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BP-06768V {-^ � j J.ELEV. E� 133 5 133 5 , r , a .. if 4 , e _ 2 5 . r 4 > r . • ^ :. 4 SCAI LOCUS .r , ^ 9 A' ,l . .'. > • ^ `9 6 (A) SANDY LOAM ( B 1 ) SANDY LOAM B2 ( ) A SANDY LOAD,. (C1) SANDY LOA (C2 ) LOAM SANDY M D 0 132.8 9J7 SANDY ' LOAM 132,8 (B1) � ANDY` LOAM 132.0 19 131.9 (B2) AN Y LOAM 131.4 ;f 28 131.E C1 _ ANDY L0A 130.0 8 3 130.3, 129.4 f 4�-, 1 9L. 2 , SANDY LOAM 25 5 91 - • , • . _ .. _ PERGOLA � ION RATES. 7 n �n. PERGOLA 29. EL— M 49 = 1 4 (tTTL1 G EL -. r _ _ , -_ - ?rEEPIf�U 70 �L 127 7 _1�V�EP r No modificationS, L shall be made `to this system Withmmt ,or written axp roval by the e, iA6,er and thal. Board ef . 3. Engineer and,the E'oard o Health Twz,�;t 'i�rspect the otr la�t� d y tern prior to back-fill'back-fill' Ing. 4. Elevations- shover, on, �plan care b Red �r� 'a "subd.ivgSIr 'datum S. txva, ,equipment shall -no � b�. � � �; � �y_ run � th'- d ` o' al c �tc�a. '. All unsuitable sail- is to be excavated i�' 0�71 the Lea^hin• �x sha�wn on plan,,.and bttc ,f`�l..led with clean _1 or coarse sand as appeei ed in 310 CMS ?� ,���{" ). 7. Ta hed crushed etc-ne Shall b+�. ee of ��°�, ,fuzes and rst. . Septic t, a tr b�iti n ba etc." �ha�: be of ci •;meet b . Rotondo Sons Inc. or approved `ea��.�al, a�Ld ins4, %led .per ma?'�2t fa•#���t.� e "s �ci ica•t 'Grout, shall be used to MarcV' ide a` water tight seal at all jo�tnts 'u1.hcrc F. enters car leaves a con.crete rtrutt re. 3, Outlet di t.• 4b ton liress shall iae level � r a �ni: ui,; , O t r.'f"st t�; r Q r s R fir' 1 a�,f their Za:`na�aPh a� specified �.n 410 1 f? .t""� VETZGEN NO. 198-MF AGEPRQOF MAS, ER FORM E OIETZGEN NO. 198 MFAGEPROOFMASTERFORM IIIEFZGEN.NO: 198-MF AGEFROOF MASTER FORM 800 MECMNICALS & PRIMARY FOEL 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 (specify) - Air conditioning - (separate unit) None of the above to be provided Hot Water Gas Electric Fuel Oil Other 900 SPREWCLERS FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential Required, —Plans provided,L-7-plans not provided, why? Not required, not to be installed, Why? 1000 !1EQUMED OFF-STREET PARKING for ZONING & Architectural Access NOT APPLICABLE Parizing Plan submitted To Building Department L Planning Board Date submitted Number of spaces indoors' outside total provided H-ndicap spaces - required ves no. If yes, how many as a pirt of the total required number. Is Route 6 (State Road) Entrance permit required? yes % no If yes has it been issued yes = no Submit copy of application and/or permit as soon as available. 1100 11DENT1FICA7ION (print or.type except as noted) iiur �ent owner - name 1�L1®; l �Ut S address 'c p one # If corporation. officer in charge ArchibxWEngineer for overall design Company name Address Phone number Certified by State of Massachusetts as Certification number NOTE Signatures and seals on all plans, affidavits and other documents SHALL. BE originals and not .reproductions. - ArchitecVEngineer - project supervision and reports Company name Address f Phone number Certified by State of Massachusetts as Certification number I NOTE Signatures and seals on all plans, affidavits and other documents SHALL, BE originals aind not reproductions. General Contractor (i Homeownerf1state homeowner here then complete section 1300) Company name J c&1 0 r c�lJCLrJ& dCl Address �- � K �oUSc' �"� / �.ic1 jC , r�l L4 A 6Q 71/1) 4hone number 7 �� - 4 3 C) Construction Supervisors license number NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals amd not reproductions. 1200 FOR RESIDENTIAL REMODEL WORK ONLY Are you a Home Improvement Contractor subject to (780CMR - 6) ? Yes.— No _ If no go to).next section! Are you claiming exemption from the requirement? Yes _No if yes, submit the requiredl affidavit! Rea_ ,)del contractor name (please print) Address Registration number (if none sate "none") Phone number PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write: Home Improvement Contractors Registration One Ashburton Place - Room 1301 Boston, MA 02108 (617) 727-8598 Owners name (Print) Signature Date . 