9 SAVOY RD - BUILDING INSPECTION r
44-AM M11:1 TAM ffLvE!34 D APPROVED BY T44E
=P XT.4_R. PRWfl Tp A PERMT.BEING GRANTED
CITY OF SALEM
No.r� , 0� T �; \ _
1 `ctA '��T^. . Date
Ward
���cdnrve�' Zoning District
Is Property Located in Location of
the Historic District? Yes No Building 0Sav6u 2c�
,
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Decks Shed, Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name exe.Q I P Y'
Address & Phone q Sa-yoS, M (161 )Co31 1 U 31
Architect's Name
Address & Phone ( )
Mechanics Name
Address & Phone ( )
What is the purpose of building? �nvY112_
Material of building? C9Joo CY If a dwelling, for how many families?
Will building conform to law? Asbestos?
$ it,cx�o
Estimated cost $ .^ City License n State License is
Borne Improvement r-
lC)�u J
/ Lic. t Yl
Si nature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
�t'Pv-na�iP 1 hC�-I�I�trtx�lnn � �P lexo. .�-P
MAIL PERMIT TO:
.1.
i
No.'�A
APPLICATION FOR
PERMIT TO
LOCATION
T
PERMIT GRANTED
7�1 19
APP,R \
IN//S//PECTO F BUILDINGS\
j
i
CITY OF SALEM
BUMDING DEPARTMM
HOIYMOWNER LICENSE EMOM0N
Phase Pdd
QI Sct-�ro c-, 'R.� Q.�Y-Yl
IMLOCAMON
. HUMEOWtd•A Q, Scty� ��'
ADDP=.
'fELF�HOI'11E '
pREWTr MAU-W.G ADDRESS -
TW
oti of'bomeowvars'was rxteada to bxludc owvcr.occu*d dweMi r GCT M0
Units w amca nmp�i fos bbe wbo does v%pries•
U a]as
and to allow such bomeowttas to�an btdividtgJ. .
Lawc,.ymvidw tbstthe owner act as suparvbw-
DEFlXMW CBF HOIAEOSVML• oa whhit that{R or Y
Pcrson(s)wbo corns a pw=l of land on wbicb bdsbc raider of Wends to tssdr. to%* ttse andkr
intatrkd to be,a one to two bm0y dwcMn&attadwd m dctac'Md tartrctt " �od"q ttol Tx eonsl0'
farm strucwm A person wbc construcu nmrc than one bom in s two-y Pcr1
a bomom=. Sucb-htm Tar shag subnnt to the BttDding O awd tta a ft andbadod
bbe tOL
Building Offd .that bdshc be tapotmbb:to aD such wotk pafofrttcd tmda the bttildiog petst�
TIK tmdcrsipad-bomeownet"azsv m tcspot''bdM for compliw=waht K Stag Btdit Code w d
oLha applicable San by-bvm.rules Ind>egv12601 L
The tmdasigaed-hotnea wnd'aftifm that hdshc ttndcrsw ds tla Cry of
amnnnn v spwuon procsdwa we tcgtarctacros and that bhhc will comply
Tc9 •
HONMOWNWS SIGNATMIR
APPROVAL OF BIWING IKSPEC'I'OR
Sm otter sdc fm scan code
HOMEOWNER'S EXEMPTION
The Code atatcs it= 'any honuower performing tbodk for whicb a buildb g permit is jegabed shall be
exempt from the provisions or ibis section (Section 1U911-Uccnsing of Coostruetion SupesvHorlo
Provided that is a honmeowtrer engaga a person(s)for hire w do.sucb work that such bmneowaa dm so
u mvwvbOe
.
Mara bomeowners wbo use ibis exemption are inmware that Iky we site .
Ica
supervuor(see Appendis Q.Ruled and Regulation for 1Jecnsing Coostruetiom Soperrlsom Sarum
.L24 This lack of awareness cd=nngu in scrioas probkm n pardcuhrV when the.bomwwr=bbee
unlicensed persons In this case yew Board cmice proeecd&Saunas tht:uWkcnaed person as M world wig
licaucd Sapmisor. 71t boo "ver Acting as saperAw Its aWoateb 1stsEonsible,
To auum that the homcowna is fully aware.of Wha responsibilities,nuM aoann udil a regob%m pee
of the penis appliotim that the homeowner ccn*that he/she wu asunds the seapmsibjHd=da
super m. You may east to amend and adopt sad a foradctlti=dw fm twit in your commmk.
r
PUBLIC PROPERTY DEPARTMENT
120 WASNINCTON STREET, 9RD FLOOR
SALEM,MA 01970
TEL. (976)745-9595 EXT.980
FAX (078) 740-9646
STANLEY J. USOVICZ, JR. -
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,S34,I acknowledge 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 c III,S 150A"
The debris will be disposed of at
Location of Facility tt
' )Ajxl'x A 0t- 01 1 0 1
"t Signature of Permit Applicant Date
FULLY complete the following information.
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
I
Firm Name,if say
01 SO-Iroy (Lcl So—kCm , t—t A
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 clII, S 150A, and the building permits or licenses are to
indicate the location of the facility.