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7 HILLSIDE - BUILDING INSPECTION ' 1' � . 10 � . . ; C�� 33 '' . ��1.5 Oh l�'19 nG�'G�'J� I� �L�QS�iiS��EffL{-�-ifJD APWR01iED $Y ��iE,/ I ,U�S,P.�J'�1J� ,PF,i�b1R IP.A.PERMIT.B,EWG GRANTED CITY OF SALEM I' -I `1 UL \' �P�� � No. Z.� n -7 Q Q c`t ..� *'Zs,� Date � � ''. ,5 :�� .3�:i(:, k�. , �\�l`i�! . • �I O > �f t . : �`�MINe�y . ' Is PropeAy Located in Location of the Historic District? Yes_No� Building � ' �(� 5,�� Is Property Located in � the Conservation Area? Yes_No_ BUILDING PERMIT APPLICATION FOR: ' Permit ta � , (Circle whichever apply) Roof, eroo �4ns���g, Construct Deck, Shed, Pool, � Repaid eplace;Other. �oY�!M r �' � PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING 5 �0 , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications - owner's Name I�t ✓,'� � . � 1,�/_,�.�/r�YL-L Address & Phone ������/9'� • 5 � ' ��� ���' � l� � ArchitecYs Name !7/✓� Address & Phone ( 1 Mechanics Name �ti, �-..-r�/I/'� 4 Address & Phone /f�l n�� rQi� .F�� �� �-s.�� `" ��J� , What is the purpose of building7 � �1 � ��7 r l/�'l 2` /� Material ot building? l�/� If a dwelling,tor how many families? � Witl building confortn to law? f Asbestos? ,�t/ �� EsUmeted cost �� City License # N p' State License � �.� 7 O Home Improvement $IOl °�° r.��. � O � � LK 3 ' ` Sign ture f pplicant '� SIGNED UNDER THE PENALTY � OF PERJURY OESCRIPTION OF WORK TO BE DONE � � � i7 r✓r'�✓ J�� �r�1 r� l' � � i �n%� (�r `����..�f 5 �v� i2 vo w� , � 1 ; � MAIL PERMIT TO: � • ; _� � �t , No. 2� � -Z��� APPLICATION FOR PERM(T TO Co�vS���� 5/��Pti1 � ' . �.�..er/.. lj� y°�� LOCATION. 7 f��l�s�;,��r �� , PERMIT GRANTED ; o� �C? T APP�OV�D —,,,.. /'i (J��i l o.. INSPECT OG��II�GS � � ; � � � ::� ; . . �_. .. __ . _. . . ., b�.R . . _ . _ i� . .,_ , ' ..:�.,'• �� : .. --5. _ __ �� . . �4 t � ` �� ��� � . . ... � � -.: . . .�. . . � �—���) • � -� / /�.y L/4� �i� • �� . <</ ' . _ ?t— i��. .. _ ._ . . _ , . - _."� . .... . .�. . . �-- / ' ��{ � � -� �� . ���r a��v � .,� /6'�� a N G �o(c.vi. �� e • ��0 1'"r'" , 2 x �� � '' G �J k _�# � o � � lt ��u�r��¢ s/��/� ,f, ,- _ ��. ax�,�5 Q - ; _ S°�✓�"� v/ Sc�l S ' r 'r� �J� p �'�� aoo3 a s�o L/S GG�% �y�o/6 0` " — .. __ :�CiQ • � �t� �,. „n�a�l by€tny t�{�..�„7" •. i ' �— SCJ � �-.. `t_3o ,, ' X s �,: a- �»:iariictao� � .;�p_ , �i) � "Zt�.�... S� ---- --- R-/3 ',=_�. -,��t?N�i7�L! ���r. fi ' � 9 --.-�. 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' �.�.r�_�___....�....�....,,.....__�-.. � ......_..__�._..�.. .....__._._�___......_._..._.._ �t\ 1Pf � ,' ' . . , , � . �.�....� , -"^n� .r..�.. . � � . . . .., � . . _ . . ,' ,�' .� . . : -�-A.4-..�.-. . �. ,;... _ . „ `, . . . , . . .. . f � , i ' � � i � I I , . � OVU. . � I � � �. � , ��� , �� + .. ...���;�,�w� , ' ' ' ' � t � � � � �' . i �_ y.' "'� � a I ..;�� � I � 1 � i � i � � , �. . � � � �^ , � �\" — ���, ,,,'o � � 4 N � ; � ! _.y. , ,, I �-_, �_. : `^ f A � V I M1 � 7^ + ' � O i � � �.. 'C � � \ ' ! � O � � � � Ili I1 I ............. .............. a � � ' , �.'; o i ' °' �. � �._.._. ._ , . __� �-� " �_--- � ( S Y � �� � � � � M � � � � , � � ' \` � �� I n ! I C p � � � �I � � � � ', wa ' � �` 4 } I C � � i h j � � Ky � _ '1 ♦ •+l� L.�......._»_. ..�"__ ` . . � _ �`�.:.�L� w���=._.__� ._: ' � � �V �� � � � � a � �, �C x � ,�-..��.a.v!�7"Z��,.