The URL can be used to link to this page

11 CRESCENT DR - BUILDING PERMIT APP (002) ---- --- --- -- CITY-OFSALETNf - PUBLIC PROPERTY DEPARTMENZ T MAYOR 130 wwswncrom bkntm•SAL&w Mnssnaasti»s 01970 74a:97L745-95"•FAX:976.740-95" APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION. DEMOLITION, OR CHAINGE OF USE OR OCCUPANCY, FOR ANY EXISTIN!rA STRUCTURE OR BUILDING 1.0 SITE INFORMATION LocadonName: It fl�>r k%P- Building: Property Addreaa: i , Cre r 1 V Property Is boated in a: Conservation Area YM �rs Historic District YM 2.0 OWNERSHIP INFORMATION 2.1 Owner of Land _ Name: o5eph V IC1C- `/ Address: Telephone: 9-n- -7 ( -- Iy a-o 3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use New Demolition Existing X Approximate year of Area per floor (sf) Renovated construction or renovation of existing building New 9dd1 Description of Proposed Work: ( �plac,e K 51 x►-dd- �l5l,w er S4-0ve — - Mail Permit to: ------ --— -- - What is the cur rent use o the Building? 1 )VS e 1 Material of Building? Ljoac-4 If dwelling, how many units? ry Will the Building Conform to Law? 2 `i Asbestos? n"0 Architect's Name 41, Address and Phone All Mechanic's Name Address and Phone Construction Supervisors License N HIC Registration M Estimated Coat of Projed i sue' Pw mk Fee CalaiWW ' © Estimated Cost X$7/$1000 Residential �Permit Fee$ - � Estimated Cost X$i 1/$1000 Commercial An Additional $5.00 is added as an Administrable 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 perjury X::z Date � o N v v .• Z O C7 v g` x s '' a