0008 CASTLE ROAD - BPA-08-09 >)
The (,oil monwedlth of Massachusetts u
Bnm"d of Bwlding Regulations and S(and;trds L( llt
\ vI ISSachUSCtlS Sate Building Code. 7SO('MR, 7"'edition \II NIl H, \1 I I 1
f Building Permit Application To C'onstrurt. Repair. Kenotate Or I)emoIish a RrI I, /M „rr,
One- or rnvt-Vamilr Ditvllin,ti
This Section For Official ITse Only - --�
13mlJine PerntiI Numhe ---7
Date Applied:
Si_n;nure:
- -- ---- -
t3wlding C'onvni„uunvi hispeaur of Buildings U.ur
SECTION I: SI'fI•: INFOR:\L\"PION
1.1 Pryyrpert/y .\ddress: 1.2 Assessors .Map & Parcel .Numbers -------
— - ----------
I.la L, ibis an ;..'c' neJ �:rc'e C' \r. nn Slap,;\u n(hrr Par.rl Number
i((.3�� St
-
I Z.:mng. Dr_tria Pro. -r.cJ I,hr
LS Bmtdmg Setbacks (ft) 1
-- Front Yard754) 1.7
Side Yards
r— Rear 11id
Kc uiirJ PrUV'J`' yuurJ Proided Kryuucd PnniJcJ1.6 Water Supply: (NI.G.L c. od Zone Information: 1.8 Sewage Disposal System:Private ❑ _ Outside Flood Zone?
_—_ Check it yesGY Stumeipul l Grp .8e Ju1t1»al sy n(em ❑
_ SECTION 2: PROPERTY OWNERSHIP' 7
2.1 Owner' If Record: —�
19 C^ �
I \', Print —_ Address lCit�r Service:
Sign rr —_. Telephone` ✓ !� `��� _ ___ ___
_—_ CT►ON 3: DESCRIPTION OF PROPOSED WORK"(check all that applv) —�
h,W Con=rructfon Existing Building ❑ Owner"Occupied ❑ Repairs(:+) ❑ � Alierattonts) ❑ Adduiva ❑ i-- — J
L'rmuli:i..r. ❑ ,Accessory Bldg. ❑ Number of Units Other ❑ Specify:
2
IBretDcsaipuonufPrupusedFvork': T� u� � I
Y
SEC i'[ON 4: ESTLMATED CONSIAUCTION COSTS
Estimated Casts:
hem Official Use Only i Labor and Materials) J
1. Buildingrc --
S I. Building Permit Fee: 3. 2�— Ind,rate h I fce is Jr(ermtneJ:
2. Elec(rical S ❑S(andard City/Town Application Fee
00 ❑Total Project Cust' (item (j) x multiplier x 1
1. Plumbing S _'. Other Fees: S ��U
4. .Mechanical (HVAC) .5 (�_----
i. Mechanical 'Fite 4 --
Su t rc»wN Total All Fees: $ 2 I
Check N,t. Check :\mount ('ash :\utoun(:
Total Project Oust: 5 � -- ..
1 ❑ Paid in Full ❑ Ou(standing Balance Due:
r
i
SECI•ION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSLI
F
Llrelise Nunther Fynr,ouon Uutr
Namr ui CS1.- Ilolder Lest CS1. [\pc iwc hclow)
Dawn
\JJres+ l L'nn•sulclrJ In,r tolirK O
R Rastru led I�_' F.unlh Dw rlbn¢
SI�Iraune �1 \I:uonn lhtly
RC RaslJrnoal Ruotinc lu+a
\\'S Rc+IJrullal \11nJu„ .mJ
felrphone
SF Rr+IJruu,J XuIIJ Purl liul niu_ \ Lm_lu+Lill.an ni_J
D Itr+IJauoul Ile m,lh Uan
5.2 Registered Home Improvement Contractor (IIICI
RCOutI'atln❑ Number
HIC Company Name or cgtstrant Nance
Address F+puatwn D;at
relcpm,nc
Sl gnature '—
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT IM.G.L. c. 152. § 25C(6)1
Fthis
ers Compensation Insurance affidavit must be completed and submitted with this application. Failure to pro+iJe
ffidavit wilt result in the denial of the Issuance of the building permit.
d Affidavit Attached'' Yes .......... 0 No .. _. 0
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property herebv
L _--- ut act on my behalf. in all matters
authorize
i
relative fit w•_nk authorized by this building permit application.
