Fillable CITY OF PROVIDENCE BUILDING BOARD OF REVIEW Petition (City of Providence)

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CITY OF PROVIDENCE BUILDING BOARD OF REVIEW Petition (City of Providence)

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Revised 1/07
CITY OF PROVIDENCE
BUILDING BOARD OF REVIEW
Date: ________________________
To the Building Board of Review:
Petition for variation or modification of the application of certain provisions of the Rhode
Island State Building Code:
Owner: _____________________________________________ Tel. No. _________________
Address: _______________________________________________ Zip Code ________
Applicant: ___________________________________________ Tel. No. _________________
Address: _______________________________________________ Zip Code ________
Lessee: ______________________________________________ Tel. No. ________________
Address: _______________________________________________ Zip Code _______
1. Location of subject property:___________________________________________________
2. Assessor’s Plat(s) _________________________ Lot(s) ____________________________
3. Dimensions: Lot # ______ frontage _________ depth __________ area __________sq. ft.
Lot # ______ frontage _________ depth __________ area __________sq. ft.
Lot # ______ frontage _________ depth __________ area __________sq. ft.
4. Zoning District(s): ____________________, Overlay District: ________________________
5. Present Use of Premises (each lot): _____________________________________________
___________________________________________________________________________
6. Legal Use of Premises as recorded in the Department of Inspection & Standards:
___________________________________________________________________________
7. Proposed Use of Premises _____________________________________________________
8. Type of Construction _________________________________________________________
9. Are the Premises located within the Historic District: Yes ____________ No ____________
If yes, have the plans been approved by the Providence Historic District Commission?
Yes ____________ No ____________
10. Are there outstanding violations concerning the: RI State Building Code
Zoning Ordinance
Housing Code
✔
✔
Revised 1/07
11. The undersigned hereby applies for a variation or modification of the application of the
requirements of the following Section(s) or Table(s):
12. State briefly the proposed change of use or alterations and explain the variations or
modifications sought. Be specific as to the uses within the building. (Use additional sheets if
necessary.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Respectfully submitted,
Signature(s) of Property Owner(s): Signature(s) of Applicant(s):
____________________________________ __________________________________
____________________________________ __________________________________
Address: Address:
____________________________________ __________________________________
____________________________________ __________________________________
Please Note: Unless all requirements listed on the instruction sheet are complied with, this
application will not be accepted.
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CITY OF PROVIDENCE BUILDING BOARD OF REVIEW Petition (City of Providence)

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Completed 14 July 2020

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