7 HILLSIDE AVE - BUILDING INSPECTION i'
Ao"-'6fi-BEffLf9-iN0 APPROVED BY T44E
.II�,P.�TDB P;FWR TP'A.PERMIT B,BING GRANTED
CITY OF SAL_ EM
No. �>�� �� , ;Hc`. 'aeo��r ` \
Date
it a
�q�gry�g Day
Is Property Located in Location of
the Historic District? Yes_No_ Building I H ( L-L,S( E)F—
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:
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: LL
Owner's Name l�2°r/, kr U y y1/i��
Address & Phone ' !7 %/`Ls
T�
Architect's Name
Address & Phone ( ) !
Mechanics Name 7/—,q V-1
Address & Phone
/ /�
What is the purpose of building? 1/��r !?fir � h �rl/Si 7 � �C mod/ �/�T,0 ,/- 1
Material of building? wD 0 If a dwelling, for how many families?
Will building conform to law? rv5 Asbestos?
Estimated cost ?10/ G City License# N A state License #
Home Improvement a
Lie. i �" �i`l
Si ature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
i
MAIL PERMIT TO:
No.
APPLICATION FOR
PE�R/MIT TO - -
LOCATION
CO
PERMIT GRANTED
AP�ROVfD
INSPECTOR OF BUILDINGS