89 WEBB ST - BUILDING INSPECTION Y!?SiVI�iSitiBEf+Lff NPR POVED 6Y T44E
If i F.C7L f�IOA 7D';A.t? T SFMG GRANTED
CITY OF SALEM
No. 2-9 -2-0O Ll Date 0 3
iy!
FtC
Is Property Located in Location of
the Historic District? Yes_No_ / Building
Is Property Located In / �jr'L✓�`i` —
the Conservation Area? Yes_No VVV
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof Install Ming, Construct Deck, Shed, Pool,
Repair/ ep ace, 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:
Owner's Name o p-1 D/vfvt
Address & Phone
Architect's Name LZA
Address & Phone
Mechanics Name
d 1
Address & Phone 2 ��otcs (� ) 0-
What Is the purpose of building?
Material of building? (N If a dwelling, for how many families?
WIII building Z,O6
tolaw? �S —Asbestos? �d /
Estimated coGIV City License«40 stato u se r /2 ✓2 D 2
Hose imp t
Lie. / Ob7 Z
(� Sig t re of Applicant
S NED UNDER THE PENALTY
cv- l"L b S S F PERJURY
DESCRIPTION OF WORK TOPE DONE
GAG , �1vfi� �' s� 2y , /3Aoi;
Ybnl5j ,
MAIL PERMIT TO: P/� O&Tc'y? �7
s
No. 2q -Zoo
APPLICATION FOR
PERMIT TO
"y
LOCATi [
PERMIT GRANTED
ApPRovfm
1 z
INSPEG OR OF BUILDINGS
- y -
.CONN . ' OF SALEM. MASSACHUSETTS
7 PUBLIC PROPERTY DEPARTMENT
®' 120 WASHINGTON STREET, 3RD FLOOR
i yA a SALEM, MA O 1970
TEL. (978)745-9595 EXT. 380
�GnmB FAX (978) 740-9846
STANLEY J. USOVICZ, JR. .
MAYOR - - -
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,S34,I aclmowledge 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 cpIll, S150A.
The debris will be disposed of at: 1
Location of Facility
Signa of Permit Applicant D
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
Firm Name,if any
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 cIII, S 150A, and the building permits or licenses are to
indicate the location of the facility.