38 DEARBORN ST - BUILDING PERMIT APP (002) ,
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i a,:• ; '} it ,'1,7
OVEfl BY T+IE
7 BEING GRANTED
ITS' OF S BEM
Nd; �7 Date
jo 1-Q�
as
a. irk Wend
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\ Zoning District
If"PropWrty Located In Location of 1
�tt14'Mlotodc District? Yes_No Buildin8 _�l��f'G✓by,-ti .t
i
,,i it i�Fropprty Located in
r;otrs�rvao Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, ShecJ, Pool,
Repair/Replace, Other: u U11 I/
PLEASE FILL OUT LEGIBLY &COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications:
Owner's Name
Address & Phone Q
Architect's Name
Address & Phone ( I
Mechanics Name
Address & Phone t
What Is the purpose of building?
Matedal of building? <S�►I(I c If a dwelling,for how many families?
))�_
Will building conform to law? _Asbestos? U
6sdmated cost-02Cj 00, City License# State Hoanse #
Mass Zmprovagsnt / 1
(� Lie. III �l
S ature f Applicant
,DER THE PENALTY
OF;PERJURY,
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO:
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