BP-11298S,
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o�° s arilbe iaills and
- raaeri ,. +ai of
pas
as^s .
�p q
+v,' ' a:. arid `h&*6 � -.z's }1i,F'"s+ieeA
to tlE { € _
as e ¢pf # Eta>ai �SC�zi [4.ias � �w��'v:6�c
f ..,'Yea'•. `t Flpl. Stops
te � .. 4i$S�8L s-
S` 014,
(J(
J
i
i
1
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,
f1 J"fj
IFJl
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It
t _ �
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Cop' Of This Eritkarsed
BUILDING DEPAa TM W
JL N�..® _.
-plans east Be Kept On Site
Town of DartmouthAn
A be
O t1
[ � �d a O 1
anntc
A
3
r
�I .'S
f4
si�.�.,;$mii.�.-5.�d `n zip ..+ r.
for
Dwl:J S..o. 3+.tA a.0..f a..S..ifa.$x'"¢
'YC JJR DRAWING MUST SE KEPT
a fv��ndatio aMjrpm.��n or
THE BUILDING DURING THE
THIS WORK.
any� furtheir construction.
. i,,OGRE aS OF
nl-
t€LR NG £PAME!.
Town of DartmouthL
E
��;,
12'1 Zv
i
a` T cv2'4 sF:1
CIE'
VIER
6'S
Wo'I
a 12 1
i
i
I I1 6'2 3'
This j� /� CV N
p1sarriust BeKept itc
�en�° � N I
Buiri Cotes r i —
t -
i <V
r % I
O o
SOt 0-TUBE SIZE AND DEPTH } �
.r
INSPECT!£3,,q IS REQUIRED BEFORE. Cx�i
THE CONCRETE is POURED. � 14'5 5' T8 9,2
i
9JUILDING DEPARTMENT i
'down of Dartmouth �
M
YOBi
fT THE BUMPING DUR
.� OPEss OF TIi1S WORK. � �' �
} �
I / r
i�4LD9 G DEP� TMENT
I ,
M To%,,tn of Dartmouth
UP-
2'6i p
ao o�
I 13'6 9'2
a N I cl Ji
2'6 - I
ar. As Buiit &F a''Y ¢*.:
D, t. t)rincr to caii-M f6,r IVING AREA
a, foundation ins ec"dofi or 1102 sq ft
any further constm-uct n.
2'6 T 4' 2-4 —=1, 6'8 k, 2'6 -._ I 13'
38' 1
FIRE- STOppj
{
LOT#15 MILLE
RS FARM
14
!".netJ Gs$iis? #s tcu rated w'sd 1Y'$ls 'R3id floors
Sealed with a rea r°8 . 3
N. DARTMOUTH PAA
prime o; a ,x C e%l hCA 'ifihvti vubje0e;
tO the remilrements of t�,Test Standard specfflc /
SECOND FLOOR
Fire Stops ASTM-E-8 4. —
f- SCALE N/A ( DATE:MAY 8 1998
I
67
171 7 811 2'----t)'3 13 T8
24' 57 66 47 . 1. 4'5
r
- -
------------- _ '_ _
STOPPING :i �..
� EN4ENTFIRE
rte#r#10s #rru rued=lld f��r sh
all be
� � r< 9 iO Of
preventing the
sealed r a and l rc t When
sub;ee#ed
I p�( < �`e �(
- -,
� O !G
-- ---- i I , to the red
uiren nts 0# the e # t , ►d rd sect X
I -- -- - — ---- ------ 46
--- -- --- ----------- TSB-E 814
_ for Fire Stops
' ` ------ ---- --------------- t
,
( (
,
! i
,T-
NCrfICE4,
I -
,
i + I 711 N
SMOKE DETECTORS � II be installe i
, f sr :I I
ac o ance with ? 0 �CR, SAT' ( M
dH
ect on 3603.16.
i I 21' 4,2 — 1210—�
DETECTORS -- althouSh strongly reco ended �
i are not currently rdq4ired per 7g CMR, Section Cn I
UP l I
a D 'l �i I + I j
I !
