44 BUFFUM ST - BPA-2005-93 i
a
�L1ldfSiMliST�E fi *f APPROVE0 BY T+IE
.MWECTDB PFWfl TD A PERMIT G B,EIN GRANTED
CITY� OF SALEM
v -
No. Date a `�
Ward
Zoning District
Is Property Located in Location of
the Historic District? Yas—No_ Building
Is Property Located In
the Conservation Area? Yea No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding,QConstruct 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 Cl Ll l3 a f=/=a Al S T y 8
Architect's Name
Address & Phone
Mechanics Name
4
Address & Phone ! I
What Is the purpose of building? D C Lea gm a
Material of building? If a dwelling, for how many families?T
Will building conform to law? Asbestos?
Esffmated cost /S dO City Ucense N state License K
V p ! � �roveaent V. �,.. ✓�
(� ignature of Applicant
SIGNED UNDER THE PENALTY
DESCRIPTION OF WORK TO BE DONE OF PERJURY
MAIL PERMIT TO:
1
No. (�
APPLICATION FOR
PERMIT TO
49n5�ry�f �Cl� 17
LOCATION
PER IT GRANTED
APPROV�D
INSPECTOR OF BUIL NGS