19 BOARDMAN ST - BPA-2007-359 REPAIR FRONT STAIRS EIT�OF
PUBLIC PROPERTY
DEPAR'1'1bIENT
IOMMU EY DRISCOLL
MAYOR
130 WASmNCro iftEET•"LLK%ASSAOR sLj-rS 01970
I'm 978-745-959S 9 BAx.97&740.9g"
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDDUG
1.0 SITE INFORMATION
Location Name: Building:
Property Address:
Property Is located in a: Conservation Area Y/N HW61c District YIN
r
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name: E/ D is o p
Address:
070
a Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN t=YtcrtNG BUILDINGS ONLY
Addition Existing
Renovation �2aN7✓ Number of Stories Renovated
,25
Change in Use New..
Demolition Existing
Approximate year of �� Area per floor (st) Renovated r
construction or renovation /
of existing building New
Brief Description of Proposed Work:
�P�`GtC�i Alr
/Za�u/Cc-/ l/+/ C�JtJvD, l
---_--- Mail Permit to: - ----
a7 �l
What is the current use of the Building? AV `
Material of Building? U in o D If dwelling. how many units?
Asbestos?
Will the Building ConformLaw?
1
Architect'aNamsAli
Address and Phon
e
Mechanids Name
Address and Phone /✓ A
Su isors License# HIC Registration#
Construction pelt' _
r�� ,�, Fes Calculation
Estimated Cost of Pro s� Estimated Cost X$71$1000 Residential
Permit Fee i PertniT
Estimated Cost X$11/51000 Commercial
An Additional$5.00 is added as an
Administrative charge-
make sure that ail fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of perjury
Date
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