24 SOUTH ST - BUILDING INSPECTION (4) b
r ,
-PL*W1AWT19E f#W84A ND APPROVEO BY T+IE
.NS,PECTOA ,PRIOR Tp A.PERMIT BEWG GRANTED
I CITY OF_SALEM
�No. Date 71t=
13 s: x
Ward
Zoning District
Is Property Located In Location of
the Historic District? Yes_No
Building
Is Property Located In
the Conservation Anna? Yea No
Permit to: BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, 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 { P 5 a ��
Address & Phone U 918l y , 6 '7 6C.
Architect's Name
Address & Phone
Mechanics Name
Address & Phone
What is the purpose of building?
Material of building? -k �t n „ If a dwelling,for how many families?
will building conform to law? v e S Asbestos?
Estimated cosstC�r>\y City License M State License M
Oz 6 ` z�C/ ear �rovcaent
Lie. -
igna u e o ppli nt
SIGNED UNDER�THE PENALTY
DESCRIPTION OF WORK TO BE DONE OF PERJURY
MAIL PERMIT TO: �Q '
r
No. L—V�
APPLICATION FOR
PERMIT TO
f
TIATION,,,, '
1r\\
PERMIT GRANTED
APPROV D
mz"lw
INSPECTOR OF 6UILDINGS
i
CITY OF SA1FM
BUII DING DEPARMM;T
HOMEOWNER LICENSE DMOTION
Please prm
DATE-7
JOBl ocAnON hL �S r>�L( �
HOMEOWliFll
o v �✓ry
ADDRESS
rn� 7 x 1 M
TELEaOME
PRESENT MAIIdt?G ADDRESS L L S n ti C
on of-I,=.wawl uwr was cxtcndcd w include arocs.occopka dwcluv Of Two
The avretY c�empti iae Lire wLo does sot posses a
Units a Las and w slow surh Lomcownma to CIP&C an individual.
L'«nse,.prwidcd thmlbo owner eel 02 supervisor.
DEFWITION OF HONMOWNML'
Penn(s)wbo owns a parcel of land on which Wshc resides or irucnds w trside,on.vldeh�Lt
intended w be,s one w two fmaly dwcllmg anaci cd or dctada:d strucwa erb
od shy nol Le eonndAw
farm svucnves.A person who consvucu store than one home s two-y p�
s ho wmw. Such"Lotnoow''xf' shall subn*w the Budding Official.on a fw*3rxe1tab1e b ibs
Building Official,do WOm be tespor-%bk to all such work puformcd WA=the pa=L
The tmdcrsigad-homcowsut"Lw mta tcspon-n'bift for compltara with tM Stau Bntldg Code tmd
other appGcablc goes by-laa+s,toles sad te8ma600L
The wAmipr,rd-honreowna"ecrafia that Wsne undcrsuids the Cigr of Ssktn Bnildmg Depw m".
minimwn inspation ptoczdura and rcgtnremcros and that 1Jshe will comply with said ptooedtves m d
tequireasr�.
HOMEOWNERS SIGNATURE
APPROVAL OF BVI DING INSPECTOt_l ,-,�
A —
Sec otba side for sma code
4
HOMEOWNER'S EXEMPTION
The code states that.• 'am honmwmr performing work for wWcb a buDdirrg permit is requb sba0 be' .
exempt from the pw%isions of Ibis section (Section 20P.LI-Ilmosiog of Conaruetiou Supervisoeo;
Provided tbat h a hornemmer engages i person(s)for hire to do.such work tbat such homeowau dndl get
as •
Mary bomcowners who use this exemption are unaware that they are&wwm ag the>espons are
supervisor(see Appcodis Q,Rules and Regulatloos for Lktosiog Construction Super dsom Secd.m
.2.24 This lack of swwwicu often results in serious problems,partieulart when the bomeownerbbs
u kensed persons In this case your Board cumot proc=d aphM the milieeamd person as 1t would wl&
licensed Super+isa. TDe Domeonvcr suing as svpervbor is uWsnste�rsaEooslble,
To ensure that the bmocowrrcr is fully aware of biA=respounblSties,marry c ommwdtia itgob%as part
of the permit application•that the homeowner ecrufy that btla w Understands tdse responsibilities aft
supcniM. You may care to amend and adopt such a form/ocnificatim fox ust in yatr oomuounia
PUBLIC PROPERTY DEPARTMENT
+'/ y 120 WASHINGTON STREET, 9RD FLOOR
SALEM,MA 01970
/ TEL (979)745-9595 EXT. 360
FAX (076) 740-9646
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFmAvn
In accordance with the provisions of MGL a 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 soh&waste
disposal facility,,as defined by MGd,c III,S150A
The debris will be disposed of at
Location of Facility
sgnib"offpermit Applicant ` e "
FULLY complete the following information;
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
Firm Name, if any
a ��c c (,
d c1 � � e r'i2n�sT
Ad ,City&State
Thu 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.