22 BUTLER ST - BPA-2008-682 What is the current use of the Building?
Material of Building? if dwelling. how many units?
Will the Building Conform to Law? YCS Asbestos?
Architect's Name
Address and Phone ( )
Mechanic's Name W l S
Address and Phone /.O '��'`�
Constriction Supervisors License# 7g� .3 HIC Registration# / 3 fY3
Estimated Coat of Project S_,7V — Permit Fee CftWW
Permit Fee$ Estimate Cost X:?n1000 Residential
Estimated Cost X$11/$1000 Commerclai-
-
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 Perm o bu to the above stated
specifications. Signed under penalty of perjury
Date
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CITY-OF,
PUBLIC PROPERTY
DEPARTNT LEI IT � >
KINOWU M DuUXV.L L�J
MAYM 130 WA%UNCrM S EEr
may..MtiSACFI{:Sh1lS 01970
T L 978-745-9S"•FAX 979.7.10.90N
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: 27- guTCEe ST C6unrlknxl Building:
Property Address: ZZ 6Nne Sr
Properly Is located in a:Conservation Area YIN—A,)—Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: LC. A4 n `
Address: 'ZZ Suri'L`e ST'
_ ,4- 100
Telephone: 'q */j-/U
3.0 COMPLETE THIS SECTION FOR WORK IN EXISMbia BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use Now
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation 06
of existing building New
Brief Description of Proposed Work:
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— Mail Permit to: �6t) S r7aT 400
1111 IlAli r Customer Name W 7LLIM,, r t+AluE l.aJuuJMJ Customer Signature
SKETCH Contract Date I t 1,29/0-7 Sales Representative Signature G
ATTACHMENT CustomerPione 9-7S-74l-Ysfo Contract Price 5'a719
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NOTES: 'Each box equals one foot unless otherwise noted.This sketch is a good fail
representelion of the work to be done, It is understood that all dimansions
derived from this sketch are approximate,and that all locations of outlets,light
fixtures,plugs,jacks and/or switches are subject to change if necessary.
LI%JIY I IlAli I Customer Name W ILWIV, r ffuw' el I.JAm/ Customer Signature 'N
SKETCH Contract Date I I lJA/o 7 Sales Representative Signature 04^,G:-
ATTACHMENT Customericione Contract Price *A's -719
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NOTES: 'Each to equals one foot unless otherwise noted.This sketch is a good faith
representation of the work to be done. It is understood that all dimnsions
derived from this sketch are approximate,and that all locations of outlets,light
fixtures,plugs,lacks and/or switches are subject to change if necessary.