3 MILK STREET - BUILDING INSPECTION Plans must be filed and approved by the Inspector I
prior to a permit being granted , S S,`�
CITY OF SALEM
No. ' CITY
/ Ward
HISTORIC DISTRICT? Y N Date '�Y
IF FOR SIDING, HAS ELECTRIC '+y Home Phone
qF6--F-de
PERMIT BEEN OBTAINED? Y N Bus. Phone E 0 '9 6 4— lot
APPLICATION
�j [�� // ( FOR f 1
PERMIT TO 5�5 tAX11 (�0 l ll \ \C-tO�U �� 1 "D, �
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the
following specifications:
Owner's name and address &6/\r � &
Architect's name
Builder's name ( (
G�� V v� W,P . pviG�P1t�
Location of building, No. 3 W` \ 1„ \\ S�
What is the purpose of building? (
If dwelling, # of units? Material of bldng?
Will building conform to law? ytP Asbestos?
Estimated cost I_i Q Ci City Lic.# State Lic.#
Signature of Applicant
SIGNED UNDER THE PENALTY OF PERJURY
DESCRIPTION OF WORE TO BE DONE
Mail Permit to: 3 5t 7C
i
NoWard
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location (kfl 5-r-
PERMIT GRANTED
ii / SJ 194
Approld _
\ p Gq_P Bu�o Insp ori