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L
27'
88,E :
.
� SE, SANI
85.5
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t
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-7 Q4
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LOAMY SAND
(B ,)
LOAMY SAND
(CI)
�,OARSE SANE
(C
TEDIUM SAN
90,'
69,E
87.2
80,3
t'--g, PERCOLAT
RATES: ,/tr .
tS 3rtr�„In,
��.�', � i�N .:RATE .. ,:
rz r_ ;
SCALE:_ _ o t TABLE i? 1C 1 ��_
h _ CATER
,
LOCUS A
ER TABLE 1 E 7',S
>I
CiRRr I A
IPE ING 1N"
ENCPkP rb �9R�I' �ATIG� TEST AKEN� 3/ /
aG�.SCPL ,IALlAR, JIMWALSH
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y 1.
' 1 ��,1.�,r_C t ❑fit CHRIS MICHAU
GENERAL NOTES
e E
i l I
se c r.
i t�u�t> ba 4n accordance with the l�. �sachu.��.tt.z l�.:pa
- _ 1. All work �;, � , f ,; :,
`.. e OD 1 �i.QrJ �. c
Protection, = Regulations 310 ��, � �
Environmental l'~' 9 ,., ,
and an 1pac�t _yard c�# �l�;a(th #��sdsfs..atsans.
'-
s . „rr without prior
- - -,
2. No mcsdsfscat,ons shall be made tp t�s s y n_, � t�
E peal Boc"'a Health.
I approval by the engineer and the l
• ' e d s p e,
3. Engrrs�:er and the Board of Health mast sn..
tier:.- to backfilling.
r kli:Ct�d1 ,CCi datum.
✓ ��: �, shown on lan are .used pn an ,
_ " �> Elevations ��a ¢�
��PRO�POSE�DWE.�LLs .. rc,tE?t'1i.
y /Ma
+ disposal s .
� us rn�nt shah not lea run over t P
.i .. 5. Neap e
i Leaching
x } vated from
unable 5psl t� tc� be exE�a
� r 6. All tins .,
4 _ SOILS
ravel p. coarse
DESIGN � shownplan, nc9 backfilled �:'tth iea , �3
t w ...
w_
w _
P specified in .310 i5.t�2 ,
FL.n��. ���, � � ����
Tp d DESIGN
cJ: - ines an dust.
r !. c f t
� s shall lea Ord o f star
-- - , - �h crus,7ed stone s
4 EEACH FI E _ D
7. ' Washed
o 4 _x2S#rays.>.
i AREA f turgid la
to - a. LEACH anu ac
L a bay etc. sha 1
Septic tank, ds.trt#utpn, .,,, ,.
facture
�� .. . _ _ + � ..r menu
fv
� � .x A installed
� , , \ _ Es-,,....� `; ": <_ inc. or approved, ..
a.
_ ,' Sens g
_ F'
a— 4,0 d a
ENT
k
. �.,,.—.: CALCULATIONS- 24 ��
a Eater is l . sea[ at a #
t 'shall tad use
tea provideg
Grout ,
M
r r � a concrete .structure
enters or leave. .
. ,
c _ '\
..
�, �! CQ r, �. --- -, .. --, _.. e .level fp
� � . ,� , , . -- ,-m of the
Outlet
ciistr,butspn
�. r s , jj
1 r i.d J i
_ e
t_:..a..... , , _ r _ ._ - -- tt;etr lc�na;l�i as s�e�,sfsed sn'' 3�C? C,,,F? 1,. i
.. _u :u — , cif .� _
3 AREA CALCULATIONS!
S
j
RESERVE
A
�E�� - n A � .$� , Et ,t' ;f }� �3t"~ii s?C:'ir tw
y f r t
i r r , r`a { C t„ n t
r r _ � d'SOILS,.�, k-,f-- •< •,=E t l.A rckn._ra„� � u t .,?'� C ,
.�. . - �� SIGH '�'L2t.., <,�,r,,�tt7, �,�� �� 1 ra;�st .,.. � ,,.,,n �c� � Up
On
C I t
�\ r..
'
DESIGN FLDW*jf
,., , , , r— ,., , T. r.,, L , a y ,. _,, i' � LEACH i' t [ t 1 a . , . , , : , >a i
t ... rf ," ,_ , i^" �-. ja , i , � v i 1. C_ L ...
