BP-54588SECTION 8 - INSPECTOR'S REVIEWICOMMENTS
1. Date plan reviewed:
2. DENIED (see project review worksheet):
Date:
3. HOLD
Reason: Date:
4. HOLD subject to Zoning Board of Appeals action: Date:
Comments:
Inspector's Signature: Date:SEP Z 9 200
$ CTION :'-APPLICANT NOTIFICATION
Applicant informed
of above: j Dz
Comments:
t/ Time: �v v
SECTION 10 - OFFICE/INSPECTOR'S NOTES
Less Application Fee: $25.00 Remaining Balance:
Total Permit Fee: $
Other $Amount $ ----aq
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TOTAL FEE:
��S
Permit Issued to
9
Gross Area - New Construction total sq. ft.
Gross Area - Alteration total sq. ft.
RESIDENTIAL ❑ Approval in Part (Per 780 CMR.5111.13)
$25.00 APPLICATION FEE IS NON W&FUNtABLE A NON
Zoning Review: Signature: �q /i DateSEP 2 9 2008
Energy Report: Signature: Date:
Fire Chief Signature: Date:
Board of Health: Signature: Date:
Conservation Commission: Signature: Date: a
Other. Signatured.
Date:
Brief description of work being perfo
SECTION 1 - SITE INFORMATION
1.1 Property Address: _l-�f '� ' `j I eLf tS y , `� 1.2 Assessors Map & Lot Number:
t�tj �y � Lot
� I�
Lot Area (sf.) _y ry Q, 01) � Frontage "I � 0 Map -
Required Provided
Front Yard 1.3 Historical District ❑ Yes ❑ No
Side Yard Has application been submitted to the Historic Commission?
Rear Yard ❑ Yes ❑ No Date:
1.4 Water Supply (MGL 54):
❑ Municipal Private Well
1.5 Sewage Disposal S ste
0 Municipal On Site Disposal System
0 CONSTRUCTION PLANS
❑ SITE PLAN ❑ENERGY REPORT
RESIDENTIAL
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED
AGENT
2.1 Owner Record:
D,_n�7hl/
Name (print)
Contact Address Phone Num
2.2 Authorized Agent:
�1 )VA- x usa ��� V►�t IA- G
NL t�1.c, cM�110'S
i►'� V
Name (print)
Contact Address Phone Number
SECTION 3 -CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Not Applicable ❑
Licensed Construction Supervisor: Mk i L LS ���1 (3"�
License Number. d
Address: '2— AA LS5 '' / �
Expiration Date:
r
� -' 4(�O �6
Signature: phone'
Air- 1
3.2 Registered Home Improvement Contractor:
Not Applicable ❑
Are you a Home Improvement Contractor subject to (780 CMR.110.R6)? ❑ Yes ❑ No
If No, go to the next section!
Are you claming exemption from the requirements? ❑ Yes ❑ No
If Yes, submit the required affidavit!
Company Name:
Registration Number (if none, state "none"):
Address:
Signature: Telephone:
Expiration Date:
3.3 For Residential Remodel Work Only
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND:
QUESTIONS OR COMPLAINTS call or write:
Home Improvement Contractors Registration, One Ashburton Place - Room 1301, Boston, MA 02108, 617-727-8598
1 am a Homeowner performing all the work myself.
Owners Name (print):
Signature:
By signing the above, the homeowner acknowledges that there will be no eligibility to the Guaranty Fund
Date:
3.4 Homeowner Exemption - One & Two Family Only
FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT
5108.3.5 Licensing of Construction Supervisors: Except for those structures governed by Construction Control in Section 116.0, effective July 1, 1982, no individual
shall be engaged in directly supervising persons engaged in construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of buildings
or structures, unless he or she is licensed in accordance with the rules and regulations promulgated by the BBRS entitled Rules and Regulations for Licensing Construction
Supervisors.
Exception: Any Homeowner performing work for which a Building Permit is required shall be exempt from the provisions of this section; provides that if a Homeowner
engages a person(s) for hire to do such work, that such Homeowner shall act as supervisor.
For the purposes of this section only, a "Homeowner" is defined as follows: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than
one home in a two-year period shall not be considered a Homeowner.
