HomeMy WebLinkAboutElm St. #510 - 9/12/1994ASPA)MONT OF PUBLIC NBALTN/WPARTMBN7 OF LABOR i MDUSMISS
NO7IPICATION OP =JADINC WRx
All'sartions of this form lust be completed In order to Oomply with
t" notitlostion requirements of B.C.L. C. 111 9197
PILL NUMBLR
Conusceor pestoMln7 p/rojwe: (1,? fr (S��rl,1�rgcl Csrtllicstlon 6 �CCncsr9�
Lead Palest Inspector P9-/�`Lrte of Inspectlaw /gal �Y�9�
Addrera of Project.;
Buildlag Name (it sny) SS Floor
Street Add%rrosss 5 jX ? �IV? APt. NO -
city //�/ �� ✓ f�/� lip �o� O
Deleading Nethods ^�SCRAPIti�% BEA7 Oath LNCAPSMA7ION xxozr7ION
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POOR S XNG CAUSTICS�RBPLACBM3 OrM
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Check one: dwelling s Nalti-family single familyt� !� /11Z <SC kx)
Start date �� Completion Date 7 �Z `v
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Project Supttvisoe "Name �� 920 vv� -certificate
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Address <7/C' �/i ✓��
State
Telephone / Q 7
In case of emergency contact
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00318/S rev 116189