0008 - 0010 FRANKLIN ST - BUILDING INSPECTION 1 t
e
The Commonwealth of Massachusetts
Department of Public Safety
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fl l7 City of Salem
U Building Permit Application for any Building other than a 1- or 2-Family Dwelling
(rhis Swctiun For Official Use Onlv)
8u lding Prrmt Numlxr: Datr Applied: Building Inspector:
SECTION 1: LOCATION (Please indicate Block 0 and Lot a for locations for which a street address is not available)
22t --yo 1�747 /4 sT lrg1
.No. and Street Cih• /Town Zip Gxir Name of Budding(it applicable)
SECTION 2:PROPOSED WORK
If New Construchun check here O or check all that apply in the two rows below
Existing Building Cl Repair O I Alteratiun O 1 Addition O 1 Oemulition (Please fill out and submit Appendix 1)
ChengeofUse ❑ Change of Occupancy O Other O Specify:
Are building plans and/ur constructiun documents bring supplied as part of this permit application? Yes ❑ No ❑
Is an Independent Structural Engineering Peer Review required? Yes O No O
Brief Description of Proposed Work:
aNI DLZI
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDMON,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Evaluation is enclosed(See 780 CMR 3402.0) O
Existing Use Group(s): Proposed Use Group(s): r
Existing Hazard Index 780 CMR 34: Proposed Hazard Index 7B0 CMR 34:
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) -
Total Area(.sq. ft.)and Total Height(It.)
SECTION 3s USE GROUP(Check as a [I able) -
A.- Assembly A-1 O A-2r O A-2nc O A-3 O A4 O A-5 O B: Business O E: Educational ❑
F: Facto F-1 ❑ F2 D H: Hish Hazard H-1 O H-2 O H-3 O H-4 O H-5❑
1: Institutional I-1 O 1.2❑ 1-3 O 14 O M= Mercantile O R: Residential R-10 R-2 O R-3 O R4❑
S: Storage S•1 O S-2 ❑ U: Utility O Special Use O and lease describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check as Applicable)
IA 111 IIA ❑ IIBO IIIAO 11180 IVO VAO VBO
SECTION 7:SITE INFORMATION (refer to 71L0 CMR 111.0 for details on each item)
tVater Supply: Flood Zone Information: 5ewage Disposal: Trench Permit Debris Removal:
,\ trench will not be Lsa•n.rd Uisia+.J Site❑
Pubbc O O'hvck d uutadv 19.+...1 Lona•❑ Indicate muntcip.il ❑ re+ usratl O ur trench .L . +
I'nvate❑ orindvnttf�-Lune: -oron,nr.r.tvm ❑ l -
permit i,enclti ad O
ftailroad right-of-way: Hazards to Air.Navigation: t1a 11n1. n. l �'.mm -non H.•.�... 1'r.�.r••:
\nt \pphcab(v❑ I.�trucwn•+.ithm.nrport.,pi'n each area' I.their re,iew completed.'
a l n+vaq In 11ud.1 cncL+vvl ❑ \v-❑ ur Xo❑ Ye.❑ \.. ❑
SECTION 8:CONTENT OF CERTIFICA rE OF OCCUPANCY
I dmon 11, ('.,,ft-. ---- O-v l�roupt.r. r\pvo,L',o,trucuon: lkcttpant Load i,vr I L+a
l iv- iha•buddu+q contom,in FinnAlcr tip.tcm` ,ipvcial'>upohiion,