130 BOSTON ST - BPA-2005-773 U4 RENO KIT & BATH N -� City of Salem Ward
i � M
APPUCATION
FOR
PERMIT TO BUILD ADDITION, MAKO LARATIONS OR NEW CONSTRUCTICIP
- _ IMPORTANT•Applicant to cdrilpAsto aB itwM in sections:4 la In IV,and IX.
��. L _ .-,., AT ILOCATIOIG 17,40� 4 � .� OISiWCT
LOCATION 10>�
OF BE�N , '' AfaD �Ro✓� 57:
BUILDING caoeastaat,l If3IMSTiEEn
_ SUBDIVISON. LOT Ste
N. TYPE AND COST OF BUILDING•All appOcaiits`compleN Parts A'-Q-
A. TYPE OF IMPROVEMENT 0. PROPOSED USE•FOR-DEMOUTION-USE MOST RECENT USE, .
1 Q Now euiaUq. - Rwld�nbal, Ne�brandulWf-. .
2 Q Add1V0ntaa3idwWAwarnuabwoflf9'w 12 Q OMIN* -: 1B Q,AmuarnmLnoaamlW
ha=*uma■ dad.d Wv.n pWa 131' 19 Q�CMCILOMWnagial�
13 Q Twb a cola WnM-Enaal nnnbv
3 Q ANNIRMn pine 2 a bm$ of units .- 2013 �
.�PaPae aplaGnw 14 Q Tan wd MO,I.nnMa ckwu0mv- 21 22 Q 3«MN gwaWIeOaa fTnBa
S Q W1w*nD itl mom",afWMYl,anYtnmd�r FilYramlbraunitt .
23
❑ auaal0ataa..
d urutr n autlnp n.Pa t0. Ian 18 Q Gmw . 24 Q OM=bank pawoa_ rl
613 mw*InNoolonI 18.Q Cwwn YS Q.Pitle u181y
>• Q wl.aalononry 17 Q 0dw-so" n (3 � .aom.f
S.OWNERSHIP 28 Q:.Unk&kp
B D(J Privabl lrMiMEuaL CaPonbon.iionPbit.: _.. a . .
l (�wm1Mim e1e.1 29 Q dbar'SpaoaY
9 Q Publie IFedwaL BwL or boon QwAmnwa
l.COST IO*cwm NWOOM w-Daavda in deW wopim- u at buad 4M&a..Iwo abee..q pwc
_ MWOM afaa2.Wndty butdsq AS hompllaL OW aift p anlaa sepbtdry w*0A,bbaapb
IQ Cpalaingwanml 6 PA�faansenbot.pa1Ma99an9aw s,on;nnan oin aM, buadaq
- - rntllWwpWll:Buaaa nstnp ■ antM paL
.. Toasaraead but not aaetlafad - � '
-m un avow cost
e. tfsralp,ar oaldawlaq _�' - . . .
d.08w waawot.ann
.11. TOTAL COST OF BAPBOI&MENT
IIL SELECTED CHARS OF BUILDING •For new buildings and additions,.complele Parts E-L;dWnOWkw.
c Only Pars J 8 M,all others Skip to IV
E PRINCIPAL TYPE OF FRAME F. I wxmL TrPE OF mw=nit O. TYPE OF SEWAGE DISPOSAL 1. TYPE OF MECt1AlaCaL
.. - 32 D'w r bartna Q or - Ao Q PubAeapnaalabaapnn wralar
cm
coulowww
Q,sebee.r r.af Q �adndly ., Q Pnilawaa;WaL.Me.1 es13YM b
13 No
33 OR Con*M 3613 cm H. TYPE OF WATER SUPPLY WE Bum by an waaaprI
3e Q Otw•SM* 3013 OBw-*w* 42 Q.Ptd crv*A aeonwrM
asQTa.. 4713No
- .. . 43 0 RMla naa9 clarnlr
J.onAENSIONS M. DEMOLITION OF STRUCTURES:
