39 LINDEN ST - BUILDING INSPECTION What is the current use of the Building?
U l�t�c ` c�pnt �
7 i/p �, ._ If dwelling,how many units?
Material of Building? y� 5 Asbestos?
Will die Building Conform to Law?
Architect's Name ( )
Address and Photo
Meahank:s Narm
Address and Pho"
Construction Supervisors UCenSe ! HiC Registration M
Estimated Cost of Proled$ °Q 0 Pem^K as Caleulatlom
Permit Fee= Estimated Cost X$7/$1000 Reside"
Eallmated Cost X$11!$1000 Commercial
AnAdditional$5.00 is added as an
AdrminWmdve 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 stated
specifications. Signed under penalty of perjury
Date
� I
01 fV �
e-
iD��=off
jl, 61,1,71 CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
viiaw n"Dau:ou.
MAYM 120 WAMW W W Sn M•SMEK MAWCHLSEM 01970
TF.L 978.745.9595*FAX 978.740-9&4
HOMEOWNER LICENSE EXEMPTION
Please Print
Date
Job Location
Home Owner Address
Home Owner Telephone
Present Mailing Address
The current exemption of"Homeowners"was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who,does not possess a license,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on
which there is, or is intended to be, a one or two family dwellin& attached or detached
structures accessory to such use and/or farm structures. A person who constructs more
than one home in a two year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official,on a form acceptable to the Building
Official, that he/she be responsible for all such work performed under the Building
Permit.
The undersigned "homeowne► 'assumes responsibility for compliance with the State
Building Code and other applicable by-laws and regulations.
The undersigned "homeowner"certifies that he/she understands the City of Salem
Building Department minimum inspection procedures and requirements and that he/she
will comply with said procedures and requirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING INSPECTOR
See other side for state code
°.� CITY OF SALEM
PUBLIC PROPRERTY
DEPARTMENT
�SALF.M. S1.Ui. ChL.iLf1S0191Z
TF.1;978-745.9595 •F.+-K:978-74G9846
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5
Debris, and the provisions ofMGL c 40, S 54;
Building Permit # .-__ .— 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
111, S 1.50A.
The debris will be transported by:
(name of hauler)
The debris will be disposed of in
(name of facility)
oftacihto
s _iatura of panni[applicant
EIT7tOF&AL
PUBLIC PROPERTY
DEPARI'�IE►�iT
ni..mFxsr o•��
�Urae 130 WMMNanw btn F=& '
�3k YnssAas:setn 01970
74i 979-74s-g b•Ree M140.9W
APPLICATION FOR THE REPAIR. WMIMY A'Wffd%N. CONSTRUCTION.,
DEMOLITION. OR CHANGE OF USE OR OCCirntCy. FOR ANY EXISTING
STRUCTURE OR BUILDIN .
1.0 SITE INFORMATION "
Location Now Building:
Property Address:- -
Property b bested in e:C"Grvatlon Area YIN Hlstarb District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land '
Name: '� L a (o✓
Address: 3 5�--
.S /'1 Q/r9 ) t�
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN El(ISIIN3 BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (s0 Renovated
construction or renovation
of existing building I Newt
Sdd Description of Proposed Work..
fa
Mail Permit to: