16 GRANITE STREET - BUILDING INSPECTION 16 Granite St.
/ 7 6 \3a
Plans must, bie filed and approved by the Inspector
prior to a permit being granted
CITY OF SALEM
No. Ward_
�/ � C��/
HISTORIC DISTRICT? Y N Date— L- -
IF FOR SIDING, HAS ELECTRIC +y Home PhoneSsGS- 7V!5-- Rl� U
PERMIT BEEN OBTAINED? Y N Bus. Phone
APPLICATION
FOR
PERMIT TO
TO THE INSPECTOR OF BUILDINGS: F lNit
The undersigned hereby applies for a permit to build according to the
following specifications:
Q�-,
Owner's name and address
Architect's name
Builder's name
Location of building, No,ZT-
What is the purpose of building? � �A
If dwelling, # of units? Material of bldng?
Will building conform to law? Asbestos?
Estimated cost �5 City Lic.# State Lica/
Signature of Applicajn �2��,,,��_
IGNED UNDER THE PENALTY OF PERJUR
DESCRIPTION OF WORE TO BE DONE
moo, C') 6
Mail Permit to: /� �� /,1/z1F1-/
No. k Ward />
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location 16 lC
PERMIT GRANTED
18 %f
Approved
o c ' llding I pector