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0011 VISTA AVE -BPA-05-992 �L�lIB�AIlSTaEfLI94ND APPROVED BY TM ASPECIt1B WOR W A PERMIT WING QRANTkD No�� �C CITY OF SALEM 5 ware zorrrp DMW Is PmPWtY L.oaad In iocattoa of a»trpodc DhUld7 Us No— / a l i Jura Ave Is Plommy Locabd to • rn CarNmdoe Am? Ye No Permit to: BUILDING PERMIT APPLICATION FOR: (Circle whichever apply) hoof. ROM&, InsWI Siding, nstruct Deck, hod, Pool, Repair/Replace, Olher: PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS W PROCEMW TO THE INSPECTOR OF BUILDINGS: '• The f iIined hereby applies for a permit to build acco".to the ktg.foRow Owner's Name ihL !F eM rR)c Address 3Phone It J65TA- AOC 76qq Architect's Name Address A Phone ( 1 Mechanics Name Address A Phone ( I Whtl is rn pspaa it brldYrp4 ideterrs-or bYdtrg4 IN©o t r a dwNNq,br how mmy f nAm? WE b ft ow"'. to aw9 S AdxMs? tj 0 Fwnwad we 4 -k CRy Homes r 81sM t loerw r Signature of Applican` ' t SI-IN" Wam TEE Pm"LTY1 OF PERJURY DELI r A FTION OF WORK TO BE DONE 4 e MAIL PERMIT 1 57A M e e l APPLICATION FOR PTO LOCATION PERMIT GRANTED 19 INSPECTOR OF BUILDINGS 1 j,. CITY OF SALEM9 MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR SALEM, MA O 1970 TEL. (978)745-9595 EXT. 380 0(b FAX (978) 740-9846 STANLEY J. USOVICZ, JR. MAYOR DISPOSAL OF DEBRIS AFFIDAVIT In accordance with the provisions of MGL c 40, S34, I acknowledge that as a condition of Building Permit# all debris resulting from the construction activity governed by this Building Permit shall be disposed of is a properly licensed solid-waste disposal facility, as defined by MGL c III,S 150A. The debris will be disposed of at: Location of Facility � � J1ar2 OS� Signature of Permit Applicant Date FULLY complete the following information: (PLEASE PRINT CLEARLY) Name of Permit Applicant Firm Name,if any V L�7A V e SA t:All Address,City & State The above statute requires that debris from the demolition,renovation, rehab or other alteration of building or structure be disposed in a properly-licensed solid-waste disposal facility as defined by MGL ca S 150A, and the building permits or licenses are to indicate the location of the facility. CITY OF SAIEM BIWING DEPARTMEff 1iMa0 PM LICENSE Exwno d Pkw Pdln DA � A 05 > BI=T10lf 11 JIsre4 SA-j AA- Aratzo 11111c:ll„�a� 2" q+5 18 TE XPHaiyfs PItXSE rMARJNGADDREW The cwn d.cwmwou of-homeowque w"uuadee w lmbwg ewoe"Wari +&n n v.iTWO Udts w kis and to Blow coed bomevwoera to sosass as kidfvida�l lx khs trio dxa aloe poneen t ]kcmy.prorrided that�e e+raw sei a w�ervlaatt. . DEFIDDTIOAI OF HONE0W"lW Pcnm(h wbo owm a parrsl of Lod on whkb belshe resides of kaeoda to Tema.ou whkb tw dl ksrakb . intendd to bt,a one a two� dwcMQ&ataKW a dwdrod �xy 1 Noennsld N farm anwwm A yenta w•Lo oonR=u mmt ttm oat bm"in a twvysar PcdW be a boa�oowaet Saab-horrarowar!'shaitaabr�dt to the Bufldio� � Bm7ding Odxiil.that bLWw bt mpomtbk to aU sv&woh perfaraedarchbnikllos Pv=L Tht midmipicd nomeowmf MOM respow*ft fa comp&=w uhtht sate Bun ft Code;ttd ' other app6obk Socs by-kwa,rain aad tefaladoaa The a woup a-Mmeownci ¢rd6a thtl Wft unda an k the C1W Of s . nm moo bdponionproc dma and rtqidtmew and that hlsht w•Bf wrap rtgakear� HOMEOWDTfR'S SIGNATURE APPROVAL OF BUILDING iNSPECrOfR Set otka ode for S=code -r HOMEOWNER'S EXEMIMON - TM code sates thsC•am perform6�j w9di for s boDdh yaJm-Ti bier""- -- ---- mmpt from►tha pr0+4dom clibb secdon(Scariest 7q id-1lrensict of Caastnretista sopavi wo ep Provided ibm ie a bmmeowmer er ppo,panto(i)fa Mm to do.sack Weak tbea sold bo®eowa-&s eat MM bomeoM=wbo we this osmpdm are imsware Thet they are atsmdnt to 1 5,Ashwas aU supoviror(ace Appeodbs Q,Rules and Replo-sloos foe Vervolot Comanwdois Supwv%om smc*n .2.15): This bolt of awamwa ofiea umlu io serisara pmbiemy Fodeobu�v'Le?tba bosaeoeraee bbae uniiocmed pcnomt In tbbr mac yam Board ssrmot proceed ataiom the mmoemea pe:po ae kvvm va !!ceased Smpmins. Tba bom e" T saint as mpcevlsee f o !2 Maw . To emsme dm Os ho mowm L f4 awa+e ctkVhw u:sponeibOdes,=MV eommmddea rngv4.as pact of the permit sppficadm that the homeowaw enad&dm bchhe midecssn I do nspoosi umn stst supuvisoe: Yon may mre to amend and adopt sues•tormlbrnilisatbto foa rats ba yostr oommml0. :1 tom. AAAi _- l-fie wrtl1 18 .E . e.�e�2�� A_rAl,_�nr_f. yf}ir1 �_t4,.��5 rolz EytnrZ�f�J�', ll I N f ';i _ , ` 'e ` , :� � ��__ _ _ ___. .._ -.�_.�.�-r-_�� - _�..«-rT.s.. __,.,..,.-n.-f-�-,,.-._. :�a� e 1 `_ 1 � �}� � \ ' f _ - -- . __.. - _.. i .� ;� � � F � \� ,� � ,.�, _a-.s_,..�-t.�-..,-.,.- -.-,......�._- , .. �_.. :� 1 •