53 TREMONT - BUILDING INSPECTION What is the current use of the Building? many units?
Material of Building? if dwelling.how
Wilt the Building Conform to Law?
Asbestos?
Architect's Name
Address and Phone
Mechanic's Name
Address and Phone HIC Registration S
ConsVuction Supervisors License 0
Estimated Cost of 014tcl.SJSd Pemtil Fee Calwlatiort
Permit Fes S �' ' Estimated Cost X$71$1000 Residential
Estimated Cost X$111$1000 Commercial--An Additional $5.00 Is added as an
Administrative charge.
Make sure that all flelds are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of perjury X
Date
N
0
a
� � o
F •D � °o O� >nit
g
Gr
--
- - -
CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
KIMBE LLEY DRISCOLL
MAYOR
130 wA4UNCTON SI4HEr*$M F..Y ,ASUCHL'S6TR 0197e
TEL 978.745.9595• FAx:978.74e-984
HOMEOWNER LICENSE EXEMPTION
Please Print
Date C�
Job Location S� I �� 0/1
Home Owner Address S-- � 7—(�p mo n 7' —
Home Owner Telephone q i4 e-
Present Mailing Address Y-557`P Mon t7- '
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 "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
s7-2
EIT 0 �xLE�
PUBLIC PROPERTY
DEPARTM �1T
til\MGM LY p�1y'l V 1
MAYOR 130 WaWNGT N b`R 0 SALEK MA5fAQ11:5t1'IS 01970
TtL-973-745-9S"*FAx 976740.9aN
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 Address.--- -- - —
�e Sf
Property Is located in a:Conservation Area YM Hlatoric Dftict YM
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: r 4 r.J C rc) t— (I Sol
Address:
S_ T�2✓na Alt- St
Telephone:
3.000MPLETE THIS SECTION FOR WORK IN EX1AT1Nn 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
Brief D 'ption of Proposed Work:
-----_ _---Mail Permit to: