23 FELT ST - BUILDING PERMIT APP f
CITY-OFg
p�g� PUBLIC PROPERTY
DEPARIMENT
KIN DROCULL
MAYM 120WAAUNGWW J`rRWr SALEK.%r..u..alLsk„s 01970
M3:971-745.959S 9 FeY:97S.740.9g"
i .APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION OR CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTLF OR BUILDIN .
1.0 SITE INFORMATION
Location Name: ��>:' �, ��,.; , e s Building:
Property Address:
Property Is located in a;Conservation Area Y Historic District Y
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name: P; hes
Address: 3 /f f f
Telephone: j�
�- 7-Z yy-
3.0 COMPLETE THIS SECTION FOR WORK IN FYlcT1NG BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change ir, Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
abet Description of Proposed Work: /
-- - -----_ Mail Permit to: - ----- ,
S
What is the current use of the Building? if
`+a many
Material units?��----
Material of Building? /euo�
Asbestos?
Will the Building Conform to Law? yf -
Architect's Name ` r
Address and Phone S'
Mechanic's NaMnO y �� it d
Address and Phono a o r r fie P Q3 d r�
Construction Superv'isore License# D y j /z HIC Registration# /
Estimated Cost of Pr9oct S y__0} Permit Fee C at X lon
�=— Estimated Cost $7�1000 Residential
Permit Fee$
Estimated Cost X$1 '$1000 Commercial
An Additional$6.00 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 pelury
Date .�
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