6 COLUMBUS AVENUE - BUILDING JACKET (o �10 S Ave, �..
___moi
Eri Y P-SALEn
PUBLIC PR
OPERTY
DEPARTMENT
KINW RI.EY DRISCOLL
MAYOR. IA WASHINGTON ST&ET 0 -
JNt1H,MAasnCHl;S6l-IS 01970
TEL-978-745-9595♦FAX:97&740-9W
APPLICATION FOR THE REPAIR, RENOVATION, CONSTRUCTION.
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: 10 Ma 0 1 Ne- /e, Building:
Property Address: (O Co Ae� h u S A
Property is located in a; Conservation Area YIN Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address: /
Telephone: q7 e 79-V— 2Q 2
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
12elo/acc- rroff(-'V- r'-0)? / 11061-c4
Mail Permit to:
a
What is the current use of the Building?
Material of Building? VOO4 if dwelling, how many units?
Will the Building Conform to Law? :7 Asbestos?
Architects Name
Address and Phone
Mechanic's Name
Address and Phone
Construction Supervisors License#�_HIC Registration#
Estimated Cost of PEOject$ OG/ Permit Fee Calculation
Permit Fee$ Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
An Additional $5.00 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
9 N
O
4.1 f/1
� 9
L
O C
� _ a
No. Ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location
PERMIT GRANTED
X46 —19
Building Inspector
d�la�l�y
1/�/ 6 hS
Plans must be filed and approved by the Inspector before a permit will be granted.
No. 0a-O/ City of Salem Ward
IS PROPERTY LOCATED IN THE
HISTORIC DISTRICT? Yes_No w a
IF SIDING, HAS ELECTRICAL JkGr
PERMIT BEEN OBTAINED? Yes No Home Phone # 7 y5 — SSS —2—
APPLICATION
APPLICATION Bus. Phone # c�
FOR
PERMIT TO ROOF, REROOF OR STALL SIDING
Salem.Mass.,
TO THE INSPECTOR OF BUILDINGS:
The undersigned herebv applies for er i to il acc ding to the followin pJc�fica[iojf�
Owner's name and address ---- = / �o �t.o qVI _
Architect's name _
Mechanic's name and address -
Location of building.No.
What is the purpose of building?
Material of building? Asbestos? irz-V
If a dwelling,for how many families'.
Will the building confonn to the requirements of the law?
Estimaied cost U Co actors Lic.No.
Signature of applicant �
RfEMARKS 5IGNED UNDER THE
�yws PENALTY OF PERJURY.
c.'�•�F `�t"� t��!� ._'��+'4�rat.,9.w�.?"?�-t'cc'"J'x'•�"�.`1''".� "G"a:.�r�r�'�,'.�°?"c'�r1{��1r�
Citi/ of, Salem ,Maes
Fri � _ •` �t
ELECTRICAL DEPARTMENT
44 Lafayette Street
PAUL .M T'V T.L E Cl T Ylm E,LECTRI` iAti
a' DATE. : . . r
�To INSPECTOR OF,BUI'LDINGS
i • R, w 41
" alem Mass:jk
a,
Elea
tncal Contractor
9 pp .- ..-l +r '
r (Si n8 re of Applicant)'
tum\ f/_.� l •/ -• -..... ��
.................... yyg.
signified their intention of ,performing the 'required,:electrical ^a
f � work;wiz: removing and later replacing all`electrical wires,,,flxtur_es, �. '.
K 4'
1
-N &
➢ - _ ,
�.receptaCles, etc , on outside of building•located at T
r ? Y-� , ,,; ��<. ) �• Street .
;n s, ................................ n
a.in;con unction with a wa
b K
r I 11'siding installation 4o be'made
Y.....,J E;�(!• 9Y.'S t-�{f ..... * 'Siding'Contractor&7�''
u
r '"•
r
ISSUEMB
ur _.. ...
n.
yThis',isfa requirement, prehmmary to th"e issuance o q permit
for thei,sidewall�inst((allaiion by theLlnspector of
4
7 ORIGINAL
-SIDEWALLdNSTALLER' i *r
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