19 LARCHMONT RD - BUILDING INSPECTION State LIc #015544 � �
City of- Salem Lic #947 DATE. DDj 5
Cit ar�m,
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building
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Building Permit Application For:
YCircle whichever applies) Roof, Reroof, Install Sidin ct Deck, Shed, Pool
Addition, Alteratio epav/Replac Foundation Only, Wrecking
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:
Owners Name: Contractor:_ 4gy) y7
Street_ 19 LcyCyt,v 0-r),f4�[City � Street g?Z 36),vn1,V 2S1'City L Urn ('e
State,6ije..- Phone M-0)) 7y11--3y 11 State Phone(78/) 313 q— Cp 9/9
Architect: k/DA/C City of Salem Lich_ 9 Z-/!!z
Street City State Lic# 0/ S _y B1P#
State Phone ( ) Homeowners Exempt Form_yes_no
i Structure: (please ci Single Family Multi Family# Other
Estimated Cost of job S r'tyl
Will building confirm t¢jaw?_ . V s no .
Asbestos? es V 00
Description of work to be done:_r s rn o- 2.,or t r S 4- t/v1y�
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C)r 0 t-tt_, lZalu ) Kr j-,- o y-) COUAfer JF p S S QJn pa �
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Drawings Submitt !_yes_2 no Mail Permit to:
n
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Signature of Application, SI ED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE--,COMPLETED WITHIN SIX (6) MONTHS OF PERMIT ISSUED DATE
Department use only: Permit#IZkbb0{ Zoning Map/Lot
Permit fee$ (A<- 3 5
COHMENTS:
No. 12-1— z —
APPLICATION FOR
LOCATION
1 -2
PEFlMIT GRANTED
APPROVfp 4
INSPECTOP OF BUILDINGS
CERTIFICATE OF OCCUPAFCY
YES
• FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT
In compliance with the provision of Section 113.3 of the Massachusetts -
State Building Code, and under guidelines agreed upon by the Salem Bldg.
Inspector and the Salem Fire Chief, the applicant for a building permit
shall obtain the Certificate of approval and stamped plan approval from
the Salem Fire Prevention Bureau.
The applicant shall submit this application with three (3) sets of plans,
drawn in sufficiant clarity, to obtain stamped approval of the Salem Fire
Department. This applies for all new construction, substantial alterations,
change of use/or occupancy, and any other approvals required by the Mass.
General Laws, and the Salem Fire Code.
EXCEPTION: Plans will not be required for structual work when the
proposed work to be performed under the building permit
will not, in the opinion of the building inspector, require
a plan to show the nature and charactor .of ,the work to be
performed.
NOTICE: Plans are required for fire suppression systems, fire alarm
systems, tank installations, and Fire Code requirements.
The. Salem Fire Prevention Bureau has according to law` (10)
tens working days to review and reutrn stamped plans.
Sub-contractors' may .also be required to file dndiv dual'
applications .for a Fire Department Certificate :of Approval
for the''area of their work. Such Sub-contractors shall file
an application to Install with the Fire prevention bureau prior
to commencing any work for those areas applicable.
t"DPWITMENT FOR FINAL `
' -
APPOINTMENT FOR FINAL`
INSPECTION MUST BE
MADE AT LEAST ONE WEEK INSPECTION MUST BE
AHEAD.......-..
-: __. MADE AT,LEAST ONE WEEK
AHEAD
}�PPOINTMENT,FOR,FINAL
,INSPECTION MUST.BE'
MADE AT LEAST.ONE!WEEK..
^HEAD -..: