8 MAPLE AVE - BUILDING INSPECTION mil-*NS1AWT-9Ef4Lf0--Afl0 APPROVED BY T44E
ASpZj;TDB PP" TP.A PERMIT BFUNG GRANTED v
CITY OF SALEM
Date 3J7-0S
Is Property Located In / Location of
the Historic District? Yes No l� Building
Is Property Located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
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: —�
Owner's Name ✓9'kv s-
Address & Phone MAPS _ 6VE
' Architect's Name
Address & Phone f
Mechanics Name
Address & Phone
What Is the purpose of building?
Material o1 building? If a dwelling,for how many families?
Will building conform / V to law? ! S Asbestos? n b
Estimated cost 16) -Cly License# N A state License ii_
Rome Improvement �.
Lie. t X
' r Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
1 _
No .t.
�
\
APPLICATION FOR
PERMIT TO
,OCATION
P RMIT GRANTED
J� Lh
API OV DD
�G
S ECTOR OF ILDINGS
o CITY OF SALEM9 MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MA 01970
TEL. (978)745-9595 ExT. 380
FAX (978) 740-9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40, S34,I aclmowledge that as a condition
of Building-Permit# -"33a S yall debris-resulting-from-the-construction activity-------- - - - - -
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL c III, S 150A. r
The debris will be disposed of at: Tk 2, S g�e N' Tr-A^, 'fcc- r-
Location of Facility
11L 3 -10 - 0J
Signature of Permit Appli&nt Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY) —�
Name of Permit Applicant
Firm Name, if any l _
Mo\.
Address, City & State
The above statute requires that debris from the demolition, renovation,rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIII, S 150A, and the building permits or licenses are to
indicate the location of the facility.
CrrY OF SALEM
BUIIAIIdG DEFARTmW
HOIAEOWNER LICENSE E)MO11GN
Mast PAM
malocATM
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AWIM
Tammom
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PRFSbrr TdAti WA ADDMW
Tm emroa. ptiau d`Maeowoe a Was etaoaded to bs hak a roer efeap��O�T�
Units Q leas gad b a11ow such boraevwnrri b srga�s OI .�bias Nh0 does tat paves� .
V=w,pmvided tm ie ewan ad as overvi am
DEFOCrMCFHOMEOWWR
• Pcraon(�)wbo owm a penal d Lmd vo whkfi heJahi nsidrs of brands w reaift eu widd►twe Is,er k
intended la be.aone to two lam1M�dwellb>i,atuehod m dcaded str>asR7 w ad tae aadlrr
farm svoemret A pagan who coT&a=mots tun ams home Ins ewo-rw Pcrkd*A mKbt tans Ww d
a inI ft aer. S dw UJdw bed k w all S%b wwt j=f vwd �Pnd
Btr7db�Odidd. .
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other appiicbk So"by bwt.roles and nSWadwL
73c m dcsipe d'homKowted'=Zfm to hs.15hs wAamrdt the CIW of Sakm Ball ft DgwumK.
n,inimma aupaction proadw a aid rcq*==me and tut Wda wM tom w hk maid p madom d
regobmwm
HObffAWKER'S S]GNATURE e'
APPROVAL OF B=ING WSPECTCR
Sa Wm ode fm sate code
HOMEOWNER'S EXEMMONI
- - — The mode lutes dim.'.ar9'IwmcowAcr ycr�orm5►�wvmk for whkb s ba0ffi�pera3t If Tegai d�1 M - ---
exempt from the p ar4dam arm secdom (Secsims tlV.0-limnslag of Comnadvie Sam;
provided>bst b a itotmaeorrma aWia p peaam(s)!er kits to do.such want,thq sireb bomsowme dra set •
MwW homeowttoa who on this exemptlem are wants*a they are ammubg da lespoodbMides aU
svpavbw(see Appesdh Qq 7tsks and]teplark+m fw 1JocsstsS Cmmnretiw Smpuvi m,Saeea
L2* M Axis of owwcneu dkcarwhf in scrims p obkms psnie*" v the foneosrsetbba
unRooued persomt hi this cue your Hard eamtot proceed apbm the mttiocmed pa"a as*wvM wl&
ikeued Sapa+isge. 71e Ooaseow7cr seyis=as superdwr Y shiss�p tsatomalL .
7o canoe dnt tAm homeowner b fWV aw we of M&a toponAbOdes,mmq oomsmmddp require.a pain
of'ds perini{sppgodoa Out the bomwwna amt*ilia behm m I sn I da responshumn da
mpavbm You mq can to amend and adopt saw a fosmdoerdiiodas Sa sal im Yost aomssaiIP6