78 TREMONT ST - BUILDING INSPECTION D �i.L'Gr
What is the current use of the Building? 15/C
--
Material of Building? 12C[°�?P if dwelling,how many units? ' �
Wilt the Building Conform to Law?
Asbestos?
Architect's Name ( )
Address and Phone
Mechanic's Name ,
Address and Phone HIC Registration#
�ftcyon Supervisors License#
Pemdl Fee Ca ulaflon
Estimated Cost of Pro)ed i�1 Estimated Cost X$71$1000 Residential
permit Fes i
_-- . - ------- - -- _ _ - Estimated Cost X S11/51000 Commercial
AnAdditional$6.00 Is added as an
Administrable charge•
ib
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Pelate
uild to the above stated
specifkaUons. Signed under penalty of pedury
N? r 07-?
of
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CITY OF SMEM
PUBLIC PROPERTY
DEPARTMENT
MAYOR120 WA.%UNGUM SnM•SMEK MAStACMSM-M 01970
TM-978-735-9595*FAX;978.740.9&4
HOMEOWNER LICENSE EXEMPTION
Please Print
Date r 0 -�
Job Location_7A
Home Owner Address 5MI to
Home Owner Telephone / - 97l ' 09- fps---�3P
Present Mailing Address— 5A" C
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.
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 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 "homeowned'certifies that he/she understands the City of Salem
Building Department minimum inspection procedur "an requirements and that he/she
will comply with said procedures and r uirem
HOMEOWNERS SIGN
APPROVAL OF BUILD G OR „n
See other side for state code
CITY OF SALEM
1 �e PUBLIC PROPRERTY
DEPARTMENT
' nl it ni,R LEl'!?Ruia?I 1.
120 WAi111VG,—!0NSCRGET ♦SALEV, MASSACi1LSLCIS 0197'
Tr..t:978-745-9595 ♦r.ax:978-740-9846
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
in accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit # -_-. __ is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
mrS ,_�
(name of hauler)
fhe debris will be disposed of in
(Hume of facility)
la(ircss of fucihty)
---_._ si;raturc of penmit appiicant
Q� 'd7 7
'!ate
---
PUBLIC PROPERTY
DEPARIIbIF1VT
1J.�OIFFALrLV Dam-d I
NAYOR
147_97L74&gS9S•FA3C 976.740.9e16
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION_
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTINI'
STRUC—U OR BUILDING
1.0 SITE INFORMATION `J SO . --
Location Name: I` L Building:
--
Property Address.—
Property --- - - - --- _
Property Is located in a:Conservation Area Y/N Historic DleW YIN 1_
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land 1
Name:
Address:
[TelePHEI c 7 p S 3
3.0 COMPLETE THIS SECTION FOR WORK IN EXISIINp BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated 2
Change in Use New
Demolition Existing
Approximate year of �� Area per floor NO Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:�
CVd/6�A�e �. yE� Gv2Q /2 y/
��e' XF Z,
---_--�--_-Mail Permit to: --- --