31-33 HANCOCK ST - BUILDING INSPECTION (2) DATE: �D �7 •Q�f
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED L
Location of Building_3i -6�
Building Permit Application For:
'(Circle whichever applies) Roof, Reroof, Install Siding, Constrict Deck, Shed, Pool
Addition, Alteration, Repair/Replace, Foundation Only, Wrecking
Other:
PLEASE FELL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
To the Inspector of Buildings:
The undersigned phe�reby applies for a permit to build according to the following specifications:
Owners Name: /.'ke�"d-I/PQWtp,(� �OC kru0, Contractor: C h r; a t n nh a r Z o r z y
Street_ `j-�j��}pyL()(�; � City Street115 North StraatCiry ga7Pm
State Phone ft) State MA Phone(978) 741-0424
Architect: City of Salem Lic# 14 0 5
Street City State Lic#0 5 7 7 3 3 HIP# 101609
State Phone ( ) Homeowners Exempt Form__yes no
Structure: (please circle) Single Family, Multi Family# _Other
Estimated Cost of job $ ty)
Will building confirm to law? yes no V
Asbestos?_yes_Zno
Description of work to be done:—&4larea. X l // a r'�/)rl hf D /irnf/�l>lt7n[7
Drawings ubmitted: es no Mail Permit to: 115 NORTH STREET
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Signature of Application,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX(6)MONTHS OF PERMIT ISSUED DATE
Department use only: Permit# Yl _\ oning Map/Lot
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Permit fee$
COMMMS:
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