3A GRISWOLD DR - BUILDING INSPECTION (2) What is the current use of the Building? .
Material of Building? if dwelling, how many units?
Will the Building Conform to Law? Asbestos?
The rmaey uys
Architect's Name P. ,
Address and Phone PPAhu ft M A 01960 ( )
Mechanic's Name 978-977-9900
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost of Project$ !9 80 Permit Fee Calculation
Permit Fee$ 2 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 property and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to Id to the above stated
specifications. Signed under penalty of perjury
Date t 3 n
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PUBLIC PROPERTY
' DEPARTMENT ��9-61:mawILEY Dwscu"
MAYM 130 WALuNGww]HEFT SALkJ4 N1AYSAQU:ShIIS 01970
T43:976.74i9595 0 PAX 976b740-96N
APPLICATION FOR THE REPAIR. RENOVATION, CONSTRUCTION,
DEMOLITION, OR CHANGE OF USE OR OCCUPANCY, FOR ANY VaSTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION
Location Name: Building:
Property Address:
3 fl G �-
Property is located in a:Conservation Area Y/N Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land _
Name:
Address:
3 "q
Telephone: Ct g O,
3.0 COMPLETE THIS SECTION FOR WORK IN EXIS IIJQ BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use a New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Met Description of Proposed Work:
Mail Permit to: