81 LINDEN ST - BUILDING INSPECTION (2) tY,
IM.A VS Mid T13E fiLfG-ANO APPROVED BY T44E
UUSPECTOR ,PRWR TO A.PERMIT BEING GRANTED
J CITY OF SALEM
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Date
Ward
�°�rrnNe� Zoning District
Is Property Located in Location of
the Historic District? Yes—No Building -21 Irndcn K4
Is Property Located in I", A4 A
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replac 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:
Owner's Name Lc�) o �SCfTrn i1 ��
Address & Phone ZI �//4 tom) /5 - 99(-r-)
Architect's Name /9,
Address & Phone ( )
Mechanics Name ,v1,F1
Address & Phone ( )
What is the purpose of building? Ces:;r 'rn
Material of building? /,r�rr5-n4 If a dwelling, for how many families? L
Will building conform to law? Asbestos? >r
Estimated cost City License# St a License #
Home Improvement
Lie. i
v Sign ure oJnt
SIGNED UE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
` I
No.
APPLICATION FOR
PERMIT TO
LQ,C�TION
PERMIT GRANTED
1s
A7OV�D
INSPECTOR BUILDINGS
MY OF SAIDd
BUnZINGDEPARTNSM ON
xorrgowrm��ICErISE E 'I1
Pktoe prm
7CB10CAMON , w o� �o n-r
A A I a
ADDP=.
PRESENT ItM11.II?G ADDRESS �r�o c c�.bC�tyS
The nvteat.",*on of`homeowness was cmaded to include o De��d Tm
Units a less and m allow'such bornevwvers to�an individual .
]iccnse,.providrd dmtbe owacr net as M"rr4K.
DEFIICrM CF HOMEOWNMLor b
Penn(s)w•bo owns a petal of land on wbleb bt/dw resides or auesds to reside.oa wAddt it
intended to be,a am to two family dwelTmg,aoadsd to daadrcd srrucm m s=m_ w
farm sovcaues A perwat who constructs tnont than one home Inan a!Dash a=gtabk to tits
a borne mm. S " bk w aU sudt work pafoiraed undes tw i lam'
Building Official.Ihm WOK be
The under ipcd`bomevwrwi assmmtes rcaponn'bUk for complisma with the State Bn Cnbe tsA
otlw applicable goes by-]aw%=In and rogubfiaM
The whmipa ahomeownet"ccrdfia*A Wshc mdcrststds the City of S .
nmmmo ing=on pm=dura and togtdremetas and that won will comtpty
nagtdT=KNc
HoNjBov 4jR'S SIGNATURE
APPROVAL OF B=ING INSPECTOR
i
See otba sdc fm state code
HOMEOWNER'S EXEMPTION
The code sates that: 'aT honmwmr performing work for wbieb a but7dbtg permit b tequb sbal ba
caempt from the provisions of Ibis section (Section 309.31-13ceasing of Construction Sopervisov*
Provided that is a homeowner engages a person(s)for hire to do.sucb wont.that such homeowner dell so
as Impadmue
.
Mwq bomeownen wbo use ibis exemption are ivm n that they are anuabog the TCpoM%Mdes oft
svper eiwr(see Appeodbt Q,Rulet and Reguiariom for licensing Cooslfwcd n SupC vbosa,Seeds
L24 7bis lack es awareness otdm uralts in scrionn probksns,pardeobwV wbm tba bomeowaer bbaa
uriliocnsed persoac In ibis can your Board cannot proceed agahm the unlicensed pawn as it would wid
licensed Supcnisa 7be bomeow ner acting as supervbor L oldsoate�tssLwosPola,
To ensure that the homeowner Is fully aware of bin=responsibilities,vrAM eeotmauddea iKpiee;as
Of the pcmdl applimtion,that the homeowner Certify that hrJahe urdemwi s the tzsponsibilides eta 1
super isa. You may ears to amend and adopt suit a Smnlecu fieation for tan in yenta couunudW.
PUSUC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 9RD FLOOR
SALEM,MA 01970
TEL (976)74S-9593 EXT. 380
FAX (976) 740-9646
STANLEY J. USOVIcZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of Mf i L c 40,S34,I acknowledge that as a condition
of Building Permit# all debris resul6ug from the construction activity
governed by this Building Permit shall be disposed of in a properly licensed solid-waft
disposal facility,as defined by MQ,c III,S 150A. j
The debris will be disposed of at ,4 it jam.
Location of Facility
Signanne of P rlicant Date
FULLY complete the following information;
(PLEASE PRINT CLEARLY)
Name of Permit Applicant
Firm Name,if any
Address,City&State
The above statute requires that debris from the demolition,renovation,rebab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facilityas defined MGL c by III, S 150A, and the building permits or licenses are to
indicate the location of the facility.
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