67 ENDICOTT ST - BUILDING JACKET DATE:
CItp 1RaE;!5arbU!5Ptt5
PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building_l0 Z
Building Permit Application For:
`(Circle whichever applies) Roof,Reroof, Install Si ' ct Deck, Shed,Pool
Addition, Alteratio epair/Replac 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 permits to build according to the following specifications:
Owners Nam : �
e lJM � hIM 01?14W Contractor: Chr; 4tnnhPr 7.nrz
Street (P7 Sf-ppkin•.Cj le" Street 1 7 5` N n r t h S t r P P t City S a l Pm
State.Ph Phone � )_'�f/b �`J�3 State MA Phone(97g) 741 -0424
Architect: City of Salem Lic# 1405
Street City State U00 5 7 7 3 3 HIP# 101609
State Phone ( ) Homeowners Exempt Form__yes__,�/no
Structure: (please circle) Single Family, Multi Famil _Other
Estimated Cost of job s
Will building confirm to aw? yes no
Asbestos?
_yes to
Description of work to be done: yin
hnnne� ��ti;c�il�/11n/S
Drawin s m' ed: ERV'CBS
g _y s� no Mail Permit to: !16 NORT13 STREET
0.
Si of Application,SIGNED UNDER THE PENALTY OF P.9R.IURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX (6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# Zoning Map/Lot
Permit fee s 2.7-Lt —ZootA�
COMONTS:
r
ti C D
�)Sb31.(iuCYY�'ii•?_ /..y.:j.•' .;is Q'
M
r ,
L�,�iscnAr-r,( �;ffara•l .:.�;.;.
pRlsi'�rA7Y �i:Lflrf'� br,<;:.pol 4,•IL. '
s:y+.aJp•�;