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BP-64574SECTION 12''ESTIMATED 'COiISTRUCTION COST Item Estimated Cost ($) to be completed by permit applicant 1. Building "IS 2. Electrical 3. Plumbing 3 Cton Co 4. Mechanical (HVAC) 5. Off -Street Parking 6. Total = 0 + 2 + 3 + 4 + 5) Estimated Total Cost Including Labor. $ ,60 OWNER AUI HORlZATI ` to'be completed when owner's agent or contractor'appliesfor building permit) (PleaPrint) I, as Owner of the subject property hereby authorize rapt g {J _ cn(e?a to act on my b"ehalf, all matters relative to work authorized by this building permit application. Signature of O er Date �� SECTION 13B - OWNEPJAUTHORIZED AGEP�?T DECLARATION' ), �Q'C GL-KL©CG= 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 under the pains and penalties of perjury. Signature or Owner/Au orized Agent Date SECTION 14=INSPEGTOR`S'R=VlEW/COC(iMENTS 1. Date Plan Review: 2. 30 Days to Review Period Expires: 3. OK to Issue Date: 4. Per CMR 111.1 Rejection Letter Sent: 5. HOLD - Reason: Date: 6. HO D - P,ect to Zoning Board of Appeals Action: 14 8. Inspector's Signature: Date: CT[ N 15 APPLICANT NOTIFICATION ' Applicant inform f above: Date: �l Time: Clerk: Comments: SECTION 16=OFFICEIINSPECTOR'S:NOTES Less Applicat n�e.e: $'25.00 Remaining Balance. $ Total Permit Fee: $ Other $ Amount 8 TOTAL FEE: � �Gross Area - New Construction total sq. ft. /�1 L Gross Area - Alteration total sq. ft. Permit Issued Page 4 i S25.00a T' ci. 3't� l � FEE ![S TvJo ti y :. ' 9 ^' E _ ART1VTATEgRyEJS�I� T. DAR I iOOU fl H BUILDING DEEPS° R T MEN I ».� 400 Slocum Road, P.O. Box 79399 2011 OCT ( I AN 11: 37 Dartmouth, MA 02747 Phone: 508-910-1820 Fax: 508-910-1838 Ih64 .i www.town.dartmouth.ma.us APPLICATION TO CONSTRUC , VEPAIR, RENOVATE OR DEMOLISH A COMMERCIAL BUILDING (including 3 or more family dwellings) TN! R OFFIGIALUc E ONLY. SECTIOPFO DEPARTMENTAL APPROVAL Zoning Review: Signature: Date: Energy Report: Signature: Date: Fire Chief: Signature: Date: and of Health: Signature: 4 Date: _ C Commission: Signature: D ` Other: /��Lv� Signature <Q Brief description of work being pert ornned. SECTION 1 - SITE INFORMATION 1.1 NUMBER OF PLANS SUBMITTED: '�AU, 1.2 SITE PLAN SUBMITTED: Dyes ❑ No 1.3 Property Address:.1 i nc L)�� ���e � , 1.4 Assessors Map & Lot Number: Map _ Lot _- Nearest Cross Street:jp2cXxy— R,�. 1.5 W `er Supply (MGL c40 s54): Business Name:171 Municipal ❑ Private Well Business Phone 'I: 1.6 Sewage Disposal Sysy;*m: Total Land Area Sq. Feet: ❑ Municipal YOn Site Disposal System SECTION 2 PROPERTY OWNERSHIP/AUTHORIZEDAGENT . 