20 BAY VIEW CIR - BPA-2004-105 REPLACE 4 WINDOWS DATE: 7- I / - 0
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED n
Location of Building eW
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install Si ' ct Deck, Shed, Pool
Addition, Alteratio Repair/Replace, undation Only, Wrecking
Other. F
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:
Owners Name: { �j( ,ST 7/e/r Contractor: C ,r; 4tn;nPr 7.nr7.y
Street&W.1361U1/IPl(J &-ClP City Street115 North 9trPPt City Sa1Pm
State Phone State MA Phone(978) 741-0424
Architect: City of Salem Lic# 14 0 5
Street City State Lic#057733 HIP# 101609
State Phone ( ) _ Homeowners Exempt Form_yes no
Structure: (please circle) Single Family, Multi Family # Other
Estimated Cost of job$ � 7110, 0T1
Will building confirm to law? yes no
Asbestos?_yes Z no /
Description of work to be done: L S -tif//_ r�'/T
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Drawings ub fitted:_�es___�/ no Mail Permit to: SERVICES
115 NORTH STREET
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Signature of Applic 'on,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX(6) MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# X6-20oy Zoning Map/Lot
Permit fee$
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