!' �" N� kl {' t;... � f ..... .i a s`� � t.`: 4 # . r r +� r .,'+
ti
.... .. . t -^ - - — , r - -. ,-. C, ,r r �t !�,- :` h` ,Z�. �i . ar_.� :..r�.�asa�
r _lJ lJr I t'_> �aF
t j ( t Z3CS J ,,
, E .._�_ � .. ri-, .�AL�,I_�w_A
j
i 4 F P c Y , it . PIPE .3 C l� ` 4 tF l � 1 l31"� � .i R..f l � ,. � .`.�. � -
,. r _ _ .,,. ,�.r. ; 'i. - :.: 56
/ •, --�—,6 ISTIP-1G CONTOURS �
r i _ DISTRIDUi
PROPOSED CONTOURS
.i
.TEST PIT
RESERVE
ALE:-. N-T'S.
LEACH AREA
e i
} BI.1 TEST
€ / :—,
�€,i,, WATER LINE
t � �; ,� k3EP�CN
n �,""" WELL
_-. �_° .. r N,P 1P q�- V2-
800 MECHANICAIS & PRIMARY FUEL
Furnace (hot air) - Fuel
Architect/Engmeer - project supervision and reports
gas (natural or propane), fuel oil, electricity, other (specify)X
- =
Company name a
= 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)
Phone number
— Air conditioning- (separate unit)
Certified by State of Massachusetts as
None. of the above to be provided
i
p
Certification number .:`�, �. � t ••;�, ,� .g; • , ' � ��-� ;s��� ..
..
Hot Water Gas Electric Fuel Oil Other
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals anto not
900 SPRINKLERS - FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential
reproductions.
— Required, —plans provided, -plans not provided, why?
General Contractor (if Homeowner, state ho eowner here then complete section 1300)
Not required, not to be installed, Why?'
Company name
M
o N r ^79r
Address
1000 REQUIRED OFF-STREET PARKING - for ZONING & Architectural Access
a
Phone number C.C�`�"'r
NOT .APPLICABLE
4. •�j G
Construction Supervisors license number
I'arl:ing Plan submitted To =Building Department =Planning Board Date submitted
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals an( -di not
Number of spaces - indoors . outside total provided
reproductions.
Handicap spaces- required re
q _yes no. If yes, how many as a part of the total required number.
Is Route 6 (State Road) Entrance permit required? ves — no =. If yes has it been issued yes = no �.
1200 FOR RESIDENTIAL REMODEL WORK ONLY
Submit copy of application and/or permit as soon as available.
Are you a Home Improvement Contractor subject to (780CMR - 6) ? Yes No If no go to mext section!
1100 IDENTIFICATION ( print or type except as not d)
Are you claiming exemption from the requirement? Yes _No _If yes, submit the required :affidavit!
Current owner - name G
Remodel contractor name (please print)
address
Address
phone r (� ��/1i _• jf,
Registration number (ir none state "none")
If corporation. officer in charge 'L409 PEA
Phone number
a.'Rrj
a/ e•
h e
J
Architect/Engineer - for overall design '. -.
}
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE
A.
GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write:
Company name
Home Improvement Contractors Registration
One Ashburton Place - Room 1301
Address
Boston.:MA 02108
(617) 727-8598
Phone number
Owners name (print)
Certified by State of Massachusetts as
—�.
Signaturee,,
Certification number
`
Date
NOTE Signatures and seals on all lans, affidavits and other documents SHALL BE originals and
not reproductions.
1300 OWNER SIGN - OFF
I. the undersigned, am the owner of record or authorized lessee (provide documentation) and I have reviewed
A
the application herein submitted. I state that to the best of my knowledge and belief that the information provAded in this
t x
application is true and correct and that the permit requested be issued.
p .g p•
Further 1 understand that the permit wall expire to six months from the date of issue, if no work i• begun
. g or
n
six months after the last inspection if work has begun and that the permit may be extended for six months i€ o work is
P y
�r
anticipated if I request such an extension in writing. I understand that the permit may be extended only three times by
written request. I understand that once the permit expires a new application may be required, including fees and current
other requirements (including Zoning).
Name
Signature J1J*ZL4__-_
The above ignature is my voluntary act and is signed under the pains and penalties of perjury.
