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4 FAIRFIELD ST - BUILDING PERMIT APP (002) - EI`�'��F�LLEi ----- �`' ' PUBLIC PROPERTY �` DEPr1RT'N1ENT � � ���� I:I�MFJILEY DNISl:l1LL �Invoa . 1�W.�����-�1 Sa��;�cH�m��rs O1970 � 'I41:9?&7i5-9595� R�7c 97&7i0-9&16 APPLICATION FOR THE REPAIR RENOVATION. CONSTRUCTION, DEMOLITION OR CHANGE OF USE OR OCCUPANCY. FOR ANY EXISTII�TG STRUCTURE OR BUILDING . 1.0 SITE INFORMATION Locatlon Name: �e,n ta A S enS 0 Building: Property Address: <} ra I P-�i e�� J�'�' propeAy ia located in a;Conservatbn Ares Y/N Hlsto�ic Dtstrid Y/N 2.0 OWNERSHIP INFORMATION 2.1 Owner ot Land Name: {.�q �c� As�ns _ Addtess: !� F'at� �i G�o� Sf .���m �� Telephone: 9�$- 3oS-9o0�{ 3.0 COMPLETE THIS SECTION FOR WORK IN FY�¢T�N�= BUILDINGS ONLY Addition Existing Renovation Number of Stories Renovated Change in Use New Demolition Existing Approximate year of � Area per floor (s� Renovated construction or renovation of ezisting building New AriPf Descriptian of Proposed Work: Remodel �.�Tc�,tn C�a�s +n� a - �'✓/�IXOwS -/ � �aC�• F�OOOr Go.�in 2TS -� GpvnTCrs ------ . _ -- ---- Mail Permit to: f y What is the curcent use of the Building? 1Q e S Material of Building? If dwelling, how many unitsT / Will the Building Contorm to LawT 3' '��° Asbestos? ArchitecYs Name Address and Phone ( ) MechOnk'S Name CA-�+n e'����e_'�� Address and Phone -36 N���� ���^�M $'� ��" "e�s ."�'JA oi q� Construcdon Supervisors License# O 1 6 6�5 o HIC Registration# /5"� �3� Estimated Cost f P o/je1ct 3�6 i`�983 Pertnit Fee Calculatbn Permk Fee S v` v Estimated Cost X$7/51000 Residential EsUmated Cost X$11/a1000 Commercfal M Additional $S.UO is added as an AdministraUve charge. Make sure that all flelds are properly and legibly written to avoid delays in processing. The undersigned does hereby apply for a Building Permk to build ta the above stated specifications. 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