30 HANSON ST - BUILDING INSPECTION (2) f14� 1610116TIIIEflWO-AND APPROVED BY T46
IWPMIDB Pwil TD A_PEaw a ra GRANTED
CITY OF_SALEM
No. 1 �� 7
Date
I i
Ward
Zoning District
Is Property Located in Location of
the Historic DistdW Yes No L sending
Is Pmpery Located in k
ft Conservation Area? Yes No
Permit to: BUILDING PERMIT APPLICATION FOR:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Sh ool,
Repair/Replace, 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 accor(L'1g.to the.following
specifications:
Owner's Name I Jrnhn J�Dw�tnc�
Address & Phone an Sf (9�81 7yi —yoga
Architect's Name
Address & Phone
Mechanics Name
Address & Phone () I
WIW Is the propose of building? pot)Et) f /.n S�w L.
M"w of blrlldW B a dwelling,for how many famYlea?_
Wsi fwik"conform to law? Asbestos?
Edmated coat f 00 CHy Uww Stattucense e
Holes
S' ature of ican
SIGNED UNDER TH ENALTY`
OF PERJURY
DESCRIPTION OF WORK TO BE DONE /f
� �fgl( oo ) Cb0L aFIDunaf
MAIL PERMIT TO: 3L (<I o-n s o n S S6.1 en, J�G DJ 97�
ASF
No.\ \_/
APPLICATION FOR
PERMIT TO
�T�GI /✓C I
Locnn
PERMIT GRANTED
19
APrVFD
INSPECTOR F BUILDINGS