12 1-2-14 DANIELS ST - BPA B-2006-760 SIDING DATE: 3-70 - 0(O
Citp Df 'c5arpm, a'E;5arbU5Ptt5
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building /a�� /'� �Civii �S ,�t•
Building Permit Application For:
jCircle whichever applies) Roof, Reroof, �tallSidinConstruct Deck, Shed, Pool
Addition, Alte , /Replace, Foundation Only, Wrecking
Other:
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, Contractor: C h r i s t n n h p r Z n r z y
Street 6)L.C64- sf. City ¢ Streetil5 North Strppt Ciry 4atpro
State Phone 95� State MA Phone(97g) 741 -0424
Architect: City of Salem Licq 14 0 5
Street City State Lic#0 5 7 7 3 3 HIP# 101609
State Phone ( ) _ Homeowners Exempt Form_yes_no
Structure: (please circle) Single Family, M i Farm Other
Estimated Cost of job S '�(D,
Will building confirm to law? ✓/Yes no
Asbestos?_yes ✓ no
Description of work to be done:__�� S/u l/ 1?> 414 r e or Vi n �W 54
SERVICES
Drawings Submitted:_yes / no Mail Permit to: 115 NORTH STREET
IL SAT.RMA9A a,Awn
x
Signature R Applica ' n,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX (6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# Zoning Nfap/L.ot
Permit fee S
COHMEtTTS:
A� Y���
, 2
No.
A�PLICATION FOR
' PERMiT' to "
i,4/r
LOCATION
PEgMIT GRANTED F
1-7
APPROVED
E T'O OF BUILDIN S
CERTIFICATE OF OCCUPANCY "
YES
NO �• �
17
2