9 ALBION ST - BUILDING INSPECTION -VL�SJAWT-BE fi APPROVED BY 744E
JAI:�PZ=DB P'WR TD.A.PEAIWT BEING GRANTED
CITY OF SALEM
No.G Date
is Ply Located in / Location of
to Ntetodc Dwdiat? Yes No— Building I Jl
la Property Located in
the t;orroenrabon Area? Yw No
BUILDING PERMIT APPUCA71ON FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Con"7"A Deck, Shed, Pool,
Repair/Replace, Other: F�.vcP move Owrs 7 o s viT
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name W/&OLM (�OLwIt/ 6
Address & Phone q Al is n/ <-L
Architect's Name
Address & Phone f
Mechanics Name
Address & Phone f
wrw is uw pwPoee Of W Wlrq?
Matetwl d bum rq? ff a dwe",for tow teeny tamiYes?
wo buwW cordomt t law7 Aebastos?
Esomated cost� CRY ucertee r ►� 1'' stow +►
Boma raprova.ant
Lic. t► Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
Move Ste/ems 7o 6L6CaM0)4L e Fetid
MAIL PERMIT TO: i`�ll��arh ` , LQur.vS'by Cf f9/�,�0� St <41"' ell
No.
APPLICATION FOR
PERMIT TO 1
-Hole
LOCATION
9 A/6raw 5�.
PERMIT GRANTED
�i�kr� ZD 2.006
APP OVFD
ECTOR OF UILDINGS
CITY OR SALUM9 MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WA9NINGMN 3T11EET, 3E0 ILOOR
SALEM. MAE9ACN{19ETT9 01070
TELE►MONE: 978-743-969s MM. 380
►AM 978-740.9848
Debrk Dbpwd irn.•...
In accordance with the provisions of MGL c40 S 549 a condition of your
Building Permit is that the debris resulting from this work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL
Chapter III, S 150 A.
The debris will be disposed of in:
T�a.�fF��- S�Q7iyla/e�a ocation of Facility)
L > ��
Signature of Applicant
2a o�
Date
CITY OR SALKmo MASSACHUSETTS
^+ PUBLIC PROPERTY DEPARTMENT
120 WASNINOTON STREET. 3no FLOOD
SALEM. MASSACNUSETTS 01970
TELEPHONE: 970-745-9395 E ff. 300. - _
_.._ ... . . FAX: 670-740-aa4a
HOMEOWNER ucrosE KxuwnON
Pbaas Print.
Dan 20 06
Job Location o.v S7�
HanrsgMnefAddeeaa- iati
Ra"Oi snett TelggWa e 9
Pfft"Mailin. Addmn;.
The current cm Mdm ot"ffombowwe-wat.extended to include OW=60ocupied
h=wbo does no a Of laa and to allow andlia mg�ge atuu individual
P a licenag provided that for
_ as supervisor
DEFINITION ORPervan( HOMEOWNES;
st l.who ogv0 a pwail.of land as which he/she raid"of mta*to m=K m
which i+4 mtonded to b%a one of two&Wly dwcft&a sdW a detached
strncAues acceso:y to such use and/or� . A��who m�
than one ham in a two year period shall not W considered a Mmwwm. Sm*
Onk*"hOnNOWIlm" �ubta t to the Building Official,on a gm at,M610 to the Building
Permit �ponelble for all such work performed under the Building
The undersigned"homeowner"assume nmponsrbility for compliance with the State
Building Code and other applicable by-laws and regulations,
The undersigned"homeowner"cerMes that Wshe understands the City of Salem
Building Department minimum i
will comply with said procedure and rognC°S and that he/she
HOMEOWNERS SIGNATURE 4-LT
APPROVAL OF BUILDING INSPECTOR
See other side for state code
I% Y
Wo&for which a Buihliu�Pasm�u
The Code stataa that N�H sects(�0°109.1.1 —
jkAwdng
to
raraimd shin gupat$fiv p -and that admit a Hom°°wm canon a P�s)for hits
� �the sueb�Ooarner shall ad as S1p�►+aw•
we unaware that>beY
in
1 l.y H who me this 0 Wcmd Ruhs sad g�ygiooe far Licm
C ofSection 1.1Aunuccow aramew°�Paso& this CM YOW
PuOVAarlY °° caused y ''at it would with a N�the Homeow�r
W.
i&
IpWA
MMY
acs�m that the Homeowto is & Y aware of 1OW Ho ca*that
To
�u 06 y To# a putt of the Pesmit On the bot POP of thin issue is a
hdslte: t 6YFa You may cs�e tomad ad adopt swd by. a
fora►c • fac ust m Y
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