1 ;-- - - -- - ------------------- --- AREA? , - --
- ; ,-----------------------------
4,6 (
----- --- --- ----- ----- G q ft I ,
tlVil�
ii s I
t I ! ! I
II i LIVING AREAto
i
1665 sq ft � I
,
i --------------------------------
,
,
y
,
I
1�— 6' 918- 13'
24'4 24'8
62'
'P� F u o gr a mUST 0E IT T
U 1T THE SU4i.DtAlG DURING THE �. .-
A COPY f This, Od
PROGRESS OF THIS WORK.
Pt2, 'Ust Be rse t Oil Site BUILDING DEPAFITMENT
LOT 15 MILLERS F 4RM
g� gg
8`zs>zrT
_r
qq
3=.
ND DEPTH 3 .. a N. DARTMOUTH MA,
SONO-TUBE SIZE At • Pr-;" r 9
INSPECTIONIS REQUIRED BEFOREI L
_ -" for
THE CQCF111411
?ETE IS POUtED•t:$Q1 'Q�
�f�&ter CQ FOUNDATION PLAN
suiLDING DEPARTMENT p`ti� #ion
Tovjn of Dartmouth
SCALE N/A DATE:11lIAY E3 1998
r3, �
E z i i Ir
by �, y'+bj i v}a •^ xyy
Jk M, F � i VO, it u T
B 9i
j° Of 3�*, :> rid
11""I'vat 'Go t'rept On Site
R c ,
E
A OR
FINISHED. GARAGE FLO
FINISHED OAST FLOOR
TOP OF FOUNDATION'
177 3
179.3
178.25
FINISHED BASEMENT FLOOR
170.5
INVERT AT FOUNDATION
175.47
INVERT INTO SEPTIC TANK
175.25
INVERT OUT OF SEPTIC TANK
175.00
INVERT INTO D-BOX
174.88
INVERT OUT OF D-BOX .
174.70
INVERT- AT INLET OF FIELD
174.68
INVERT AT END OF FIELD
174.58
ELEVATION QF BOT. OF SYSTEIV
174.0
NATION OF G.W.T. (adjusted)
'ELEVATION �ed)
168.47
MINIMUM FINISHED GRADE EL. ■1T6.0 GENERAL E
R4L OTES
FIN. GRAD = 6 2 COvER lA ER OF ,
E 17 .O MIN ..
♦ _ TMINr9
N 4 • PERF. PIPE WORD
�. •� ,e=- - .;. _
WASHED (PEA) STONE 1 ...: .,a a'.
� � - � "-• •-' The sanitary sews" a disposal system shown hex'eon shall
T.O.F. 17@°2 FINISHED GRADE [76.75 / W/CONTACT.OR UNITS,
1 ° y g Y _ 3 ccordancewith the requizements of
174,68 - I WASHED STONE 4 be constructed in
174:70 •• I 0 ate Environmental Code and local
0 175.47 12 MIN. EL. _' 178 6.. LIQ °` ID LEVEL TITLE V of the St j
a ? .0 klations.
�;. y.1 a. �, :•�:.. -----_•,,• - ---- - Board of Health regt ..,
Q DOUBLE
O" v"
_ 1 +'" EL, = MIN. STAINLESS
Sa 2 12 S-.01 BOj 174.58 2, Any modification {o this design must be approved in
II , P,, 1 - eer and the local Board of Health
min. :< 1 ,
CLAMPS writing b the en 3n
175.00 ., I TEE q 14 5. 3' g Y g ion °
-• .. • . - - - - -- r-• 1 ,� i a. prior. to Zmplementa�
175.25 .. 1p 1 , o
-- 5
w
• +• f ..and check the BENCHMA].K as sho n
t ,. r actor shall ve5l y
SEPTIC 174.88 i 3, Contractor proposed
r mHl._ 'Irv^ f ,. I STAINLESS i?r to construction of th , prop
170.5 TANK e 1 �` _ on this plan pr
I, . 5 ., a SEE DETAIL El. [74.0
A• i ._ ,:•.; GAS BAFFLE system •
SPLASH SHIELD, END PLATE _ SEE 30 SEE
„� o.
,� I . a.A"> . �. t on
AI :.. -:.� -.., .. .> .._ ..o r. cafes soil trondi i
4 D SDR-35 ..TAIL DETAIL nInformation indicates s
:... r .., :. SOLI �-+
„ T ND PLATE � t 1 I �.....d:.-: •a•. ,
�.. ,
INLET E A
___ <. ._ • ,.:.o • -- •♦ `.. . s • - 4 ° Deep Test Hole Ini
1 4 SAND OVERDIG ' percolation rate, a" d waver table elevation "a�: the time
ALTERNATE POLYETHYLENE UNITS MAY BE USED. EIL.170.00
AL and' location of actmal testing and should be Irerified at
SOLID PIPE OVERALL FIELD SIZE REMAINS THE SAME. 10.5'
4 SCH 40 PVC '
• the time of construction, y
MAXIMUM GROUNDWATER TABLE EL. = 168.47 ;
OR APPROVED EQUAL
5• The contractor shall notify the local Board o: Health if
" - GROUNDWATER or pCHED WATER is encountered et a '
PR C 15�C® GAL. SEPTIC TA
higher elevation thin indicated on this desig;t plan.
I
SYSTEM PROFILE
6, Notify the local hoard of Health when the (system is
ready for INSPECTION, Prior to any backfillinl3.
A
NOT TO SCALE
7° If CONFIRMATION OF CONSTRUCTION is required by an
engineer, notify this office prior to anybaciicfilling,
w e house and the septic tank hall' be
�,(� 8 ° The pipe between the „
S 51�' T S� G 4" extra heavy duty cast iron,,Schedule 40 PVC, or othez
l I OF I A E
1FROM suitable material a P approving Y•
(', 6 SETS 0F,3 STANDARD, ice table to: the a rovin authority.
' SEPTIC The -slope of this Pipe must be a minimum of.#0,01 (0.12
TANK INFILTRATOR UNITS BUILDING USAGE:
4 BDRNA. RESIDENCE inches per foot) ; A slope of 1\4 per foot is
W14" SOLID PIPE SIZE OF TANK: recommended,
NATING ATSTART" 1500 GA.L,
TERM( - -
GARBAGE GRINDER: N - 9, The septic tank shall be 1500 gallons minimum) unless
INCLUDING GENERAL TOPOGRAPHIC f - PLATE W (SPLASH 0
EXISTING TOPOGRAPHY,'
otherwise specified on this design plan, an'd 'equipped
SHIELD BELOW with INLET AND OUTLET TEES of pro er length
AE
RIAL SURVEY AND ROADWAY CONTOURS, OBTAINED {, , t CLOTHES WASHER: YES,
PLANS DATED 11/16/92. 3.0' ' ESTIMATED SEWAGE FLOVil: constructed of concrete,, PVC, or cast iron. Septic tank
FROM MILLERS FARM SUBDIVISION
440 GAL �DArY concrete strength is to be 5000 psi at 28 -days
16.5'-
" _ /2" PERCOLATION RATE: TP 1157 7 MIN /INCH TP 156 3' conforming to a'.1 applicable ci fied H-] 0 loading
3/4 [ [ MIN /INCH
NOTICE OF INTENT Notes. 3.CS'
WASHED STONE requirements, unless otherwise specified,
DESIGN PERC, RATE: ip NIIIN/INCH CLASS II SOIL
' 10.' If- any components of the proposed system are specified
.I- LEACHING AREA,
as HEAVY DUTY, tP:ose components shall conform to all
state and local recuirements for ASSHTO H-20 loading,
16,5' WIDTH X 45.5' LEN' =
- "'J Vt:il - leu W1Ui111 a rcCJl�
iUCllldll J-n L'Ot:Iz.: t8,7 :GTH 750.75 S.F.
