2 ANDOVER ST - BPA-2004-245 INTERIOR UPDATES 17tf6T-BE filz-E D AfIPROVED BY T*IE
,WP.BGTD-R ,PM0R TD.A .P.ERMIT.BEING GRANTED
CITY OF SALEM
No. 2bS -Z0c)LA ! "� '� Date A116;11, Z003
Is Property Located in Location of
the Historic District? Yes No_ Building 4AI00yFR $T
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
Address & Phone z95 /JoD6i; Sr AE�� elIf 97L ��i2�-6695
Architect's Name i/p✓VL
Address & Phone ��r
Mechanics Name /f/[�Z. LE&
Address & Phone
What is the purpose of building?
Material of building? If a dwelling, for how many families? -3
Will building conform to law? Asbestos?
Estimated cost City License a N p' State License 0
r
Home Improvement
Lie. r:p �30
CK 2 10l Sighollreo pplic�
SIGNED UNDE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
Z'y5fi9zL BIZ BH J-H lST rLO0R, _
7Z� /f rCH AI
MAIL PERMIT TO: C
it
No.Z�oS- Zc�d
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
in? 2.0
APpmov D
INSPECTOR OF BUILDINGS