5B STILLWELL DR - BUILDING INSPECTION What is btu current use of the Building?
Material of tluild(n97 M dwelWng.how rteny units9
Wilt @e Building Conf m to Asbestos?
ArchitOds Nan O
Address and Phones PeatwdY,MA 01960 -
970-977-9900
Meda Ws IS
Address and Phones
Construction Supervisors fin"0 - HIC Registration•
n
EslYnatad Cod C76 Per *FeeCalu+latlorr
Es*m tsd Cod X$71$1000 RasidsMhl
Permit Fes S
Es*natad Cod X SW$I000 CammerclfL_.__
An AddMonal$5.00 Is added a.an
Adminldm"charge.
Make an that all fields are properly and 14W written Do avoid delays In processing-
The undaraigned does hereby apply for a Building ted
Pwn*to build to the above sta
speacations. Signed under penally of perjury x
Dats
s
rd
S
i GrI TU1T5.�.E.�
PUBLIC PROPERTY
DEPARTM&NT
IJ.VIERIY[y.v,r
t'A W.�wwc�w SS11iR�;3NYI��1A�AGa:Sf<'17f O1970
TW M-74114M f,F to l7L710 9e1e
APPLICATION FOR THZ REPAIR.RENOVATI(]111_ ['n>tre's RUCTION
DEMOLITION. OR CHAnt OF USE OR OCCr nN V_ FOR ANY FjaXMG
STRUCTURE OR 913LDING
1.0 SITE INFORMATION
Location Name: t?luildlr
AddreW-
Properly is Ideated in a;Conssrvs&m Ares Y/N Historlo oistrld YM Jj _
2.0 OWNERSHIP INFORMATION
al Owner of Land NSTW.
Address.
Telephone;
3.0 COMPLETE THIS SECTION FOR WORK IN EYISIING 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
8dd Description of Proposed Work.-
The ChimneyGuys
-- P A Se- 4074 - --
Mail Permit to: feah-oft NIA 01%0
gas �77 woe _