63 PALMER ST - BUILDING INSPECTION (2) 1
-pco tS9MffiT13E f4L+_ i A?PROVED BY T44E
II P T 1 ,PF,WR To A PERMIT B,EWG GRANTED
�n ^ /} CITY OF SALEM
No. Date
'A
��YMIN6
Is Property Located In Location o(7
the Historic District? Yes_No_ Building
1N�u
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/Re laace Other:
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
h following
fora permit to build according to the
The undersigned hereby applies p 9
specifications:
Owner's Name �V�
Address & Phone �(0 (�fionJ >
Architect's Name
Address & Phone f
Mechanics Name I� �
Address & Phone c!2 Cat Ak A4.0 DI -C Ll, (Ml 32d—Z-CT t �
What is the purpose of building? K_
Material of building? If a dwelling, for how many families?
ng
Will building conform to law? Asbestos?
Estimated cost coo City License# N A State License # 06
Rome ov Cnt V
Si tture of plicant
SI ED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE ( J
CIAc&5&t (`P lf�c, e
MAIL PERMIT TO.2 0 UiU ./ TK_ 0— VuAAL -P 1AL l'MoL(�f,`6
,t.
No. 1��!/
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
2-0 _
APP OVi D
ZI
IN PECTOR OF BUILDINGS
0 1
BEDROOM
I I BEDROOM BEDROOM 1
° I I
1
I
CSA-fHROOM CL. HJkF3� M {
1
MAIN CL. I
CL ENIJ ANCE {
��► 40.3' C1 I
1
UNIT 3 51 a 1
AREA •
I
BEDROOj
1089 t S.F. 1
L i 6 yv,RL r+1 i