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10 JEFFERSON AVE - BUILDING INSPECTION
0010 JEFFERSON AVENUE 51-2004 �is a: -�zs6 . COMMONWEALTH OF MASSACHUSETTS Map zs CITY OF SALEM ' �sio�k: �,or. oaso "----- Category: 437 Nonresidential:ad jPermit# 51-2004 �UILDING PERMIT �Projec�� t# JS-2004-0069 Est. Cost: $70;000.00 �Fee $705.00 � 'Consr. Class PERMISSIONIS HEREBY GRANTED TO: Use Group: Contractor: License: iLof Size(sq. ft.): 42159 PETER STROUT Gen.Contractor/Code I G -022467 (Zoning: R2 �Owner: MOFFAT REALTY TRUST Units Gained: 'Applicant: MOFFAT REALTY TRUST Units Lost: I �AT: 0010 JEFFERSON AVENUE �Dig Safe# � ISSUED ON: t6-Ju1-2003 AMENDED ON: 2g-pug-2003 EXPIRES ON: 15-7an-2004 TO PERFORM THE FOLLOWING WORK 51-2004 CREATE OFFICE SPACE FOR MASSAGE THERAPY SCHOOL PER BOA DECISION. FRD POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Buildin Underground: Underground: Undergruund: Excava[ion: �` �°' ��Service: Meter. Fuotinge: Rough: Rough: Rough: Foundation: Final: Final: Final: Rough Framc: Fireplace/Chimney: D.P.W. Fire H ea Ith Insulation: Me[er: Oil: Final: Housc# Smoke: Treasury: Wacer: Alarm: Sewer: -� Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF Y.OF ITS RULES AND REGULATIONS. ����.� �,�„ . A 1 ��-o Signature: Fee Type: Receipt No: Da[e Paid: Check No: AmounC BUILDING REG2004-000073 IS-.Iu603 1191 $70i.00 G�II for ��er�i� t� U�ccupy GenTMS�2003 Des Lauriers Municipal Solutions,Inc. 0010 JEFFERSON AVENUE 51-2003 �,cis a;- 2�6 � COMMONWEALTH OF MASSACHUSETTS Map: 25 CITY OF SALEM Block: g . ,, Lot �.. �� „0480 -, ' � Permd ; Building ' � � � Category _, � �„ . 437 Nonresidential:ad, BU����NG PERM�� Permit# ;�:u,.:- 51-2003 Projec't# � � JS-2004-0069 � � — — --- --- _ . . Est. Cost: ,$70,000.00 �Fee: $705.00 " " PERMISSION IS HEREBY GRANTED TO: �Const. Class: Contractor: License: C1se Group: PETER STROUT Gen.Contractor/Code lG- 022467 Lot Size(sq.ftJ: 42159 _. 'Owner: MOFFAT REALTY TRUST Zoning: R2 ` " Applicant: MOFFAT REALTY TRUST Uniu Gained:. :�AT: 0010 JEFFERSON AVENUE Units Lost:_� � ISSUED ON: 16-1u1-2003 AMMENDED ON: EXPIRES ON: 15-1am2004 TO PERFORM THE FOLLOWING WORK 51-2003 CREATE OFFICE SPACE FOR MASSAGE THERAPY SCHOOL PER BOA DECISION. FRD POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbin¢ Buildin Underground: Underground: Underground: Excavation: Service: Me[cr: °octinesr Rough: Rough: Rough: Foundation: Final: Final: Final: Rough Frame: Fireplace/Chimney: D.P.W. Fire Health Insulation: Meter: Oil: Final: House# Smoke: Treasury: Wa[er: Alarm: � Sewer. Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEl�ON V�OI�T� OTy#1NY OF ITS RULES AND REGULATIONS. /u`��••-� I'C- ���(�-�� Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REG2004-000073 15-Ju1-03 1191 $705.00 � _ a CaIN for Permit to Q��cu�� GeoTMS�2003 Des Lauriers Municipal SoWfions,Inc. 0010 JEFFERSON AVENUE S1A-2004 --- -- cis #: z�6 COMMONWEALTH OF MASSACHUSETTS Map: 25 CITY OF SALEM iBlock �Lot: 0480 Category: 437 Nonresidential:ad� Permit# 'S1A-2004 �UILDING PE�IT Project# JS-2004-0680 Esk Cost: �$50,000.00 Fee: $505.00 �onst. C�ass: �i ' PERMISSION IS HEREBY GRANTED TO: iUseGroup: �Contractor: License: jLot Size(sq. fr.): 42159 PETER STROUT Gen.Contrac[odCode IG -022467 Zoning. R2 �Owner: MOFFAT REALTY TRUST Units Gained: _�Applicant: MOFFAT REALTY TRUST Units Lost: � �AT: 0010 JEFFERSON AVENUE �Dig Safe#: ISSUED ON: 11_Dec-2003 �AMENDED ON: EXPIRES ON: 11-7un-2004 TO PERFORM THE FOLLOWING WORK: S1A-2004 ***Addendum to 51-2004*** Change of use to commercial,tenant fit ou[of building and additional monies($50,000) received. Frd POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbina Buildin UnJerground: Underground: Underground: Excavation: Service: Me[er: Foo[ings: Rough: Rough: Rough: Foundation: Final: Final: Final: Rough Frame: FireplacelChimney: D.P.W. Fire Health Insulation: � Meter: Oil: Final: House ri Smoke: Water: Alarm: Treasury: � Sewer. Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF TTS RULES AND REGULATIONS. Signature: Fee Type: Receip[No: Date Yaid: Check No: AmounC � CERTIFICA'fE OF OCCUPANCY RBC-2004-000728 I I-Dec-03 240 $505.00 ' GeoTMS�2003 Des Lauriers Municipal Solu[ions, Inc. �� / 0010 JEFFERSON AVENUE 51-2004 �is a: —zs6 �� COMMONWEALTH OF MASSACHUSETTS N1ap: 25 CITY OF SALEM Block Lor. 0480 �Category: 437 Nonresidential:ad Permlt# 51-Zoo4 .. BUILDING PERMIT �Project# JS-2004-0069 IEst. Cost' $70,000.00 Fee: " `� $705.00 ` � � const. C�ass PERMISSIONIS HEREBY GRANTED TO: Use Group: Contractor: License: I Lot Size(sq. ftJ: 42159 PETER STROUT Gen.ContractodCode I G -022467 Zoning: R2 �Owner: MOFFAT REALTY TRUST Units Gained: �Applicant: MOFFAT REALTY TRUST �Units Lost �AT: 0010 JEFFERSON AVENUE �Dig Safe#: I ISSUED ON: 16-1u1-2oo3 JAMENDED ON: 04-Nov-2003 EXPIRES ON: o4-Nov-2oo3 TO PERFORM THE FOLLOWING WORK S I-2004 CREATE OFFICE SPACE FOR MASSAGE THERAPY SCHOOL PER BOA DECISION. FRD ***STOP WORK ISSUED*** 11/04/2003 ROUGH FRAME ONLY***. POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas PlumbinQ Buildin UnJerground: Underground: Underground: Excavation: �� Service: Meter. . . � Foo[ings: Rough: Rough: � Rough: Founda[ion: Final: Final: Final: Rough Frame: Fireplace/Chimney: D.P.W. Fire Health � Insulation: Meter. Oil: Final: HnuseN Smoke: Treasury: Water: Aiarm: � Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Reccipt No: Date Paid: Check No: AmounC BUILDING REG2004-000073 IS-JuI-Oi I191 $705.00 GeoT�'IS0?003 Des Lauriers Municipal Sulu[ions�Ine. 0010 JEFFERSON AVENUE 51-2004 c�s#: � �� � z36 .�; �� �� COMMONWEALTH OF MASSACHUSETTS tvtap: " 25 � li ., CITY OF SALEM Block: , ` # Lot 0480 Category: 437 Nonresidential:ad� DT7 � �Permit# , 51-2004 ; 17 V ILDING PERMIT Project# JS-2004-0069 i Est Cost , � .