236 LAFAYETTE ST - BUILDING INSPECTION IMST13E fiL+- l3 A>PPROVED BY 744E
LNS,PEXTQA ,PIRICIR T-0 A_PERMIT B,EWG GRANTED
CITY OF SALEM
"N
No. �c\�t ..L �.,\ Date v?
.. I
Ward
NE�yn Zoning District
Is Property Located in Location of
the Historic District? Yes_No_ Building �� V
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: I,
Owner's Name -ah, ��1f�(YYIa� u
,1. J Ll 70
Address & Phone Q3h la�uP' Ile Sfi �m (9 ) 7y {
Architect's Name
Address & Phone
Mechanics Name A I R�I�I
Address & PhoneC�FfJfi.�CdY�I��j��Il�+ ( ) )9l3-C, �&,-3E!i
What is the purpose of building? u 1 I ki a P"O& 'YIA
Material of building? If a dwelling, for how many families?
Will building confq*to law? S Asbestos? V\
Estimated cost (j City License# State is se #
Home Improvement
Lic.
ig ature bf Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE D E
� t7
MAIL PERMIT TO:� d�1E >'
c\
No. C�V�
APPLICATION FOR
PERMIT TO
1.l`�lYl�0u�7 K,���PfY)Pn I .
LOCATION
PERMIT GRANTED
19
APP OVFD /
iNSPECTOK OF BUILDINGS