8 MILK ST - BUILDING INSPECTION (3) What is the current use of the Building?
Material of Building? If dwelling.how many units?
Witl the Building Conform to Law? Asbestos? ---. -
Archioas Name
Address and Phone
Mechanic's Name
Address and Phone
Cwwuucd Supervisors Um"0 so Registration
o►
Estimated Cost of Project Pam* --so
Permit Fee S �1 Estimated Cost X$7/51000 Residential
Es dcostxpllS1000Cammwciav------ -- -An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to b to the above stated
specftatkxrs. Signed under penally of perjury
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CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
K11MF�!cv rvwvv L
Nw1/0R 1'')WA411NG70N S'nIM•SMAK NASSACHLSCM 01970
7ki 97$-74S-9S"9 FAX 97L740.964
HOMEOWNER LICENSE E)MMPTION
Please Print
Date fl 7
Job Location
Home Owner Address
_ /��-
ner Tel Te Home Ow ne C
Present Mailing Address " /
The current exemption of"Homeowners was extendeµd to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who.does not possess a license,provided that the owner acts as supervisor.
DEFINTfION OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on
which there is, or is intended to be,a one or two family dwelling, attached or detached
structures accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official, on a form acceptable to the Building
Official, that he/she be responsible for all such work performed under the Building
Permit.
The undersigned "homeowner"assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations.
The undersigned "homeowner"certifies that he/she understands the City of Salem
Building Department minimum inspecti Yyu edlum and req irements and that he/she
will comply with said procedures and r uir ents.
HOMEOWNERS SIGNATUREcc
APPROVAL OF BUILDING INSPECTOR
See other side for state code
CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
..\1:::■1 tY"Ai!\:4`I 1.
\L\11`K 1icvr.w".—..Oss.-RUT4S.\LiM.at\\CN::11 .kIl)
To:vM745.,A i •F.%X:9MAC-984
Construction Debris Disposat Affidavit
(required for all demolition and renovation work)
In accordance w ith the sixth edition*(the State Building Code, 7S0 CNIR section 111.5
Debris, and the provisions of MGL c 40. S 54;
Building Permit N _ ._ is issued with the condition that the debris resulting from
this work shall be disposed of in a property licensed waste disposal facility as defined by.MGL c
l i 1. S 1 SOA.
The debris will be transported by: S
(name of hauler) l
fhc debris will be disposed of in : l� a—z
Mo. �
♦ry.aY:C al ,:.f11 dt..17 i1.IG 14[ _ .___
..lt.
Erry-OF
PUBLIC PROPERTY
DEPARTMENT
ICI\e��n.wry
wroa 130 W.�ur�7c�+ll�see!•
��t 4w�aa:srr�s 01970
M&-976745-9S"•FA=M7i0.9M
APPLICATION FOR THE REPAIR RENOVATION, CONSTRUCTION
DELMQLITION. OR CHANGE OF USE OR OCCUPANCY, FOR ANY FMS M--G
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location New OA& Bulldtngt
-----
Property Is loafed In a.Conservation Arse YM Histaft DWkk t YM
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Telephone: /j- O 8 8 Cv 79- 2i5--�
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use Now
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
&iel Description of Proposed Work:
ct
--- - ---Mail Permit to: 5