BP-0750070
R = 19 5. C-) 0'
L 4 87'
Z01
45
, P0
55'
L
PLAT 44T A-i 48 1 0 T G
1 `j IF N. KAPLAN & SON,
'ION 1
N
A 4 0, CDO0 Ft
PROPOSM 3 B T%E
DWELLING
TOF=139.20 i4- 121
(VA PRIES)
LO
PROPO�-C,
tK
ID F,
5' ON/ERD1
1,71
4
SU 7-3 LOT -f7
[333 M 0 R N E-P,
r,ON' . PAD
F C1,AJ
1 =30'
r I
1"Up 0
-A
TF S)
1 m 0
LOC13S MAP
LOCUS
SCALE: N.T.S,
D 'S I G N D A"'i'"A
F S! G N PERC, 7min./in. 'jas-z 2 SC)l' S
L
D E__ S 1 G-1 N FLOVV: 7f, 3 R. x 110 GPD/E3R
c r %1, DESICN C)F 6010
1 E,�'E. x,34! L�7 A CH F I L i�--
-CH AREA:
C ALC i AT ON S: 18'x34'xO.60gpd,/s..---7=�6/.2qpd
3,
0 c C
0—
.3
i
Z 0 _NN I N G
_S
1-QLJ J, f � 1�'Nl E N, I
7ON!"IG IS SPA,
— SINGIE RESSIDENCEL A
NAIINIMIJ-M LOT FRONTAGE
1 r; 00'
1 1�,! 1 tk,4 U ,1 C) TA L
AR
40,000 ft.
VA V i_J 'Ai % I OT
COVERAGE
50%
GRANDFATHER
SE TEACK R ('E
I
Q U i REEM E N T S:
F F ]F'ONT
YARD
5000'
A i Nikwl U Jkll YARD
2020.00
RSIDE
M
D
L N!4 L.0" CC1VT'_RA";'1
J,
< 5� 0
k R� F NCB` -Fj -2C)ijOF PRUIPOSi7D L�:ACH'NG
6'
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0
U
0
6'
7
X
10, m
'74. 3
Xxl�
15
y
SCHLE, 4-0 PVCtT FES; L,=;��!;p
4
7 P
A)
4
z
_NT z 14 TOP Or,- BASEIVILE
1 2 8
FLOOF,' EL. 1311.8 12J
RV.0 SWITIM
A
4 — -----
3A 658
7 'A"
2'
ttt
IVEL .`:7 i TZ P- 1, L7 r'A �F
.7
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LF VL'1 FTZ, 11 j
V
j
A 4 V
NO TiE: i
r�, V 0, i 1� 0, r '1_ V
VI -Ole every attp,-npt has, h�en mcd-� to ovoid the nick,�I- jt�� ,�fv 4 t I C; C
C) f
jr, tc
Any conflicts shdl be briught t,O thl- c
C_ 0 L 1C) Cr
FD
-115 #!
tJ
DATE: 1/ 30/9"
DA _-E.
1/30/96
77 r
4
(Al
i
1�ANF)Y LO.11\1`,t.411
(E3
�52)
kzZIANDY LOAM!!
ISANDY LC;i�.
H
'!SANDY L0
A
I J J.
is
41
LOAM
1 2. 8
9"
_SANC')'
ol
132.8
SANDY LOAM
19"
131,9
3
r1ANfL-_,Y LOAM
131.4
28"
I
131.2
SANDY LOA�
13 0. 0
38
- - - --- - - -
130.3
12-9. t
44
2
129.8
SAS C -Y LOAM
PERCOLATION RATE : 7r-njn.1;,. EPCOLAT ON �ATEI_3:- 5min./in,
'S4� J1,1 0 T TIL 1 IN G 449" EL= 129,4 M 0 T TL - 1111G Z.
g7 FiL= 127.2
WEEPIIIN,-� @70" E-L=- 127.7 WEEN PIG 6"
Si,,ND31NG Wk, TE R @8 4 "' EL 125.3 STANDING ,,,`ATER @84" EL= 12 6. 55
P L_ TION TEST _Ri -1.
ERCOLA P�L\FORMED B'�' ,,,LAN FIEUREUY
LJ1ATOR- ALAN HEUREJ^
r
INS.PECTC-)R: SUE GR!,FFIN, C1iRIS MICHiA UL)
GENERAL 011390
-1. All work mu.st be in acccrdance with tie p-,,.Ssachusetts Department of
Environmental Frotection Regulations 310 Cap;R 11.00 & 15.00 (Title V)
ar,d any local Board of Health Yodificatio'7),s.
