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r , <br /> �hr£rrr,¢reen � . p�NSTRUCTION • • � <br /> Ci7Y OF � <br /> �verett PERMIT pERMIT NO. 064�2 <br /> CIT\' NFLL 259 8745 <br /> ev[�err,v✓n eeza+ ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBIhu <br /> O�:NER MAILB➢�A655 CIIY ZiP PMONE <br /> Edward P Adrian 2512 Colby �8201 252-3153 <br /> t4C!ul(Gi OA C`iJotiLP MAI�ppDPE55 CIIY LP pr1pNC <br /> „U:U�FL CONTRAGTOB MAIL�O�PE55 CRY ZiP PHONE li�CrvSE/ <br /> Same <br /> :'!C��4`IILAL CANTRACTOR MAIL ADDPE55 GITY ZIP RIONE UCENSE Y <br /> i.J'.•L'�NGCANTRAGTOR MAILPUDRESi QTY 21P PNONE UCENSE/ <br /> C V�SS OF WOPK <br /> ❑NEW ❑AD�ITION �j ALTERATIDN ❑REPAIR ❑DEMOLITION ❑FENCE ❑SiGN ❑GARAGE <br /> ':%�i',4110Y OF WORH <br /> s �(}(�}(K}�}C 900.00 <br /> oc�cnme woaK <br /> lower ceiling and repair wall <br /> Fn[4CSED USE OF dUR^iNG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> r.�.,n�nescaianoucFraoeearr�sNowoeiov+oa�nneHrouWeoaies� PL�CATION AND KNOW THE SAME TO BE TRUE AhD CORRECT. <br /> 27-28 561 Monitor ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ,- niaK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTFIORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW fiEGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> Si �AiVR�OF.00Ni ❑ ORAUtHORIZEDAGENi PA�L <br /> ipo nn�aess a, �8/9�79 <br /> 2512 Co3by Avenue X Q a �r.tJ <br /> PLUMBING MECHAtJICAL , � <br /> N0. TYPE OF FI%TURE UR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> V✓ATER ClOSET ITOILETI ni�couo.uNirr�—ii e�n <br /> OAiN'UB REFPIGEf7ATION UNITS—HP.EA <br /> LAVATORY IV/ASH BASIN) BOILERS—N P. EA. <br /> SHOWER GAS FIRED AC CNITS—TONNAGE EA. <br /> KITCHEN$INK d DISR PopCED AIR SYSTEMS—0 T U. M EA <br /> DISHWASNER WALL HLATENS—�.TL. M <br /> LAUNDRYTRAV LII�ITHEATEfiS—BTL. M <br /> _ CIOTHESWASHEfl EVAPOpATIVECOOI[RS I <br /> \NATER k/EATER CLOTHES DRYERS _ <br /> URINAL V[NiILAT10N FAN I <br /> DRIIJKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDIING UNIT— C.F.M. <br /> VACUUM BREANEPS STOVE <br /> ROOF DR�INS—AAINLEADERS ME7A�FIREPLACE 8 CHIMNEV <br /> SINKISERVICL—BAR.EiC) <br /> SUOTOTAL SUBTOTAL S <br /> PCHMIT f PERMIT S <br /> TOTALFEE i TOTAL FEE S <br /> Frt�� YAR�SE7BACK STREET SET3ACK qEAR YARD SLT�ACK PLAN CHECN NUMOER PLAN CHECK FEE <br /> FEE �7ECEIPT NO. <br /> u:r tONE LOiAREA VACANTSITE <br /> GYES ❑NO FEES VAIUAT10N FEE <br /> T���F OF CANST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUtLDING S 900.00 9 00 <br /> Si'<E OF BLDG. NO.OF STORIES MAX.OCC.IOAD <br /> PLUMBING <br /> FIRE ZON[ BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL <br /> C1YE5 �1N0 <br /> APPROVALS BY OATE OTHER <br /> t CNVIRONMENTAL CHECY.L15T P[HFLTY U B C <br /> SEC.303(e) <br /> .^. l3UILDING PlANS — <br /> 's. �IRE MVDRANT 70TAL 9 OO <br /> a fiR[FROTECTION SYSiEM PERMIT VALIDATION � <br /> 1NHEN PROPERLV VALIDATED�M THIS SPACE)TNIS IS YOUR PEFMIT <br /> 5 GHn�MG <br /> �; ���:A���A�� 0 6 61 T� �9.0 � `"�o� <br /> ? LNVIRONMENTAIIMPACTSTATEMENT • C'� <br /> �, HEqLTH 0157RICi YO U R RE�E tPTo <br /> N'PLICATION PCC BY PLANS CHECKED 9V APPR.FOR ISSUANCE UY <br /> Tt-1ANY� YO U <br /> , ; . <br /> ; .: , . <br /> , , : <br /> �1CDRESS FILE , ' I O �+ �9 <br />