2D DEWEY DRIVE - BUILDING PERMIT APP JACKET BUILDING
PERMIT
JOB WEATHER CARD
DATE19 PERMIT NO.
APPLICANT j. ADDRESS 4�4
(NO.) (STREET) (COMIR-3 LICENSE)
"ANA i Z x ;' � -'�- '
PERMIT TO - , _�:' !!-� � NUMBER OF
I—) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) N0, (PROPOSED USE)
AT (LOCATIONI ✓ L.'lUIAW'V ZONING
(NO.) (STREETI DISTRICT
BETWEEN 9-b- ��ewe-\ AND
(CROSS STREET) (CROSS STREET)
SUBDIVISION LOT
LOT—BLOCK SIZE
BUILDING IS TO BE FT. WIDE By FT. LONG BY FT. IN HEIGHT AND SMALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: 7
AREA OR
VOLUME ESTIMATED COST $ PERMIT
FEE s
tCUSICISOUARE FEETI
OWNER
ADDRESSBUILDING DEPT-
'BY
THIS PERMIT CONVEYS 40 RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR
popPERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE. MUST BE AP-
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREECALL IAPPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIREDFOR PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION
WORK' CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND
1. FOUNDATIONS
OR FOOT"" MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(READY TO LATH).
3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
2 2 2
BOARD OF HEALTH GAS INSPECTION APPROVALS FIRE DEPT. INSPECTING APPROVALS
OTHER CITY ENGINEER 2 2
WORK SHALL NOT PFIOCEEO UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD
INSPECTOR HAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE
STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION.
5 ! CERTIFIC TE ISSUED
CITY OF SALEM DATE
s SALEM, MASSACHUSETTS 01970 BUILDING. PERMIT
Ta4c
CERTIFICATE OF OCCUPANCY
_ DATE ct _
APPLICANT _ 19 PERMIT NO.
AODAESS
1 (N01 ISTPERI
PERMIT. TO
STORY --' NUMBER OF d
IT.PF OF I PPOVE M[NTI ( .�1 DWELLING UNITS
!� j� 0' IPP OPOSEO VSEI
AT (LOCATIONI ZONING
1 EE 1 DISTRICT
BETWEEN - - -'- -- --_--
ICRO55 Si REE iI AND
ICNO55 ST PEETI
SUBDIVISION
LOT BLOCK LOT
S12E
BUILDING IS TO BE FT. WIDE P.
FT, LONG BY FT. RI HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE' USE GROUP
BASEMENT WALLS OR FOUNOAL ON
REMARKS: ITVPEI
AREA OR y
VOLUME � �
&1071'1 111,
L:BIL SOVINE fFETI (Q���EE}�W1IE� �¢I�l'��7!�j
OWNER � _ Vf11v�-rlvltlenlel7lornvll v,TO BE Cil o'd1vEB vvly�-rl vrCll sl
ADDRESS SEE REVERSE SIDE FOR C�-rlONDITIP
ONS IOF CERTIFICATE
„ DEPARTMENTALAPPROVAL FOR CERTIFICATE
f of OCCUPANCY and COMPLIANCE
L To be filled in by each division indicated hereon
upon completion of its final inspection.
BUILDINGS Permit No. #172-93
Approved by John J. Jennings Date 6/14/93
Remarks
PLUMBING Permit No.
Approved by Date
Remarks
ELECTRICAL Permit No.
Approved by John Giardi Date 6/14/93
Remarks
OTHER Permit No.
Approved by_ Date
Remarks
OTHER Permit No.
Approved by Date
Remarks
No.zz� -19 City of Salem Ward �
I
�N,cn�+r�tr
'C
a
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete an litems in sections:1, it, III, IV, and IX. I
1. NIN
AT(LOCATION) D STRICT
LOCATION
OF BETWEEN AND
(CROSS STREET) - (GROSS STREET)
BUILDING LOT
SUBDIVISION LOT BLOCK SIZE
11. TYPE AND COST OF BUILDING -All applicants complete Parts A-D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION'USE MOST RECENT USE
❑ building
Residential
(it residential,enter number of new 12On 16 Nonresidential
[:]
2 Addition
® One family 18 ❑ Amusement,recreational
housing units added,it any,in part D,13) 19 ❑ Chruch,other religious
13 ❑ Two or more family-Enter number
3 Alteration(See 2 above) of units ....................................................... 20 ❑ Industrial
21 ❑ Parking garage
4 ❑ Repair replacement 14 ❑ Transient hotel,motel,or dormitory- 22 ❑ Service station,repair garage
Enter number of units .......................
5 C:] Wracking(It multi/amity residential,enter number 23 ❑ Hospital,institutional
of units in building in Part D, 13) 15 ❑ Garage 24 ❑ Office,bank,professional I
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School,library,other educational
17 ❑ Other-Specify 27 ❑ Stores,mercantile
B.OWNERSHIP 28 ❑ Tanks,towers
8 ® Private(individual,corporation,nonprofit
institution,etc.) 29 [:] Other-Specify
i
9 ❑ Public(Federal,State,or local government
C.COST (Omit cents) Nonresidential-Describe in detail proposed use of buildings,e.g.,food processing plant,
machine shop,laundry building at hospital,elementary school,secondary school,college,
10. Cost of improvement ........................................................ $ 3 o parochial school,parking garage for department store,rental office building,office building
. at industrial plant.If use of existing building is being changed,enter proposed use.
