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65 PALMER ST - BUILDING INSPECTION (3) cr - . . -M"ST�EfiL{- �iJD APPROVE{) 8Y T+IE fJ�S+PECJ.OA ,PfWA TP.A PERMIT BEWG GRANTED CITY OF SALEM Date lJ ... , Jb]�(i,, is Property Located in Location of / the Historic District? Yes_No_ Building ,, V�ll 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, GR�aldReplace, ther: 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 �� I'r'� 7 Address & Phone t� 7) �` 3 Architect's Name Address & Phone Mechanics Name Q Address & Phone What is the purpose of building? Material of building? 1 ^Ln II a dwelling,for how many families? Will building conform to law? Asbestos? Estimated cost �© © City Licensee N A state License a ��7 d G Rome Irovempu `' 4iihature o Applicant SI NED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE n c- �1anJ� MAIL PERMIT TO.3a baAUNCJV QC ILL MA026 DM f-2 't No. �� APPLICATION FOR PERMIT TO LOCATION PERMIT GRANTED APPROVED INSPECTOR OF BUILDINGS ti j e,? F 1 � BATH 1 1 d 1 1 1 BEDROOM i I � I 1 BEDI1OOM I CL I RCb . aC Mio 36X�-o 1 34.0` 1 KITCHEN a MAIN ar ENTRANCE I U,1NM I I A�IF.JA i ' j I I 1898 S.F. ROOM 1 I oIn�ING 1 i I ROOM ' I � j � I