42 CROWDIS ST - BUILDING PERMIT APP (002) �L QSIAUST-BEffLf D APPROVED By T44E
,=P XTDjj ,PFWA TP:A .PEANllT.BEWG GRANTED
CITY OF SALEM
No. I $a ��`� .L �''�� Date
Is Property Located in Location of
the Historic District? Yes_No (� Building
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, hed Pool,
Repair/Replace, Other: V-oA,yg)A 6-2122 P
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: n n
Owner's Name Qyla PA � \ ,
Address & Phone 71 7 q,4� 7L I
Architect's Name
Address & Phone ( 1
Mechanics Name 4
Address & Phone ( 1
What is the purpose of building?
Material of building? Go - If a dwelling, for how many families.?
Will building conform to law? \ es Asbestos? )AC
Estimated cost 0 City License# N A State Lj6ense #
c��SoD J Improvement
'Y /GK—,6'l Sc-� —
Si nature of Applican
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
(1 d1q-Oi V)
MAIL PERMIT TO_: t c,e"4
�a• C�lro� CQ�S ��
4 (qc 2
No. 1
APPLICATION FOR
APERM T T/O/
Cowes
LOCATION
PERMIT GRANTED
2.0
AP/P DVfD
zto
INSPEGTO F BUILDINGS