106 BOSTON ST - BPA-2007-718 Erry-OF S-ALEx
PUBLIC PROPERTY
` DEPARTMENT
AI.%RIERIE'Y DRIS/:OLL
MAYOR 120 WASMNGTON STRE6r•SALE MtA NSAcxLSta-s 01970
I'm-,978745-959S*FAx:978-740.9"6
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: o le-N Building:
Property Address: /DG I,sIlol�- S PY Z
5,zLklv,7i
Property is located in a;Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address:
Telephone:
3.0 COMPLETE 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 (so rN
ed
"construction or renovation
Hof existing building
Brief Description of Proposed Work:
-------Mail Permit to: 0 01V
What is the current use of the uil din g,7
Material of Building? fl If dwelling, how many units? n
Will the Building Conform to Law? Y�S Asbestos?
Architect's Name
Address and Phone l )
i
Mechanic's Name C`orin/ 5'O'/S �o„J7/Gf/CY N� Cb
Address and Phone 2.9 &2 f7— 5-7— SNZ!Z�'�4Z , - --
Construction Supervisors License# HIC Registration# �8 Z5 3
Estimated Cost of Project$ Z5 O Permit Fee Calculation
Permit Fee$ Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
An Additional $5.00 is added as an
Administrative charge.
Make sure that all 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 perjuryX04
Date 0 7
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