19 BECKET - BUILDING JACKET r
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OF LAND IN
SALEM, MA
SCALE., Jo = 20 , OcroQE.e 27� 1997
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No. 609, , COASTAL SURVEY
9ry�ES � YADSMORTH VILLAGE — DANYER9 BUILDING
0 d 7 � ° F MO CENTRE ST, DANCERS, MASSACHUSE,75 ,
A PROFLTS A OR (508) 774-9450 47
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What is the current use of the Building?
Material of Building? "a nm�� If dwelling,how many units?
Win the Building Conform to Law? �( es Asbestos? N
Architect's Name t."
Address and Phone ( )
Mechanic's Name ; , �
Address and Phone 1 �r, 1 KQ
Constriction Supervisors License 0 HIC Registration 0
Estimated Cunt of Project Permit Fee Calailatbn
Permit Fee:
2 7, ��C Estimated Cost X$71$1000 Residential
Estimated Cost $111$1000 CornmsmIal ---- --._.
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of perjury X J
Date Ln
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PUBLIC
PROPERTY
DEPARTbIE►1iT
/:I\pWXLEV ORISCLXJ.
130 wAvuN=w b'm"•1MAAk.MA0ACHLSl11S 01970
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION, OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDIN
1.0 SITE INFORMATION
Location Name: Building:
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Property Is located in a.Conservation Aron YIN_ `i Historic Dtstrld YM
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: l �✓l e L. ��fl
Address:
Telephone: g Z 4 S BOCO
3.0 COMPLETE THIS SECTION FOR WORK IN PRINTING BUILDINGS ONLY
Addition -D,e ( Y-, Existing s
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
8def Description of Proposed Work:
-Pe e+- 4- ste*, as
Rep)el r
)elro F/� 1 'S S / G , f
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- Mail Permit to: _ - -