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48 CLARK ST - BUILDING INSPECTION • ' No. z00 `{ c,lty of Salem ward 0-7 C o-J- Do o l AP Pi UG tON w PERMIT TO BUILD ADDITION, MAKE-ALTERATIONS OR NEW CONSTRUCTION = CTION IMPORTANT-A'pOicant to_c�e al items-in sections:y 14 0K IV,and IX. L AT(IACA710N1. X LOCATION° Q OF eETwEeN 11f"9•Jllcdl4 cI AV66 garh1ti Ana. BUILDING �+ =RM fcR=sTnwA sIAT oN [ _�a r/�C fZ �Jc�¢nsis LW_BLOC SIZE j;, IL TYPE AND COST OF BUILDING-A11-6pplieatils-cOrnobt,)ft s A-D A. TYPE OF IMPROVEMENT D. PROPOSED USE-FOR`DEMOLITION"USE MOST RECENT USE 2 l00 AddidW alms dwWst wWmw*iaasir. 12 ff2 linoil!. 19[3.A-AmA t.lepasair ncuru,P un¢audl0.d,any.n,pitD.131 13 ❑ Two a mne Froiy•6dv wn*w 18�1Q-'�11.lTNd4otl+s.mli9iois. 3 Q Abmooe ISas 2+bore/ at u1b __ ... 1...1 21 Q Pprltrpgiaps -. 4 Q ReOr mpaosnem 14 Q fW WstoW.moel adom:nry• +;Eniieeidmis 22 Q_Senaoaeoaon.aspr gaopa ' 5 ❑ W"OP'a!!b7v+P1'/mldneAL riMma,aA/': . _.. 23��/eapalLaelWir Of ontr n&A.WW it PM 0.1M 13 Gawgs - 24 1"I S Q.Mo1+o0 VaWato,y. -:. 1s 0 Caroa1-. 25{].PmaadraY. 2o.Q,5dnpl.fMry.Wr.adueatprl 7 Q FdulOaadlaiv 17 , ther SpW& .. ❑._O .. ... 27�.Slo,a aliraaals B.OWNERSIUP 26 0 y 9 [ rPT1W1riwias4 cv,pariion:iN-nep l - - ... 29 Q Odr-SM* �eieoriaiet 9 Q Pdic WedwA S aW W nai ewe - - C.COST - fQY,Pewim -_ N Oeaclian EsmA{hoppeed�..d tuldogs.eq.taG p�oorsoq,pWt . ... - aW40sr.=W,aay ouadan inamai.eWWIWY 8dnd.0WdRPaohool.WNW^ 1Q C mofi1fDN,enwa s 9a Qdo. Senn 0Wft a cW.ara4ak,rdd0ai�es.fbAieaileluee.'araaio.:uee.ara.g .. ._ ... a1n�FBWa.Ymed.atainglVl9nga0en9 9e4 an1et0AP= d+a1L . >, f3settal - n_PbrjajL� -f4si9.emndaWi9 1/.TATASCOST OF*APROVBAB1f. ... . �'— - .. .. . III. SELECTED CHARA XS,OF D#.tG -For new buildings.and addifans compleAa Parts E-L;demOMM tD c to on Pails J 81Li a(I others skip N -E. PRn#cxv&TYPEpFFRLvE F."PI mmm TYPE OF11El1rm Rim G. TYPE OF SEWAGE DWVSAL L TYPE OF MKNANCAL 3o 0_AWaW(w4beenno 35.,.0�- Gsa 40.a;PW Wvnwnw4eaianY Yw#1 towmsY �y:� tiro 31 lJ d 36 0y 01 41 Rawls laaPlb Wat alc., carlWWV? . 32'Stubaal MW ' 3Y_Q E3e0ildly 0 a O'�66 45 Q..NO 330 ReiA_ mraele 38©,:Coal .. H. TYPE OF WA.TER SUPPLY W*v4 &vwswjww? 34.3:OPerspedY 39'0 ftW.spW* - 42loop Orvem..aon"MW w E3 yes 0 ao DO NOT WRITE BELOW THIS LINE VI. VALIDATION -Building- FOR-DEPARTMEW USE ONLY Permit number Building use Group Permit issued 19_ Fse GraAirg Permit Fee $ _7 ��/ Lin Loading Certificate of Occupancy $ Approved b Clocupwry toad y. Drain Tile $ Plan Review Fee $ TIRE NOTES-AND Data•(For department use) PERMIT TO BE MAILED TO: DATE MAILED: Construction to be started by. Canpleted by: J.DIMENSIONS I DEMOUTION OF STRUCTURES: ne N.m wSlaws .._ _......._..