35-37 HANCOCK ST - BUILDING INSPECTION a
t CITY-QF-
PUBLIC PROPERTY
DEPARTMENT
i IMMALEY DWSCOIL
MAYOR 1-10 W&iHINOTON STREET
SNP.Mtitisncxt:serrs 01970
TEL,978-745-9595• Fm:978-74O.9W
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: Building:
Property Address:
Property is located in a; Conservation Area YIN Historic District YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land `
Name: e.T c
Address: 35 114-aox K S7-.
SlE1� /Kk. olS)o
Telephone: 52$ ?q* 3 /
3.0 COMPLETE THIS SECTION FOR WORK IN EXL TLNG BUILDINGS ONLY
Addition Existing
Renovation Number of Stories Renovated
Change in Use 3 New
Demolition E cisiing
Approximate year of Area per floor (sf) Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
Re.,..e�>z.. �x•yr•�S a s,-.QypoQc4. A•��1 �...•/D nre..J � sroey �oPc/,
Mail Permit to:
C.4/2..v1 MA ol4 ?O
What is the current use of the Building? 3
Material of Building? t,._g e.m If dwelling, how many units? 3
Will the Building Conform to Law?
Asbestos?
Architect's Name
Address and Phone A j
Mechanic's Name
Address and Phone
Construction Supervisors License# CS o 2 oZ ll 11 HIC Registration# �L�--
Estimated Cost of Pro7ct$ o • Permit Fee Calculation
Permit Fee $ Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
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 d! DS
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