11
11. Septic tank, �
dzstr3bution bor., and leaching
A. Jilt pit (if -any) °
'� 2' - ACCESS fIANHOLE CO�S are to be built up to`within 12"
_: a t a A ...:.L._ d_ 1 L9.,..s1 TT ---- A 7_ H 1 Vll i'L14
n altE 1J SSVI lVl.dlGU V11u1111 d JtlGc,ldl 11VVu r,4.nru c,�ne as �u� I 45.5 - ♦ de unless otherwise speci:.sed on..this ,
D ' of the finished gr�
SYSTEM CAPACITY: design plan. ?
Flood Insurance Rate Map 2�0051 0015 B dated 6/1i83. , j
•' 12, Septic tank and distribution'box shall be placed on a 6" .
C. Site is NOT located within an estimated habitat of rare wetland -Nildlife 1 EACH N G AREA. p E TA
LOT 15 750.75 S.F. X 0.60 GALL/SF/DAY= 450.45 GAL/DAY minimum compacted GRAVEL BASE to prevent { heaving or
• Lsettling.. 1
Pc� NOT TO SCALE - 2.98 AC.± 13, All joints must g ,
s �.les.
be watertight, sealed wl�,th asphalt
cement" or other cement" suitable for th�Lt specific
D. Site is not located i� ithin a ToNAm of Dartmouth Zoned Wetlands component,
D EP TEST P17 INFORMATIO
i
• d leaching facility are located 25'
E. It i5 the Contractors responsibility t0 secure all necessary permits prior t0 any
14 , I f septic tank 0 g y
e building foundation, a foundation
-� -I54 PERFORMED BY: KEN F0RTIER / CHRIS HENRY / OLDE BOSTON (minimum) from tiled at the owners discret Lon.
site activity. 154
drain may be insta..
WITNESSED BY: SUE GRIFFIN 15. Excavate all UNSUITABLE MATERIAL in p_ the area
F. A 1ybale Checkdam is to be installed, as shop;�n on the site plan, prior to any
N DATE: I I-29-88 shed stone leaching facility to the
aCt.
Vitt/ and are t0 remain 12] place and be maintained Until all activities are surrounding the in
W limits specified in regulation 15,255 of Title V and
c&apletedandvegetationestablished. LOT 16 � TP 156 EL. 171.8 PERC EL. 165.1 DEPTH 80" replace with clean coarse sand and gravel,` free -from
/ ► , nics 'stain s and 'waste construction
O
O - 12" TOPSOIL fines, clay, orga,. , stumps,
of �_ 1 all- a ..:+t,: 't0� foo �f+t, �o, materials.
G• i\Tr� re�lt\+11ng ofvelljb es IS a11V"%AA ,ti1uu11 1 Iwt W Iu�..l.,�Ou1C., cu..a. I Jr4
/ 12" 32" SUBSOIL 16. If any Leaching Brea EROSION CONTROL BARRIER WALLS are
-�5 32' 86' SAND STONES a TRACE OF SILT Shown on this design P y
6
$ All construction litter and debns is to be removed from the vicinity of the -� �-- I L s i n plan, n, the shall. b e constructed
' watertight, .without weepholes or other pervious
„ nt regulations. Future l local -
1-Ia rbale line daily. 86' - 132 GRAVEL $ STONES (NO SEEPAGE)
construction, in accordance with ":.all :applicable
IN -SEASON WATER TABLE TP 376 4-19-89 EL. 173.Z
building departmF g e leaching:,
GROUNDWATER FOUND Ali 70" facility enlargem=nt may require the extension of these
