4A FLETCHER WAY - BUILDING INSPECTION What is tM c urent use of the Widing?
Material of fluiiding? If dwelling.how many wits?
will the sulami Confbmn to law? Asb�?
The Chimney Guys
Arohiads Name _.
Addreae 978-977-9900
and Phone a ni oln —
modw ws Name 00
Address and Phone
Construes SuPervims License S HIC Reghtration 0
Estirnsted Cost of Projed$ -2�2 Fe!
Permit Fes S Ex&rated Cost X S7/S1000 Residential
EsOnated Cod X$11/S100A Cammmdal-
An Additional $5.00 is added as an
Adrninh&sdve charge.
Make sum that au fields are properly and toobly written to avoid delays In processing.
The undersigned dose hereby apply for a Building Perm**to build to to above stated
specMations, Signed under psna*y of Penury --
Date
I
Cho
s v 3
5 s� —
crrrOF
PUBLIC PROPERTY
DEPARTMENT
Wwa 130 WXu mcwo meat•Sew M&%►aasrrs 01970
APPLICATION FOR TM REPAIR. RENOVATION CONMUCTIOM
DE.vtOLITION.OR CHANGE OF USt OR OCCUIP.tLnt[_'v- FOR ANY EXISTING
STRUCTURE OR RUtJ G _-
1.0 SITE INFORMATION
Location Name: f:ck .0 (Y Building:
-----
Property Is located In a;Camarvallon Area YIN Historic 01shict YIN
2.0 OWNERSHIP INFORMATION
2.f Owner of Land _
Name: e a R S
Address:
Telephone: r; 55
3.0 COMPLETE THIS SECTION FOR WORK IN EXl833NQ BUILDINGS ONLY
Addition Existing
Renovation Number of
of Stories Renovated
Change in use 1 New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
FLdd Description of Proposed Work:
'a e P/,�Ic e Key/,�t� t•,� e..�.�-
The Chimney Guys
-- —._
—--.—_ _-- --- -- - —PeehodY,"NIA 0196
Mail Permit to; 978-977-9900 - -
i