2 AMANDA WAY - BPA-07-1148 NEW, SINGLE FAM HOME City of Salem ward
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APPUCATION
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PERMIT TO BUILD ADDITION, MAKE AftRATIONS OR NEW CONSTRUCTIO`
IMPORTANT.Appm=m to cwwiw*#h)ww in secdo - lb, iv,and Lx
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LOCATION OF t AAn7 h
AND
LOT C
BUILDING SueonnwoN GVvIQ �—II t kS LOT 62 toaai
L TYPE AND COST OF BUILDING-AN applicants Parts A-D
A. TY,.P�E/OF IMPROVEMENT D. PROPOSED USE-FOR"DEMOLn10N"USE MOST RECENT USE
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5 ❑ >"aada,o ro maa'aNy ra+denelµ star rwmbar Errla a ward umel—_�_._—.— 23 O Howet.tr.dbdmw
of unite i1 buddbp in Pwt a 1M is ja-"dww
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8 ❑ MOWN(Mbrawn) is O Canx0t. 2S ❑ Pub4 uft
7 ❑ Fourdatlan m4 77 ❑ Ot)w•SW* ffi ❑.Sdtml,R=y coot educaborral
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S.OWNERSHIP IP 28 ❑ TaNaS brae
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Red"WM Wn3y buedbrp at hwft eba wdwy ed wA eeaanday school COaeoe.
10. Caa1d+mPrOwrrWa_Lf Sc�(m dA'llDn8 i WrOddW 8dwK pukk Oaap for deMbnae abM rarW cMw brdraq,'loos buidtrq
at irdrsbW 0"It up cl Uisbrrp buadrr9 a bebp clw04 arch papomd uea
To a bamead bud not knifed -
in Ore above coat
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11. TOTAL COST OF IMPROVEMENT ,.
IIL SELECTED CHARACTERISTICS OF BUILDING-For new buildings and additions,complete Parts E-L;demolition,
complete only Parts J&M aH others skip to IV
E PRINCIPAL TYPE OF FRAME F. PRNCPAL OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL L TYPE OF MECHANICAL
30031 w(Wal bean9) 35 � 40 �ife or pnaM Cwvww Y
ham
32 LJ Sinchral stet 37 ❑ 41 p PmalB(aepb taNc aim) µ u ❑ No
33 ❑ Retrbresd canuete 38 p car H. TYPE OF WATER SUPPLY WINOwe by an a OMW
34 p COW•SW* 39 p OyW.SW* 42 19*4W a PrWa*=nPaM 46 D Yes 47 Q ^b
43 p Prwa»(wet cafan) .
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a o AL- DEMOLITION OF STRUCTURES:
a6 NjftW d stow..____
as TOW�red d Mu ant. 1 Has Appraral from Historical Commission been received
N soave.WSW an as enar for any attu tune over fifty(50)years? Yes— No—
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sa TOW uod a"M to n—9-e�-(a S-&R Dig."Number
K rruaea of o�sreeer vuurwo SPACES fn9at ConlraC
s,. Eb°r.°---------�— HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
sz Wdoon_.-------- Yes No
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� EIS
Gas:
�( Fua Sewer:
54' NiiWCd DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
barradnes Aumr..-1L—.— BEFORE A PERMR CAN BE ISSUED.
N. COMPLETE THE FOLLOWING:
Historic District? Yes— No� (n Yes,please enclose documentation tram,HWL Coma.--
Conservation Area? .Yea— . No_ (if yes;Please enclose Order of Condidons)
Has Fire Prevention approvedand stamped plans or applications? Y V No_
Is prop"located in the S.RA district? Yea.—
Comply with Zoning? Y No— (d no,enclose Board of Appeal decision)
Is lot grandfadtered? Yea_ NoJe—/ (d yes,submit documentationlif no,submit Board of Appeal decision)
If new construction,has the proper Routing Slip been enclosed? Yes/_ No
Is Architectural Access Board approval required? Yes_ No--- (d yes,submit documentation)
Massachusetts State Contractor License C S 0 711 H7 Salem License* S I S i
Hone Improvement Contractor# Homeowners Exempt form(d applicable) Yes— N04 i
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: /�0�/�I t)bfY J)St a CQ7 in writing to the Inspector of Buildings
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V. IDENTIFICATION• To be completed by all applicants
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I hereby certify th"e proposed work' authai ed by the owner of record and that I have been authorized by the owner to make this application
as his autho iz and we r to cant to aA im ble laws of this jurisdiction.
SgnaNre of Address A icat en to
o. a 0 o as
fire -Department
;8 Lalayette tiIrrl
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FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT
IN ACCORDANCE WITH THE PROVISIONS Or THE MASSACHUSETTS STATE BUILDING CODE
AND THE SALEM FIRE CODE, APPLICATION IS HEREBY MADE FOR THE APPROVAL OF PLANS
AND THE ISSUANCE OF A CERriFICATE OF APPROVAL FOR A BUILDING PERMIT BY THE
SALEM FIRE DEPAIRTI[ENT. Ref. Section 113. 3 of the Mass. Bldg. Code)
JOB LOCATION:
OWNER/OCCUPANT: /////S
ELECTRICAL CONTRACTOR:
FIRE SUPPRESSION CONTRACTOR:
SIGNATURE OF PHONE 1;
APPLICANT:
ADDRESS OF CITY OT
APPLICANT: TOWN:
APPROVAL DATE:
Certificate of approval is hereby granted, on approved place or submittal of
project details, by the SALEM FIRE DEPARTMENT. All plans are approved solely
for identification of type and location of fire protection devices and equipment
Al-1 plans are subject to approval of any other authority having jurisdiction.
Upon completion. , the applicant or installer(s) shall request an inspection and/or
test of the fire protection devices and equipment. (ADDITTIONAL REQUIREMENTS,
SEE REVERSE SIDE
VL
NEW CONSTRUCTION.
PROPERTY LOCATION HAS No COMWLIAXCZ UITR THE PROVISIONS OF
CHAPTER 148. SECTION 26 C/E, M.G.L. , RELATIVE To THE INSTATLA-
TION OF APPROVED ICCRE AUR,%J DEVICES. THE OWNER OF THIS ?RO-
?.cR'FY IS REQUIRED TO OBTAIN COIMPLIA:;(:: A� A C01"ITION OF
OBTAINING A 311 "i-T)ING PERMIT.
PFO"rr�-,,Y LOCATION IS Co:j': ' 1,ACIIP: ;l ;t ',!!F. ",''01"LSION 'C-Ar�
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