2. 1,,o r-Lodificat4ons shall be made to this s,,y,,e'?M without prior written
approval by the e-,7.gincer and thR local .Board of Health.
8. 1;7-,I,�ineer U.-n1 the 1?oard of hFivalth raLtzst in, -,ec' ttce completed system
pntor to bac�filling.
4. sho-wri, on plan are, based 0-r, a,7-1, iwbd-ivisn data.
5, 11.?avy equip-o-Lent shall be mler t& diss', osal system.
S. All uns-attable soil is to be excavated f, from she Leaching Area,
u5 shrwn on plart, and backfilled with cZea-, gra-vel or coa.rse §dnd
as sp r c ifit, d in 810 CYP4 15 _? 5- 5(2),
7. Washed cu.,shed stone shrill bp free of iron,,, firAt's a7id dust.
S. _S7rpftc icank, d-Lxtribution boz, etc. shall be mnuftryctured &y 'Rctondo &
So-zz Inc. or approved eq-vzl, and iru�talled ,�.ar marcufacturer s s1--,ecificat-,
Gro-ut shall be u.srd to Provide a water tilt > seal at all joints where pir,
E'Pters or lea-ps a concrete structure.
a-' th• fj S4 W
,9. Outlet hrx--. i-;�ball bc level f6r c� r70,ni,?mim. 'I
it 310 CJfR
10, _4 Bcarrd of Jleclth certificate of Co-,rplianu- as reqi_tired b'd 310 C,,Z,,fp 15.
11pon Qf 4"crk-
7 1-,nrs t
A
J
4
S IIC, TANK
7
'5 6, 1 E X 1 COC'N' T J S
CON701,;R:7 DIS37RIL-IJ T ON BOX
TEST PiT
S r, v
Wl,"-JER L:N`E T ER _W3' 7 TE
BIENCHMARK
TMARD
r ED W I T HOU
!i 1 71- -3 i _ri
A
CONSTRUCTION OF THIS SEPTIC SYSEIP,..",
MUST BE COMPLETED WITH THREE 7,
�A T F_ 0 F 1,�,
YEARS)F THE D
This System Is Not Designed
For Garbage Grinder, Whirlpool
Or Other High Water Use Devices.
ENGINEERS AS AS-BUIT
PLAN & CERTIFICATION
V
STATEMENT REQUIRED
t p��
THE APPROVAL By THIS OFFICE 1998
DOES NOT GUAVA TEE THE
MAY- 2- 7 1998 EFFECTIVENESS OF ANY
K I OUTH
4 jlf(
- INSTALLATION DAR'EN2
BOARD OF HE�LTH
13't( DARTMOUTH BOARD OF HEALTH t-uMUff_V0A__LTH 1' F' ION
REQUIRED WHEN FXCPAff�'ITE
?
Mm"
M,
x SERUBE
ND. 35W
07600
800 MEC21ANICAM & PRD6 ABY FUEL
Furnace (hot air) Fuel�g=atural or propane), fuel oil, electricity, other (specify)
Boiler (heating) uel gas )Jatural or propane), fuel oil, electricity, other (specify)
s
VAC (combined unit) - Primary fuel, natural gas, propane, electricity, other (specify)
Air conditioning '_ (separate unit)
None of the above to be provided
a/Hot Water Gas --I/— Electric Fuel Oil
Other
900 SPRINKLERS - FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential
Required, -Plans provided, ✓plans not provided, why?
Not required, not to be installed, Why?
1000 1EQUIRM OFF-STREET PARKING - for ZONING & Archit
ectural Access
it< NOT APPLICABLE
Parking Plan submitted To Z Building Department ``Planning Board Date submitted
Number of spaces - indoors outside
total provided
H'�ndicap spaces - required _ ves _no. If yes, how many as a p-trt of the total required number.
Is Route 6 (State Road) Entrance permit required? yes no ®. If ves has it been issued yes no
Submit copy of application and/or permit as soon as available.
1100 IDEN'ITFICATION (print or type except as noted)
VC=mnt owner - name
J�
address
one # i
n.�
If corporation. officer in charge
ArchitecttEngineer - for overan 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 S
reproductions. HALL BE originals and not
ArddtectlE weer - project supervision and reports
Company name
Address
Phone number
Certified by State of Massachusetts as
Certification number
NOTE Signatures and seals on all vlans, affidavits and other documents SHALL BE originals and not
reproductions.
i
General Contractor- (if Homeowner, state homeowner here then complete section I300)
Company name !V Ki } ..
4 ,/�' 14 / V � lfl ��.� � ,--
ddress
i
one number
zl�&nstruction Supervisors license number C
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals amd not
reproductions.
sssssssssssssssssssssssssassssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss:ssssssssssss
1200 FOR RESIDENTIAL REMODEL WORK ONLY
Are you a Home Improvement Contractor subject to (780CMR _ 6) ? Yes v NO _ If no go to `next section!
