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5 OSBORNE ST - BUILDING INSPECTION (3) 5S-� 'PL�ftW1 ffA94ND APPROVED By um XIBP==.PIl R TOA:PEBMi ,BZM MANTkD i CITY OF_SALEM ward Z«+w DWW- ft., obtrw Yn NoL o"IdLacmd in ft of � G � aailtiq L�7"••`N' ,r Is Powuly Loaded In ft L'on M11ronA1M4 aw1 rGr1 W AP rYCMT� Permit to: (Circle whichow apply) Roof, Reroof, Install Si In% Con bvd Dsok. Pool. ft"WReplsce. Otl1ar PLEASE FILL OUT UMLY i COMPLETELY TO AVOW DELAYS N PROCESSM TO THE INSPECTOR OF SIJILDINGS.The undw$OW '• hereby applies for a perk to build aocordbmq to do tNowkV Ownsrs Name ��CA� ( P ` 6 u s c o m Address 6 Phone 5 0 5 hO W 0 5t, MR) A7 6616 Archksst's Name Address A Phone ( t Mechanics Name Address A Phone ( 1 wnn is ffr PrPM a b~ 76 5fa(g jmL IiAobm d w04_ won II a dwslY g.for few marry fw~ VAN had"OMr0111110 inw? Ar 9 EsIrrhd am r CRY u0me• 77m • ft= Sip N00 of AppiCWO 60 THE PENALTY' DESCRI'I10N OF WON(M w WNE OF PER,NNiY by s . . r MAIL PERMIT 5�Or n),P. 5T I q- cf 64 . M, � Jf i sawnria d0 uomusm CrAlMVV9 LWFl3d NOLLV= QL JAMUW Lva kmvonddv i CITY OF SALEM. MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR SALEM,MA 01970 TEL. (978)745-9595 EXT. 380 40 FAX (976) 740.9846 STANLEY J. USOVICZ, JR. MAYOR DISPOSAL OF DEBRIS AFFIDAVIT In accordance with the provisions of MGL c 40, S34,I aclmowledge 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 ca S 150A.` The debris will be disposed of at: J al " ws lr- 94� Location of Facility � nAA'11 m� ( LlmlM 5/l6 �QS Si o Permr cant Date FULLY complete the following information: (PLEASE PRINT CLEARLY) paxAl A dNs� n�1 Name of Permit Applicant Firm Name,if any s sd �e 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 I50A, and the building permits or licenses are to indicate the location of the facility. Q � S�ve� 170 ,ol sd d � � afy oF SALEM BUDDING DEPARTMM HOMEOWNER LICENSE EMOMO N Pkase Pd DAf>ti i >OBIACATION s ©sb��ti e s�, . TELEFUM Pn>•si:Nr teAn a+o ADDRFlE ri 0 S Did rnl P,� sr TAe pa,ers.oamµiai of-tomw roe e was cmeaw a iratode ewser epwrw daeA:o afrwo tlahs a e>s and to snow Inch homeowmaa so c p M .*ff MM w,Ao don as pow • llocaaq.provided dm dw aweer ad sa caper.ism DErvancMcFHcmECw aW Person 0)wbo owm a pool d kad on w"behhe insides a brads to TMW eo w+lJeh k Of inw,ded m be.a one w two firmly dwclliad,aukhad a dwdwd at OHMS*aa7 Wm swocwm A perwo wbo wravocrs more Osa cat boma br a two-year FOM am ssn be eomidotl s boaseowsas. Sud►`lwmeowve>"slay suAruil to the Builsti�Oiisr3a��� ��d Bw7ding Oduid,tdm Aelsise be respo�k to all sad►�+eak palormed �• TAc wdasigned-houseow•ssd'assnmses repannb0iq for rzmplbmec w�tlse Stnse Ba9dlo�Code d ' enhu qo abk goes by-kws,rues cad segukdooL The mdvsigmd'homeownct ocrtifies tMa wft w,dasw&tAe Ciq of Sam o minimum inspection p+oetdoa and reriffieme an ms d to bight will comply i HObff.OvVm-s SIGNATURE APPROVAL OF BMDING DMMCrM 2 See otAa sidr for smae code HOMEOWNER'S EXEMPTION The code seta tttsc•aiq hotneowma performtin,S wvdc rtR wfikb a tio�diuS permit h mgd+e��itie • -- - cxcmpl from is po►isiora of th&secdou Okalou 3IF44-3JazosioS of Cosnunetiom Sapavbwil provided that b a homeoema cW"!pas=W for Um to do.swA wcsk tha snd homeowner spats ttet a� . MW yospeowmu who ON this Ommpdoo an i mwm that they ao assmdaS fire pwombMn do svpavime(sce Appeedh Q,Rulss and 7ttVbiloa for IJ=ostoS Coostructsan So pervlaem Sown .2.3s). Thss lock dawammw chm Rmlu to wThm pmbkms,pw*a w Lea the itosseooaa Td� mJkaned pasomt In this erne yaw Hard esTmot procc d si filar the taioezased pafon sa It can w!d liocased Sapenmisor. 71e hoaaeoTraer aatoS as auperdser b nYlswe0 TesjoosML . To easort dm tht homcorrncr>s fidb scans or hiAia TespoaTblUtles,mW eomsasaddes Tetpi�s;a past of the pa Wl spoimdm that the homeowner eaft aim 1rJshe mdasaaads 68 Tespmsbnmw eta supavbm You mq ens to nncod sad adopt sad a kraAmd imam In t.s is yow commodes