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55 HANCOCK ST - BUILDING INSPECTION �L9klQS�dttiSi�E fiLf N{)g APPROVED BY T+IE a I1 P�GTL1 ,Pf3�1;R T I,A,P.ERMIT BEING GRANTED :CITY OF SA°LEM No. "` "� pis ^ Date 6 Flo it is Ward \rdtrniNs '^ Zoning District Is Property Located in ✓ Location of /� the Historic District? Yes—No Building �j D A6^c2ILL6 9-�, 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/Replace, Other: Cor s Fc-uCV Poi c l eg 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 � 10-J C— �Ca Address & Phone '565 40 vac ,j S (qw )&?Q S - 00/13 Architect's Name Address & Phone \ ( ) Mechanics Name rs� �Ctl R q0 --5 Address & Phone 3 4 � P �r� !/e o9b) ! 0 3 What is the purpose of building? Material of building? VJe�e�k If a dwelling, for how many families? Will building conform to law? Vt-� 5 Asbestos? k d Estimated cost L4,C�P City License # State License # ` 5 dt✓ 3 ( ({ Home Improvement Lic. / �� / +� Sig attire of Applicant SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE c-d10 V✓9- ©/cf_ Fo c G-,2 S /`A(- t AWO PC)/-c �e S S MAIL PERMIT TO: S 4 Ave i . r , I ., •"r•; �. %dr 4" " xk .E. �;` . " 9 rb �iF G y & 9's�z.h .� .Eat ,$Jt : akr t "d z a ^M'Ni�ut Z z O uill J 4 t "wZ ,>R�:3 �'�:,} Vy W3 •�D�I,.�. "^5�»�9�+r� t",d'4''�u F u LU Z 0 a Q CO ?