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FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: �2 Pr v Phone
LOCATION: Assessor's Map Number Parcel
Subdivision Lot(s) r,
Street ,�� G_ P_,)2 St. Number `1 r
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Conservation Administrator
Comments
Town Planner
Comments
Food Inspector -Health
Septic Inspector -Health
Comments
Public Works - sewer/water connections
driveway permit
Fire Department
Received by Building Inspector
Date Approved
Date Rejected
Date Approved
Date Rejected
Date Approved
Date Rejected
Date Approved
Date Rejected
Date
3 M ;6 `i Oi l ' /' tt-YFi+C4 '• +� J� ^iii T7 >
t ��,�a\3-� i h al. '� $_\tf
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OEPARTMENT OF PUBLIC SAFETY
Restricted To: 00
CONSTRUCTION SUPERVISOR LICENSE
Number: Expires:00
- None one
,t�pe4saoaoaarroat
CS 050605 0611211996
lA - Masonry only
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taaksrattnAxsmT
06/12/1?52
Restricted To: 00
1G - t & 2 Family Homes
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STEVEN MAN
39 GOLD S1
YNITMAN, MA 02382
F� S 6 S CnnStrurti.nn
R
OI 39 Gnl_d Street
m Whi_tma'n , 'M&' 02382
PROPOSAL SUBMi l 1 E D TO.
NAME - -- -
DNR Reai_ty Trust
STREET _
48 Pearl. Street
CITY
Chealsea
STATE
Mass
839-0084 1.0-01-94
11 ;
41_A Eastwater Street-
No.
treetNo. Andolrer Mass
1..
Tnstal_l.
si.x (6) 1 uan interior dnnrq,.
2.
Rernlace
six (6) wi.ndnws with -,7i_nvl. renl.are*nent windnws and
new nine
cas i.na side . s ten and sill..
3.
Tnstal.1_
new steel. door units in front and rear entrance and
new snli.d
rare door at the tnn of the cel.1_er stairs.
4.
Bui.1.d a
nati.ti.on wall_ in rel -ler between 41.A and 41_B with fire
rated door
and 5/8 fire ended sheetrnck both sides of wa1.1..
5.
Tnstal.l_
3_/8-hl.uebnard al.l- reil_i_ngs and walls with one (1 )
coat of
nri.mer and two (2) coats of finish r)ai.nt .
6.
Tnstal_1_
five (5) feet of canner and lower cabinets and bathroom
ani.ty with rnunter tons.
)tip hereby pi,opose to furrli;h lalrrrr nu(l malr'l l.,:, ; I, 1(
_ e i_ght thnusan(i five hundred and f i..f_ tv S8 , 550.00
FOUR T1401JSAND (S4,000.00) to start , three thousand. ($3,000.001
half wav thrnu -fob and fifteen hundred and fi.f_ty ($1,550.00)
:-et-7-�n
t X11 matrrial is kuaranteed w be as speclfied.Arl lra'h to IN'
P triol above specifications imolvillf exin, CO."t"), St :!i lit' e\t`Ctnt'(l ul;i} Uht'.1 c'1'+,�';• u: t+ '.,( lilt iih Alll; (N".� ..
U`U.'1•eelllents contingent tlpoll stl-i a's, al'Cll t'lll of (lc -lav, bPV-(11111 (1(11' t olll i't,l. ". (o r
( I Int i(cc(pki ,ct 11I;I .11
thereafter at the option of the midersigued.
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Viking Inspectional Services' { ...' :.• . j . " .•`
Vincent Occhipanti 24Y-405-7 Telephone 617-284.6759
181 Protpect'Ave , . .. • . _ ..
Revere Ma 02151
LETTER OF LEAD PAINT (RE)OCCUPANCY:'(RE)INSPECTION CERTIFICATION
THIS NOTICE DOES NOT CONSTITUTE DELEADING COMPLIANCE
Date: `
Dear ►2 le�, _ JcX �i: LOS
This letter is to serve as notification that a (re) occupancy (re) -
inspection was performed at -If I; Cca6-r iJ4-1e L !�P in the, City
or Town of 1UtXL4 A0_cAooFQ and all applicable common area and
interior surfaces have met the conditions for (re) -occupancy set in 105
CMR 460.760(A). This notice does not constitute deleading compliance.
Prior to the (re) occupancy (re) inspection, all sanding was com•-
plet,qd and no additional sanding will be permitted following the clean-
up provisions required by 10.5 CMR. 460.160 (D) . No other interior abate-
ment may occur unless the conditions of 105 CMR 460.160(A) through (E)
are repeated.
As this ,is ONLY notification that the conditions for (re) acc°-
pancy have been met,eno letter of compliance will be issued until
all applicable exterior surfaces have been abated according to 105
CMR 460.000 and 454 CMR 22.00 by A' %v4
Date
ocumen ation has been provided that windows will be replaced
C(,
by JWtVL - to 1 `t Lb _
i
Date
If applicable, the, conditions stated in 105 CMR 460.160(A) -(E)
must be observed when replacement -window installation occurs.
�eu2 tV FiFfzR O
ame (s) & License Numt
Si c ely,
� �2- o
Spector H License Number
7INSPECTION AND ABATEMENT HISTORY
M
M to--) l
nspector Who Performed
tial Inspect
Ayt,y.jeLv2� p1 / I
) r1 r(S ,Njce_j1A ncc- �n 2 jpeevCT
Date of (Re)occupancy (Re)inspection Name & License Number of
Performed (Re)occupancy
i. _Ta 36o
Inspector Who
(Re)Inspection
�Name(s) License Numbers) of Department of Labor and Industries licensed
.Del eading- contractor-{ s }_ _who Performed -Abatement--( if: -abatement was*- performed)-:
Do
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