20 BARCELONA AVE - BPA-2008-382 REPLACE 11 WINDOWS i
EI`IY OF-&ALEM-
1 PUBLIC PROPERTY
DEPARTMENT
KINWALEY DRISCOM
MAYOR IV WASFIINGrDN S1REEr*SALhK MA.%SACHLsk--i-IS 01970
I45:978-745-9595 0 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: Building:
Property Address:
,20
Property is located in a. Conservation Area YIN Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: 8/( ( fINTDI�I /fll7ES _
Address:
Telephone: 9 77?
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation New
of existing building
Brief Description of Proposed Work:
Pcf/C� l / W1A/ID6z-,J.5 /N7-0
&-)C%577N6 6)PEMAJ6 S
Mail Permit to: ELL
What is the current use of the Bwitlingl
Material of Bwiding? $"' If dwelling how many units?
ial s "" x .r 'a
Will the Building Conform to Law? Asbestos?
. Afchltedt's Name"
Address and Phone
Mechanic's Name '
I'Address and Phone
Construction Supervisors License# d�i�ti HIC Registration# �
k, "
Estimated Cost of ect$ Perm lc it Fee Caulatio
Rermlt Fee : n
r Estim ,�ated Cost X$7/$1000 Residential��
N 4}
F �
q EstiriiatedCostX$11/$1000 Commercials
An Additional$J.001s added as an
y
Administrative charge
Make surd that fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply fora Building Permd to,bwid to the as stated "
specifications.. Signed under penalty of pedury
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Date �T�7
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