55 APPLETON STREET - BUILDING JACKET 5S
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MADE IN USA
GET ORGANIZED AT SMEAD.COM
FROM :Jcppa Design FAX NO. :19784621797 Jun. 09 2005 03:04PM P1
� J0PPA
d e s i g n , Inc
X67 �'�� FAX S5 r-,Ppl
DATE: 9 ju=2005
TO: Mike Bolduc/Bolduc Electrical Contractors,Inc.
p.978,774.1312
f. 978.774.3120
FROM: Noel Ochtman Total No.Pages: 1 (incl.this page)
p/f. 978.462.1797
Below is the structural plan for your deck.
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The infoimstion wnteined in this transmission is Ovikgod and confidential. h is intended for the use of the individuai
nrcntily maned above. If you havt;loxivcd this communication in cuor,please destroy this transaction and
notify us Immediately by telephone. Thant you.
39 high street new6urypert me 01950 ph/fx 978.462.1797
www.joppadeaignim,co m
The Commonwealth of Massachusetts c
Board of Building Regulations and Stan RECEIY�D CITY OF
0*Massachusetts State Building Code, 780 CTIONAL SER ICESsALEM
Revised Mar 2011
Building Permit Application To Construct,Repair,RenoVO�r�er�tI"'N 10 3 8
One-or Two-Family Dwelling 1t08
This Section For Official Use Only
Building Permit Number: Datenlplied- t .
I JJ Building Official(Print Name) Signature Date
t r� SECTION 1:SITE INFORMATION
�) 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
1.In Is this an accepted street?yes no Map Number Parcel Number
13 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(Ivi.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of Record:
M C r. — � 1 )D10(aC_ Sa-l-,m mA 015''70
Name(Print) City,State,ZIP
,� S G1 p p 12foA) `Sr S78 7Y1 -.2v&7
No.and Sueet Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ 1 Addition ❑
Demolition ❑ 1 Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work : %n l o �h t M+ /7 L146g)A) '1-d �7j &h F//A)A
12nn6 / Pbc1rl�l
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
abor and Materials)
1.Building $ -7 00 . 0(.) 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Five $
Suppression) Total All Fees:$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ a 7 0 0.00 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
Qe ltnL 0a 4 C S O umber a-13 - 1 ILicense Number Expiration Date
Nilme of CSL Holder
5 a ^j)a laA d nL List CSL Type(see below) U
No.and Street / J I Type Description
(` r• m 0'9 .'a U Unrestricted(Buildings u to 35,000 cu.ft.)
�\ i(XiYr'� R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofinu Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
C'7& -7yU 1001 I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) Ll & y 2
f HIC Registration Number Expiration Date
Hir Company Name or HIC Registrant Name
;5�2chQnd tL
and Street Email address
oirn rnn ojg3c) ,17fZtFy/UU �
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..........V 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 \ f 6 it n U—)a—(, h
to act on mX behal in all ma ti e to work authorized by this building permit application.
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 best of my knowledge and understanding.
1 4, r, u3cj s h
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.gov/oca Information on the Construction Supervisor License can be found at MMEM ss.¢ov/dos
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 of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"