13 HANCOCK ST - BPA 4
A
a tj 13E fiUEG-A+ {I,APPROVED BY T*IE
.IWfXTDA ,PFai B TD.A.PERMT.13FING GRANTED
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CITY OF SALEM
No. 2- 4 -�O Vim" '� ��\' Date
Is Property Located In Location of
the Historic District? Yes—No Building 13 [14MCO(,k Sf
Is Property Located in
the Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair eplace, 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 J Uh n l la� Z S
Address & Phone 13 Ravl cock
Architect's Name
Address & Phone ( )
Mechanics Name
Address & Phone ) ( )
What is the purpose of building? gt6cic ���� Uc�PIITJ C-�X_1.4 t^pii.3A 1
Material of building? If a dwelling, for how many families? I
Will building conform to law? e5 Asbestos? yo
Estimated cost 13 (-! . 00 City License# N P' State License #
oa Rome Improvement d / /mot E- , f
93 Lit. I Y 1 Signature
,I Adul1Yt
� I� tC� ignature of Applicant
SIGNED 'UNDER THE PENALr"Y
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
LOCATION
Z3 _ c��
PERMIT GRANTED
1 8' 2.0 O �
APPROVF-D
INSPECTOR OF BUILDIN S