$7Q000.00 , �, ,; � I Fee ' ��� $705:00 � Co�st Ctass: PERMISSION IS HEREBY GRANTED TO: Use Group: Contractor: License: Lot Size(sq. ft.): 42159 IPETER STROUT Gen.Contractor/Code 1G -022467 !Zoning: R2 Ow�1er: MOFFAT REALTY TRUST Units Gained:° ° Applicant: MOFFAT REALTY TRUST Units Lost ,AT: 0010 JEFFERSON AVENUE �Dig Safe#: ISSUED ON: l6-Jul-2oo3 AMENDED ON: o4-Nov-z0o3 EXPIRES ON: 04-Nov-2oo3 TO PERFORM THE FOLLOWING WORK 51-2004 CREATE OFFICE SPACE FOR MASSAGE THERAPY SCHOOL PER BOA DECISION. FRD ***STOP WORK ISSUED*** 11/04/2003 ROUGH FRAME ONLY***. POST THIS CARD SO TT IS VISIBLE FROM THE STREET Electric Gas Plumbine Buildin Underground: Underground: Underground: Excava[ion: Service: Meter: . Foo[ings: Rough: Ruugh: Rough: Founda[ion: Final: Final: Final: Rough Frame: Fireplace/Chimney: D.P.W. Fire Hea Ith Insula[ion: Mcter: Oil: Final: House# Smoke: . Treasury: . Water: Alarm: Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receip[No: Date Paid: Check No: AmounC BUILDING REG2004-000073 IS-Jul-03 1191 $705.00 GeoTMS�2003 Des Lauriers Municipal Solu[ions,Inc. I` � � r � :� r�o. � � -ZC�� �/ City of Saferr� Ward R I . � ����°�c� . � � � � ` , ...�9 ; a> . . . .acom,e w/ . APP�fCATION " F�, PERMIT TO BUILD ADDITIDN, MAKE.ALTERATIONS OR NEW CONSTRUCTION ' IMPORTANT-Appficant to-eorripfete alblfems in seetiorts:�ll, l/l, N,and IX. " I. ., ATICOG7ION1. �O�C��F�/cSO/✓ �✓�fl � �� . LOCATIpN • OF eErwE�+ u+o BUILDING "�S� �g'"�" ,t� SUBDNISION � lOT_BLOpC SI� 11. TYPE AND COST OF BUIL�ING •aiFapplicants compJete Parts A-D A TYPE OF IMPROVEMENT D. PROPOSED USE•FOR"DEMOUitON"USE MOST RECENT USE � , � Q N�w euiwrng � AnWMua1 ... � Noamq�W _ . � Y [�nedNwnrn�esiaem�v.emernumeerarow tx Q�Onslemly. � . te � M�wmsN.�t,refe�W . nawngunns,adqetl.Yarry,nP�t0.f31 �3 Q Twoamae�amM'Enrarnumber t9�� ��� 3 Q Atterawn ISee 2 a0orol M uYs _ 20-� k�OwMol. .... i < Q R�rRplacenMrM � 14 ❑..TranaetihoPol.rtnlelorOprmilwY• Z� �..�99r+0o ' .� - . .,6w.wmeramoo 22 ❑•servce.emn.�pa.�yaray. �. � � 5 („� Nhs��BW�Y�dv�ealanfsnntler �. . ___ . �{ �.�y�,� � I . . olwWsnd�i�irtyini9rtO.13) 1S � Garags 21 �pRo�cFunlc.Y� . 6 O �9VebraEOn�. � - xs ':P„tlie,.i�V � . . ,e Q Qaoa, �� 7 Q Foir�tonmly . � �,Q:.Scnoa4YEiarv.d�w.edKaua� 17 � Otls•SpectiY .. . .27��..S�aw,.ne�qile � B.OWNFRSMP � � .T9.Q:Taia.brsa . e ��Prmatel�tlNiOw4mrCorauon.norPd'R � ��.�Y ��.i ❑ 9 p ���.�..«��,.��. _ _ , C.COST� , �. . � �tanearp� w.eadem omqes_noeta+ni'cooaea�seaeideigs.a6.roaa.pows.g.omnc rtiatlii�e enoo.mu�WY�+9 m naeP�.�Y�ciioal aecmaarY��ool.coYe9e. pa�eMie�aMoa4carlmggarage for�Eeaai&i�eit atas.iafal olfice bd�ii9:�01fd EWtliS 7Q Co9dinP�ouemenl .. . . i ��Ql,'�1�� �.�.qyy.pweal.e.eon4d�n9�e�be+9�4aaw-papasetl�ar . Tob�itledhrtnnlnriUed � �� ' � � � ��.w,�� OF�icc� 3�ec� �2 wr�F 7N�a:�c� a EMcvim �'� . . . � ,v�e,,,, �O ooc�,— 5c#lckiL ��+�w.a. � cc�oo — , - ; _, a�eew�eb.ror.wet .. ._ . . � . . _. . .. . -.g._. _ . . .�t.i9►/1��.COSTOFIMPROVB�IENi . .� 3 . ... . . . . UL SELECiED CHARACTERISTICS_O_F.BULLDING -Fw new lwtidings and addiLais,comp�ete Parts E-L,;demdiNon, coin ete on �aits J 8 M,aU oU�ers skip to!V . E PFtI1K�AtTYR,EaF.Flii1� . .F.�'PR�7CP!¢iYPE�OF'HEA741GFUFl.