150 NORTH ST - BUILDING INSPECTION (2) What Is tl►s cum"use of the Bwlding? L! y i v✓ G S s+-t-e
W 00 lj It dweW+&how many unit? C J//U--, 6-1
McWW of euadi +d+ /V
vw the Iluiking Confona to Law? YP Asbasims?
Architds Name -
Ad&00 and Photo
Msdwft%Noma
Address and Phone HIC RsgWs&Wn 0
Canstn+dlon SupWvMcm Ucanae f/
Estimabtd Cast � Perm FM CalaiNllon
Psm+R FN Eatlmsted Cost X S7/$1000 RNldw"
--. -- — Es*natd Cast X f41/:1000 Conxnardt4----An AddMlonol f0.00 Is added as an
AdminMm*S dwg&
Make mm that aN fields me VcpwN and hobV"Ytftn to avoid delays In p vcoul g.
The and mWad dace hereby ap*for a Building
Pwn*to buNd to the above stated
sue, Signed under PNWV of PWr O X {uz of f + n>
Date a
v
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ft A
1 • rccr
VITy-ot
PUBLIC PROPERTY
DEPARTMENT Z
MONFLE.010cu"
A_pPLCATI IN FOR T= RVYA_M 1rTaQ%?A 310rL Cgff TRrr�-rrnN_
=NIOLITION,OR CAANGZ OF USZ OR OCCUPANCY_ FOR my ZXLU tyG
STRUCTURZ OR BUILDR Q
1.0 SITE INFORMATION
Location Nance
Property---
/5o No 2 rhF ST - -
RvWV Is located ins;Carsrvation Area YIN W Hk1orto 0I - -Rt YM
2.0 OWNERSHIP INFORMATION
2.1 Owmw of Land _
Nartw. M /C Ire c !2 G e -
Address: / S"o
TONph .
3A COMPLETE THIS SECTION FOR WORK IN MUSMM BUILDINGS ONLY
Addition Existing Z
Renovation Number of Stories Renovated
FA
Use
Existing
te year of Area per now(sf) Renovated
n or renovation g
building / �(� New
iption of Proposed Work:
2 �J12eq�v�� spa ce .
--- -- ---Mall Permit to: - - -
CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
KIfO1F11IY ntw•,v�
130 WmwNGTc"S-nw=•SMAK MAMAC14LWM 01970
TtL 970-745-959S 9 FAiL 978-740.9&4
HOMEOWNER LICENSE EXEM"ION
Please Print
Date hh5hIt I
Job Location /r n
Home Owner Address /5-o N o•z.;r-1- r
Home Owner Telephone 97 k ? y s La L--/ 5--
Present Mailing Address /,s o nl D IF-9 -/y- 9T
The current exemption of"Homeowners"was extended 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.
DEFINITION 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 inspection procedures and requirements and that he/she
will comply with said procedures and requirements.
HOMEOWNERS SIGNATuRF���.C,PL—"1-Z—
APPROVAL OF BUILDING INSPECTOR
See other side for state code
--------------
32' 0"
1
13'0" 1
108d^
— 1910,
Skylight
I
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Smoke
y'6„ ♦•
1f Skylight
I
12'8 UP
Smoke
Showe
Showe
Smoke
(po S (-
Skylight
'p.
6'0" —► 38' 0"
7 0 1k
12,8„ 1
Skylight �
I I
15,0"
AI
I �
AL
6'0"clearance
5'0"clearance
20' 0" suhject to awicsal:b7.ary a e:
authority,ha71-g,:
CITY of
GARAGE
I '
151 0. 76 R. (SET )
40.4 1 5 4.00 "
LIS - — — 1I2. 37
v
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v M M
1
4.4 � 24.4
DECK
O
O - O
'O LOT 246 O
r` ro AREA = 4, 440 S.F.
m
_ 1
W I
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1.10 —
Q 5.3 9.2
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a #15 4.0
N I
h
� PORGN,
-1
1.54 22.5
4.00 -- — 4.21 - 25.52
49 .34 DH (FO J
NORTH STREET
GARAGE
l 51 0. 76 IR (SET )
--- -- — 5--- 4.0.0
L 40.4 .
,5 - — — 1 ,2.
Q
4.4 24.4
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DECK
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PORCH,
1.54 i 2 5
— -- _—__--4.00 4.21 2 5.5 2
49 .34 DH (FD )
NORTH l STREET
CITY OP SALOA
- - PUBLIC PROP-RERTY
DEPART.IEM
..W 1 S1 at- AMA`t L
altt.a l'1'7.%fiNr.awl un•iatttk 1thimm
ttit:Yts►f�19'�I�f.�1t:'��6'taM
Construction Debris Dbposat Affidavit
(MtW^d fix an dentolitiom and rmovation work)
in aowMMM w ilh the sindt edition o(dw stars&dMINCodk 7W OUR section I I L!
oebris,wA dw provisions of M- GL a 44 S 54
gWldlq Pon p _ _ is issued with dw condition that the debris rerAdnj fhna
,his wort shall be disposed of in a pevperlY licensed waste disposal facility as defined by WIL e
tl1.! 15"
The debris will be transported bY:
_ fe UL( T/lP�(name a(houted
rho&--bds will be disposed ofin :
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