23D MARION RD - BUILDING INSPECTION (2) What is the current use of the Building?
Material of Building? If dwelling,how many un'ds?
Will the Building Conform to Law? Asbestos?
Architect's Name The Chimney Guys
ox 411
Address and Phone
Mechanic's Name 97R 977 9400
Address and Phone
Construction Supervisors License# HIC Registration#
Estimated Cost of Project$/ � Permit Fee Calculation
Permit Fee$ Estimated Cost X$71$1000 Residential
Estimated Cost $11/$1000 Commerciai-------- -- - -
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 L
Date
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Nnrw 130 WAskuNGTnm hrmur ]ALL+J{MtitnIXLstl-rs 01970
TEL 9.18-74S-9593 44AX'976740.9346
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: a3-C>
Property Address:----
Properly Is located in a;Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address:
Telephone: Z9 -7 6 e-f 4 I
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing
Renovation L✓ Number of Stories Renovated
Change in Use New
Demolition Existing
Approximate year of Area per floor (so Renovated
construction or renovation
of existing building New
Brief Description of Proposed Work:
/3'LPtcJ"
The Chimney Guys
- - - Peabody,-MA4191 ---- _--
Mail Permit to: 978-977-9900