8C RUSSELL DR - BUILDING INSPECTION (3) what is the current use of the Building?
Material of Building? If dwelling.how many units?
will the Building Conform to Law Asbestos?
Architect's Name 40
74
t
Address and Phone Peabody, MA 01960
978-977-
Mechanic's Name
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost of Project i (qOO1C:) Permit Fee Calculation
Permit Fee i --- Estimated Cost X$71$1000 Residential
Estimated Cost X$11/51000 Commercial
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are property and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of penury X
Date
v
Ool
N
a v
o 04
a ��" 9 r.
-- CITY-OF S-ALETNr--
PUBLIC PROPERTY
DEPARTMENT
Kl.%QWALEEY ORLUX) .
MAYON 120 WA5MUNGT0N SMEffT 0
SLLK%IA►SAa1t:5t.'1'IS 01970
T a:978-745-95"*F=976-740-98"
APPLICATION FOR THE REPAIR. RENOVATION. CONSTRUCTION.
DEMOLITION. OR CHAINGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: _ " p n Building: G
Property Address. 4 C, 2Gu�z x��-C O OA ,
Properly is located in a;Conservation Area Y/N Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: GO I ^/A
Address: p�
0 G
Telephone: '7 - -7 p0
3.0 COMPLETE THIS SECTION FOR WORK IN EXIQT G BUILDINGS ONLY
Addition Existing
Renovation L/ Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sn Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
Mail Permit to: