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BP-7780 z 0 Yam_ Oisle SC,L?� z 59 , C� R -1 111-� 15' co r:. Crl r- 0-1 Ul 0 800 MECHANICALS & PRIMARY FUEL x _Furnace (hot air) - Fuel gas (natural or propane), fuel oil, electricity, other (specify) a/Boiler (heating)- Fuel gas (natural or propane) fuel oil electricity, other (specify) _ HVAC (combined unit) - Primary fuel, natural gas, propane, electricity, other (specify) Airconditioning - (separate unit) None of the above to be provided Hot Water Gas EIectric Fuel Oil V 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 REQUIRED OFF-STREET PARKING - for ZONING & Architectural Access NOT .-APPLICABLE Parking Plan submitted To Building Department Planning Board Date submitted Number of spaces indoors --EL— outside o, total provided 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 If yes has it been issued yes no �. Submit copy of application and/or permit as soon as available. 1100 IDENTIFICATION (print or type except as noted) Current owner - name �/ C� T T l5 l� /'c 1 ct, address 7SCJ R ✓ f / / • o7a�/ v� phone # 6 7 7 - 3 (o If corporation, officer in charge Architect/Engineer - for overall design Company name .Address , Phone number Certified by State of Massachusetts as Certification number NOTE Signatures and seals on all ratans, reproductions. affidavits and other documents SHALL BE originals and not 1r 'f Architect/Engineer - project supervision and reports 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 andl not reproductions. General Contractor (if Homeowner, state homeowner here then complete section 1300) Company name O AleG Address S o e 6f Dt a (@ AV P t✓ i Phone number (a Construction Supervisors license number NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals ands not reproductions. 1200 FOR RESIDENTIAL REMODEL WORK ONLY Are you a Home Improvement Contractor subject to (780CMR - 6) ? Yes No If no go to neext section! Are you claiming exemption from the requirement? Yes No �If yes, submit the required afffidavit! Remodel contractor name (please print) Address Registration number (if none state "none") I Phone number PERSONS CONTRACTING NVITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write: A Home Improvement Contractors Registration One .Ashburton Place - Room 1301 I Boston,:MA 02108 I (617) 727-8598 Owners name (print) Signature Date i 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 proviided in this application is true and correct and that the permit requested he 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 tno work is anticipated if I request such an extension in writing. I understand that the permit may be extended only three times by Alteration of existing, .no increase in gross square feet. A separate Refuse Disposal Declaration required. written request. I understand that once the permit expires a new application may be required, including fees and current other requirements (including Zoning). Demolition - describe structure Name Number of dwelling units Number of bedrooms A sepataf`fe Refuse Disposal i Signature Ig Declaration required. Th a ign is my voluntary act and is signed under the pains and penalties of perjury. Moving - Provide copy of D.P.W. moving license) Type of structure ( ! Date Y o2 from where (plat/lot or address) // �j /,[ to 15-e (/�/ Who is authorized �p)'ck}p the permit at he Building Department:' ipleaseprint) nld �acJtp[w/2 O to �- N. � g 9 % 7 to where (plat lot or address) Address loSB /�� 2 Phone Number of dwelling units Number of bedrooms per dwelling unfit 1400 HOMEOWNER EXEMPTION - ONE & TWO FAMILY ONLY Re -roofing - (for existing only, is included in new construction) FOR HOME OWNERS WHO INTEND TO PERFORII AND BE RESPONSIBLE FOR THEIR OWN PROJECT Number of square feet Number of layers alreadyr existing of Construction Supervisors: Except for those structures governed b Construction Control 109.1.1 Licensing Pe p g Y Number layers when complete in Section 127.0. effective July 1, 1982, no individual shall be engaged in directly supervising persons engaged in of construction. reconstruction, alteration, repair, removal or demolition involving the structural elements of buildings or A separate disposal declaration REQUIRED 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. • _Replacement doors and windows - (for existing only) (only where doors and windrows exist and will not be Exception: Any Home Owner performing work for which a Building Permit is required shall be exempt from enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelling will be 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. iconsidered as an Alteration, otherwise will be included in new construction. (see Conde section 3401.10 for For t. a pu,:poses of this section oniv, a "Home Owns r" is deff-ed as follows: 7erson(s) who owns a parcel of land - residential and Article 8 for commercial) 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 Temporary structure- includes when allowed, trailers, tents and the like and only foss limited periods of time. two -tear period shall not be considered a Home Owner. — If you are applying under this section sign below: Describe Signature 500 CONSTRUCTION PLANS carries certain responsibilities,t ecessarily limited to ' u si natureincluding but no n general liability Your gg g =None submitted. Why? NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any Li submitted, usually three sets required. Four sets for food serviceuses. Number cif sets submitted licensed Construction Supervisor, whether or not they have taken the permit are responsible for code compliance. (see 2.15.2 of section 51 600 SITE PLAN 1500 COST / p (� �(� O ©i% ❑ Not required, why? Cost of Improvement 5 (� . �� Submitted When? - Previously, date ✓ With this application Items to be installed but not included in the above cost: Electrical 5 Plumbing 700 UTILPIIES HVAC � � r Water supply required _yes _ no, public . ves ® no, on site well. ✓ yes no, pply - q Other existing? a yes _. no �y TOTAL � a 6 ?k 6. 