57R GROVE ST - BUILDING INSPECTION IL
-ft*NS Mill T-BE fiL-E� APPROVED BY T44E
UNSPECTEDR PMDR TD A PERMIT BEWG GRANTED
CITY OF SALEM
No. Date 6 - 3 U - o Y
l6 � r.
7 �iy�n Is 0) Ward
s� �rmNE Zoning District
Is Property Located in Location of
the Historic District? Yes—No Building SS7 e 6 /2uVi-5r
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other: It'iA-LL.
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 NA'W-D 6 12 EWAIA-A/
Address & Phone 70 3 1,1,A y d 1U s7, 2-6 S
Architect's Name
Address & Phone ( )
Mechanics Name
Address & Phone ( )
What is the purpose of building?
Material of building? if a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost 3 U 0 0 City License# State License #
Home Improvement `�
J 1 Lic. i;1 J Sig, ature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
/5 Ui e. ID /d&7w/it//etl 6 w Alt- w/ns Cl-AN/ 725' ,r7yr✓r3
✓,-rV&-ot/ Ply MvoPeW-rY Ajr- 16S MI7-JVA) An(O 07' 142oOePz/ry
.47- T7 R. G-910 vs- ST.
MAIL PERMIT TO: /0 S MA1 Al r/'• rSA( 6-ri c)1)7 0
,t
No.
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
7l Lw ,9
APP ",D
INSPECTOR OP BUILDIN
I
CITY OF SAUX
BUIMINGDEPAPTMM
HONMOWNEItLICENSEE menoi;
Plcax Priv
DATE
IOBIOCATION
Hol�owr>Fuu 165 ll ks'Own) V7
ADDRESS
H 97,4 2`1Y 9i63
TE»M
PRESENTMAIIW.GADORES! S<I
oti of"hmneow•mere was emc ded to include owuev ow=pled dwel6ap dT9M0
The curt less aempti bete wbo does not posses t
Vnits a leas and m a11ow Sufi bomeowttaa to engage tin iadividml. .
b'ecMe,.pruvided thin fin owtser act as supot•vbw-
DEFi CTIONOFHOBvZOWMe M is
Person(s)who owns a pa ctl of land on wbieh bs/she resides or intends to reside,on whkb k
intended to be,a one]o two family dwelling,anadmd w detached strucnna D=cNM7 =be���
farm stnueaaes.A paw nso
n wbo eovets more than one home In a two-y PVW sds11
a boatevwva. Sufi`hwwov',nc ' shall subnm to the Building Offietal.tin a form atzq*tk to*A
Building OMeA that brAhc be nuponstbIt I*all:»fi wort ptzforsned tinder the building pe>radL
The undtasigned-bomeowrvd assumes respons''bUM lot comply whb the Stale B931 tg Code toad
outer applicable goes by-laws.Tula>ndnVbSGM
The udenignrd"hon'eowttd'=dfm that WAc undas'srds the City of Sak m Buildng Deparoot.
minimum Wspcnlon pmecdura and negtpreuteaas and that Nshe will comply witb said Peooedures old
HON>EOWNER'S SIGNATURE
APPROVAL OF BUILDING INSPECTOR
Sce otba sdc for sou code
II __
At
HOMEOWNER'S EXEMPTION
The cods states that 'say houuowmr performing wmk fa which a budding permit is required sball W
exempt from the provisions of this section (Section 3091d—lictosiog of Construction Superv6oso;
Provided that is a homeowner engaia a person(s)fOr hire w do.such work that such hometywou chap apt
Y sttpavisa�'
Mara bomeownen who use this exemption arc unaware that they an-sFambg the ides are
supervisor(see Appcodis Q,Rula and Reguistioos for liceosiog Coostroetba Supervisors,Seeliaa
.2.14 This tact of awareness ollat nsahs in serious probkms,pardeabAy wbea rite hermeow=bbw
u jk=sed persom in this case your Board cwmot proceed agabot the mtlieeused person as It wouid Vft
licensed Supervisor. 71pa boasearoer acting as supervisor Its ahiaaste(y r Sr nsbi%
To cttsttra that the homeowner is folly aware of hi/her re3ponslbi5tles,marry eomrntaddes require;as past
of the permil application,that the homeowner ccrdt that he/she undastan is the reapms%Ma of
Supcnisor. YOU may Care to amend and adopt such a forntlocnV=tia►for the is yom eommOdW,
JOB C n h a n HOBBS ENDEAVOUR CORPORATION
34 Rockland Street SHEET NO. OF
Swampscott,Massachusetts 01907 CALCULATED BY DATE
781.581.2454 978.744.4646 L 31 ` 04-
CHECKED BY DATE
fl ✓/ f
SCALE
f 5 8 ] ] B ] 2 ] a 5 I ] ] ] 0 1 3 ] < 6 1 0 3 5 B ] 0
12 � B ]
m _....: ...... ,
I
roe/ f y .o.ds
3r Oraers
x :
ce.
_... Tm1 fi✓/,G n ...... PG/.....✓, VG r_f°.Ben/ _ ]
.. .
B
.
B
� k 5
J
� 2
_
n 0
be iv I
m ... ...i
.�. 6 FAA?3hD r
„ .._ .._. _L .
_ N0.20763
a
lfl Ce 912E A)IW 926 ,2 GS- 28 Y 7