38 DEARBORN ST - BUILDING PERMIT APP (003) t
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ICITY OF SALEM
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No. 5`v '� f3� Date M
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�.i.. C1/Ward
\ m.s� Zoning District
Is Property Located In / Location of ��� �
the Historic District? Yes_No_ Building J
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct De k, Shed, Pool,
Repair/Replace, Other: M ��1�1/�7dh
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: l�x
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Owner's Name P,Y d o /, P L
Address & Phone (- d JP_Ctr�LL4 L21 (IM 745'— (aS21'
Architect's Name
Address & Phone ( )
Mechanics Name 4
Address & Phone
What Is the purpose of building? T/ O h 1 'a;
Material of building? If a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost City License # State License #
Home Improvement
Lip.
Signature ofAplicaint
SIGNED UNDER THE PENALTY
OF'PERJURY
DESCRIPTION OF WORK TTO" BE DONNE
MAIL PERMIT TO:
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