0 - 2 DEFRANCESCO AVE - BUILDING PERMIT APP l
No. City of Salem Ward
APPLICATION
- FOR `v.
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTAW_Applicant to compiew.a.0 Remit in sections C 4 fig IV,and Of.
L AT RocitTiONI �O `` DIOmeT
CATION yeEnNEeNCAND
q li
BUILDING LOT
1 rna�smffn cnoesn
.. .. - SUBDMSION- LOTBLOCK SIZE
p
U. TYPE AND COST OF BUILDING -AB applicants complete Parts A-D
c A. TYPE F IMPROVEMENT D. PROPOSED USE FOR"DEMOUTION"USE MOST RECENT USE
5 1 New bugd(rng _ RasWentid NOMI$k%nm
E 9 ❑ AddI Mn(a iesldeitW enter number of new 12'1On6 family - - te_❑.Ain ser alL rocreetbnal
Musing was added,y airy,in pmt D.13) .• - 19 ❑ CrvutlL other religious
13 C] Two or more fairly-Enter number ❑
3 ❑ Alteration(see 2 abs") d ones_��--_:. 20 Inndwebw ,
2/ C] Parking
4 ❑ Repair replacenad - - 14❑ Trandad hoK mold.or dwwANV 22 ❑.Service ice gasps _
dation,repair flera9e..
r 5 ❑ Wreckrg ill multl w*iaddisnW ernes number . . . Enar number of unrta__.....:...:._.__. 23 ❑ Has nlelamgGlal
of units in building in Ped a 131 15 Q.�Caarege ...•. .. 24
❑ 01110e.EmdL pn,IselorW..
5 ❑ Mowing(relocation) 16 ❑-�Iprt, - 25-❑ Public uAy
7 ❑ Famdation onN - -17 ❑ Other sPeodl' - .. . 25 ❑-Sd"larmy..oga eduwtlorW
27 ❑ Shim mercantile
13.OWNgWW 25 ❑ Tanks,towers
` a Ea Private(1tdividud,corporation,nonprofll ❑,OUa-3pe�lly
1 indth tion etc.) .
9 ❑ Pudic(Federal.State,or local gmremment ...
I
C.COST (OMt cents) Nonresidenael-Describe in dein!proposed use d buddnga,a.0.food processing Plate,
nttchine dDp,laundry buidinng at hosp#t 1,elennerary stxDaL sooty day edDOL 00089111•
4 pem hkd sch ok parking garage for department sae. a odDe buiDa9.d5cs budding
66F` 10. cost d improvement __.----------• a at Mustdd plate.If use of existing buklig is being changed order wgwwd tae.
To be instd)ed but not meluded "
in the above cost j
a. Electrical—___...........__-_._..._•_.--._—_.-__ _
d
i
Q Flsttrip,air porDebnag...._..._.__________
+I
5
�I 0. Otfner ,(elevator.
a 11. TOTAL COST OF IMPROVEMENT
III. SELECTED CHARACTERISTICS OF BUILDING-For new buildings and additions,complete Parts E-Q demolition,
{
complete only Parts J&M, all others skip to IV
'w E. PRINCIPAL TYPE OF FRAME F. PRWASnW
OF HEATING FUEL 0, TYPE
J,OFF SEWAGE DISPOSAL L TYPE OF MECHANICAL
3D ❑ Masonry(wail bearing) 35 ILJ ""' 40 l:7 """�a Urtrate oomPanY Vldl tC00here becentralori
31 0WOod lrarrq 39 ❑ 01 41 ❑ PMate(sepsO tank elo.) Dt�/� 45 ❑ No l
NJ
32 ❑ Sbuchr a dad 37 ❑ Coal eY H. TYPE OF y11ATER SUPPLY
33 ❑:Reinforced concrete 38 ❑ Cod � llrlr/ - Wi,tlae M an eNvaWll
34 ❑ Other-speay 39 ❑ Oga-SW* 42' FLDgp or oiN company 46 Yes 47
f 43 0 Private(wdL cisbm)
J.oNENSKM M . DEMOLITION OF STRUCTURES:
as NumbeaabNim _._.__._...._..._..._._ .........__ - ,_.�
as. Tar spore teat of Ma area, < Has Approval from Historical Commission been received
ae Mas bases an eaoena
�Qa_-- for any structure over fifty(50)years? Yes— No_
fir---- _./_
5a Tar and arm ea n _1- -------
Dig$ete NUmNumberm.
IC NUMBER OF OFF-STREET PARIUNG SPACES
Pest Control:
51. Erdowd HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
sz oadoaa....-- -----....__.. Yes No
L RESMOMAL eUEDNGS OW Water. . .
Gas -
Ful Sewer.
54, Nwwrw DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED
balleoan. Parcel........... BEFORE A PERMIT CAN BE ISSUED.
