44 PINGREE ST - BUILDING INSPECTION �kfISilllliSfi�E{.}L g�fID:A?PROVEfl 8Y TJiE
LNSPFxTD_B ,PRIOR TD A.PF-WT $EUNG GRANTED
CITY OF SALEM
Date PAA1 2Q . 200 to
No.
Located in Location of
erty
Is Prop Building 149the Historic District? Yes—No z
Is Property Located in
Me Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to: Pool,
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed,
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 P,
Address & Phone
Architect's Name
1 )
Address & Phone
N--Mechanics Name
Address & Phone ,
What is the purpose of building?
Material of building? If a dwelling,for how many families?
WIII building conform to law?
Asbestos? !J
Estimated coat �5° 0 city Lice # N A ate License# `
vV Lie- I i reezeent
�'�`' � '" '�--�� Si atur of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
%
it b J t,q
= Loa2 3
MAIL PERMIT TO: �N
5 4,p,e, Iltq k v 1 '
No.
APPLICATION FOR
PERMIT TO,/ /
e
LOCATION
PERMIT GRANTED
AlROVfD
Tj6L-
INSPE, F BUILDINGS