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18 MAY STREET - BUILDING INSPECTION � 8 M►��-� S i \SuperTab. 90%LarwLabal Arco /// I SMEAD KEEPING YOU ORGANIZED No. 10301 FEW Owr «MIRK q W�NWA WTOMANIMOVUEAMOM The Commonwealth of Massachusetts RECEIVE© CITY OF (� 1 Board of Building Regulations and SI £ b Massachusetts State Building Code, 7S�1 CTIGNAL ScR CESSALEM "` qt , ReviseJ,Llur 1011 Building Permit Application To Construct, Repair, RenoucUe Wet "sAa 35 I One-or Two-Family Drivelling L00�177 This Section For Official Use Only Building Permit Number. Date.Applied: " 1 Building OlTicial(Pont Name). Signature, L�� SECTION 1:SITE'INFORNI co Ll roper Address: 1.2Assesso t�tf�Y �fi Sci le"I Y404- 2 � I.la Is this an accepted street es no Map Number �t�FflLLf_ kJ� 1.3 Zoning Information: 1.4 Propert ApEaAe 0 Zoning District Proposed Use Lot Arca(sq R 1.5 Building Setbacks(R) p �� Front Yard Side Yards Required Provided Required Provi 1.6 Water Supply:(M.O:L C.40,§54) 1.7 Flood Zone Information: — t Public❑ Private❑ Zone: _ Outside Flood Zone Check If yesO ^/ : SECTION 2. PROPERTY OWN91C 2.1 �VIr�2�ecor� V��IP 'Sc��2Wl ( & / lqime(Print) City,State,ZIP /7� St d° 35331/ enl�2/2iF�mva1(e�jn�4 •Com No.and Street Telephone •Email Address SECTION 3:DESCRIPTION OF PROPOSED WORKS(check all that apply) New Construction 0A Existing Building O Owner-Occupied ❑ Repairs(s) 13 Alterotion(s) ❑ Addition ❑ Demolition ❑ I Accessory Bldg.❑ I Number of Units_ Other O Specify: —� Brief Description of Proposed Work=: F4291 Yt C SECTION 4:ESTIMATED CONSTRUCTION COSTS llcmEstimated Costs: Ofticial Use Only ` Labor and Materials C Building, $ 1. Building Permit Fee:$ Tndicute how fee is determined: �. Electrical 13 Standard City/fown Application Fee ❑Total Project Cost'(liem 6)x multiplier x 3. Plumbing S' ?N Qther Fees: S nl�!`\h y1 .��, - 4.Mechanical (tiv.\C) S List: ` V 6 0� •U U 5. 1%fee icaI (Fire S , Total Fees:S - ' Su ressiun) " Check No. Check Amount: Cash Amount: 6.Tu d Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due: �ta240 — 2'i-0055 1 � 25-0054 25-0053 j i i 28-0039 r' 2rr0052 a � 25-0137 �.,. X005 I /4CC 25.0040 _RoAO If,. ML ab49_