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8 HATHORNE PL - BUILDING INSPECTION r 4 t3 � if 14 T own G .P T I EWG GRANTED j IT OF S EM NO Data Oc�, 3 , 2a03 Ward i Zoning District I ,jPrWpgrtyLocatedIn Location of ' I���OVh� nl '{tie Hisf kc District? Yes_No Building rJ l __pgrty Located in re'emi",ratl9n Area? Yea_No X BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof Install Siding, nstruct Dec Shed, Pool, e air/Re lace Other: e.uod'/ PLEASE FILL OUT LEGIBLY &COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's Name Address & Phone ��c�l'�'rtu '� (97P) M ,?70S-_ Architect's Name Address & Phone Mechanics Name /gN�i�er7, � • r /�� Address & Phone ,30 Asorne S �2%}u J� (9900) 71-I — S �v What is the purpose of building? Material of building? If a dwelling,for how many families? 1 Will building conform to law?�Y es Asbestos? /y0 y Ilstimsted cost ar/�city License s state License to 4?/77/ Hare Improvmnt Lit. 1 Signature of Applicant ��� SIGNED UDDER THE PENALTY OF,PERJURY DESCRIPTION OF WORK TO/BE DONE MAIL PERMIT TO: Z4/ e 'LAC- �4 s WIF Ya vo _ on N/13 tls� -1 C) 14 1 W"V '�.o ay;A.Y,t.'.du"a. yli L' 7YS io_I PLC.da,.tmeYti .. f.b ...._. ..-8fan'r ip ry tr10 ^t;+;:i4.pFrl Oil! �'4''� ..�...._'��'•Y y oaresf, Isr�f3a;4'Yasaf;�rCT IJ of o i?7,' �Y76 .+r s'� IY X;.: tt7 'i'e'�'!"l .�a"8,"J i i✓kl a.t x, 1i `.''rt;`{,7A 1`iw+li t"d{.71ii�il,_ ... Wl ?TA 30 GI€J'V:A OT "4".dl373JqU0,3: A v J80"i J ?a.CO Url . AW"4 14".r C;T ;N'1et,Vrz�h•v9 w^I Co �i'G�7 ze^J.bP9 i1�i. C" s� {iY" tr :; 3>',l onJl ,7h'?: Wt.:�ay!➢d'f ya.' F.ra,.4CS'�:a.l'4 lh;;=§:_�, .Y 11.ti4yc @fir It .'a �mkffmbl ';N1W. W+Ir1 uii QKligsae+ A 4!_ . _ ......... �.. `krf NJ I� =F"ifalLFk ^if3RJ1wk, i t f--*a rt^!^stPtlr,' �Etlk I IC HWi ~a,a�ea�ewmha+xv';*�urwl esxmxy8 t•�z'Y.tl.i EASY iB i ll.R� J� l9Ci� ' 0008 HATHORNE PLACE 368-04 cIS #. 3611 COMMONWEALTH OF MASSACHUSETTS Map: 125 CITY OF SALEM Block: Lot: 0304 Category REPAIR/REPLACE Permit# _ 368-04 - BUILDING PERMIT Project# JS-2004-0518 (Est. Cost: $25,200.00 Fee: $155.00 Const.Class: PERMISSION IS HEREBY GRANTED TO: Use Group: Contractor: License: Lot Size(sq. ft.): 3500 " ` MAPLELEAF BUILDERS Home Improvement Contractor- 133683 Zoning: R2 Owner: BUCCI VINCENT Units Gained:- Applicant: BUCCI VINCENT Units Lost: - lL � Dig Safe#: `4T.- 0008 HATHORNE PLACE ISSUED ON: 15-Oct-2003 AMENDED ON. 04-Nov-2004 EXPIRES ON: 15-Apr-2004 TO PERFORM THE FOLLOWING WORK: REMODEL KITCHEN T.J.S. POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Building Underground: Underground: Underground: Excavation: Service: Meter: Footings: Rough: Rough: Rough: Foundation: Final: Final: Final: Rough Frame: Fireplace/Chimney: D.P.W. Fire Health Insulation: Meter: Oil: Final: House 4 Smoke: Water: Alarm: Treasury: Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2004-000532 15-Oct-03 1425 $155.00 GeoTMS®2003 Des Lauriers Municipal Solutions,Inc. 0008 HATHORNE PLACE 368-04 cIS#: 3611 COMMONWEALTH OF MASSACHUSETTS Map :'` 25 Blo CITY OF SALEM ck: Lot: 0304 Category. REPAIR/REPLACE T 7 Permit# 368-04 BUILDING ILDING PERMIT Project# JS-2004-0518 Est. Cost: $252,000.00 Fee: $155 00 Const. Class: PERMISSION IS HEREBY GRANTED TO: Use Group: Contractor: License: Lot Size(sq. ft.): 3500 MAPLELEAF BUILDERS Home Improvement Contractor- 133683 Zoning: R2 Owner: BUCCI VINCENT Units Gained: . Applicant: BUCCI VINCENT Units Lost: „Dig Safe .AT.