222-224 LAFAYETTE STREET - BUILDING INSPECTION Y
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In accordance with the Massachusetts State Building Code, Section 108. 15, this
CERTIFICATE OF INSPECTION
Ais issued to . . . .S., Az r cl. . . . . 1\. �+Nj. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
der ifU that I have inspected the. . . . F r 9. . . . . . . . . . . . . . . .known as. . . p o� t y' ►,$!y S . .
located at. . . . ?. . . . .� A E.4s�! 4TlC .57' in the. . `� . .of. . .,s�9 �Pi. K. . . . . . . . . . . . . . . . . . . . . . . .
County of. .es's ee. . .Commonwealth of Massachusetts. The means of egress are sufficient for the following
number of persons:
BY STORY
Story Capacity Story Capacity Story Capacity Story Capacity
��oor. V �;tS . • E1o� � uw;�s' . . F �ooc- : uk:+s . .
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly Place of Assembly
or Structure Capacity Location . , or Structure Capacity Location
331 - z0oz ,
Certificate Number Date Certificate Issued Date Certificate Expires -_�a4in9 Official
ty
The building official shall be notified within (10) days of any changes in the above information.
1
PERIODIC INSPECTION REPORT
This form is to be completed each time a Periodic Inspection is made. At the time
a new Certificate of Inspection is issued, a notation indicating that the fee has
been paid will be made to Application Form prior to the new Certificate of Inspection
being issued. Any changes since the last inspection are to be added to the file card
of the premises.
Street d Number �Z �" - Q, 6-o, I E:Q e
Name of Premises jj C hn 2w'ts
Certificate to be issued to: S 72 0.,C I
Address '1, -2,+ L 0. f F Cti u ti -S i- S h�j
Owner of Record of Building S-j-e- V P- ice' O 1 e- M e tia k o
Address Z- 33Z L.a�PTIC ST 511112 �C
Purpose for which premises are used 1,s U h 1' 1� C
Changes since last Inspection (required on file card also)
1.
ry
2.
3. Q-
4.4.
5.
Date Order Issued:
Order Issued To: Address
Date Violations Corrected: `
REMARKS: S V n O ��n a O
I have this day inspected the above premises, and the same conforms to the pertinent
requirements of the Massachusetts State Building Code and the rules and regulations
pursuant thereto.
Date "Ing Official
Certificate # 23� 'q 2 Date Issued: S �l
Date Expires:
_ /�2.v4
Recommended Neat
Inspection:
Q1
Xhit (ff= vuwjvMI#4 Af fitassar4usttb
W
e CITY OF SALEM
In accordance it,itIt the Ma.s sa c h it setts S t a t c Building Code, Section 108. 15, this
CERTIFICATE OF INSPECTION
is issued
to t SF>RF?TA IREALTY
I (unity that 1 have inspected the premises known as 15 UNIT APARTMENT BUILDING
located at 1baE=4 I....RFRYF_TTE STREET" in the city of Salem
County of Essex Commonwealth of Massachusetts. The means of egress are sufficient for the following
number of persons:
g BY STORY
Story Ca' Szs� ss� Capacity Story Ca ' t8$7KSL Capacity
1ST FLOOR UNITS
2c!NI.) FLOOR 5 UNITS
,FRD FLOOR UNITS
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly Place of Assembly
or Structure Capacity Location or Structure Capacity Location
T ih Zi O
Qi iT 0
91-17 v'rT/ 1 S�/ 1 797 Oi9/ 1 S 0 r
Certificate Number Date Certificate Issued Date Certificate Expires ing O i
Buildal
The building official shall be notified within (10) days of any changes in the above information.
r
COM- EALTH OF MASSVAAWsDEPT. .
CITY OF
���LLpFF��ii
� + APPLICATION FOR CERTIFIGI9 6 BNse> igf
Date Z,- 2 :-R 7 CITY oFECq ' 84e Required S (7
SCAyE oN"& Required
In accordance with the provisions of the Massachusetts State Building Code. Section
108. 15. I hereby apply for a Certificate of Inspection for the below-named premises
located at the following address:
Street & Number2 L0. C-CL 'C
Name of Premises " 'PARS 1
Purpose for which Premises is used t S
License(s) or Permit(s) required for the premises by ocher Governmental Agencies:
License or Permit A¢enev
Certificate to be issued to: SpA 'TA QF-AL-Ty
♦� - g: yam . ., AyP-ffe' Sr ZaAem
_ , , n r
b <✓ � ICY
M*n..'w, �•` ,; , + Y. Address' ,/� I
Owner of Record'of'Buildia ¢ �P'AfzTR �� }LT` P6iepo—_- L,�,v"1
+s e
Address: `��S . _.,LAFA yET` 'c /dI.If3fY)"s�
Name of Present Holder of Certificate:
Name of Agent. if any.. .
(13LL� _� &Zq-
S gnu ure of Person to woom L'ertiticate TITLE
is issued or his/her authorized agent _a (o.- lQ7
Date
INSTRUCTIONS: Day time phone ; AOR 7 yt}'I D 17
1. Make check payable to: The City of Salem
2. Return Chia application with your check to: Insnecror of Buildings: City of Salem
Building Department. one Salem Green. Salem. MA. 01970.
PLEASE NOTE:
1. Application form with required fee must be submitted for each building or structure
of part thereof to be certified.
2. Application & fee muse be received before the certificate will be issued.
3. The building official shall be notified within ten (10) days of any change in the
above information. p
CERTIFICATE 1EXPIRATION OATEN '1—'c'.ZId=T
ill
13 I� � x.�.v
BUILDING DEPT
SALEM FIRE DEPARTMENT COMPLAINT FORM q
FIRE PREVENTION BUREAU g,Tr 1.6 �6QQ 15�TIME
Location of Complaint or Nazardy���
Complaint by �I/22� / Address
Nature of Complaint U /1P�Si/rg
y
Received by
Investigated by OATS. 19--»TIME—•
Action Taken Fe2�tQp � Ui � D; IJG �� C6}�Ii�tEti
1 ? 90 a M.M
y �/1ll`� ��6. A�.,or��� �--� `s• /fes �`� /Q�,_,—
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other Department Notified