60 LINDEN ST - BUILDING INSPECTION -ft�-WAt4E fiL40411 lG APPROVED BY T44E
ap PECIDB PWOR TD A PEANUT BEING GRANTED
CITY OF SALEM
No.ZLL_1fie Date I�
s: r �.
Is Property Located In Location of
the Historic District? Yes No f i]Aing bO L)M_�F"�
is Property Located In
the Cormrvatlon Area? Yea_No 7
BUILDING PERMIT APPLICATION FOR: i
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, 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
Address & Phone (172) I I ova
Architect's Name
Address & Phone f
Mechanics Name
Address & Phone f
what is the purpose a building? 2 1 r l l �-
3 7 Materiel of WON? In COT) FFf9- F if a dweYing,for how many families? 2-
Will Wiling conform to law? Asbestos?
Eatlnlated coat City ucenae r N A g
Hoag Improvement
Lie. qFP
r f Applicant
SD NDER THE PENALTY
OJURY
DESCRIPTION OF WORK TO BE DONE
l�-'tCiV�l 1.;�)iyiC9•r11 �it'7"�-r\t�1Cr IiI.A�Y�Ii�
i iJ Si tit t_ C-C)
MAIL PERMIT TO: �0 �' ��
No.
APPLICATION FOR
PERMIT TO / / L^
LOCATION.
PERMIT GRANTED
�i/ log 2.0
APP OVFD
nn
INSPECTOR 09 BUILDINGS
CITY OF SALEMv MASSACHUSaTTS
PUBLIC PROPERTY DEPARTMENT
120 WASMINOTON STI1[R 3R0 FLOOR
SALCM, MAssACMtlS" 01970
STANL[Y J. IJfCVIt=, JR•MAYOA TKULPHONS: 979.745-959S EXT. 380
FAX: 978-74p984S
u
In acxnS pece with the provisions of MGL c40 S 54, a condition of your
Buildinrg 1'erarit 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:
(Location of Facili
� I
Si f Applicant
Date
n I// CITY OF $ALE140 MgggACNUSETT!
• PUBLIC PROPERTY DEPARTMENT
120 WASNINGTON STRSaT, 3RO FLOOR
SAL[M, MASSACNUSSTTS Of 970
TELa►NONa: 970-743-959S EXT. 390
FAX: 97e-740-984e
HOMEOWNER UMSE EXEMPTION
Plem Priat.
Job Location
HOM Owner Addrep 6a C.1ND�J
Hams Ow»e!r Telepbagp�z z�, � �s�
Ptaeat Mailimmg Addlnse o �r, , S
dThewe ol"HMeownere was.Utalded to include o d
hire wboo does no Possess
1a9 and to allow apcb Capp an individual for
Possess a
hcafla%
provided that the owned as
DEI'AATIO�I OB.Fi011�pWHEg: . •'
Pa3*2j'.wh i own'aPated-fif land oa which he/she mdd' a or Wends
which there Zr is intended to bq a one or two family dwaM4 d .
sttnctures accessory to such use and/or ihrm A p arsim who consoum more
than one home is a two year period shall not be considered a homeowner. Such"homeowna "shall submit to the Building Official,on a form
Official, that he/she be responsible for all such work acceptable to the Building
Permit. Performed under the Building
undersigned
uodia and other applicableras m responsibility for complianoe with the State
by-lawsand regulations.
B �Fa"homeowne "cMUes that hd lands she uad the City of Salem
g Department minimum inspection
will comply with said procedures and7requirements and that he/she
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING INSPE 0
See other side for state code
HOMEOWNE118 Y�MIT[Oli
work for which a Budit P�is
IU Code states that: "��°o�p Saeo* (Seem 109.1.1 —Uceosin3
to
m4 shan g viaora);Proms Homeowner end a p�ou(s) hue
do��aad that such Homeowoar shall ad as 3 •
H who use this ex���°endix �that
and ReVdations Ix 11090d"
lAh"of M Section�1TW. of awermen otM t
Consrn � hifa unlieenled Persons' lu this�e®�
cam rut
when the Homeowner , ....
probleeak PsraulaflY ana< unticaeead.PmaOa ere d would ,h
Board cannot1P�4es00deowner acf`aais.
Supervisor, i
o coon that the Homeowner is MY aware of hisThar r ��� �*�
comet. �ha as a part of t1�e Permit ppplicati the but Pala of thin is a
issue
hdebe the nbilitia of a SuPer AM and adapt a
You may cars to>metd such
form,cutrw►ttY used by.eat!�community.
formlcad8c014�uee in yo,_ .
goes,