2 DOWNING ST - BUILDING PERMIT APP JACKET �i.4kNSiNliSfi= fFL4MO APPROVED BY 744E
IAISPF.CJ. ,PwR TP A PEWT 13EWG GRANTED
CITY OF SALEM
Oate o
No.�
�i
Location Of �
Is Property Located In Building l Ix x7
the Historic District? Yes_No
Is Property Located In
the Conservation Area? Yes_No
BUILDING PERMIT APPUCATION FOR:
Permit to:.
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
epair/Replace 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:
Owner's Name i orr O9` ,
Address & Phone
Architect's Name
1 )
Address & Phone
Mechanics Name ) V i'ar r�
"-7'1
Address & Phone
what is the purpose of building?
Materiel of building? If a dwelling,for how many families?
Will building conform to law? Asbestos? n)�
Estimated cost
City License• N P' state License#
Barge Improvement Qn.i.Ra 1 tL
J/Qd I'i`' 'Si5naiDe of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
/iZ1 PRo fF�t' --n G� <-'u vyc.2<v e <<uGt�lse d6
T
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
w �.0 S7/i�i"ia.� of �.4rA',eBay
LOCATION
1
PERMIT GRANTED
APPROVFD
*AECT�ORF BUILDINGS