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21 BARCELONA AVENUE - BPA-05-589 NEW HOME No� � •J O City of Salem Ward 30 N.towrr.� r L 7 APPLICATION FOR PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION( IMPORTANT-Applicant to complete all Items in sections:1, 11, Ul, N,and 1X. 1. AT(LOCATION) / pM LOCATION 1Mw /� v OF BETWEEN r �"id AND'MiiM BUILDING srRFEt CLOT n SUBIMASION LOT_BLOCK SIZE 11. 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 ga-=budding Residential - NotrptC4ntlY 2 ❑ Aadill 10 resdarnWl.ensr Wender or new 12 ne am4y 10 Q Amusement,raaaudntl Idunng units added,if any,n pvf D.13) 13 ❑ Two 19 Q CMCR other reinsl s a mpa t4mdy-E/1M pumper 3 Q Aaeretdn(See 2 aeon o1 unite 20 Q Industrial 21 Q Paddng grudge 4 ❑ Reyrrepl9unsW 14 ❑ Transientberahotel.metal WOdnWMry• 22 Q Seneca stadeR moargwapa Enron nunumbero/unila_______ 5 Q wmmng In muadwair resdensd,msr rdm6w 23 Q FMsOW inaeedprW or unds m bwdrg m Pan D. 13) 15 Q Garage '24 Q oxla,hank,omNsenors) 6 Q Manng luebratronl to ❑ Carport - 250 Public utility 7 ❑ R unmtdn only 20 ❑ SddW.kbwy.bitter admkwml 17 ❑ Offs-Speedy 27 Q SMse.rntatrantse B.OWNEgSHIP 20 ❑ Tanks,towws a Pmes(.an dual.mrpardtdn.nonprofit 29 Q Other-Sw* unmutdn.etc.) 9 Q PuaiC(Federal.SIaOs,ar tonal government C.COST IOnw twdssI NoraasdemW-Dew"In dinar proposed use W busdatge.e.g.Mod Prowssng plant, � O'er me&"sndp.laundry budding at hospital,ekmM lsr r school.secordary whool,Cd age. to. Coal of imprdsensnl ..([L s BOO dal achoW.tauketg garage Mr depeMteM store.renMl office husdng,o1Xoa huidnug al ndutrlal Went.ff wee at eex swV ou*&V s berg Chwugetl.enter ProposedUML 'n aw"C old noraCludad es<N w" a.me mare edu B� a fJsetrrJl_—_ � e- ate_ e MEN w oddiffautg. e'"w O �v d. oesr(elandW.or-) � ��}� 11. TOTAL COST OF IMPROVEMENT e / ono III. 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. PRMWAL TYPE OF HEATM FUEL G. TYPE O SEWAGE DISPOSAL L TYPE OF MECHANICAL 30rft=U=vI (was heeregl 35 Gas 40 Pubs:or is w cornberuY Ads diem b* str 31ms 30 41 Q Prins,($am bast,erect 32 anal 37 Elsoicey �45 Q No ❑ ❑ Cow H. TYPE TER SUPPLY wi ens M n elewaffn 33 Rerioroed COrurJase 30 34 Q Oder-sidecOy 39 Q Odw-Speedy d2' PteeeapNw mnroerty ae Q Yes 47 Q No 43 Q Prlvere Ines.Was.) i J.DIMENSIONS M. DEMOLITION OF STRUCTURES: 48 Numcer or stores ............ - 49. Tow square met of„mr area n 8 Has Approval from Historical Commission been received . oara R a.: oases an earenar O 'ad for any structure over fifty(50)Years? Yes_ NOSl a.,. oom s ......................._In1...._�.�}. - _.. 5o. Total Lana area so.n..._�!._Y.._,_ �..r_ Dig.Safe Number K.NUMBER OF OFF•STRE ARKING SPACES Pest Control: 51 Enclosed....-........._. .—.._._....._..__.__._...__._._.. HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED? 52. O,naoore...._..._...—— ...._..- ---.._....-- Yes No L RESIDENTIAL BUILDINGS ONL�S - Water. . T/ � 53. Enclosed EIBEleElectric:I -'� Fua__.Y;n/ Sawer: If ,! 