83 BOSTON ST - BPA-2006-464 ROOF il:W61iAtl6t*E ffA*#ND APPtaO VED 6Y 1W
I A-gpgZrJDB PaW TD A.p r AGING GRANTED
�ln CITY OF_SALEM
No.`� lT \ DAD 1 n o5
Is PMpwly L.oulid In Location of
j"Nidala OlsldG? Yet—Na L aoi7dioa l —
Is ftapwty LOGNed in
ft CanurAton Mao Yat_No n
BLULDL40 PERMIT APPLICATION FOR.
Permit to:
(Circle whichever apply, Inatall SWO Construct Dank Shed. Pool.
/Replace. Other.
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS W PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specilicabow
Owner's Name SG u S2
Address & Phone
Architect's Name
Address A Phone ( 1
Mechanics Name
Address & Phone ( 1
Whal Is on puposa of bA*q?
mftw of bh~ d a dwa&q.for how amr Wofte?
we hound mdaim to Iaw? Mbaaoa?
Ewmatadwd '4'3XO_— cw ucem r N o► dk
C2 7'0� aawa
Lie. apso�aot!! X77-sft'a6t�Signature of Applicant
MINED UNDER THE PENALTY
OF PERJURY
OF WORK TO BE DONE
MAIL PERMIT TO: 6(lJWI/l
APPLICATION FOR
PEROT TO
LOCATION
PERMIT GRANTED
l��a✓e.« du 18 2.00
APPROVED
0ii OF BUlLbINW