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BP-81514#• I0'1 IY�1-C�11 2'-10i1L 121- 411. nor k \ bIHIH& ROOM w„ \ ��►���.� G��1 - - Properties -- - --- Y-- --- ----- --- _ d . 1��0 Soldiers Fief Road . . r, 7 ---- ---- --- --- ------ �o v PE, To Bo -ton, MA } • � � � 3� ]tl i it �r-�tl yl,�p , N ehz IU pawing: it 2� II-:gvUP111O (-(D Ca I I ----.. 12 PvTwl1 DIA. o _ - - Tyr J� AWZaN , - f I �or 5 aI _O oo - e • ,y 0 - - I I 1 i a ,- S� 9 L � Z • � �I 2 { T O `n O `� I I ; � " •�°�s��EAND DEPTH �, 24 21 _sJ1 O 1 - i I O ci Y,G rI. I - i . I i . .s. j Wow,.- O Boa a... I..� Se„.�`s—tr. " _ n„ ----- - pFf�K W/ I Cr;Tr , II�IN� cIZKFAi kITGN�I- I - : 1 , , _ 71� UfGYT I I i �� I � - - I i I plwl \ — 1 I A 141 il.l5 '-Coll 4 —� j IJ ate: 24 �!'� I�Iy 2: Scale: .114 I -v s F - : 1 --- _ 1 - - � ' t ! : O - i o o 1 N-------- ----- ; -- I - _ Crawn Check i ! - 15 ( I by ed by: �M , a - - DRAWING tvUST BE I-- WA.Lw iU r3E , - _ , POGRESS OF BUILDING L�l1;K. G TI-fE UU ---,� � 5T�P 11P "ULD '� � ThtS hV®aF�• . I _ I 81f r�qr-411 3�-iDll -• r I L -------- - I - — J- i visions: i — VIJI,L r2oWW i , + u ---- ATTIC T/x Ara. ate By tho , r �y i� • P tO calling r S P� { LfourLdatiOn s a. _ �,�7 �k":Y�hG�° �°®11Staid6:tl®�1 • "l j ry r TOWN' Or- DAER-MUTH RECORD PLAR A Copy Of This da!md • Plan Must LL ,. .. M' e t DuringCn istruction Date EP 15 I99P)e'10 /4 1 _--_ - --- r -_ - - I- I II 21. 411 �,•�II i r•�il i1..1-ill► 1II 1 II :3, 1 f-r� CD '.- 2 v 2a Iv CAMBRIDGE. j OWN OF DARTMOUTH BUILDING DEPARTMENT+A 13 ( It , 1, II this plan has been reviewed and accepted as a record copy of work proposed *•� - — o be performed in with 780 CMR 6TH Edition . The owner; `r ,pplicant/agent and/or architect/engineer is responsible for insuring final ;ompliance with the above -mentioned code notwithstanding any errors or )missions in the record plan. Any change in owner, license contractor )r engineer must be reported to this office immediately.An change in 11 11UUR j` 141-1 • 1 I II�rJ� ��L/L/f` f I.�I'1 p Y g r ®�� 1 )Ian must be submitted to this of e in a timely manner, i T CID_ signature a x ` CEP 15 �99D K ?ate ffi. � SY�4 • I WVD T;LIr1 hUOD GthPP�OAh I'L � it iII,I;I,I !• \ \ WOOD • �1r� �1,� ; , - . �I�1�1(�I.i'h, '�� ri- �, , +i'�r _- _.�.. ,,;II '�'i... �ia1Ub h � � ''t�:� I � it , --- - I T q ©Ocl- --- © ©— _._ ICI Xuou : WNP 9G%?-P63 i I F*5 F - tt A A �)ELTION A111, -161 I/q if Ott WPIIHIL�IUII-) CPAvr VMA r 2x to z;TUn Wtiu. 9 ' TO :- D� ��.'1�1�Iz �Ni►161,�E� - �v�- `:, UT 167 H t - b � II i i F i I i WiUf7l�W a vFIH r a U.S. Properties T 120� Soldiers Field Road Boston, MA 1; 1 Droving: ul� -t;7/411 itatio .._..- ---- ---- 1 - 4 FO eta - • ls, _ — - Dd?9 24 FL6 h 4L Scale: 4/ ',I' 00 0 0 0 0 0 SµN — _ --- — — - _ Dr wn by: { Checked by: 12., f�,F / t IrZ" &UE A� - '.W�SKIMc01sT� —__ W -- R 0 0 0 I - _ FSiORS- r- "4RA'TIo'TOP-' IPi 9 ---- --- =. - -- uulr . No Date By ' TYP, ?'YP M ?2ATl-I M , 4 ATI� � v, 6 �v NJ �-L� VAT I'O H AT F-PTP.r. l-lv I1-1 � � �I �1.