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14 WILLOW AVE - BUILDING INSPECTION 4 ..s. What is the current use of the Building? Material of Building? W6DD -F aM� if dwelling,how many units? j Win the Building Conform to Law? Xg Asbestos? NO Architect's Name Address and Phone Mechanic's Name N o N E Address and Phone Construction Supervisors License# HIC Registration# Estimated Cost of Project$ 100 _000 Permit Fee calculation Permit Fee i IL02 ^ Estimated Cost X$71$1000 Residential ----- —- - -- - — -- Estimated CostX$11151000 Commercial ------- -An Additional$6.00 is added as an Administrative charge. Make sure that all fields are property 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 penally of perjury X w6 ,- , C� Date 4-19 - Z007 w O 0 N y A V C3 1� a ry e y a °�� CITY OF SALEM ( I PUBLIC PROPRERTY :� 4 _ DEPARTMENT �;\u;r nLer unlsa;u. \L%y Alt 120 WASt"IIXG"!"ON STREET♦ SALFM, R4,\%\c1 tCSL 1-1 S 0197E TEL:978-7ii-9595 +FAX:978-74G9846 j j_ wy 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 ofMGL 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 11 t, S 150A. The debris will be transported by: (name of hauler) The debris will be disposed of in �RANSI=-F' R Si�`�-It�a1 (name of facility)_. �I�l_Er1 i'��SS (address of facility) signature of permit applicant 2oa? date CITY OF SALEM PUBLIC PROPERTY \ DEPARTMENT KMMFYIEY DRS:OLL MAYOR 130 WASMNGTM S RM•SAWA.WAc AMUSEM 01970 To-978-745-9595*FAx:978.740-9M HOMEOWNER LICENSE EXEMPTION Please Print Date 4- 19 ` 2.007 Job Location 14 W(LLo W AUE 5jQFr1 MA Home Owner Address 14 l�j(LLoW AtIE S hI rra MN Home Owner Telephone 9-7,q -740-275 2- Present Mailing Address 1� WILLOW S U E 5 ff rM M A 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 hue 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 INSPECTOR 7 See other side for state code EI'Ty-or _ PUBLIC PROPERTY DEPART141F.�tT KI.MELLGY ORMCM . MAvoa 120 W"MNCrM b`n •SALEK%IASSACHLSh7l5 01970 TEL-976.74S 9S9S♦FAx 97e.740.9g" APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING STRUCTURE OR HUHMIN . 1.0 SITE INFORMATION Location Name: Building: ES I D ErLX-F Property Address:--- -- SALE>� -- Property Is located In a;Conservation Area YIN Historic District Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land 51)L L`/ t) &o R D1W CL 6 R X- Name: �;A LL 0 GO R Do vj C L A R i< Address: 19 w 1 a0w 19 V t=; S A L.Fi'"I M/� Telephone: 78 - 7 0 . 27.5 2- 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing 2 Renovation Number of Stories Renovated 2— Change in Use New Demolition Existing Approximate year of 94 9 Area per floor (soRenovated construction or renovation of existing building New Baef Description of Proposed Work: RE91-ACE F UN j RE�12 �NzRY Doz)p -65; "o RE► L-ACF FR11N7r v RERR PORC14ES s 5,ee-o �CPLF}CF 10 FIAS FLook WI1vDDWS �roa Mail Perrnitto: G©RDotj Ct-ARK 14 W11LOU AI lAthjsm Mh