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, 813- 78U -UUCU Lily ui L rcillill rlpNnvutiv. �� '� f Building Department `i' Pate Received- Phone Contact for Permittin• U / __ ti?� 1 -- 3 � 3 IIt111Ittt1Itti iv / .! /r� ` 17"7 'f Iwner's Name 1 <� Ir ,/ ! . n Yoko S�er-0 -- Owner P N umber (•! O) ' -- / r / 0 0 f_ _/II /0 a 3 G I Owner Phone Number 1 1 Iwner's Address j 341 N ��. �- 41 y � N y ee Simple Titleholder Name Owner Phone Number ee Simple Titleholder Address 1 ,3 75 -. DA LE H4 774- 76 ,9/14.1, �L 535 1 ,0 1 �� LOT # 2 ;UBDIVISION I E/G� OB ADDRESS o �' 2 E 6 7 4 • 4 7 / t / 0 / ° / 9 x . , , 1 PARCEL ID #1 0 3-26 _21` 0"23 0 00000 ` 2 030 (OBTAINED FROM PROPERTY TAX NOTICE) VORK PROPOSED I �_:•'A NEW CONSTR ADD /ALT I SIGN I I MOVE 1 DEMOLISH MN INSTALL .,>•C REPAIR PROPOSED USE = SFR 1 1 COMM 1 OTHER YPE OF CONSTRUCTION BLOCK 1 1 FRAME ( STEEL [ 1 OTHER I I )ESCRIPTION OF WORK 1 /C. / Root 1 ..Tht./G- tf " F/rit'/ /Gy 042,E Areve f r/1,/ l 3UILDING SIZE I 1 SQ FOOTAGE /53 / 1 HEIGHT 1 a s7-be& 1 B $ 31 65".9 VALUATION OF TOTAL CONSTRUCTION / ELECTRICAL $ .3 T yv AMP SERVICE PROGRESS ENERGY 1 I W.R.E.0 PLUMBING $ i4 3.Z MECHANICAL $ 41.2 9c VALUATION OF MECHANICAL INSTALLATION GAS 1 1 ROOFING ( 1 SPECIALTY 1 1 OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES 1 INO i tlr.:rcaur BUILDER /� - `' LE/V/1/4/2., COMPAN LELE/V/1/4/2., /,�0 /1/A�e iI SIGNATURE , REGISTERED 1 Y / N 1 FEE CURRENT 1 Y /-N Address /5 L16 1 At. 101 /0 C LOP w/tTrILAFL MA License # C 43C / A 5 5-'7.5 / b COMPANY C�h 50 WSJ EC ECT /(,. .ZN C • ELECTRICIAN �� SIGNATURE REGISTERED L Y/ N 1 FEE CURRENT 1 Y/ N Address , *-341/ .SK• /f p ' 4'12,1P7704 'r"LA 33 6/3 License# I C 00 0,25' 79 PLUMBER X . COMPANY 8/9 YoNET pcLi/kt6/ t #O. 94C SIGNATURE _. REGISTERED Y / N FEE CURRENT Y / N Address I i -'09( 5 Oi["' " yoNEf Awir l Z 3 fVb License # C FG o_�"Z 9 9 8 MECHANICAL ' p COMPANY 8q O/✓�guMO /�f/G, /4-,9774/6-,1 /1 G SIGNATURE > , ` REGISTERED 1 Y / N I FEE CURRENT I Y / N I Address / ? 0. 8oX S30g 84yaNFT G[- JY67r71 License # C4 a 0 s8 0 6 2 OTHER //� COMPANY Co NS /iV(,- ( vq[ /Ty /POOF - c' SIGNATURE / "/. REGISTERED 1 Y/ N 1 FEE CURRENT I Y/ N I Address ,y2 //. 5 # O A L L/uE C 3 c . v o c 5 P a d N G / Y ' / t . G ` 663si6o License # C Z ' Co S 99 / RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Sill Fence installed, Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions /large projects COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R -O -W Permit for new construction, Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance SIGN PERMIT Attach (2) sets of Engineered Plans. ****PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner & Contractor sign back of application, notarized If over $2500, a Notice of Commencement Is required. (A/C upgrades over $5000) '• Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences (PlotSurvey /Footage) Driveways -Not over Counter If on public roadways,,needs ROW