0005 COLUMBUS SQUARE - BPA 05-165 ADDITION 'I `
�5s -
gPPM1ftST9E fIL{GAND APPROVED BY T44E
AMMIDR PWR TD A PERMIT BUNG GRANTED
No.\� � CITY OF SALEM /
Date
r, ward
le
Zoning Distnot 2-1
Is PMP"LOCated in Location of
the Hlstaft MOtiW Yea No✓ sasiei„g 52Allll154
52
Is PMPO"y Loctited in
the Cwmwva*m Araa? Yes No
Permit to: BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Cong met Deck, Shed, Pool,
Repair/Replace, Other: AC\D*. C`tOA 7
0
PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS: '.
The undersigned hereby applies for a permit to build accor&ag.to the following
specifications:
Owners Name 114�elv 6Q 12AVLA
Address & Phone 5 (� 61-OAI BUS r� 2 d` 1 L AV
Architect's Name WAL��j T l/113
Address & Phone 152 ► f&�NiAr'471t 57. _/ , 'X1 AL ZW
Mechanics Name <Ey.N A0
Address & Phone k4 ANC I (17Z
what Is the purpose of build �Mt`o C2crsM
V
fdetedal of WNW wd CA If a dwe",for tow many families?
will twllding conform to law? Asbestos? No
Esgmated cow 75T CHy Ucerma r< %ft Ucsrma N
r�ic. ��on 1
a oo 9
Signature of Applicant
SIGNED UNDER THE PENALTY'
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
2 ' X ?1L Twcs stoc-y ApQ xtViot/
A��e, 190 l7 to(AA
MAIL PERMIT TO:
� r Lt'cy M :�v,assachusettts "
�iie'Dgartm_ent s
48 Lafayette Street ;
�' } 29, For
9ea6ert'W?urner, Salem,Masset -usetts 01970 3695
rim 1
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CHECK-i
LOT 153
J. MORRA` I F. SIMPSorA
E. SIMP5oN
20 GOLUm6U5 AVENUE �l
51 0%
eq LOT 13
PeTEM 5, & DIANE M, HAywooG ,
TMOSTCES of D•M, H, REALTY TRUST
3A WINTER ISLAND ROAD
LOT 1s
0
-AREA-
LOT 14
yaE
PETER S, & •DIANE M, HA`IWooA,
TRUSTEES 6F P.M,N. REAL1y �'; LOT 19
TRJ5T 1: PETER S. S DIANE M. HM\400D
�} CDLUMBU5 54UARC TRUSTEES OF
OJERloovt NOMINEE TRUST
3 WINTEM IS.LANO ROPID
New 2 STORY UEck l I`
5T R UCT-U gC —OVEWONG
L67 17
�J ANTOINCTTE E. M. LE0140
WINTCA ISLAND ROAD
10' SIDE V,gLb SETL CLi
to-
lo' SIAEYAeb SEr6ACC-
8
EXIST/AJ6 SrRU,'_rL) .E
To !3E pEMULIS NE4 is. V
MAZES
v_
LOT I2 UJ gp H\RGS
PETER S. & DIANE M• NA9W00D,
TRU5T66S OF M,S,H. REALTY TRUST ® LOT I6
3 COLUMBUS S0.UARC GEORCE rJ, scul JR. S
3 1 I ELEANOR I. BERRY r TRUSTEES
of l COLUMBUS SO.UARC TRUST
CK
i
NOTC:
LOT NVONSCRS FEFER TO CIT`) OF SALEM
AssE5SOR's MAP 44
9'x19 ' PARCI&16 C�P.4c15
PLOT PLAN OF LAND
REFERENCE:
LOCATED IN
DEED : REC. BK. 15114 PG. Zh9 SALEM
PLAN : AK, 18S PLA4 91 1No`reasS4 PREPARED FOR
I CERTIFY THAT THE BUILDING(S) ' cnl PPVLPc PI,, 6A0TNIER- KEENS
HEREON ARE LOCATED ON THE GROUND SCALE i'a 30 JUNE IS 2004
AS SHOWN. smin+
asoaa
NORTH SHORE SURVEY CORPORATION
47 LINDEN STREET-SALEM, MA.
HEG. PROFESSIONAL LAND SURTM Al I p1U
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