39 LAFAYETTE PL - BUILDING INSPECTION (6) -s
'PL-*M1dUST-9E fiLfD-*ND APPROVED BY T44E
.IAISPFCTDR,PRIOR TTl A PERMIT BFNG GRANTED
CITY OF SALEM
No. ) t Date ��/&201Z
Ward__
Zoning District
Is Property Located in J Location of
the Historic District? Yes No_ guLld:Lng
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, 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 according to the following
specifications:
Owner's Name MQUrPPYI 1 pc�ri sea u
Address & Phone 3y le, cau e tfe 7 37a
Architect's Name
Address & Phone f
Mechanics Name
Address & Phone
What is the purpose of building? /f,P 5,'L(�r��'�
Material of building? If a dwelling, for how many families?
Will building conform to law? �� Asbestos?
Estiti//�mated cost co 73 00 Clry License fr State License M
/ lie Improvement /�
Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
=nSkr" uCk+0r1 v-f 2001 .
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
LOCATION
P RMIT GRANTED
APPRD
INSPECTOR OK BUILDINGS
i
t
CTl'Y OF SAlEM
BumiNG DEPAILmam
xONEOWIER UCENSE F mOMON
Pkaae PAM
DATE 7 /& O
�B1.00ATION
HOMEOwrmt 3 9 A o Fa Lie t1 t? I a I eaa
ADDRESS
HOMEOWM 978- 74 73-72
Tnmwom
PRESENT MA71.II?G�� '
Tha c maa.e WMUosi of'homeowme pas cxtc m Imbdc owees-opmow dwesOp aTm
UWu a Im and to albw such bomeowmm m C"P sn bdWdW*c ldm who dam aot possess a
,.provided tbat tbs eweer act of super+�Mas:
DEFIIWM CF HONMEOWt= m resdde.on+AJd�there!s R Y
Person(s)who owm a peca of bad ea which hehhs resides or breads m saeh m smdlsr
intada m be,s cm to two funDy dwelft snschod atdwd"str+rctmes be evasldasd
farm svocwm A pcnm who constructs mole than one Imbc in a two- a!W sbaU to M
Bm7ding Odic that h�clsh�e be nspotmbme k two all such work pahnNA WAU dse buildiq perait.
Tho undenivad-booxow7ta"au=m M"Ustbift for=MPU'R whhthe Sure BWW=g Code sad
otha appliabk Saes W4vws,roles and u=ubdaft
.�tadasiSrtcd'hovKowrret"oatibes that heJshe wdastards the a9 01 Sak=
with
miaimmo inspection pmccdma and nngtmemcros and that hhhe wiD'A�7'
APPROVAL OF BUII.DING INSPECTOR
See other sde for sass code