1D HALSEY WAY - BUILDING INSPECTION What is the current use of the Building?
Material ai Building? if dwelling.how many un'mts?
Win the Building Conform to Law? Asbestos?
Architect's Name a Uhimney Guys
Address and Phone ( )
Mechanb's Name Peabo
Address and Phone
978-977-9900
Construction Supervisors License 0 HIC Registration#
Estimated Cost of Projed i /� Permit Fee Ca Wflon
Perron Fee$ Estimated Cost X$7/$1000 Residential
_ -. . _ ---_ -_- ----- _ -- --___ _ -- ---- Estimated Cost X$41/$1000 Ccmmsmla4--------
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
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CITY-oF-SA= -
PUBLIC PROPERTY
DEPARTMENT
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I'M 97e-704M•FNc 976740.9s1&
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: P Building:
-- Property Address-------
Property Is boated in a;Conservation Area Y —AL Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name: Z
Address:
Telephone: p a
3.0 COMPLETE THIS SECTION FOR WORK IN iJ8TtNn BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
The Chimney Guys
- -- - - --Peabody;MA-0196-0 -- - -
-Mail Permit to: -9900 _ -