. Munroe
Director of Public Property
Inspector of Buildings
Zoning Enforcement Officer
June 15, 1990
Mr. Jason Kates
Polar Bear Realty Trust
52 Nancy Avenue
Peabody, MA. 01960
RE: 1 0- Canal Street;Salem,MA.
Dear Mr. Kates:
This is to notify you that you are in violation of the City of Salem Zoning
Ordinance, Section V, Paragraph 8, which prohibits all residential uses in an
I (industrial) District.
You have an illegal apartment in one section of the building at the above
referenced property.
Violations of any of the provisions of this Ordinance shall constitute
a misdemeanor. Any person who violates this ordinance shall, upon
conviction thereof, be fined not more than one hundred ($100.) per vi-
olation. And in addition shall pay all costs and expenses involved in
the case each day such violation continues shall be considered a sepa-
rate offense.
To correct this violation, you shall discontinue the use of the apartment
or apply at this office for an application to the Board of Appeal for a variance
to allow it to remain.
Failure to contact this office within seven (7) days upon receipt of this
letter will result in this office taking legal action against you.
Sincerely,
James D. Santo
Assistant Building Inspector
JDS/jmh
c.c. Ward Coucillor
Fire Prevention
City Solicitor
Board of Health
EASTERN ADJUSTMENT COMPANY, INC. it` t
151 ANDOVER STREET DAN VERS, MA 01923-5074 7743323
OCT
Multiple Line Adjusters, Surveyors & Appraisers PEiEit ('�
CJTY QF fira.1_°,1 € A6S.
NOTICE OF CASUALTY LOSS TO A BUILDING
Under Mass . Gen. Laws , Ch. 139, Sec. 36
TO : ,Building Commission_e_r-or Board of Health or
r-Inspec.tor_o_f Buildings Board of Selectmen
e1970 ) Addresses ( /
( SCC wt - ��-' al F7CJ
RE: 'Insuror: Lucu7zu� -irsu,1A ,YCF Insured:
Property
�l�BSoN
Property Address : I7-0 C,4M.4c SV--
Policy Number: .SWP-
File and/or claim No. : nn/�_ u1�,3
Loss by:. ('e6t� /Jury On : Sops /7 19�6
As representatives of the above captioned Insurance Company,
we hereby notify you, in behalf of said Insurance Company, that
claim has been made involving loss , damage or destruction of the
above captioned property, which may either exceed $1,000.00 or
cause Mass_ Gen. Laws ChaQter 143 section 6 to be applicable. If
any notice uno"e-r as �err: 'Laws , h. 135,Sec. 3B is appropriate,
please direct it to the attention of the writer and include a ref-
erence to the captioned Insured, location , policy number, date of
loss and file or claim number.
FQ, hGLCEO��
Adduster
On this date I caused copies of this notice to be sent to the
persons named above , at the addresses indicated above, by first
class mail ,
9-24-& 5
Signature and date
X exwXnan .�
_qo01�Pum;5I Xa"
Bailus Walker, Jr.,Ph.D.,M.P.H. �5� ✓renran.0 JCixec,C
COMMISSIONER
Seventh Floor (` od&n 021il Tel: 727-6214
February 13, 1986
Edgar Paquin 'C�t
Office of the Building Inspecter
Salem Green
Salem, MA. 01970
Dear Mr. Paquin: L\
Our office was recently asked by Arthur Freedman, DVM; to inform your
office of our policy regarding the safe use of x-ray equipment.
Please be advised that for new installations, our Division requires
that a written plan of the facility be submitted. The submitted writ-
ten plan is reviewed by our Division to determine if minimal shielding
standards have been addressed in the design for the facility. Should
the design appear adequate a letter to that effect is sent to the
facility.
Our regulations further require that the facility register with our
Division prior to possessing any x-ray equipment.
In that it is only possible to determine the actual adequacy of an
installation after the x-ray equipment is installed, our inspection of
the facility is conducted after the facility has taken possession of
the x-ray equipment. However , the operation of the equipment by the
facility is not contingent upon our inspection; in that, the facility
is legally responsible for compliance with the regulations.
Should you have any further questions kindly contact our office at the
number stated above.
5i��/i 1� e
Robert M. Hall ' sey, Dir Ctor
Radiation Control Program.
RMH/RW/bb
nn• D TArocr7m en
fbId161A rjjEfUfg#NiD APPROVED BY T44E
JNrP�JDB PRIOR TDA.PERWT AGING GRANTED
CITY OF_SALEM
No.�06
5 ,
Is Pf"wty Loaataa in Location of /20
the--. - -c[Nddd? 57'
: Canonwon Ana? Yak_No �!
