197 LAFAYETTE STREET - BUILDING INSPECTION 197 Lafayette St.ri
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Plans must be filed and approved by the Inspector
prior to a permit being granted
CITY OF SALEM
No. �� _9 Ward � � //�G
HISTORIC DISTRICT? Y N Date*—,4
IF FOR SIDING, HAS ELECTRIC S Home Phone 7zl /
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PERMIT BEEN OBTAINED? Y N Bus. Phone
APPLICATION
FOR
PERMIT TO
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the
following specifications: /
Owner's name and address
Architect's name
Builder's name
Location of building, No.
What is the purpose of building?
If dwelling, # of units? Material of bldng?
Will building Aconqorm to law? Asbestos?
Estimated cost City Lic.# y L +1
State Lic.I� Z
Signature of Applican JAL_ ��77
C--,)
SIGNED
SIGNED UNDER THE K&ALTY OF ?AiJiMY "
DESCRIPTION OF WORE TO BE DONE
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Mail Permit to:
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No. 66 `DIY Ward—
APPLICATION' J/
s,
FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDG
Locet[on
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PERMIT GRANTED
Approved
Building In to
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