38 BUCHANAN RD - BPA-14-14 • - � � � .- is� ��"
� �� �
� ,,� The Coimnomv�altli of 4tassachusetts
1 � �, Buard of Building Regu�atious and Stan�ards CI"CY OF
� i�� ',� . �(assachusetts State Building Code, 730 C�[R S��LE�(
Revis2d��fnr 201!
Buildiug Pennit Apptication To Construct, Repair, Renovate Or Demolish a
One-or T1uo-Family Divelling �
ChisSection:ForOfficialUsa .ntg.
Building Permit Numberr te A p i >, .
t.
BuildingOfFicial(PrintNama) � , �� ignature � � . Dnte � �
SECTION L S[TEINFORb OY
L1 Property Address: Ll Assessors Mnp 3� Parcel Yumbers
3� /S�cl.c,�ti,� 2a4� J4(e.,na or9��
l.la Is this an acceptzd street?yes_ no ti�ap Number Parcel Number
1.3 Zuning [nform�tion: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq R) Frontagt(ft)
1.5 UuildingSetbacics (ft)
� Front Yard Side Yazds Rear Yard
Raquired ProviAed Required Provided Required Provided �
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Fload Zone Information: 1.8 Sewage Disposnl System:
Pu61ic�,f Private❑ Zone: _ Outside Flood Zone7 N�unicipal�On site disposai system ❑
ri' Check if es0
" ' SECTION 2; PROPERTY OWNERSHIPL ': `
21 Owner�of Recard:
.JTeve,� /d. fs�dc,' .Sa )�'n Ms� UI `17�%
� Narne(Print) City,State,ZIP
3a' �uc�,G,+GN �ocu- `��J'-744- 42L� Srek� Q�ya�,uu.c�„�
� No.and Strcet . Telephone Email Address
�ECTIOiY 3: uESC:RIPTION OE PROPOSED WORK'(check all ihu2 appiy}
. New Construction ❑ Ezisting Building�' Owner-Occupied � Repairs(s) ❑ Alteration(s) Addition ❑
Dzmolitiun ❑ Accessory Bldg. ❑ Number of Units Other ❑ SpeciCy:
F3rief Description of Propased\Vork3:
�7.PtL llfiln/ �✓���- (.c,.�,� e�-�d��'��rc.i
SECT[OY�: ESTI�L�TEDCONSTRUCTIONCOSTS
[[em E�timated Costs: pffieial Use Only ,
L�bor and�faterials
I. Buifding i f soo I. Building Permit Eee: � rndicate how fee is determined:
Q SL�utda[d.CityCCutvn App�ication Fee
2. filcccrieat $ D ❑'Cotal P�oject CosP(Item 6)s multipGer x
I 3. Plumbing i Q 2. pther Fees: $
t. ,\Izchanical (ffV:\C) $ � List:
i. \fe�h:miral (Fire $
s������=�„�,> _ O r��,� :�ur�rs: .�s_
Ch�ck No. Citc�k�\mounr. _ �a5h \inounC
I n 1'ntal Prnjcc[ ('ost S r 5"Do � p I'u�l in l�uil OOuts[:iudin, Il iltite� I�u
" -- -
- --- — -- - - -- . __
�
srcriou s: co:�s rituc rio� sE:avicF:s
5.1 Constructiun Snpervisur License(CSL)
I..icensa Nwnber G.epiratiuu D:�cc
N;ime uf CSL I(older List CSL'I'ype(sea belu�v)
�pY�z � . . � Descriptiun
Nu. and Street
U Unrestrictcd DuilJin��s u tu Ji,000 cu. tt.
R RestrietedlSe2F;unil Dwellin>
� City�fu�vn,Smta, ZIP bl ��lusonr
2C Ruotin Cuvcrin
WS WiiidownndSidin�
SF SuliJ Fuel E3uming Applianas
[ Insulutiun
"fcla hona Email nddress D Demolition
5.2 RegistereJ Home fmprovement Contractor(H[C)
tl[C Ragistntiun Number E.epiratiun Uate '
I IIC l'umpany Numa ur(�IIC Rcgistrant Name
Na.and Street Email�Adrcss '
Ci /Tuwn, State, ZIP Tale hune
SECTIOY 6: WORKERS' COMPEYSA'C[ON IYSURr1NCE AFFIDAVIT(M.G.L. c. 152.§ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
diis affidavit will result in the denial of the [ssuance of the building permit.
