24 WEBB ST - BUILDING INSPECTION (2) What is the current use of the Building? how many units? Z�
Material of Building?. If dwelling,
Will the Building Conform to Law? Asbestos?
Arcpited"ame ( )
�"�'d'Phone
Mechzff�s Name
Address and Phone
License# HIC Registration#
Estimated Cost of Project S �°od' Permit Fee Calculation
o r Estimated Cost X S71S1000 Residential
Permit Fee S --
- Estimated 6ostX S41/51000 CommerGa�--------
O 3/3 An Additional$6.00 is added as an
Administrative charge.
Make sure that all fields 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
Date o 4 - 2 t -07
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PUBLIC PROPERTY
DEPARTMENT l 41:1\GfFJLSY Dew.0 L 7
M3.M745-9S9S•PAZ M74048"
APPLICATION FOR THE REPAIR RENOYATION CONSTRUCTION
DEMOLITION OR GRANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDIN .
1.0 SITE INFORMATION '
Location Name: 2 We� S Building:
Property Addrms:---
-- --
SQ Wl �
Property is located in a:Conservation Area Y/N Historic 0Is4kt YIN
2.0 OWNERSHIP INFORMATION S' as
2.1 owner of Land s'p kA s?
Name:
Address:
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN DINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use N"
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brie[Description of Proposed Work:
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------- ---Mail Perrrlit t0: y la/e�ij - - -
CITY OF S.ULEM
PUBLIC PROPERTY
DEPARTMENT
KIfO1F1L6Y D�ww
MAYOR
13O WMMNGTON STREET♦SALEM.MAWACH:SEM 01970
TVL 978-73S-9S9S*FAY 978-740-984
HOMEOWNER LICENSE EXEMPTION
Please Print
Date fir✓h e- 2 I -117
Job Location -2--A S4
Home Owner Address cI 7f3�74 4- 4S
Home Owner Telephone
Present Mailing Address 7_ - e[�l q
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 INSPECTO .�
See other side for state code
CITY OF SALEM
1 ' I PUBLIC PROPRERTY
DEPARTMENT
\ AWK 120 WASJ am'';JN SCREET •SAL F.M. MAYSuatt iL 17i 0191.
To,973-745.1595 #F.--X:978-74G9M
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit # _ .. _— is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c
111,S 1.50A.
The debris will be transported by:
---E Z LS posAr
(tame of hauler)
The debris will be disposed of in
Z5 DY�. _�� �✓
(aume of facility) 1
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