To be installed but not included
in the above cost
a. Electrical........................................................................... 1'
b. Plumbing....................................:.....................................
c. Healing,air conditioning.............................................
d. Other(elevator,etc.).....................................................
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions, complete Parts E-L;demolition,
complete only Parts J& M, all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ❑ Gas 40 ® Public or private company Will there be central air
31 ® Wood frame 36 ❑ Oil 41 ❑ Private(septic tank,etc.) conditioning?
32 [:] 1�.I Structural steel 37 ❑ Electricity 44 ( Yes 45 ❑ No
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
34 ❑ Other-Specify 39 ❑ Other-Specify 42 ® Public or private company 46 ❑ yes 47 ® No
43 ❑ Private(well,cistern)
J.DIMENSIONS
48. Number of stories M. DEMOLITION OF STRUCTURES:
................
squ
re
or
49. Total ors,based on
oteriorarea, Has Approval from Historical Commission been received
all floors,based o f exterior
dimensions ......................................................................... for any structure over fifty(50)years? Yes_ No_
50. Total land area,sq.ft. .................................................... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed ........................................_.................................
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
sz. outdoors........ Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed ........_................................................................... Electric:
Gas:
Full...... Sewer:
54. Number of
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partin BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No4 (If yes,please enclose documentation from Hist.Com.)
Conservation Area? Yes_ No_ (If yes, please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No
Is property located in the S.R.A.district? Yes_ No
Comply with Zoning? Yes4 No_ (If no, enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No_ (If yes,submit documentation/if no, submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ No
Is Architectural Access Board approval required? Yes_ No-)r (If yes,submit documentation)
Massachusetts State Contractor License # b S 34 SNoSalem License # I Z )
Home Improvement Contractor# Homeowners Exempt form(if applicable) Yes_ No_
CONSTRUCTION TO BE COMMENCED WITHIN SIX (6)MONTHS OF ISSUANCE OF BUILDING PERMIT
I
CONSTRUCTION IS TO BE COMPLETED BY: If an extension is necessary, please submit
in writing to the Inspector of Buildings.
V. IDENTIFICATION - To be completed by all applicants
Name Mailing address-Number,street,city,and state ZIP Code Tel.No.
Owner or
Lessce ut ,M
z. L ' _ -
Contractor Builder's /
l License No.
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his authorized agent and we agree to Conform to all applicable laws of this jurisdiction.
Signature ap licant Address A icati n date
—C
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number /.7oZ
Building use Group
Permit issued _�a s— 19 9 3
Fire Grading
Building
Permit Fee $ _ //`— Live Loading
Certificate of Occupancy $ Approvey: Occupancy Load
d b
Drain Tile $
Plan Review Fee $
TITLE
NOTES AND Data•(For department use)
I
�I
PERMIT TO BE MAILED TO: 0. Q
DATE MAILED:
Construction to be started by: Completed by:
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD - SIDE YARD
REAR YARD
NOTES
SITE OR PLOT PLAN -For Applicant Use
O N
0
OF
P PR OPERTY
FDEPARTMENT
KMOBOn DSQDOIL
MAWS 130 WwWJGWW Sneer*swrk.%rw0WoRsaTM01970
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION,
O&MOLUM&OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUII.DD G
1.O SITE INFORMATION
Location Narrw SUNOW
Property Addrsss:---- --- --— -- - --
a0
Proprly kt"basted in e;CansenretiDn YIN Hhla+b DtetrOot YIN
2.0 OWNERSHIP INFORMATION
2.t Owner o1 Land _
Name:
Address:
ao
Telephone: - 8 3 �
3.0 COMPLETE THIS SECTION FOR WORK IN MWIXING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use C2 New
Demolition Existing
Approximata year of Area per floor (at) Renovated
construction or renovation
of existing building Now
Brief Description of Proposed Work:
rrhe Chimney Guys
-- .-P.O. BoxAQ .- -- .. . — - --- - -- --. " .
--- -- --- ody9;{1fh0io�n - -- -.
Mail Permit to: 97R g77_"00
— id
What is the curtest use of the Bw myT
Material of guildbgT It dwelling.h row many unitsT�
Will the B MOV Conform to Law? Asbestos?
grohitedS Name The Chimney Guys
P.O. ox
Address and PtMW ,
Mechanwa Name - -
Address and Phone
Consbucdon Supervisors Ucetwe 0 HIC Registration tr
Es*nabd Cod of Project PemQt FM Crala�letlort
Permit Fee S Estimated Cod X$7/51000 Reskte"
EstYnated Cod X S41/:100A Conxnmda�------ --An Additional $5.oO is added as an
Administrative charge.
Make sun that all flelds an proPmiy and 164tlY ry Mw to avoid delays in prmmaing.
The undanigned doss hereby apply far a Building Permit to build to the above stated
stations. Signed under penalty of perjury X -,
Date 12
o
Iv