��//�ji(�N L/ 11,011 IN WkKFM,T RM .41 • --0 0 o 0 0 o 0 it 17 I _A i tgp ,"tU pN�Nf r o , �l GAM B:..DGE, ��- -'>' MA k KITGI k kIT H H� H KITG�I N kItGNEN .� '� ' _-- _ 44 _ imp_._ VE DODR SCHEDULE SCHEDULE 1/INDOW DESCRIPTION UNIT DIMEN. SOURCE NOTES - ac W m -LOCATION W w Q Q.w J CD z cos z I� 4 Z (� .. Z � Z V ti _cc w CC m Zco •Lf. EXT TjD�� T IN�IJU I�) lam, A. 6 I I 0 it A 2'- ��1 --- - 2'-C�" 2 bit 2-bib t fi�v) •oi►� 1------- - --- --- - Ivt� - -- -- I-wbv -- 1 ---- — =- -- -- - — - _ --- ..VDU=- � rJ06, 1.1* ti To IW(� j 41riL14C4 CA RNOEi, , - -fi 1P�l�.r GLA4A POP, y ' M' ITN - -_ . 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Properties 120 Soldiers Field Road 4 Bolton, MA . t LAP ov- 5PaGE4�, . AµO TPM ICU W*) , , 1 � N I � r t =1 F_ pccr-I w (v, �Tm4� En . Tv i TW M F 4IQX ,� ` ,���, Gr�x ��YWn �I�•il�b. 1 ��IG�L SIDI�Ca TAM • 4 5 IN ql It31Z, PATT I N'SO A 110 N Akr,K-Ev _ N wlrH 4 m& vAPoR Ii ,Appa-p Al 2 3 � I PIrIE WATERT/$I.E� GI,AL�'OAP-p over 'IV PLrrIcOD 1 bl Pliic rwri -�. `.T<7wlrM� irv�M� B�Tv+N I �'�- 1012.�i I \ 5'rorsaoAr Gt''''�' GrE onI-Y 0t.8D. `r// ROuGH PLASTER �I rFv�R�•F I I 5 oo Fl G GWF� A6A(14e* — — --- -_-- —rIN�SH FLo� �qo PLrr+a�p �u�FI��P-, ?x I� JOISTS@Ila"c,G.i°'��=^_G'if,INSUt.., 5, -------- b --- --- -- r _s I I, gIt O. v� �� fI{fi IyD�OD M t I ll j 2.2 xlo �' I • SILL PEAT EG TY�C1,:�i � c'v Yt t'� - '� •. I ' T• O. Vi• I ail- T � RMIfiy SHI:i.D HITt� Iw, . w',TN SILt.s�pt, GAS}-:T�TrPrA�) - , t � . It . Y E�. T.o.y. f 4 �6A2S (coN rj h _ u5) L ct� ANGHo e-,- r5_Cr YF14AI.) III RI Gi D ii`I=��i1t i v�l WITN G.M ENT Skl tltGAi' `t • . j, a • ' ` � f�'i U`r ? J aJ �S Z+A lip C1 4 tVlrPt.EOIAR WLAL•LLl oorlN�-r 5%a 3o � DGr�pL. •F, C1,�.,%'•�..��_ rrvr J. GOI`ITINNUOIS �1SJ�OIIti� � ION -� L}'�� I �'� W'tl• � ... - `Cl-pTll�-t• VK ��RIF (t � . G/aU}L� � � Q 4 v .:` - = ' _ I '' •� =- _I , r� — __ �° GdNGf�g i 4MOAI3 h►IiN Wrj;= 6V44, Hzi xY42•I01 -I 1 �I�_=1h =till={I11=NH=i(I(' - o, �� 1=1�IaL ;..' {z2tNFopuN!� &Iz'v cr?'li-=> — I1=Nil=INI=1111-11i{=illy= ft�'�� ~tia� }� cl(oT431 GI' pE¢FoRA l ap PMM II C-;L DRAW ra H C ✓ , �G 0 CGt �� FPt3 IG (,dV�QIKG GGGNiIKUQIF. 1JrLhil� T l = .(Mc,Ut=tt„�i11='�.t_ I I II — 1 t —J i I YJ • C�� I ' Co o� oo _ -_; • . t . �' --2 4 6c�tz°CTt�lta�-� FODJNDATI N WALL_ _ @ AhAtoE 7NI�EESNv►.t� 1��~ ' FDtJNQAfilON WAL.I. p='TAIL fo r Ilil IIII II s�{ U�ptyTURP�D SOIL• Ilg1=lliiillll :'Till-llti=llll=11t1 =Mali I 3m , If - _ SCA.' t 1 O TYf' IGA PG IAI L_ 1. F4�1 tJ DATI o N ' "' I I I I ' 3 I— s I I 11•,t-U1VJAIU. I I ---------- _ 100,001 - .;: Re isions: tL • T,O. WALL I E� T. U. WALL No. Date By , �� ,O,Poonp(,- I 333 `t(o,451-D' j �3 x 31 1c) N SLAIN OH &PADS 9 SwP� /0 /FT rO / 0 — f I pr r.11 Ar, tom-, ------ -}-_------------ � � QUO ��o i'•10" 2f��p '�jl,?''M ILD'�Un 1 �M.