IV. COMPLETE THE FOLLOWING:
I
Historic District? Yes_ ko,,2 (If yes,please.enclose documentation.from.Hist Corm)—
Conservation
Conservation Area? ,Yes_ (If yes;please enclose Order of Conditions)
Has Fre Prevention approved and stamped plans or applications? Y No_ 1
Is property located in the S.RA district? Yes_ No_
j
Comply with Zoning? Yes No_ (If no,enclose Board of Appeal decision) I
Is lot grandfathered? Y No_ (If yes,submit documentation/rf;no,submit Board of Appeal decision)
If new construction,has the proper Routing Slip been enclosed? No—
is Architectural Access Board approval required? Yes— No (If yes,submit documentation)
1
Massachusetts State Contractor License# Salem License#
I
I
Home Improvement Contractor# Homeowners Exempt form(if applicable) Yes_ No_
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMIT
// H an extension is necessary,please submit
CONSTRUCTION ISM BE COMPLETED BY: �OD�pfJ� / in writing to the Inspector of Buildings.
V. IDENTIFICATION• To be completed by all applicants
Name Madiq addre -Number,OW city•and sW& ZIP Code Tel Na
C�clu � �3tIS>fi�Gw,J ST 5 7 619 9
a 5}T LPI�I
Z 6&ps j
CatlM= Buildele
Bram Na I
NcbileA a
I hereby that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application
as his ori ed and a nee to form to all kxWe laws of this jurisdictioica
n /yI
S' of Addess
LGI ' , SCJ �O� ce Q
4
DO NOT WRITE BELOW THIS LINE
VL VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Use Grout/
Building moo
Permit issued Fire Gfadiq
Building Lim Loading
PermAFee $ /f OSS
Occupancy load
Certificate of Occupancy $ Approved b .
Drain Tile. $
Plan Review Fee $ Lo or,
TRLP
NOTES AND Data• (For department use)
t
1 ,
Pe-
AJ
S U
p✓L AJ
Cu 17ee, S
PERMIT TO BE MAILED TO:
DATE MAILED:
Construction to be started by. Completed by.
�1
VI ZONING PLAN EXAMINERS NOTES.
DISTRICT
USE z
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
SITE OR PLOT PLAN-For Applicant Use
I
i
O "
i
_ 9
CITY OF SALEM
ROUTING SLIP
NEW CONSTRUCTION/—
CERTIFICATE
ONSTRUCTIONCERTIFICATE OF OCCUPANCY
LOCATION: pe��nC�'nSc� 1/ � DATE 3 � .y"cam
APPLICANT: y I L K
ASSESSORS
FRANK KULIK DATE,
(93 Washington Str
CITY CLERK —7
CHERYL LAPOINTIF //ic/IRJ6 kT DATE: /Z 0
(93 Washington Street)
PUBLICE SERVICES tl /
BRUCE THIBODEAU r DATE:
(120 Washington Street)4°Floor Nt
WATER
U / DATE
DOTTIE THIBODEA
(120 Washington Street)4h Floor t
CROSS CONNECT SUPERVISOR
BRIAN THIBODEAU DATE: .
(5 Jefferson Avenue)
PLANNING
�Ln,DiE GINCoeti t� DATE:
(120 Washington Street)3id Floor
CONSERVATION COMMISSION
�q DATE:
5 (120 Washington Street)3n0 Floor
ELECTRICAL
JOHN GIARDI DATE: 4 Z O
(48 Lafayette Str 0 /
FIRE PREVEN 22
ERIN GRIM DATE: V
(29 Fort Avenue)
HEALTH 11 ri r•t�l �/( NGI C(�
JOANNE SCOTT
�� DATE:
(120 Washington Str 4i°Fl r
BUILDING — I
THOMAS ST.PIERR DATE:
(120 Washington Stree 3 r
CITY OF SALEM
ROUTING SLIP
NEW CONSTRUCTION -
CERTIFICATE OF OCCUPANCY o 9
LOCATION:r) DATE_
APPLICANT. v tri
ASSESSORS o rn
FRANK KULIK DA R w
(93 Washington Str O T\ w w 5
O
O opo � � � y
CITY CLERK 7 r n\•. `"p c \ ° (� h
CHERYL LAPOINTE DA' O_ Jd ° o
(93 Washington Street)
PUBLICE SERVICES
BRUCETHIBODEAU DAT Y c
(120Washington Stree04 Floor Uj w
WATER
DOTTIE THIBODEAU DA1 t m
(120 Washington Street)4"Floor
CROSS CONNECT SUPERVISOR }
BRIAN THIBODEAU DAT
(5 Jefferson Avenue)
w
PLANNING
ALALTOUE-GING4WH DX
(120 Washington Street)3r°Floor e L
CONSERVATION COMMISSION
ptp� \. y ���a�A JN i
0'^ (120 Washington Street)3d Floor
ELECTRICAL
JOHN GIARDI 1/C - DAT
(48 Lafayette Str t)
FIRE PREVE T N ,
Efl
ERIN GRIFF7 01 DA7�V h
(29 Fort Avenue) F 9
HEALTH Qr ttci ✓(AAF�,,1 ���f
JOANNESCOTT `r1i v ./1t�t/�(" DAT ±q
(120 Washington Str 4i0 Floor O
BUILDING
THOMAS ST.PIERRE DA
(120 Washington Street) P Floor