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115 NORTH ST - BUILDING INSPECTION
r-ZT3A 9N,q-��nQ yar��l.sri3'J DATE: ZI 05 Citp DfaYTu, aaLju�Qtt PLANS MUST BE FILED AND APPROVED BY THE INSPECTOR PR IOR TO A PERMIT BEING GRANTED Location of Building IIJP N©✓r� ( JI ��' Building Permit Application For: '(Circle whichever applies) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool on, Alteration, Repair/Re lace, oundation Only, Wrecking Other.' 6GZYGICa� (S PI,) lu, Slab %z�Ui>o1c7�0� 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*-CA-1,5 f jjDhlY �19 rZ Contractor: M h r; s t o ph P r 7.n r 7 V /I Street City /e Street_11 5 North G t r P P t City S-LI State Phone O76) State MA Phone(978) 741-0424 Architect: City of Salem Lic# 14 0 5 Street City State Lic#0 5 7 7 3 3 HIP# 101609 State Phone ( ) Homeowners Exempt Form_yes__�/ no Structure: (please circle) Single Family, Multi Family# ('UY111�1Zr( I Estimated Cost of job$ I& Izo, �)c7 Will building confirm to law?_ yes no Asbestos?_yesZno / Description of work to be done: Tt"ZS // 0� X HQ J�az-a GAP _ SERVICES Drawings b fitted:_yes no Mail Permit to: 115 AIORTH STREET X .AT.F nI,4 a=aUE X Signature of kpplica n,SIGNED UNDER THE PENALTY OF PERJURY CONSTRUCTION TO BE COMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE Department use only: Pemut# ` \ fi ning Mapd of Permit fee$ COMMENTS: