2A SPRUANCE WAY - BUILDING INSPECTION What Is the current use of the Building?
Material Of Building? 9 dwelkS taw Marty units?s?
—
�� Asbasto
Wir the Building Contbaa 10 The rmsey u
Amhbds Naar
Addms and Phan 978-9
77-9900
Madmwe No"
97&9
aa
Address and Phan H�Regbtration•
Consoudion supervisors License 0
EsWnated Cost_ =
Permit Fee S Pem�1 FeeCalwlstlon
Jl, Es*nabd Cost X i71SIMO Residential
- - Esaw ted Cost X 51 Vi1000 Corrsnercld
An Additional$5.00 is added as an
AdmwdraWe charge.
Make sun that all flelds are properly and legiaY written to avoid delays in proms1ro
The undarsigrrd dm hereby apply for a Building Paanit to bui to the above stated
spec&aWm Signed under penalty of PedufY
Date
n
s
� a
6
i GrTTUFSi�.E`
PUBLIC PROPERTY
DEPARTMENT �
u•.ter�•••,,•
13o�lrwu�cw der!s�wsuaK:srrrsoi97o
11L•f.'L7is93e!�F�f7L7�0.9e1a
APPLICATION FOR THE REPAIR. RENOVATION r�nlvc�tr['�'Ip�,
DEMOLITION. OR CHANGE OF USE OR OCrrl ANCY FOR ANY EXISTIN
STRUCTURE OR BUILMG
1.0 SITE INFORMATION
Location Name: tluilding;
Property Addrasa: -
a 02 t cam!Nce ��
Property Is tooted In a:Conservation Ares YIN w H YRd_!L
Too
OWNERSHIP INFORMATION
2.1 Owner of Land
Name: 114 _
Addrsee
a -A
To
Isph nc. 7 VO-7 L 2'3
3.0 COMPLETE THIS SECTION FOR WORK IN E7pSI1dLi BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Oemolidon Existing
Approximate year of Area per floor(sf) Renovated
construction or renovation
of existing building New
9dd Description of Proposed Work:
r
e
P.O.Box 4074
Mail Permit to: Peabody,MA 01960