56. Numoer of , oamrdaru 1 _ DOCUMENTATIONf.M THE ABOVE MUST BE ATTACHED j Parfim --- BEFORE A PERMIT CAN BE ISSUED. IV. COMPLETE THE FOLLOWING: Historic District? Yes_ No (If ye ,please enclose documentation from Hist Corn.) Conservation Area? Yes_ No_ (If yes, please enclose Order of Cond ' ) Has Fire Prevention approved and stamped plans or applications? Yes No_ Is property located in the S.R.A. district? Yes_ No_ 1 Comply with Zoning? Yes Z No_ (If no,enclose Board of Appeal decision) Is lot grandfathered? Yes_ No (If yes,submit doeumentabon/f no,submit Board of Appeal decision) / I If new construction, has the proper Routing Slip been enclosed? YN--L No_ Is Architectural Access Board approval required? Yes_ No_ (If yes,submit documentation) Massachusetts State Contractor License* 42 9, Salem License# B"/w e Home Improvement Contractor x 3 S 3 Homeowners Exempt form(if applicable) Yes_ No_ CONSTRUCTION TO BE COMMENCED WITHIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMIT ` `P CONSTRUCTION IS TO BE COMPLETED BY: If an extension is nets please submit d in writing to the Inspector of Buildings. V. IDENTIFICATION • To be completed by ail applicants -Name i v.. .. Malilg atlaresa•Numosr,Street.cM• nd a wale LP Cade Tel No. o (r - eY C reds �� ,q d<97 a LAseee 2. D �Sb6 C✓e �� -7 Caron= Buidwe LOOM No, 3. Atonilea,or E^PnMr I hereby certify that th roposed w is authorized by the owner of record and that I have been authorized by the owner to make this application as his aumori De wgA§mde to conform to all aoolicable laws of this jurisdiction. Signature of pf Address Applip ttal lY DO NOT WRITE BELOW THIS LINE VI. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number Building Use Gr mo Perm@ Issued 19_ Fire Grading Building Permit Fee $ Live Loading Certificate of Occupancy $ Approved b �n`Y Load y. Drain Tile $ Plan Review Fee $ NOTES AND Data- (For department use) e S le a I. PERMIT TO BE MAILED TO: eqn DATE MAILED: Constriction to be started by. Completed by. s VI ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES SITE OR PLOT PLAN •For Applicant Use I ON f �J �G CITY OF SALEM ROUTING SLIP CHECKED DEPARTMENTS REQUIRE SIGNATURES BEFORE BUILDING,PERMIT WILL BE ISSUED. LOCATION: �e P �7T DATE: ��I6 APPLICANT: C J �� ASSESSORS OFFICE Q 93 WASHINGTON ST. FRANK KULIK DATE::�� CITY CLERIC(if involving a new street) @93.WASHINGTON ST. DATE: CNLrRYL A Lq )A37Z r W;�@120 C SERVICES(En ' ring DbPt. C&r/� ,gyp yzew P� 5yA byP rQ120 WASHMGI'©NST,_4T" - /BRUCE THIBODEAU �Ii ATE: WATER DEPT. . (Qa 120 WASHINGTON ST,4T"FL. HELEN JIADOSZ DATE: CROSS CONNECT SUP'R' $��E Q2l a 120 WASHMGTON ST,30.D FL. DATE: PLANNING QI}0 WASHItGTON ST.,30.p L.. B£ I6E kfrL�fiRE DATE: VMwrR+a-C.t3 fsR.t,N- I—L CONSERVATION COM11�[IS�I0 (P a Dept @120 WASHINGTGN ST.,3RD F . DQN- tt.0 I DATE: ?»� ELECTRICAL ND 48 LAFAYETTE STREET,2ND L.R R JOHN GIARDI DATE: , r ,/� FIRE PREVEN i'()u29 FORT AVE(WILLOWSAR�A) � CAPT.HUDSON �/JjL DATE: Ja a p< HEALTH @120 WASHINGTON ST.,4T"F r JOANNE SCOTT Y DATE: �a BUILDING DEPT G 120 WASHINGTON ST., "I °FL. TOM ST.PIERRE ✓ - --dz � " DATE: ***SUBMIT WITH PERMIT APPLICATION WHEN COMPLETED*** o y- 00 La-c e .., Y � '4 S S r � � � �. -r .� .>