Date
Vvho is authorized to pickup t4 permit at the Building Department. i e' dt- �rGfiry
d e Ad r ss Phone
1400 HOMEOWNER EXEMPTION - ONE & TWO FAMILY ONLY
FOR HOINIE ONVNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT
109.1.1 Licensing of CoistrvctioiiM1S ier ors Except (Wkh6se'Structure go P3;ngd by Construction Control
g m� Sept n 12TA effective July 1, 1982, no individual shall he; engageiig n di£e^ctlX supervising persons engaged in
codstActi6n' recortstrlictio , a'�f ra1�#on1` epau-,!Tfto-VAl or demo7iYiontinvol�ing t~lie+,structprai"elements of buildings or
structures. unless he or she is licensed in accordance with he rwle4, and,, regulations promulgated by the BRRS entitled
*, • . „".'
Rules and Regulations for Licensing Construction Supervisorsr
Excepdon: Any Home Owner performi`ni`wori, f$r 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 siupervisor.
For the purposes of this sectio! only, a "home Owner" is de617ed as follows: Person(s) who owns a pac�el of land
on which he,,she 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 -dear 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, 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 section 5)
1500 COST
Cost of Improvementg 00 0m,
Items to he installed but not included in the above cost: Electrical S
Plumbing
HVAC
Other
TOTAL 3 00 t Ot Ate.
The following section for official use only.
IN ISPECTORS' REVIEW
Date plan reviewed
30 days to review period expires
OK to issue date
I
Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration irequired- j
Demolition - describe structure
� pa p�sai "
Dumber of dwelling units Number of bedrooms A separate Refuse Dis
Declaration required.
i
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 lavers when complete_+
A separate disposal declaration REQUIRED
Replacement doors and windows - (for existing only) (only where doors and windows exist and w✓ill not be
enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelling will be
considered as an Alteration, otherwise will he included in new construction. (see Code section 340L.10 for
residential and Article 8 for commercial)
Temporary structure - includes when allowed, -trailers, tents and the like and only for limited periods of time.
Describe
500 CONSTRUCTION PLANS
_ None submitted. Wtfv?, •" ,p
Submitted, usually threes'r is required Four sets for food serviceluses. Number of sets submittedd
600 SITE PLAN
❑ Not required, why?
0
— Submitted When? Previously, date tj_ With this application
�JiIR�®�U�hreN '�it�G.
700 UTILITIES
public ? yes no, on, site weH9 es no,,
Water supply - required yes no, p ®- y
existing? yes no
If required and not existing have necessary permits been issued? no yes,, date
(NI.G.L. Chapter 40, section 54 provides that no building permit may be issued unless a water suppll'v, when
required, is available. See Code 780 CMR section 114.1.2)
Sewage disposal - required _ yes _ no, public sewer yes no
l
private septic - on -site yes no. Submit copy of permit as soon as available.
a
l Woodstove - used (will require inspection prior to installation), new (provide manufacturers
OK to issue subject to requested submittals (see project review worksheets) date
instructions). Location(s) (list)
DENIED see project review worksheet date
Fireplace(s) - (includes flue) List location(s)
HOLD reason
date
Game Court -describe (include ov dimensions)
❑ HOLD Subject to Zoning Board of Appeals action -
�� Cm 7C 2c.�
Tent, Trailer Mobile Home Other describe _
I, ( ) (
Q 12'
Comments
300 COMMERCIAL -PROPOSED PROJECT/USE - INCLUDING THREE FAMILY OR MORE AND EXEMPT USES
= THIS .SECTION NOT APPLICABLE
Inspectors signature Date MAY 19 7997
o
(The following descriptions are based on the Massachusetts State Building Code Article 3, AS NOTED) (See the
Applicant inf ed of above -Date time staff -� (fax, phone, in person)
'
Code)
*xxmsx*x**xx*xxmxxx*x*x**x*xsxsx**sxsxxxxxx*xxxx*******x*xxx*xs**xxsxx**x***xx*x*xxr�s**x**xss*a*****s**x** �',
Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe
Over six months since approved for issue - DEEMED abandoned.
Advise applicant. Hold 90 days for return then u disposeif not picked P P
Business - office, assembly with less than 50 occupants -indicate Medical or other professional (see Code
Inspector Date
Section 303.0)
Advised applicant Date Time staff - PP (by phone, fax oir in person)
_ Educational - structure for training including child day care for those over 2 years 9 months (see Code Section
304.0)
OFFICEVNSPECTORS NOTES
Factory / Industrial - (see Code Section 305.0)
TOTAL FEE ,�-
High Hazard - (see Code Section 306.0) 4
I
Gross area - neF, construction Total Sq. Ft. S
Institutional - hospital', *nursing home, infant day care (see Code Section 307.0)
'.
alteration Total Sq. Ft.
tY ,• y ...,
- NI antile - retail sores (see Code 308.0)
s P„
rt -
7"
Permit ' �s issued
Pe �to
Residential - three or more family, hotel (see Code Section 309.0)
_ Storage -.,includes garages (see Code Section 309.0) ',
,. « . ;
.d tl�!