� G. TYPE�qFSEWAGEDtSP08AL -�L�TYPEOFMECHANCAL . 30 Q•M�Ybithe�iip) 36,Q.Gas . 4U.E��P+WiearaMrsaemOrM 11�IIveOsorwrr � canEYlori��t r 31 �'YN]otl4Ynw 38 W 41 a Privabl�0aC10�rcMCl . . 32�SUu�al aletl 37 �Fk�Jid1Y . - . . �. ..� . M-�Yls d5-Q'ND a3.0.ne�a,o.a�cmee ae Q.car rt trPE waTEn sl�xv _ vwrws�w.p«a..n_� �,a«�.-�, �a«�-�. . � �`���� ,� o �,� ;�e',� � ���.,.m.a:�; ; u- . — — -- , �.oiMer+sroNs /} �v}:.DEMOLITION OF STRUCTURES: � . ag Numceror stones .._.._..—_._........_.................. ` ..�. "• 39. Toa�sauare feet d Xoor area � � � � n���e�, Has Approval from Historical Commission oeen received ���„ _...----.---.-_----.---:. �c��,� for any struclure over fiflY(50)Years? Yes_ No_ � 5p_ T„a un,,,ea sa.K_— `Dig�Safe Number IC NUMBQi OF OFF•STNEET PARqNG SPACES r ���; � 51. Er�ea_. `FiAVE THE FOLLOWING UTILfTIES BEEN DISCONNECTED? •� °i"0001 ` " Yes No , � . � . L flE9DH7FlN.&!9l1MG3 OIU.Y - �: ' � ;;. •,-�F: � . .., . . . „` . � . ... . . . .. . . . . . . . S1'6cloxC ' . .�' . � . _, .. . . .. . .C]88.. ,.: . ._ . . � _ .. � . FA $BYYCf; . 50:�flimber d � `oammma DBi.�)MENTATION FOfl THE 1180VE MUST BE ATfACHED � BEFORE A PERMR CAN BE ISSUED. - ,.; N. COMPLETE#IiE FOLLOWING ,. HiStoric District? Yes_ No (ff Y�,P��enGose,documentation�n•Hist f,o�j _: - -- . . _ _. _ :._ _ .. _ Conservation Area? Yes_ No (H Yes,please encf"ase Order of Conditians) _.__..._.._ , Has Fire�revention aPPrwed and stamPed Plans or aPPtications? YeS__ NO_ Is propeAy IocaUe�in the S:RiC districl? Yes_ No Cornpy vMh zoning? Y __ No_ (ff no,endose;Boardc�nppeal decison) Is bt grandfathered? Y l,' Nb_ (H yes,submii docurtientationfif no.submit Board of App�t decision) If`new cor�strucdw4 has 1he:Pr�er Fiou6ng SIiP been endoged? Yes� No Is Ar�itectural'Access 8oard aPProval reQuired? Yes_ bb_ (H yes,s�mit documentatlon) � Massachusetts State Contracror ticense# r92�S'� � saiem uc�r,se x Hwne Improvert�ent Contractcx# Horticowners Exempt form'('rt appP�cable) Yes_ No_ , - . : �. CONSTRUC170N T�BE COMMENCED W1�Fi1N S4X�6)MON7}iS OF ISSUANCE OF BUILDMG PERMIT CONSTRUCTION IS TO BE COMPLEfED BY: I i. �,3 ��extensan�r�ssary ptease submd in writing to Cie in'spector'qf 8'u�ngs. Y. IDENTIFlCATION- To be completed by all applicants Nsro Mali4 atltliea•Munder.sAeet edP,an0 tlie 21P CAh Td Na 1. - . . . ..... Qwr a . . . _ . � . .. . Imee ,,. ;.:.�O�d�- 7 - .. ... . . Z � 2-9 .Z ,�t� t� D _ L-�" ` � 70 �yr- i ,. c�av .,:. _; _,,. _ ,e�or� _. • , u�...,� . O�YG � ;p ' � c� �vo�v �`7" _ L . .MCIYeaor . . . . . . ..�P� _ . . _... . _, � . - . � . � ��Y�Y tlmt ib Dosed� isautlid'aeA 1�die arner of�{et:ad.and th�.l.Aave been autlmraed by the owmr to�malce�tl�is�aRP� � as liis aumoraetl'� � a we . .co. �.... So all anolicable laws of tliis iurisdiction. � . .. . . . _ ._.. . . ��re of: _ Add�S..�l �E/ZI/.Q�E daze � , �o�T,k �,... _ '- OF SALEM. M�`.SSACHI:SETTS �� � � FUBLIC PROPERTY DEPARTMENT � � ° g 120 WASHIN6TON STREET, 3RD FLOOR � a 3. .