140 WASHINGTON ST - BUILDING INSPECTION (6) )
No� City of Salem Ward
00
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APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete ant items in Sections:1, 11, 114 N, and Ix.
I. AT(LOCATION) 140 Washington Street- p B5
LOCATION 1N01 "
OF BETWEEN Rartnn Square AND Norman St.
BUILDING iCNOSS STREET) (CROSS SMEEn
SUBOMSION Map 35 LOT 0003 BLOCK LOT 0 sq. ft.
II. TYPE AND COST OF BUILDING-All applicants complete Parts A -D
A. TYPE OF IMPROVEMENT D. PROPOSED USE•FOR"DEMOUTION"USE MOST RECENT USE
1 ❑ Nov buffeting ReslOMbal Narresseendnt
2 ❑' Addtdon NtesidailW.enernrrmber of new 12 ❑ Onstarney IS ❑ AmWsnenL leaNbaorel
housing unrfs addI I d any.m part D.13) 19 ❑ Chrick oMer nMgibw
13 ® Or more tarrmdy•Enter number 20 ❑ inettom
3 �. Aseratnrm(See 2 above) Of of unie—
21 ❑ Pat"garage
4 ❑ Repsa replacement 14 ❑ Trarwre her,rrmolel.or dormitory- 22 ❑ Servies statim reps°gamp
5 Wreck Erttannurrmbsiaundo._—�
❑ M Ie mu IOfandY resdstafet enM numbr 23 ❑ Nosprsll.seetuporel
of unds in bwaeq m Pan D. 13) 15 ❑ Garage 24 ❑ Office.bent,proras.rI
8 ❑ Moeng(mWaeen) 18 ❑ Carmen 28 ❑ Pule uWy
7 ❑ Founmton only 28 ❑ soled wym oiler eanueerw
17 ❑ Oetw•Speedy 27 ❑ Stares.meromee
B.OWNERSHIP 28 ❑ Tanks,towers
B ® Private rmdiriduaf.corpora m nonprda 29 ❑ Otlw Specry
insp utipr,ek.l
9 ❑ Public lFedentl.Slats.a kral 9monvine n
C.COST I01ntt erttal Naealnemal.Describe in dew propmen use of puddings.es-food proeeuM plate,
macs ne stea laundry,budding at hospital.eer enury SOW.SecaWary adept,coesge.
10. Cost at 202,500 °ar0or1a1 tC11001'Parkeel°rage tar dew wwa stare rental aloe buddng,office buk" 1
at ffxkiw l plain.0 use of esistm budding a oeemg Charm9ed.enter proposed tr. P.
TO be ASMW buf not reaead
mmeaw"cow 24,000
a. Fmcbme __ ✓'
b. Pxnn WIN g 36,000
G IeW9 wmndibrmn9 OmerLNIA
et. Op tebvslor,rG
11. TOTAL COST OF IMPROVEMENT
IIL SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions, complete Parts E-L:den101iNDn,
complete only Parts J&M.all others skip to IV
E. PRNCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL 1. TYPE OF MECHAMCAL
30 Ej Mnary Mrell beefegl 35 ® Gas 40 ® Publk Or pe Corrpsny Wa Ihere be 04nti21 r
7 ® 00 at ❑ Prks °epee wet.Sir-) ®32 ❑ Strtsar eest 3 EeepicdN 69 45 ❑ No
33 ❑ Reemtareset camcrrs 38 ❑ Cost H. TYPE OF WATER SUPPLY WE 0ws by On SWAM?
34 ❑ Otter-Speedy 39 ❑ Oiler-Speedy 42 ❑ Ptelie or pours COMPWW 46 [3 yes 47 I] No
43 0 Prkab twat CisMml
J
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
48 NumDer w 510n9a ........_.4........._....................._........_. ,
49 Taat aware,an ot now area.a::noors oases Has Approval from Historical Commission been received
eamlqr
a;menswna ........ .a..L.l.3_...S.q.......f.t__.... for any structure over fifty(50)Years? Yes_ No_
50, Total Mal area.go.It......13,_920._sq_ f Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES:
51 E,Kbseo...._......_._.--.............. a . ..
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
ez. Omaowa....__.-.......
_.._._._-----_-.._� Yes NO
L RESIDENTIAL BUILDINGS ONLY - Water: -
53. FJ,daeee..___. EPIC:.. 1
Full_ Sewer:
oa"Wootoma DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED 5
Partial------ BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No}— (If yes,please enclose documentation from HisL Calm) {
Conservation Area? Yes_ No.XL (If yes, please enclose Order of Conditions)
i
Has Fire Prevention approved and stamped plans or applications? Yes_ _ No_
i
{
is property located in the S.R.A. district? Yes_ No_
Comply with Zoning? Yeses No_ (if no,enclose Board of Appeal decision)
i
Is lot grandfathered? Yes_ No_ (If yes,submit documentation/If no,submit Board of Appeal decision)
If new construction,has the proper Routing Slip been enclosed? Yes_ No_
Is Architectural Access Board approval required? Yes_ No_ (If yes,submit documentation)
i
Massachusetts State Contractor License# CS 065097 Salem License#
Home Improvement Contractor # Homeowners Exempt form(if applicable) Yes_ No_
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMIT
If an extension is necessary,please submit
CONSTRUCTION IS TO BE COMPLETED BY: 8/30/05 in writing to the Inspector of Buildings.
I
V. IDENTIFICATION • To be completed by all applicants
Name Mall aooree9-Numoer,urea[coy,a b$l LP Code Tel.No.
Owbror140
Of 7 01915 978-922-
LOU" Trust Beverly, Ma 01915 0800
y 7 Rantoul Street Suite 100B - 01915
cormaCOf Beverly, Ma 01915 Wawa
CS 065097
3. H&H Morant & Co. 221 Washington St
Engirber Inc. Salem, Ma 01970
,
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his nuthorizea aaent ana we agree to conform to all applicable laws of this iunsdi n.
Signatur f ap cant Addr Applicaaon date
DO NOT WRITE BELOW THIS LINE
Vt. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit Issued 19—_ Fire Grading
Building
Permit Fee $ Lne Loadvg
Certificate of Occupancy $ 0==Wv Load
Approved by:
Drain Tile $
Plan Review Fee
TITLE
NOTES AND Data-(For department use)
(� p iron
nX �la
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by. Completed by.
VI ZONING PLAN EXAMINERS NOTES
DISTRICT d
USE
FRONTYARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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SITE OR PLOT PLAN -For Applicant Use I
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December 23, 2004
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MULM PRE'
140 Washington Street Trust
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Goldberg Proerties Management Inc.
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7 Rantoul Street, Suite 100B, Beverly, Ma 01915
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