Comments/notes on permit
- Utility & Miscellaneous Structures - mcudes t161
ents 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
-
proposal briefly, -
Describe the ro brie INCLUDE number of dwelling units and bedrooms or occupant load as applicable,
�
also existing condition
400 TYPE O C CiiOl�l WWA-AI'O BE PERFORMED
New CoJMIt mction ' ` - total gross squa=e fwt.- p
r +
(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 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)
A„i'PLICANT TO PROVIDE
d S-i
2
1600 TO = APPLICANT AND APPROVAL
Date of Application submission - f -- q
Plat 6x_ Lot treet - L e
a 1 )a _ Aquifer Zone
OwnerCL
-------------
Owner mail address t
Owner phone #
zs::::szzz:z:zssszs:sass#as###x##s##sssssssssszasssssxss#s##sssssssssss:sssssasssssss#s#sss:#xxxsxszzzssz
OTIiER INVOLVED .•AGENCIES - The following agencies require sea jurisdictional
g q separate J rsdtc ad permits or approval for your
proposed project. CONTACT TEEM FOR REQUIRED SODM1SMONS.
COLLECTOR — Approved roved =HOLD By Date
Conservation Comm Z Approved By Date
❑ D.P.W. water — Approved By Date
❑ D.P.W. sewer --Approved By
Date
❑ D.P.W. cross connection = Approved Date
❑ D.P.W. enzineering — Approved Date
( ' Board of Health well — Approved
\. Date
6�o�rd of Health septic - Approved Date
❑ Board of Health food service = Approved Date
IRE DISTRICT lI - II I'f1� Approved Date
❑ Planninz Dept _ Approved Date
t h c r Approved Date
t)thc — Approved Date
.mmunts
zz:zz.....zzzzszszzssssas:ss:s##zzzss:szzxssssszzssszs ssazzsz z1zzzzzzz:ssszzss:s:sss##s#xsss:ss#s#z#sa:
Prnlecr summary new constructions alterationidemo sewage disposal publictprivate
[After. -add interior walls] [add rooms] [add footprints water supply public:private well
[pools [garngecshed] (game court] [food service]
Descmbe
z:zzza zz:z:::ssssssz#=s###s#s#ixss##szss#lszzxixi#x##sz#####z#zsssxsszzzz##zszzz#zi#sz#####i##z##i#x####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 anv reason to withhold the requested permit is "found. please advise. Your assistance and
c000err-tion is appreciated.
The Building Department
Date sent for review_ (� —q'l
J . B'
Iastroetions
The applicant shall complete this application to the best of their ability prior to sobmisvori.'leaving no itetm wmaswered• The
Department staff will be available during regular business hours to assist as necessary: 1!i/A should be rose ed for those sections
which do not apply. A properly completed application will help avoid unnecessa" delays. Koh= fmog fms'ts Brat
(foe office use only) •'
Applicatiion fee S �t (J� received by . Date �- I _ e � 2�
Total Permit Fee $ ✓ Permit ;'# f 4311
100 LOCATION OF PROJECT
CURRENT ACCESSORS' PL.-�T LOT�Q• rZ� ZONING DISTRICTi+
OTHER ZONING OVERLAY DISTRICTS , if applicable
NUMBER & STR.,ET
NEAREST CROSS STREET
SUBDIVISION NAME & LOT #
nr RTTCT. iFCC 1I RtA' -
O«'NER�iVG'
200 RESIDENTIAL PROPOSED PROJECT - one & two family residence oniv
THIS SECTION NOT .-APPLICABLE 2
Sinzle famih• - number bedrooms
number baths '
= Two family = number bedrooms unit 1 number baths unit 1
number bedrooms unit:! number baths unite - -
.-Accessory apartment Total gross sq. ft.
- .-Accessory structure
Garage _.. to dwelling, dimensions L L�9 V^'' '
Carport - detached - attached to dwelling, dimensions L W'
Shed - dimensions L w
a f
= Gazebo - dimensions L W
i
= Swimming pool above ground in -ground Size total square feet
Chimney - # of flues.,