23A MARION RD - BUILDING INSPECTION CITY OF SALEM
PUBLIC PROPRERTY
� DEPARTMENT'
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Insurance Company Name:
Policy 0 or Self-ias.Lie.M
Expiration Dam-
Attach. )orb Site Address:
Attach•copy of tlr workers'con aaatba City/Statemp.
Pe ItoBey declarations page(also -------
win the pulley number sad esplrsdou dace)6
Failure m secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal pansides of a
fuze up to$1.500.00 and/or one-year imprisonment,as wen as civil penalties in the form of a STOP of up to 3250.00 a day against the violator. Be advised din a co of this sta
Investigations of the D for nce insura coverage verificstioo. ItY kment may ba forw WORK ORDER and a Rae
arded to the ORice of
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Of ciaf use onIA Do not write iw this areq to be cowpkfed by dfy or Iowa o,Q7cid
City or Town: Permit/Lieen"M
Issuing Authority(circle one):
L Board of Health I. Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector6,Other
Contact Person•
Phone*
TO: Paul Walsh, 23A Marion Road
FROM: Jill Fama, Property Manager � eY`"`e 7� 1 - g3a— X air
RE: Deck Replacement
DATE: April 11, 2007
Please be advised, the Board of Trustees for Pickman Park does not object to the
replacement of your deck. Please be advised of the following requirements:
• You may not change the dimensions of this deck.
• Any changes to the appearance must be approved in advance by the Board of
Trustees; however, they have approved some composite materials in the past.
• A licensed contractor must replace the deck.
• A permit must be pulled prior to this work commencing.
• A copy of the permit must be sent to me.
• Once the work is complete and the Building Inspector has signed off on this
work, a signed copy of the building permit will be required as well.
In addition, the Association will reimburse you or pay your contractor directly to install
flashing between the deck and building. This is typically around $75.00. In the event
additional rot is found when the old deck is removed,please contact me so that we can
make the necessary repairs in order for your contractor to move forward.
Should you have any questions or concerns,please feel free to call me directly.
S � CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
I:IAI I:ItNI mil"UKISCOLI.
120 fir;\SHT\'GTO`STREET ♦ SALT:M,MASSACHGSE ITS 0197C
Trt:978-745-9595 ♦ FAX:978-74rr9846
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions ofMGL c 40, S 54;
Building Permit # _._,-.._ is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
t It, S 150A.
The debris will/be transported by:
(name of hauler)
The debris will be disposed of in
Noo,--Ii St o e Cta_=�_
(name of facility)
_ 11142it1 o,n.0 o
(address of facility)
signature of permit applicant
(late
debri:¢f(duc
erry-oFgALE� _ -
PUBLIC PROPERTY
"'aDEPARTbIE,�JT
MANM 120 WASMNGTnN btilFFr SALUk MASSACHl:Shl'IS 01970
TIL 976-735-959S•FAM 97&740.9g"
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: Building:
Property Address.-
-- --
�3�4
Property Is located in a; Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: Ul. W1glS1A
Address:
Y1 A (0
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition *ExisfingRenovation Number of StoriesChange in Use Demolition xstng
Approximate year of Area per floor (so Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
1�c 5)1-e $ x 12
- ---- Mail Permit to: ----- --
I_
What is the current use of the Building? 1 16 , e—
Material of Building? / 0 a Q If dwelling,how many units?
Win the Building Conform to Law? S Asbestos?
Architect's Name
Address and Phone t
Mechanic's Name
Address and Phone Construction Supervisors
�sors License# OS .S^a S D— HIC Registration# /O
Estimated Cost of Project$ 00 Permit Fee CftWtion
Permit Fee i ��� 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 property and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to bu Ind to a above s
t7atdd
specifications. Signed under penalty of perjury
Date / 2
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