B-19-303 - 0011 AMES STREET - Building Permit Z.Zcv I O
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Massachusetts State Building.Code,780 CMR SALEM
Revised Mar 2011
Building-Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use Only
M Building Permit Number: Date Ap ie
® - 3/7 /
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
11 Ames Street 37 37-0050-0
�
9 Ma l.la Is this an accepted street. yes X no P Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R2 Two-Family 5800 sf 95 ft
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
t
Front Yard Side Yards Rear.Yard
Required Provided Required Provided Required Provided
0.5' existing Of10, 29.2' 8.4' existin 8.4'
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone?
Public Private❑ Check if yes Municipal On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Stefano J Basso Beverly, MA 01915
Name(Print) City,State,ZIP
7 Highland Terrace, Apt C 978.578.1255 Stefano@svdesign.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORIO(check all that apply)
New Construction❑ Existing Building M Owner-Occupied N Repairs(s) 14 Alteration(s) PQ I Addition 0
Demolition ❑ Accessory Bldg. ❑ Number of Units 2 Other ❑ Specify:
Brief Description of Proposed Work 2: Repair, renovation, addition to existing building. Scope bf .
work includes all brand new utilities systems kitchens bathrooms finishes roof & deck.
New addition to be on concrete sonotubes W kT" bq C-o"C0rA v,�oP.�t�L�
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 260,000 1. Building Permit Fee: $ Indicate how fee is determined: .
❑Standard City/Town Application Fee
2.Electrical $ 25,000 s
❑Total Project Cost (Item 6)x multiplier .x
3. Plumbing $ 23,000 2. Other Fees: $
4.Mechanical (HVAC) $ 22,000 List:
5.Mechanical (Fire $ 0
Suppression) Total All Fees: $
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 330,000 ❑Paid in Full ❑Outstanding Balance Due:
C LLe='p y P• u 01 1%- S'"I f , s 5
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS-099233 1/27/20
Sandra Cook License Number Expiration Date
Name of CSL Holder
23 Broadwa List CSL Type(see below) U
Y
No.and Street Type Description
Beverly, MA 01915 U Unrestricted(Buildings up 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
617.678.1341 Sandi@tirodesign.com I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 178358 4/9/2020
Tiro Design & Construction LLC HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name Sandi tlrodesi n.com
23 Broadway @ 9
No.and Street Email address
Beverly, MA 01915 617.678.1341
City/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 .......... I@ 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 Sandra Cook
to act on my behalf,in all matters relative to work authorized by this building permit application.
Stefano J Basso 5 3/4/19
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER'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 bestof my knowledge and understanding.
Stefano J' Basso sd "'f 3/4/19
Print Owner's or'Authorized Agent's Name(Electronic Signature) Date
NOTES.
1. 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.mass. og v/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq. ft.) 3000 sf (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) 3000 sf Habitable room count 15
Number of fireplaces 1 Number of bedrooms 5
Number of bathrooms 2.75 Number of half/baths 2
Type of heating system Forced hot air Number of decks/porches 2
Type of cooling system Central Enclosed Open 2
3. "Total Project Square Footage"may be substituted for"Total Project Cost" $330,000