� . . , � ' . . : ' �/ �o �_. . f OF �P:LEM. lRF��fa�.nv��- . , -• ` '� PUBLIC PROPERTY DEPARTMENT " • ° 120 WASHINGTON STREET� 3RD FLOOR � '. SALEM,MA 01970 �Sr�� TEL. (978)745-9595 EX7. 380 .� �G,� FAX (978) 740-9846 STANLEY J. USOVICZ, JR. � � � MAYOR DISPOSAL OF DEBRIS AFFIDAVIT ��cordance with the provisions of MGL c 40,534,I acl�owledge that as a condition of Building Permit# ,all debris resulting from the wns��°II�►�ty govemed by this Building Permit shali be disposed of in a properly licensed solid-waste disposal facility,as defined by MGL c III,S150A. . The debris will be disposed of at: .��i)__„__!Y�5//�l�—�'p �`�� �'v c,, ,5�'�jr «f f�. I,ocat►on of Faciltty �� � � � c/ � (� � Si ture of Peimit Applicant � D� FULLY complete the following information. (PLEASE PRINT CLEARL� ���r� /M ��/`�.,/n��L L Name of Permit Applicant Fum Name,if�y � 1 c��-� ���� � G S�-���J'L'1 i� �;y �� Aadre—`,ss, ciry &state The above statute requires that debris from the demolition,renovation,rehab or other alteration of building or s�ucture be disposed in a properly-licensed so�id-waste disposal facility as defined by MGL cIII, S 150A, and tl�e building permits or licenses are to indicate the location of the facility. , -� . ,� � � �— � �o�nmonw�:aLCh o� 111a�eac�at� =t ; ', J.pa,Im.nl e/9ud+i�+t,iaf J"acius�+ S F . boo w�,�,y�.��...f �ameeJ.GmooeY Uo�oa, //lasuchuuw 0�1 /1 Ca-�ss�ona Woricers' CompensaLion Insuranee Affidapit 1. - �i.........�.:�..� . . wich.a principal plau of business as: iu.ris..�✓s�.� do hereby certi(y under the p�ins nnd penaltia of PerjurY. tfia� O I am an employer providing �vorkers' compenzation covenge io� my employea workiaf oe chis job. / � �';�/ G^l r � -�-A/5 , r)C-I�5 �l 7 '7' C7 � n. � Insunnce Compam Poliq Number 1 am a sole propriaor and have no one workini for me�n-� �WarY- () I am � sole propriecor, genenl con:n or or ho em owner (orde one) and have hired the / ' com tnsas�on polities: � � �� .worksrs p �'/ 1 consnaon lisced below who have the llowinq � J 17�a�� 1� 'I�u� ���n�f"rr�_ (1' r�'��� L ..�.r✓� � %-v/ Consnesor Insunn�e Company/Pohq umber Concnaor Insurancc Compamr/Policy liumber Conttaaor Insurance Company/Poliq t�lumber () I am a homeowner performing all the work myself. • I une<rwna wt�cwY o!thi+w�mimi�b�ion+aru0 m t1K Offce ol Imedt�w�u ot ttu DlA la co+erat���°O^����1O�e co.�era�a a� rewrra unoa Seviwi 25A o!MGL 1 S 2 c�n k�E w Nr►nownion of cr6ninm oen�ues corsaont vl 7 fiae el w tei I.SOOAO�n0la oni rears':nxuomment ai.vo m eiri oem�uef in me �orm e(� STO P W ORK ORDER ana� f+�t of S 100.00 a aaY�[+���• Signcd this , �c,� day of �(°� ' -•--.'�=�� �iccrsce/Fcrmit[te building Gep�rcn�enc Licensing board $e{eamens Office !ieafth Dep�nmenc ���� '.��RI�� C��VEr.L,G� it:rC��=:�-�.-.�ICN CALL: � 1 - -�;-�900 X4C= , 40<� apc epo Z7$ � , , K QPQT �T vr � G�oss��U ETO� QQiN� .; � NS � 69,15 � �x � ��QAFE � 1 __ � � h W LoTsN � 1l Q 6606 � 5� 4 � � m � 0 m "y,� y e M } � o P � � gH � 0 7.:33 �-_� . / h tp � � Q 0 � / No. 7, '� � .i PWELG/qlG. . v � � Z � 20�t ' 65.00 � _ �' ;_og�a N! L C s �D E /a vENUE ,� _ __, �����;tt+oF ny,4,,,;���� m r DAVID tiv�\ ��c�i PH���� Plot Plan of Land �� TERENZONI � E ' No.38720 J. 7 Hillside Avenue e Salem, MA . . ,,� ., � .�� � o _� � � ,s,� / ��a] '►.:o:•' Prepazed For: Assessor's Map 15, Part of Lot 406 Kevin ODonnell Existing Lot Coverage: 25%+/- Scale: 1"=20' September,2003 Deed Ref.: Book 13305 Page 571 & L.C.PIan 16595g