Are you claiming exemption from the requirement? Yes ---No -If yes, submit the required`affidavit.'
Re>Z odes contractor name (ylease print)
Address
Registration number (it none state "none")
Phone number j
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE AC=SS 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 ji
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 is 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
six months ,after the last inspection if w begun or
P work has begun 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
written request. I understand that once the err e three trines by
P xpires a new application may be required, including fees and current
other requirements (including Zoning).
Na e ITC-) 14- U
i 14 r t l�
S.nature
F
dlA—
The a ve signature is my voluntary act and is signed under the pains and nalties of e u
pe p rj ry
Date
Who is authorized to pickup the permit at the Building Department?
Address C �f .5� _a �s �Q a{i�r�., phone �; `± S- 3 -2- 5`
1400 HOMEOWNER EMWTION - ONE & TWO FAMILY 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
aged in
construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of buildings or
structures, unless he or she is licensed in accord2rce with the rules and regulations promulgated by the BBRS enti"ed
R:.les 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 sectior. 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 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.
If you are aprlying under this section sign below:
Signature
Your signature carries certain responsibilities, including but not necessarily limited to, general liability
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 sectiva 5)
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1500 COST
Cost of Improvement S
Items to be installed but not included in the above cost: Electrical $
Plumbing
HVAC
Other
TOTAL
Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration trequired.
Demolition - describe structure
Number of dwelling units Number of bedrooms ® A separate Refuse Dispicosw
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 -rooting - (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 wiill not be
enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelliuig will be
considered as an Alteration, otherwise will be included in new construction. (see Code section 340 WI--.10 for
residential and Articl- 8 ft.: commercial)
i
Temporary structure - includes when allowed, trailers, tents and the like and only for limited perioOls of time.
Describe
500 CONSTRUCTION PLANS
None submitted. Why?
Submitted. usually three sets required. Four sets for food serviceluses. Number of sets submitWd
600 SITE PLAN
I
❑ Not required, why?
= Submitted When? Previously, date `I 44,with this application
700 VTH,TITES
Water supply =required yes _ no, public ? _ yes _ no, on site well? _ yes V no,
existing? _ yes _ no
i
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 suppliy, 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 yes _no. Submit copy of permit as soon as available.
_ Woodstove used (will require inspection prior to installations, new "(provide manufacturers
instructions). Location(s) (list)
1-/Fireplace(s) - (includes flue) List location(s) PAKA, iu J(n0 kA
_ Game Court describe (include overall dimensions)
Tent, Trailer (Mobile Home) or Other - describe
300 CO�M14fERCIAL - PROPOSED PRO,JECTIUSE - INCLUDING THREE FAMILY OR MORE AND EXEMPT USES
3. THIS SECTION NOT APPLICABLE
(The following descriptions are based on the Massachusetts State Building Code Article 3, AS NOTED) (See the
Code) _
.Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe
= 'Business office,assembly with less than 50 occupants - indicate Medical or other professional (see Code
Section 303.0)
Educational - structure for training including child day care for those over 2 years 9 months (see Code Section
304.0)
Factory. / Industrial - (see Code Section 305.0)
_ .High Hazard - (see Code Section 306.0)
_ .Institutional - hospital, nursing home, infant day care (see Code Section 307.0)
Mercantile - retail stores (see Code 308.0)
— Residential - three or more family, hotel (see Code Section 309.0)
_ Storage includes garages (see Code Section 309.0)
Utility & Miscellaneous Structures - includes tents and agricultural structures (see Code Section 311.0)
— 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?
a
_ Other
Describethe proposal briefly, INCLUDE -umber of dwelling units and bedrooms or occu t bad asapplicable,
also Ming condition P� PPlicable,
400 TYPE OF CONSTRUCTION OR WORK To BE PERFORMED
✓ew Construction and/or Addition - total gross square feet 100
3,
(For commercial oaky total gross cubic feet) - indicate t
It will be considered new construction if there an increase in square footage addition
alteratioto any
n(s).
If project is an addition to existing structure - Total gross square feet of existing_
~� FOR COM OERCIAL 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 y
W I this project require Peer review (over 400.000 cu.ft.) Yes No (see Code Appendix n
AP'PT.TrAW Tn PDnvr"r,
The following section for official use only.
INSPECTORS' REVIEW
Date plan reviewed
30 days to review period expires
OK to issue date
OK to issue subject to requested submittals (see project review worksheet) date
DENIED see project review worksheet date
HOLD reason date.