I. Any substantial silt accumulation against the i1a)°bales or silt fence, that may is , (EL. 167.47) barrier walls.
6 ADD I' HANDICAP (EL. 168.'47)
cause overwashing of the cbeckdam, is to be removed by band labor. \ /
TP 157 NOT LOWERED without the ct elevations
EL. I73, PERC EL. 167.7, DEI" TH C 4„ z� , Top o f a i s edabut
1 �nsent of the'
15$ �� may be raised ..but
easement and first flooi
T, Stockpiled earth materials are 10 be located 15.feet minimum up-Qradiant of O 12 TOPSOIL
DRAINAGE EASEMENT "B" %s ( / engineer,
the ha •bale line: 1,725 S.F. 6 \ 12" 36" SILTY SUBSOIL, 18. Unless specified y g, ,
\ _�-� ` - t in the Basis of Sanitaz Desi n this
36'• - 90" SAND, ROCKS,, $TRACE OF SILT designed for the use of` a garbage'.. • - "
v F- -r _ _ r- �...-^
a : t t tag ..._�..L system is NOT 4
�. t, �acwuauTu,uvu, VlllClCu� c, u 1CatuuC�1, 1� TU vC uClu uCTV1•cCu wC vvuual.Tvl \ / 90" 120" SAND, GRAVEL hot tu3>, or other
16 \ -156 / highwaterusage.
and The Conservation Agent prior to construction. evi c e s
o �- 158- (NO SEEPAGE)
..D to be topsoil. ,
19. Top 8' of fill 'is
s required at the completion of the roject. `'
L. A Certificate of Compliance i q p P _ \ \ \ 1
eE'0w�/ r• .°+ '^ 20, No HEAVY EQUIPMENT shall be run over the components or
•��.ir+.t:iai tt„s(an++.ao.•arnt:n., A n0„t o.,A tho T...5,a:,raac°.rnn ("'n.+•+.an,aar f°nr near �carni:.n,t • - J _ .
u1y lli�. %_WLLZI.A,4llWUA�Vllt culU W.. L11 LL1YVlLL1� \ V1111,411y 1Wa uuy aa.yuu�v Q ' \ / fP/' '
/tea' } -'"s,' _ the leaching are'
unless those items are :pecified as
-pections, reports, or As -built Plans that may be required.
HEAVY DUTY,
_.-
� �'/• °� ,.•� ,,.• 21, RUBBER -TIRE MACHINERY are not to be driven over the
K. D { elling is to serviced by municipal water service. l \ � � \ s o e or s
\ m' ��� /�u"', prepared natural it bas and/stone bed during
�'
'tt �� _ _ -- - -'"'" _ system installation.
DRAINAGE EASEMENT ' w I l
, J ,; c -- J -•- 22° For ro er performance, the septic tan. sho d' be
h s '� ul
1,780 S.F. O0 2� \ ID. µl!)t• WOODEN POST I z - Tea rn�+ - INSPECTED annually and when the solids and escum depth
I I�Fj• / s \ I�'. exceeds 1\3 of the liquid depth, or three years has
♦ \ -
3kt \ ;l I ao ►. LOCUS elapsed it �e last pumping the tank
and the
\ I elapsed since t6, P P g,
0OPEX "SILT STOP' g p (if any) should be pumped.
F
LIMIT SEDIMENT CONTROL
\ / •,• - r
FABRIC OR EQUAL
IMPERVIOUS BARRIER WALL MAY BE / ) • '
RED IF FUTURE RESERVE AREA ,� ,' \ _
STRESS RE/Nf'ORC MENT � �
c� \ \ BANQ (.TYPICAL. `R - Rf QUl / _
. Y
l ALLEO.
