156-158 BRIDGE ST - BUILDING PERMIT APP PUBLIC PROPERTY
DEPARTMENT
�aamFxatr o.K•-•�
M.�roa
I'M M74&9S93 0 PAZ M740.91N
APPLICATION FOR THE REPAIR RENOVATION CONSTRUCTION
DEMOLITION. OR CHANGE OF U3Z R OC FANCY FOR ANY EXISTING
STRUCT[JIL OR BUII nnv�
1.0 SITE INFORMATION
Locatlon Name: Mudding-
Property Address: ..
RWwty Is kx=ted Ina:Conserva0on Area YM Historic ftblct YM
2.0 OWNERSHIP INFORMATION
2.1 Owner a1 Land
Name: P
Address:
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation pC Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (st) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
IN ST � �Zc55 S�2�L/ �1F7-
What is the current use of the Building? / un'ds?__�
Material of Building? l jjfge2 It dwelling.how many
Will the Building Conform NL%� Asbestos?
Archmas Name ( )
Address and Phone
Mechanids Name di 2� 3<- V7`f
Address and Phone N
(D 8
Construction SuPeMMS License>t� —
HIC Registration 0
Esfimetsd Coat�of X:7151000 Residenti
Proled S l � PermM Fee COMMetion
Permit Fee
3 �..� Estimated Cost al\ Es*nated Cost X Si'/$'000 Commercial---
( An Additional $6.00 is added as an
Administrative Charge-
Make sure that all fields are Property and legibly written to avoid delays in processing.
The undersigned dose
herby apply for a Building P ild to a a stated
speciflcatione. Signed under penalty of Penury
Date
�I
N
y 'j
L.J--
-�- - a.--. _. .4._-. - ----