2.1 Owner Record: �11b V\`t\ Q® or A. �oc�,�a�TrnnLIMA RA Name (print) Contact Address Phone Number 2.2 Authorized Agent: QGLC- VR� 3A SIR �, � A� �l ��os `I�U�CisSeLc� � o, ��%) Name (print) Contact Address Phone Number Page 1 Revised 9/09 SECTi0i�1 3 -CONSTRUCTION SERVICES':.,, 3.1 Licensed Construction Supervisor. Not Applicable ❑ Licensed Construction Supervisor: license Number: e, yt Expiration Date: :o� jAddress: gnature: Telephone: p� — SEG ION 4 -;WORKER'S COMPENSATION INSURANCE'AFF.IDAVIT (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 o; the issuance of the building permit (MGL 152 Section 25A). Signed Affidavit Attached: NrYes ❑ No SECTION 5 - DESCRIPTION OF PROPOSED. WORK (Check all ap�licabte). . ❑ New Construction 'Addition ❑ Repairs ❑ Accessory Building (Shed/Garage/Other) ❑ Other (Specify Sec. 6) ❑ Demolition ❑ Sign ❑ Replacement window/door No. of Windows Doors ❑ Fire Protection SECTION 6 -`PROPOSED P.ROJECT;USE -'INCLUDING THREE FAMILY OR:MORE.AND EXEMPT USE The following descriptions are based on the Massachusetts State Building 7th Edition, Code Article 3, as noted. See the Code. ❑ Assembly - restaurant, lounge, theater, school, etc. (see Code Section 303.0) Describe: Business - office, assembly with less then 50 occupants - indicate Medical or other professional (see Code Section 304.00) ❑ Education - struction for training including child day care for those over 2 year 9 months (see Code Section 305.0) ❑ Factory/Industrial (see Code Section 306.0) ❑ High Hazard (see Code Section 307.0) ❑ Institutional - hospital, nursing home, infant day care (see Code Section 308.0) ❑ Mercantile - retail stores (see Code Section 309.0) ❑ Residential - three or more family, hotel (see Code Section 310.0) ❑ Storage - including garage (see Code 311.0) ❑ Utility & Miscellaneous Structures - includes tents and agricultural structures (see Code Section 312.0) ❑ New Tenant - for any of the above, please indicate (see Code Section 110.0) ❑ Tent or Trailer - temporary Purpose? ❑ Other: Describe the proposal, INCLUDE number of dwelling units and bedrooms or occupant load as applicable, also existing condition (if extra space is needed, attach an additional sheet): ti SECTION 7 - TYPE.OF.CONSTRUCTION OR WORK TO BE:PERFORMED , t$ New construction and/or Additional (total gross cubic feet proposed) - indicate ;�8(4 FT ti ,JMA s2.V`ney\� If the project is an addition to existing structure - total gross square feet of existing: 9y0p ��QFr ❑ Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration is required. ® Will this project be subject to CONSTRUCTION CONTROL (over 35,000 cu. ft. ) Yes ❑ No If Yes, see Code Section 116.0 Designer to submit Code Synopsis in additional to original plans and if existing building Section 3402.1.1 Will this project require Peer Review (over 400,000 cu ft.) ❑ Yes l4o (see 110.11.1 Code) APPLICANT TO PROVIDE PEER REVIEW AT THEIR EXPENSE. SEE 780 CMR. ❑ Demolition* - describe structure: ❑ Trench Permit Required? ❑ Yes ❑ No See Trench Requirements G.L.C. 82A and 520 CMR 7,00 et seq. ❑ Moving* - (provide copy of DPW moving license) *Type of structure: from where (map/lot or address): to where (map/lot or address): number of dwelling units: number of bedrooms per dwelling unit: ❑ Replacement doors and windows - (for existing only) (only where doors and windows exist and will not be enlarged) EGRESS dimensions must be maintained. ❑ Temporary structure and uses - includes, when allowed, new tenants, trailers, tents and the like and only for limited periods of time. Describe: :: SECTfQN 8.=: 4fEC14AICAL 'PRIMARY i?(✓!EL ...... =urnace (hot air) - fuel gas (natural or propane), fuel oil, electricity, other (specify): ❑��B--oiler (heating) - fuel gas (natural or propane), fuel oil, electricity, other (specify): 5 HVAC (combined unit) - primary fuel, natural gas, propane, electricity, other (specify): ❑ Air conditioning - (separate unit) Roof Top Unit (RTU) New ❑ Replacement ❑ ❑ None of the above to be provided Mechanical Ventilation ❑ VHot Water: Gas Electric Fuel Oil Other SEC o I®W 9.:= SPRi !' R� [ C/� ;Ffl � P ?C)T�CTEC3 � 3 GQP€E OF LEI �'4iwb SQUIRED. ❑Required: plans provided plans not provided, why? M/Not required, not to be installed, why? Narrative Submitted? ❑ Yes ❑ No SECTION OFF-STREET 0ARKING (for;Zoning and ArchitecturalAccess) GS Parking plan submitted to: Building Dept. Planning Board Date submitted �!DNI Vk Number of spaces indoors 53 outside _ _ Total provided,4 Handicap spaces - required Yes No if Yes, how many as a part of the total required number Is Route 6 (State Road) entrance permit required? Yes No V1111, if Yes, has it been issued? Yes No Submit copy of application and/or permit as soon as available. SECTION' 11 ..:IDENTIFICATION . 11.1 Architect/Engineer - for overall des' n \ Company Name: VT r-10171 all 1•. Address: p Phone #: S - lA - b Certified by State of Massachusetts as: Certification Number: Note: Signatures and seals on all plans affidavits & other documents SHALL BE originals and not reproductions. -11.2 Architect/Engineer - project supervision and reports Company Name: Address: Phone #: Certified by State of Massachusetts as: Certification Number. Note: Signatures and seals on all plans. affidavits & other documents SHALL BE originals and not reproductions. 11.3 General Contractor Company Name: on r Q�C'�g �nSRSz,� Address: Phone #: �4- 00 an \nvl) Cj � Construction Supervisors License Number: Q_Q1,J 1*1 rx,� Note: Signatures and seals on all plans affidavits & other documents SHALL BE originals and not reproductions. Page 3 Page 2 LANDSCAPE KEY SYMBOL COMMON NAME (BOTANICAL NAME) SIZE QUANTITY 0 MP NORTHERN BAYBERRY SHRUB (MYRICA PENSYLVANICA) 3-GAL. 6 KEENAN + KENNY ARCHITECTS, 1 Tn X67.657.65 189 Main Street Falmouth, Massachusetts 02540 508-540-0075 TEL N/F N/F 508-540-0079 FAX / 1 / ^ kk.arch®verizon.net KENNETH J. & �� KENNETH J. & USA M. MEDEIROS www.keenanandkennyorchitects.com i i USA M. MEDEIROS X66.7 DRILL HOLE -L X66.7 DRILL HOLE BELOW G, A% BELOW GT% 3 _REBAR 3 �- P. CAPE COD -M -.