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5 LAUREL ST - BUILDING INSPECTION - _ oil. a a3 0 o fil4mull Lacmd h 11rf��Mo S Lf}Ul2�� ST. as Iado w nm,0 -- b pew low"b /l :� MOnaal�aAwrt BULp" p MV APPLIMM Fork Do Ps"Im tok. (Ckw wNolwMr aPPbI PWL �M�MaY� nmu mL OUT LEprLY U©OYN.lmv TO AVOW O�LA,If A pi MOCiN�M4 ` TO THE RGPWM OF W LDW3G MOW aPPbs for a PW" a bldid �� 10 to 1oYawr+p TV* m Owllara NMas Addmn+PhM Anhheat'a Nilm � t Ad*wa L Phony . madmnica Nam f 1 Addim• Phony M1d"d Gd aay y a w law■AV A0 1W rf�q o0d011r,10 Mkt ,�/ A Iola Y 12.�Zcri•� /�' ff ir�a aat CM��• N A a� � � MMTW MALTY OF PWAW DUCFPMM OF MW TO EE DONE V �l�(nCOD!.^ 3P rIDU� — 2— [�� � f sc�Ns (+1 sm MAIL Pf�IT 8E�N f19 d0 g �Lt �1Nr�1O1�Lid . ' ; NOLlYJOr7 - �f1 5'Crt f S'�✓s7/V:a'o n M OLMVAMd �l rr G Q .ON CITY OF SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET. 3RD FLOOR SALEM. MASSACHUSETTS 01970 STANLEY J. USOVICZ. JR. TELEPHONE: 978-745-9593 EXT. 380 MAYOR FAX: 978-740-9846 Salem Building Department Debris Disposal Form In accordance with the provisions of MGL c40 S 54, a condition of your Building Permit is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL Chapter III, S 150 A. The debris will be disposed of in: /�'o�?HSi�C ce�izT wG (Location of Facility)s60RmfsC,aTrRj. /5 Sjfature of Applicant T�o� Date CITY OF SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 wASMIN6TON STREET. 3RO FLOOR SALEM. MASSACHUS" 01970 wwroR STANLEV J. UEOVIC2. JR. TELEPHONE: 978-745-9595 EXT. 380 FAX: 878-740-9846 HOMEOWNE$LIEENS E EXEMPTION Please Prise Date Job Location L f{U =L .7 - Si/zzm M Home Owner Addrm � E Owner Y _ � 1 htphorie 7K s3 S_ � Home , ftesent MailingAddrenR �_ �sLrnP,SHiL�E /�n dwellings t aremppon of"Homeowned"was extended to inchule owner pings of two Units or len and to allow such wed hire who does not possess a license.Provided that the ow*"to engage an individual for as supervisor. DEFMITION OF HOMEOWNER ? w aa)` °� O land(a'which heshe reaides or intends to revide, on there ' 'or is b%a one of two family structures ,r9 to such use aad/or fans elling,after W or detached than one home in a two Year period shall notconsidered a hompason who conettu more/ "homeowner"shall submit to the Building Official.On a form 0wner. Such Officit. that he/she be ponaible for an such work performed undarthe Buildinle to die g7ding PermiThe undersigned`°homeowner"assumes responsibility for compliane with the State Building Code and other applicable by-laws and regulations. The undersigned"homeowner"certifies that hdshe u Building Department minimum i nderstands the City of Salem will comply with said inspection Procedures and requirements and that he/she procedures and requirements HOMEOWNERS SIGNATURE I - A., - APPROVAL OF BUILDING INSPECTOR See other side for state code H011�OW1�iE1tS EXEM�TION wort for which a Building Pamft a 'The Code atata that: "Any Home do I'zons°Wg�on��on lou.1 — or wrini regWred sha11 be ex�Iko provided that a Homeowner salts a person(s)for hire to of suc �such Homeowners shall act as S�sor- are unaware t���e pwftthe Many Homeowners who use this exemptionQj Rules and Regnlaaons for Licensing po�ilities of a S 1 Section 2.15Appendix �of awareness oRm�n�in serious resConstruction S Oi°' hires unlicensed persons. In this case your problems.Particularly when�H P as a would with a licensed Board cannot proceed nsible. Supervisor. The Homeowner acnng ut aware of his/her re bilitiM many To ensure that the Homeowner is fully �t the Homeowner c�fY� communitiesrcq as a part of the Permit Application. . of thin issue a helshe underst�me responsibilities of a SUPS t �od led page such a form cry used by several towns. You may care formlcefification for use in your,commudty n 5 0 0 APPROVED Subject to appreaal 1,y any ci,:z_r suthdrit .haplr�j�r:;cv�ziea. 3 r� F//OCR CITY.of SyA M, i_^: Q TIRE VEZIIT:Crj L. ftJ • � BY= -- 5n.'FE AND F,OE'MON Cr ! Ft'..HRP PRvI'EG IOt rDcVit-- i A '.a.L�TAND INSPE 1ION.FOC ANcE PATTH THE FIRE COM. �NI /� 1� VII b I � 1 f of -- . PAC IC 4 1 r ! --_ i i �I I h ` ^ ro i 7 V n/ o, r • �' �� ► �----1 � � �, I �� ,�: r- i i f I � l r n c� w (/�( N I f3 R s e ine ti'� r l r all 0 - APPROVED— 21A 3--0 E--a;,. 8uWect to approved by any c >:i, // authority.ha j4% .c:cn, 3 f c F(00 / CITY of SA!2 ;i, S a . - PLAN_ , vAPPRGVFD G L'7 . - T.TE AMD CF Pit.: PRU�Enl ON Dnnrc3 C. Ti TI-s:T AtiD INSPECTION,i u�:;d ,� - ANTE WITH THE FIRE CUUE. Sr 'Ic �j VIA POO y n � i r / 2_Gc Zn , I - I �� 1 Gil Lvu Cs ,q Sc