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BP-6347(Ap:.)FINE L11AM'°' SAND (B ,)FINE LOAM'S SAND CB w 2A FINE LOAM "' SAND (C", FINE LOAM',, f SAND (C' 2) W -JEE TIED, SAND 77,8 9& 76,5 2311 7,6 2,7 72h I13' 69.0 67,9 C- -7 -7 (Ap)FINE LOAMY SAND (BW)FINE LOAMY SAND (Cl)FINE LOAMY SAND C2>MED, LOAMY SAND <Ap)f-INE LOAMY .. SAND 78.9 78,3 CB ,. I",FINE LOAMY SAND 77A 22" CB ,-. FINE 7` ,7 LOAMY SAND 34" 7617 (C-) 73,0 ` FIDE 69,6 SANDY LOAM 54' 75:0 7 AIR s � � � Architectggngineer - project supervision and reports Soo MECHANIC.MS & PRIMARY FUEL Company name = Furnace (hot air) - Fuel gas (natural or propane), fuel oil, electricity, other (specify) Address Boiler (heating)- Fuel gas (natural or propane), fuel oil, electricity, other (specify) Phone number HVAC (combined unit) - Primary fuel, natural gas, propane, electricity, other (specify) us etts as ed b State of Massachusetts Certified Y Air conditioning - (separate unit) Certification number None of the above to be provided !, NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not, ,riot Water Gas - Electric Fuel Oil Other reproductions. 900 SPRINKLERS - FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential General Contractor (if Homeowner, state homeowner here then complete -section 1300) Required, _plans provided, plans not provided, why? ! ✓id?�a �x Company name J91�✓f ®s r Not required, not to be installed, Why. y -tom Address C Access f `� r ' 1000 REQUIRED OFFSTREET PARE3NG - for ZONING & Architectural Phone number II' _ NOT APPLICABLE Construction Supervisors license number Lz i = Parking Plan submitted To - Building Department L Planning Board Date submitted NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and nott reproductions. j Number of spaces - indoors outside total provided H9ndicap spaces - required _ yes ®no. If yes, how many as a pirt of the total required number. 1200 FOR RESIDENTIAL REMODEL WORK ONLY Is Route 6 State Road) Entrance permit required? yes E no. If yes has it been issued yes = no 7. • _ � o If no o to nextsection! � N 780CMR Y g Contractor subject to ( � Are you a Home Improvement Submit copy of application and/or permit as soon as available. Are you claiming exemption from the requirement? Yes �If yes, submit the required aff0 avit! 1100 IDENTIFICATION (print or type except as noted) Ren_,)del contractor name lease Tint Current owner - name Address ,address Registration number (if none state "none") phone Phone number If corporation, officer in charge WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS 70 THE ArchitectlEngineer - for overall design PERSONS CONTRACTING GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write: Home Improvement Contractors Registration Company name y�., One Ashburton Place - Room 1301 Boston, MA 02108 Address (617) 727-8598 Phone number Owners name (print) Certified by State of Massachusetts as Signature Certification number Date NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not reproductions. j 1300 OWNI�R SIGN - OFF _.. 1, the undersigned, am the owner. of record or authorized lessee the application herein submitted. I state that to the best of m knows (provide documentation) and I have reviewed application is Y edge and belaef that the info pp true and correct and that the permit information provided in this P 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 it I request such an extension in writing. I understand that the permit may be extended onI written request. I understand that once the permit expires a new application may be required, including fees and y three current other requirements (mcludin Zoning). Names �t Signature The above Sig a re is my voluntary act and is3igned under the pains and �� � _ Penalties of perjury. Date: 1 Who is authorized to pickup the permit at the Building Department? (please onnn Address Phone �J ,3�° j I y 1400 HOMEOWNER '1TON - 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 in Section 127.0, effective July I, 1982, no individual shall be engaged in directlysue Control construction, reconstruction, alteration, repah removal or demolition involvingthe structural �0 eIIgaged in structures, unless he or she is licensed in acaw, e-ral elements of buildings or ce with the rules and regulations promulgated by the BBRS eati"ed Rules and Regulations for Licensing Constn.ction'Supervisors. Exception: Any Home Owner performing work for which a Building Permit is required the provisions of this section; provides that if a Home Owner engages a person(s) for hire to dos such workethat such Home Owner shall act as supervisor. For the purposes of this sectioc only, a "Home Owner" is defined as `follows: Person(s) who owns a parcel of land on which he; she resides or intends to reside, on which there is, or is intended to be, a one or two famiiv dweilin , 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 applying under this section sign below: Signature Your signature carries certain responsibilities, including but not necessarily limited to, ssssssssssssssssssssss::ssssss:::::ssss:ssssssss:ssssss::ssssssssssssssssssssssassssssssssliabillty ssssss 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 S) - sssssss*ssssssss::ssssss::::sssssssssssxssssssssssssssssssssssssssssssssssssssssasss:ssssssss:ssssssssss 1500 COST. Cost of Improvement Items to be installed but not included in the above cost: Electrical 5� - • a, Plumbing. HVAC Other TOTAL 1. _ Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration requiired, = Demolition - describe structure Number of dwelling units Number of