7 GRAND TURK WAY - BUILDING INSPECTION 7 Grand Turk Way
"MUMW
�'`
No. L City of Salem Ward
3
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT_ -Applicant to complete all X.
,items in sections:1, 11, 111, IV, and I
I. AT(LOCATION) / L . 7 Alba✓ D STRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
STREET)(CROW
ssSTREET) ICROas LOTET
SUBDIVISION LOTBLOCK SIZE
II. TYPE AND COST OF BUILDING -All applicants complete Parts A-D
A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLITION"USE MOST RECENT USE
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential,enter number o/new 12 ne family 18 ❑ Amusement,recreational
housing units added,B any,in part D,13) 19 ❑ Chruch,other religious
13 ❑ Two or more family-Enter number Industrial
3 ErAeration(See 2 above) of units ....................................................... 2 ❑
211 ❑ Parking garage
4 ❑ Repair replacement 14 ❑ Transient hotel,motel,or dormitory- 22 ❑ Service station,repair garage
Enter number of units ...........................
5 ❑ Wracking(It muttilamily residential,enter number 23 ❑ Hospital,institutional
o/units in building in Part D,13) 15 ❑ Garage
24 ❑ Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
7 ❑ F-oundation only 26 ❑ School,library,other educational
17 ❑ Other-Specify 27 ❑ Stores,mercantile
B.OWNE$SHIP 28 [:] Tanks,towers
8 CrJ'/Private(individual,wrporation,nonprofit
29 ❑ Other-Specify
institution,etc.)
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,
/ n parochial school,parking garage for department store,rental office building,office building
10. Cost of improvement ......................................................... (/ 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........................................................................... fff ^
b. Plumbing.......................................................................... /
c. Heating,air conditioning.............................................
d. Other(elevator,etc.).....................................................
11. TOTAL COST OF IMPROVEMENT $ C C 1
III. SELECTED CHARACTERISTICS OF B ILDING 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 O�AGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ Masonry(wall bearing) 35 ❑ Gas 40 Public or private company Will there be central air
31 ,-, WW-d frame 36 L Oil 41 cond'4ioning?
❑ Private(septic tank,etc.)
32 ❑ Structural steel 37 ❑ Electricity 44 [:] Yes 45 ❑ No
33 F1Reinforced 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 0 Private(well,cistern)
6
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
4e. Number of stories ............................................................
as. Total square feet of ea
floor area,
all floors,based on etr Has Approval from Historical Commission been received
dimensions ........................................................................ for any structure over fifty(50)years? Yes_ No_
50. Total land area,sq.e....................................................... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed.............................................................................
52. outdoors............................................................................. HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Enclosed ......................................................_.................... -Electric:
Gas:
54. Number of Full.:......................................... Sewer:
_
bathrooms DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
Partial........................--.....-- BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No (If yes lease 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. ' trict? Yes' No
Comply with Zoning? Ye No no, enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No—y (If yes,submit documentation/if no,submit B?,ard of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ Noj
Is Architectural Access Board approval required? Yes_ No (If yes,submit documentation)
Massachusetts State Contractor License# C7 Salem License#
Home Improvement Contractor # Homeowners Exempt form (if applicable) Yes_ No
CONSTRUCTION TO BE COMMENCED WITHIN SIX (6)MONTHS OF ISSUANCE OF BUILDING PERMIT
If an extension is necessary, please submit
CONSTRUCTION IS TO BE COMPLETED BY: 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.
l
Owner or r 11
Lessee A- V o '
2. / L
contractor
Builder's
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 contoo-m to all applicable laws of this jurisdiction.
S' nature of ap lican C E6L24j AddressApplication date
\I'
FK
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
BuildingUse Group
c3
Permit issued _� 19!
Fire Grading
Building ��11
Permit Fee $ cx) Jvk, , Live Loading
Certificate of Occupancy $ Approved by: Occupancy Load
Drain Tile $
Plan Review Fee $
TITLE-1
NOTES AND Data-(For department use) (�
-Z v,u W A-
PERMIT TO BE MAILED T0:
DATE MAILED: — 6'
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