8 ALMEDA ST - BPA-12-790 EXTERIOR STAIRS, FROM KITCHEN �, hhe C'onunumce;nlh of Massachusetts
Board ol'I)uilding Regulations and Standards CI'I'1' OF
U r Massachusetts State Building Code, 7SO C NIR \Ll:,\l
Building Permit Application To CorisIrLICI. Repair, Renovate Or Demos s
Ulm•or ruw•FanotV Du ellin.p
This Section For OlRc"" Use Only
�Building Permit Number: Date Applied: _
Ihrilding 011iciai(Print Mona) Si laturc Dale
SECTION 1:SITE INFOR�IATION
1.1 P erly Address: 1.2 Assessors blap& Parcel Numbers
S , a.
I.la Is this an acre tad street? 'es no Nap Norther Parcul Nunlhcr
1.3 Zoning Information: 1.4 Property Dimensions:
Zuning District Proposed(Nu Lot Area IN It) Frontngu(it)
1.5 Building Setbacks(R)
Front Yard Side Yams Rear Yard
.i
' Required Provided Required Provided Required Provided
1
1.6 Water Supply.(M.O.I.u.Jo.§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Rlblic O Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposals)stem ❑
Check if yesO
SECTION2. PROPERTY OWNERSHIP'
2.1 Owner'of Record a�
_� ";Alp— V.— 0),
Q Zb
Nana(Print) City,State,ZIPP I
8 A-(AA,o A a . S �'"'140 —
No.and Street Te ephone Fmuil Address
SECTION J: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner Occupied ❑ V Repairs(s) ❑ 1 Alteration(s) ❑ Addition O
Demolition ❑ Accessory Bldg.O 1 Number of Units_ Other ❑ Spucily:
Bricf Description of ropos Work':
s+
SECTION 4: ESTIJIATED CONSTRUCTION COSTS
ItemAcost)
Estimated Costs: 0111c1a1 Use On
ly
abur and .\Materials)1
I. OuilJing I. Building Permit Fee: S Indicermined:2. Electrical O Standard Citffuwn Application Fee
❑Tunl Project C'ustr(Item 6)x multipl1. Plumbing �. Other Fees: S ..__ ._J. \Iech.mica List:
il Wire
ti1l.rre441Un1 fptlll .\R Fcc4: 5 ..._ .('hcck No, _(lncckAmount:n lnul I'rn _ ❑ Paid in Full ❑Untstanding Il
SEX I'ION S: CONS'I-RucriO,N SF.RVU F.S
i.l ('unstructiun Supervisor Licensr(C'SLI
- - - ---- ----
I icense Nunthcr I \piruion Mite
N;une ol't'S1. Holder I ist CSI. I)pc Vee hauttl._
h)PC Mscription
Na_dnd Street
------ _�- (I l4vcstneled I Ifuildin�s li to i5,11110 eu. IL1
R Rv.,tricted 122 1.amil L I)ttcllin
Cirri Illan. state.LII' __—.. . . U \lasuu
R(' Rtmlin Oncrin
µ'S window and Sidin
SF solid fuel liuming Appliances
I huuI Mon
1'ele bona IGnail adJrcxs D Denutlition
3.2 Reghtered flume Improvement Contractor(HIQ
III('I(cgtstraiun Number li.\TI M11ion Dale
I IIC C'ompin) Name or I IIC Itegistrunt Name
No. arid Street Email address
city/Town. State ZIP talc hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. I52,1 23C(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 ........_ O No...........O
SECTION 7a:OWNER AUTHOIZATION TO BE Eld i1 L
R ETED 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 Uwncr's Nutne(Elcorenic 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 Ofpiication is true and accurate to the best or my knowledge and understanding.
"fund
i/ �
Print ttncr's d,\gent's Name I t runic Si gnatura) Date
vores:
1. .\n canins a building permit to do his.her own work,or an owner who hires an unregistered cuntractur
!nut regi Hume Intproventent Cuntractur(HIC) Program),will nr) have access to the arbitration
program or
fund under M.G.L. c. IJ?A. Other important information on the HIC Program can be found at
n . nformation ern the Construction Supervisor License can be round at c,c,c Itla•' Iry Oh^
2. \\hen substantial\vurk is planned, provide the iafunnntiun below:
rota) flour area(sq. 11.1 . ____.._1 including garage, finished basement attics,decks or porch!
Gross liv ing area 154. Il.l ..----' Habitable rounl comic
\unlheroffircplaces Numberofhcdruums .. ..
\tlnlherot'hathroums._ .-- ._. .. —_ \umberofhaifhaths
I\pe of heating s)aenl . . . - Nlunher ofdecks• porches
� I 1(,l`Uf ePOhlig it lidlil
I`.nclosdd (!parr
1. "l,n.il 1'r„iect Square Fool,tgv Allis he substituted 1'or"1',n;d 'reject Cost"