229 LORING AVE - BUILDING INSPECTION 1a11.11INS1M T1§EfiLf4l'#ND APPROVEo By 774E
ASPUTDR PMOR TO A.PERMIT BEING GRANTED
CITY OF_SALEM
Date
�^ !
/rr Ward
Zoning District
Is Property Located In Location of l
the Historic District? Yee No &dlding
Is Property Located In
the conservation Ares? Yee No
Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) �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 accorWig.to the.following
specifications:
Owner's Name qg �45se� l
Address & Phone Qa I Limn'1 4 ( 1
Architect's Name
Address & Phone i
Mechanics Name ,(� S� VbC'Qtu�s
r'
Address & Phone c T� p'qat� P'P-6A
Whet is live purpose a building? AA J
Mdeft of Wow If a dwelling,for tow many famitin?
WIN bullding con or,, to,law? Asbestos?
Estimated
/cost
xxsw� qty Lira a
Basis�(J V Lie. �=
7ff(M;A�
tgnature of Applican
SIGNED UNDER TH PENALTY`
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
No. V
APPLICATION FOR
,��// PERMIT TO
Tf�2
LOCATION
PERMIT GRANTED
2��/oy ,9
APPROV Q �
INSPECTOR OF BUILDINGS
PUBLIC PROPERTY DEPARTMENT
i_ i(20 WAfNINa70WSTREET, SRDFLooR
SALEM,MA 01 970 TEL (976)746-S596 EXT.380
FAX (676) 740-9646
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFMAVI`f
In accordance with the provision of MGI,c 40,S34,I acknowledge that as a condition
of Building Permit 0 .all debris resulting from the construction wdvity
governed by this Building Permit shall be disposed of in a properly licensed solid-waata
disposal facility,as defjned by MGL c III,SIM&
The debris will be disposed of at
ILmoxcaffimi6mof Facility
7c ??f
ofPermitAppli Dab
na a .
FULLY complete the following information;
(PLEASE PRINT CLEARLY)
Name ofPeamitAppHemt
Firm Nsme,if my
Address,City a State
The above statute requires that debris from the demolition, renovation,rehab or other
alteration of building or structure be disposed in a properly-lieeaaed solid-waste disposal
facility as defined by WIL c1II,S1SOA, and the building pemdta or lfcenaea ate to
indicate the location of the
faci>;tY•
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