82 TREMONT ST - BUILDING INSPECTION �L wi�uS��Er�t� APPROWW BY TW
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CITY OF_SALEM
No. /dam ow G/�lo w
""off Lacom in Yak..No Lecotim of
:� Caw�oaMat Y��NO�
WMLOM PERWT APPLIMO i FOR.
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RapaidRaplaoa, other;
PLEAa 9 LL WT LEW LV A CCYPLE MY TO AVOW BELAYS W PROCESSM
TO THE MrSPECTOR OF BtJILpINt3S;
hemby appl a for a pu t 10 bum aoow&q to dw famwa p
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now r N A atsr tlorw r
als.+�c x rya. Sip iWn of ApW&V
GWONED LMiDER THE PENALTY
OF PERJURY
DESCRIP�" OF WORK TO U DONE
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CITY OP SALI91411 MASSACNUSKTTS
Pusuc PROPERTY DEPARTMENT
120 WASHINGTON STREET, 340 FLOOR
• SALUN, MASSACNYSSTTS 01e70
. . TELSPNONSs 97e.74e•eeee ny. 3e0
_. IASI 970-746994e ...
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nw . at"lloolomme-wo ofto6d to kWh*ownw4mopw
w othm L%to a Ina and to aibw au*h eo�e an imividual for
ire who doe not poem=a Hca u%p vvhw that
as supeaviear.
DIiQ+IIHl tN Of H0WWM
Pa a a�ho aMal apeas/atbodas!�ci hdah�AWN arWm&to
wbcb dteev i4 a b hrtmded to b�,a sae a taro AM*4Oep�atorw o dsW ad
strocbtt+a accpeory to each tree and/oror than ant bases in a taro year period chap not be=Wdaled a
ilrnt a�tt Wei. A V p ea whe cona�enoq more
"homeownaa"steal!submit to the Bwldiod �,on a ' Sub
P�thit hdsbe be r>xpoaable tar aU such wmlt Performed under the Building Iding
1lmldinu C1ode and om �ee��� �Ptianw with the State
om
The undo Wpw"houmwme aadsee that he/she erode the City of Salem
HuildinH D minimum in"c"m Procedure and mqukeareeta sad that he/she
will cOmPIY with said Procedure and ropL-jmeata
HOMEOWNERS SIGNATURE �o
APPROVAL OF BUILDING INSPECTOR
See other side for state code
F ..
VA"a Dll� 'i Y�is
_dmb "AM HoG eow�p wait Sec"log.1.1-
to
MrAind da to cumot o°k p�Po"i �Homeoermr®P� to hne
• of Cam�°� ��meoerm���1e
do swdt wad. afie no tb3s ,fig �d"moms m +i
a orsors s 5upwwaamsodam�1WM� Mom e�P��• In dds Y"
w� as itwoold mod►s llcao�e�
Hameowow is&ft awns otbbAw :�' Nemeowmr gamy ca,fo*d
To *A&sim as IL poottbe Yemvt App1 y""Vof d& is s
hd��a 'und by Yormsy +oo amsod
imd � sod
`I�Izoos
CITY OR SALX349 MASSACMUSM"s
PUNUG PRCPRMM 09PAWUCW
120 va"INems freem 2" ou"
11"81% M"emmu eT" atf70
TeLap""m 00.746•"a ftf. 3"
/As 978.746""
It aoom*ms with the p wAdm at MM MO S A a coadW=*(yaw
suffifts Fermit Is that the ddxb m%fts ftm this walk AM be&posed
at ht a peopady'W@o ed S*U wasla dqmd hdft=ddbW by MM
ChVW UL S I10 A.
MW debla will be diapoW of ie:
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Date