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85 ESSEX ST - BUILDING JACKET -z— h Massachusetts'State Building:uodcq7q.w edition .......... Budding Pertnet licafion'lwudnstruct;�,Repujr,,r.Kcnpvdtt One to- al v ThirUa. d-Offichil I lon$.F a ..............Applied.......... MINIM L 'la- -W.th �,.Strget ZJjCS�j 777-7, pan, itOptef 14 E H s ul c t i,';I!T, Okd.u .g.. ... ... ....., Wy' ........... 0- JL, ......... 17 Flood Zane'fiff" 1j8 SeWerge Dispostil System Zone?Zone OuL9ide Flood 1,7 . . . ...... 21 -1 j. 6v 0 f It ...... X.L':S, ............. i N p4mjj ut;og Ps n r PFt 'up p Accessory S .......... Bricf Description vfTriiOwtfd,,,,War 1,6 Esti r.A jjjjkd Costs u 1 Budding S, ^' I Building Permit Fee $ Indicate hoW feeds determenpd 4.. cw _7�-77 7 P.. ............. 5 Mechanical (Pere, $ z;�nv- II Ch ed k NO �V- -t�i K�C hipa WA-mthi h t- �Tj Cash Amount. ' 1; I �g" Due 'A' N 13 i F* p� 1*�U CONSTRUCTION SERY 1 SERVICES Q -5jLgSupervisor_Llcenwa�Lmi IN ,"W1 . ts 4MAN UN CQL`n .......... ....................... LL - ............. .... rR S MAC CS1 dar,w IM wrl HICIC fik ......... ...... ...... MWS1 hij.'WIMMv- d i� 1!BWWdjVAfjb1h SF "R Sfi TuL pS4 p� %R e�s'm 6 Wo"W:Number '- 'O".' : Rezc5, 1WmpENSXnONiNsukANC" Gjz iasw..§1,2sc(j4)vS ----—em e� V us becompleted_WoikRfAGd Mg hdriddiuffidd it U . vel C.iq, -N�etNb e, . ...... af y �Zasuvvnerortbe su i=zprdperty.-,hereby .... ......... ,PW UTHORtZk"1GENf6WLAjU,.T;ONr ...... IL4 -j .1_1111---------- "ed and informationon,,trie'f6,r*'cgotng:app ca War"CUTUCUn accurate el I'll "e, ....... M permit to do hlsliter own work, f An OfferN�10 M,ew building 0, ! QC :ZY tUffirindfidfidixAMTHICP e6 2AYOdt&-jffi&' rogrom programor�guaranty.jfiind tinder-MiG:L., :94 and �ciifiiiiijICSQ lEiiEfdiihd4i6,'.780:CNM-,RiioUttiiiiii�lI TIMR nstructow uperIVIS MRS W"W" Sj re_specnvelyyt,�'.. When 1su"b ......H jvp M;?provide -Mad WN,fill. f." planned Z z", 1 prov e.: in OW ow::..-,�-, otai Flouts urea (s (i& Odifig;ged cinth atuci. 44 ?Type of caolmgtsys}em ' ' Enclosed Open eQ ............... .... ...........� W WWI& "total Pffi* -,Cdi UCCL aW P., I 1 z R, ep, :rlw d 1� Conumoinvealth of INlassachLISCUS 1 � Sheet Metal Permit { I)ate: 7-7— eke 12_ — Permit# Fstima ted Job Cost: .y_(p000. ev _ Permit Fee: - flans Submiltcd: YES_ NO ✓ Plans Reviewed: YES _-NO Business License# t7 f Sti `f Applicant License# --- Business h,lbrination: Property Owner/Job Location information: Name: L1n v4i oL�.� I IU✓f Name: &.vriS 03 Ley Street: Street: _C5— City/ibwn: .J" MA City/Town: telephone: 78-1—S`l9—L/! 00 cf 7�- 5—C,a- �7as-- Telephone: Photo I.D. required/Copy of Photo LD. attached: YES— NO_ -1 /,Y D)mrestricted license siR1nhNI J-2/ M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family_ Ylulti-fan,ily—X Condo/Townhouses_ Other_ Cbmntercial: Office_ Retail_ Industrial _ Educational_ institutio`,nal_ Other_ Square Footage: under 10,000 sq. ftal . r over 10,000 sq. ft._ Number of Stories:_ Sheet metal work to he completed: New Work: ✓ Renovation: _ IIVAC ✓ Nfetal Watershed Roofing_ Kitchen Exhaust System_ Metal C'hinu,cy/ Vents_ Air Balancing Provide detailed description of work to be done: --�P t✓ ��yS AGM 2�eOa /31�9i/>/ INSURANCE COVERAGE: I have a current ilabili insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes❑ No El ate the type o f coverage by checking the appropriate box below: If you have checked Yes•Indic Bond ❑ A liability insurance policy ❑ Other type of indemnity El 3 does not have coverage Massachusetts ER'S INSURANCE GeneralWAIVER:I am and[heat ware that h signature license, �this permit application avInsurance requirement. 6y Chapter 112 of the my Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent - accurate to the beat of my knowledge and that all sheet metal work and installations performed under the permit issued fw this application will be By chocking this boxy,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and ns 11f of the General uws. in compliance with ail pertinent provision of the Massachusetts Building Code and Chapter Duct Inspection required prior to Insulation Installation:YES_NO Pro ress Inspections Comments Date Final Il�tion Comments Duty Type of License: By ❑Master i race ❑Master-Restricted ❑Joumeypetson Signature of Licensee j ponud x.-_�— ❑Journeypersom Restricted License Number: �---- roe i -- —-- ❑ — Check at •v n r,•s.,1ov! 1L I I j i Inspector signature of permit Approval __--- Y+I en -6 .' f--dWPUBLIC PROPERTY DEPARTMENT KMOWMEY DIUSC OLL MAYOR - 120 WASHINGI'ON STREET ,AI L:;ry MA1SACHl:5hTT3 01970 TEL-978-7S5-9S9S*FAX:978.740-9&% 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: 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: pxr�s Dick _ Address: 1 �� Q ✓ l S _SPf M Telephone: 9? K 7Y�__ C%Tj_ 3.0 COMPLETE THIS SECTION FOR WORK IN EXICTINC BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use New Demolition . Existing Approximate year of �y O Area per floor (sf) Renovated construction or renovation of existing building New Brief Description of Proposed Work: Adak dQ&41;,t.4-1 Mail Permit to: What is the current use of the Building? Material of Building? If dwelling, how many units? P Will the Building Conform to Law? Asbestos? h n Architect's Name Address and Phone Mechanic's Name Address and Phone Construction Supervisors License#?�� HIC Registration# Estimated Cost f Pro'ect$ Permit Fee Calculation Permit Fee Estimated Cost X$7/$1000 Residential Estimated Cost X$11/$1000 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 /A r Date Ab o a