44 EDEN ST - BUILDING JACKET EITrOF S -
PUBLIC PROPERTY
DEPARTIMENI T
KIMMUZY
120 WASMNG a bMMr•SMXJ4 HAMfJ1L%1-M 01970
TE-973-745-959S•FAx 973.74498"
APPLICATION FOR THE REPAIR, RENOVATION, CONSTRUCTION.
DEMOLITION. OR CHANGE OF USE OR OCCUPANCY. FOR ANY EXISTLNG
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building:
-Property-Address:— — — --- —
Property is located in a;Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land _
Name: — —08 6
Address:
Telephone: q 7 V
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing �7 3
Approximate year of l�Z1 Area per floor (sn Renovated
construction or renovation
of existing building New
86*1 Description of Proposed Work:
cJy42 3 �,e4 eve C 0 L.v-,
— ---Mail Permit to: L2 V,-,; M t7-;5 J
u
What is the current use of the Building?
Material of Building?
l nr.v6 G If dwelling. how many units?
Will the Building Conform to Law? 4 L 5 Asbestos? ✓�o
Architect's Name 6
Address and Phone
Mechanic's Name
Address and Phone
Construction Supervisors License# HIC Registration#
oa
Estimated Cost of Poled 0O v Permit Fes CalcuMm
Permit Fee$ Estimated Cost X$7/$1000 Residential
— -- Estimated Cost X S11/51000 Commercial-------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
Date v
N
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1 CCO V J V
M �o
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