If you are applying under this section sign below:
Signature:
Your signature carries certain responsibilities, including but not necessarily limited to, general liability
SECTION 4 -WORKER'S COMPENSATION INSURANCE AFFIDAVIT (MGL c 152 § 25)
Worker's 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 ❑ No
SECTION 5 `- DESCRIPTION OF PROPOSED WORK (Check aU;applicable)
❑ Deck ❑ Pool ❑ Repairs ❑ Alteration ❑ Chimney/Fireplace ❑ Woodstove/Pellet Stove
WOther
❑ New Construction* ❑ Accessory Bldg. ❑ Roofing/Siding
(Energy report required) (Shed/Garage) (Specify below)
❑ Addition ❑ Replacement window/door ❑ Demolition
(Energy report required) No. of windows _ Doors _ (Specify below)
*If new construction, please complete the following:
Single Family: No. of Bedrooms No. of Baths
Two Family: No of Bedrooms Unit 1 No. of Baths Unit 1
No of Bedrooms Unit 2 No. of Baths Unit 2
❑ Furnace (hot air) - fuel gas (natural or propane), fuel oil, electricity, other (specify):
❑ Boiler (heating) - fuel gas (natural or propane), fuel oil, electricity, other (specify):
❑ HVAC (combined unit) - primary fuel, natural gas, propane, electricity, other
❑ Air conditioning - (separate unit)
❑ None of the above to be provided
❑ Hot Water: Gas Electric Fuel Oil Other
Description of proposed work:
VJ 0 , uj W) WV I �^2
SECTION:67 ESTIMATED CONSTRUCTION, COST -
Item
Estimated Cost ($) to be completed by permit applicant
1. Building
2. Electrical
3. Plumbing
4. Mechanical (HVAC)
5. Total = (1 + 2 + 3 + 4)
SECTION 7A = OWNER AUTHORIZATION
(to be completed when owner's agent or contractor applies for building permit)
(Please Print) AQ
I, (Lp l (Z. . as Owner of the subject property hereby authorize
to act on ha , in ak matters relative to work authorized by this building permit application.
la �
Da�
Signat er
;SECTION 7B - OWNER/AUTHORIZED AGENT DECLARATION
as Owner/Authorized Agent hereby declare that the statements and information
on the foregoing application are true and accurate, to the best of my knowledge and belief.
Signed der a pains and penalties of perjury.
Signature if Owner/Authorized Agent Date
01TOWER ELEVATION
,,16„ _ ,,-0,
0
�o
FOUNDATION PLAN
MAINTAIN 12" SPACE
BETWEEN CONDUIT 4 REBAR
AND/OR ANCHOR BOLTS
0
N
COMPACTED
BACK -FILL (TYP)
1 41_n"
5'-6"
16-0"
G)FOUNDATION SECTION
, j = 1'-0"
— _1
e
Inn, r F ? 6 50
(16) *1 HORIZONTAL REBAR
EQUALLY SPACED EACH
WAY: TOP 4 BOT, (64
TOTAL)
CENTER POLE ON SLAB
FILE Copy
(20) 08 EQUALLY SPACED SEP Z 9 2008
ON A 63" DIA
04 HOOPS 10 6"oc VERT.
POLE MOUNTINCs PLATE 4 DESIGN LOADS:
ANCHOR BOLTS BY P = 11.2 kips
MANUFACTURER V = 7.9 kips
M = 446 ft-kips
SOIL BEARING CAPACITY = 3,000
PSF MINIMUM
POLE MOUNTINCs PLATE 4
ANCHOR BOLTS BY
MANUFACTURER
(20) *8 EQUALLY SPACED
ON A 63" DIA
04 HOOPS m 6"oc VERT,
(16) 0-1 HORIZONTAL REBAR
EQUALLY SPACED EACH
WAY; TOP 4 BOT, (64
TOTAL)
1-1/2" AGG;REGsRATE.
;7\/%
4,500pa1 CONCRETE MIN.
�//
(3" COVER IT BOT, 2"
2'-011
COVER AT SIDES 4 TOP)
FULLY VIBRATE. 4516 - fo%
AIR ENTRAINMENT
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d' No.7d48 s
VO NATTAPMn,,
MA
Th OF ON P
BTwGT€SF1fa1
S(0. Ji3Lt
COORDINATE ALL WORK
WITH MANUFACTURER'S
DETAILS FOR INSTALLATION
NOTES:
1. ANY OVER EXCAVATED
AREAS SHALL BE FILLED WITH
1-1/2" CRUSHED STONE TO
BOTTOM OF FOUNDATION
2. COMPACT UNDER
FOUNDATION TO 98% DENSITY
3. ALL BACKFILL SHOULD BE
COMPACTED TO 95% DENSITY
4. IF STANDING WATER OR
SATU TED SOIL CONDITIONS
ARE- OUND, CONTACT
ARCHITECT FOR DIRECTION
5. CONTACT ARCHITECT FOR
REQUIREMENTS FOR DITCH
POUR
I ®57 a vw, Mare Ch 92-202119
50 I
Shattuck
90' Wind Turbine
34 Barney's Joy Road
South Dartmouth, MA
FOUNDATION DESIGN
D— By:
SLK A 1 . 1
Daiz:
May 10, 2008
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