14 CURTIS ST - BUILDING INSPECTION DATE: 4-/CLi o3
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED /-
Location of Building // (nOU -kS . #3
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool
Addition, Alteration Repair lace, Foundation Only, Wrecking
Other: 1
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:
Owners Name: .4h W a H7)n Contractor: r%,r i s t o p p,a r Z n r 7 g _
Street /y LI'L S1, #3 City,q Pm Street 115 North Straat City Calam
State "P Phone (979),59y gala State MA Phone(978) 741 -0424
Architect: City of Salem Lick 140 5
Street City State Lic#0 5 7 7 3 3 HIP# 101609
State Phone ( ) Homeowne Exempt Form no
Structure: (please circle) Single Family, Multi Family# er
Estimated Cost of job
6
Will building confirm to law? Z vcs no A
Asbestos?_yes L,-' no _ / 1
Description of work to be done: J- 9,S-IZ /l -lbreef I P l-Vor
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ERVICES
Drawin Submitted: es no Mail Permit to: 116 NORTH STREET
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Sio 2.we of Ann!ka .nn SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX(6) MONTHS OF PERMIT ISSUED DATE
Department use only: Permit 92,9Z.2,C01oning Map/Lot
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Permit fee$Zq dC (p(098
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