63B PROCTOR ST - BUILDING INSPECTION :.rya •' � a .; .
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CITY OF SAO.EM
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�DMq PlRMR APPLICATION FOR: r
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Oft WhWWW apply) Rod, Raroof, Irmd sm-�p, cvrm t.Do* Wli4 Pa L
RopalplRaplaOa Olhar: ne.nce-w}-
MAN 19LL OR LAMLY A COMPLETELY TO AVOID DELAYS IN PROOMMM
TO THE INSPECTOR OF BIALDINOB:
The herby for a PWM to bUld aoo Xft to ea alle-
2 wr.-, 'o "lase.
Ad*Mi& Phone
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Pusuc PRoFERTY DEFAnrmENT
120 WA{NINOTON aTRaaT, aRDFLOOR
SALaM,MA 01 s70
TEL(270)7454595 En.360
FAX (970) 7404846
STANLEY J. Lhwvs:2, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the p uvidom ofM(X a 4Q,S34,I aclmowledge tint as a coo&d n
of Bmv3w Pamit/ .sH debdo rau*g fi m the casafrucdm activity
&ovaaed by thin Buil ft Permit abdi be ill a ed of in a MWaly li mwd solid-waste
bcal ty,a defoed byWX c a SIXA.
The debdo will be diapered of at et.,N$.r 9►�.�4*ti d.^ (1-'e r r 5
Locahca ofFscldy
kit f1dy
Signature ofka=Appliad Date
FULLY compiete the followng mknnsSon;
04AASB FR)Nr CLEARLY)
A,4El.k,✓ ()_ /-rP.-,-L
Name ofPamitAppHcm t
Fnm Nam%if nay
b36 PNLy4r Sd Saiyh ^4 df9-7V
Add moo City dt Stdo
The above statute requiter that dduia fim fhe demolition,Te wvabM mhab or other
skaodon of bu&fgg or stt mum be disposed in a pnopaly-hemsed so"wasfe d qoW
facility as de)SW by MGL cIq SMA,and the building pamits or&a=ate to
ia&de the locadoa of the facility.
� Y
CTfY OF SAIFM
B=ING DEPARTMEM
BUEOWNFRUCENST Emys noN
Pkase Prw
DATE �i3lJ`i
IOBLOCATION b313
HOTME.OWNFA �✓� P�fc Jv a^ S�..
ADDRESS
N0ME0*T>}3l
TELEPHONE
PRESENTMAIIVG ADDRESS b
The.cwmg - mpdon of'homcownas"was cmcndcd w bxludc owocr-ocwpled dwclliop of Two
Uniu a km and w allow such Lomeownus 10 cngagc an individual lot bite who does not poaseaa is
limusc,.provided that the o*ecr sd ms supervbw.
DEF1 cnoN Of HOME0wsEk0
person(s)who owns a pa=l of land on wbich MJshc raider of intends w ncsm on which 1k or b
intuded w be,a one to two fmrDY dwciling,anadud 01 detadmd szrt><U=&=cum to
farm avucnves A pctson who constructs mofc than one homc in a two-ycar paiod shall mot be mmldcmd
omeowvef shZ subnut to the Building Oi5asl,on a torn S=pubk to**
a hs . Sui`h Building Official.that hcJshc be lupotmbk to all sudt work pafotloed mtdcr the butldmg park
T is tmdasipxd'homeownsr"asnm==Ponnbility lot ccm?liw=w M the State Bmilesag Code w d
otha applimbk gocs by-laws,nits and ncgula6=L
The tmdeniptcd'houwawmt"=rdSts that hclshe undasm�the City of Salem Bmildmg Dcpamntsft.
minimttm inspation pfocedum and rcquimmcmu and that Wshc will comply with said Ptoadtms trod
HOMEOWNER'S SIGNATURE �'ti
APPROVAL Of BLMMING INSPECTOR
See other sick fot state Code
HOMEOWNER'S EXEMPTION
The code states that `any bomeowncr performing work for.vhicb a building permit is re pi ed sba be
exempt from the pro isions of this serdon (Section l(ly.l.l-ISccnsiog of Construesbn Suptrvtsors)
Provided that is a bomemAaer engages a person (s)for hire w do.such wort,that such bormtawM dMA so
as sqavi�
Many homeowners wbo use this taimption are unaware that they art assuming the teRpansibit M CC*
supervisor (set Appcndh Q,Rults and Regulations for Lietwict Coossrucdon supervisors,sectigw
2.15} This lack of swareness often rtsdts inserious problems,vat icubAl when the boraeosvnc b3M
unliocnsed perosa In Ibis ease yew Board cannot proceed against the tsnliccsssd Paz.=to it'"VM Wilk
licensed Supcnisa. Tbt loomeonvtr sling as supervisor b uhisoateiy rsu�onaiOIL
To ensurt that the homemvncr is filly aware of lti/hea respon.1bibt3es,nresry eoummitia tegwt;as past
of the permit applieadM that the hom00%vner certify that hdshe undastards the rtspousib"M160 Oft
supcnisor. You may care io amend and adopt such a form/ccnidxatiaas Tar use in yoke tUnsmmiQ
To whom it may concern,
This letter is to inform you that we,the Proctor Street Condo Association, are
aware that the owners of Unit B wish to renovate the baser i6dportion of their unit and
have no objections of their doing so.
Signed,
Signature ZJ Date
Unit A 5 3�J
Unit C pL
Unit D
Unit E
Unit F
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