28 HANSON ST - BUILDING INSPECTION i
{
No.
.2
APPLICATION FOR
PERM4;i TO
LOCATION ,.
PE MIT GRANTED
4
APp
INS E On OF BUILDINGS
CERTIFICATE OF OCCUPANCY .
YES
NO - 1
DATE• S
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PLANS MUST BE FILED AND APPROVED BY THE
INSPECTOR PRIOR TO A PERMIT BEING GRANTED
Location of Building�t'gv LQ/Z50h 51 -2e
Building Permit Application For:
YCircle whichever applies) Roof, Reroo Install Sidin Construct Deck, Shed, Pool
Addition, Alteration epair/Replace, 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: n t
Owners Name:,lorr'a f. PCf'fl"IGiQ G)rJ4n Contractor: A IA SexyICe5/C17Y15 ?�r�
street 3d &)nnnf c1rva f- City Ac-&n Street l i5 N alh 5�. City .`j I cm
State` Phone State PA H Phone. (a70
Architect: City of Salem Licd(_ N D5
Street City State Lit n 5 J HIP# 10I to 09
State Phone ( ) Homeowners Exempt Form yes no
Structure: (please circle) Single Family, ulti Family Other
Estimated Cost of job S o?_� 7 `
i
Will building confirm to law? bL ves no
Asbestos?__yes V/ no
Description of work to be done:
illn tLl �n
A&A SERVICES, INC.
Drawings Submitted:_yes no Mail Permit to: 1 SA.LEM, MA_0197.0
g - lo�a 741-0424
X !� WWWA-A9ERVL-MMUW-
Signature of Applic 'on,SIGNED UNDER THE PENALTY OF PERJURY
CONSTRUCTION TO BE COMPLETED WITHIN SIX MONTfIS OF PERMIT ISSUED DATE
,