0027A MARION ROAD - BPA-07-1055 What is tM Current use of the Building? if d"ling.how many units?
M atwW of Building? Asbestos?
Wig ta SUN&V carjoin
to Law?
The Chimney Guys
Arehitset's Nance
Addnsa and PhOM
MedmW*Name 978-977-9900
Address and Phoaw HIC RoQMM W f
won Supervisors Llcsnse M -
EsWnated Cod of lwla8o
P�rojed a 7vd permit Fee Can
Permit Fee f� Esdrnated Cod X$7151000 RasidWW
Esdrnatsd Cod X S11/51000 Cornnercisl--_._
An Additional$5.00 is added as an
Administrative charge.
tdaM sure that all fields are properly and legibly written to avoid delays In proeessing.
The undersigned does hereby apply far a Building Permit to the above sta�pd
spec&atlom. Signed under penalty of Perjury
Date
of
N
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3
G1Ty-0fr37ALEN -
"Is PUBLIC PROPERTY
DEPAR'PINIFNT
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N.►vas ; .. ", � ' $,yyyy,�,�o�LsnflsOt970
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APPI.ICAT[ON FOR THE REPAIR. T111(1V&n0N rnNMUcn0N
DEMOLMON. OR CHANGE OF USE OR OCCUP_ AN_r_'v_- FOR ANY g,MSMG
51RlLCTURE OR jilaLmG
1.6 SITE INFORMATION
Location Names Building:
_ _ ...
Property Address;
Peoperly is, in a:Conswvetion Area YIN / HWAft Dlgrld YIN
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land
Name:
Address. 7 ` �c✓ i� r7d.
Telephone: (W-2 _Sl:;)y - G/
3.0 COMPLETE THIS SECTION FOR WORK IN Etf182M BUILDINGS ONLY
Addition SExIs,
Renovation Number of St
Change in Use Demolition Approximate year ofArea per floorConstruction or renovationof existing building
Sae[Description of Proposed Work:
r�'�.,,r,�„2 �-��s�i�.� ��jlcc�. fC�iin✓� vte/1'f�s
aX
The Chimney Gays
_ ---- P.O. oa 4094 - - —
Mail Permit to: PpnhndXg MA 01960