BUILDING PERMIT APPLICATION FOR:
Pert to:
(Circle whiotwver apply) Roof. Remd I Cwwtnkt Do&, Shed, Pool,
PAPUAI�
PLEASE FY.L OUR LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The urtderaigrwd hereby applies fw a permit to build according to the following
Owners Names= ���
Address 3 Phone 7Y�/I 12-3T O . 1
Amhkeds Name
Address 6 Phorw !
Mechanics Name
Address 6 Phone !
No is ms pumm a twYogq? 6ccSi ass
Motm m al taliOYq? A-t t-k M a oNswq.br how many lami m?
wo kdci q oowm to law? X-aL AWNWa? �c�o
Edmw=a lo, 3 o c, CIO wom r N k _atw umus a
is a� 1� Lww. t X
SignaWm�of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE/ f
c9Le- c�rL✓ � t° GzCG�
MAIL PERMIT TO:./�t/
No. /O/ � i
APPLICATION FOR
PERNT TO
LOCATION
/Z6) Ca�la� fit.
PERMIT GRANTED
�viy6 13 20 b�
APPROVED
*WrPTOR OF BUILDINGS
i
,t City of Salem Sign Permit Application Worksheet
i RECEIVED
SERVICES
10-Sep-15
^ Hawthorne Animal Care -
J / 120 Canal Street SEP I 0 P 4-- 31
Q., Zoning(reslnon-res) I
Entrance Corridor(YIN) Y
Lot frontage 255 feet
Building or tenant frontage 63 feet
#of businesses on site 2
Bldng dist from street center <100 feet
( Multiplier 1
f3`ttdin-"eft_ fade'.Si9)133- �`. ;'�•' "au�.� �- .,
maximum area permitted 63.00 sq ft
total proposed sign area 12.33 sq It
sign 1
Front Building Sign length 148.00 inches
height 12.00 inches
sign 2
length 0.00 inches
height 0.00 inches
sign 3
length 0.00 inches
height 0.00 inches
sign 4
length 0.00 inches
height 0.00 inches
sign 5
length 0.00 inches
height 0.00 inches
. . , ...'__4i.
maximum area permitted 32.50 sq It(per side)
maximum#of signs permitted 1 signs
maximum height permitted 12.50 ft tall
sign 1
proposed sign area 32.00 sq It
length 96.00 inches
height 48.00 inches
proposed sign height 13.50 ft(approx)
sign 2
proposed sign area 0.00 sq It
length 0.00 inches
height 0.00 inches
proposed sign height It
Application meets standards set
forth in the Salem Sign Ordinance Yes
Recommend approval Yes
The existing free standing sign is taller than what would be permitted in
an entrance corridor today. The new proposed sign is shorter than the
existing freestanding sign, and therefore is permissable.
Nn srajT ro rtar,�
- -- - -- -- - -- - - - - -- -- Permit Number
tr
ya
APPLICATION FOR PERMIT TO ERECT A SIGN y Qpp
r NOTE:BUILDING PERMIT MUST BE OBTAINED BEFORE SIGN IS ERECT ' " Y p..
Location,Ownership and Detail Must Be Correct, Complete,and Legrb a �w
Salem,Massachussip 017015
Date
To the Building Inspector: DEPT OF PLANNING&
The undersigned hereby applies for a permit to K Erect, ❑Alter, ❑Repair a sign on the following descQ
1 -Ttr—eetAddress Zoning District
�1 ❑Urban Renewal Area Entrance Corridor
2T (yob( �l rcGt ��'pMO . a Historic District a None
• a,thme FjwddMt1#i
{ Telephone 178— +f/_ 29 O 1 floor• ' 3 j
• I-t an 2" floor
1 Address �2 0 C 5 3 floor
11— Telephone 978- 7y/ .23M 4 floor
E-mail 54 VG he al im A i . cebrHow many businesses are in the building?
If a corporate body, name Frontage
of responsible officer _
c/amtom. f h CornI Building 7 V6linear feet
Construction Sups License No ! Applicant's Space(if multi-tenant) 6p linear feet
Address S' Rf'd u10oa/ �c0 rt Property /a/61 linear feet
Telephone $_s- 6 6 d/9G
E-mail ff .qs A y60_ "1ft 'Sign Owner o Sign Erector ❑Other:
Si ns (If nore than three signs ar pioposed attach additbnal sheets)
Sin 1 Proposed Sian 2 Si n 3
❑Surface ❑Surface ❑Surface
❑Right Angle to Building a Right Angle to Building ❑Right Angle to Building
,1(Fres Standing o Free Standing a Free Standing
❑Awning XAwning ❑Awning
❑Portable(A-Frame) o Portable(A-Frame) o Portable(A-Frame)
❑Other(specify) - ❑Other(specify) ❑Other(specify)
Sign Materialss�G � � Sign Materials cd"Vds Sign Materials
Sign Dimensions Sign Dimensions Sign Dimensions
a 4
5G &tA'-tgh
Sign Area .j. s., Sign Area ft Sign Area s ft
sq ft Z. s
Sign Height(if free standing) /3 S Sign Height(if free standing) Sign Height(if free standing)
Estimated Cost of Net Work
$ /s oa o. D0
Existing Signs
Type Sign Area To Be Removed? Sig
❑Surface sq it o yes a no
❑Right Angle to Building sq ft ❑yes ❑no
,KFree Standing - sq ft X yes o nc 20,
i is A riz re ti
){Awning eq�ft y<yes on o
❑Other(specify) _sq ft ❑yes ❑no Pro rty O
In u Srita �,
Internai Review
I ring&Community Development Departme A Historical Commission
Approval
J Gam"
Building Inspector
o 4110 ev
r "Commonwealth of Massachusetts
3 City of Salem
120 Washington St,3rd Floor Salem,MA 01970(978)745.9595 x5641
Return card to BuildingDivision for Certificate of Occupancy ,
Permit No.$0 B_15-965xr PERMIT TO BUILD
FEE PAID: $0.00
w dY
DATE ISSUED: 9/16/2015
This certifies that FREEDMAN ARTHUR B
has permission to erect, alter, or demolish a building, .__,120 CANAL STREET„ Map/Lot: 33001'0-0
as follows: Signs SIGN PERMIT, AS APPROVED FOR: i
HAWTHORNE ANIMAL CARE
Contractor Name: MICHAEL E. CLAY - -
DBA: CLAY SIGN -
Contractor License No: CS-037120'
p. 9/1612016
F tl
Building Official Date
' - This permit shall be deemed abandoned and invalid unless the work authorized by this,permit is commenced within six months after issuance,The Building Official
may grant one or more extensions not to exceed six months each upon written request . , s
All work authorized by this permit shall conform to the approved application and,the approved construction documents for which this permit has been granted.
All construction,alterations and changes of use of anyFbuilding and strictures shall be in compliance with the local zoning by-laws and codes.
w
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the "
work until the completion of the same.
The Certificate of Occupancy will not be issued until alf applicable signatures by the Building and Fire Officials=are.provided on this.permit.
HIC#: 108288 "Persons contracting with unregistered contractors do not have access to the guaranty fund"(asset forth In MGL c.142A).
Restrictions:
Building plans are to be available on site.
All Permit Cards are the property of the PROPERTY OWNER.
RECEIVED C>10 d
WSPECTION r
~J The Commonwealth of Massachusetts
MAR 22 A & 22 Department of Public Safety
IJ�I//1 Massachusetts State Budding Code(780 CMR)
Building Permit Application for any Building other than a One-or Two-Family Dwelling
(This Section For Official Use Only)
Building Permit Number: Date Applied: _Building.Official:
SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available)
I ^O Cc ri 0.) Sr SCI\eFrt fr1A C7\a'] Otv",.-,ej C11 0tG
9 No.and Street City/Town Zip Code Name of Building(if applicable)
SECTION 2.PROPOSED WORK.
Edition of MA State Code used_ If New Construction check here❑or check all that apply in the two rows below
Existing Building❑ Repair Alteratio Addition❑ Demolitio
� n ❑ n ❑ (Please fill out and submit Appendix 1)
Change of Use ❑ 1 Change of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No
Is an Independent Structural Engineering Peer Review required? Yes ❑ No 1
Brief Description of Proposed Work:
t'Z.Year CI C, v w, a<o .-, n y.�P l Y c�� W •Ar
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here Ilan Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑
Existing Use Group(s): I Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq. ft.)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑
I: Institutional 1.1❑ 1-2❑ 1-3❑ 1-4❑ M: Mercantile❑ R: Residential R-i❑ R-2❑ R-3❑ R-4❑
S: Storage S-1 ❑ S-2❑ U: Utility❑ 1 Special Use❑and please describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as a pId ble)
IA ❑ Ill ❑ IIA ❑ IIB ❑ 4QA ❑ IIIB ❑ 11 IV ❑ VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Trench Permit: Debris Removal:
Water Supply: Flood Zone Information: Sewage Disposal: Licensed Disposal Site❑
Public❑ Check if outside Flood Zone❑ Init
dicate municipal❑ A trench o not c P
required❑or trench or specify:
Private❑ or indentify Zone: or on site system❑ permit is enclosed❑
Railroad right-of-way: Hazards to Air Navigation: :�I�\I ligtnnc.G,nnninion it,�yic.v_In_xc+,<:
Not Applicable❑ Is Structure within airport approach area? Is their review completed?
