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2 OSBORNE HILL DR - BUILDING INSPECTION City of Salem Ward APPLICATION Fora- .. PERMIT TO BUILD ADDITION, MAKE.ALTERATIONS OR NEW CONSTRUCTIC M1PORTAW-Appmasm to car,rvi r air no n.In seotlora:R 14 A% IV,and Of. LOCATION ,y G�D/Js�e fief01 AM OF aETYlEEN �/ ���� BUILDING �� m�B D77//3 LOT -� t3LOCK � 9 50 5F _ L TYPE AND COST OF BUILDING-AU applicants complete Parts A-D A. TYPE IMPROVEMENT D. PROPOSED USE-FOR-DEMOU nOW USE MOST RECENT USE I Now bWWMB R1111eldoolle/l .. Noretld4nar 2 ❑ AtlATaon(a rseldrrtla6 emr nwMer a new 12 1(Q Mne�y is.❑.An earns t nwaYfmral housing units add@4 ti my,in pad A 13) 19 ❑ CMUCK sour MfigiWa 13 ❑ 11 w mwe lmnsy-Enw munbr 20 13 lrrdulrw 3 Q Alienation rSss 2 aEa+1 a uNls 2/ Q Sarum Woo4 ❑ Repab raphowal 14 ❑ TmslrM inlet,M04K a dorMbry- Swvim a ❑ Wrsclriw(it MA%nrsy reslio"~w.Ww Ever A,mwduas--------• 23 22 Q W aer■w of units in buipip it Pan A f3) 1S ❑.fiarap� 24 ❑ onbei bank pratseebrrai a ❑ MoNrw(rebcaUan) 1a Carport 25 p Public utility 7 Q,Fol xWm only _ _ 26 pnd,Sd library.ot)w aa+caaonal 17 ❑ onw'swch 2713 $Imes,rnsreareb B.° 2e ❑ Tartu,borers 8 arP019de(indiwdual,con WONT nonprdll 29 Q Osw-Spscsy irmtlhalwt ste.) 0 p Public(Federal.Sta*w local awem wt C.COST (Dana cent4 Nonsldenliel-Deeabe in detail proposed rrs d busdnps ao,bad proossabw Giant rrOdYn-shop,chitty bu"M o hospaK eerrwsary edwd,seeordwy xI c011e0% la Come a Irrtptpvettterlt —_ a oe - pwochW sdwat pwkkw QWW for dWo It wt elite,renal otTtes 13LA01%offkM bu7dkw at ir141abW Per*a use d me"bL"V a b8ft durt0ed.ardor Proposed uea 7o be instaasd but not atc4rded in the above cost (O �O el �/W / ,,, le a. Ebcbtcal p b. Piaroiry..__._.----------___--- �G 000• Nit m. �'✓c0 .P lOrr oC/E d. Other(elevalor, 11. TOTAL COST OF IMPROVEMENT IL SELECTED CHARACTERISTICS OF BUILDING •For new buildings and additions,complete Parts E-L;demolition, comPligils,onlY Parts J 8 M all others skip to IV L PRINCIPAL TYPE OF FRAME F. XWX#1 AfPE OF XEATWO RAL O. TYPE OSEWAGE DISPOSAL L TYPE OF MECXANICAL 30 p Wa wry(.ai bmM) 33 rtlfQJ/ 40 Ln Public ar WwW oomPany WE Owe be central aY 3/ VWOod frame 36 Q ON 41 p Privale(septic mnk sic.) off. 32 ❑ Stnrctval stesi 37 p Electricity 44 45 ❑ No 33 ❑ Rebtbrced cartwels 3813 Coal IL TYPE ATEA SUPPLY yrE thsi by an eWalolr 34 ❑ Othw-Sp" 30 p Od w-SWdy az Pub9e w W omnGany 4e ❑ Yoe 47 No 43 ❑ Pritrate twsy cisurrtI I I OrrErsrors a, j M DEMOLITION OF STRUCTURES: as Wumhar d grpip _.__—_................_....._.._.___ >.: as TCW SWM her d emr anl; Has Approval from Historical Commission been received a,eoo a booed on m a v � cS� for any structure over fifty(50)years? Yes__ No— mnre�. ---— — so Tour Wod afar,ea R—g S e Number Dig. . . KM WIMBM os osFSTRW PAW JW SPACES ppyt Conti* s,. Endoaad.._..------------ HAVETHE FOLLOWING UTILITIES BEEN DISCONNECTED? yes No sz auteoas----- ---- y� _ Gay _ Fu/ .SaM18<: S Na"bW Of DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED badvoom P, . -- BEFORE A PERMIT CAN BE ISSUED. IV. COMPLETE THE FOLLOWING: Historic District? Yes— No— (f Yes.Please enclose documentation from,Hist.Coma.. . Conservation Area? ".Yea_ No (M Yes please widow Order Of Cork"ons) Has Fire Prevention approved and stamped Plans Or applications? Yea i(� No_ Is property located in the SRA district? Yea— No— Comply with Zoning? Yes_ No_ (M(H no,enclose Board of Appeal decision) Is lot grandfathered? Yea'_ NoJ! (s Yes,submit documentation/if no,submit Board Of Appeal decision) If new construction,has the proper Routing Slip been enclosed? Yea— No v Is Architectural Access Board approval required? Yes_ No_ (If Yes,submit documentation) Massachusetts state Contractor License# �o 6a Pel7 Salem Ucense # PIP Home Improvement Contractor # Homeowners Exempt form(if applicable) Yes— No-L,� CONSTRUCTION TO BE COMMENCED WITHIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMIT If an extension is necessary,please submit CONSTRUCTION IS TO BE COMPLETED BY: (��{/ �oD� in writing to the Inspector of.Buildings. V. IDENTIFICATION • To be completed by all applicants Maw Alahg ad&M-Numbs%s"K co and stag zr CodaP-7& -?3 � rn-e / D•zaccnrra'tor o L Nor3. euseolQ� 1 hereby certify that the pr work is authorized the owner of record and that I have been authorized by the owner to make this application as his authorized we to orm t e laws of this jurisdiction fat Signature of applicant A Tess AX 7�p , �p / ^plcla 1710 e } L DO NOT WRITE BELOW THIS LINE VL VgIJpA710N FOR DEPARTMENT USE ONLY Building Permit number uaa Gw p Building 19_ Fro Grading Permit issued Building Fee a Lira Laadho Parmoowpwcy Load C tficate of Occupancy $ Approved by. Drain Tile. $ PIS Review Fee $ `SAD TILE NOTES AND Date-(For department use) - t AJ S O N C S PERMIT TO BE MAILED TO: DATE MAILED: Construction to be started by. Completed by. VI ZONING PLAN MUMMERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES WE OR PLOT PLAN-For APA!icmrt Use oN �VLaJ1) .; / idY 7� � .t-/ e C'17CI7"f7Yent G. F K4 [.o!J;tta , rn•;l 29 :'ort A -[t. L; 0 i 9;D-_�t l•i:o FaX 9,78 T45-aE;a6 '8-�a�-77;7 FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND THE SALE4 FIRE CODE, APPLICATION IS HEREBY MADE FOR THE APPROVAL OF PLANS AND THE ISSUANCE OF A CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT BY THE SALF.4 FIRE DEPARTMENT. ( Ref. Section 113.3 of the Mass. Bldg. Code) n7 JOB LOCATION: CL/�4zl{I/L�' /--)^ OWNER/OCCUPANT: ELECTRICAL CONTRACTOR: FIRE SUPPRESSION CON CTOR: SIGNATURE OF PHONE APPLICANT: ADDRESS OF / /t/�J �y .�Jfj CITY OT APPLICANT: C�' ✓// C� /6 TOWN: dlr�iU APPROVAL DATE: . Certificate of approval is hereby granted, on approved plane or submittal of project details, by the SAT FIBS DEPARTMENT. A11 plans are approved solely for identification of type and location of fire protection devices and equipment All plans are subject to approval of any other authority having jurisdiction. Upon completion, the applicant or installer(s) shall request an inspection and/or - test of the fire protection devices and equipment. (ADDITTIONAL REQUIREMENTS, - SEE REVERSE SIDE **) LIKNEW CONSTRUCTION PROPERTY LOCATION HAS NO COPTLIANCZ '41TH THE PROVISIONS OF ED CHAPTER 148, SECTION 26 C/E. M.G.L. , RELATIVE TO THE INSTALA- TION OF APPROVED FIRE AL1FM DEVICES. THE OWNER OF THIS FRO- PER'PY IS REQUIRED TO OBTAIN CO.XVLI,,•10E AS A CONDIT_ION OF OBTAINING A BUILD7NG PERMIT. PP)PFFiS'f LOCATION 1S 16 OO:i"- :@CN ;i .i! _.'F'. k )v ISI02J Ali r.l :,_ 143 , SECTLuN 26 LLr-I fZ' 11�I. 71 tiZ C� © 'J' �../`/r_ / -_ _-_ 1 $30 . 00 . ... CHECK f/Z 79S`L Professional Land Surveyors 8 Civil Engineers ESSEX SURVEY SERVICE. 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD 8 WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN fkZEA1 MASS. L�rZ� lasov 2-7 41 GlLv,Sal� -� �L,eLUto- /OS.Ga i I hereby certify to the 5&L A Building Inspector that the pro- ZONE: LOT AREA: N LOT FRONTAGE: posed construction shown conforms to the dimensional zo FRONT YARD: 15,6 SIDE YARD: fQT REAR YARD: ail' S 4GI-/-" Mass. HSH o F gssc SCALE: -IV /o CHRISTOPHER yam\\ g R. �1 MELLO ti ,p No.31317 0 F E REFERENCE: ��! BK i PG ,�� opher R. Mello 104 LOWELL STREET PEABODY, MASS. 01960 (978)531-8121 FAX: (978)531-5920