5 & 7 BARSTOW ST - BPA-2005-94 REPLACE WINDOWS, DOORS 142%"S111110ST13Efft.-E� APPROVED BY T44E
INS, FXTDR,PWDR TD A PERMIT BEING GRANTED
G
No. `y\ _ CITY OF SALEM
ward
Zoning District
Is Property Located In fi iltiof +�
the Historic District?? Ye No Building
Is Property Located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
RepaflReplace.,Other:
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 �APS�Uty Sj / H v Q7�j 7`//- /G30
Architect's Name
Address & Phone f
Mechanics NametAv�
Address & Phone t udoi,- `kuevl (V' ') R2z 03
What Is the purpose of building? �I 4G Me
Material of building? k)G G If a dwelling,for how many families? _
Nil building coRform to law? Asbestos?
Estimated co a�city License M State License e
Hers Iaprover.ent e
tom. ignaturb of Applicant
SIGNED UNDER "i PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
1�2n�l�CP IMPy1 ( t �lv��rl�� k 'lC� irrl fJ�t�� lydp- t
ye I Q Ge 4wx11 0'y\A y eav �cll�c e
r
MAIL PERMIT TO: �'1 A\'j
No. j
APPLICATIO
N FOR
PERMIT TO
LOCATION
PERMIT ]GRANTED
19
APP OV D
2L6 x�n
INSPECToA OF BUILDINGS
<r
' 1
k
Wi 1 OF SALEM
BUIIDING DEPARTNENT
HOIvME0V1 M LICENSE FXDVUC)"
pkae NO
• DATE 7- r�/- •
]OBLOCATION � 7 l�A�s�ci C� ���E� ass
HOkffA� S M
ADORES/
HOIEO M �711 - 7W- 16319
TELEPHM
P,tESEN?,dAn.II?G ADDRESS sA�tC' .
ne C=,m.ucmptlon of-Iwmevwme was txteDed w Imhdt oreerstwpld.dw4mv o[TWO
umn a less sad to allow snch bomeowma to srWV an bdiridua *r b M wbo does scot pries a
liocme,.provided the�e e+rses'set tl ngetsiasa
DEFROTIM OF HOMEOwtIM to reside.oa.fideb that Y,a Y
Person(s)who owns s ps'scl of IwW an wbkb Wsbt asides a$utads s aa�m s w
into w m be,a am m two hmOy dwellbz&sasdad a dwdad warn es_�s1y �� ��
farm swcwmL A ptrsoa who constructs mac Om oat home in s two-y m s� toms
Bw'ldb g bamcowua�sS tubrJOw be respomtble two an��ptrfoe�mda to boudlq peak'
The tmdemipted-hoawowte assumes ropMw*I"is wmplit =wbh tbt suit Bci ft Code ad
otha appliabk Sao by zvm.rule:sad te=ulsdwL
The wAca ip cd-hoawvwmf to a5a that wdtt wAasteads+h<Cro of s.1ao Bt>Z1dbt�Deparoasl.
minimms inspccti on wa wA aitdaascrns and that h/she will comply w itb said ptooedma sad
- prtxzd re
rWub=jcm
HprgOtKNFR'S SIGNATURE
APPROVAL OF B=ING INSPECTOR
see otber side for arse code
II
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 9RD FLOOR
SALEM,MA 01970
TEL (979)745-9595 EXT.980
FAX (976) 740.9646
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MCM c 40,S34,I acknowledge that as a condition
of Building Permit# .all debris resulting from the construction scdvity
governed by. this Building Permit shall be disposed of in a proPealy licensed soH&waste
disposal facility,as defined by MUL c ID,S150A.
The debris will be disposed of at _ $� cc) —Lt1 C,
Location ofFadlity
Sigiann+e ofPermtt licant Date
FULLY complete the following information:
(PLEASE PRW CLEARLY)
Name ofPen it Applicant
Firm Name,if my
7 fi S mw S% Sl�LEN !1/r
Address,City dt State
The above statute requires that debris from the demolition,renovation,rehab or other
alteration of building or structure be disposed in a pmpaly-licrosed solid-waste disposal
facility as defined by MQ ca S 150A, and the building permits or licem a ace to
indicate the location of the facility.