79 ALMEDA ST - BPA-15-916 STRIP & REROOF IL3-7 ! 3 2
The Commonwealth of Massachusetts RECEIVED
Board of Building Regulations and\ StFRq"gTIONAL SERVI ES CITY OF
Massachusetts State Building Code, 780 CMR SALEM�. vised Mar 2011
Building Permit Application To Construct, Repair, Ren>n*cto6allAol s�t
.10 One-or Two-Family Dwelling
- .This Section For Official Use Only "
Building Permit Number: Date Applied:
Building Official(Print Name) Signature I Date
( SECTION 1: SITE INFORMATION
Pr erty Add\ess: / 1 _ 1.2 Assessors Map& Parcel Numbers
I.I a Is this an accepted street es no Map Number Parcel Number
1.3 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:(M.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'',
Name(Print) City,State,ZIP
9 G�vN•l i c1c 5� M_ aaa3 -336-1 .
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction ❑ Existing Building❑ Owner-Occupied ❑ t Repairs(s) ❑ 1 Alteration(s) ❑ Addition d13
Demolition ❑ Accessory Bldg. ❑ Number of Units Other Specify:
Brief Description of Proposed Work'-: S11 i 1p CAm
SECTION 4: ESTIMATED CONSTRUCTION-COSTS,
+"r ,
Item Estimated Costs: +, OPfieialUseOnly_
Labor and Materials
1. Building $ ,Sc,J 1. Building Permit Fee: $ - Indicate flow fee is determined:
2. Electrical $ ❑Standard City/Town Application Fee.
❑Total Project Cost'(Item 6)z.multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ _ t
Suppression) Total All Fees: $ _x,• , "e
( Check No Check Amount: Cash Amount
6. Total Project Cost: $ I S ,3 ❑Paid in Fulk ❑Outstanding Balance Due:
coo) f e-c-64-C
Massachusetts -Department
Board of of Public Safety
Building Reg
S n ulations and Standards
Conscru ct nn upe r SpedalR
License: CSSL_101027
RONALDO SOLAR
BNorth Street .f
' them MA 017 s
Expiration Commissioner
12/09/2015