13 HAWTHORNE BLVD - BUILDING INSPECTION (002) 44--"SWOST-DEf UEf APPROVED BY T44E
,=p,ECTDj3_ PWRI T_ . .PERMIT .B,EING GRANTED
CITY OF SALEM
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No. 3 1 (—'LfJoi Date
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�qfC/MINC�y��
Is Property Located in Location of
the Historic District? Yes—No Building 13 Hawthorne Blvc
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:
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 Archdiocese of Boston
Address & Phone 617-746-5669 )
Architect's Name NA
Address & Phone j )
Mechanics Name William M. Fallon of BWK Construction Co, . Inc. z
Address & Phone 14 North Main Street ( g7g) 777_nrn7
Middleton, MA 01949
What is the purpose of building? Repairs from water damage
Material of building? Brick If a dwelling, for how many families?
Will building conform to law? YeS Asbestos? NA
Estimated cost $ 70, 000.00 City License # N�A State License # CS 028716
t Lome Improvement
Lic
. / NA
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X Signatur of Applicant
(:�jc 31-5 ( SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
Repair and replace carpet, drywall, paint, check P1pntriral
replace flush valves on toilets and urinals.
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
7P�P• ASS
LOCATION_
/ 3 A4 Ite
PERMIT GRANTED
AP V'D
f4--
INSPECTOR OF BUILDINGS .
i
Y OF ,SALEM. MA5 -
3 PUSU,7, PROCtERTY DEPARTMENT
• • 120 )NASHINGTON STREET, 3RD FLOOR
• y SALEM,MA 01970
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TEL. (978)745-9595 EXT. 380
FAX (978) 740-9846
;TANLEY 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.
The debris will be dispose dofat: Wood Recycling Farm Ave peabody, MA
Location of Facility
23 September 2003
Signature of Permit Applicant Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
William M. . Fallon
Name of permit Applicant
BWK Construction Co, Inc.
Firm Name,if any
14 North Main Street Middleton, MA 01949
Address, City & St
ate
The above statute requires that debris from the demolition,renovation,rehab ns o t disposal
er
alteration of building or structure be disposed in a properly-licensed solid-waste sp
facility as defined by MGL GM, S 150A, and the building permits or licenses are to
indicate the location of the facility.