16 ABBOTT ST - BPA-07-273 2&3 FL PORCH RPR erry-OE SALE
PUBLIC PROPERTY
DEPARTMENT
KIMBERLEY DRISCOLL
.MAYOR 120 WASHINGTON STREEr♦$
ALr-+,MAssAa ILsL-I-rs 01970
TEL,978-745-9595 ♦ FAX:978-740-9846
APPLICATION FOR THE REPAIR, RENOVATION, CONSTRUCTION,
DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: ka Akx�f'f- ,S - Building: SL*e E7�,v /r orn
Property Address: I /
16
Property is located in a: Conservation Area Y/N A/ Historic District Y/N //
2.0 OWNERSHIP INFORMATION
2.10wnerofLand vaseph Ar%d J'od, 1v7A2Finu
Name: \30seek C, MfkfL-A,nC,
Address: Wo ► 66c)\� Si
le+n p
Telephone: 0 e2/l Zd-- g — Zy-43
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation e S Number of Stories Renovated
Change in Use New 3
Demolition L5 Existing 9o0 Z!-J
yoo z
Approximate year of Area per floor (sf) Renovated
construction or renovation 05y New
of existing building
Brief Description of Proposed Work: (CeMcval zed F lo�✓< rated 2F�/r
Aylcl %caNSbLuc-b,73 zod b 34a F/ooic 5 _ �Cr ��fj Alp otG(
--- ---- Mail Permit to: - - ------ — — -- --- - -- - - ---
What is the current use of the Building? ra-rl,,/i/ 61o,"e
Material of Building? von ct If dwelling, how many units? 0.
Will the Building Conform to Law?—T S Asbestos? n<!1 e
Architect's Name PII keyl I ✓uin D�/li+ldre.n
Address and Phone 6—Jill
Mechanic's Name
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost of Project$ 11 "0 Permit Fee Calculation
Permit Fee $ 700.00 Estimated Cost X$7/$1000 Residential
Estimated Cost X $11/$1000 Commercial
/1 An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permi
t to build to the above stated
specifications. Signed under penalty of perjury /� r
Date
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