4 CALABRESE ST - BPA-2004-306 WINDOWS, DOORS -ft*146lAtIST-BE ffL{-� APPROVED BY T*IE
< If P CTS?1 PRWR IT _PERNll7.B1*WG GRANTED
CITY OF SALEM
No.30(0'200 � ��\ Date
Is Property Located in Location of
the Historic District? Yes_No_ Building �(J
Is Property Located in
the Conservation Area? Yes_No_
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
Address & Phone ( 1
Mechanics Name
Address & Phone ( 1
What Is the purpose of building?
Material of building? If a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost q �' City License # N A State License rt
Rome Improvement f
Lic. /
Signature of Appl ant
CAsI 1 SIGNED UNDER THE PENALTY
OF PERJURY
DESCRI F WORK TO BE DONE
MAIL PERMIT TO:
No. 30b-- NI-A
APPLICATION FOR
PERMIT TO
yoiv /� d b c7 r¢iJ
LOCATION,
PERMIT GRANTED
AP ROVfD
—1
INSPECTOR 6F BUILDINGS
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