38 BUENA VISTA AVE - BPA-2007-43 What is the ciurent use of t" Iding? : .rrl i�i%z
Material of SukWV? If dwelling.how many units?
Wlti dw Bum**Conform to Lavin `� - Asbestos?
Arditeds Nam t
Address and Phone ( -
MsdtamW$Name
Address and Phone
Construction gupsrvisots Lkw"d --- HIC Registration f
�t e- -
Wd PeY Fes Cawh w
Es*naw Cos C
POMIR Fe Estimated at X i71:1000 Residential
EstlrnaW Cat X$i i/$IOOG Conwnsrdml -
An AddMwW 55.00 is added as an
Adminhtrattve dwrgs.
Make m that all fields are property and legibly written to avoid delays In grossing.
The undersigned does hereby apply for a Building PwTrA to!wild to Ow above stated
specifications. Signed under penalty of PwJurY
ADateOW6 - ?"O 7
7
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F e� v
GITTUFS.�Eti
PUBLIC PROPERTY
DEPAR'TME►NT ` �CO
NJtiaY Nw/YY 1
r� 130 WA"NM1M i,UW
3NAK MAua&srTts 01970
APPLICATIOIYFOR THE REPAIR.RJMO ATION CONSTRUCTION
DEMOLi'I'ION, OR CHANGE OF USE OR OCCUPANCY_ FOR ANY F.XISMG
STRUCTURZ OR WELDING
1.0 SITE INFORMATION
Location Nams:Prop"AAd%&knw
Building: b
_ .
�rev«ty is kleated in a;ConsarvraCcn Aroa vfN o-1 DtaMet vme
2.0 OWNERSHIP INFORMATION
11 Owner d Land
Name:
Address:
Tow~. D
3.0 COMPLETE THIS SECTION FOR WORK IN EYI8IINQ BUILDINGS ONLY
Addition Existing V
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximates year of Area per floor(sQ Renovated
construction or renovation
of existing building New
fidd Deesyw"d of
Proposed Work: /
14
Mail Permit to: