7B GRISWOLD - BUILDING INSPECTION What is the current use of the Building?
Material of Building? If dwsl0rg.how many unit?
VW the Builov Conform to Lavin p sbestoe?
The money uys
Archtbces Name
Pea' ^a.. MA fit 460 —
Address and Phone 978-977-9900
MeehmWs NWO
Address and Phow HIC Rsgktratbn 0
CmIstruction Supervisors License 0
Estimated Coet = / �� Per"Fee CabuMm
Pennil Fee f J Estimated Cost X:71:1000 Residential
- - Estlm ftd Coat X i1l/fil>DO Carranercld —
An Additional$5.00 is added as an
Administrative charge.
Make:ur.that all}lelds am properly and legibly wdon to avoid delays in processing.
The undersigned does hereby apply for a Building P ild to the above stated
spsci0catlans. Signed under penalty of perJury
Date
O
ST
s
r ... lt31LNd . 1.et
i GiTTUFSa�.E�
PUBLIC PROPERTY
DEPARTNMNT //�
Vnwe 13oars�uMcrnM�it I �,
�+irw+uocs�cnsot�o
0
TfL rs4 i"'j FAx m?40.%%
APPLICATION FOR TBZ REPAIR.RENOYA37-ON_ CONSTRUC ION .
DEytiOLiTION. OR CHANGZ OF USZ OR OCCUPA_NCY FO ANY FMF MG
STRUCTURZ OR BMIN .
1.0 SITE INFORMATION .
Location Name: BuUd4
- -
-7
Property Is bleated in a;Conewvatbn Ana Y/N. �� HWAft DbV4 YM Al
Z.0 OWNERSHIP INFORMATION
&I Owner of Land
Name:
Address:
7 — 0
Tom: 9`7 y,23 3l,�
3A COMPLETE THIS SECTION FOR WORK IN UILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use L� New
Demolition Existing
Approximate year of Area per floor (so Renovated
construction or renovation
of existing building New
8dd Description of Proposed Work:
The Chimney Guys --- - _
-- — --- 24074 - -
Mait Permit to: Pnnhn.ry MA 01960
9?0 97? 9900