36 BUFFUM ST - BPA-2007-1069 What is the current use of the suilding?
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Material of Bu'Ading9 ItdweltN,g,hove many units9 -
WIN the suiktirq Conk m to Lawn VC S Asbestos? (J
ArcAitsets Name ( 1 -
Address and Phan* J
Media IWO Name
Address and Phone HIC Rsgbtret W 0
Canstiuction Supervisors Ucw"
Estimated of Project S Permit Fee C
P A FN Estimated Cost X$71$1000 Residential
_ Estimated Cost X$11/$1000 Canwnerciai~___ .. .
An Additional$5.00 is added as an
Adminwm"dwrge.
Make are that an tieids are property and legibly written to avoid delays in Processing.
The underelpned dose hereby apply fo►a Building pwTnl to build to the above stated
spacillca ns. Signed under penally of PwJurY X
Date A I��
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U06
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PURIIC PROPERTY
DEPARTINMNT
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MAW= 130 WwuNanw*UW•3Ku�Mnsuaasrrls 01970
APPLICATION FOR THI REPAIR ItENAVA7Mnty %.ONS R cn0M,
CHANG 3
DE�IOLTITON.OR E OF USE OR OCC[Ip�xrw Fog EXISTtN
STRUCTURE OR gUL r
1.0 SITE INFORMATION
Location Names 8uildkl¢
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COWRYAddrew-
SWLc-w1 , WI dg
OI 9'�o
Property le kxxded Ins:Conswvatlan An10 YIN Historlo 0wG YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: «M \2 CD y"
Address: 31� //Z (3 'i ti S-1
SA LIE vv1 k vvl v-N O k 9p
T 9 �g 86
3.0 COMPLETE THIS SECTION FOR WORK IN E KISIVRenovated
LY
Addition l)ia��1�y2p h1
Renovation Number of Stori
Change in Use 2
Demolition
Approximate year of Area per floor(sconstruction or renovation
of existing building
Boet Description of Proposed Work:
(y1 is �\wG ►� ()qZ �QD o W\ O v\ A-o p 000
- Mail Permit to: Q-C�t�vE����t_L 163 I-Cw I S ,5 �-A w v\1 mV3 J Q2