7 LAWRENCE ST - BUILDING INSPECTION (3) l
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CITY OF SALEM
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Permit to: A BUI M Pl MIR APPLI CATION FOR:
Palo wtlmw r apply) Roof. Reroof, Wall Siding, Canst W Do* Shad. Pool,
RepaiN willsi , Outer:
PLEASE PILL OUT LAmL.Y a OOYPL UELY TO AVOW DOLAVS fill Pllll) rfr0
TO THE INSPECTOR OF SUILDINOS: '
The / hereby applies for(a� permit to build a000rditto tha.toMowkig
Ow Ws Name e f(C� 1
Addnns a Phan. Wet-c,-j k-c-t-t G
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Addmas A Phans
Madienics Name
Address A Phone ( 1
whr r e.puPM of bu~
mm"d blrang4 e•drweYq,for how m,ntr 0111aN7
WE bd"conform 10 law?
Eee11111ed QOr �0 Ca/LJom10• alert 1
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STANLEYJ.U§DVICZ, .ft. - --- - --- -
MAYON
DISPOSAL OF DEW AFFIDAVIT
b aaoordaooe with the povidama of MC$,c 4%SK I aclmawlWp bat r a omdiom
of B ni ft P I ../ debris r oft am the omwacdom udit
pwmW by this Bm'1dioS Paaou"be&VwW of is a pope*lic=W aoii6+wmb
digpowl ANO7',as&dtmd by)AX c DL SIX&
Mw dab&wM be dLpm d of at 5 6A-j . „c e
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side of ApplicM Doe
FLUYconq)lftdwfDMmbSOULASEPPRM CLEA iose®a000:
er Ile Idc2
Name otPeaaait Appliaot
1%=Nam%if moW
A&W%City A Stab
Mw above atatnb aegr h=that debris from the d=Ndc w fuwvadoo,mb&or O&W
aitaadca ofbaaO ft or*act=be disposed in a popaly-lioenaed aoVd-waeb dirpoaai
AcTity n dedaed by MOL cUL SlSK sad the buOdmS panmita a licenser sae to
indicate 6e badm of the Lc ft.
`. CITY OF SALEM
BlJimmi DEPARTMENT
HOMEOWNER LICENSE E)MOM014
irksa NO
DA78`B -lL D '-( c
]OB LOCATION � �C(,'u•f^�ttC � S
• HO&IEOw)P.R
ADORES}
TELEPHate
PRESENT MARWO ADDRESS
The cmIm V=Puao of-JOB eo.wc r was uuDdcd w b=lude m+acF-oCC pwo dwgn:v of A WO
t)nln erle,a.nd to allow such ,toega�m bdfiidu�llor hbe who des as poves. .
ad as mptrvbw.
DEFR4rjONOFHOMEOWN= or b
Pcnoo(s)wbo owns s peed of land on wWch bclshe resides of buends to reside.an wild tan k
imeadW to bc,s one to two famUy dwcUin&snadwd or dcuds sw d cnm 1 M t o dow
farm svacnoet A perm who con�svoen nwre thin a=home bl a two- _stm
mumowme
Bm7diq Off s aw+d WOw br.=pombk w au xg&woo*ppobr�mda t a bn°diq pam L
The midcsipW-bemeowne amvm responsUft fcT camplb=wkhtdse state I nOndbi;Code m d
other appgcabk gas by-bmA6 rota snd rep►lsda &
The mW,,.p d-b.wog ned•ecrrfm that hdit mr-lcnands sire CIW of Salem Bedf g
minimmn bdpesvon pmcsdmo and tcgldreawms and that hlshe will campv with said pcoedtmes ad
HOMEOWNER'S S1GP(A
APPROVAL OF BLMMING IWSPHCTOR ti
See otba side for sate cede
HOMEOWNER'S EXEMYnON-
The code suta 9= 'Fq bomeowna puformin work lot wWcb a ba a*permit Is gabed stall In
cumo Lvm the pvm3crm of tbb serdon (Section 30pa 1-33assins of Comneaed"sopa vitssa
Provided to is a homeowna emMu p person(s)for hire to do.s»ch wWo sbat AxIl bmwowaa dates sal
ss supayisa�+
Mara bomeowmess wbo use ibis exemption are ivmwate tbat they are assumtup the rVousibmala d� -
super Asm(ace Appendix Q,Roln and 7tegulstioss for l.ictosioj Cousinwaos soper+%fta,see"
.2-251 Ibis lack of swannem man restdts in«riots pkoblcmt,pardeulary When dw hoseeowaa bk
urilksased Pena= In this can yom Board cam of proceed apl=the museerned Pa4m to it would Tft
lkcnsed S>tpa►isa The bosoeo++acr aekio=as apetvltor is umnst*. tsstoosll!k
To encase tint the homeowner is fully swam of hvba mponsibi8des,rosrp eonaamddes tequK-d pal
of drc pumil application,that the honmwner ecrdty that hemm mkdosurdt the nspmsibmmn eta
supmisa You msy can to WTMW and adopt suit a lorm/oukificadon In not in your eommmuft,