47 BUFFUM ST - BPA-2006-324 -PL-*NS1dU6T-BE f1LgEQ N, ) A?PROVED BY T44E
j=PFX3'D~]PRIOR TD A_PEBWT BEING GRANTED
CITY OF SALEM
No3r-g�_ „ "� *� Date �U
s.
Is Property Located in Location of �,t�
the Historic District? Yes No,� Building '7 /
Is Property Located in
Me Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroo Install Siding, Construct Deck, Shed, Pool,
it eplace, 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 /Y) lgzm �f
Address & Phone mg 6-70
Architect's Name dV�/fi
Address & Phone II ( )
Mechanics Name L-4ya)c 1,
Address & Phone
What Is fhe purpose of building? S l T6,
Material of building? L()ddb FA9Al F If a dwelling,for how many families? Z
Will betiding conform to law? YZS Asbestos? A)d
Estimated cost /mod y City License R N A State Licanso 0
✓� /� Hcae Improverant
5 nature of Applicant
KaNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
L/7
�� L�1 &Z, 01976
No.
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
APP O �D
INSPECTOA OF BUILDINGS
i