39 BUENA VISTA AVE - BPA-2006-774 -pL-* lSjftjSfi-9EfH.fe,#A0 Af"OVED BY T44E
.aW, X3,DB ,PFwR TD..PEANUT f3fmo GRANTED
CIT
Y
Y OF SALEM
oate Ola
No.
h7NS
Location of �J
Is Property Located in Ll �Jlx,✓� (/��
the Historic District? Yes_ No C� liuildinE
Is Property Located in Yes No
the Conservation Area?
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, 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:
Owner's Name
Address & Phone
Architect's Name
1 )
Address & Phone
Mechanics Name
Address & Phone 1
What Is the purpose of building? _
flAaterial of building?
i, _ BG3�� ,, If a dwelling,for how many families?
„� -
Wlfl building conform to law? i//i� Asbestos? lJ
Estimated coat /5 e ,
t.> city Licenser
Bose Impsov nt
Uc' Si ature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
No.
APPLICATION FOR
PER/MIT TO
LOCATION
PERMIT GRANTED
pu/gsQc/, 20 Z06C,
PROV D
t
ECTOR OF UILDINGS fi