21 APPLETON ST - BPA-06-543 ROOFING in
vw Dow la4
Is�ow�i�d yok No. Bondi"
Is Plopniy Loomed In
an OmnonUMOn ANO yok �No_
BUILOrp PUMNf APPLICATION POR:
Pamtk to
Acla wtli how m*) P=4 WOW SWb,% CO ARM ado Slod, POOL
Othar.
PLEASE PILL OUT LEGLY•COMPLETELY TO AVOID DELAYS IN PROCESSM
TO THE INSPECTOR OF SU LDING&
The ur4wa lad hwW s fts for a prank to bold aocwft to Ow blow"
OwnarsNama D" u c� dq ','�ofY o�v
Address A Phorw 2 i R A Lp-,� 51' 19,)2-s 12 3 y
AMhkods Naww
Address A Phone L 1
Mechanics Name
Addrasa& Phorw ) S9 ST- (D4k--f f) en /�L19 1 �7-0, /Sg � .
UN 10111r pnpON it b1dl WW S aX`�4 f-a-r�t y"' o or
MOAN d Mad w W ,, o o r a 1 11 g,for how wmq Nn1W0o?�_
YII11 e1rlaYq oadon)0 b Iwr e 5, T U ! o
ESY11wd coat C�Uoo1w r N A sltl0 Lloolw r CY12Z�9
�� . , X �4�-e
SWaWn of
SIGNED INr M THE PENALTY
DESCRIPTION OF WON TO BE DONE OF PEaluar
_ nS�� ZlS1,f Sc1 U ,� of 1VSaUlnct �-orvlPaSt� ���sZ
MAIL PERWTTO: Q N3 gnprt iv 21 ST
r '
Nc. 3 -06
APPLICATION FOR
Q PERQ l TO
LOCATION
PERMIT GRANTED
ASP .
OF BUUANM