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18 RAYMOND AVE - BUILDING INSPECTION What is the current use of the Building? Material of Building? Cl) �,f If dwelling.how many units? will the Building Conform to Law? Asbestos? Architect's Name Address and Phone ( ) Mechanie's Name - �. Ff�217D Address and phone s`T�A�sIiS �G��oiZb �vi$SSy. Construction Supervisors License#CS �� HIC Registration# Estimated Cost of Project S oo Permit Fee Calculation Permit Fee$ Estknated Cost X$741000 Residential Estimated CostX$111VOW Commercial-- --- - - - -- . An Additional$5.00 is added as an - Administrative charge. Make sure that all fields are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permit to b ild to to stated specifications. Signed under penalty of perjury X Dated S ©7 0 � I F a V Y a ,ems i Ila G� 9� � t i•, fl i Board of Building Regulations and Standards ,. f a• �;" Construeftlon Supervisor Lleense I Lio"eq CS 95799 8�R haste--4126I1959' E l4r1 2 010 Trill 95799 L90NARDO RABEL 6 STEARNS AVENUE��,S;•. MEDFORD,MA 02165 Commis@loner I CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT aat.oastr ttetaooti I"Valk t2o.Aomw.�aatStaasr a yu�y...aa:arss ol�oo Tan W Wes. M o PAN;VW00% WWWW CelmpusadOn IwwU t ARUIn : gtpd�yC Ann at Ita6madw �YY blue f _L Naant( I iy 71zN C i n iG City/Shttrlia /�i /co�ZrJ 02 S5 Pbppt 6-/7 q An yN a on~Cheek As ap♦ropetay ham a employee va�_ tL Q I at a pond eeaatdsr and I [13.1V06. Prgsat emplsyeas(11ef aadlar paetdma}e IM kind the w�mhaeelis 2.Q I as a Bola deapdaeet or peem�a hand a the atadmal cheat t , emodaye f ship ad kwe as employs" Throe woel ft he me k ray capecky. waekow comp huntesaa" �oiitioe �1 O0� maaresaa S. Q w�a�ampmaela and its wd d m 3.Q 1 as a homeowner doiq an work ri fht of mteted•ad their014deal npdn at addidosr tr�a per MOL mAbg�at addh(ota �l ]t anrp. a 1 vaekms'd va bovea of eepe6s coo!P1 C�L,,7 'i►isrwa..eetat,.rr►set..r.h.040* ..W=erear�e.iy�ae,�, 1 dm&g aw as aft at:Casamae ems!6b Ins o e am a1 s dibleed Am ��r eaaueo stiralr aemo cunt yro ft ma lam aue mleeeaerloa ri 6rk wdYa'es�Odet+�rraa !w +Ant b psslBad worRaa'nwPaawba 6rwn+aeaJJr►�,eatofeyeK dafwD b tAa �7 mafJat s11a Gssuraon Company Name Policy t<ar SaWina Lie. &Pirwoo, Job Site Addm m /8 ko9 , _ Att"ll a cep of the workan'coospaesedon Polley declandes pap(ahovlep the Faihsa ro aeeme coveeap as mq dmd under Secdon 23A of MB.a I S2 ca lead to imposition Pft mau e f dab)• fine uP to f 1.300.t10 and/or t @ vi utter. Bo advi as well"cial peoaltiea in d s Carta of a STOP WORK ORDER sad a fts of up is$50.00 a day spinet the uROlata< 8e advised Iba a c ravtetiptiosa of the DIA veritkatioa opy of this teatettteat may be fonvardad to the Of1lu of f di he"by end/j aaJ" r/evp over at G�anteadoa i�utfabew Azerw eaend l la.i f OJJ 04W ono OJIIA De are wrke In A&aree►fa be eomplefa/y c!z)r a fovea gi fdal City or Taws: Permlt/Lkeaso Issuing Authority(circle ose)z i. Board o!Health 1 Bulldleg Other Departmeat 1.CityfTows perk I. Electrical raspeetor S.Plumblag inspector --------------- tl Coatact?true: a CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT 12C Wd911XG�ON5IREET •SALF%I.MASSU%IL ILL-IS 0191: TEI.:979-745.9595 •G.--X:979.74C 9846 Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# _ _ ,_ is issued with the condition that the debris resulting from di this work shall be sposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be transported by: G AD Zt v _ (name of hauler) The debris will be//disposed of in (came of facility) .. . ._._ iA,Iress of fac:1,I,Y) . EITSt67 gXLE� - - PUBLIC PROPERTY DEPARTbIE,�1T &MiK MAMACHLsMs 01970 TEL-M745-95"•FA1C M740.96" APPLICATION FOR THE REPAIR. RENOYATION, CONSTRUCTION, DEMOLITION. OR CHANGE OF USE OR OCCUPANCY. FOR ANY FMSTING STRUCTURE OR BUILDING 160 SITE INFORMATION Location Name: Building: Property Addreaw--- -- -- - ---- - - Property Is located in a:Conservation Area YIN Historie District YIN 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land _ Name: Address: Z3 G//3 0aNS PG/�cN �o Telephone: 3 -36 ! 3.0 COMPLETE THIS SECTION FOR WORK IN EYtATWO BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated K Change in Use X New Demolition Existing Approximate year of Area per floor (sf) Renovated construction or renovation of existing building I I New Bdef Description of Proposed Work: Mail Permit to: k�TtA/zNS 19rUe /(ED/o/P-J - 1,f/-7 - 0 55 .