45 FEDERAL STREET - BPA B-06-260 fL�+16�Ag6teEft:094Np APPROVED BY T44E
MPZ=M PINOR TD A PE W BEING GRANTED
CITY OF SALEM
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Permit to: BIALDINGI PERMIT R:APPLICATION FOR:
(Circle whichever wh) Install Siding, Construct Deck, Shred. Pool.
<9;=. . Other.
PLEASE FILL OUT LEGIBLY A COMPLETELY TO AVOID DELAYS N PROCEMW
TO THE INSPECTOR OF BUILDINGS: '.
The undersigned hereby applies for a permit to build aocordwsig.to the toNowMq
Ow Wo Name I/it A L
Address a Phone
Architect's Name
Address A Phone ( )
Mechanics Name Mac %Cffn 6 444w
Address A Phone 7 LM-VA iff ", LwI et &7 y10
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SW&Wm of AppWcant
SIGNED WIDER THE PENALTY'
DESCRIPTION OF WORK TO BE DONE OF PERJURY
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MAIL PERMIT TO.
-------------
NO.!
APPLICATION FOR
PEffi/T TO
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LOCATION
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PERMIT GRANTED
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INSPECTOR OF BUILDINGS
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6"wadiiaven area
Boston,MA 02111
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Oman of Lvteadgsdmi
600 wa"glml Strtiet
BOOM MA 02111
TeL # 617-7274900 ext 406 at 1-877-MASSAFE
Fax 9 617-727-7749
Roviwd 5-26-0 www.mmgov/tlia
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