21 MAPLE ST - BUILDING INSPECTION (3) Fl�f�i5
Professional Land Surveyors 9 Civil Engineers
ESSEX SURVEY SERVICE. 1958 - 1986
�JU OSBORN PALMER 1911 - 1970
BRADFORD & WEED 1885 - 1972
PLOT PLAN OF LAND
LOCATED IN
SALeM MASS.
53,ro t----
� I Shen
4j izI
'� EX/51iJ�1•
<J:
j L/I7(ri%�s^iU
I hereby certify to the
/ Building Inspector that the pro-
ZONE: K/ LOT AREA: �7D1/GS' LOT FRONTAGE: !'OJ posed construction shown conforms
to the dimensional zoning of
FRONT YARD: IS/% SIDE YARD: /lY" REAR YARD: lv �}�jc!°J Mass 4a.
SCALE: I ' 70 •��� �..
A N OF hSq
DATE: jar
ar 11 ��90 � - CHRISTOPHER kG�
c R.
REFERENCE: BK PG ��/ istopher R. PM0.y LA
3131>317
F
104 LOWELL STREET
PEABODY, MASS. 01960 SO
(978) 8) 531 1
FAX: (978) 531-5920
.. i
-� --
� �
�-
- -
�x���es�. -�-�.-�� I c�" �.c.
-_ --_
y
j .
i
EI'I�OF3XI.E�
PUBLIC PROPERTY
DEPARTNI�.1�1T
N..roa 13oWASMtWG br&E1.7•S IMMMASUCHLUXIM011970
To.979-745-9595•FAX:97L74048"
APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION,
DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION J
Location Name: Building:
-_--- Properttr Address:——_-- — —
property w bested in a;Conservation Area YIN Historic DWM YM
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: 70 \cc +
Address: 1 � `4 i U)9
Telephone: 1 J
3.0 COMPLETE THIS SECTION FOR WORK IN EXISX G BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
add Description of Proposed Work: (�
-- ---- ----Mail Permit to• --
What is the current use of the Building?
Material of Building? If dwelling.how many unitsT
wig the Building Conform to Law? Asbestos?
Architerd's Name
Address and Phone l )
Mechanic's Name
t T oil1s °�8 83b- lidb
Address and Phone E4
L�,,.JS Lex.a� n
Consbucgon Supervisors License# Ca)c-15 HIC Registration#
Estimated Cost P piect�S cob Permit Fee Calculation
Permit Fees � ��,/ � Estimated Cost X$7/$1000 Residential
---- - -lr�' EstimatedCostXi41/51000Commwdal----- _.. -
An Additional $5.00 is added as an
Administrative 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 the above stat
specifications. Signed under penalty of perjury
Date
0
a3
a
- or - -- -
- 1