0041 FORT AVE - BUILDING INSPECTION 0044 FORT AVENUE 245-2004
GIS#: 1436 COMMONWEALTH OF MASSACHUSETTS
M p:` 42 CITY OF SALEM
Block: Y
Lot: 0087
Category: DEMO
Permit 4, „, 245-2004 r BUILDING PERMIT
Project# JS-2004-0362
IEst. Cost: $2,000.00
IFee: $20.00 "
Const. Class PERMISSION IS HEREBY GRANTED TO:
Use Group:_ I Contractor: License:
Lot Size(sq:ft.): 7000 jFleet Environmental Services LLc
Zoning: RI Owner: SOUTH ESSEX SEWERAGE DISTRICT
Units Gained: Applicant: SOUTH ESSEX SEWERAGE DISTRICT
units Lost: AT: 0041 FORT AVENUE
Dig Safe#:
ISSUED ON: I I-Sep-2003 AMENDED ON. EXPIRES ON..08-Mar-2003
TO PERFORM THE FOLLOWING WORK:
245-2004 DEMO Demolish a 400' sf brick building. Pump house. Contractor lic AC00120. Steven Durrell. Tjs
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Buildin
Underground: Underground: - Underground: Excavation:
Service: Meter: Footings:
Rough: Rough: Rough: Foundation:
Final: Final: Final: Rough Frame:
Fireplace/Chimney:
D.P.W. Fire Health
Insulation:
Meter: Oil:
Final:
House# Smoke:
Water: Alarm: Treasury:
Sewer: Sprinklers:
THIS PERMIT MAY REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS
RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Date Paid: Check No: Amount:
DEMOLITION REC-2004-000379 08-Sep-03 105424 $20.00
GcoTMS®2003 Des Lauriers Municipal Solutions,Inc.
FROM :BU1LDIt1GDEPA'R27ME11T FAX NO. :5767409B46 Aug. e1 2a0S 12:41PM F2
. .
v S
(flit of 3ttlem, Mass ar4us etts
i aw
!i public PropertU Department
Vuilafng Mcpartment
cone tizlem P,ren
509-74i-9595 rut. 39a
Leo E. Tremblay
Director of Public Property
Inspector of Building
Zoning Enforcement Officer
Section 116.0
DEMOLITION OF STRUCTURES
Structures over fifty (50) years old met have approval of the
SAL&4 HISTORICAL COMMISSION .
UTILITY DISCONNECTIONS REQUIRED__
Authorized ent
/ Date of Disconnection
WATER: 3 d i .70 PPI L cA,6
ELECTRICAL: Lp /Lc-tom O �alJ=o3
CAR: �U ( YQj2/I C,4f3
dl,<, _
SEWER:
DIG SAFE NUMBER:
PEST CONTROL:
***DOCUMENTATION OF ALI. THE ABOVE MUST RE ATTACEED BEFORE***
♦* PERMIT CAN EE ISSUDI *e
Fee for Demolition: ;5.00 for application plus $2.00 per 100 square ft.
gross area, minimum ;15.00
�.. -�
James .. Brennan,
Salem Fire Department
j
(6/761
��oxrnr OF SALEM. MASSACHUSET?S
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
1, an
SALEM,MAOI 970
TFL. (978)745-9595 EXT. 380
FAX (976) 740-9846 .
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,S34,I aclmowledge 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.
E i ��S iC�C_ �VOC1n.TW
The debris will be disposed of at: C�
Location of Facility
j --1
Signature of Permit Applicant ate
FULLY complete the following information.
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
Firm Name,if any 1J
1r_, — l) U O 1', A-\.1-3z
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 clIl, S 150A, and the building permits or licenses are to
indicate the location of the facility.
f
L �0 ,
iPL*MSfiVHiST-MfIL{ fJfl A?PROVED BY T44E
% k` LwsPFCTD-R PFwa TP`A.PEAMIT 13,EWG GRANTED
CITY OF SALEM
L45—�No. �� �v" '.� �\' Date
•a�• �' pis
Is Property Located In Location of "
the Historic District? Yes_No Building
Is Property Located in �
the Conservation Area? Yes_No�l
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other: u LIT�LO
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:
Owner's Name ED ec_-T)'Ll C 90 0Y, o 0, (,
Address & Phone
Architect's Name
Address & Phone !
Mechanics Name
Address & Phone ( )
What is the purpose of building? 'RU:M
Material of building? 3 rt_l L,L< If a dwelling,for how many families?
Will building conform to law? Asbestos? \/,o—
Estimated
,2 /� t �1
Estimated cost d X)h G�City License# N A State cense # A• e C'C7 I ci C�
C)5t4 HomeImprovement
Lic. i
MooSignat a of Applican
2 Q SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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MAIL PERMIT T0: 75 VOVt� All-e— Rot b c k , W4
Sl-� A�02�ss
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No. 2—q Ll ZCSp�
APPLICATION FOR
PERMIT TO
Din aoxao
LOCATION_
7'
PERMIT GRANTED
APP.ROVFD
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INSPECTOR OF BUILDINGS
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