11 FREEMAN RD - BUILDING INSPECTION (2) PtW**"ir gEfK*g4WD APPROVED BY TW
JdSPfCs1Mf PWR TDA.PEMIT BEING GRANTED
CITY OF_SALEM
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Is PwpMty foamed in
the Cm erAWn Am? YN NO
BIALDWG PERMIT APPLICATION FOR:
Permit to:
(Ci(cle whict►ever apply) Root nataU Sidin Construct Deck, Shed. Pool.
tiler' r 1/1� PL-Aa)lQX
PLEASE FILL OUT LEGIBLY i COMPLETELY TO AVOID DELAYS W PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The underagned hereby applies for a pemttt to build axording to the following
sm"bons-
Ownses Name' / / �CooY
Address A Phone '� OAA) 6a f 9 -91 )-V ySa3 s
Architect's Name
Address & Phone
Mechsnics Name PW0' 1-i ZJ
Address 6 Phone U� t�� ) o�y/ 3 5-a
YMW a IM PAPaa it WNWW
mmm of Eid q? �yo,o CeA U a ammG.for how amy h W"?
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Stgn"m of Apwwr
SONED CINDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
&Iffel A&d1W Ael"W F 1 ),�,
MAIL PERMIT TO:
J
No.
APPLICATION FOR
PEAUT TO
�1
LOCATION
PERMIT GRANTED
APP OVfD
OR OF UIUl NGS
CITY OR $ALSM9 MASSACHYltTTS
PUBLIC PROP[RTV Oth•ARTMttrT
120 VAUW#0e10s sT0aa7. 300 noes
Sftgu. m"aAmlusam 01676
T[LaNWNp 670-748.9804 UT. 340
PAM 978-740•9"4
Iding
to accords= with the Provisions of MGL,c4O 3 J4r a condition of your
Bull, Pbrmit is that the debris re"ldnj fe�om Ibis worlt shall be
Of in a PCOPedy licensed solid wasts'disposal facility as defined by M
O pter UL 3150 A.
The debris will be diap W of hL
4• aAcaton o(Fac Hty)
Alpa
Ithtre of Applicant
Date
BOARD OF BUILD ING REGULATIONS
License: CONSTRUCTION SUPERVISOR``
Numb6i�,CSr t' 089011 a iflw `
Birt,hdate t/7911969=.,. ' E
ExxPP(rea TT/19 00& +- 1 Tr no P
: 89011 ;
ResGieted
GERMAN GOI&LEj3 d
tic 21 BAKER ST a
i „ t YNN,;MA d1902 ; /r
Commissioner- -_ r
' Bo3fa0ile a� � 1100 Ol 8e 8f<9`
HOME IMPROVEMENT CONTRACTOR
on: 150540
Reg
41612008
Ype DBAlug
; -
s
_ G&G CONSTRUCTION_AND PAINTING
GERMAN GONZALEZ'`:
13 SEW ALL ST f Deputy.4Anjuistrator
LYNN,MA 01902 r _ _
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The Dopaumownses addaest:telepbooe and tilt samba wealth o(Massachusetts
TbeDqattmant dIndustrial Acctdaota
OZa of Iavesdpdod
600 WL*betoa Stt'ed
Bostod,MA 02111
Tel. 4 617-72749�406 of n49 7-MASSAFE
Fax 0
gcvised 3-2"S www.mm.gov/dia