26 COLUMBUS AVE - BUILDING PERMIT APP y DASEs 12
UP of fiaj*M, :Rla5�at�ju5ett�
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED/
Location of Building C a I s ^r
Building Permit'Applicatiom For `--
Xcircle whichever applies) Roof I;eroo , Install Siding,Construct Deck,Shod, pool
Addition, Alteration,Rgm&/Replaoe,Foundation Only, Wncjdag
Other:
PLEASE FILL OUT LEGIBLY& COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inspector of Buildings:
The uodasigoW hereby applies fora permit to build according to the"owing specifications
Owners Name: G y b (o K 4 � -
Contractor. ) �. 4F �,)�Y , G r k
Street_ 2 Co o��N ��s �'t city �I,n Street I(z r /s Y 4.I � v-d City Ca p
State` Phone ( ) State./a�
Arehltect: City of Salem LictL I �4
Street Ciq' State LiaMdg7q3 Z_State Phone ( ) Homeowners Exempt Form___pas ao
Structure: (ply ) Single Fanui , Multi Family NOdw
Estimated Can of job$ `06 ao
Will bulhfieg confirm to!W. on
Asbestos?____yea t�/on n
Descnptiam of worn_to be dome:
Drawings Submitted:__Yes no Mail Permit to:
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SipaWre m APPueadon,$ GNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO B . OMPLETED WITHIN SIX MONTHS OF PERMIT ISSUED DATE
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Departmeut use only: Peru*' Zoning __ —
Permit fee$
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