-,REBAR W/ ..'�' -�O 01p W C i4.4 BERM (TYP.) / / pp / W�OPOSEp FLMOD CB / / P OPOSED / 4 LIMP X66.51 , �``'i3.3 X66.51 / ULC�I F&G E(b'5-64.05 x63.3 - - _ - - PRIME ENGINEERING i5.6 5. _ / / PROPOSED CONCRETE 5 _ - / P POSED LEACH PIT INC ( APRON (TYP.) / `O F G EL.=63.00 '4 5 / £0� / X64.5 • CIVIL ENGINEERING P.O. BOX 1088 f0 350 BEDFORD ST. .i5.8 X6 .8 Gf F� ` • LAND SURVEYING G • ENVIRONMENTAL LAKEVILLE, MA 02347 BENCHMARK:5 //4 . I��/\ 1 BENCHMARK:5 64 0 4 I C�Vf 4° LOAM AND TEL / / / \ gs. / / / \\ \ S ? 508.947.2004 ASSESSMENT 50 EP�I\K/E IN POLE EXISTING / I � � _ 281ycb f SPIKE IN POLE EXISTING 0 6,� �` � 66� 8I¢, SEED FAX.•508.947.2004 GRAVEL �, I '3 7 , '��� 62 \ 1g ELEV. = 65.69 GRAVEL 3.7 :��� - 4' PROPOSED EROSION 6�.78 � �5.3 / � � � /�/'�� - - `- 8g¢, � 6�.78 �� / 5.3 I � '�� - - lgg9¢' CONTROL / OVERHEAD WIRE / i �- I / - - 8.4 / : , OVERHEAD / EXISTING ® __�/. / � (�. 1 / / � ) / PROPOSED .5 THICK IXISTI G � � WIRE/ _ _ i 4� - - \ � ` 8.4 MAILBOX I /i5.3 4\ /� / `� �\ _ - X58. BIT. CONCR PAVEMENT MAILBOX/ X65.39 i� \ �l 1 \ \\ � / / - ��- - - - - - _- 58 x58.7 ( ') X65.39 i� ` \ \ l PRo Off / - - 1 _ 58 X58.7 CAPE ALIT \ \ \) / \. / r Nfl AP 64,50 -�- - / PLANTER \ / / �_' --E� - - - -_ _ P UGHT f P T U 'i \ \) C - . 00. 4.5\ x l --_ _ 64.89 / - --p ---- / \ / 6 57.5 P0�'E • METER - d Xb __ RISER I \ / _ 65.0 X5 .6 / 7.5 / o o POE :,( METER // / I x56.6 RELOCATED// MPi4.7 `Oo / �. / ,� / 56.E \ RISE��FPEX55.6 I / X64.81 _/. 4. / , / GRAVEL , . ,; _ �\\� I i Z EAR MAILBOX _ / / / / i. / G 56 ,n W�CAP / �'' P / 794. 8.4 /� 6 \\\ Q ,LET W�CAP Q THRE HOLD i 45,dfi\� Fq. \ / I N�F-DCC-1 PROP. FLAG a 64 95 / - -_ 45 >� �� F�. i / O� EXISTING ELV. = 57.3 �. - - 61 - - ( � \x54 6 3.9 ( / O/ POLE 5.05 /ISTING ELV E HOLD _' % 1 \ / 1 MP �` - - 61 - - ► (Ewl \\X54.6/X53.9 ( 1hIF-DCC-1 / \ FLAGPOL - I 1 \ \ 1 I P. UG -' FLAGFOL x64.71 / \64.4 / x64.56 U] -' I I I PRO . o 1 1 1\ 11 / x64.68 L I I X64.71 POLE 4.56 I U I I al4 3.87 - - 1 III PAR ING SIN / / x / [ \ FFE E) STING \ I I I I� [ I (SE DETAI E) TING // 4.47 X 65.1 \ \ SEPTIC 6TANK X61.3 I X60.4 I. I I I I I WF CC-2 P. CAPE C0� 1 64100 4.47 6 15 k61.3 \ j X60.4 /xc 64.82 65.1 I BERM TYP �' P oo 64a0 E SEPTIC SANK 1 I WF CC-2 J / / c X63W X64.16 \ I III ( �' 65.1 \ � ` \ (EXISTING I / I � -� t o 3.'92 X64.16 t / TO BE REMO�/Ep III 1� Stamp \ (IXISTING Ico I 4.38 / a! \ \ 6� \ �'�EA/CH PIT \ / �� 50.9 // \ 64.45 6� -I-EACH PIT 1\ I III / ov 3.61 \ BIT. / Gpy \ -5 \ 1 z / / �o x X64.38 3.61 I ' I / / / 50.9 / k6' ERATOR -1 62.5 � a, / I / / al4STANDING \ BIT. \ 62.