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9 OAKLAND ST - BUILDING INSPECTION (2) -IKiST13Ef4L{D--A+M APPROVED BY T*IE 1Al�SP rC7 1 ,PRWR TP A'PEF9MIT BEING GRANTED CITY OF SALEM \ \ ON�'U p No. \ — �'`� .,L �`'''^\ Date it`I) Ward 60 \AFcrmN9�°j° Zoning District Is Property Located in / Location of the Historic District? Yes_No_ Building 9 ©a,41aj Is Property Located in / the Conservation Area? Yes_No l_/ BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof, nstall Sidin , Construct Deck, Shed, Ppol, n Repair/Replace, Other: Ka.�,u�Q�lwti SZ0( LI &M U (M.c��( P. - PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's Name e,5 ULV-- lso Address & Phone 9r!ih.�� 0Vr) 7z(O-/9§�� Architect's Name Address & Phone ( ) Mechanics Name Address & Phone nn n ( ) What is the purpose of building?? `'r, / a11./ Q•o. , Material of building? WOO L F('a y-,-e!- If a dwelling, for how many families? Will building conform to law? ye!G7 Asbestos? Estimated cost�3, 0 C? , City License# State License # QRome Improvement` Lic. i ignature o plicant SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE U2-f�IcL(�e uG>°��•e /y � o)`' G�'n YYCvi. /--eta/a gAa�os-�/�l c MAIL PERMIT TO: t No. APPLICATION FOR PERMIT TO 4142 LOCATION PERMIT GRANTED 2- 2- is APPROV�D D INSPECTOR OF BUILDINGS PUBLIC PROPERTY DEPARTMENT 120 WASHIN@TON STREET, 3Ro FLOOR SALEM,MA O 1970 TEL. (979)745-9595 EXT. 360 FAX (076) 740-9646 STANLEY J. USOVICZ, JR. MAYOR DISPOSAL OF DEBRIS AFFIDAVIT In accordance with the provisions of MGL c 40,S34,I acknowledge that as a condition of Building Permit# , all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid-waste disposal facility, as defined by MGL c III,S150A The debris will be disposed of a1 Sw�e w� \ ' g - 6v Location of Facility eel/ tea y Signature of Permit Applitinit ' Date FULLY complete the following information: (PLEASE PRINT CLEARLY) j 5�L-ca ([jl(fL, Name of Permit Applicant - Firm Name, if any Cal�70 Address,City&State The above statute requires that debris from the demolition, renovation,rehab or other alteration of building or structure be disposed in a properly-licensed solid-waste disposal facility as defined by MGL ca S 150A, and the building permits or licenses are to indicate the location of the facility. CPfy OF SALEM BURMING DEPARTMM HOMEOWNER LICENSE E)MAPMON Pkast PAN /J � I�LOCATJOl1 Le— ✓7'- ADDRESS TELEPIOMB PRESENTMALN.0 ADDRESS The C=cd cumptiom o!`M mwwms"was cmmded to indudc dd :WO Unin a Jos audio allow such homeowm n w a&W sn indirdmJ. l;=nM prvvdcd thta the owner ad av supervisw. W?WL w tesida;oa�wldch then h,or h Pe � Ma s pw=l aJ land va which bclshc n silo yr WcDds b sut�me sodl� invaded to be,a am w two famdly dw lft snsdied or dctadted swxwa iq t swt be tamslNN Sarm wocw s.A poser who consumu come than aoc hoot is a two-��sta l"bcptobk t0 tbR a homwwvu- Such OW 'homeoA nsbk w awU wthe �mk pefaataed m,dex,hc ltuildhi Pcm+L Buildims Official.ow bcjft be asswM tcspowi ffiv Sot wmpliara c svntttlte state BtdldimS Code tud The mgpbcabk om W- watx Ma�� otlrcr appl;tabk gas by-►sa'a. homes arrisea that Wft mdasialds the Ct4'of ssleam Bnildmi Dcposam". The ty,dasigrcd' with said proet"""a nnrtimtam ingccdon pmcodwts and regtarcmtcnu and that Nshc will• mPly Te9 HOMBOWM'S SIGNATURE Q/� APPROVAL OF BUILDING INSPECTOR 1il �h�l%"""' Sec otter ode 101 state code HOMEOWNER'S EXEMPTION The cods suta ibw 'any hmrmwna performing tvmk for which a buDding permit is mqubed Shan yo c.•templ from the provisions of this section (Sectim]opjU-lJansing of Conmuclim SupervlwS>a Provided thm is a homeowner engaga a pawn(s)for h m to do.Such wt�rlt,that such bomeowaa dtr arse as sup"Visoe bmnccwmu wbo use this ext • � � ? ft arts Mao mprion are iaaware that are ilre n7crvisor(see Appcodb Q,Rulu and Regulations for l.iecoaing Coostrucdm Supervboy,SaAft .2.]5} 7his�ckofewanamao�>�in Pmb�.7�� thebomwwaabbo unliecased resat in this mx proeced gairtst pemoa a S would m liccnred SuPcnisor. The bOwev%'6er&cling as sopervfsor i aMloate�resLwosnsy, To cw=dear the bomcow ner is fully aware of hVha.respo mbMtk%map eommmddea ftqdb%m pal Of the permii sppliodcA that the homamair scrnfy that hc/ahe undawwWs the tespmsibilida ds supervisor. You say cwt to mrand and adopt subb s formhxnffimdm forme in yom oontmmiq.