40 CHESTNUT ST - BUILDING PERMIT APP T
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Ii1 ZCT.,D-R PRWR TL3 A PEFINT EIFMIS GRANTED
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CITY OF SALEM
Date Z 2-cc
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Is Property Located In Location of
the Historic District? Yes—No Buildi 1
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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: -Cfefrws5:1k CHI'Z-, fcPs d � �ethcw
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 NameJeQt'Pia 1
Address & Phone e+h O e&.11" f- Sr or) 7`f0 ^qr so
Architect's Name c�,��-17
a'(fin x, ,
Address & Phone I
Mechanics Name E
Address & Phone f )
What is the purpose of building? IMF S r
Material of building? .t If a dwelling, for how many families?
Will building cQnfomt to law? 1 ,' Asbestos?
Estimated cossttt _1 " AT City License 0 N P' Slate License n
Rome Improvement
I3c. /
Ig ature of Applicant
SIGNED
PERJURY UNDER THE PENALTY
OF DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
No. 7aa- 06
APPLICATION FOR
PERMIT TO*G�1 Cn F(Po n pei bek
LOCATION 1
PERMIT GRANTED
AP10R6VFD
INSPECTOR OF BUILDINGS
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