4B FLETCHER WAY - BUILDING INSPECTION What is the current use of the Building?
Material of Building? If dwelling,how many units?__�
Will the Building Conform to law
Asbestos?
Architect's Name
peabody,MA 01960
Address and Phone 978 977-9900
Mechanids Name
Address and Phone HIC Registration#
Construction Supervisors Ucense#
Estimated Cost of Project Permit Fee Calculation
Permit Fee$ Estimated Cost X S71S1000 Residential
- Estimated Cost $111$1000 Commemial -----
- An Additional $5.00 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 perjury X �
Date 3 �0
0
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CM �.
EIT�t 07
PUBLIC PROPERTY
DEPART14IE1�1T
Kl.%QWJUEV
MAYOR
130 WASMNG ON braftr•SNK,y.AMAC UTM 01970
TEL 975-715-9S"9 FAX 9711.74098K
APPLICATION FOR THE REPAIR, RENOVATION CONSTRUCTION
DEMOLITION OR CHANGE OF USE OR OCCUPAN FOR ANY EXISTIN
STRUCTURE OR BUILDING
1.0 SITE INFORMATION "
Location Name. ,,ate �� P Building:
- Property Address.--- ----
/ - e W
Properly is kx:ated in a:Conservation Area Y/N rt/ Historic District Y/N—,,L
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: G 102.e V
Address:
Telephone: 7 _ -�� _ 60
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation t� Number of Stories Renovated
Change in Use / New
[Approximate
molition Existing
year of Area per floor(so Renovated
struction or renovation
xisting building New
Brid Description of Proposed Work:
ge_Qimnev Gu s
- P.O.Boa-4D24 --- - - --
-- ---- Mail Permit to: _ .- -