60 SCHOOL STREET - BUILDING INSPECTION 50 SCHOOL STREET
f - x
r
llll p
No. 153L.2
HASTINGS. MN
LOS ANGELES-CHICAGO-LOGAN.ON
MCGREGOR.TX-LOCUST GROVE.GA
U.S.A.
No-7a -9 3 City of Salem Ward
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant tocompleteall items in sections:1, 11, Ill, IV,and IX.
1. AT(LOCATION) O J L�� S �1 D SNING
LOCATION (NO.) (STRet� t—
/ / /-
OF BETWEEN _co-tlrrrJeVC 0'` .SCLiGCJ�S / AND scl I�Nc [ /Z� �f/
BUILDING LOT
(CROSS STREET) (CROSS ET)
SUBDIVISION LOT BLOCK 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(It residential,enter number of new 12 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 E] Parking garage
4 E] Repair replacement14 E] Transient motel,or dormitory- 22 E] Service station,repair garage
Enter numberber o of units ...........................
5 ❑ Wrecking(if multifamily residential,enter number ❑ 23 ❑ Hospital,institutional
of units in building in Part D, 13) 15 Garage
24 ❑ Office,bank,professional
6 ❑ Moving(relocation) 16 ❑ Carport 25 ❑ Public utility
26 ❑ School,library,other educational
7 E] Foundation only 17 ❑ Other-Specify
27 ❑ Stores,mercantile
B.OWNE HIP 28 ❑ Tanks,towers
8 Private(individual,corporation,nonprofit
institution,etc.) 29 ❑ Other-Specify
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,
}( ;GC 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� �
in the above cost
a. Electrical...........................................................................
b. Plumbing
c. Heating,air contlitbning.............................................
d. Other(elevator.etc.).....................................................
11. TOTAL COST OF IMPROVEMENT
111. 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 ❑�yl Gas 40 ® Public or private company Will there be central air
❑J
31 Wood frame 36 Oil 41 ❑ Private(septic tank,etc.) conditioning? �-y1J
32 ❑ Structural steel 37 E] Electricity 44 ❑ Yes 45 rNo
33 ❑ Reinforced concrete 38 ❑ Coal H. TYPE OF WATER SUPPLY Will there by an elevator?
34 ❑ Oher-Specify - 39 ❑ Other-Specify 42 Public or private company
46 ❑ Yes 47 16 No
43 ❑ Private(well,cistem)
J.DIMENSIONS
4e. Number of stories M. DEMOLITION OF STRUCTURES:.
49. Total square based oneoor teriorarea, Has Approval from Historical Commission been received
all floors,based on exterior
dimensions ......................................................................... for any structure over fifty(50)years? Yes_ No_
50. Total land area,sq.If....................................................... Dig Safe Number
K.NUMBER OF OFF-STREET PARKING SPACES Pest Control:
51. Enclosed .............................................................................
sz. 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, please enclose documentation from Hist. Com.)
Conservation Area? Yes_ NoZ (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? Yes No_ (If no,a close Board of Appeal decision)
• Is lot grandfathered? Yes_ No_ y bmit documentation/if no,submit Board of Appeal decision)
If new construction,has the proper Routinglip been enclosed? Yes_ No
Is Architectural Access Board approval required? Yes_ No (If yes,submit documentation)
Massachusetts State Contractor License# 05-3V' Salem License# / 3Jc'
Home Improvement Contractor # 10 7 (o / / 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: (y y 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
Lessee
Contractor
Builders La
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 of applicant Addre =�J Ir,l� - Application date
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit Issued 19 Fire Grading
Building /
Permit Fee $ 2(7 . c°Z Live Loading
Certificate of Occupancy $ Approved by: Occupancy Load
Drain Tile $
Plan Review Fee $
ITLE
NOTES AND Data • (For department use)
PERMIT TO BE MAILED TO: Z 2 C
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
ZY.
O N �`
�� SCltooL S� ;V- 93
C
a
�k
60 school St L�
30 �,�
10`fi
3,2f
Proposed Driveway
ramp
IS ,
y°
�� C�✓t f f/U7�1 /Ul^�
' t
13OB-BUILT CARPENTRY
24 LENOX ROAD
PEABODY, MA 01960
-yo3y
2d�e4t- %