2B DEWEY DR - BUILDING PERMIT APP JACKET What is the current use of the Building?
Material of Building? If dwelling.how many units?
Will the Building Conform to Law? Asbestos?
p rchited's Name O ^ 1107 l_�Fi�o �'1-N q77 q9
Address and Phone !
Mechanic's Name
Address and Phone
Constriction Supervisors License S HIC Registration#
Estimated Cost of Project S CC'CYC> Permit Fee Calculation
Permit Fee S Estimated Cost X$7/51000 Residential
Estimated Cost X$11/$1000 Commerclal 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 Permit to build to the above stated
specifications. Signed under penalty of perjury X
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PUBLIC PROPERTY
I's DEPARTMENT
K1%WJ11Y0RWX l
WAYM 130 WASMNGWW.S1t •
01970
74]:978.745-9S" •FAx 97s.740.9s"
APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION
DEMOLMON,OR CHANGE OF USE OR OCCUPANCY, FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building:
Property Address.. a 13
Property Is located in a; Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address:
Telephone: 010
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use c Near
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
-- - Mail Permit to: --