46 ENGLISH ST - BUILDING PERMIT APP (002) �L�IItlt3lMWT-qEfIi£4I`� AfPROVED BY 774E
IWZC=PP" TD.A.PE W' T BEING GRANTED
(�� CITY OF_SALEM
.50:�No. 0 �y \ Date �!�/•5 65
Is Party Located in Location of
theHiatoricDlatdct? Yak_No sa-11A4ng 4& ENo\(iS+( ST-.
\.�\ .
Is Property located in0 c970
go CarmarAdon Ares? Yee No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) ( oof Reroof nstall Siding, Construct Deck, Shed, Pool,
Repair/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:
rOwner's Name QY-ONAr �e g1AvC C C/}Sr1-C ConcSrrKc7'nna Co 'rwcr
nhorl
Cwv
Address & hone k/ca flccr / Pe o(u�(��a)
Archit 's Name
Addre s Phone 1 1
Mechanics Name '
Address & Phone ( 1
What is the purpose of building? $ '� I< FPIM i l v PO M O.
R Material of buildirq? If a dwe",for how many famffin? _
WN building cordon to law? \/-e-S Asbestos? /V o
Estlmeted cost 4.700 0-1 C4 Licanee• ►.1 A state Lwwtse r oS4 SSa
BLae L"rovaaeat� beg --�_C Db Lit. 11 t 7 84C_ X Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO: akm
No.
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
AP AOy f D
•
INSPECTOR OF BUILDINGS