4 AMANDA WAY - BPA-15-573 NEW SINGLE, FAMILY HOME No-_m City of Salem Ward
APPLICATION
FOR.
PERMIT TO BUILD ADDITION; MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:y IS 114 IV,and IX.
;.AT.(LOCATION) - ; �: .. �� � kC,/ -'I�IJ -/GLg DISTRICT 'K +
LOCATION
OF
BETWEEN . -- ///I�DZ�9'N AND
/r/1/��r /� ;
BUILDING BUBOMSION �/t �D�rI� ��/�� LOT LOCK ': . �ETpEETI .���/��
a
11. TYPE AND COST OF BUILDING -All applicants complete Parts_A.-D"
A. 77O OVEMENT D. PROPOSED USE-.FOR,"DEMOLITION"USE MOST RECENT USE
- t Wave Dulidlrp .... ReeldanWl � Hprtreelden/W
2 ❑ Addition(if residential,enter number of new.... 12 []315te femiky - _ _ - 1 a-❑. Amusement MCM1100nal . .
housing units added,it any,in part D, 13) 19 ❑ Chr ch,.oMe.rehgious --
13 ❑ Two more feel).-Enter number .❑
3 ❑ Alteration(Seen above) - ofvnmit s __.._: _. _� 20 Industrial '.
21 ❑ Parking garage ..
4 ❑ Repair replacement _ ._ 14 ❑ Transient hotel,motel,or dormitory
- ...Eller number ofunrta 22 ❑,.,Service statiw<repair garage
5 Wrecking(H mul0lam' residenas(enter number .._... ..
❑ dy ._ 23❑ Hfepddl.Institutional
of units m building in.P D, 13) 15
- _-_ O.O.ar- - 1.J _-.. _ - .. 24 [:].Office,bank.professional
6 ❑ Moving(relocation) __ 16 ❑ Carport -- - _ 25 ❑:Pudic utdity _.
7 ❑ Foundation one _ .. 26 ❑_School,tbrery„oiler educational
. . .17 ❑ other-Specify 27 ❑ Stores,mercantile ...
B.OWNERSHIP .- 28 ❑.Tanks,towers. 1
8 .. to(individual,corporation,nonprofit
institution,etc.) 29 ❑.:other-Specd)' j
9 ❑ Pudic(Federal.State.or local govemmenl -.
C.COST (Omit cents) Nonresidential-Describe in deli proposed use of buddkrgc,wg food procesakg,plant.
machine shop,laundry building at hospital,elementary school,secondary schodt cdlege,
10. Coat of improvement .:___.. _:_ -. S �o �J� parochial school.-perkirg garage for department store,rental office budding.office building
_ ___ __ -_ at Industrial plant If use of existing building is Dekq chertged;.entacprpposed use.. ..-
To be k stalled but not included r
n _
in the above cost / �I(?'y 4 t 1Z.40 / a '.
a. Electrical ......................_......_......_......._-................_ V /�� AI4
b. Plumbing,.._- - ......__................_..___... le) D''Ov' .� Tf 16Ja] .� ��/hy / l l!
1 (
o. heating,air.conditioning
d. Other(elevator,etc.)....___.______.....__._...__... eJ
11. TOTAL COST OF IMPROVEMENT S L/UdGf,'-
III. SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions, complete Parts E-L;demolition,
complete only Parfft J& M, all others skip to IV
E. PRINCIPAL TYPE OFFRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE OF AGE DISPOSAL I. TYPE OF MECHANICAL
30 ❑ t (wad basing) 35 ,ae 40 is or private company Will there be central as
Q �
31 frame 36 ❑ Oil .41 ❑ Private(septc W*alc.). conditioning?
32 ❑ Structural steal 37 ❑-Electricity 44 Yee 45 ❑ No
33 ❑ Ramfaced mncrele 38.❑ Coal K TYPE-Ob4fATER SUPPLY Will�by an elemtor?
34 ❑ Otter-Specify ... ..39-❑ Other-Spectly 42'- Public or pmate company - .
46 ❑ Yea - 47 No
43 0 Private(welt cistern) " . _
i
J.DIMENSIONS M. DEMOLITION OF STRUCTURES:
oa Number of stores .............._...__..._............................. . a -
ae. Total sa+ Iml of hoot arm ��(�- "•' Has Approval from Historical Commission been received
all Moos,based based on exterior d�� O
diriisMMS ....._...._..._..._..._._._...._.__._..._..._...._..._. i i ':far any structure over fifty(50)years? Yes_ No
5D Total IaM
!3f1 __ Dig Safe•Number
arm.St1.R _.. .____
IL NUMBER OF OFF-STREET PARKING SPACES j'Pest Control:
51. Erriosed ._...._.. _...._... ._._. _..._..
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
52. Omdops... - - --.. : = ' Yes No
L RESIDENTIALE117 MY ,,. Water
V Electric:
53 Enclosed..._ - .
Z Gas:,...
