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15 HEMENWAY RD - BUILDING INSPECTION • �IT'�©F�XLEI- -- ' PUBLIC PROPERTY DEPARTMENT Z A1S6lFJ YDRIX:OLL MAYOR � 120 WASMINGCON��7REEr*$A1kdr,WAISACHL56TI301970 TEL,978-73S-9595*FAX 978-740.9846 APPLICATION FOR THE REPAIR RENOVATION CONSTRUCTION, DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING STRUCTURE OR BUILDING 1.0 SITE INFORMATION Location Name: t) d1a rV Building: Property Address: Q�i✓dy' rid. property is located in a: Conservation Area Y/N Historic District Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land _ Name: C_ Address: V Telephone: Li? 1 I 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use New Demolition Existing Approximate year of Area per floor (sf) Renovated construction or renovation New of existing building grief Description of Proposed Work: Mail Permit to 1Ac—�,�yl MWAIruA< 4 LAva v,or� LA 'Wv) MBA Qlgl s What is the current use of the Building? Material of Building? If dwelling, how many units? Will the Building Conform to Law? Asbestos? Architect's Name Address and Phone ( ) Mechanic's Name Address and Phone C,5N1ny)t E>)2t-ce-4 ��f ve M`q Construction Supervisors License# HIC Registration# Estimated Cost of I"ct C Permit Fee Calculation Permit Fee $ / Estimated Cost X$7/$1000 Residential Estimated Cost X$11/$1000 Commercial An Additional $5.00 is added as an Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to build to the above stated specifications. Signed under penalty of perjury X \ - Date N c o`, 3 b ri 9 O r1 OA- u -- o I n��n�u������nst n�nu-���CnLn��LnLPLr IMPORTANT DOCUMENT 5 CPrtlf itatP Of flamic 141koI.9tatur 5 5 REGISTERED �� ISSUED BY �5 �5 APPLICATION a s �® Date of Manufacture'Y 5 5 NUMBER �(]Qj���+ 1 WDUSTRIES INC.:, - 2/26/99 EVANSVILLE, INDIANA 47711 Order Number C� 5 F121.4 0 216154 5 5 �T MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated 5 C5 (or are inherently noninflammable) and were supplied to: h5 RICE RENTAL CENTER 5 5 TAYLOR RENTAL CENTER 5 115 CABOT STREET 5 SBEVERLY MA 019155108 5 5 Certification is hereby made that: 5 5 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 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5 5 The method of the FR chemical application is: 5 5 Serial #: 8105660 (0005) e5 5 5 Description of item certified: e TENT WAL 6-10 X 20 VL W W 2/CA 5 5 5 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric e5 5 TATESVILLE, NC Signed: 5 Name of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC. o rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�cPrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJrJ�rJ�rJ�rJ�rJ�rsrJ�r�c.n�ntPrJ�rJ�rJ�rJ�rJ�rJ�rJ�r�rJ�rJ�r�r�r�rJ�rJ��nrJ�rnrJ�rJ�rJ�rJ�r��n�nrJ�rJ�rJ�rJ�rJ�r�rJ�rJ�rJ�rJ�cncP�nrJ�rJ�rJ�rJ�r�rJ�rJ�r�rJ'�P�nrJ�rJ�rJ�rJ�r�rJ� � KUL:n�n�r�r�srs��n�IRr�n��nu��nrrrr��nrsu��nrr 01 IMPORTANT D O C U M E N T M nrr�nrr�nursrrurr�rr��r rrr�nr�r?n LpLrrrT�rp a 5 erdifltate 0f fYame Rot"Itante 5 REGISTERED ISSUED BY 5 APPLICATION �� Date of Manufacture 55+ 5 NUMBER4�INWSTAIESINCO 02/19/01 5 5 � EVANSVILLE, INDIANA 47711 Order Number 5 5 MANUFACTURERS OF THE FINISHED 333649 S 5 Dj TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated 