162 BOSTON ST - BUILDING IJACKET r -A"S 1MtIS -BE TILEP T APPROVED B1 144E
.W3P,EXTD13 ,PRWB T-0 A.PERMIT .BFMG GRANTED
CITY CF SALEM
No. :`� "� `�?� Date
�FG'/MINB� a
Is Property Located in Location of
the Historic District? Yes_No� Building /(y
Is Property Located in /
the Conservation Area? Yes_No V
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding,_Constru,�t Decky Shed, Pool,
Repair/Replace, Other: m G—it §A / ;Y C.
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 dG ff/<�P; /� 1� o-1-0i NC► '�`/ /
Address & Phone /42. ��N S 1/q O) �T•3� �'eel,9
Architect's Name
Address & Phone L )
Mechanics Name
Address & Phone
What is the purpose of building?
Material of building? ad /,/ If a dwelling,for how many families? �OYyt M rr2C�-L
Will building conform to law? Asbestos?
Estimated cost ty License # N A State License # Cos AP593 VA
-4 SS a6 Home Improvement
8 Z Lic. i
Siffurle-bf`TpOrcafff
SlIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE /
(f frta7 Aw prG T s�• MC��/ l�i •
t�G
MAIL PERMIT TO:eft C G 0 SJ Ole *4 �'
,t
No. 1 Lt 3
APPLICATION FOR
PERMIT TO
LOCATION..
PERMIT GRANTED
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APPROVFD
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INSPECTOR OF BUILDINGS