27 JAPONICA - BUILDING INSPECTION what is the Current use of the Building?
Material of Building? If dwelling.h how ow many u units?
will the Building Conform to Law? °��
Asbestos? A/
Architect's Name
Address and Phone
Mechanic's Name
Address and Phone
Construction Supervisors License S HIC Registration 0
Estimated Cost of Project i Permit Fee Calculation
Permit Fee$ Estimated Cost X$7/111000 Residential
Estimated Cost X541/i1000Commercial------ ---
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above statedspecifications. Signed under penally of perjury X Gam'
Date 3
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PUBLIC PROPERTY
DEPARTMENT
YuaIMUsr 13RZCLUL
%"NVR 120 WAMUNGMM S MFWr 0 ••••K ,yA=ACHL3LM 01970
TU.97e-74SAS"0 PAZ M740.n"
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION, OR CHANGE OF USE OR OCCUPAN[`Y FOR ANY EXISTING
STRUCTURE OR BUILD
1.0 SITE INFORMATION
Location Name: Building:
__- -- Property Address:--- cou S
'! alem , NLA- 01`70
Property la located Ina; Consavatlon Area YM Hlstut District YM Al
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name: bn art 6-IM 'e Ib
Address: 6-1-7 OIL i C-a 5-Op2f-
S N( 019 7D
Telephone: S-d �73
3.0 COMPLETE THIS SECTION FOR WORK IN EYISM12 BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use Now
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brie[Description of Proposed Work:
Re p la c.e. ex i sfi ng J eck 8-x l(o
----- ---Mail Permit to: ���ec-� : . S d— $►9 vn Or - - - -
FROM :FISHER CONSTRUCTION FAX NO. :16038823457 Aug. 29 2007 08:38PM P2
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CITY OF SALEM
4D PUBLIC PROPRERTY
DEPARTMENT
�t.��•.K I!C W.til ak:.Zs S'RW•3.%U U. .t t'1 a
To:~45-im •F m 9MACr964
Construction Debris Disposat Aftidavit
(required for all demolition and renovation work)
in accordance with the sixth edition of the State Building Code, 7S0 CNIR section 111.5
Debris.and the provisions of MGL c 40.S 54;
Building{ Permit 0 _ . I_ is issued with the condition that the debris resulting from
this work shall be disposed of in a properly licensed waste disposal facility as defined by.MGL c
t 11. S 150A.
The debris will be transported by:
�onC��cY eo �7(7
jilame of haul")
fhe debris will be disposed of in :
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♦ 1j..L LYIC 1f :J(VII`ry:Lq-.1�1J-JC.L.1r
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Board of Building Regsladona and Slandard,
Construction Supmisor License
License: CS 85776
Birthdate: 11/91,978
Expiration: Ijgy2006
Restriction: 00
K NNET FISHER..
710 WEST HOLLIS ST
NASHUA.NH 03062 Commirlioaer
__..___�\-- It�FY'��rFfttlffilYn �31fr7n`: �FLii1'n"J'.hi7i.'t�'
y1 HOME IMPROVEMENT CONTRACTOR
R091stmoOn: 140594
h d Expiration: 11/312007
.Type: DSA
FISHER CONSTRUCTION
KENNETH FISHER
5 HORTON LN.
BILLERICA,MA 01821 Adminim.wr
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