121 1-2 BRIDGE ST - BUILDING INSPECTION ft PS ST�EfiL{- �iJD "A„PPROV€D BY T44E
,IAISJy;>£C WPAWR 'IP`J PER11iT AFJNG GRANTED
CITY OF SALEM
No. "T ^"ZU t>� ,5 .. . Date3d Is Property Located In Location of /
the Historic District?
Yes_No_ Building 6/7CY�(✓
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR: 36 ^ d S
Permit to:
(Circle whichever apply) Roof, RerooLjnstall Siding Con truct Deck, Shed, Pool,
Repair/ eplace Other: 73
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 f
Address & Phone ��CVIh-VI'A✓ST _( -2C# y/ I
Architect's Name
Address & Phone �j ( 1
Mechanics Name O/ /D CJ
Address & Phone, P r !�/fir' �✓ /� 17�1 ST/�'� ,�
What is the purpose of building?
Material of building? If a dwelling, for how many families?
Will building conform to law? Asbestos?
.�\ Estimated cost City License# N A state License#
Home rov ent
Lie. I 5 --
g Signature of Applicant
(0:VP LM, Cr— SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
C l
MAIL PERMIT TO:
J �3�l1JU L I T kek Pep C 9,457D 1. t 0 ' SLA53"
NO. U -
APPLICATION FOR
PERMIT TO
LOCAT4ON:
IZ i %. .'8RIcoca Sri—
PERMIT,GRANTED
APP�/ , fD
INSPECTOR F BUILDINGS