�'q _ N0.3553 N d 3 CAh;L;N1C)GE. i I' ' 22,,�11 —_. - �•'' ID'1 ZI,Utf6�^rle,_ .MAL Li•if�aV: ql It31Z, PATT I N'SO A 110 N Akr,K-Ev _ N wlrH 4 m& vAPoR Ii ,Appa-p Al 2 3 � I PIrIE WATERT/$I.E� GI,AL�'OAP-p over 'IV PLrrIcOD 1 bl Pliic rwri -�. `.T<7wlrM� irv�M� B�Tv+N I �'�- 1012.�i I \ 5'rorsaoAr Gt''''�' GrE onI-Y 0t.8D. `r// ROuGH PLASTER �I rFv�R�•F I I 5 oo Fl G GWF� A6A(14e* — — --- -_-- —rIN�SH FLo� �qo PLrr+a�p �u�FI��P-, ?x I� JOISTS@Ila"c,G.i°'��=^_G'if,INSUt.., 5, -------- b --- --- -- r _s I I, gIt O. v� �� fI{fi IyD�OD M t I ll j 2.2 xlo �' I • SILL PEAT EG TY�C1,:�i � c'v Yt t'� - '� •. I ' T• O. Vi• I ail- T � RMIfiy SHI:i.D HITt� Iw, . w',TN SILt.s�pt, GAS}-:T�TrPrA�) - , t � . It . Y E�. T.o.y. f 4 �6A2S (coN rj h _ u5) L ct� ANGHo e-,- r5_Cr YF14AI.) III RI Gi D ii`I=��i1t i v�l WITN G.M ENT Skl tltGAi' `t • . j, a • ' ` � f�'i U`r ? J aJ �S Z+A lip C1 4 tVlrPt.EOIAR WLAL•LLl oorlN�-r 5%a 3o � DGr�pL. •F, C1,�.,%'•�..��_ rrvr J. GOI`ITINNUOIS �1SJ�OIIti� � ION -� L}'�� I �'� W'tl• � ... - `Cl-pTll�-t• VK ��RIF (t � . G/aU}L� � � Q 4 v .:` - = ' _ I '' •� =- _I , r� — __ �° GdNGf�g i 4MOAI3 h►IiN Wrj;= 6V44, Hzi xY42•I01 -I 1 �I�_=1h =till={I11=NH=i(I(' - o, �� 1=1�IaL ;..' {z2tNFopuN!� &Iz'v cr?'li-=> — I1=Nil=INI=1111-11i{=illy= ft�'�� ~tia� }� cl(oT431 GI' pE¢FoRA l ap PMM II C-;L DRAW ra H C ✓ , �G 0 CGt �� FPt3 IG (,dV�QIKG GGGNiIKUQIF. 1JrLhil� T l = .(Mc,Ut=tt„�i11='�.t_ I I II — 1 t —J i I YJ • C�� I ' Co o� oo _ -_; • . t . �' --2 4 6c�tz°CTt�lta�-� FODJNDATI N WALL_ _ @ AhAtoE 7NI�EESNv►.t� 1��~ ' FDtJNQAfilON WAL.I. p='TAIL fo r Ilil IIII II s�{ U�ptyTURP�D SOIL• Ilg1=lliiillll :'Till-llti=llll=11t1 =Mali I 3m , If - _ SCA.' t 1 O TYf' IGA PG IAI L_ 1. F4�1 tJ DATI o N ' "' I I I I ' 3 I— s I I 11•,t-U1VJAIU. I I ---------- _ 100,001 - .;: Re isions: tL • T,O. WALL I E� T. U. WALL No. Date By , �� ,O,Poonp(,- I 333 `t(o,451-D' j �3 x 31 1c) N SLAIN OH &PADS 9 SwP� /0 /FT rO / 0 — f I pr r.11 Ar, tom-, ------ -}-_------------ � � QUO ��o i'•10" 2f��p '�jl,?''M ILD'�Un 1 �M.�'q _ N0.3553 N d 3 CAh;L;N1C)GE. i I' ' 22,,�11 —_. - �•'' ID'1 ZI,Utf6�^rle,_ .MAL Li•if�aV: MA jo t a H F 4 A , , ^t i 1 jR • 1 1 � a- 7", Unit, "OAT 7, nAlly <. a 1990 ZZ d d i y a + a ,, „- _ •r. a .- 'a , _. ....:_ .: i. ..r, lam: -�- .. i r ry ; b ' 1 ♦too !Olt.... .,. : ,`� ,.: ,.. .. ;- '., a ... .., _fie :E ' :.°C• Y .,� (, , vim.:,.,.:. � - v. a...r � n•^„ r ._.�_�...,_...�..,. rv. ., =.h ', .- : , ., ,. t-.. .:; to.I4.A. .....�, ;A tn,, - �.- T.. ,v., �S t ..:k •'F'.: t: a. , ', „ • .' :,. . 1 4 , .k'Yt;.l .. w :,;' .: - - � I ., -' _A � � -. , -.� r xr m a r, z __ , .a'^...e c* s . , bx ,. 1 a '_% „ 1 as ., .: e- ... si�'� , "Yi'u.. ..t a a POOR I,A,II CO i e w � p P 11 v ktL N'P•`.,: �- a x�' �4, �.