46 PEABODY ST - BUILDING INSPECTION EI1Y OF r
PUBLIC PROPERTY
DEPARTME,�1T
wMO' t3orr�wna,�wsnsst•
AlPI1CATION FOR THE RIPAUL RRNOVATION CAntgTQucitorr
D HANGZ OF USE OR C>rMrr G
;3 MUCTURR OR RIMaDi(i
1.0 W§MFORMATION
Locadon Names &
Pr poV r boded Ina CwmrAdm Am M Hboofb of —m-YM
.410
2.0 ONMEROM INFORMATION
2.1 Ownar of Land _
Namur 64'lf r-A o &mmclin Le bpilA 610
Addre" ma 1, S7t
q7 r- gas- q e o
LOCOMPLIM THIS SECTION FOR WORK IN MUSt!lIIfE MJILDINOS ONLY
Additlon Exl"
Renovation Number,of storlee Renovated
Change in Use New
Demo6tlon Existing
Approxbnate year of Area per flow (st) Renovated
construction or renovation
of existing building New
Beef Description of Proposed Work:
duo aJ R �,1d s .�s � har�m�•�"'
+'0 -39J
--- - --- _ - - — - - 7y
Mail Permit to: 0ry'2M f" ��,
What la u►a aurant use d the now manor unUa9
ftA8ww d eugding� 0 R tl K d tg.
WI/tlta etdlaMto Catlbrm b t
Mqdl@tCs Nanr
f
— r
C nsvucdan Supsrvi on l f� /')ro U 7�HiC Ragia�or► y 7
EatlrnaMd Coat alPn�jaat a ' Paeni F."Calculation
Pam*Fee i E + X i741000 RwfdaMW
_- . --- - ENYnabd Coat X i1141006 Conwewela�--—An Add ft"i6.00 in added w an a
AanhNtralh»enarga. 1:
Make sure than al Mlde an pmWV and Wbti wftm to avoid delays in proaasaino
rw urtdamWod do"herew appy for a Building Pwn*to baud (above stated
specrAgdons. S%rad under Panaity Of Ps"
Date 6
� 1
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