______._ ., 4e TWA sa teen Of Hoo area Has-Approval from Historical Commission been received a:Hoorn.oases w ez for airy structure over fifty(50)years? Yes_ No— *SaleToren nos arm.w.It. Safe Number K.NUMBER OF OFF-STREET PARKING SPACES SI. ErcJmee � F'eSt(i0fltra: 2 'f1VE�LLOWING UTILiIlE5 BEEN DISCONNECTED? 5z oukbm ` " Yes No u RFnAt maliares orar 53. ErrJoseC .. ,_ . .t .Gas:.• _ _ .. Ful 2 .Sewer: "Aw. ww at oae.00aN Pam / MMMENTATION FOR THE ABOVE MUST BE ATTACHED. BEFORE A PERMIT CAN BE ISSUED. N. COMPLE77HE FOLLOWING: H'isibric District? Yes_ No✓f (If yes, please ercloseAoc umenfafion treat^His1 Cep Conservation Area. Yes_ No (If yes,please enc(o5e Order of Condctrons) ,... .:x . Has Fcre+Feven9on approved and stamped plans or applications? Yes_ No_ Is property located m fhe S.RA disftP YBa NO Cm"wW&Ze&ir Yes v No_ (If no.wdo eZo"&Appeai decision) is W WwWUftfW. Yes No_ (If yes,submit documeMIiIwIf no,satinet Board of Appeal decision) N*new Bor on iras the:pioper Routing Slip been encased? Yes_✓No_ Is Architeckr&Access Board appnovafrequired? Yes— No-� (N yes,sjbmR documentation) Massachusetts state Contractor License# C .Oi 0 7 63 C 7 Salem Liceree# +IemetmprovemerdCanlragtor# Homeovuners Ezen0form-ftapplicablel Yes_ No_ CONSiRUCTION:TO B&COMMEJCED WITHIN SA((6)MONTHS OF ISSUANCE OF BUILDING PERMIT W an ension is CONSTRUCTION IS TO BE COMPLETED BY: Md C 2 D/f in writinext fria bra Cgs a CO V. IDENTIFICATION• To be completed by all applicants Nm MNti9 ae0ie�-MnlEer,asrot City.srtl awls ...ZIP Cove Tet Nn _ . o�.a a err or9s M SY3 ------------ Gar.mr<> . a BOW - I hgeby oerEttY.Y�at.tlie WpOSad•wGdr erizW by We owner of recaFd,and M.tbm ebb>u&cmed by the owner tD slake#ft I iDB9Dn as 66 almwrBed'a nI"are we .. 12 ap aoalicable laws of Bi's iurlsditfion. c C� o2 �t le9e CITY OF SALEM ROUTING SLIP f�J CHECKED DEPARTMENTS REQUIRE SIGNATURES BEFORE BUILDING PERMIT WILL BE ISSUED. LOCATION: `fp r /�� DATE: �! APPLICANT: j a ft a S ( �©ly N J cx Q ASSESSORS OFFICE / @ 93 WASHINGTON ST. FRANK KUL a-�DATE: (� CITY CLERK(if involving a nRw street) , @93 WASHINGTON IT. DEBBIE BURKINSHAW / iyln('/L S DATE: PUBLIC SERVICES(Engineering t.) .idj @I20 WASHINGTON ST,4T"FL. BRUCE THIBODEAU----='� 7"�A DATE: 3 i �] WATER DEPT. @120 WASHINGTON ST,4T"FL. _ H£L 9,87? DATE: J© -a F l�o�IE T1.11 C'SC�I, CROSS CONNECT SUP' BOB DESCHENE @120 WASHINGTON ST,30.D FL. - / ' DATE: PLANNING @120 WASHINGTON ST.,3"D FL. DENISE McLURE DATE: O CONSERVATION CO SSION(Planning D pt.) @120 WASHINGTON ST.,3RD DON CEFALO L. DATE: s n ELECTRICAL @ 48 LAFAYETTE STREET,2"D RE JOHN GIARDI DATE:"�I� FIRE PREVENT N @29 FORT AVE(WI L S A �' CAPT.HUDSON ' �� ' ' DATE: HEALTH CC @120 WASHINGTON ST.,4T"F JOANNE SCOTT t R Wz� DATE?/4 °� BUILDING DEPT @ 120WASHINGTON ST.,30.0 FL. / 1✓ TOMM ST.. PIERRE l/ .�[�,(/[ DATE: ***SUBMIT WITH PERMIT APPLICATION WHEN COMPLETED***