73 FLINT ST - BUILDING INSPECTION (2) ` DATE:
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building -73 Et I /'t S-t� et
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool
Addition, Alteration, epair/Repla , 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 permit to build according to the following specifications:
Owners Name: @ )-eyj kxta St?,LQ Contractor: Chr; Gtnnnar Zorzg
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Street /J t �✓i'lL 6+aJ City JLi Streetl15 Vnrth Straat City_ Calam
State M4( Phone State MA Phone(978) 741-0424
Architect: City of Salem Licq 1405
Street City State Lic#0 5 7 7 3 3 HIP# 101609
1
State Phone ( ) _ Homeowners Exempt Form_yes_no
Structure: (please circle= Single Family, Multi Family# Other
Estimated Cost of job $ k 3 ZS
Will building confirm to law? yes no
Asbestos?_yesno Description of work to be done: IV S faJ1 P I-V P:vl Cl I �(to 4 L veto(ace kttD,,e/1/J
SERVICES
Drawings Su mitted:_yes ✓ no Mail Permit to: 115 NORTH STREET
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Signature ot Application,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit#Zoning Map/Lot
Permit fee$
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