51 SALEM ST - BUILDING INSPECTION Emr-O��E:�r--
P T LIC PROPERTY '
'0 DEPARTME►�IT
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Tim 978-74S-959S•PAX.97`74(�9er6
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building.
Property Address: 5� p� �1 2 , 3
lA%/,cJw. 2v.
Property Is located in a;Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address:
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN tXna•riNrs BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (so Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work: _
Mail Permit to: \Z
What is the current use of the Building? o� 2 � ��
Material of Building? If dwelling.how many units?
Will the Building Conform to Law? Asbestos? AJo
ArchitecCs Name
Address and Phone ( )
Mechanies Name �a 1 ° �"•
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Address and Phone
Construction Supervisors License III o C�°�D°�� HIC Registration S
Estimated Cost of Project i ono c� Permit Fee CalcuWm
Permit Fes: � 2 Estimated Cost X$7/$1000 Residential
Estimated Cost X$1 US1000 Commercial
An Additional $5.00 Is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing. .
The undersigned does hereby apply for a Building Permit to build to the above stated
e
specifications. Signed under penalty of perjury
Date �
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\\ \: APPROVED o
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Subject to approsal bq allq cthor
authority.hawi^g j r asuiiioro.
CITY of
PLANS ARE APPROVEO SOLELY MR r"E£,T'l "J i'Q i C F
-...,� T.FE AND LOCATION OF FIRE KK I ..-J.
fi!% FIR9 PROTECTION.DEVICES.^..^-.0 CL'o =CT YO A
I'Al.TEST AND INSPECTION,FOR COtdFLUL COW11-
At,CE VATN THE FIRE CODE,
iu
APPROVED-
442-1-60-2
Subject to appmvil by. any o&�r
CITY,d SAtEM,,,M,(,GS-
T
For IT Bull"
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PLANS ARE APPR08EO SOLELY FOR'tMVmF;c M, F
ANDI 1M --U.
AT$ON OF FIRE ,
ti I.F;',IF PROTECTION DEVICES !.2!:
tvu,mtsT AND INSPECTION,FOR COM'FL=
ANCL WITH THE FIRE CODE.