0010 STORY ST - BUILDING INSPECTION What is the turrw t use at the SwWiM?
un
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Malarial at BOOM? ner its?
Asbestos?
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0
Ashit d*Name '
Addrsall and PhonS
Meoha des Name
Address and Phone HIC RepistaUon 8Cwwkucdm &Vetvisam ucwwo 8
EsWnsosd Cost � d Perna Fes Calarlatlort
Permit Fee Estimated Coat X=?f:10 O Resider"
- Esltsatad Cast X$411$1009
-- --- An AddlBonal SILO0 is added as an
Adminwradve dwga
Make sure that all fields are properly and kipibly w Mm to avoid delays in wocaslro
The undersigned does hareby apply rar a Building;Permit to bullet to the above stated
ap�q ns sW"under penalty of penury
Date
3
d
EPI'Y OF aSAAT.bb
PUBLIC PROPERTY
DEPARTm&NT
ua.ouatt oonrt - `>
�J1Ot ,30W woe=mMm Suaftwr aRswsnulsro
APPLICATION FOR THE RUAM RZNOVATinN CnN_rrt U(n3nnt_
DEMOLITION.OR CHANGE Olf USE OR OCCUFAWY_ FOR AW EXIBEG
STRUC'TURR OR BULDt UG --
1.0 arm INFORMATION
Location Name: v,Q Buis e
---- -
o S7�4 S�T,
Properly Y kxabd in a:come nation Ares YM Hftft DkMd YM 61
2.0 OWNERSHIP INFORMATION
L Ownw of Land i - r . /:v i G r ? 7 Z�
Namr GL rc f G�i'L r �d 9
Address:
J71,
T"wlone.
0.0 COMPLETE THIS SECTION FOR WORK IN MUIMNO 9UILDINOs ONLY
Addition Existing
Renovation Number of Stories Renovated
r
ange in Use New
molition Existing
proximate year of Area per floor (sf) Renovated
nstruction or renovation
of existing building New
add Description of Proposed Work:
1px-e cl v ,./ ) d /ql Fhe W j �� o,J u 1-3
� �s
SN4lle - Sh�a( e �u o�
--- -- ---Mail Permit to:
Yi
CITY OF S.UEM
PUBLIC PROPERTY
DEPARTMENT
oa�nu.
wroa
f aawAvuNcraN sTwsar•sAL9K NwsuoaYsrrs ot97o
TVL 97a.745-959S•FAX.978-740.9W
HOMEOWNER LICENSE UMN11 PION
Please Print
Data
Job Location
Hom@OwnwAddren
l�
Home Owner Telephone
9' 7 Soy!• �o t<
Present Mailing Address /,-D .Sri � 'S
The current exemption of"Homeowners"was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who does not a ' pro
vided ded that the owner acts as
P Pm
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on
which there is, or is intended to be,a one or two family dwelling, attached or detached
structures accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
"homeowner"shall submit to the BuildingOfo ctal,on s form acceptable to the Building
Official. that he/she be responsible for all such work performed under the Building
Permit.
The undersigned "homeowner"assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations.
The undersigned "homeowner"certifies that he/she understands the City of Salem
Building Department minimum inspection procedures and requirements and that he/she
will comply with said procedures and uirements.
HOMEOWNERS SIGNATURE ~
APPROVAL OF BUILDING INSPECTOR
See other side for state code
Crry OF SALEM
PUBLIC PROPRERTY
DEPART%-am
...v:.a ar• ar.►•r�
�1��.a lffi 7.�eyr:otci 7rtt•�i�ta�r.fLwpt�w a}r1s::9
Construction Debris Disposal AfRdsvit
(required for an demolition aid'Wavadan work)
itlactotdatyee with the sixdt edition o[dw State Building Cod@.7SO CUR sactiou l 11.!
oaci%and dw provisions of MCL a 40,S SK
gyiw f*Permit 0 _ _ is iswted with dw condition that dw debris resulting Bats
this wart sWI be disposed of in a property Seensed wow disposal &cility as dented by%iGL e
1 l 1,s 110A.
The debris will be transported by:
sY,.o
rho debris will be disposed of in :
fxduy)-
_�-
/vim e7
REFERENCES Not To Scale
SOUTH ESSEX DISTRICT
REGISTRY OF DEEDS:
PLAN BOOK 1001, BOOK END
DEED BOOK 15590, PAGE 463 /
ASSESSOR'S Garage
MAP 23
LOT 15 Air Conditioner
(1.5'x2.7') 0.3'
Encroaches N
IL
Air Conditioner �i/
(2'x2')
Encroaches 0 8'
1 .0'
(1.5'x2.7') 0.2'
avow ftjwvncroaches
0
v
c
m
Lionel P. LeBlanc 15 Read St. Condo
1-13 Read St. Condo
o iP/ 110' :.
t
.0
Wood LOTS 3&5
Garage 11,000 S.F.
Shed 24'Above
Air Conditioner Gound Pool
(1.5'x2.7'
Encroaches
,Air Conditioner
(2'x2') I/ +'
Encroaches
#
1.5'x2.7') a
Encroaches N/F
22 4' Richard J. Petrino &
o I Maureen M. Sullivan
N/F o
Stephen P. & 3
Joan B. Lovely > 1 t%t Story
o Deck Wood .
#16
22.4'
4 � �
110' Co 00
Fnd
STORY STREET
PLAN OF LAND
o'er` JAMES SG
IN .. Bou o s � .
SALEM , MA .
NO. 10 STORY STREET JAMES W. BOUG R.L.S. DATE
aREvnnEO FOR: GLORIA R. & WILFRED E. MATTON
EXISTING CONDITIONS
BRADFORD ENGINEERING CO . SHEET 1 Or 1
MWN RG nED: BRM
3 W A S H I N G T O N S Q . REVISIONS BY
CHECKED: JWB
H A V E R H I L L MA . 018 .30
JWB 03-03-06 RG
�' 1" = 20' PHONEi(978) 373-2396 F ` (978) 373-8021 D„ar rd_.,q,o,.,,rm.net
DATE: FEBRUARY 27, 200 g — H41E: FnE NO:
140067s