bedrooms A separate Refuse Disposal Declaration requhm& Moving - (provide copy of D.P.W. moving license) Type of structure from where (plat/lot or address) I to where (plat/lot or address) Number of dwelling units , Number of bedrooms per dwelling unit Re-roormg - (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 nett be enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelling wO be considered as an Alteration, otherwise will be included in new construction. (see Code section 3401.10 Vor residential and Articl- 8 fi._ commercial) Temporary structure - includes when allowed, trailers, tents and the like and only for limited periods of twine. Describe I 500 CONSTRUCTION PLANS None submitted. Why? JI Submitted, usually three sets required. Four sets for food service uses. Number of sets submitted 600 SITE PLAN I ❑ Not required, why? I Submitted When? Previously, date With this application' 700 UTILITIES I Water supply -required _ yes no, public ? yes no, on site well:' fyes _ 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 es no, public sewer yes _ no private septic - on -site e yes no. Submit copy of permit as soon as available. I Woodstove use (µ.W require inspection prior to installation), new (provide manufacturers instructions). Location(s) (list) Fireplace(s) - (includes flue) List location(s) Y , Game Court - describe (include overall dimensions) Tent, Trailer (Mobile Home) or Other - describe 300 COMMERCIAL PROPOSED PROJECT/USE - 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 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? Other Describe the proposal briefly, INCLUDE ember of dweiting units and bedrooms or oocn t load as a also existing condition P� PFlirable, 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 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.) Yes No (see Code Appendix 1) APPLICANT TO PROVIDE 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) datra DENIED see project review worksheet date HOLD reason date HOLD Subject to Zoning Board of Appeals action Comments Inspectors signature Applicant informed of above - Date time staff (fax, phone, in person) ssssssssssssssss:ssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss*ss*s�sssssssssssssss:sss 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,. rperson) sssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss**ss:sssssssssssssssss:s OFFICEVNSPECTORS NOTES TOTAL FEE y Gross area -new construction �° Q Total Sq. Ft. t alteration Total Sq. Ft. Permit is issued to I Comments/notes on permit +.-�-++•=ssssssf##ff##s#iii#!lisisfssifif##fif###!#####i#i#i#i#finis#ffisii####ii#i##i#lain#fins# _ 1600 TO THE APPLICANT' i RAT. AND APPROVAL Date of Application submission Plat Lot Street Aquifer Zone Owner . Owner mail address Owner phone # Y#lx##xxx:xx#x#x#affix##xffx#ffis*fiff##*xiisiiifffsfi#fiixif#f#nix#fif#f#ii:fiiisiiiif;i#!#sfffffi#ffff#f OTHER INVOLVED AGENCIES The following agencies require separate jurisdictional Proposed project. CONTACT Tffi?�I4 FOR Permits or approval for your ���BMIS.SIONS. U TAX COLLECTOR = Approved HOLD By Date_ ® Board of Appeals Approved By Date ❑' Conservation Commission Approved By Date o D.P.W. Water Approved By 17 D.P.W. Sewer — Approved By Date ❑ D.P.W. Cross Connection Approved By Dante ❑' Treasurer (Bond) ❑ Approved By I -f ❑ D.P.W. Engineering - Approved By ' ] Date -1 Board of Health (well) ll) =Approved By Date ❑ Board of Health (septic) roved B 1 -, Approved y Date ❑ Board of Health (food service) Approved By Date Cl Planning Board (parking) _ Approved By ] Date ® FIRE DISTRICT (I Approved By :sssssss::::asssssssssssssssssssssssssssssssssssssssssssss:ssssssssssssaasssasssssssssDate :::sssssss BUILDING DEPARTMENT APPROVAL: ❑ ZONING ❑ BUILDING INSPECTORBUILDING COMMISSIONER ❑ CONTROL CONSTRUCTION AFFIDAVIT i#s#xix#ssfsxfss##ffsf##sffx##ffiff#sssf#sisxssxiffffff;ff###xf#ass##sxxs###sfs#is#isfs#s##f#s#s#f##s#fs PROJECT SUM31ARY: new construction/ alteration/demo sewage disposal -public/private [Alter;add interior walls] [add rooms] [add footprint] water suppiv - public/private well [pool] [garage/shed/deck] [game court] [food service] Describe x#####i#fss##li#xxfx###f##ifxssiif#s###ss#ff##Tiffs#s#sfff##s#ffsffsfs#sssxff#x#xs#lsi#x#fx#Tiff###:fx#ff## 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 TELEPHONE 508-999-0720 FAX:508-999-CM8` I I APPLICATION FOR ZONING AND BUILDING PERMIT Iasitocfiom The applicant shall complete this application to the best of their ability prior to submission, leaving no item unanswered. T�EnI e Department staff will be available during regular business hours to assist as necessary. N/A should be inserted for those seslions which do not apply. A properly completed application will help avoid unnecessary delays. Nsft 1Ykg Am in not (for olke use only) s^ '1�TON C)NLY Total Cost § ' Received By Dam Rce'd Less Application Fee § b11' Total Permit Fee §$� C v ( Permit # Lssaed D2t+e p 100 LOCATION OF P dECi' TOTAL LAND AREA SQUARE FEET CURRENT ACCESSORS' PLAT LOT 2 d 2I ZONING DISTRICT �. OTHER ZONING OVERLAY DISTRICTS, if applicable NUMBER & STREET f •i' NEAREST CROSS STREET =' SUBDIVISION NAME & LOT # for BUSINESS NAME z:!-� 1 s-PREVIOUS TENANT / OWNEReL� arr 200 REF )ENTLA_L PROPOSED PROJECT - one & two family residence only €'TIT SECTION NOT APPLICABLE - Single family - number bedrooms number baths P, Two family number bedrooms unit 1 number baths unit 1 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 >r Gazebo - dimensions L W _ Swimming pool above ground in -ground Size Chimney - number of flues