IS INS 1 \ 100`HAYBAt1
\� BUF ZONE HECKDA
\,5
• �, ,,.-•.�A, �°'' � THE APPROVAL BY THIS OFF6CE
- • ' SEP .1 6 1998 DOES NOT GUARANTEE THE
EFFECTIVENESS OF ANY
/74
I ` BY: INSTALLATION
DARTMOUTH BOARD OF HEALT11 '
®CUS - OT TO S LE
.. I TOWN OF TMOUTH ,
BACKFILL TRENCH , _ _ BOARD OF HEALTH
'V
Cowart o , ' 1 \ 4- _ 6• r
l
�/60 LEGEND SEPTIC SYSTEMSIG P;L
NATIVE SOIL.
�- Area . 12 D.E.P. sFi LOT (4 OF
o � \ Sego � EXISTING PROPOSED
v ROW -
fV27
O PT FOl1Y
o RARE SILT FENCE DTAI
,
�, too----
ICONTOURS lO0
\Na� t
- �74�O 91 x POT ELEVATION ,.91.1
�4g s \ �o . \,6 NOT To scA� EEVATIONS BUST NOT BE 9 s, ,Ear°MAP 709 LOT 13-15
Oa o R Q �\' •• - PROPERTY LINE
i - \�' \ CHANGED WITHOUT BOARD
0: B M\ \
SEE NOTE #15
EXCAVATE ALL UNSUITABLE MATERIAL
WITHIN 5' HORIZONTALLY OF THE TRENCH
FROM THE PEA STONE COVER OWN TO
EL.1�7,7 (64" t below exist. grade)
EXCAVATION MAY BE REQUIRED TO EXTEND DEEP R
IF Ut4IFORM SUITABLE MATERIAL IS NOT ENCOUNTERED
AT EL.167.7
N
176
PROP. WELL
LOT 14
E.P -EDGE OF PAVEMENT E.P. r ' <
OF HEALTH APPROVAL �,OF � MILLERS
,-` STONE WALL
�*� WELL �� KENNETHR, J` SIT PT FOR TOWN USE ONLY 0 FERREIRA �
i [SEEP T EST HOLE v NCIVIL5836 � O. D R O U t DARTUOUTH
0
S! n�--_--� LEEACHING TRENCH c►s��� �e..
This Systenn Is Not De [PLUMBING ING PIPE
PL
SITE GRADING PLAN For Garbage Griner, �, .r
Al1L REV/S10N5 DONS AFTER DUNE 30,1995 :A
V
O r 0 � Z' wcRE PERFORMED BYr � .1Fa
Other
1 h Water Use evic ,
KENNETH R, FERREIRA ENGINEERING, INC. 1,
w
SCALE: 1" = 40' 46 FOSTER ST. NEW BEDFORD, MA.',02740 jFti 1
,_ _.t ,S R� CTIO O THIS SEPTIC g� 1 ¢ `,
S08 992-0020 FA?- 992-3374
„ n fi WITH TREE �I Land Survey Co., Inc. / Engineering Co., Inc. / Environment;il Assoc., Inc.
MUST E COMPLETED `t
S �� DATE d� APPROVAL 3 RESERVE NOTE 8 CONTOUR LINE 172 William Street New Bedflrd, Mass. 02740
YEAR K.E.F. a-2t3-9 Tel. #(508) 997-6494 FAX #(508) 997-`9656
N.O.L INFORMATION
ERS AS -BUILT
2 K.E.F. 7-22-911
ENGIN«; . GRADING K.E.F. -22-Drawn By: S.M.B. Drawing No.
i S.A.S. LOCATION9 Job Number:
R RTIFICATION SE 6514.15
I BOARD OF HEALTH INSPECTION LAN �a ,E
REQUIRED WHEN EXCAVATED STATE IZI1)T REQUIRED No, Description B Date Checked B K.R.F.
Q P Y Scaler 1.. = 40 y� E eJ 11+. 1 5
Desi ned B
Revisions Date: 6/26/95 9 Y: K.Q.F.
ReSudential
2.2 Authorized Agent:
%7
Contact Address,
Name (print)
Telephone
0 TA
3.1Licensed Construction Supervisor:
Not Applicable ❑
Licensed Construction Supervisor 0 V
License Number <►-
Address
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor:
Not Applicable ❑
Are you a Home Improvement Contractor subject to (780 CMR-6)? ❑ yes ❑ no -
If no, go to the next section!
