10 ARTHUR ST - B-2004-127 REPLACE 26 WINDOWS i L-MS1 tJS*-@E f1lLf ID.Af'PROVED BY T44E
.IW,WT.DR .PF,WR T-D.A .PERMIT BEWG GRANTED
CITY OF SALEM
No. w./—�00`( �� �,\. Date
,y
���i'IINC DD�P
Is Property Located in Location of C^7 '�"""
the Historic District? Yes_No_ Building l
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/Rept 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 / G `Q�u��IJJiL_� (791) 77/ — fZvo �eG(
Architect's Name <Th wee vv ,�U C�
Address & Phone V I4�-7 L- (,/r)) 3
Mechanics Name
Address & Phone )
What Is the purpose of building?
Material of building? If a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost zz °f' City License rt N PA State License a
.0 JS Otic Baine Improvement v o". a,,,f O�� Lic. t fA1
'Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
y
MAIL PERMIT TO: :500 5"i>,4e 601KIDC),-4
d
I.
No. l Z?-zov
APPLICATION FOR
PERMIT TO
LOCATION.
PERMIT GRANTED
20m3
APPROVFD
INSPECTOR OF BUILDINGS