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B-19-302 - 0107 BRIDGE STREET - Building Permit j 3 (a0 The Commonwealth of Massachusetts Department of Public Safety Massachusetts State Building Code(780 CMR) _ Building Permit Application for any Building other than a One-or Two-Family Dwelling (Thus Section For Official Use Only) Building permit Number: Date Applied Btilding Official: © SECTION 1c LOCATION f 4 7 • ... r 9 c,70 . No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2 PROPOSED WORK ^ Edition of MA State Code used If New Construction check here❑or check all that apply in the two rows below Existing Building Repair 0,- Alteration 0"' Addition❑ 1 Demolition ❑ (Please fill out and submit Appendix 2) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes No ❑ Is an Independent Structural Engineering Peer Review required? Ye� ❑ DW,P Brief Description of Proposed Work: R t')-\d C)P d br-k 1 j+h q 0,4 C req-�Q 4 4 NZ ? SECTION 3:COMPLETE THIS SECTION IF EXISTING.BUILDING UNDERGOING RENOVATION,ADD ON RP CHANGE IN USE OR OCCUPANCY ^ Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A. Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional 1-1❑ I-2❑ I-3❑ I4❑ M: Mercantile❑ 1 R: Residential R-10 R-2❑ R-3❑ R-4❑ S: Storage S-1❑ S-2❑ U: Utility❑ 1 Special Use❑and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ IIA ❑ IIB ❑ IIIA ❑ IIIB ❑ 1 IV13 VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ 1 Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑ Private,-0 or indentify Zone: or on site system❑ required❑or trench or specify: permit is enclosed❑ . Railroad right-of-way: Hazards to Air Navigation: . MA Historic Commission Review Process: - Not Applicable❑ Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No❑ Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: ,3�22a C4:>t-� SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address f Property Owner v�-e P L• fSIS Ie5 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property Owner hereby authorizes: C g V^N +� Cp a 1 C rek,c,0, S�- Sc;1 e'-\-, Y✓1� 01 S �o Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this budding ermit application. SECTION 10 CONSTRUCTION CONTROL(Please fill out Appendix 1) If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here Q Otherwise provide construction control forms see section 107.i.n the code as r aired.. 10.1 Re `stered Professional.Res onsible for Construction Control(the mfessional coordinahn document submittals). Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Company Name Name of Person Responsible for Construction License No. and Type if Applicable G,D, .I Ci re h C s- Street Address City/Town State Zip q 7kSs,o W4 Telephone No.(business) Telephone No. cell e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152.§25C 6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the is ante of the building permit. Is a signed Affidavit submitted with this application? Yes IV No O SECTION 12.CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ `� C5 I CW Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ L(0f o©o appropriate municipal factor)=$ 3.Plumbing $ 4 L,)0 Q 4.Mechanical (HVAC) $ a V 60 Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ `� 0049 (contact municipality)and write check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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. `�'a h C the G e;,P� �r�r77SG Please print and sign name Title Telephone No. Date G A 1 ci"rev�c k 3\,- S G 1-PVV\ rv\c,. 0 I 70 Street Address City/Town State Zip Email Address Municipal Inspector to fill out this section upon application approval: C Name Date FIRE PROTECTION LEGEND: 31'0" smoke m fire hom light 13'MY, 13'0" emergency light M manual pull station r12� S@D smoke.l carbon detector MP ® knox boxBedroom MZ Addressable fire zone panel all Bedroom Automatic sprinkler system to be designed by Fire Protection I ® ® oe Engineer and submitted to Building Dept for approval. 4 2W 21'T' ®up Bathroom B 2 D D so w,D -0 D M Bedroom o 19'Cr Unit 4 I ® 46 4, `aro Third FIIzoT Plan A Kitchen Bedroom W Scale,3�16°=1'-0" Wall --- "— oP 10' - 33'0" Closet r: 3'1" rL7r� do Closet D DA 1 hr Fire rated walls C exdsting Uving/Dining stalNoorridor wells w/(1)layer O • Unit 3 13'6° o sre"type x gwb on unit ewe M Bathroom Stairs between stairs walls 2 We Q — S 18"oc w/thermoflber.Reduosd e'g" 4 to(1HR)in lieu to the Installation of an automate aprtnider system. (� A Cq -J SIT 25' t6 48'6" FIRE PROTECTION LEGEND: 31'(r ® smoke cr fire horn light ( IT IT 13'0" 000 emergency figs MP manual pull station s@D smoke I carbon detector la knox box Bedroom MZ Addressable fire zone panel (12'g' Bedroom Autotratic sprinkler system to be designed by Fire Protection Engineer and submitted to Building Dept for approval Stairs i Stairs a Bathroom a O O @D � O do ----- - -- -der Bedroom i © 46'4" o oO Kitchen S w .15 Second Floor Plan 10,6" up Bedroom IV 0" = mif 8 is 33'W s� door Unit 4 ' . label do doFS r O 1 hr Fire rated walls Q extWM A Uving/Dining 13'6"stair/corridor walls w/(1)layer 12'6"W21k In O '' : Stairs Unit 2 W type x pwb on unit side S between stalre wells 2 We Q Closet room _ 18"oc w/thermofiber.Reduced to(1 HR)In lieu to the Irtetallabon or on automsft spdnlder system. up label Unft 3 d o� 25' g 48'6" FIRE PROTECTION LEGEND: 15'0 l Os smoke �Z fire hom light 11no emergency light ® manual pull station S@D smoke/carbon detector MP Q ® bm box . 1 W. 10 g ga Addressable fire zone panel Bedroom M Bedroom SeD Automatic sprinider system to be designed by Fire Protection Engineer and submitted to Building Dept for approval. ac 2 ' 1014 s elv a St irs"; Star athroom T Bathroom up t 3'1" w/D --- n C=) oho --- o - - 46*1 22 0" CS up A © ID of First Floor Plan uvi t o Dining Bedroom s'6 Kltohen do E Cc 1/2 Bath 13'0" ` 26,6 -- -----,- s� oo 9 O 1 hr Fire rated walla Q existing - ®o A Living/Dining Unit 1 slaidoord or walls w/(1)layer ' 5/8"type x gwb on unit side i Stairs c between stairs walls 2 We Q G" Mitchell � 16"oc w/thermofiber.Reduced to(1 MR)in lieu to the Installation Mail of an automatic sprinkler system. i z ' 46 6" FIRE PROTECTION LEGEND: ® smoke m fire horn light CLP emergency light MP manual pull station �— S@D smoke/carbon detector ® knox box ,Z Addressable fire zone panel Automatic sprinkler system to be designed by Fire Protection Engineer and submitted to Building Dept for approval. ----------------------'----------------------------------- to 21'r 11 „ LL II II 11 II 11 11 11 II 11 11 11 II 'si3 46 4'' 11 � o Basement Basement Aga Basement Floor Plan 40 4 11 W - GO 11 II 11 33!a' 1 II 11 II 11 1'1 11 11 1 1 Ig 11 11 II In 11 11 II 11 II " s up 1 c J1 4V W