31 PLEASANT ST - BUILDING INSPECTION CITY OF
PUBLIC PROPERTY
4� DEPARTMENT
Vwvaa 130WwuuNGww!`nwzr• l"& • ,yAAAcns&-rn;a1970
IU-973 71S-9S"9 FAX 978-740-964
J APPLICATION FOR THE REPAIR. RENOVATIO?h CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDING.
1.0 SITE INFORMATION -
Location Nana: Building:
--- -
- Progeny sx------- - — -- --- -- - - - - - --- ------ - -- - . . _ _ ----
Property Is located in a.C&umvatlon Area YIN Z Historic Ohtrict YIN�G
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land �; C
Name:
Address: 3 / /J�/�4 5
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN EYISXLNG BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Bidet Description of Proposed Work: / ,p
------ ---Mail Permit to e,J�
What is the Current use of the Building?
Material of Building? It dwelling. many units?
Will the Building Conform to Law? Asbestos?
Architect's Name
Address and Phone
Mechanic's Name �' r
S
Address and Phone
C
Construction Supervisors License# 7/ 7 7 HIC Registration
Estimated Cost of Project i _ Permit Fee CabuWon
Permit Fee i Estimated Cost X$7/$1000 Residential
Estimated Cod X i11/i1000 Commercial----—-----An Additional $5.00 is added as an
Administrative charge.
Make sure that all flelds are property and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the abov sta r
specifications. Signed under penalty of perjury X
Date
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p�
y s`
a
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