241 LAFAYETTE STREET - BUILDING INSPECTION 241 LAFAYETTE STREET
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e CITY OF SALEM
In accordance it,ith the Ma ss a e h it s e t t s S t a t c Building Coda, Section 108. 15, this
CERTIFICATE OF INSPECTION
is issued� to s SF'AFR'TA REAL._TY
7 �Pl'2tf1� that I have inspected the premises known as UNIT AP6=1RT'MENT BUTLDItIG
located at 0.'-24 1. L._AF-AYE'I'TEi: STREET in the city of Salem
County of Essex Commonwealth of Massachusetts. The means of egress are sufficient for the fallowing
number of persons:
BY STORY
Story CCapacity Story Ca [ � `� t7d`� � Capacity
IST" FLOOR 2 UN:[TPi
at!I7 FLf.IOR 2 UNITS
3RD FLOOR I UNIT
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly Place of Assembly
or Structure Capacity Location or Structure Capacity Location
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Zi Qi
th 4R-1297 ih t.1/15/ 1997 019/ 1 F�/2 0O
Certificate Number Date Certificate Issued Date Certificate Expires uiIding Of Y,,ial
The building official shall be notified within ( 10) clays of any changes in the above information.
1�
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CITY/TOWN OF
—T
In accordance with the Massachusetts State Building Code, Section 108. 15, this
CERTIFICATE OF INSPECTION
1
isissued to . . . .! .p A-n T O.. . .\.l it a-�.tV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .QQ. . . . . . . . . . . . . . . . . . . . . . .
7 Teitlfg that I have inspected the. . . �Copg-.. ' . . . . . . . . . . . . . . .known as. . . !!.?.Ft".1..►Y) h•fs. . .
located at. . . .?,.`HI. . �,A.FE�J.e,-1t?. . . . . . . . . . . .in the. .!�.! y. . . . .of. . . . . . . . . . . . . . . . . . . . . . . .
County of. . . . . . . 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
15t z rt ; 3 r c/ C
Floor ; Units Floor' - Floor-- UPL
Jln,;t�
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly Place of Assembly
or Structure Capacity Location " or Structure Capacity Location
3 - 3 / - ZoaZ
Certificate Number Late Certificate Issued Late Certificate Expires Buf4g4iWg ictal
a
The building official shall be notified within (10) days of any changes in the above information.
f
• 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 b Number Z ((- a. F' a S t
Name of Premises 4Q c VV\C " f
Certificate to be issued to: 0.l fi `tti
Address ��, �o. 2"Gk e S�
Ower of Record of Building St-e' P. ?r) I P K. VQ„In 0.V: Ln s
Address ?. '33 {j A�P 1M ck-SS 0) ?;7(9
Purpose for which premises are used 5
Changes since last Inspection (required on file card also)
1.
2. 8h q
3.
4.
5.
Date Order Issued:
Order Issued To: Address
Date Violations Corrected:
REMARKS: S m o K Q-c l//''
[a a-t t'e c�r,0��
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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.
orf
Date i g Official
C (7 i
Certificate $ 3 0 �� j Date Issued: �� G
Date Expires:
Recommended Neat
Inspection: ! (JCl
COMMONWEALTH OF MASSACHIISE1 51LDING DEPT.
COMMONWEALTH
e� CITY OF SALEM �'`BJ1l
r ` APPLICATION FOR CERTIFICA �UTE OF CT$LStS pll e0Z
Date Z—Z5—CI7 (lAS�f fgy9� iJJ3ed51.5, 00
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 5 Number 2 L' ( L0.
Name of Premises
Purpose for which Premises is used
License(s) or Permit(s) required for the premises by other Governmental Agencies:
License or Permit Agency -
Certificate to be issued to: '�f� 1
Address: a4-1 l_PrC-AqP��qL, �l
-. er of Record of Building: 5p-
'V
pa
Name of Present Holder of Certificate:
Name of Ageut, if any.. .
igna u e of Personro wnom tertzficate TITLE
is issued or his/her authorized agent ,2-6 —17?
Date
INSTRUCTIONS: Day time phone I
I. Make check payable to: The City of Salem
2. Return this application with your check to: Insvecror of Buildings. City of Salem
Building Devartment. 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 6 fee must 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.
CEB•TIFICATE I "! EXPIRATION DATE: (
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