62 WHARF ST - BUILDING INSPECTION (2) Cri-f OF
PUBLIC PROPERTY
DEPARTm&NT
APPLICATION FOIL THE REPAIR RENOVATION CONDUCT M
DILMOLMON,OR CHANGE OF USE OR 0001F,ANCy FOR ANY K3MVG r_
STRUCTURE OR AIULDWG
1.0 SITE INFORMATION
l ocadon Namsc n o �e�nyUla rl
1
ion whc,rF S�ree,�- S� m rKr arsma.. _ _
Properly Is located ins;Conswvdbn Ares Y/N HhAorb 0 tict Y/N
2.0 OWNERSHIP INFORMATION
2.1 OwnM of Land _
Name:
Address:
Tele~.
3.0 COMPLETE THIS SECTION FOR WORK IN E7LI>LTINp BUILDINGS ONLY
Addlion Exleung
Renovation Number of Stories Renovated
Change In Use New
Demogdon E dsdng I
Zo
Approximate year of Area per floor (at) Renovated Z 6 O o
construction or renovation
of existing building New �;�o 47'
add Description of Proposed Work: Adrt d' c- AT HI- oFF-c-, stun
AC 7 E�. �T/e FI -00,t Ft-
SF�.�/�rl viJrlC � /
--- - ---Mail Permit to:
What i<Ilte current uM o1 the w....f 7? e ,l�.cio 44"t 4/o
Mat Sulding? it
wo the o.dmv Cormcm to Law? ?
s Nartw 1- J D s t Cs�o .
ArchiledAddress and PAa+e
EO 60, UYK3 5g/� � —( 19�8 -7s�s=i3IS
LAedta d s Name s ti Q a c Z t ; t +
c
Address and Phone ' 2 !
tenon gupervisas tleertse 7 06 7,3 HIC Registratlon 00
Es*nded Cade of Projest voo P.mrii F«cala,auon
Permit Fee Es*nated Coat X i71i1O0O Residential
- - Estlmatad Cost X i11/i1006 CamrnerdaL----- -
r An Additlonal i0.0O le added as an
l.dminwiradve cliargs.
Make sure than am nelds am property and legibly writtan to avoid delays In P ng-
'Twuunde'sipned does hereby appb far a Suildinp Permit to build to the above stated
spwg4a*m Signed under penalty Of pwlury
Date /d " D
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