14 KOSCIUSKO ST - BUILDING INSPECTION E
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A P MG GRANTED
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CITY OF SA rm
Ode6/4/04
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SINS D 00 PERMR APPLICATION FOR: '
' Pannk to:
(Groh whiohawr apply) Roof. Raroof. Inat l Skflnp, CWWW.Doak, Ont Pool,
RapaldReplaoa. Other: see below for info.
PLEAN PILL OUT LEGIBLY III COMPLETELY TO AMD DELAYS IN PROMS
TO THE INSPECTOR OF E UILD M&.
Ma undw� haraby appW for a Wmk to build a000rdinp to fha fokaMrU
speolflftftw
Owneea Name Lisa Connolly & David Bardwell
Aditu A Phone 14 Kosciusko Street Salem (97A 1 744-241,l;
Arohkeat'a Name
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Name
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SIGN4D UNDER THE
OF PWUURY
DESCRIPT!OfN OF TO 1:1"r .°
renovation to kitchen. Replace ceiling & re-plaster walls.
Replace (1 ) entrancg d000r. Replace storm door & trim. j•
4.' Minor repairs to exterior Sidin
Painting of exterior house.
f • r
rKu , MNL PMIT 1`11 Lisa Connolly, 14 Kosciusko St, Ialem MA
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I Free Estimates
Quality Worlurkanship
Fully Insured&Licensed
B&D Building and
Remodeling Co.
GENERAL CONTRACTOR
Paul Domenici
Phone:(781)438-7890 P.O. Box 80446
Fax: (781)438-1774 Stoneham,MA 02180
Pager: (617)546-0855
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Workers' Compensation Insurance Affiltlavit
I, Paul Domenici of B&D Building and Remodeling
. . with-3 principal place of business at:
38 Montvale Ave, Suite 160, Stoneham, MA 02186
. . jcagia.aa✓aw)
do hereby certify under the pains and pcnalties of porjorya thars
() I am an employer providing workers' compensation coverage for my employees working on
this job.
WC 00547831600
AIG
Insurance Company Policy dumber
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 pol➢cies:
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
O I am a homeowner performing all the work myself.
I uneenuna wt a cony of thb ww we we be ioewaroee to tnt Ofnce e7 lmeictawro of she DIA iW to*erate 'e WKaden ana O X 411,01 m Wawa
co.eraar st rev+rte under Section ISA of MGL 15 2 can ka0 as tnr inoowion of uterirnr oetraron commons of a Ent of me=4 I.SMAO ender ont
Y(N7• 6.woohhn t L q!d u ciri der ,do n the form of a STOP W0RK ORDER ano a bre of S 100 AO a era/ ago rnt.
Signed this
4th day of June 2004 -_
� n
uccnscci' err ittet Euilcing Gepartn+ent
'-3censing heart
Paul Domenici, Owner Seiectmens Office
B&D Building and Remodeling �Iti; Dep:r-r en
38 Montvale .Ave, Suite 160
Stoneham, MA 02180 _ _ _ - LnL L[c _0c -r-y>_
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM,MA 01970
TEL (978)745-9395 EXT.380
FAX (976) 740.9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with&a provisions of MGL c 40,SA I w3wowledge that sa a cenditien
ofBuildng Permit 0 .all debris re Wftg from the consMwtwn activity
gov®ed by. ibis Building Permit shall be disposed of in a properly licensed solid-waa(e
disposal facility,as defned by M($,c In,S150A.
The debris will be disposed of at Wood Waste of Boston, 85-87 Boston St, Everette MA
Locadw ofFad-My
6/4/04
Sngwtuie ofPesmit��jn�hcad
Paul Domenici, o�`B&D Building and Remodelin gape
FULLY complde the following M&MMUM
(PLEASE PRINT CLEARLY)
Paul Domenici
Nana ofPennitApplicsnt
B&D Building and Remodeling
Finn Nave,if any
38 Montvale Ave, Suite 160, Stoneham, MA 02180
Address,City d<State
The above statute mquim that debris from the demolition,renovation,rehab or other
alteration of building or st iewie be disposed in a properly-licenud solid-waste disposal
facility as defined by MG,ca S 150A, and the building pamits or licenses are to
indicate the low of the facility.
✓xl 1J04/1.IILOIt[(t82�L/L Pw'l rllJJ(LC�(GIHCW
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 008129
Birthdate: 0 910 4/1 9 51
Expires: 09/04/2005 Tr.no: 3974
Restricted: 00
PAUL P DOMENICI
PO BOX 80446 �,'�
STONEHAM, MA 02180 Administrator
i
(// IJdINiI%IJOXLW.(Y�UL O�
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
f7 .y Registration: 102017
.y Expiration. 6l30/2006
'type: DBA
B&D BUILDING&REMODELING CO.
Paul Domenici
38 MONTVALE AVE SUITE 160
Stoneham,MA 02180
Administrator
Z,
Salem Histofical Commission
120 VMSHINIGTON STREET SALENI f0ASGACF!USE-rTS,_'j1?70
;9'M 745-9595 EXT.3"! FAX 1%97R) 7;u0404
CERTIFICATE OF NON-APPLICABILITY
It is hereby certified that the Salem Historical Commission has determined that the proposed:
0 Construction 0 Moving
-4 Reconstruction 0 Alteration
El Demolition 0 Painting
0 Signage 0 Other Work
as described below does not involve an exterior architectural feature or involves a feature covered by the
exemptions or limitations set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic
Districts Ordinance.
District: Derby Street
Address of Property: 14 Kosciusko Street
Name of Record Owner: David Bardwell/Lisa Connolly
Description of Work Proposed:
Restoration of dentil details and missing modillions to replicate existing. No changes in color, material, design
or outward appearance. Non-applicable due to being in kind maintenance/replacement.
Dated: April 5, 2004 SALEM HISTORICAL COMMISSION
By:
The homeowner has the option not to commence the work(unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals)prior to commencing work.
Salem ist cal Commission
120 INASH!NGTOti STREET SAL EM, MAS.SACHUSETTS 6i970
(978)745-8545"X T, 311 FAX (97S'-740-0404
CERTIFICATE OF APPROPRIATENESS
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction ❑ Moving
❑ Reconstruction Alteration
❑ Demolition Painting
❑ Signage Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: Derby Street
Address of Property_ 14 Kosciusko Street
Name of Record Owner: David Bardwell/Lisa Connolly
Description of Work Proposed:
Replace vinyl fence with wood fence (same style as 102 Federal Street) in same location as current fence.
Option.for each section to have pickets straight across or to curve into the center.
Paint colors: Body-Mesa Peach
Trim (including porches,fence and window sash) - Navajo White
Doors -Mill Springs Blue
Porch decking-to remain gray
Replacement ofrear door to match front door of 12 Kosciusko Street.
Dated: April 26, 2004 SALEM HISTORICAL COMMISSION
By:
The homeowner has the option not to commence the work(unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
+; THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals)prior to commencing work.