Full........_...._. _ __. _. Sewer. _
54 Number or / DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
bathre Partial.......... ........... BEFOREA PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_. No (If.yes,,please enclose,documentation.from HisL Com.)_.
Conservation Area?, Yes No (ff yes:Please enclose Order of Conditions)
Has Fire Prevention approved"and stamped plans or applications? YeS No_
Is property located'ih the S R.A district? Yes No�G
Comply with Zoning?` Yes_° No_ (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No (If Yes,submit documentation/if,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—
�1No— (If yes,submit documentation)
Massachusetts State Contractor License # S a 21 7 Salem License# �r
Home Improvement Contractor # Homeowners Exempt form (if applicable) Yes_ NOIL_�
CONSTRUCTION TO BE,COMMENCEf);WITHIN'Six(6)MONTH.11 S OF ISSUANCE OF BUILDING PERMIT
- '"` If an extension is necessary,please submit
CONSTRUCTION IS TO BE COMPLETED BY: '.r gwy in writing to the Inspector of Buildings.
V. IDENTIFICATION • To be completed by all applicants
MadN address Number,stmi,co,and stale ZIP Code Tel.No.
t° , 11s
Pr
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auadets q
dr / License No /
ArcN,eo or
Ens �s
I hereby certifXAq the proposed work is zed by the owner of record and that I have been authorized by the owner to make thus application
as his auth ent d we ee form to all piicabie laws of this jurisdiction.
Signature of ddress `�/ t �J,f%f �fid
44 Za!wyet te Iir;,,t
29 tort A
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FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR A BUILDING
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE
AND THE SALEM FIRE CODE, APPLICATION IS HEREBY MADE FOR THE APPROVAL OF PLANS
AND THE ISSUANCE OF A CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT BY THE
SALEM FIRE DE?ARPfZNT- Ref. Section 113.3 of the Mass./Bldg. Code)
JOB LOCATION:
OWNER/OCCUPANT:
ELECTRICAL CONTRACTOR:
FIRE SUPPRESS1014 CONTR+CTOR:
SIGNATURE OF PHONE
APPLICANT: z-1;iw-1-1--z71—v1
-7
ADDRESS OF CITY OT
APPLICANT: TOWN:
APPROVAL DATE:
Certificate of approval is hereby granted, on approved plans 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
All plans are subject to approval of any other authority having jurisdiction.
Upon-Coll,pletion, the applicant or installer(s) shall request an inspection and/or
4
test Of the fire protection devices and equipment. (jD56ITfIONAL REQUIREMENTS,
SEE REVERSE SIDE
NEW CONSTRUCTION.
PROPERTY LOCATION HAS NO CCFPUPLIANCZ WITR THE PROVISIONS OF
CHAPTER 148, SECTION 26 C/E, M.G.L. , RELATIVE TO THE INSTALA-
TION OF APPROVED FIRE ALARM DEVICES. TIRE OIWFNER OF THIS PRO-
PERTY IS REQUIRED TO OBTAIN COMPLL'—' ;C-r AS CONDITION OF
OBTAIIiENG A 3U-'- LJ)7M(-, PERMIT.
PPO'r-rk7i LOCATION IS 1", CO"Pf '—kC'J- Ij
146, SFCT1,jX 26 L.
RA I II-1,
$30, 00
$
C H E C K
Professional Land Surveyors B Civil Engineers
ESSEX SURVEY SERVICE. 1958 - 1986
OSBORN PALMER 1911 - 1970
BRADFORD & WEED 1885 - 1972
PLOT PLAN OF LAND
LOCATED IN
5 4 ZZ11 MASS.
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I hereby certify to the S9L
Building Inspector that the pro-
ZONE: rGl LOT AREA: NSA LOT FRONTAGE: IfIlh posed construction shown conforms
FRONT YARD: J j fj SIDE YARD: IUD REAR YARD: I-� to dimensionalMasso
/In sG
SCALE; t� ( CHRISTOPHER ^
� R.MELLO
yt�
DATE: ) 2CO 9. ,Q No.31317 Q J
REFERENCE: BK. PC Christopher R. Mello
104 LOWELL STREET
PEABODY, MASS. 01960
(978) 531-8121
FAX:(978) 531-5920