Are; you claiming exemption from the requirement? ❑ yes ❑ no
If yes, submit the required
affidavit!
Company Name
Registration Number (if none, state "none')
Address
Signature Telephone
Expiration Date
3.3 For Residential Remodel Work Only
PERiSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY
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
~
by signing the above, the home owner acknowledges that there will be no eligibilty to the Guaranty Fund
Da.e
3.4 Homeowner Exemption - One & Two Family Only
FOR HOMEOWNERS 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 116.0,
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 accordance
with the rules and regulations promulgated by the BBRS entitled Rules and Regulations for Licensing Construction Supervisors.
Exception: Any Homeowner performing work for which a Building Permit is required shall be exempt from the provisions of this
section; provides that if a Homeowner engages a person(s) for hire to do such work, that such Homeowner shall act as supervisor.
For the purposes of this section only, -a "Homeowner" 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 family dwelling, attached or detached structures
accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered
a Homeowner.
If you are applying under this section sign below:
Signalure:
Your signature carries certain responsibilities, including but not necessarily limited to, general liability
c:\wpwiri\forms\bldgapp.res Page 2
January 20, 1999
I, as Owner/Authorized Agent hereby declare that the statementts and information
on the foregoi�apph�cafionaretrue �andac�urate, to the best of my knowledge and belief.
Signed under the pains and penalties of perjury.
Print N e
atur wn A orized Agent Date
c:\wpwin\forms\bldgapp.res Page 3 January20, 1999
Residential_
1999
Residential o FOUNDATJ'v�'VLY
i
1999
1. Date plan reviewed:
2. 30 days to review period expires:
3. OK to issue date:
4. OK to issue subject to requested submittals(see project review worksheet): Date:
5. DENIED (see project review worksheet): Date:— -
6. HOLD reason: Date'
7. HOLD subject to Zoning Board of Appeals action:
8. Comments:
9. Inspector's Signature:
Applicant informed of above Date:
Comments:
Date:
f- >DY Yr : m t�rr�rnvr rr*k:rntryxt .
Time: Clerk*
Total Permit Fee: $ Y3 S,,,► . �-X) Less Application Fee: $ 25.00 ' Remaining Balance: $
4
TOTAFEE; Gross Area - New Construction total sq. ft. ,�
,
Gross Area Alteration total sq. ft.
'j
Permit Issued Toy
MouTH ti s DATE RECEIVEDID7'
DARTMOUTH BUILDING DEPARTMENTi a s f '_ •_
400 Slocum Road, P.O. Box 79399
T Dartmouth, MA 02747, ` ° °' UQ
is t
508-999-0720 FAX 508-999-0738
APPLICATION TO CONSTRUCT, REPAINT, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING`,
Zoning Review: Signature:_UA
Energy Report: Signature:
,,Fire Chief: Signature:
Board of Health: Signature:
Conservation Commission: Signature:
fOther: Signature: "
NUMBER OF PLANS SUBMITTED'!%o'�
1.1 Property Address: �+
Nearest Cross Strcet:�5--L-( v
Subdivisioi Name:_,
Total Land Area Sq. Ft.: — =�� a - ,9 994,
1.4 Water Supply (MGL c 40 § 54):
Municipal, Private Well
Name (print)
Date: .
Date:
Date-- -24-%�q
Date:
�j
Dater
� � f
Date:
SITE PLAN SUBMITTED: Os ❑ no
1.2 Assessors Plat & Lot Number:
Plat{,_ Lot
1.3 Historical District ❑ yes ❑ no Has application been submitted to the Historic Commission?
❑ yes ❑ no Date:
1.5 Sewage Disposal System:
Municipal�''n Site Disposail System
Contact Address
OV �� . Iphone number
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January 20, 1999
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