26 ABORN ST - BPA-07-181 FINISH BASSEMENT, FAMILY ROOM EI`I'�O�'
/�j- -- PUBLIC PROPERTY
DEPARTMENT
KI\(IERI.EY DNISCOLL
MAYOR M WASHINGTON SIREEr♦S AL,EM,Mti.SAC3tt:5tl'rs 01970
TEL-978-745-9595*FAx:979-74o.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: Building:
Property Address:
Property is located in a; Conservation Area Y/N Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name:
Address: a n ba IV S f
L E IVI ail OAQ10
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING VONLY
Addition
Renovation Number of Stories
Change in Use D2mnRion Approximate year of Area per floor (sf)construction or renovationof existing building
Brief Description of Proposed Work:
Mail Permit to: a-L,e a .
What is the current use of the Building?
Material of Building? If dwelling, how many units? r)
Will the Building Conform to Law? pti
Asbestos?
Architect's Name
Address and Phone
Mechanic's Name
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost of Project$mod-00 Permit Fee Calculation
Permit Fee$ 7 00 Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
i 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 Permit to build to the above stated
specifications. Signed under penalty of perjury
X �w clC
Date d
U b� y
a o
x °o Uhl > c
1