39 SALEM ST - BUILDING INSPECTION r
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-PL-*NSINUST-eEfiL-Eat APPROVED By T44E
lNS,P CTOR ,PRIOR TP.A PERMIT BEING GRANTED
CITY OF SALEM /
Date 3'=
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Is Property Located In Location of (�
the Historic District? Yes_No Building ( Sa�-e)7
Is Property Located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) P
ant, ReruL.,Install Siding, Construct Deck, Shed, Pool,
Repair/Replac 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 cl-a G
Address & phone P-e r t✓-e L
Architect's Name
Address & Phone
Mechanics Name dJ 1171 E
Address & Phone
What Is the purpose of
building? o c l�
Material of bullding? /� ri,� `�-- W oo c( If a dwelling,for how many families?
X Will building conform to law? �0— <�- Asbestos? /1/ 0
Estimated cos' S-�_City License k N A State License # 5-C9 CI l
Home Improvement D
Lice i
lgnature of Applican
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO: )-Z ('Q�IC�v cre�QL vy,
No.
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
AP VFD
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INSPECTOR OF BUILDINGS
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