4 BARTON ST - BPA-04-355 REPAIR PORCH, NEW WINDOWS PB I
I
fAIDE UVEfl BY T*IE
IflA O .P T B,EING GRANTED
s T �
law IT OF S EM
11 I 1
3
Date
y` iR ward
f .s
Zoning District
IfRroparty Located In Location of , 4
0"111 l'dilc District? Yes_No Building SN f 1'
al
RropRrW Located In
1tYalo sirvetlon Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, er Install Siding, onstruct Shed, Pool,
Repair/Replace, Other: r_
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name ham(. ACLJ AVA-r-Fi
Address & Phone -4 76) q6 T5
Architect's Name
Address & Phone J i
Mechanics Name 1 o' Eogyu1ywG el cJl/1O 4
Address & Phone I LC r97b i 7/� 969�
what is the purpose of building? hk-1�L X l�� P y/5 'l��o noyl/
V/
malarial of building? OL I If a dwelling, for how many families?
Will building orm to law? Q Asbestos?
¢sumated At boo , It city Ucense x state UCK" #
�or)( � rmprovsnt
signature of Applicant
' I SIGNED UNPER THE PENALTY
I OF RERJ.URY
=DESCRIPTION OF WORK TO BE DONE
-rA.KE, I N V t j t TO LQ _NC - 7) pC eN.
Are ilir�r. ✓,_ � ��� �
Svrv&W
MAIL PERMIT TO: e CIAV/1 r%) "
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