TOWN OF GRANVILLE 707 Main Road I Town Hall• P.O. Box 247 • Granville, MA 01034 Building Permit Application Date _____________________ Building Permit Number ______________________ Issued : S ig n at ure = _____________________________________________________________________________ Building Official/Inspector SECTION 1 - SITE INFORMATION Property Address ________________ Assessors Map Number ____ Parcel Number __ Owner's Name ____________________ Home Telephone# ______ _ _ _ Home Address ____________________ WorkTelephone# __________ Building Setbacks ( ft). Front _____ Left Side _____ Ri g ht Side ______Back_____ Ot h e r __ _ ___________ _ __ _ SECTION 2 - CONSTRUCTION SERVICES Compan y Name _____________ __ Company Address ___________ _ _ _ ______ _ _ _ ___ ________ Te lephone ____ ___________ __ Licensed Construction Supervisor ________________ MA License No. _______________ Home Improvement Contractor _________________ MA License No. _______________ SIGNATURE:_______________ EXP. DATE: LCS _____ HIC ____ Attach a copy of LCS and/or HIC Registration SECTION 3 - DESCRIPTION OF PROPOSED WORK (check all a p plicable ) 0 Other 0 Foundation O Demolition 0 Modular 0 Addition 0 Dormer(s) 0 Ramps O Gara g e Number of Ba y s ___ _ 0 New Construction O Existing Building 0 Repair(s ) 0 Alteration(s ) 0 Deck O Porch 0 Increasing Size of Living Space Location _______________ _ SECTION 4 - DESCRIPTION OF PROPOSED WORK - SQUARE FEET - FEET Proposed Use of Building ________________ Est. Construction Costs (ALL)$_____ Size of Buildin g _______ _ __ (Over All) Size of Building 1st Floor _______ x _______ 2nd Floor _______ x _______ Other _______ ____ ___ _ x __ __ ___ Other ______ _ x _ _ _____ = Square Feet ______ = Square Feet ______ = Square Feet ______ = Square Feet ______ TOTAL S Q UARE FEET _____ X (FEE) $ _____ = $ _______ TOTAL FEES PAID $_____ CHECK# _____ FIXED FEE $ ______ _ CHECKS MADE PAYABLE TO THE TOWN OF GRANVILLE (Over)