48 WEBB ST - BUILDING INSPECTION (3) �I t�EA��IiP offlf" y®w we
•pl�11�A�r•�Nq MANf�D
CITY OF SALEM
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Permit a: CAM PNMI APPUCAATM !OR
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APPLICATION F
PEPOW To
LOCATION
PEF*AT GRANTED
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APP o4POF OPLOPM
,
ary OF SALEM
BUIImIIBG DEPARTtvM
HMaOWMUCENSEE MOMON
Plan No
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HOWOWNER'S SIGNATURE
APPROVAL OF B=ING V4SBECTOR �r
See otba ode for start Code
ary OP SALEM
Bunzim DEPARTmm
HOMEOWNER UCENSE E mww"
plem Pda
DA72
s OCATION
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HamEo m
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pRESEliTMA1L11?G ADDAE!! .
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1iea�.p�ovided 1bSt tbt ewsv ats d wee*+I�.
DEF>rUT101'i CF HOIdEOWNM w teida.m.Ad�lhas is,a Y
PeTaoo(s)Wbo owm a parcel d lsnd on wwCb bthhc iaides a 1n1eTdS w nTt!tft audlYS
buorAod w be,a one w two�b dv"dMg.amrehod a deudred struenoes aoA oonsld%r
fum Svueaaaa A ptum w�bo COTTTVVM more then=home in S twa an a crUAfw**A sale toou
ad
ufi'homeow•ad' ShaRSubmdt w the 13agn O>lu+�
a bourrowaet S
to
Bw7db>j Odleial,that btlshe be TtspoTwbk to all sodt wok pefamrd Soda the bafldioS perm.
tadcsipKd,bo w.MOM��for�p�wilt the start B�Code ad
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olha applicable Sao W4xw%Tula amd Tep k6cm L
The wWcmipwd`homeowmar tcrtifia tbre hthhe wdauw ds the ClW of
minimaa impaction r=dwu and Tegimtmems and that hlsht WW WMPIY
HOWOWM'S SIGNATURE
APPROVAL OF B=ING WSPECTOA
See Oda adt im srau Cade
} ) CITY OF SALEM9 MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MA 01970
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 aelmowledge that as a condition
of Building Permit# ,all debris resulting from the construction activity
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL c III, S 150A.
The debris will be disposed of at: n,D f 1 v b lit l�'�l C101
Location of Facility
4� All
' Signature of Permit Date
FULLY complete the following information:
(PLEASE PRINT11 `CLEARLY)
r 1 S�l Yt(�Yl s'D n
Name of Permit Applicant
Firm Name,if any
� �l•��blo � ��n w� I'rl �-
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 cIlL S 150A, and the building permits or licenses are to
indicate the location of the facility.
II