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11 ANDREW STREET - BUILDING JACKET ! 11' Andrew St. J i Meq � I �,�-_stl �a-a• o - — L c m � � 0 F7,- i � ' I � � m p tO N � r f� � Y pPlof�os�l� COIMI�iIUMS -"T I ! 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(Gil) qy-1 3-745 I'S T �� The Commonwealth of Massachusetts Department of Public Safety tg�1, � Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family wel 'ng, (This Section For Official Use Only) Building Permit Number: Date Applied: Building Officia SECTION 1:LOCATION(Please indicate Block#'and Lot It for locations for which a street addr s ' not av it le) I Anetv_Q-I�- Sl ;aLe, " pt4ljv No.and Street City/Town Zip Code - Name of But ding(if is le) SECTION 2:PROPOSED WORK Edition of MA State Code used If New Construction check here❑ or check all that apply in tl V o rows below E�fisting Building❑ Repair i�'. Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ 1 Change of Occupancy ❑ Other ❑ Specify: a 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? Yes ❑ No ❑ Brief Description of Proposed Work: tint. K•UL-" —etr ..t r-%- SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR F 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 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ 1 H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional 1-1 ❑ I-2❑ 1-3❑ 14❑ 1 M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑ S: Storage S-1 ❑ S-2❑ Ik Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA IB ❑ IIA ❑ IIB ❑ 1IIA ❑ IIIB ❑ 1 IV ❑ VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply:, Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal❑ A trench will not be Licensed Disposal Site❑ Private❑ required ❑or trench or specify:or indentify Zone: or on site system❑ permit is enclosed ❑ Railroad right-of-way: Hazards to Air Navigation: 1�1 I Inc n� c',i�m�,�„� n r„�,p I �, ,•<: Not Applicable❑ F 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: Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: 14AM 'To : i G�t•55 �� SECTION 9: PROPER R AUTHORIZATION Name and Address of Property Owner .. l( , &' e v�, mA 019 )U Name(Hint) No.and Street City/Town Zip Property Owner Contact Information: CLUIS _6p ZVI bo[� Title Telephone No. (business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes f� Ew_ m%e_ t1 C �G9 ty tpt:<� Nta OIQ/ Name Street Address City/Town State Zip . to act on the 2ro2erty owner's behalf,in all matters relative to work authorized I y this buildin ermit a lication. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check hue 0 and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control Ell � Q2k-S?B- � c1eLrGs�s�, S�ra1 i �66Szz Name(Registrant) Telephone No. e-mail address Registration Number /I Cass 4�. 6/flAl Street Address City/rown State Zip Discipline Expiration Date a 10.2 General Contractor Company Name Ft� cd-%,_ CS [yOS a Name of Person Responsible for Construction License No. and Type if Applicable ll Crz6s S} 13f tc,G MP 619er, Street Address City/f6wn State Zip Q>&57s_ 80Yz7 eC,r- C2C1,eseeenhr&eI-ne . �L Telephone No. business Telephone No. cell e-mail address SECTION 11:kV0PKt?.FS'COMPFNSAI'10?