HOLD Subject to Zoning Board of Appeals action
Comments
Inspectors signature Date
i
Applicant informed of above - Date time staff (fax, phone,, yin person)
s:sssssssssssssssssssss:s:ss:ssssssssssssssssssss:sssssssss:::sssssssssssssssssssssssssssssssss�:sss::::s:
Over six months since approved for issue - DEEMED abandoned'
Advise applicant. Hold 90 days for return then dispose if not picked up.
Inspector Date
Advised applicant Date Time staff (by phone, fax or in person)
ssss*ssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssa:sssss:ssss �
OFFICEUNSPECTORS NOTES
TOTAL FEE C7 e)- l
Gross area - o new Total S . F construction � � t.
as � q
alteration Total Sq. Ft.
Permit is issued to
I
Comments/notes on permit
i
j
I,I
III
sssssssssssssassggssas:asss:ass:sassssssssss:sassssssssassssssassssssass:ssasssssssasssasssssasassssssas
1600 TO THE APPLICANT/REFERRAL AND APPROVAL
Date of Application submission `2 7—
Plat Lot Street oZ- Aquifer Zone
Owner
Owner mall add
Owner phone # zssszxxssxsxssssssxssxssssa*sssssssss:sssassasssssssssssssssssssssssssssssssssssssssssssssasssssssassssss
OTHER INVOLVED AGENCIES -'The following agencies require separate jurisdictional permits or approval for your
Proposed project. CONTACT 7TEEM FOR REOUTREp
�5)x COLLECTOR Approved Z HOLD By
SQBMMONS.
—
Date
17 Board of Appeals _ Approved By
conservation Commission e Approved
Date
By
Date
❑ D.P.W. Water — Approved By O D.P.W. Sewer — Approved By
Date
o D.P.W. Cross Connection Approved By
Date
❑ Treasures (Bond) O Approved By
Date
o D.P.W. Engineering - Approved By
Date
4 oard of health (well) = Approved By
Date
(��Bo d of :Health (septic) _ Approved By
Date
13 Board of health (food service) — Approved By
Date
13 Planning Board (parking) - Approved By
®FIRE DISTRICT (I - II
Date
Approved By
Date
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BUILDING DEPARIMM4T APPROVAL:
❑ ZONING
Q BUILDING INSPECTOR/BUILDING CONLNUSSIONER
C3 CONTROL CONSTRUCTION AFFIDAVIT
aaxisxsssaaffasffiiifafsafiiiaaKiia#asaasatafa#as;ssExa#ss#saafaisxsxisaxssxasfiixa#saa#afiaaasss#ai##s7c
PROJECT SUMMARY
new construction/ al ration/demo sewage disposal - publiciprivate
Alter add interior walls) [add rooms] [add footprint] water supply - public/private well
[pool] [garageished/deck] [game court] [food service]
Describe /'
sassssssss:sssssss:ss:sass:s:ssaassssa ssassssssasssss
To the various departments:
sasssssssas:sassssssssa:asssssssss**xasssaxs
o
This notice has been forwarded to yu 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 reviews
By
TOWN OF DARTMOUTH -BUMDG EPAR NT
TELEPHONE 508-999-0720 g : -_ .... ; FAX> 50-999-0738
APPLICATION FOR ZONINAND BUELDING PERMIT
Imtruetiom _,
The applicant shall complete this application to the best of their ability prior to submission, leaving no item ®answered. 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. NAw Finns fee is aunt
(for olifim use only) (, 0 FOUNDATION ON' Y
Total Cost $ ��'" Received By Date Reed _:L: 7� �e�
Less Application Fee S 0,�_etb q -
Total Permit Fee $ Permit # 150 0 Lued Date l
100 LOCATION OF PROJECT TOTAL LAND AREA SQUARE FEET
CURRENT ACCESSORS' PLAT LOT ZONING DISTRICT
OTHER ZONING OVERLAY DISTRICTS , if applicable
LAg6
i� NUMBER & STREET t�
NEAREST CROSS STREET
SUBDIVISION NAME & LOT # 4P !A q
�-�--
or BUSINESS NAME
PREVIOUS TENANT / OWNER
Zoo RESIDF,N'TIAL - 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 1
number bedrooms unit Z number baths unit 2`'
Accessory apartment Total gross sq. ft.
Accessory structure: t
r
Garage - detached attached to dwelling, dimensions L C9- T" W IX
a Carport detached - attached to dwelling, dimensions L W
Shed - dimensions L W
Deck dimensions L W
® Gazebo - dimensionsL W
Swimming pool above ground in -ground Size
o-
0
VChimney - number of flues
aL J''I"')