164 FEDERAL ST - BUILDING INSPECTION (5) fLylINSIftSTaEfIL611 t 11 APPROVED BY T44E
Jb6SPFC DB PPWR TD.A PEAW BEWG GRANTED
CITY OF_SALEM
NoV� V� ":4 Date
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Is Property Located In Location of
the Hiatodc District? Yes L No_ Building
1s Property Located in
Me Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other:_ of-
0
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Ownees Name
Address & Phone tU�k
' Architect's Name
Address & Phone
Mechanics Name
Address & Phone
What is the purpose of building? Q a C,R_ -
MaWM of bulldirtg? 1 A 9 c90A n a dweYfng,for how many families? '
WIN bukbrq cordorm to law? 44 AsbWos? Jc1,U
Eatlmatad coat S. City License a N A state Lianas 0
Some Improvement
CCJJ"" Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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MAIL PERMIT T
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APPLICATION FOR
PERMIT TO
LOCATION;. lollQr
PERMIT GRANTED
APP 1/fD
INSPECTOR OF BUILDINGS
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u CITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3Ro FLOOR - -
$ SALEM, MA 01970
TEL. (978)745-9595 EXT. 380
FAX (978) 740-9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40, S34, I acknowledge that as a condition
of Building Permit# , all debris resulting from the construction activity
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL c III, S150A. c 1
The debris will be disposed of at: S 'Vk'G(,i,( a)mkk
ncafion of Facility
Signature of Permit Applicant Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
Firm Name,if any
Address, City & State
The above statute requires that debris from the demolition, renovation, rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIII, S 150A, and the building permits or licenses are to
indicate the location of the facility.
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GTY OF SAlEM
BURDINGDEPARTM7 r
H0ME0WIER u(misE Dm'DON
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TELEPHOIas
PRFs>xrwmmm ADDREss P a. P S'#— �A
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tlmla or tes aad a,anon.sncb Umeowm a b cWp wt bd(�.�him who deer as Paul8
naau,.p,ov eee tbo dw awaw*d n wpwvllm
DEFDGTMOFHCMZOWI 'M
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intended b K a om b woo lamilp dwegla&aasdwd a abm1 MA UK be eooddowd
farm satteaves.A persat wbo oorxvtav man than tax hams la•ewayear p� .
a boateowaer. Su* lwmwwad'ahaIIstrLstdt b the BniltSag OJfiesd.au a to iw
Bw•ldind Odr<id.that hchlw be nspombk to aH swdt wank pafwrmed order the pta=IL
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other oppgabk goes by4mm nim mad njohdom
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minimtam inspection F p=dwu mid ngtmc ntms and that blslw win eom*wi*sald pro t&=d
regWeemetwL `�
HOMEOWNER'S SIGNATURE
APPROVAL OP BIIBDING MPECIOR� .r—
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HOMEOWNER'S EXEMMON
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provided to b a bomeowna cwga p pas=(s)for Mm to ao.nrL tbat aa&bo®eowaa t tint .
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supavba(see Appeedb Q*Rulea asd Ragubtbm for Liocoaleg Cooatrwcdm Sops vbsas•Seralw
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urikcased peraema In tbb a m yom Bond tarutot pm=W agabot tbs=paFu w 11" V16
liaased Svpanisar. 71e homeowwer acing as sm rvlsar b elllaasfe�eespewSfl� ,
To emus that the ltoroeowrrer is fuib swan ct hMcr-mvpomlbWdes,rump oomramddes new m rs
of the peredl appliadm Oat the bcmeowna ca ter that behhe mtdosm=is the neapensbuun eta
aapavboL Yoo mq cane to amend and adopt oft a tmmfacnVAwdan fn vas la yatr oommmlR
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Salem Historical Commission
120 WASHINGTON STREET,SALEM, MASSACHUSETTS 01970
(978)745-9595 EXT 311 FAX(978)740-0404
CERTIFICATE OF APPROPRIATENESS
It is hereby certified that the Salem Historical Commission has determined that the proposed:
❑ Construction 01 Moving
❑ Reconstruction )Er- Alteration
0 Demolition ❑ Painting
❑ Signage ❑ Other work
as described below will be appropriate to the preservation of said Historic District, as per the requirements set
forth in the Historic District's Act(M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance.
District: McIntire
Address of Property: 164 Federal Street
Name of Record Owner: Donna& Peter Bimbot l
Description of Work Proposed:
Lengthen rear of garage toward Bridge Street by 10 feet, keeping existing height of shed roof, matching existing
siding, cornerboards, trim,foundation and paint
Dated: July 7, 2005 SALEM HISTORICAL COMMISSION
By: �4WW4
The homeowner has the option not to commence the work(unless it relates to resolving an outstanding
violation). All work commenced must be completed within one year from this date unless otherwise indicated.
THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of
Buildings (or any other necessary permits or approvals)prior to commencing work.,