-- Date
Signature of owner
SECTION 7b: OWNER t OR AUTHORIZED AGENT DECLARATION
V , as Owner or Authorized Agent hereby' declare
1,
that the statements and information on the h regutng application are true and accurate, to the best of my knowledge an
behalf.
Print Name O o
Date
Sienaturc of Ownc 'x Authorized Agent
1 Si ned under II � ai , and enahics of era NOTES: -
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires all unreglsteted amtractor
will not face access it) the ;uhitration
(nut registered in the Hume Improvement Contractor (HIC) Program).
program or guaranty fund under M.G.L. c. la'_A. Other important information on the HIC• Program and
Construc(im Supervisor Licensing (CSL) can be found in 780 CMR Regulations I MR6 and I It) R5, icspecnsell
' When +ubstanual work is planned. pnrvlJe the intixmtion below:
tanclud(including garage. finished basemenUatucs. Jerks or porch,
Total doors area tSy. Ft.) Habitable room count ---
Gross living area ISy. Ft.) Number of hedrooln, __---------
Numberof fireplaces Numberot b•Ilt/haths ------- -
I Number of h:uhnx,ms Number ut decks/ ponhes -__ ---.---
T.pe of heating sv+tem Lncb sed — Upcn _ -
ry'pe Ut r loIIng System
1. -Total Project Syuarn Footage• may be >ubsututed for "f„t:d Pnljert Oust•
4
LOT l9 LoT I S
�S,00
I
sHec LGT /5 a d AISW /2�X 171
pa,a or LOT l`l OV/6rj l
LOT 20 ,etrinn�t �
,r LoT !y
E,
2 SToe Y
o
3Z`�
1 L I
CASTLE 10 D
REFERENCE:
DEED: REC. BK. 16II PG. /05
PLAN: 591 a-F 194'+
TO: S-t. JOSEPN CREDIT 0AJ 10AJ
THIS PLOT PLAN WAS NOT MADE FROM
I CERTIFY THAT THE BUILDING(S)SHOWN HEREON AN INSTRUMENT SURVEYAND IS FOR
ARE LOCATED ON THE GROUND AS SHOWN AND THAT THEY THr PURPOSES OF THE BANK ONLY.
CONFORM TO THE HORIZONTAL DIy1ENSIONAL REGULATIONS UNDER NO CIRCUMSTANCES ARE OFFSETS
OF THE ZONING BYLAWS OF THE LIT Y OF 3ALEYY) TO BE USED FOR ESTABLISHMENT OF
AT THE TIME OF CONSTRUCTION OR ARE PROTECTED UNDER FEIICES, WALLS,HEDGES,ETC.
GENERAL LAWS CHAPTER 40A SECTION 7.
1 ALSO CERTIFY THAT THE DWELLING SHOWN IS NOT pL1H OF IV41 MORTGAGE INSPECTION PLAN
LOCATED WITHIN A FLOOD HAZARD ZONE AS LOCATED AT
DELIN�ATED ON THE MAP OF,COMMUNITY# 25o I OZ- GAIL 8 CASTLE ROAD
SRL Em MA,EFFECTIVE 9,5 • 17 S5 0� L SAI EM
BY THE FEDERAL EMERGENCY MANAGEMENT AGEIICY. sMinl PRi-PARED FOR
No.35043
P� �` �lONItJ J• M�I NON E y
\lGISTF xfn.yW
Lm%`) :. SCALE 1"= 20' Fa 82 VLgf Y /7 2005
NORTH SHORE SURVEY CORP.
DA E 'REG. PROFESSIONAL LAND SURVEYOR 47 LINDEN STREET, SALEM,MA
#2438 N