5 (or are inherently noninflammable) and were supplied to: 5 S6928255 5 5 RICE RENTAL CENTER 5 TAYLOR RENTAL CENTER S 115 CABOT STREET 5 5 BEVERLY MA 01915-5108 5 Certification is hereby made that: 5 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 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5 5 The method of the FR chemical application is: 5 SSerial #: L�U c 8023300(4) Description of item certified: 5 FI EXP MID 20W X 10 VL W W 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric 5 JOHN BOYLE STATESVILLE NC Signed: _.� I5 of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC. 5 O rJ 3rn�PrPrJ�rJ 3cPrl3rl3r PrPrJ 3cPrJ�cPrJ�rJ 3r PrJ�rJrJ 3cTurJrlorr3r JrJ 3rJ�rJ 3rJ 3cPcPrJ�cPrJ 3rJrJ�rJ 3cJ 3cPrPcPrJ 3cJ 3cPFJ 3cf3rrlc flrJ 3rJ�rJ 3r f3rrlrPrl3r PcPr 13rr11 Prr3rJ�rJ 3r?nrJ 3rJcPrJ 3cPr�rPFJ�cPrJ�rJc J�rJ 3rJ 3rJ 3cPffl33 p _ i LLPLPLPLLPLPLPLrjgIDEuEugim'mliMPORTANT DOCUMENT 5 Certif leave 'Of Flame Resistapee 5 5 REGISTRATION ISSUED BY 5 5 APPLICATION Date of Shipment 5 5 5 _ C,ffl! D3nv0s 5 NUMBER s INDUSTRIE iNc. fj 5 Ji EVANSVILLE1 INDIANA 47725 Tent Identification 5 5 5 Fl2t.a °r MANUFACTURERS OF THE FINISHED 04033875 rj5 TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated 5 5 (or are inherently noninflammable) and were supplied to:692825 5 5 RICE RENTAL CENTER 5 rj TAYLOR RENTAL CENTER#14978-4 5 115 CABOT STREET 5 5 BEVERLY MA 019155108 5 5 5 ' 5 Certification is hereby made that: 5 5 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 5 5 Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. 5 5 Serial # 8023000p1 5 rj Description of item certified: 5 5 FIESTA EXPANDABLE TOP 20WX20 C,f WHITE VINYL ? 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric 5 5 JOHN BOYLE STATESVILLE NC Signed: Q--,n/ 5 `/SPECIAL EVENTS DIVISION-ANCHOR INDUSTRIES INC. O rJrJ�rJ�rJ@PrJ�t:Pr.PcP�P�P�PrJ�cPcPrJ�cP�PrJ�rJ�cPrJ�rJ�rJ�rP�P�PrlOrJ�rJ�rJ�i:Pt:PrPrJ�rJ�rJ@PcPc.tOrJ��PrPrJ@PcPrJ�rJ�rJ�rJ�rJ�cPrJ�rJ@P�lOrJ�rJ�rJ�rJ�rJ�rJ�rJ'rJrJ�rJ�cPrJ�cTrJ�PrJ�rJ� O ° `K����I M P O RTA N T DOCUMENT'����'��LI'L�LPLPLPLPLPLp� o 5 Certificate of Flange Resistance 5 5 REGISTRATION ISSUED BY 5 5 Date of Manufacture APPLICATION v 5 s CN�R®5 NUMBER 05/08/03 5 t INDUSTRIE INC. 5 5 i EVANSVILLE, INDIANA 47725 Order Number 5 5 F121.4 MANUFACTURERS OFTHE FINISHED 368094 5 STENT PRODUCTS DESCRIBED HEREIN 5 S5 This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: 5 5 5 692825 5 RICE RENTAL CENTER 5 C5J TAYLOR RENTAL CENTER#14978-4 5 5 115 CABOT STREET 5 5 BEVERLY MA 019155108 5 5 5 - 5 Certification is hereby made that: 5 5 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 5 5 Fire Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5 5 The method of the FIR chemical application is: 5 5 Serial # 8I05960(4) l 5 5 5 Description of item certWWAL 6-IO X 30 VL W W 3/CA C 5 5 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric �5 5 JOHNBOYLE STATESVILLENC Signed: 5 5 Name of Applicator of Flame Resistant Finish TENT DEPARTMENT-ANCHOR INDUSTRIES INC. 5 O rJr�tPrl3rJ 3r�3c r3[l3rPcPcPrJ�rJ�r PrJ�rldJ�cPr�rPr nu�cPrJ�rJ�rJ�rJ�u�rPrJ�rJ�rJ�rJ@PcPu�u�rJ�u@nrJ�u� �ncnu�rJ�rJ��nrJ�rJ�cPrJ� L3pLp�uLpLpL PLPLLFL3PLr PLPLLPLPLPLnuL E,