27 BECKET ST - BUPA-2008-732 ROOF What is the current use of the Building?
Material of Building? If dwelling. how many units?
Will the Building Conform to Law?
Asbestos?
Architect's Name
Address and Phone Mg
Mechanic's Name
Address and Phone
Fin/ C S; S4 Ile O 1 1 �f
Construction Supervisors License 0 D s9 Sd HIC Registration# 1/ 8�—
Estimated Cost of Project Permit Fee Calculation
Permit Fee i ` 33 Estimated Cost X$7/$1000 Residential
Estimated Cost X S111$1000 Commercial
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are property and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build jo the above stated
specifications. Signed under penally of perjury X
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PUBLIC PROPERTY
' DEPARTbIENI T
KI?WFJLEY Onvw [
MAYM 130 WASkUNartM NTW" 3MAK MASfAClU:StlIS 01970
11197a.74 -9S"•PAX 975•740.%"
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:
a 1 (3ecye rif LS '1- s4 te-" /Yq.
Property Is located in a;Conservation Area Y/N Hietorlo District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: Zet,)I lener: i llo '
Address:
a, 13ezKc,*� r ; s�reti
Telephone: yt-P: 61 1 9 - 6 7 r 6
3.0 COMPLETE THIS SECTION FOR WORK IN FYicTrua 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
of existing building New
Brief Description of Proposed Work:
R2 /w9 Sh;V i2 l ri! Nl ✓
Mail Permit to: w: 11 i-e