14B RUSSELL DR - BUILDING INSPECTION What is the Current use of the Building?
Material of Building? It dwe&t%how many units?
WO the BuO&p Conkm to law? Asbestos?
The Chimney Guys
ArohROWS Name
Address and Phony � ni n6S1
Mecharoes Nar w 978-977-9900
Address and Phone
Oxwo ction Supervises Ucw"• C Registration
Estirnded Cod of Project:/'� ' Pon*Fes Caleulatlon
Permit Fee= Estlnated Cad X i7/s1000 Residential
Esiknded Cost X:41/:1000 Cownsmial, - -An Additionsi Slim is added as an
Administrative charge.
Make sun that aU nelds are properly and legibly`""men to avoid delays in Woc"W ng.
The undersigned does heroby apply for a Building Pennit to build to the above stated
spec&Auone• Signed under penalty of perjury X
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PUBLIC PROPERTY
DEPARTMENT
,:�..a18.rsvosatauu
MAWS 130 wAfWNG"STRM.sAwrL wrAAocsrrs 0ts7o
APPLICATION FOR TSB REPAIR. RENOYATIAN. CANSTgucnoN_
DEMOLITION.OR CSANGB OF USB OR OCCUPANCY. FOR ANY EXISTRVG
STRUCTURE OR BUILDING
1.0 SITE INFORMATION ..
Location Name: ,t3
--- Property Addross:----- /--46 12ccP// D2
Property Is located in a;Conservation Ame YM Hislaft Diablot YIN
2.0 OWNERSHIP INFORMATION
1.1 Owner of Land
Name: Leon/
Address:
Telephone: g78- 7S/l
3.0 COMPLETE THIS SECTION FOR WORK IN E UBMING BUILDINGS ONLY
Addition Existing
Renovation �� Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per Raw (sf) Renovated
construction or renovation
of existing building New
Brie[Description of Proposed Work:
/i-lee P/fre
The Chimney Guys
-- — - --Peabody,MA-01960 -
------ ---Mail Permit,to: 978-977-9900 - - -