14 SUNSET RD - BUILDING INSPECTION (4) What is the current use of the Building?
Material of Building? if dwelling,low many units?-Sl
Will the Building Conform to Law? Asbestos?
Architect's Name
Address and Phone
Mechanie's Name
Address and Phone
Construction Supervisors License 0 HIC RegWration#
Estimated Cost of Project SL Perna Fee Cakulatlort
Permit Fee S °� Estimated Cast X$741000 Residential
Estimated CostX$4141000 C4mmswAa4-- - - --
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;Permitthe above s led
specWAdons. Signed under penalty of perjury
Date �� G
N
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96
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REGISTRATIONcnA, I-SISUE0 BY Data Of PJ1.211UIaCWM-
05/03/04
NJ AP "6(;ATI ON
r 10i NUMBER NIL111111GIV
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EVANSVII,PJ--, Ij\jf)jJ\NA 47725 382725 r
F 12 1=4 MANUFACTURPRS Or THE FINISFIFID
TF.NT PRODUCTS nI.--SCRIBF lir-11EIN!
This is to vevtify that the materials desovibed haV0 been flame-retardant UeatOd ul
(or are inherently ntwainflarmable) and were tuppiled to:
5 692825 5
RICE RENTAL CENTER
TAYLOR RENTAL CENTER#14978-4
Ej 115 CABOT STREET
BEVERLY MA019165108 5
r
5
9r
Certification is hereby Made that: a FArh oved
The avilcles, dosrribed on this Certificote IN',"VO Ljenn treated vilitfi a flaMe-retardant i*lt V�'
5
vv"I's done in with culifub'dila-
rhemical and that the applicatiOn 01 WiwiGlIG-1-11ir-11
Ara marshal Code. All MIME, Pas o't Nrpl'I 70'i-90, (,'13fj1 P,,3, ULC,
rnahoo m, tiu., , nchel-flical mpplication W':
Dc"wripkion of itell'i Milifif-01:
ALL PURPOSE CANOPY TOI'20WX20 Ej
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CITY OF SM.EM
PUBLIC PROPERTY
DEPARTMENT
�\NGl1 GY plli(•N 1
1 w..v„ S17Fm MAGMSSM01970
7E:971-7354S95•FMC 978-7.10.9&6
HOMEOWNER LICENSE EXEMPTION
Please Print
Date-T-�7
Job Location
Home Owner Address J� Y
Home Owner Telephone 7� _ J- _ s Li
Present Mailing Address
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 possess a license,provided that the owner acts as supervisor.
DEFIMTION OF HOMEOWNER
Persons)who owns a parcel of land on which he/she resides or intends to re on
side,
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 Building Official,on a 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 requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING INSPECTOR
See other side for state code
-CITY OF-SA= - --
PUBLIC PROPERTY
DEPARTMENT
I:I�dcM Gy D�IXOLJ.
MAvaa 130 WAUUN=W S�MM•
SJUW4 MnSUan;stl'R 01970
'RW MUSAS"•Fns M740.9"
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 Addmsm:--
Properly is located in a:Conservation Ares Y/N Historic 01strid YIN
2.0 OWNERSHIP INFORMATI N
2.1 Owner of Land
Name: At-,el —�;7-��
Address:
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING 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
Bdef Description of Proposed Work: 1 a x �2
Mail Permit to: - --