\ INSU RANT AFI-I DAVIT 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 issuance of the building permit. Is a signed Affidavit submitted with this application? Yes❑ No O SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs: (Labor and Materials) Total Construction Cost(from Item 6)_$ 1. Building $ r7 y ' Co Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ , 7)L7- appropriate municipal factor)_$ 3.Plumbing $ cJ 1. Mechanical (HVAC) $ Note: Minimum fee=$ (contact municipality) 5.Mechanical Other $ Enclose check able to 6.Total Cost . $ payable 2���' (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 mid understanding. / it SC�v� dAt, Lh14T� Q'7t5- V6_- &M Please print and sign name Title Telephone No. Date 11 C�-�s St• Tk� OWo Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Date 134," 01. 18" 30" -12" 2,r Wttt4 1242 DW42242 140OD-2 N A tV Bt6SS � - S Gii _ Q Pt 6WC Shoe Storage F im built on site f . t7 VD '29WVV--D 29WD _ iri i 4- Schrock Pleasant{tilt Sch fa coj coj t9 Paint White cabinets ca with a Prestley Maple ra m 1"> BGP24FH comer cabinet W = ao CID lu Tf � s OD n O co Date. _ _ � Cabinets arid hardware � iv � o #Pull H52 stainless steel ca V �+ pull 7.38 center line a = v Stlt6"overall rfJ N 24.DlSf-tW TD-15Wi BCP24Fh1 N = � BEPF .5FPE _ Sh S Presf Maple cabinet 24" 2 " 15" : 2 " 27" 12" //��� 6" All dimensions size dCS11102ti.."S N 20�'�.',This is an orignal design and tnu9 DesignerL S27/2o12 glum are subject to verifisatian. �', reenrsotovuf J�' �, �eleasod or enpeed a me Printed:8MrM12 job site and adjusnneat w t'¢job applicable fm has been paid as job condilio�. '.or+der p1a�. Mickey FlralherYalonS All �Dmwing#:1 NoG--]- , i �c, � ; q �y�L�� ; � Ii1�1IT ti l V v � � � , $ „ � � � � � � � �----�— � � � a �pplic�uou for peruut to: � g '� � � p • � � s a � s � � z � � e�� � ,F�� e� -8-�} • a � W� �, � � � � � � ,g���✓o�, y � d U.I$. � � 3. o aQ � � � �, x a s �C( �wQc2�r/ /T�'�¢!� � i{ o '��'S• � � -�J � � C � « r U^�� .1} � m e ' � M C a' S � s �qrmit Grs�nted � � pd (1. � � R'� � a 20_ � �8 d p� s 1r ° z � " � " � uved by: � �, � •� � m — . �� � c � , � � � � o nispecwr ut �s � g z v '�j J S� � X �q � � � m � � � 3 � s � � � � � . � � � < � � � � � � ° � � � A $ � � � � � $ � S g S j v � � � � , o � � _ � � � � � � Q $ � � � S p � � � � � . p��, S d� � � � � � � , i , � . Y i E�-o�g�.�t _ . ,, . PUBLIC PROPERTY � DEPAR'Ii���1T �h ��/� � I:I�OIEtlliYD�1SU111 ��rj 7 Vwvat 130 WAfHtNc.'RY�lh1EhT� ' J �J��A1SAOl{;StiTi3 01970 . Tk7i 97L7ii9S9S�F�le 97�.7ap9{K , APPLICATION FOR THE REpAiR, RENOVA�rrnN CONSTRUCTION� DEviOLITION. OR CAANG� OF US� OR OC �AN�y FOR ANY EI�Q3TING STRIICTURE OR BUILDnvG . 1.0 SITE INFORIIAATION �� ' " • - Locatlon Na�rw: 8uildin� _._ ... . Proparty Addresc- � � iv Dr�v �5 __ _ _ , SPi�rn M� PropulY is beated in a:Ca+servatlon Aroa YM Hbtaric DI�MCt YM 4.0 OWNERSHIP INFORMATION " 7.1 Own�►ot Land ' Nams: l. �v Turn�r � Addreas: II Rrvo�v sb- �1le�v� rti"4 Te�epNon�: $-91 - I 3.0 COMPLETH THIB SECTION FOR WORK IN ��¢Tiun BUILDINGS ONLY i I AddiGon ExisGng Renovatlon Number ot Stories Renovated Change in Uss N� � Demolitlon Existing /�� A�proz3mat� yeat o! Area per floor (s� Renovated � (o� canstruction or renovation of existing building New Q G� J 9det Descriptian of Praposed Work; To c�.�i►�o �x%�firic� K,'Lc.�t�/ ,qn'c� Cn�vs<.ric� A �+'��v ac�d;�.o've �ri. 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