^S i e , P .r t 'k> o _ s - t r .A s,,.. - .... : it ,, ,.., ,.. _. •. ... ., ,y.: ., .. .:. .. U .n r fi. - : .. .: s, ;.. ,,. a •'. .. ., a .;• -71 777 ..t _ r e ..i a .. : ' v: • - - __ n .1. ... :' .. J� _.. . '9.v �:6v SEWEREASEMENT N/F q HOMEOWNERS ASSOCIATION ia I � I I -'4 #9 143.5' j GARDENIA I DRIVE I I I 1 N 8821'01' W 150.20 N/F . CATHERINES CONVENT INC. D 9 GARDENIA DR. AS -BUILT 10-29-98 C 82 FAIRWAY DR. AS -BUILT 8-26-98 B 3 GARDENIA DR. AS -BUILT 7-23-98 A 5 GARDENIA DR. AS -BUILT 7-17-98 EV. DESCRIPTION DATE 3t_ i — L DRIVE R 602 0.002 0 Ra720.00 S 89 36 * 02' W o in 4463.87 85.37 I M I J p0 � OPEN SPACE S 89'36'02' W a m LLl - 140.00 3 m I N GPI �JE O� 55.5' o a-30 3• ui w N/F I i N � DOHERTY o� ,n _ N 87'4548W 205.29 C 0 P I A Copy Of This Endorsed I : Situ { Plan Must Be Kept On S Onrin Co strgI n Date 800 MECEANICALS & PRIMARY FUELArdi -- Furnace ' eer - project sups talon and reports (hot air) Fuel gas atu or propane), fuel oil, electricity, other (specif) y Company name Boiler (heating)- Fuel gas (natural or propane), fuel oil, electricity, other (specify) Address HVAC (combined unit) - Primary fuel, natural as propane, electricity, gas, P P ty, other (specify) �---- . Air conditioning Phone number - (separate unit) Certified by State of Massachusetts as E None of the above to be provided Hot Water Gas c/ Certification number I Electric Fuel Oil Other 900 SPRINKLERS - FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential NOTE Signatures and seals on all lens, affidavits and other documents SHALL, BE originals ana3 not reproductions. Required, _plans provided,pians not provided, why? Not required, not to be installed, Why? General Contractor (if Homeowner, state homeowner here then complete section I300) n A Company name 1 1000 REQUIRED OFF-STREET P ARKING -for ZONING &Architectural Access p� Address NOT APPLICABLE Phone number e Parking Plan submitted To = Building Department ` PlanningBoard Date submitted_ Construction Supervisors license number P b Number of spaces - indoors outside total provided NOTE Signatures and seals on all Plans, affidavits and other documents SHALL BE originals and',,not lYandicap spaces -required _yes _no. If yes, how many as a pirt of the total required number. reproductions. �. Is Route 6 (State Road) Entrance permit required. ::sssssssssssssssssssssssssssssssssssssssssssssssssssssssssssassssssssssssssssssss s*••*x**s*ssfnsssss:sss+� yes no _ . If yes has it been issued yes no Submit copy of application and/or 1200 FOR. RESIDENTIAL REMODEL WORK ONLY permit as soon as available. 1100 IDENTIFICATION (Print or type except as noted) Are you a Home Improvement Contractor subject to (780CMR - 6) ? yes _ No _ If no go to neat section! Current owner -name _ e�� ji Are you claiming exemption from the requirement? Iles —No _If yes, submit the required affidavit! address MA Ren_,)del contractor name (please print) phone # /77 117Z - 697 Address If corporation, officer in charge 9 ,'ter -ice, Registration number (if none state "none") ATchitect/EnArchitect/Engineer,- for overall design Phone number ��---t Company name i'q 4e-Q, O t s � —+F- Y-`$' Gr � �. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS 'TO THE GUARANTEE FUND! QUESTIONS OR COMPLAINTS 'call or write: Address ���5 ;/f >�S v Home Improvement Contractors Registration One Ashburton Place - Room 1301 .Phone number _` tP( 7' C) M Boston617) 7, 98108 Certified by State of Massachusetts as !{� <$ T� OZG t Owners name (print) Certification number Signature NOTE Signatures and seals on all laps, adavits and other documents S ffi reproductions. HAi"i" BE oi'iginalc and not Date I, i I 1300 OWNER SIGN - OFF Alteration of existing,_ no increase in gross square feet. A separate Refuse Disposal Declaration,Trequi ed. I, the undersigned, am the owner. of record or authorized lessee (provide documentation) and I have reviewed the application herein submitted. I state that to the best = Demolition - describe structure of m knowledge a hc2tion is true -and correct and that the permit y edge and belief that the information provided in this PP Pe requested be issued' Further I understand that the permit will expire in six months, from the date of issue, if Number of dwelling units -Number of bedrooms A separate Refuse Disf„osal no work is begun or six months after the Iast inspection if work has begun and that the permit may be extended for six months if Declaration require& no work is anticipated if I request such an extension in writing. I understand that the permit may be extended only three times by written request. Iunderstand that once the application = Moving Provide co of D.P.W. moving license - ( copy g ) Type of structure permit expires a new may be required, including fees and current other requirements (including Zoning). �I from where (plat/lot or address) ) VD Name I to where (plat/lot or address) Signature The above signature is my voluntary act and is signed under a pains gad�ofperjury.Number of dwelling units Number of bedrooms per dwelling unit _ x Date = Re -roofing - (for existing only, is included in new construction) Who is authorized to pickup the permit at the Building Department. (please Drina .--� Cam_ ����) Address (? i�oTTi Number of square feet Number of layers already existing � Phone 800 — 50 v _ p� Number of layers when complete 1400 HOMEOWNER EON - ONE & TWO FAMILY ONLY A separate disposal declaration REQUIRED > FOR ITOME OWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT - Replacement doors and windows - (for existing only) (only where doors and windows exist and will not be ' 109.1.1 Licensing of Construction Supervisors: Except for those structures governed by Construction Control in Section 127.0, July i, 1982, ' enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dweWing will be .effective no individual shall be engaged . in .directly supervis' rng persons engaged in construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of buildings considered as an Alteration, otherwise will ,be included m new construction, ~(see Code section 34(b 1.10 for or structures, unless he or she is licensed in accordance wika the rules and regulations promulgated by the BBRS entitled RLles'and Regulations for