1 MASSEY WAY - BUILDING INSPECTION (3) ^a The Commonwealth of Massachusetts ' RECEtW
, Board of Building Regulations and StandardluePEACEIL ' CITY OF
1 I Massachusetts State Building Code, 780 eM ERV
Revixe lar 201 l
Building Permit Application To Construct, Repair, Renovateep�pli�lta
One-or Two-Family Dwelling 11:DJ (1t 23
This Section For Official Use Only
Building Permit Number: Date A lied: 1S
Building Official(Print Name) Signature �IJate/
SECTION I:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
IwJj j7 oc8!7
I.I a Is this an accepted street?yes no r Map Number Parcel Number
t.3 Loaing !reformation: L4 Property Dimensions:
Q .ting
J/41&t FAM«1� 7Bf0 3¢• f,441
Zoning District Proposed Use Lot Area(sq It) Frontage(R)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
6/ 'a- �o, s- .24. qz
1.6 Nater Supply:(M.G.I.c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
PublicZone: _ Outside Flood Zone'?
Private❑ Check ifyes❑ Municipal Er/on site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of Record:
.def QVA4A)A pja��PErP1,fd� �`/ArKF rf11� Q�poL
Name(Print) City,Shue,ZIP
J
No.:md Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply)
New Construction il Faisting Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ 1 Addition ❑
Demolition ❑ 1 Accessory Bldg. ❑ Number of Units Other ❑ Specily: _
Brief Description of Proposed Work':�
SECTION 4: ES"TIMA"TED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Building vaa I. Building Permit Fee: $ Indicate how fee is determined:
'. Electrical $ ❑ Standard CityfFown Application Fee
❑Total Project Cost'(Item 6)s multiplier s
3. Plumbing $ 2. Other Fees: $
4. ;Mechanical (I PVAQ $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $
Check No.__Check Amount: Cash Amount:
6. Total Project Cost: $ lor7 ❑ Paid in Full ❑Outstanding Balance Due:_
(o(CA LPA_�,AeD -V - - AlkJEP TO iP�5NO OU� Dto .
Fou"D AT-t aN ua N t r-S -ST-p-
L-U Ll S SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supery e
or License(CSL) 3 S8c3 .l
S' 0 9 Zr ��
t ��f., License Number Expiration ate
Name of CSL Holder L?
p List CSL"Cype(see below)
� / Ssf� S ?ff�l
No.and Street TYPe Description
U Unrestricted Buildin s ip to 35,000 cu. ft.
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
6/7_ ;�Z--�7— I 1 Insulation
'rele hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Registration Number Expiration Date
111C Company Name or I HC Registrant Name
No.and Street - Emnil address
Cit /Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .......... M� No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Print Owner's Nmne(Electronic Signature) Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information
contained in
this application is true and accurate to the best of my knowledge and understanding.
Print Owner's or Authorized'Agent's Name(Electronic Signature) Date
NOTES:
I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC) Program), will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.nwss.gov/oca Information on the Construction Supervisor License can be found at www.mass.uov/dps
2. When substantial work is planned, provide the information below:
Total floor area(sq. ft.) (including garage, finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number ofbathrooms _ Numberofhalf/baths
Type of heating system_ Number of decks/porches
"Type of cooling system Enclosed Open_
3. "Total Project Square Footage" may be substituted for"Total Project Cost"
PETITION OF PASQUANNA DEVELOPERS, INC.
Table of Dimensional Variances for 18 Thorndike Street- Revised
Minimum Var Var Var Var Var
Required Lot#1 Rqd Lot#2 Rqd Lot#3 Rqd Lot#4 Rqd Lot#5 Rqd
Minimum lot area 15,000 5,316 Y 5,082 Y 5,713 Y 7,810 Y 9,548 Y
Lot area per dwelling unit 7,500 5,316 Y 5,082 Y 5,713 Y 7,810 N 9,548 N
Lot Frontage 100 72.97 Y 52.53 1 Y 71.37 Y 39.44 1 Y 20.00 Y
Lot Width 100 72.97 2 Y 52.53 2 Y 71.37 2 Y 39.44 2 Y 20.00 2 Y
Front Yard-Depth 15 10.30 Y 15.30 3 N 15.20 3 N 15.00 3 N 5.00 3Y
Rear Yard- Depth 30 21.50 3 Y 23.70 3 Y 24.80 Y 21.80 3 Y 20.50 3 Y
Side Yard (Left) -Width 10 18.00 N 10.60 3 N 20.90 3 N 5.00 3 Y 33.20 3 N
Side Yard (Right) -Width 10 15.10 3 N 10.30 3 N 10.30 3 N 21.70 3 N 26.00 3 N
Notes:
1. Denotes frontage on a Private Way- Planning Board waiver required
2. Denotes minimum lot width-variable width as shown on Plan
3. Denotes closest point-varies as shown on Plan