24 BOARDMAN ST - BPA-2008-128 PORCH CrrrOFSALE,N --
PUBLIC PROPERTY
DEPARTMENT
1:I�OIE'r�r p�wry L
NAVOR
130 wAOUNGNM�jM=•1U&A NAMAanshns 01970
TXL 9164454S"0 FAX M740.95"
APPLICATION FOR THE REPAIR RENOVATI N CON TRUCTION
DEMOLITION. OR CHANGE OP SZ OR OCR_, p FOR ANY EXISTIN
STRUCTURE OR BUILDiN
1.0 SITE INFORMATION
Locadw Name: U 1 S Q U-,�- 4 Building:
Property is bested In a;Conswva*m Amm Y Historic ftft at Y
[Addrew
.0 OWNERSHIP INFORMATION
.1 Owner o(Land p _ AV 42�(a
p A
3.000MPLETE 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 of existing building
I I New
add Description of Proposed Work:
- Mail Permit to:
Ut
What is the current use of the Building?
It dwelling.how many units?
Material of 8uddkmg? Asbestos?
Wit the Building Conform to law?
Architeas Name ( 1
Address and Phone
Mechanic's Name
Address and Phone HIC Registra*w 0
Ccnstnu 5W SUPervhsore license N
Estimated Coat of�Pcolec_- 4 R Fee caleumtlorm
Estimated Cost X$7/$1000 Residential
Permit Fee Estimated Cost X$111$1000 Commercial An Additional$5.00 is added as an
Administrative cherg&
Make sure that all flelds 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
speeftations. Signed under penalty of perjury
Date
N
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a a
• a
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