48 NuTOI.NIWlll6..._........_..._......_..__.._....._.._.._.. ..
39. TWA eaian Na a soon aroa. Has Approval from Historical Commission been received
a::Hoorn mew an eseenor .. for any structure Over filly(50)Yam? Yes_ No_
50. TOM ann as it -- Dig Safe Number
IL!UMBER OF OFF•STREEr PARKING SPACES Pest Control:
51
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
52. orndwe..._ — Yes No
' c REalD01R�L elxlauos oNur Water
_ ss a _ Electric.. _
Full $eUll6
' *soya""a DOCUMENTATION FOR THE ABOVE BE ATTACHED
"� AM" BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
Historic District? Yes_ No d,.- (Byes.please,enclose docu on f n HffiL Cola)
Conservation Area? Yes_ Nd# (B yes;Plesse enclose Order of Conditions)
Has Fire Prevention approved and stamped Plans or apPlicatiOrm? Yes_ N04g_
Is Property located in the S.RA district? Yes_ NoX—°
Comply with Zoning? Y No_ (If no,enclose Board of Appeal decision)
Is lot grandletltered? ,Yes. -No_ (B yes,submit documentation/if no,submit Board of Appeal decision) w -
B'new cpnStruction,has ilia Proper Routing Slip been enclosed? Yes_ No_
Is Architectural Access Board approval required?. Yes_ No (If yes submit documentation)Massachusetts State Contractor License# Salem License#
Home Improvement Contractor# Homeowners Exempt form(if able) Yes_' No
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMIT t
8If an
CONSTRUCTION IS TO BE COMPLETED BY: extenel re r Please� o� in writing to th me Inspector of Buildings.
V. IDENTIFICATION• To be completed by all applicants -
Neme Maing ad""•Mdrtl".&met clot:am slide ZIP Cods Tel Nd.
C e 3 tL ve- L V Mfl 0owwor
4n o�1ttD 19 1
COMM2.
01 -
Lunn fft ob l
dr'. Ce 'I�e Sr vgtc; 01V5
AMftW I hereby ro work is suthomed by the owner of record and that 1 have been authorized by the owner to make this Application
as his a z m G we ree to conlorm to all aoolicabte laws of this runsdielan.
Sig of Address dale i
M0 MID � z
r
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE OFAY
Permit number
Building
Use GMW
Permit issued t9— Fire Gmdmg
Building-- L vs Iq
t Permit Fee a
!" Certificate of Occupancy a oaer LoadApproved by
Drain Tile a
f Plan Review Fee a
TRLE
NOTES AND Data.(For department use)
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by. Completed by.
VI ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REM YARD _ II
NOTES
i
SITE OR PLOT PLAN•For Applicant Use
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per, Vw„ w _ 130 BOSTON STREET
' ?ND FLOOR
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130 BOSTON STREET
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S". = 612
l CER77FY THAT THIS PLAN SHOWS UNIT / BEING CONVEYED AND THE
IMMEDIATE ADJOINING UNITS AND THAT IT FULLY AND ACCURA7FLY
DEPICTS THE LAYOUT, LOCA7I0N, DIMENSIONS, APPROXIMATE AREA, MAIN
ENTRANCE AND THE IMMEDIATE COMMON AREA TO W➢l//CH /T HAS ACCESS
AT I30 BOSTON STREET, SALEM, MASSACHUSEnS, AS-BUILT.
DATE PROFESSIONAL LAND SURVEYOR
tom• HANCOCK alK BY
BOS'rON STREET Survey Associates, Inc. DAIF
� ®� 185 CENTRE STREET. DANVERS, IWA. 01923
� NINl1Y1 VOICE (978) 777-3050, FAX (978) 774-7816 21/41205
130 8057ON STREET SCALE. 1r = 8' JOB
N
SALEM, MA 0 4 8 16NO.11/M