14 OSGOOD STREET - BUILDING INSPECTION //Dsgooc� �����
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Plans must be filed and approved by the Inspector
prior to a permit being granted p cl
CITY OF SALEM 3 l a o a
No. /rl-l. q L/
Ward
HISTORIC DISTRICT? Y N Dated I
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IF FOR SIDING, HAS ELECrT�tI�� +y A 1 `11 Home Phone MDQ ` r9
PERMIT BEEN OBTAINED? /t(( Bus. Phone
APPLICATION
FOR
PERMIT TO NS (( y\��( Mf� <�1J1tipG1,US
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the
following specifications:
Owner's name and address 3i k � C-2RVV1ec�i 1 dSrjGoP S'�
Architect's name
Builder's name C\"0,\
Location of building, No. J Ud19 �C3
What is the purpose of building? yy7� S c
If dwelling, # of units? Material of bldng?
Will building conform to law? P S Asbestos?
Estimated cost C? RV
City Lica/ State Lic.# 0 Q 6
Signature of Applicant
SIGNED UNDE THE PENALTY OF PERJURY
DESCRIPTION OF WORE TO BE DONE
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Mail Permit to:
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No. 1-04- 7 `7 Ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location tLf ®SaOocX S
PERMIT GRANTED
Approved
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