300 HIGHLAND AVE - BUILDING INSPECTION What is the curtest use of the Building?
Material of Building? If dwelling.how many units?
WM tiN Binding Confbrfn to Lavin Asbestos?
AwA t do Name ( 1 —
Addms and Phone
Mechanic's Name
Address and Phor» HIC Rsybtrdbn fl
Canstrr+ctlon Supervisors Licen�s�S
Estimated Cost of Project a� PenNl Fee Cala+letlon
Permit Fee i Estmabd Cod X$7161000 Residential
Es*nsbd Cod X 511/111000 Canwnsrce�---
An Additional$5.00 is added as an
Adminwstive dwjl .
Make sure that all fields am properly and legibly written to avoid delays In processing.
The undersigned does hereby apply for a Building Perm*to build to to above stated
speoftatWo. Signed under penalty of Perjury X A /
Date
o �
s IP
96
City of Safemi Massachuseas
Fire Department
a4mra 48 Lafayette Street
Robert f1!Turner Salem, Massachusetts 01970-3695 ire Prevention
Chief ?e(978-744-12i5 978-744-6990 FaX 978-745-4646 Bureau
978 745-7777
eau
APPLICATION/PERMIT TO ERECT TENTAGE OVER 120 SQUARE FEET IN THE
CITY OF SALEM ACCORDING TO THE MASSACHUSETTS FIRE PREVENTION
REGULATION 527-CMR 19.00, AND THE SALEM FIRE CODE, ART. # 20
FEE $30.00
' CHECK o a 9r,2
APPLICANT:-I'MA-12 Ae--jt ,ej ADDRESS: ZccwC-
CITY: j /I /- t _ _ STATE: 1V ZIP:Ui 5&"-PHONE:
LOCATION OF TENTAGE: 5 GCi I/ifl
OWNER OF PROPERTY ADDRESS:
CITY: STATE: ZIP• PHONE:
INSTALLER/RENTAL CO. OF TENTAGE: /9- A,"M T_ PHONE: W1
ADDRESS: /L) C4;»Mrs gL C,/,- CITY: STATE: IWI�-
ZIP: C/Zc 2e
INDICATE WITH REFERENCE TO PROPERTY LINES AND OTHER BUILDINGS THE LOCATION OF
THE TENTAGE ON THE BACK OF THIS FORM:
MATERIAL USED:
MANUFACTURER:
SIZE OF TENTAGE: ;L-Cl 74-- V l
NAME OF TESTING AGENCY: CC/✓7-c,_( 1 eu%
--------------------------
AGENCY APPROVAL NUMBER: FYj9 Cy ( CERTIFICATE OF FLAME RESISTANCE:
CONDITIONS OF APPROVAL OTHER THAN AS PER FIRE PREVENTION REGULATION:
SALEM BUILDING DEPARTMENT PERMIT NUMBER:
DATE OF ISSUE: SITE INSPECTION DATE: EXPIRATION DATE:
APPROVED BR: TITLE:
FORM t��B (Rev. 8/99)
80B
Gri TUFS�E,ti
PUBLIC PROPERTY
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DEPARTMENT
Kla�r.sti oascaL
wnoa t3D�r y�r•3,uw w+uocsrms o�9ro
TRU M?4&"!!•PAZ m71496%
APPLICATION FOR TIM REPAIR RENOVAIMOWW_ 00
QNSTRUCTION,
DErtOLITION. OR CAANGz OF US! OR OCC[i>s�rtr�v vnn ANY ESQ
- — — vw ry a
MUCTURZ OR BUILDING
1.4 SITE INFORMATION
Location Name: suildirw
PropertyAddrew- 3OU
JI�Ge•� /ham C//
Property Is bestad In a;Canervadw Arse YM HwA to obsId YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land GU /fi� IiLL
Name: c.
Telephone: 2,V1 —C/a
3.0 COMPLETE THIS SECTION FOR WORK IN E)IISIIdQ BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolidon Existing
Approximate year of Area per floor(sf) Renovated
construction or renovation
of existing building New
Met Description of Proposed Work:
TPA �' ��✓ �-P� f- f�'/-r Z h e
�/611U
fiee/ 111110
-- - - — Mail Permit to: ---