21 BELLEAU RD - BPA-2008-342 10 WINDOWS, DOOR, SIDING DATE: 7-0 7
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building_a I g el hf a o Eco
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, ns t onsttuct Dec', Shed,Pool
Addition, Alteratio epair/Replace, oundation Only, Wrecking
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:
Owners Name: &M r �5oYah 'braryl+- Contractor: A 9, A Services/ 't'4115 b rA
Streeet_,X( 6e l l ea U girl City I ern Street .115 Anr4h St City, �
State.f Yl A Phone (qq S) / q i -goo 414 State M A Phone, 079) 7!1 l-_O�I A H
Architect: City of Salem Lic# I ll�
Street City State Lic ,5 HIP# 1 DI t009
State Phone ( ) Homeowners Exempt Form_yes_.Idl no
Structure: (please circle Single Fami Multi Family# Other
Estimated Cost of job S A�1'3 a�3
Will building confirm to law?✓yes no
Asbestos?_yes �/no
Description of work to be done: —TV15 6 I I I2. ' ri 5 C,UO(' ,`) ( yl n u) S id i nCf
Insf9I1 +en (io) ire nla�l��Ir��� yv�Pr2F tAJiryJ >S v, C,1 11
Ong, Ci ) L421 arnim r+ pnfra (i)or.
A&A SERVICES,INC.
Drawing b fitted:_yes no Mail Permit to: 1 SAgL�EgM�,MA 01970
Signature of Applica on,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# Zoning Mep/Lot
Permit fee S
COMMENTS:
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ApPLICA ION FOR
LOCATION
PE MIT(�GRANTED
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APPR Vfp
P T : OF BUIL GS _ - _
CERTIFICATE OF OCCUPANCY .
YES
NO