� / � / 1 CONC: pqp - o� l WATER ON // \ CONC. I P. CAPE COD �� 0 �f3E FILLEDI 1 z / /r o x PAVEM \ - 1� I / / / / ,114 `AT s \ o' I / / // WATERI ON 31 \ °- / APR. 4, 20' I / d PAVEM BERM (TYP.) \ 1 / / / / r°®� �ttcha�tD / cv x63.75 \ 4. -E "IS LINE �j (I/ �/ / �`y` I ^ �X�.31 /� D4 x PREP NE \ \ 1 ( // c / w X63.75 64 00 \ / a ( APR. 4 20i 1 ;�� ; V r� X WATER 3.7 / o -+ / E ► WATER ' 4. RAP E EXISTING P�td LINE \ ► POSEi�1(///// � SHE UMI 3.41 GATE SERVII E \ \ \ 111I / ryd` / rn SERVI E O 1 1 a o 3 7 500. G / v �1��� x x6 ' SLAB EXISTING BUILDING \ \ \ 3.41 GATE' �, 1 I / �,° J 3.99 4.5 4.5 \ \\\\ o zo aL 3.99 X6 / SLAB EXISTING BUILDING 4.5 OPOSED ► \ SEP IC TAN�tS \ � w •:' I 65.00 .� \ \ \ J 4. , 1\\\ t z J �\ \\ J I 65.00 GENERATOR 1�20) \ \ o Q I �� 1 �/ i cS i \ _ \\ 1� 1 WF-DCC-3 ; �/ X63.59 I _ N \ 11 WF-DCC-3 3.59 - R 0 / \ C� i3.81 I 4.14 4.21 \ T \��11I II I I X63.81 I 4.14 X64.21 PAD 0 \ ► ,l) I I \ .8 / I I I I CIO \ ► I X63.20 G ` \1111 X63.20 6 0 / UTILITIES WILL i E p PAV 4.5 \ \ 1 I 4L ,� 0 PAVEMENT 4 NEED TO BE \ 0 \ ► ///JI/I\ h 63.79 EMENT \ \ / I i \ 63.79 RELOCATED PROPOSED X X63.5 \ L 111 ( I I \ X x63.5 1 \ O (///( I \ No. Description Date I l / 1500 GAL i l I % RISER " I \I I6 1 I+ i I I\\ i 1 I I I YDRANT RI W PUMP CHAMBER �� rn; o \\ I I \ HYDRANT \ Y 6 N 1I11 I I \ 1. Rev. Per Town Planner 10/12/2011 \ PIPE6 5 PATI / I 1 I I 1 \ I \ PROPOSED LEACHING FIELD C ' p (H-20) / I ► I ���^yry 1 1 11 1 I " \ I'3' 1 3.5 \ 4.8i4.4 \ \ \ \ \ 11 \ � I . \ I x63. '1 20'W X`� ' X 0. ,D f ; /r PATIO I / 11111 \ 1 3.61 / wl \ \IXISTING INTERCEPTOR G I °' ' `j' \ \ 1 I I I \ \ \ WF-DCC-4 3.61 / 1 WITH IN ION $ D \ ` j ' 4.8 X64.4 r �G/ \ \ l \\\ \ 11 \ 1 WF-QCC-4 / I J. 1CANOPY I I 1 I I I I \ ' / I z \EXISTING IN�ERC£PTOR / CANOPY I I 1\\ I 1 1\ \\ \ i i YX63 8 4.7 / ( TO BE REPLACED WIT { ( I 0 I I X64.3 \ \ 63.7 `� \ \ \ WF-DCC- ' QI X63.8 Al NEW MDC TRAP J 4.7 x64.3 \ �i\ 63.7 WF-DCC-6 GRAVEL , I `a - 64 / / \ / GRAVEL - - - - - I ,1 P"01 I z („ WF-DCC-5 PROPOSED INDUSTRIAL WASTE v % 64 3.51 ' 7 I 4 -d c�i� 0 1 `D 16 . 7 REMOVE P 101 TIGHT TANK 7a �\ N /WF-DCC-5 h6' 1 I 0. -0 100.0 n; p') 5 / I v' o I / I3.4 Z �y Z X64.9 / / m - -FNI AND 3.4 z i I \ 4.9 / a' / I HI ( \ rp\ / �-�'*� - - - 4. w / I REPLACE ` r_ �, X6 X64.8 I I I__ -' 4. 48 w ( I X63.7 // X64.� � �`\` X65.1 X65.2 \ _ 65 rr, I I / 4. \ 2'� SEWER FORC�-K IN X65.2 \ - 65 - °a I 2I 1•� / � ,� � X65.1 1 rri �I \<y2 / /\ 1 �2I1 �_ / 3.39 4.3 - u / \ ® I X63 FUELING \r6 �/ X65.1 \ cn i3.39/ ® l X63.