Signed Affidavit Attached7 Yes .......... ❑ No...........❑
SECTION 7a: O�VNER AUTHORIZATION TO BE COhIPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIESFOR BUILDING PEIL1'[[T
I, as Owner of the subjzct properry, hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Print Owner's Naine(Elactronic Signature) n��C
SF.CT[OY 7b: OWNER� OR AUTHORIZED:\GEN'C DECL:�R:ITIOY -
Qy entzring my name balow, I hereby attest undcr the pains and penalties of perjury that all of the infurmation
contained in diis application is true and accuratz to the best of my knowledge and understanding,
� �- �n-Q.�i - l� �G' .2�_-r t�
I'rint Owntr'S or Audwrired:\�ant's Name(Cltctronit Signatur�) n•�t�
NOTES:
I. ;1n Owner whu ubtains a builJing permit to do his/her o�vn work,ur:m uwner who hires an unre�istared cuntractur
(nut re;istared in the Home Gnprovamznt Cunhactor(H[C) Program), will nnt have access tu the arbitration
program or guaranty timd undcr�L(i.L. c. 1�12A. Othnr importmt infurmation on tha HIC Program can ba found at
�<<vw.m:us.��ue%uca Inform:�tion on tht Cunstruetion Suprrvisor License can be fuund at�a���v.ma.,.,•u,�-dL
i. �Vhen substantial work i�pl:inned,provid�die information baluw:
Tot:�I floor sreu(sq. (t.l _ -- _(including garagt, tinishad bnsemenV:ittics,deeks or purch)
l'rro;; living:u'ca(;q. tt.l -- -- Ff,�bitablt ruom eount
Vumb�r of tirapl.ieci Numba uf bcdrooms
--------— -----
VumbaroCbadim��ms ------ Nuntbcrofh:dEbaths ------- —
--- ...-------
--
I�pu of h�.�tin�; ;y.tam _ _ --_ ------- Nwnher of,lecks/pnrihcs ---.. ----------
�'ype�rfia�rling ;y:�em _------ Finclosed __. _ Opcn ---------- -
___.._
------ ---
------ ---—------
� {. `i'��t,il Pn.�i��_t ����u.ir� P�„�I.iqr uery hc snb;titut.�l t:,r.. l'��I.�I I'rn'�eet C�nt" . . .
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I S1FtUCNRAL POSTS STRUCTURAL POST !
E7QSTING CONCRETE PAD I
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, EXISTING FRONT ELEVATION 2 EXISTING SIDE ELEVATION � EXISTING REAR ELEVATION I
in� 1�4��=1'-0�� ai 1�4��=1�.0�� ni y�4��_1'-0°
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NEW SS TO MAT 70 MAT TO MAT NEWH SS ' /�► 'J J
, SUDIN DOORS EXISTIN E%ISTIN EXISiIN SlIODIN DOORS v , OO Q Z
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. REVISIONS:
' • ' 4X8X16 CONCRETE
BLOCKS SET IN MORTAR � i,� .
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,
NEW NON—STRUCNRAL � NEW NON—SiRUC1URAL UNHEATED SPACE _ ' '
INFlLL 2X4 S1UD WALL INFlLL 2X4 STUD WALL N1hl NO 0.ECTRICA4 � '
, W/�' PLYWOOD EXTER W/}' PLYWOOD EX1ER PLUMBING OR HVAC •
' SHEATHING, 3}' BATT. � . SHEATHINC, 3�� BATT.
WORK TO BE DONE.
' INSULA710N, dc �' INTER. INSULATION, dc �' IN1ER. •
' BLUEBOARD. BLUEBOARD.
PROJECT
4 PROPOSED FRONT ELEVATION 5 PROPOSED SIDE ELEVATION � PROPOSED REAR ELEVATION NUMeER:
"' 1/4"=1'-0" DATE: 5/14/13
, ni 1�4��=1'-0�� ni 1�4��=1'-0�� ',
� SCALE: AS NOTED ',
DRAWN: PRL I
CHECK: '
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,�,��,Reu a�+l DRAWING NUMBER: '
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