30 CEDARVIEW - BUILDING PERMIT APP 'PL1N+sftW13E f IWB4AD APPROVED By T4IE
WPECU1R PWR TD A_PERMIT BMG GRANTED
NOW _ CITY OF SALEM
� � \
J \ Date 6 0
Ward "1
ZW" District
Is Properly Located In Location of Me Historic 01011107 Yes No anilaing it ?�y�u�'c v
Is Ropm y Located In
the Conservallon Ana? Yes No
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other:
PLEASE FILL OUT LEGIBLY 6 COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '
The undersigned hereby applies for a permit to build accomkig.to the.following
specifications:
Owner's Name _ &I rv.o N O S es KL
Address A Phone -31� Ceor\r v e w S-i. (ass l �4y -S9 2 6
Archftect's Name C'vv\
Address 6 Phone 1 Co C,*,4 ( P s i PP�1Sec�y 1Y2 9 31 S3 S
Mechanics Name S cs- v^ L
Address & Phone
What Is the p sMu of WNW 60
mdaim of b~ uU O o C4 N a dwaft ,for how many famlim?
wo bolding conform to taw? 1P Asbestos? h C3
Esillnated coat -I/7T LWW"a state Lianas 7
He Isrprasamt a _
Lie. 0 I �D 1�
Sionature of Applicant
SIGNED UNDER THE PENALTY,
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
Ho v
MAIL PERMIT TO:
\1 i
��v\�
APPLICATION FOR
PERMT TO
LOCATION
PERMIT GRANTED
APP OVFD
INSPECTOR OF BUILDINGS
• •1J.Paala.el e��.4dri��seiL..(.•
600 %aA&,,Msw
Iafeetlea..asa Baso. ///.ee A.& 02111
Workers' Compensadois insassstee Af Ulwvk
•(. l C ,� n� P/ nt 1M IDS
. . widl.s principal place of bodness so
161 r^ \n A r I ,e, �s.� . ��cv Sys 6
t11 ,
do bereby'ctrdly under she paint and pesuil a of pw*yo sloes
0 a an emoloyer providing workers' tompem d ne covepfs for onto eieployeea working M
,a cot n a �, 18 4 �3 q
I te smo Company p )lumber
% mat ee� 2n • yN-CA ,
1 ant a sole prop.losor and have ae one workb g fir me in mw opa .
0 1 am a sole proprietor, general contractor or homeowner (drde am) and hose bired da
cotnnno s lined below who•baw thei folkswbq workers' compensation pelldw
Comncwr Insurancs Company/Poft Nun6w
Conaaaor Insurance Comp"W/f o Number
Conauser Insurance Con*asy/Policy Number
0 1 am a homeowner performing all the work myself.
•I r.ancsa.mat a car.f 06 wwnrw.e be for warad a Ow O91c.si Invaknew of Ow DIA AV ce.eraeo..rlkedw saw ew slur a Sate
ce.araar ar r,.wrs smer f.cdaa SSA M MGL i S 2 can war is ow Wowdan of a*Wa r s.Mda cenaedre of a faw et o 041.300.00 abler w
+ran':.r.eanwre aSO a d//d.saeie in Ow Iona of s STOP WORK ORDER sea s iw of S 100,00 s an risk)oa.
Signed chit, /, ��� L day of — — O IMLI _
:icenseei'Fenniuce oullding Department
Licensinf Ecare
Selectmen Office
:;eslch Geptrmer:
-_ecCC "e : : ece apc eye 775
MORTGAGE INSPECTION
BAY STATE SURVEYING ASSOCIATES INC. JOB *
100 CUMMINGS CENTER, SUITE#316J, BEVERLY,MA., 019115
- - NOTES:
)1 0
LOCATION :S -S....................Z::IPs............... 1)This is a mortgage
inspection survey and not an
`-1 - Inst^unent survey,therefore this plot plan is for
SCALE : 1" -
36 DATE :. Q1f..:5...: `999..... mortgage inspection purposes only.
..•., 2)This survey is based on survey marks of others.
REFERENCE :A .A.x3lSi y69.P.Sic..1S� 3)Bashes,shrubs,fences and tree lines do not
al')—Mi necessarily indicate property lines.
1�� .RS. ♦)Whenever an offset is 1'w or less,an instrument
1.S�8X..QF"" •-•• survey is recommended to determine property
lines,and any possible encroachments.
TO:�1�1„FY.I,.F.1.Y.G.L.LQFiT.GqP.,S„�S.t]Rf?.,..._.._._...... 5)OBsets shown are approximate,and are to be
The location of the building(s)as shown,either used only for the determination of zoning,Not to
complied with the local zoning setbacks at the time of be used to establish property lines.
construction or is exempt from violation enforcement action S)In my professional opinion the building(s)are not
under Mass.G.L Title VII Chapter 40A Section 7 located In the spacial flood hazard zone,as _
defined by H.U.U.MAP# 25.0 I.OZ.
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° LI of 4-5atem, : wassaehusett'
Fire Department
48 Lafayette Street
P Salem MassacAusetts01970-3695 29 Fort Av
Ro6ert'W.?urner 9<2 Preventran�,
c:l;ef 7eL 97&744.12.35 Bureau
97X 744-69910. faX 979-745--4646 978 7 5-7
Bureau
.
FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT
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-DEPARTMENT.4 (.Ref. Section 113.3
of the Mass. Bldg. Code)
JOB LOCATION: 30 CZ� p f v 2 5 S -T
. OWNER/OCCUPANT:
i ELECTRICAL" CONTRACTOR: f tiff '
`r 1FIR11OPPRESSION CONTRACTOR:
F SIGNATURE OF
7 APPLICANT: �p PHONE
ADDRESS OF..
i� APPLICANT: r CITY OT
TOWN.
r �v
Ir : APPROVAL DATE: �4 3p 2ck]
l RA4 s},
J ' ' T,Certificate of approval is hereby granted, on approved plans or submittal of
„ kproi act. datails, by the SALEM FIRE DEPARTMENT, All plans are approved solely
fortidentification.of. type and location of'fire protection devices;and equipment
All plans°are subject-to approval of any other,authority having jurisdiction.
Upon' c0"mplation, the applicant or installers) shall.request an inspection and/or
. test=,of the fire protection deviceaavd aquipmevt. (ADDITTIONAL REQUIRHMENTS, ",� .Ys _ .
t SEE REVERSE-SIDE
**e
NEW CONSTROCTION, r
PROPERTY LOCATION HAS NO COMPLIANCE WITH THE PROVISIONS OF
CHAPTER 148,' SECTION 26 C/E, M.G.L. . RELATIVE TO THE INSTALA-
TION OF APPROVED FIRE AL1RM DEVICES. , THE OWNER OF THIS PRO
y ' PERTY IS REQUIRED TO OBTAIN COMPLIANCE AS A CONDITION OF
OBTAINING A BUILDING PERMIT.
PROPERTY GOCATION 'TS IN iAff1IAC,,'F 4I'1'H THC PROVISION OF cNAf T}:F
c; 148, 3FCT ION 26. . ;F. M r.1 . S
Y/s6
w.
$30.00
9
$50.00
CHEQKr
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