- 0008 HATHORNE PLACE #: - ISSUED ON. 15-Oct-2003 AMENDED ON: EXPIRES ON: 15-Nov-2003 TO PERFORM THE FOLLOWING WORK: REMODEL KITCHEN T.J.S. POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbin¢ Building Underground: Underground: Underground: Excavation: Service: Meter: Footings: Rough: Rough: Rough: Foundation: Final: Final: Final: Rough Frame: Fireplace/Chimney: D.P.W. Fire Health Insulation: Meter: Oil: Final: House# Smoke: Water: Alarm: Treasury: Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2004-000532 15-Oct-03 1425 $155.00 GeoTMS©2003 Des Lauriers Municipal Solutions,Inc. �o CITY, OF,SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 'as 120 WASHINGTON STREET, 3RD FLOOR SALEM, MA O 1970 TEL. (978)745-9595 ExT. 380 FAX (978) 740-9846 STANLEY J. LISOVICZ, JR. MAYOR E DISPOSAL OF DEBRIS S AFFIDAVIT In accordance with the provisions of MGL c 40, S34, I acknowledge that as a condition of Building Permit# , all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid-waste disposal facility, as defined by MGL c��M,, S 150A. The debris will be disposed of at: '3�2'/e' Location of Facility ZLI' �- 3 Signature of Permit Applicant Date FULLY complete the following information: (PLEASE PRINT CLEARLY) Name of Permit Applicant Firm game, if any Address, City& State The above statute requires that debris from the demolition,renovation, rehab or other alteration of building or structure be disposed in a properly-licensed solid-waste disposal facility as defined by MGL cIII, S 150A, and the building permits or licenses are to indicate the location of the facility. �ommonulaabk of //la66ackaffs s James I Unload Uoiloa, as�ae(�.W o21 1 f cornintssaoraa Workers' Compensation Insurance Affidavit (at�.eera.rrwee) with.a principal place of business at: do hereby certify under the pains and penolties of perjmY. that: I am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company 67 Policy Number I am a sole proprietor and have no one working for me in any capacity () 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor insurance Company/Policy Number () 1 am a homeowner performing all the work myself. I unetntanC Mat a coot of the uacement..a bt ie, .3roed to the OfrKt 07 inresdtatrons of the DIA 1a connate +eAkadon and out(Jaunt to WOW co.erap m reoureo amen Section 25A of MGL 152 can lead to the inoeouon of erinirnt ottwdes coratsdnt of a fine of W toi 1.$M.400 mWor one reap'i:.xuommrnt v vu gas ' ' otna�ua in the Iortn of; STOP WORK ORDER a/no�a fine of S 100.00 a am at>+ttt me' Signed this �a day of 19�l-e-,,i � �iccnscc/Fernlittee� building Geparin+enc ,Lcensing E"rd• Seleetmens Office rulrh Department - - - - - - -__� c