5 1-2 BARR ST - BPA-2004-887 EXPAND 2ND FLOOR "o
i*L1Siti6TE4
fL wPfiOVEfl BY T+IE
U�I.S,f?FCTLIR 6+R;1DR . D'; PE"T BE MO GRANTED
J CITY OF SALEM
No. � l —�—� J ;: " - Date 3 �3
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Is Property Located in Location of the Historic District? yes--No_ Building S kz. 6-Aek
Si
Is Property Located in
the Conservation Area? Yea_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whicheverapply) Roof Reroof, Install Si g, Construct Deck, Shed, Pool,
pp y) ,
Repair/Replace, Other: 6 R M F-Q
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
Address & Phone S�/2 isgg-2 ST (47%) -74q 014y
Architect's Name
Address & Phone
Mechanics Name CAYV)E
Address & Phone SAYYV�e
d What is the purpose of building? r A Pam r) E ' CTI
/ Material of building? V yb�r/ �—'^mot' It a dwelling, for how many f milies?
Will building conform to law? T Asbestos?
Estimated cos a Cly License M_L_ Ucense
---
fj 000 1� a imP= .e=ut
1 Lie. i
ature of Applicard
SIGNED UNDER THE PENYI OTY
OF PERJURY
DESCRIPTION OF WORK TO BE DUNE
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MAIL PERMIT TO:
01 C1' -�Lo
1�
No
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
AP ROV�D
J
INSPECTO OF BUILDINGS
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CITY OF SALEM9 MASSACHUSETTS
` PUBLIC PROPERTY DEPARTMENT
r 120 WASHINGTON STREET, 3RD FLOOR
$ SALEM,MA 01970
TEL. (978)745-9595 EXT. 380
FAX (978) 740-9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,S34,I acknowledge that as a condition
of Building Permit# all debris resulting from the construction activity
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL c III, S 150A.
The debri be disposed of at. r qST COAS� i S>-p-
Location of Facility
�- 2 G
ture of Permit Applicalitate
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
i -1rnmLC. � D 0V-
Name of Permit Applicant
dA
Firm Name,if an
Address, City&State
The above statute requires that debris from the demolition,renovation,rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cM, S 150A, and the building permits or licenses are to
indicate the location of the facility.
:f
CITY OF SAIM4
BUMDTNG DEPARTMENT
HOMEOWNER UCENSE EXEMPTION
Phase Prig
DATE — I
JOB LOCAMON
_ HOMEOwxfx
ADDRESS
C•" 6—] Cb `J 7- C)) l I
HOMEOWNEfI � • •
TELUBONE �}'V
PRESENTMAn-M ADDRESS -!�:� Z
The cmrcnt ctcmpdon of"hOMtaWD as"was rncnded to iricludc�cr ocwpied dwcNnp o[TWC
Uniu a less and to allow such bomeowncra tc engage an in&i ual for biro wbo does W PON=1
lictnsc,.providcd thatthe ewsxi ad as supervboa
DEFWMON OF HONEOWSM,
Pcrson(a)wbo awns s pm=l of land on wbich he/she tcsida at Wcnds to tsside,on' atlb=1%Cris
intended to be,a mu to two family dwelling,s=died or detacfied Sttttemrts ss shall aot be It andAw
farm su om=.A Person who com mcis more than one horns in at� m P
ftd
a bomeowner. Such"homeOWT-r akB'submit w the BuBding ftm a forma bk to Ertt
Building McW,that Wshc be respousrble to all such work pafonred w4cr the butldmg PaM
.Thc undcnig»cd`bomwnct"asn='c$responn'bility for eomplirrnce with the Stan BuBdiag Code ttad
w
othu appBnble goes by-laws,nrles and tegulatiOM
The undasiprd'houtcewncr" certifies that hc! cstartds the City of Salem BntldmgDeparoaettl
minimtun Vgcciion pm=dtrra and rcq ' nu- that hlshc will comply wrtlt card p and
rcgtrircu=K
HOMEOWNER'S SIGNATM
APPROVAL OF BUIl.DING INSPECTOR
Sec otbc sidt for Stan code
HOMEOWNER'S EXEMPTION
The code suits that: "any homeowner performing work for which a buDding permit is=qumd shall be
exempt from the prosisions of Ibis aceuon (Section 109.11-liaosiug v[Construction So
perYiwri)
Provided that is a homtmmu engages a person (s)fbr hue to do.such work,that such bomeowau shall aQ
85 SUperYlSa•.
Many bomeowncrs who use this cxemprion arc imawam that they arc ass mag the tespoasrbtlmes de
stpavism (see Appcodia Q,Rules and Regvlatious for Lkxosiol Construction Suptrrison,Setdm
.2.14 This lack of awareness oflcn ranhs in serious problems,particularly when the homeowaer:tkn
unlicensed persons In ibis case your Board cannot prococd against the unlicensed pawn as it'%VM w
liaased Supcnisor. Tbc bomem-btr sdiny as supervLor.b uWmateiy respoosibi6
To cusurt that the homeowner is fully aware of hirer respon_sMities,marry cammuaid=ngtme;as pm
of the permit applirWm that the homcmrncr certify that helshc widcratardD the responsibilities eta
superrisor. You may cart to amend and adopt such a fornvccnifimtion for use is your .
,
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/ 10) ua^s wnm nuotatznn 0ate. / hzs nuore is an estsmate.
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