10 WHITE ST - BUILDING INSPECTION (28) 14-*M MU Td3E f4LfD--Aid0 APPROVED BY TW
W5PBCTOF! PRWR TO A PERMIT BZNG GRANTED
CITY OF SALEM
No. J. � q, Date
y!
Ward
Zoning District
Is Property Located in Location of
the Historic District? Yes_No_ Building /0 /A,-�e S�
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/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 �.f'u✓»f�i//i?.Uf_ iolif_ /1JA/2iiL�
Address & Phone /,p Z/11 i7Z' 35 (97g fjyz
Architect's Name
Address & Phone ( )
/1reXA T�Ain.d
Mechanics Name 'y6-T 28s.J ",qif.my
/3�5bvgA/77A/ 517'
Address & Phone 4kiAE .*4 Wffl of 4&2
What is the purpose of building? /7,re et.4-77D O
Material of building?Z&&1jtt/iNi,4l AIA,')'` If a dwelling, for how many families?
Will building conform to law? ,/llo�S Asbestos?
Estimated cost /75-4 City License# State License #
Home Improvement
c.
ignature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
30�,Yb® " ^4 ZD 'X3a 79ATb 6r^.) ��LZ
'�10>40Y4L oA/ g�7�D� f� �1ja�it !� oyZ JZIo.�i/u6�
MAIL PERMIT TO: em✓y&f—
/39 SuA� 'S7—
r -
No.\yJ
APPLICATION FOR
PERMIT TO
TMP I Z,
LOCATION
PERMIT GRANTED
,s
APPROV D
ll J,
INSPECT OF BUILDINGS
1