Licensing Construction Supervisors. residential and Articles 8 fi,_ commercial)' - Exception: Any Home Owner performing work for which. a Building Permit is `required shall be exempt from Temporary structure . includes whenallowed, trailers, tents and the like and only for limited periords of time,), the P of this section; provides that if a Home Owner engages a person(s) for hire to do such 'work ,that such Home Owner aer shall act as supervisor.. Describe For the purposes of this section Daly, a "Home Owner" is defined as follows: Personwho owns a 500 CONSTRUCTION PLANSs) parcel of land on which heishe 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 two-year period shall not be considered a Home Owner. = None submitted. Why? Y'Submitted, usually three sets required. Four setts for food serviceluses. Number of sets submitt, d If you are applying under this section sign below: 600 SITE PLAN Signature Your signature carries certain responsibilities, including but not necessarily limited to, general liability "ot required, why? t_OO F— ( C) t3 —� NOTICE TO LICENSED CO CONTRACTORS: The Building Code in the Rules -Submitted When? _ Previously, date C With this application provides and Regulations'section'that any licensed Construction Supervisor, whether or not thev have taken the permit are responsible for code' compliance. 2.15.2 of section 55) (see ss#ss#s#s#r:s#sssssss#ss**#ss##sss#sss#s#sssssss#s#ssasssssssssss#s#ss##s:#sssssssss#s#ssss#s#ssss#s#sss 700 UTILITIES 1500 COS Water supply -required v yes _ no, public ? yes no, on site well? _ yes no, Cost of Improvement existing? v yes no Items to be installed but not included in the above cost: Electrical 5 Plumbing l5 b U If required and not existing have necessary permits been issued? — no _ yes, date CS (M.G.L. Chapter 40, section 54 provides that no building permit may be issued unless a water suP l F 1 when Y HVAC , � _ 6� required, is available. See Code 780 CMR section 114.1.2) Other Sewage dis posal - required L// no, public sewer ✓yes no TOTAL _ private septic - on -site _ yes — no. Submit copy of permit as soon as available. i — WOOds'tove - used (will require inspection prior to installation), new (provide manufacturers The following section for official use only. instructionsy. Locii on(s) (fi r? j INSPECTORS' REVIEW Fireplace(s) - (includes flue) List location(s) �l U(�% G��J(✓�"' t Date plan reviewed Game Court - describe (include overall dimensions) 30 days to review period expires Tent, Trailer (Mobile Home) or Other - describe = OK to issue date 300 COMMERCIAL - PROPOSED PROJECT/USE -INCLUDING THREE FAMILY OR MORE AND EXEMPT USES — OK to issue subject to requested submittals (see project review worksheet) date THIS SECTION NOT APPLICABLE — D'ENIED see project review worksheet date (The following descriptions are based on the Massachusetts State Building Code Article 3, AS NOTED) (Sew' the Code) HOLD reason - dat"te _ Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe — HOLD Subject to Zoning Board of Appeals action Comments — Business -office, assembly with less than 50 occupants - indicate Medical or other professional (see Code Section 303.0) Inspectors signature Date, EP 15 _ Educational -structure for training including child day care for those over t years 9 months ( Code Applicant informed of above - Date time staff (fax, phone:_, in person) 304.0) see Section sssssssssms**s*ssss*ss*sssssssssssssssssssssssssssssssssssssssssssstsssssssssssssssssssssssxsa;ssssssssssss e Factory ; Industrial _ (see Code Section 305.0) _ Over six months since approved for issue - DEEMED abandoned! — Advise applicant. Hold 90 days for return then dispose if not picked up. - High Hazard - (see Code Section 306.0) _ Institutional - hospital, nursing home, infant day care (see -Code Section 307.0) Inspector Datc, < ` _ Mercantile -retail stores (see Code 308.0) , — Advised applicant Date Time staff (by phone, fax or in person)) Residential -three or more family, hotel (see Code Section 309.0) s:::sssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssswcsssssssssssssssssssss ssssxsstss:: OFFICEIIIVSPECTORS NOTES _ Storage - includes garages (see Code Section 309.0) TOTAL FEE _ Utility & tiliscellaneous Structures - includes tents and agricultural structures (see Code Section 311.0)f i Gross area -new construction y.3 Total Sq. Ft. , = New tenant for any of the above, indicate above (see Code Section 119.0 and Zoning By-law I section 35) alteration Total Sq. Ft. = Tent or Trailer - temporary purpose? Permit is issued to = Other Descrff)e the proposal briefly, INCLUDE -umter of dwelling units and bedrooms or occupant load as a hcable �o eusting condition PP , Comments/notes on permit 400 TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED New Construction and/or Addition - total gross square feet (For commercial only total gross cubic feet) - indicate It will he considered new construction if there an increase in square footage in addition to any alterationis). If project is an addition to existing structure - Total gross square feet of existing - FOR COMMERCIAL ONLY Will this project be subject to CONSTRUCTION CONTROL (over 35,000 cu.ft.) Yes see Code section 127.0). Designer to submit Code Synopsis. No. (If yes Will this project require Peet- review (over 400.000 Cu-ft.) Yes No (see Code Appendix 1) APPLICANT TO PROVIDE I O i E#########tf#�ti.sssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssasss,ssssrts 1600 TO THE APPLICANTT/ROMUZA , AND APPROVAL Date of Application submissionj/ / Street Plat Lot � Street �Ck E4 Aquifer Zone Owner i f�!, At e � � r� 4 n A Owner mail address Owner phone # sxxxxxxxxxxxxsss****sxssss*sssssssssssssssssssxssssssssssssssssssssssssssssssssasssssssssssssssssssssssss OTHER INVOLVED AGENCIES 'The following agencies require separate jurisdictional permits or approval for your proposed project. CONTACT 711E I FOR RF.OLIiQ�p S-pg