(PE SALEM, MA 01970 ��'s�"�✓ TE�. (978)745-9595 EXT. 380 �G� . FAX (978) 740-9846 . . � - STANLEY J. USOVICZ, JR. � . � . - > MAYOR � � - � � DISPOSAL OF DEBRIS AFFIDAVTT In accordance with the provisions of MGL c 40, S34,I acl�owledge that as a condition of Building Permit# ,all debris resulting from the construction activity govemed by ttus Building Permit shali be disposed of in a properly licensed solid-waste disposal faciliry,as defined by MGL c III, S150A. The debris will be disposed of at: �JQ`-�f —1'/Z ddR/�C 12- � ��/�' Location of Facility , - 7 /J"'� a ' p,PP cant ] ate FCTLLY complete the following information: (PLEASE PRINf CLEARLI� ��=aL ��LOI/� Nazne of Permit Applicant —�,��, u �t/ 2 . l� ! �� ���`�r�� � �S" � ,d L �'d�2.oc.'/� Firm Name,if any � ��Z//,o/ n - % , ►v�,�. Address, City & State i The above statute requires that debris from the demolition,renovation,rehab or other alteration of building or struchue 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. . �_ � 'i� 0I q� ( ��—� �om:manw�:aGfh o� /��a��aChtv¢f� y' y �.Pa,��.,� 0/9,�,��.�f�«;�,� , ` � boo w�,��s��...� �i James J.Camooe6 f�oslon, /!/aaac�ivaslt! D�1 /l Coramrszana .. � . . Workers' Compensation insurance Affidavit �. _ ��'F'2 S?lpovf � (oe....ini.inw) . . . wicha principai place of busineu ar. � .� 9 �Ei�v.�« �D . �i1L�� , w�� ,�..,s..�.,y.� do hereby certify under the pains and penaltiu of pefjury, thas: () I am an employcr providing workers' compensation �ovcnge ior my employets workine on shis job. Insunnce Company Poliq �lumber . � � I am a sole proprietor and have no one workin� for me in any capadty. 1 am a sole proprieco�, general coranaor or homeowner (cirde one) aad have hired the contraaors listed below who have the following workers' compensasion polities: Contnccor Insunnu Company/Poliq Numbe� Contraam Insurance Company/Policy Numbe� : Contrattor Insurance Company/Poliq Number () I am a homeowner performing nit the work myself. , I�naerscane w��covr of�hit w�cmmc.�De ion+aroea �o GK Ottce ol Imesri��uwu of the DIA la co+erne.eribada+ana uut Wve�o fetwe cov�rass u r�a+rea unosr Section 25A o!MGL 1 S 2 can lead w u+e imownion ol cr'v+wui o�n„tics corwtin{ol�fne ol w toi I.SOOGO-anGa ont . rtori on,xwmmmc v.iso af cir3 eena�ua in thi lorm ef� STO P W ORK ORDER :na�fne of S 100.00 a aar�Pntt me. � Signed this . � day of ��� _ 7�3 , ��� � ��� ��� e e J Building Deparsr„enc Licensing Board Seieamens Office Health Deparzment TO VERIFY COVERAGE INFORMATIOT7 CALL: 517-727-4900 X403, 404, ?O5, 409, 375 _ 1 DO NOT WRITE BELOW THIS LINE VI. VAUDATION Buildin9 Fcxtoea�atTMerrr usE ori�v Permd number Building use G�aw PEfliII�ISSUEd i9_ � FseGra�ng . Building P'ermit Fee S �� Certiticate of Occupancy S ��0 APProvetl by. Drain Tile S ��,,...� {'�- �-1�/�� �I � � «� Plan Review Fee S � D � .�r-o.� i , NOTES AND Data•(For depaRment use) i � � • . � � PERMR TO BE MNLED T0: DATE MAILED: ('anstructron to be started by. 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