or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
Edition of Code: - Use Group(s): Type of Construction: Occupant Load per Floor:
Does the building contain an Sprinkler System?: Special Stipulations:
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Ar� I///�V I wr— t'rJ 4'✓/ j G Ti CH N y/ �� ?/l�l/I /�/ / �
Name(Print) No.and Street City/Town 0 S,,I Zip
• a !
Property Owner Contact Information:
A-VW (— 17'7$P-7ti1---oL-3ea gf76V-r7l- 08 Sali�u,ie uviaa�/�rilrg Cey�
Title Telephone No.(business) Telephone No. (cell) e-mail address �J
If applicable, the property owner hereby authorizes
Thaw,r.r � l,vf-+if .� I �1nn,•..c,cl l�.e �4e<I-o--�.l urtyk olabo i
Narne Street Address City/Town State Zip
to act on the property owner's behalf, in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) .
f budding is less than 35,000 cu.ft.of enclosed space and or not under Construction Control then check here O and skip Section 10.1
10.1 Registered Professional Responsible for Construction Control-
Name(Registrant) Telephone No. a-mad address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor - -
�iys+�te
Company Name _
T�ul'•il C,S, (Cc-J t S' �V
Name of Person Responsible for Construction License No. and Type if Applicable
Street Address City/Town State Zip
9-6 ?-V 1700 815- 371a
Telephone No. business Telephone No. cell a-mad address
SECTION 11:1VORKERS'CONIPENSA'I[,N INSURANCli AEFIDAVIF M.G.L.c.152.§25C 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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.
Is a signed Affidavit submitted with this application? Yes O No ❑
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE: -
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)_$
1. Building $ C7, 00�p Building Permit Fee=Total Construction Cost x_(Insert here
2. Electrical $ i SOU appropriate municipal factor)_$
3. Plumbing $
4. Mechanical $ Note:Minimum fee=$ (contact municipality)
S. Nlechanica Other $ Enclose check payable to
6.Total Cost $ a I j0:� (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
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 my knowlesige and understanding.
7Flowns E Le. %5 -V. q `M(- I�ruJ
Please print and sign namne �pp Title Telephone No. Date
It 5�!rw czxr yam" A D (G 6 O .
Street Address City/Town �J State Zip 1 /
Municipal Inspector to fill out this section upon application approval: Nr 314 l
Name Dot
CITY OF SALEM, MASSACHUSETTS
BUILDING DEPARTMENT
98 WASHINGTON STREET,2"'FLOOR
TEL. (978) 745-9595
KIMBERLEY DRISCOLL
MAYOR THOT\L-1S ST.PIERRE
DIRECTOR OF PUBLIC PROPERn-/BUILDING CO-IMISSIONER
Inspection Violation
May 13, 2019
Claudia Siniawski
120B Canal Street
Salem, Ma 01970
RE: 120B Canal Street
Dogville
Dear Ms. Siniawski
On March 201h 2019 an inspection was conducted by the Fire, Health, and Building Inspectors
along with the Dog Officer. During the inspection there were several violations found which
need to be addressed. One of the violations as documented is to be allowed access to a locked
room for inspection. Per our discussion on Monday May 13, 2019, your non-compliance of
access for inspection to the locked room in your business will result in your 110 Certificate of
Inspection not being issued. Failure to obtain a current Certificate of Inspection is a violation of
Mass State Building Code 780 CMR section 110.7. At this time your business is not compliant
and is denied occupancy until all inspections are conducted and no violations are issued.
Per Mass State Building Code 780 CMR section R 104.1 and under the provisions of
780 CMR, section 104.6- Right of Entry, of the State Building Code, access to the property
must be granted for the purposes of this inspection.
If you feel aggrieved by the Building Code sections, your appeal is to the Board of Buildings,
Regulations and Standards in Boston.
Sincerely,
Voula Orfanos
Local Building Inspector
CC: Don Famico Dog Constable D.J.Geary Fire Inspector David Greenbaum Health Inspector