SONS. ® AX COLLECTOR _ Approved HOLD By Date ❑ Board of Appeals = Approved By Date j Ir' 13 onservation Commission i---- Approved By Date ❑ D.P.W. Water = Approved By 0 D.P.W. Sewer =Approved By Date ❑ D.P.117. Cross Connection Approved By Date - ❑ Treasurer (Bond) ❑ Approved By at Bate ❑ D.PAV. Engineering 77 Approved By Date '7 Board ,of Health (well) Approved By Date ❑ Board of Health (septic) ,_ Approved By Date ❑ Board of Health (food service) Approved By Date ❑ Planning Board (parking) _ Approved By Date 011'RE DISTRICT (I - II - III) Approved By sss:saa:asses;ssssasssssss:asa Date sssssssssssss.:�sssssssssssssssssssssssssssssasssasssssssssss BUILDING DEPARTWUMNT APPROVAL: ` E3 ZONING ❑ BUILDING INSPECTORBUILDING COMMISSIONER ❑ CONTROL CONSTRUCTION AFFIDAVIT sszees:::zees���rsssssssssssssssssssssss:xsasssssss�sssssssssssxxxxxsxsxxsxx:ssssssss:xssssxxxsssxsxsxsx PROJECT SUMMARY: Cewconstt-rsctioti� alteration/demo sewage disposal -public/private r;add anterior walls] [add rooms] [add footprint] water supply, public/private well [pool] [garage/shed/deck] [game court] [food service] Describe sssxsxxxxxxssssssssssssssssssssssssss*ssxxss*zees:::xsssssssxssxssxxsxxxxsssxxs::xssxxxxxssssssxxxxxxxxsxxx To the various departments: This notice has been forwarded to you for your information and any appropriate action. Should you have any questions please advise. If any reason to withhold the requested permit is found, please advise. Your assistance and cooperation is appreciated. The Building Department - Date sent for review APPLICATION FOR ZONING AND BUILDING PERMIT Instruction , The applicant sball complete this application to the best of their ability prior to submission. leaving no item ®answered. The Department staff will be available daring regular business hours to assist as necessary. N/A should be inserted for those sections which do not apply. A properly completed application will help avoid unnecessary delays, Xs6m EWmg fee is (for office ose only) ❑ FOUNDATI®N ONE:Y Total Cosa f Received By Date Rec'd 01 cy Less Application Fee $�' _ Total Permit Fee s Permit # Isisoed Date 9 5 9 100 LOCATION OF PROJECT TOTAL LAND AREA SQUARE FEET CURRENT ACCESSORS' PLAT q 3 LOT ZONING DISTRICT OTHER ZONING )VEkLAY DISTRICTS , if applicable NUMBER & STREET :h ely N:7AREST CROSS STREET SUBDIVISION NAME & LOT 1# S1 % or BUSINESS NAME /- PREVIOUS TENANT / OWNER 200 RESIDEN'1'1AL - PROPOSED PROJECTone & two family residence only = THIS SECTION NOT APPLICABLE Single family - number bedrooms -3 number baths 2 - Two family - number bedrooms unit 1 number baths unit I number bedrooms unit 2 number baths unit 2 Accessory apartment Total gross sq. ft.' Accessory structure: 2/Garage - detached - ttached dwelling, cimensions L d 1 9 W 2 2 Carport - detached - attached to dwelling, dimensions L W Shed -dimensions L W eck = dimensions L W / 61 Gazebo dimensions L W Swimming pool aboveground in -ground Size Z?"Chimney - number of flues ''.