013B FILLMORE RD - BPA-08-712 What is the current use of the Building?
Material of Building? if dwelling. how many units?
Win the Building Conform to Law? Asbestos?
The tFUMERCY UUYS
Architect's Name
Address and Phone Peabody MA 01960
Mechanles Name 978-977-9900
Address and Phone
Construction Supervisors License
0 HIC Registration
Estimated Cost of Project S Permit Fee Calculation
Permit Fee S Estimated Cost X$71$1000 Residential
Estimated Cost X$11/$1000 Commercial -
An Additional $5.00 is added as an
Administrable 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 Id to theabove stated
specifications. Signed under penally of perjury . X
Date
°I
35 a
F •� S £ c7 y 3`
w a �� a- - a
- CI-ProFSALENr
PUBLIC PROPERTY
DEPARTMENT
KuOIFaLfitt Dnw-w i . ��: . :.
WAYO{
t 30 WASwtuL'i'(1N ll7fis7'0.S Lb^,yAssACHL.strrs Ot970
111-9?8-745-95" FAIL 976740.96M
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. / f` e F C�
3 �3
Property is located in a;Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land _
Name:
Address:
/313
Telephone: 97 -) 63qoo
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use Y New
Demolition Existing
Approximate year of Area per Floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
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Mail Permit to: