2 BRADLEY RD - BUILDING PERMIT AP I
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M iQSIHiST DE f4L j APPROVED BY T44E
=PECTDR PW0R TP A.PEF=T 13,FING GRANTED
CITY OF SALEM
No. �Q'ZOC9y vy � � i Date OS�
Ward
\"timNe ° Zoning District
Is Property Located In Location of
the Historic District? Yes_No V Building ( C7
Is,Property Located in V
the Conservation Area? Yes_No_
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, nstall Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other: =l u r,. ,h r✓.,, r
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 l f� h'i?q S lam. /'l oLs4/✓
Address & Phone J� 67A 21151`.Po 5 o
Architect's Name
Address & Phone ( )
Mechanics Name
Address & Phone )
What is the purpose of building? p
Material of building? (.v w' If a dwelling, for how many families? /
Will building conform to law?— s Asbestos? Leo (N J
Estimated cos 00 City License # State License #
/0 2 `� Boma Improvement -7"- /_ f� /J 0 C
oLic. i OCrr�,r
Signature 6f Applicant
N SIGNED UNDER THE PENALTY G
OF PERJURY
DESCRIPTION OF WORK TO BE DONE / rj
MAIL PERMIT TO:
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