18 SILVER ST - BUILDING INSPECTION (2) f1000'awesf nw" mpowmmum
mmmrmb�.mx m A muff a NO ORANft
1 CITY OF SALEM
�J J
�c
WWd
tonYq OMp��
k tiaYwb oo�aq ti of N. a owwa r vat i udit
r�/1a1�11M ti
M Calwnaatiaa Awa1 . Yb_Pa�
PMmk b: NUUM I N= APPUCAUM POQ'
(craw uld"Nr 4WA POA
aw.M swft amwuot(A� Slnd,. P
ow.r:
PI"W ILL,OW UMLY a OOWUM LY TO AVOW ORAVS N P W038 p
M 711E W6POOTM OF OUR DINUThe +
hemby @PPIN fOr a P9 mlt to bWM a000ekap b Yia.bNorrY�p
OMwlar'a Nanw TArn p, MTf LeN.
Add naa a Phone 19, 'Z I z ILL fir
Away Name
Addion a Peon. L
Iftam Name
rww a a++w► Val snow awr laaraat_l.��
ldwmw ant 4►Ilo�ra• arlw umw•
Lta. 1
Oman I
a
uNo■�rs
opwowio "w
ma Pew" X
s
No.
APPLO►,IM FOR
PErr,o -
LOGM1ON
PEFOAT ORANTEO
W48PECTOR OF BALDM6
MY OF SALVA
Bu DiNriDEPARTIv w
liMaOWNIER LICENSE Envenom
Please Add
fOBlACATlg1
Ha9v�Aiiifra ' �� tM
HONfFo�vl�t �� �� -711
Tait
Pn>rsFxcw+na?o ADDR» �A rn�
The e�plad,exmptloa cchomeoweofwas cmeadee ea bnhde ewoes•aFa►p�� ��Z��
Uaft a leaa sad to aDow faah bo=uwRtas ea VWW a71 lAdlvidagldhf�1Yb0 does so paves•
�,.peovided tbutbe asset set eu .
DEFITATMCFHONlFOWAM to oawbkbtheakerY
• Persoo(f)w•Ro owof a pool d lasd oa wbith behbe asides R frnfda �� o fu3 as smAPW
dhf
b s.-AW to be,a ons a Iwo tan4 dwclf 4 Bud"a dwdmd Mall > sat be Cost
fam svwwm A pceam wbc eonsoroats MM t M one home fn s twC•Ym PC
IM bkft
a bovwowM. SurA'homeowwef shal< dad
subndt to the Bnildind OQieiat, buBft9Q=L
Bwldbg Offie4 that bait be xspombk so aA sah w•adc pcfmma0
Tm wmdmiped-homeowner Lvam:s TCSPML&MV Sot eompft=wuhtbe sue Bulft Code t+d '
otha appSable goes k-kws,roles and te=akt aft
Tu tmdasip W-homeowner cad8es that hehhc the OW BWN09 .
mmmmn vwpecum pm=dmu ad nquocanms Mahe.AI , w itb said piooedtoes ast
iwuircumom
HONWWM'S SIGNAni
APPROVAL OF BMDING CTOlt " '
See mba ode for ststc Code
e �
crry OF SALEM
BURDWODEPAIITtvlM
HOIBAWMUCENSEE moon
Plate PAN
DAYl4_ .
HOIdEOWNM
ADUMO
IOBI.00ATION
HOB
TELEPHM
PRESENT MAR 3K0� �
The cdrerl.oamptloe dywmeownas'wa wcaded w bcbwg o[TWO
Unit a low rodeo Aow socb bomeownaa to eniaie o►bAWi wO*W btr wto doer sot paves e
iiocaae..prwWed dm tbs ewraei eet rt apenlatt.
DEFV
pen= TIOIi Op sw a pvccl�ao wWch bohhe nsida a kdcA&to taiBR op wmAta e k a It
buwA d wbt a m•peal rnadwd of dmadod oractmet s tee!m a 11
farm nrw b4 a ans eo nw o cm VvCN /, *A IOU couddaad
farm tvaeatec A pctsm wbo consn�av mae 4mt one bane in s two-w,l� is M
Bwldhg 5 that bWo bete rerpons%k to aA got wart jm%rm ad mda the ban pawL
The wWcnip W-homeowner"aNOM respor %ft ioe=MP"wm with*t Suu Ba ft Code md '
other appbobic`*a br- nda and ngduWm
The wWmiprd'homeowmf ecrdfiet trot hd Ac wWO=Ab the Ciq of S>�B .
mi nimmn i;pwum pmoedma and regmremems and that bhbe will Web
nay
HOIMEOWM'S SIGNATURE
APPROVAL OF B=ING iNSPECi 0!t
Sa otha ade for tau code
CITY OF SALEM,9 MASSACHUSETTS
400 PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RDFLOOR
SALEM, MA O1970
TEL. (978)745-9595 EXT. 380
FAX (978) 740-9846
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 M S 150A.
The debris will be disposed of at: r
cation of Facility
5-a��
ignature of ermit 'cant D�—
LY complete the following information:
(PLEASE PRINT CLEARLY)
76m�,:� RA/rnnOs
Name of Permit Applicant
Firm Name, if any
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 cIII, S150A, and the building permits or licenses are to
indicate the location of the facility.