0 0 If required and not existing have necessary permits been issued? ® no _ yes, %da to (M.G.L. Chapter 40, section 54 provides that no building permit may be issued vales a water supply, when The following section for official use only. required, is available. See Code 780 CMR section 114.1.2) INSPECTORS' REVIEW Sewage disposal - required _ yes no, public sewer e yes _ no Date plan reviewed private septic - on -site no. Submit copy of permit as soon as aavailable. Zves 30 days to review period expires OK to issue date El Woodstove - used (will require inspection prior to installation), new (provide manufacturers instructions). Location(s) (list) Firepiace(s) - (includes flue) List location(s) Game Court - describe (include overall dimensions) Ten t, Trailer (Mobile Home) or Other_describe 300 COMMERCIAL - PROPOSED PROJECTIUSE - INCLUDING THREE FAMILY OR MORE AND EXEMPT USES 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 i _ Business - office, assembly with less than 50 occupants - indicate Medical or other professional (see Code Section 303.0) - Educational -structure for training including child daycare for those over 2 years 9 months (see Code Section i 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) Vfercantile - 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? _ Other Describe the proposal briefly, INCLUDE number of dwelling units and bedrooms or occupant load as applicable, also e3fsting condition I 400 TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED i JINew Construction and/or Addition - total gross square feet 141 X A. I (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 0 ( 00 cu.ft.) Yes No. (If yes see Code section 127.0). Designer to submit Code Synopsis. Will this project require Peer review (over 400,000 cu.ft.) Yes No (see Code Appendix I) APPLICANT TO PROVIDE 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 MAY 91 1997 7 ell Applicant informed of above Date time staff (fax, phone, in persenn) 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) OFFICE\INSPECTORS NOTES TOTAL FEE 4 Zi Q Gross area uew construction Total Sq. Ft. alteration Total Sq. Ft. Permit is issued to r Comments/notes on permit / q X ' i 1600 TO TM APPLICANTIREFERStAL AND APPROVAL Date of Application submission0` at Plat ((L L 'A Street i C Aquifer Q Zone Owner ill j� Owner mail address Owner phone # taiZaasaia aiaiiifEifff;$f#alfiEE#!f!f!a#tiEiiaffElitffliii!!!Eflffiaiiii#itiiflflEEEii!!ff!lEEEEfEiEfaaiZ OTHER INVOLVED .AGENCIES - The following agencies require separate jurisdictional permits or approval for your Proposed project. CONTACT THEM FOR REQUIRED SUEMLSSIONS. 0 TAX COLLECTOR = Approved = HOLD By vit: onservation Comm ApprovedBy (� t? D.P.SV. water — Approved By Date 0 D.P.W. sewer Approved Bi Date 12 D.P.W. cross connection — Approved Date 0 D.P.W. engineering __ Approved Date B and of Health "well Approved bate 0/ and of Health septic _ Approved Da e 4 Board of Health food service Approved Date * FIRE DISTRICT lI - II III) _ Approved Date Planning Dept _ Approved Date Other _ Approved Date ();h`m - Approved Date ( •„PtFrLlrntS ......zz:z...z..zz:zaa.zz:a:asasaslzlfaz#s::aa:zfa:#zzzsszzz::azasza:z:sz:azza:zzzsasEzizzszszzlsszfzzi Prnjert summary new construction/ aiterationidemo sewage disposal-publiciprivate [Alter:add interior walls] [add rooms] [add footprint) water supply - publiciprivate well (pool[ [gar meshed] [game courtl ;[food service] RJ Describe id z:azzazzaszza;asss:z:assEzssssEssszf#ssz:as:::Efzsazii#zaaz:z:zsf#zizazzzzss:azsasfl:f!#f!!s!#sszlE##z##zz To the N arious 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 IF-2 Date sent for review � By APPLICATION FOR ZONING AND BUILDING PERMIT Insamcdons The applicant shall complete this application to the best of their ability prior to submisPoi.'leaviteg no item unanswer-rd. The Department staff will he available dtarias regular business hours to assist as necessary: N/Ashould be inserted for those sections . - which do not apply.prnpedy completed application will help avoid unnecessary delays. Pbaw frog i i5 MMt (for office use only) Y' Application fee $ 5 received by Date / Total Permit Fee $ Permit # � % 100 LOCATION OF PROJECT CURRENT ACCESSORS' PLAT co LOT / ZONING DISTRICT' OTHER ZONING OVERLAY DISTRICTS , it applicable eC a T NUMBER 3 STREET NEAREST CROSS STREET J ®� � r' r ✓e SUBDIVISION NAME & LOT # o Al c- ?-e S or BUSINESS NAME (� / / '�/f 1 t' ` �j/ PREVIOUS TENANT ; OtiVNER �J I 200 RESIDENTIAL - PROPOSED PROJECT - one & two family residence only j = THIS SECTION NOT .-APPLICABLE ' 2/Sint;Ie family - number bedrooms 3 number baths d7 Two family - number bedrooms unit 1 number baths unit 1 number bedrooms unit ' number baths unit Z .accessory apartment Total gross sq. ft.' L7 -accessory structures G �{ _ Garage detached - attached to dwelling, dimensions L W_ Carport - detached - attached to dwelling, dimensions L W Shed - dimensions L w _ Gazebo dimensions L W _ Swimming pool above ground , in -ground Sine. _ total square,'feet = Chimney - # of flues 1 ,