-1-2-x64�3-_� �1 / X65.1 \\ / VEHICLE TRAINING ( \ / VEHICLE FUELING \ 3.4 I ISLAND / I 6, \0 8 TRAINING II ( STRUCTURE X63.4 STRUCTURE % 1 X64.8 �o e I STORAGE ISLAND /� I I' X65.4 1 I X64.8 �o O o� ► STORAGE 10 _ _ HUT I X65.4 I/ 65 - �� � HUT U I I I II X63.43 \ I ���' i - -_- ^ \ \ �� SHED 65.E �o`° / 1 x63.43 I\O �F, /� - 65--� \ i SHED 65 Y I / / / \ \ / i STORAGE I I N/F \ / F�� / /��� / ` STORAGE I I N/F AREA \ / J TOWN OF \ / / ii/= \ \ / - - AREA \ / X65.8 DARTMOUTH / i / /i// \ _ - 66 DARWMOU 3.2 i / // / / 1 I / V _ _ �--�- (6 TT_ X65.8 X6 / / n \• „_ - xl X63.2 �6T / _ I X63.61 �� //[--_ _-_ 1 I \ \ S 87-)63.61 17'22" W 200.00 --- 1 �� //[ S 87*17'22" W 200.00' •� / / \ X---64 l i X_--64J ROGER D/SUAVE & ROGER D/SUAVE & PAULA R. CANASTRA z PAULA R. CANASTRA z O SITE NOTES: ,��,� C„�b,ry EXISTING CONDITIONSr,r PROPOSED LAYOUT 1. THE SUBJECT PROPERTY IS SHOWN AS LOT 50 ON THE TOWN OF DARTMOUTH ASSESSORS MAP 28.d }" 2. THE SUBJECT PROPERTY IS SHOWN AS LOTS 12 AND 13 ON A PLAN ON RECORD AT THE BRISTOL COUNTY REGISTRY OF DEEDS (S.D.) AT PLAN BOOK 68, PAGE 14. i 3. REFER TO BOOK 1756, PAGE 393 ON RECORD AT SAID REGISTRY OF DEEDS FOR TITLE REFERENCE TO THE SUBJECT PROPERTY. 4. THE SUBJECT PROPERTY IS LOCATED IN ZONE X, AREA OF MINIMAL FLOODING, AS SHOWN ON THE FLOOD INSURANCE RATE MAP gOs • fA3 (F.I.R.M.) OF BRISTOL COUNTY, MASSACHUSETTS, COMMUNITY -PANEL NUMBER 25005CO459F, DATED JULY, 2009. 5. THE SUBJECT PROPERTY IS LOCATED IN THE TOWN OF DARTMOUTH SRB (SINGLE -RESIDENCE B) ZONING DISTRICT. REDUCED I LEGEND ZONING SETBACK LOCATIONS SHOWN HEREON ARE AS PER THE TOWN OF DARTMOUTH BUILDING DEPARTMENT. -: - - - - 69 - - - - - EXISTING CONTOURS 6. TOPOGRAPHIC DETAIL SHOWN HEREON IS BASED ON A FIELD SURVEY BY PRIME ENGINEERING, INC. IN FEBRUARY AND APRIL , 2011 tn. _ " ' r 4. ` a • } LOCUS x98.5 EXISTING SPOT ELEVATION AND REFLECTS CONDITIONS AT THAT TIME OF SURVEY. NO CERTIFICATION IS MADE AS TO THE EXISTENCE OR NON-EXISTENCE OF ANY >> I ll A TP 1 OBSERVATION HOLE LOCATION SUBSURFACE STRUCTURE OR CONDITION NOT VISIBLE AND EVIDENCED FROM THE GROUND SURFACE. �- _ Imo, `� �A _ - _ - -=- k •..� j.•. -...r i -r:i.v �.. I i - i. ram, 7. WETLANDS RESOURCE AREAS SHOWN HEREON ARE BASED ON A DELINEATION BY THE TOWN OF DARTMOUTH CONSERVATION =� t. Ran• PROPOSED CONTOURS �- - _ __ w x_�. PROPOSED SPOT ELEVATION COMMISSION IN FEBRUARY, 2011. l -�-- PROPOSED GRASS SWALE LOCUS Q FRED0� EXISTING TREELINE 8. VERTICAL DATUM SHOWN IS ASSUMED AND IS BASED ON A PRESUMED SLAB ELEVATION OF 65.00 AT THE BAY DOORS of THE NOT TO SCALE OH Vd EXISTING OVERHEAD WIRES EXISTING FIRE STATION BUILDING. I N .0 U Q • - "aco 0 .� N N O Co -1� 0 LJ.. � .,.., E =_ = O _t Co O ` Cn O CU It-0 0L EXISTING CONDITION AND PROPOSED SITE PLAN Project number Date 1 AUGUST 2011 Drawn by JLB Checked by RJR C 1 1 . Scale 1' = 20'-0"