22 BERTUCCIO AVE - BPA-2008-516 ROOF EI'rror
y L PUBLIC PROPERTY
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IN FOR TM RUAM JR OVATION �'y1NC77iii['TiA111_
DE. [OLTI'IO&OR CHANGE OF USE OR OCCUP 111d'V- Fog ♦" ZZLvaWG
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i.o SIM INFORMATION
Locauon Nan+« &A*W
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Properly In Weded ins;CwwwvAan Arta YM Hktikft 0 M d YM
2.0 OWNERSHIP INFORMATION
2J Owner of Land _
Name•. o
Address;
Telephone; ,5-
3.0 COMPLETE THIS SECTION FOR WORK IN E7I XMG MILMNOS ONLY
Addition
Renovation Number of:!7—K
Change in Use
Demolition
Approximate yew of Area per boar(sf) Renovated
construction or renovation
of existing building I t New
aria(Description of Proposed Work:
S+i2 ,`p c04 ,,Pe Roof Q vid Re & f
--- - ---Mail Permit to: a/ �'l2 an g S' }- L�Znti, yr ,
What is the ounert uq of the BuiMhV?
Matsdal Building? ifdwW&o&how many units?
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BullOV Ccfdwm b Lff'
ArohNscts Name ( 1_
Maohanies Name i i' i i `n rn �I ?c ^/1 TP
/l /P�rJ.�a s L / z� s✓loss 7��r.Pf'S� �,53`�
AddrMs and Phone HIC ^• y/778
conswuClim�� �
Es*natad Coat of Projaat DD, 00 Penny Fso 98l9rh8on
Perna Fee i Esm -- - cost X$71:100o Residential
Estrnated Coat X$4141008 Commsrala*-- --An Addmrw woo in added as an
Adminisbady dwom,
Malta sun that an fields are properly and legiby written to avold delays In prowssinp.
The urdeMWAod does hareby apply Ibr a Building Permit to lId to the above stated
sp@cMwowdL signed under penally of PwJurYG—
Date ° o
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