1300 OWNER SIGN - OFF 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 of my knowledge and belief that the information provided in this application is true -and correct and that the permit requested.be issued. Further I understand that the permit will expire in six months, from the date of issue, if no work is begun or six months after the last inspection if work has begun and'that the permit may be extended for six months if no work is anticipated if I request such an extension in writing. I understand that the permit may be extended only three times b permit e y written request. I understand that once the p spires a new application may be required, including fees and current other requirements (including Zoning). t tame C--CILJtZrJ_CL_ CL& - Signature E A_t�.C1..Ak.4— The above signature is my voluntary act and is signed under the pains and penalties of perjury. Date �� - 9 Who is authorized to pickup the permit at the Building Department? please crnnn PA U lfs- Rey-,.i6L nde� Address h'o Phone r 1400 HOMEOWNER EXEMPTION - ONE & TWO FAMMY ONLY FOR HOME OWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT 109.1.1 Licensing of Construction Supervisors: Except for those structures governed by Construction Control in Section 127.0, 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 accords-ce with the rules and regulations promulgated by the BBRS entitled Rules and Regulations for Licensing Construction Supervisors. Exception: ,Any Home Owner performing work for which a Building Permit is required shall be exempt from the provisions of this section; provides that if a Home Owner engages a person(s) for hire to do such work ,that such Home Owner shall act as supervisor. For the purposes of this section only, a "Home Owner" is defined as follows: Person(s) who owns a parcel of land . on which hershe resides or intends to reside, on which there is, or is intended to be, a one or two family dwelliniz, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home is two-year period shah. not be.considered a Home Owner. If you are applying sender this section sign below: Signature d-c,t.aiAo, (� s1 Ro 0, W,- E. Your signature carries certain responsibilities, including but not necessarily limited to, general liability sssssssssssssssssssssssssssssssssssssssssssssassssssssssssssssssssssssssasssssssssssssssssssssasssssssss NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any licensed Construction Supervisor, whether or not they have taken the permit are responsible for code compliance. (see 2.15.2 of section 5) sssssssssssssssssssrsssssssssssssssssssssssssssxssssssssssssss:sssssssssssass:sssssssssssssssssssssssssss 1500 COST Cost of Improvement S Items to be installed but not included in the abovecost: Electrical S Plumbing V HVAC Other TOTAL _ Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration requiresd, - Derolition - describe structure Number of dwelling units Number of bedrooms A separate Refuse Disposal Declaration required. = Moving - (Provide copy of D.P.W. moving license) Type of structure from where (plat/lot or address) to where (plat/lot or address) Number of dwelling units Number of bedrooms per dwelling unit - Re -roofing - (for existing only, is included in new construction) Number of square feet Number of layers already existing Number of layers when complete A separate disposal declaration REQUIRED - Replacement'doors and windows - (for existing only) (only where doors and windows exist and will not"be enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelling will The considered as an Alteration. otherwise will be included in new construction. (see Code section 3401.10 for - residential and Articl- 8 L. commercial) - Temporary structure - includes when allowed, trailers, tents and the like and only for limited periods of time. Describe 500 CONSTRUCTION PLANS - None submitted. Why? - Submitted. usually three sets required. Four sets for food servic6uses. Number of sets submitted 600 SITE PLAN 0 Not required, why? - Submitted When? - Previously, date C With this application 700 UTILITIES Water supply - required _ yes no, public ? ,_ yes no, on site well': yes _ no, existing? _ yes no If required and not existing have necessary permits been issued? _ no _ yes, date (M.G.L. Chapter 40, section 54 provides that no building permit may be issued unless a water supply, when required, is available. See Code 780 CMR section 114.1.2) Sewage disposal - required _ yes _ no, public sewer_ yes ,_ no private septic - on -site — ves — no. Submit copy of permit as soon as available. - Woodstove - used (will require inspection prior to installation), new (provide manufacturers The following section for official use only. " instructions). Location(s) (list) INSPECTORS' REVIEW C' Fireplace(s) - (includes flue) List location(s) Date plan reviewed Game Court - describe (include overall dimensions) 30 days to review period expires L Tent, Trailer (Mobile Home) or Other - describe - OK to issue date 3(10 COMMERCIAL - PROPOSED PROJEC IUSE - INCLUDING THREE FAMILY OR MORE AND EXEMPT USES OK to issue subject to requested submittals ' ( Project review worksheet) date •= THIS SECTION NOT APPLICABLE see ro. DENIED see project review worksheet