0009 - 0011 GRAND TURK WAY & 0010 HIBERNIA LANE What is me current use of"Building?
IJ :sd�of BUNU ? ifQwelWq,how many unit?
Wir the Buiksng Cw*M to Laves — AabssOos?
Archiact's Name ( 1
MechwWs NO" C%A�Y r!S
7
Address and Ptwne._1
C;onstrudim Sues License s HIC RegMmftn 0
Estimated Cost of PrOod: / ,, Per"Fee CaWUMM
Permit Fees � Estimated Cod X$7/s1000 Residential
- Esdmstsd Cost X s111s1000 CammerdfL_._
An Additional ss.0o is added as an
Adminwrglive dwrge.
Make sun that all fields an Properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to to the bove slat'"r
speeftetione. signed under penally of Pedury /
Date ���
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a 3 $
CITY OF SALEM
1-1i PUBLIC PROPRERTY
DEPARTMENT
\ttti Ott t?C Wail IiVG'iJN S:'AEET #S.{[F\t,A\u.\C:fl iL l'Ci 0197�^
Lel/ 65;�Q� TFr:978.7454595 .i Fx:978-74v1M
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions of MGL c 40, S 54;
Building Permit# _ _ -_ is issued with the condition that the debris resulting from
di
this work shall be sposed of in a properly licensed waste disposal facility as defined by MGL c
111, S 150A.
The debris will be transported by:
/�0/j//Z,
(name of hauler)
I'he debris will be disposed of in
(name of facility)
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•iam
Crrx OF SALEM
is PUBLIC PROPRERTY
DEPARTMENT
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Faikao to Sent.Covaap lie+.gtti"under Seetba 25A of UM L 1 J2 Can lad p impoddoo of ak hW �&
f .up to S1.200 An
oa..yar impdro�as wall a df peaaldes in the form ore STOP WORK ORDER e��t�
fn .
or up to f230.00 a day apiatst t>z+vioktrar Be advv opy od toot.C of tkW sotsemat maybe forwarded to dw cls"a[od
(nvatipdatr ortkt DIA far inwranu Covmp veritladaa
J Jo Ali ey and °/pIJAVY afar At/a/a,.tdooOnrfled obtw if ew aN/Carter
Phone a3-
0JAId list#N/p Do Not wr/se/o IA&ae4 to be eospidw bl4*of Avow a,Qldd
City a<Town
PerotitR.ieew i
11,Wns Authority(circle oae)t
1. Board or Hedte L SUMBp Department J. Cityfrow.Clark d. Eltctrlcd Inspector I Plumbiap Inspector
& Other
Contact Puma:
GrI-�UFS.�.E`
PUBLIC PROPERTY
DEPARTMENT
Iit.�EeISY tywrn
NAYOe 130NrA*UXC M'9nWff•SNaK MAsaAae:7n'ts 01970
IVL-f7ti.74S.""•FAs ws.7*m*
APPLICATION FOR TIIE REPAIR RB.NOVAlMN_ CONSTgUCTIgM.
DRIMOLITION. OR OAKI OF USt OR OCttM N_[_'V_ FOR ANY FJiQ3TING
53RUICTM OR sVELDI .
1.0 317E INFORMATION
Locadon Nwm S
Property Addrssc
Yil ,o yurg' G .� `U �Y
Property is bested inc Co semdlon Area YIN HWorb DbMd YM
2.0 OWNERSHIP INFORMATION
11 Owner of Land 1p�gj
Name: �S
Address: P-,Z)o �2 f J�CI%
l�/O
Taephone: `��)- 3. %2ODlyhd4 ,9
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor(sn Renovated
construction or renovation
of existing building Now
ftd Description of Proposed Work:
--Mail Permit to:
r