43 WALTER ST - BUILDING INSPECTION .C�5,o 0
lai0
-PL111MIftST-SEflL*0,- l G APPROVE0 BY T44E
,WSpF.CTL?13 pfWR TP.A PEAMIT B,EWG GRANTED
CITY OF SALEM
p� Date
No. to
yyts:.
Is Property Located In Location of
the Historic District? Yes No Buildin8
Is Property located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Rod Reroof, Install Siding, Construct Deck, Shed, Pool,
(!epai Replace, Other:
PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owners Name
Address & Phone 3 �.i�f1 lfEfZ �r ( 97, 7�1S 9S9/
Architect's Name
Address & Phone AM /� �Ii
Mechanics Name / 8 i .ONS? Y0—#OA),/ 7�� � `�uegtaSS 4
Address & Phone
What is the purpose of building?
Material of building? /.r )0 b-b r/ If a dwelling,for how many famines?
will building conform to law? N eS Asbestos? A 20
Estimated cost 3,500. oo Gty ucwm# N k State license at 00-27-�
Rome Improvement V
Lic. 10a3 ,_ ,AF
ignature cant
SIGNED U14DER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
Lp/n I?,jrrn g�U T- C4- gD7760 1UA-e-0e LE*fns
An0 �nSYs (�S,��iCy"UcP
rz5 -Reno A-ae-s
MAIL PERMIT TO: I-Id 6 C0VS1 C -1 i O nl -,3
610ucesrFR, 914
ICIa ` d Confr' c Di9� o
No. �
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
APP ZO�V�b
i
INSPECT OF BUILDINGS
CITY OF SALEM9 MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
Y SALEM, MA O1 970
w,
TEL. (978)745-9595 EXT. 380
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-activit}�------ --
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL c
The debris will be disposed of at: J
on of Facility
d a� vs
S ature of Permit Anak t Date
FULLY complete the folk ing information:
(PLEASE PRINT CLEARLY)
Name of Penm
Firm Name,if any
JC143 d
Address, C1ty & 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 cIII, S 150A, and the building pen-nits or licenses are to
indicate the location of the facility.
�0osn90'OfH '� ° No: 046 ® Class •B-Ltd.C
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR I Expires 12/31/05
Registration: 100273 ' BOARD OF EXAMINERS
Expiration: 8R512006 CITY OF PEABODY,BUILDING DEPT.
Type: DBA - LICENSE FOR CONTROL OF BUILDING OPERATION
This is to certify that: Michael Burgess
M.D.B.CONSTRUCTION
is duly licensed to take personal charge of work under the
Michael Burgess
18 COMMERCIAL STREET 'i -� � provisions of the Building ordinances of the City of Peabody
SALEM,MA 01970 Administrator Board of Examiners,
Chairman •� -L-ma-)'j-e✓
. I J
/ie oixonaatuie¢ o� i •,—,,,fa yq A �•Y q, v Y." v
BOARD OF BUILDING REGULATIONS • ,, �� 4CITY 15r; SALEM• .,
r rr QU 411283�,f
License: CONSTRUCTION SUPERVISOR 3 •s BUILDING UC�IVSE
Number: CS 023113 "' '� •'�.r ._ , , " �,
a M�.• i •*'f Fol
Birthdate: 0 812 9/1 9 5 6 ' „}! tv`toyc•�'fy Lha} , #', ,�• t Li`V*`
Expires;08/29/,2007 Tr.no: 1090.0
1�.DA4R15•JAVENOR.•.►1+ $} Wfilbl ,Maui„ ,
- Restricted: 00 a: •� 3
Haylian qr"anl•d a'lic•nr•`by fho.8nddll,q Ansp•el n • :
` MICHAEL H D BURGESS a a ,'r ,
4TIBBETTSAVE �� +�1y. .L •• + ,-" r �, �,
DANVERS, MA 019231 Afl•p:� a '* ■r• > - a
R Commissioner ` S&PTFl1BEB>1 i9 vfi
�. � ,� s ..i�luu•d •i +t 6 � .l..
� _.. J-•R`. >. r .%�_ t` �,r. ,,,laiNiaglmp•etor :..
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