date (The following descriptions are based on'the Massachusetts State Building Code Article 3 AS NOT ED) TED) (See the J HOLD reason date 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 ✓ �'L� - Date r r � f Applicant informed of above -Date time staff 304.0) Educational -structure for training including child day care for those overt years 9 months (see Code Section (fax, phone, in,person) - 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) I Institutional - hospital, nursing home, infant day care (see Code Section 307.0) Inspector Date Mercantile - retail stores (see Code 308.0) Advised applicant Date Time staff (by Phone, fax or in person) ####s#*:s#*#s*****####*#*s#*##*#########ssr#s#s##ssssss##•*s#ssss##ssx###s#ss##s######ss##ss##::. .Residential -three or more family, hotel (see Code Section 309.0) OFFICEVNSPECTORS NOTES - Storage - includes garages (see Code Section 309.0) TOTAL FEET Utility & Miscellaneous Structures - includes tents and agricultural structures (see Code Section 311.0) Gross area -new construction .Total Sq. Ft. New tenant for any of the above, indicate above (see Code Section 119.0 and Zoning By-law section 35) Tent or Trailer - temporary purpose alteration Total Sq. Ft. Other Permit is issued to - Describe the proposal briefly, INCLUDE - umber of dw also ezisting conditions and bedrooms oroocupantload as appl�b� Comments/notes on permit 400 TYPE 'OF CONSTRUCTION OR WORK TO BE PERFORMED J7 New Construction and/or Addition - total gross square feet (For commercial only total gross cubic feet) - indicate It will be considered new construction if there' an increase in square footage in addition to any alteration(s). 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 Peer review (over 400,000 cu.ft. , .APPLICANT TO PROVIDE ) Yes No (see Code Appendix I) i i xii#Y#ii###iiaii#a####�#i#a!###!!a#si###!i!###YY#issxii#!Y#YYYYY!lYYYYYlilit#i#s#!!i#Y##i!a!#Yi#s##Yis#i 1600 TO THE APPLICANT AND APPROVAL Date of Application submission �l j Plat 1 1 Lot_ Street Aquifer Zone Owner Owner mail address J Owner phone # z***zzzz#z#z*#z#*zzz#z#z####xYttx#*#i###ss#xx###s#iixsisiYY#sss#isss##xxsss#si###sslx###!#!!#siYsi#is#ixx OTHER INVOLVED AGENCIES - The following agencies require separate jurisdictional permits or approval for your proposed project. CONTACT THEM FOR gWjfftED SUBMISSIONS. ®- TAX COLLECTOR Approved HOLD By Date ❑ Board of Appeals ❑ Approved By Date ❑ Conservation Commission ❑ Approved By Date ❑ D.P.W. Water -Approved By ❑ D.P.W. Sewer Approved By Date ❑ D.P.W. Cross Connection _ Approved By Date ❑ Treasurer (Bond) ❑ Approved Date ❑ D.P.W. Engineering Approved By Date 7 Board of Health (well) - _ Approv - By Date ❑ Board of Health (septic) proved By Date ❑ Board of Health (foods ice) `= Approved By Date ❑ Planning Board (parking) _' Approved By Date ® FIRE DISTRICT (I II - III) _ Approved By Date ssssasssssssassYssssssaxssasssssssassaacessssassssssssasssssssssssssasssssssssasssassssssassaassss BUILDING DEPARTMENT APPROVAL: ❑ ZONING ❑ BUILDING INSPECTOR/BUILDING COMMISSIONER ❑ CONTROL CONSTRUCTION AFFIDAVIT PROJECT SUMMARY: new construction/ alteration/demo sewage disposal - public/private [Alter/add interior walls] [add rooms] [add footprint] water supply - public/private well [pool] [garage shed/deck] a_ a court] [food service] Describe J- ##x####*#xxx#x##x#*xsY#xxx:iia##i####s#x###t##x#YYYxsYis#Yxix#xx##xssss###xxYsx x#sx#x#siY!#!#Yx#Ys#s##xY 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 By AV NO V W fill -fill D APPLICATION FOR ZONING AND BUILDING PERMIT The applicant shall complete this application to the best of their, ability prior to submission, leaving no item unanswered. The Department staff will be available during 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. No&_-FffWgf=isn@txvfimmhMe- (for office use only) UNDATION ONLY Total Cost $_ Received By i Date Rec'd Less Application Fee $ _ Total Permit Fee $ Permit # Lssued Date 100 LOCATION OF PROJECT TOTAL LAND AREA SQUARE FEET CURRENT ACCESSORS' PLAT LOT ZONING DISTRICT OT ER ZONING OVERLAY DISTRICTS , if applicable UMBER .& STREET A9 FJ1," ; NEAREST CROSS STREET SUBDIVISION NAME & LOT # or BUSINESS NAME PREVIOUS TENANT / OWNER 200 RESIDENTIAL - PROPOSED PROJECT - one & two family residence only THIS SECTION NOT APPLICABLE _ Single family - number bedrooms - number baths _ 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: Garage - detached attached to dwelling, dimensions L W Carport - detached - attached to dwelling, dimensions L W Shed - dimensions L W Deck - dimensions L W _ Gazebo - dimensions L W Swimming pool above ground in -ground Size Chimney number of flues 0 6 1 (