108 FEDERAL ST - BUILDING INSPECTION What is the .,,at use of the Building? �f ,
Material of BuwV? 4 D A nil Lc-. �..ti dwelWg.how many units?—
Will the Buil&g Confbmn to Lawn ` -e s — Asbsstos? -
Arehit ds Name ,
Address and Phone (= r oat
Medwdes Name
Address and MOM 7 ( o c i s i S f �anJ 2rS
Cornatudion supervioas Licanse s �3 to S HIC Regbtra*m•
Estimated Cat ! t s '_ Pem+N FeeCalwletlan
Permit Fee EstYnated Cost X i71:1000 Raidemial
-- _ Es*m tad Cost X$111111000 C mnwcid
An Additional$5.00 Is added as an
Administrative charge.
Malrz sure that all}lekle s+e properly and legibly written to avoid delays in processing.
The undersigned dose hereby apply far a Building PPe[►rn*to build to the above stated
speaitloatlone. Signed under penalty of pwIury /fit �L�l nil �G
Date 7
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PUBLIC PROPERTY
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%"VM 130WASwtw'MftUar�3iuuyy S�trR01970
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APPLICATION FOR THZ RFPA_nL RENOVATION. C0NSTgUC 0rq
DE,MOLMON, OR CHANG9 OF USt OR OCCUPANCY_ Fog ,thy FM11%q
STRUCTURZ OR A&RD N .
1.0 SITE IN
Location New /D S sue/ �T &ildklg:
�-
Property is boated In a;Cawervallon Arse YIN HwAdc Dlewd YIN
2.0 oWNERSHIP INFORMATION
2.1 Owner of Land _
Name:
Address:
Telephorw. elS
3.0 COMPLETE THIS SECTION FOR WORK IN nXISIING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use Z New
Demolition Existing
Approximate year of Area per floor(so Renovated
construction or renovation 0 If
of existing building 54D s/- Now
Sdd Description of Proposed Work:
014/a/�7 e-T Aq/lf e m e*q
- - - ----Mail Permit to: - -