2 LINCOLN RD - BUILDING INSPECTION ' ITS' C)I� 5 Al F ���
If PUBLIC PIRO ?ERT-v
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APPLICATION FOR PLAN EXAMINATION AND BUILDING PERMIT
ALL STRUCTURES EXCEPT I AND 2 FAMILY DWELLTNGS
- IMPORTAART:Applicants most complete all items on this page
S{TE:INFORAT IO '
Location Name ug�i Gauligan Bu;ldingg garage
Property Address inco n oa ,. a em
Map#
i
Located in: Conservation Area Y/N Historic district YIN
Use Groups
(check one)
Residential(3 or more Units) R2_
Type of improvement Residential(hotelimotel Rl_
(chec),one) Assembly(churches) Al _
New Building_ Assembly(nightclubs etc) A2_
Addition Assembly(restaurants,recreation) A3_
Alteration Business R
Repair/Replacement Educational E_
Dentolition X Factory(moderate hazard) Fl _
Move?Relocate Factory(low hazard) t-2_
Foundation Only - High Hazerd Fi_
Accessory Building_ - Institutional(residential care) Il _
Other(describe) htstitutional(incapacitated) 12_
institutional(restrained) 13
Mercantile. 1.1v7_
Storage(moderate hazard) S I _
Storage(lose harnrd) S2_
OWNERSHIP INFORM:CIION(Please type or Print Clearly)
OWNER Name
Hugh Gauligan
Address 2 Lincoln Road
Telephone 978-741-1260
DESCRIPTION OFNVORH IO BE PERI'ORRIED
Demolish two-car garage on site
ES17�lATED CO:N.STRUC TON COST $4,000
22 1qrw.�eQ ////0/ Dig T�
CONTRACTOR INFORMATION
Name H & S Tank CLeaning, INc.
Address 101 Foster Street, Peabody, MA 01960
Telephone 78-531-6433
Construction Supervisor's Lie# 053814
Home Improvement Contractor#
ARCIJITECT/ENGIA'EER INFORMATION
Name
Address
Telephone
Mass. Registration #
PERMIT FEE CALCULATION
Residential est. cost x $7/$1,000+$5.00 = $25.00
Commercial est. cost x $11/$1,000 +$5.00=
COMMENTS
The undersigned does hereby attest that all information stated rebov trite to the best
of my knowledge under the penalties of perjury
Signed `
AW Date 1 o
r
1
li
V\0000,
0 o
J1- CLEANING, INC. LOVO° �
ENVIRONMENTAL SERVICES
Site: 2 Lincoln Road �f
)�h
To Hugh Gauligan Phone: 978-741-1260 �
2 Lincoln Road fax: v"
Salem,MA 01970
Date: (/
H&`S rank Cleaning,Inc. proposes to demolish and remo one(1)Garage at the
above .ite address. This removal includes disposal of con and wood 5
H& S tank Cleaning, Inc. will provide the following paperwork: (aJkD-F e-0 u
1. Permit
GENE) AL WORK CONDITIONS: 1/
The ab ve work will require the use of construction equipment. We will exercise normal care,
but wil not be responsible for replacing landscaping,paving,concrete,fences or for the settling
r of the i Iled excavation area
We pr )pose hereby to furnish material and labor—complete in accordance with the
above specifications, for the sum of
Four Thousand and Twenty-five Dollars $4025.00
Hopeft y,the above will provide you with the information you need to have us schedule this project.
Please c dl if you have any questions
If you v sh for H&S Tank Cleaning to proceed with the project,please SIGN below and fax back to
as at:9 3-532-5625 or mail to: 101 Foster St.,Peabody, MA 01960
This pit posal may be withdrawn by us if not accepted within 90 days.Interest shall accrue at the rate of
1.5%pa -month on all amounts not paid within 30 days.Customer agrees to pay all costs of collection
include ;a reasonable attorney's fee in the event this account is turned over for collection
Accep ance: The above prices, specifications and conditions are satisfactory and are
hereby accepted. You are authorized to do the work as specified. Payment will be made
upon c 3mpletion.
Signal are• Date: