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BP-2000-14833
‘ 1 tl ?II/ . , .--- David F.Bousquet 37 Sundance Rd. Dartmouth,MA 02747 Dartmouth Building Department September 15,2000 400 Slocum Rd. A qikl- L-/(1/ P.O.Box 9399 r)Lit N.Dartmouth,MA 02747 Dear Building Department, I David F.Bousquet of 37 Sundance Rd.would like to request an extension of my existing Building Permit #BP-2000-14833. I have run a little short on money to move onto the next stage of my construction and probably will not have enough time to finish before my Permit expires. Instead of taking the chance of not being able to complete my construction in time I am requesting this extension. Sincerely Thanks, David F.Bousquet .._, Permit No. BP-2000-14833 GI§4tin4trtalTP Map 42$5(0 �1 : / ) sffi k *, � ` �� � t/079 t0 t olimontoo �� u 44 J::iOt F3.T$. M 8 " r `� SiIG Lo 0Q48 E _ : TOWN. AI , 1tOUTH Cate o New j ✓400 Slocum Road,Dartmouth,MA:02T47 ' Project# 7s-2000=0159 Phone:(508)999-0720 Fax:(508:1999-0738- Est Cost $9500 00 � p '� i y� � y Fee 9 _� 50 00 ' _. PERMISSION IS HEREBY CDs 0„. Gonst.Glass :� }# . r :� xx� F : , : , P e .,4hone.#: -� t �- � 3 � Contractor � ,. �-- Lot Size,'(sq t. 1;81A- Y.: Engineer. �14. jLt se ""Phone#: Zoning.- -4 SRB -� - _ �.£'S New Const 60.Q sq ft Applicant: am. Vim" ' ; I Phone#: Alt.eonstT/A : ;; BOUSQUET DAVID F x ' ' a _`' (508)995-2178 t<c Date Typed: :04-06-2000 OWNER: BOUSQUET DAVID F DATE ISSUED: g G7` TO PERFORM THE FOLLOWING WORK: 24' x 25' single story garage BUILDING PERMIT Project Location: 37 SUNDANCE RD Approved/Issued By: 4 PH ZA,LOCAL BUILDI�,(� SPECTOR All work shall comply with 780 CMR 6TH Ed.(MGL Chap. 143)and any other applicable Mass.Laws or Codes and plans on file. POST THIS CARD SO IT IS VISIBLE FROM THE STREET SCHEDULE APPROPRIATE INSPECTIONS AS REQUIRED. UPON COMPLETION OF WORK, FINAL INSPECTION IS REQUIRED. THIS PERMIT WILL EXPIRE PER 780 CMR 111.7(NOT MORE THAN 3 EXTENSIONS WILL BE GRANTED)OR ON ISSUANCE OF A REGULAR OCCUPANCY PERMIT. I hereby certify that the proposed work is authorized by the owner of record and I have been authorized by the owner to make this application as his agent and to receive this permit, I further understand other agencies may have reason to STOP WORK if items under their jurisdiction are not met; not withstanding the issuance of this Building/Zoning Permit. Signature of Owner/Agent: 76 s /3 ce Comments: REPLACEMENT FEE WILL BE REQUIRED FOR LOST SIGNATURE CARCOP Y TOWN OF DARTMOUTH 15047 BUILDING RECEIPTS COLLECTOR'S.OFFICE . ; Name ii'`i ---,, ,,- 1-''''Property ,,-t Date 4-) 12- 1 7 ' - ' ') i— ."--- !'''1.-t":1? Owner: --'v',--4--- --r- - ' Job Location: ".„, /,i I i 7, _ , eN.,: r4,17S,.. --, ' Al'1:1-"r----4 i 1 ( "---- l'',---', m l'el'27 k)' White Copy-Collector's Office Plot 77/3 Lot Li 51 ,</ j7 Yellow Copy-Customer's Receipt i / /i „ ,-,Pink Copy-File Copy , - „ 1- 0 - I - 'Green Copy-Building Department \P , Phone: - , (--- CI Description General Ledger#'s Cf.# Amount License&Permits-Building 01000-44105 /..,-,, i /7 e----- r _ .,,,C---0 11— 1", (----1 ,...-N 0 - License&Permits-Building Misc. 01000-44105 1 i ../ License&Permits-Electrical 01000-44106 - _ License&Permits-Plumbing&Gas 01000-44107 Other Department Revenue 01000-42420 il .. ., i This is not a Permit or License for Building.Plumbing or Gas Received By: x-1-'6-I.—I / / - - TOWN OF DARTMOUTH 14833 BUILDING RECEIPTS COLLECTORS O1:F10E Name , )(?.: , Property Date ---‹ •11 / ( ) Owner: - Job Location: , , / A if „km (yr -o White Copy-Collector's Office Plot: Lot: ,s,/ -4/7 It-l€,01-1- Yellow Copy-Customer's Receipt Pink Copy-File Copy t e, A '1C2,CS.1 Green Copy-Building Department Phone: s . Description General Ledger#'s CAL,* Amount License&Permits-Building 01000-44105 License&Permits-Building Misc. 01000-44105 - / (.1 License&Permits-Electrical 01000-44106 License&Permits-Plumbing&Gas 01000-44107 Other Department Revenue 01000-42420 / This is not a Permit or License for Building.Plumbing or Gas x „- Received By: -C.- RESIDENTIAL 2000 0 FOUNDATION ONLY $25.00 APPLICATION FEE IS NON-REFUNDABLE &c NON-TRANSFERABLE f �MouTh: '�, , -- - DATE RECEIVED DARTMOUTH BUILDING DEPARTMENT ` -. - ir .''_ 400 Slocum Road, P.O. Box 79399 _ kc,0 _ y, Dartmouth, MA 02747 -'SY:''54 508-999-0720 FAX 508-999-0738 APPLICATION TO CONSTRUCT,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING iiiii;:.;.:"iiiii;iiiii.;>:.;:::::::'::.;:.:. ::... . . . . ::;.;:.;:.':.:.:::.;:.>::. :..m:::.....::.: ....:.. :-- i::<c:: :» »;::-.:: : : <:»::»i ::>::::2:>' ::::>::: s.'.':>:>`:`H1S SECTION FOR OF*C:.i:AL US1N O::::.: ..: ,-..*::::>: > ,prom;: ii�> > > » a > > »:.:gii.: iiiii::< <:::>:::::::s: r>:::.»: >iiiii:>:::>:::>' >:.=>:::::::::>>:>::::>::::>: >:::::>:::;:: ::.::.::::>":.;:<::::;::;:. .::::.;...: . : : . •_....:....::.::. ..; .:...:::::>:... . iiiii,...... . ::r.:';»':;::>::>;.<::::>::>;>:>:::>:::;:;;::: :.>s:::>:.'< ;:;>:»:::<: :.::»::>: :: ,:.; : :::> :<::::>::::»::»;> .:.;' :.;:.:'.;..::.;:.:'.;:..::::.;'::;:;;.:":.;:;:.::::... .. ::;::.:: .:::. .: : :..:::. .�.T.yy:��7n.�,��.�p . p...:::: :::::..::..._::::._:::::::....:::....: ..::::::.....:.::... :.:.»"�»::>:>::.>:.::.:..a>:>:.>:.::.;:a:;o:;..::;;:os>;:,y. 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':.F iiiii:>>' >> » ' i nin s:o:❑.:.::r ;;<::::::..:©.Cas: ..:::......::::- .00nn1n ;B r..0.._ 0: etiverGard.....::::::.::. Water:;:G$rd.. i..iiN iiiii ::.a: <::: :;::::::: ::>:>><::>:<<:::::>:::::.:iiiii.. � ................. . Off .................... Vie. :.:..;;:::.;:<.;:.;:.;" :C.u#:Off...:.::.:.:. :;'. :.;'::.;:.;:. :::.;:.;;:. :.;::.;:.;;::. I Cuf ;.:;;iiiii: ::>:::.": ff:. ......................... :.;.;.;;: ;;.;:. :::::::.;:.::.;:.;:..;::<..;;:.: 1 :.$ I 71.F`o.:. Ii � S ECT �' :REV:fE�i:B 'F T S E ORE:TILE>I A. :. :':.. : »::::;::<:>: : ::> : ".' ::>:: '. S N E£?FA PERMIT:>» >iiiii;': ;>> <a :;<»;>>'>: < ;< >: .->;:>:.>:>::»iiii>:;:<:;:;:»:>::>>''::»::>;::>:>::;'_:::» >:>:>'>z:.i::>::i::ii:.;:::>:::::>..:;:>::>::>:>.::>'>.' DEP TM.ENT" " .:: .:::::::::;.;'.>':'.;:;.:......:..:.:.::..':.::.:'.;.::::_:::: iiiii' ':;::;:':;:':;:.>'::>':.;:.;:";";: .'.:: :: : Y.:.:.: .i .;";:::...'iiiii::>::>:::::'::". Zoning Review: Signature: Date: t- --`t 60 Energy Report: Signature: Date: , Fire Chief: Signature: Date: Board of Health: Signature: 0 K Date: Conservation Commission: Signature: 6 Date: Other: Signature: fDate: Description of work being performed:?" A7 ,_.,s--- ` «:<:::::::::>:.:iiiii>::>;:..;:.».>;:»::: .::<:.:.>::>:::::>:" ::..: : . .:: //:...... . : ::> >::>:::.<:> ::>: :»:>:::>:::>::::>:::>:::>::>;: ::: ' iiiii::>: N` ._ S TE I< . RFT 8: I4..>::::::::: ::.: .»:» »»»>:>: <::_:<::: :«:>:<::»:<::.:<:'.::::><.>:::>::<><iiiii ::::..:.. � T. . �':.;:.;.:".;:.:.:::. '.:;.;:.;:.;;;.<.;:;.;:.;'.: ;:.".:..;::. ;:;:.::.;:.;:.iiiii".::::::::: ::: :: NUMBER OF PLANS SUBMITTED: SITE PLAN SUBMITTED: 0 yes 0 no 1.2 Assessors Plat&Lot Number: 1.1 Property Address: ,"; ��z,,,t �� Plat I 1 Lotf Olearest Cross Street: Co/(„4 c lne,r ne.L r2d . Subdivision Name: 1.3 Historical District 0 yes 0 no jotal Land Area Sq. Ft.: / f t Has application been submitted to the Historic Commission? ❑yes 0 no Date: jWater Supply(MGL c 40 § 54): Sewage Disposal System: 0 Municipal ! Private Well 0 Municipal NI On Site Disposal System C:\bldg.forms\Bldgapp.res.wpd Page 1 Rev.January 13.2000 RESIDENTIAL 2000 - s s> c ro v —>> �al�lt� ct~svRi€ir l�clrlltzn� l��r 2.1 Owner of Record: tavt «vS � v i— /.1 Sovzd_./iikc_e d. Sad-S`is=,R[78 i Name(print) Contact Address Phone Number 2.2 Authorized Agent: Name(print) Contact Address Phone Number 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction Supervisor License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor: Not Applicable 0 Are you a Home Improvement Contractor subject to(780 CMR-6)? 0 yes 0 no If no, go to the next section! Are you claiming exemption from the requirement? 0 yes 0 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 PERSONS 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, ,tL4 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 Date 3.4 i-iomeowner 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 I, 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: Signature: Your signature carries certa esponsibilities,including but not necessarily limited to,general liability Page C:'.bldg.forms\Bldgapp.res.wpd 2 - - Rev.January 13.2000 1 RESIDENTIAL 2000 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 Appendix of 780 CMR R5.2.15) .... :... s r� € ..�Olr s co € �r Arrc..l .rs re>.. 1 r T:€1vt x c 5 2 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: 0 yes 0 no SEC ION 5 DESCRIPTION OF PROPOSEDWORK(Check al=t applicablg). ❑ new construction* 0 addition 0 alteration 0 repairs 0 chimney/ 0 woodstove (energy report required) (energy report required) fireplace ❑deck 0 pool accessory bldg. ❑ replacement window/door 0 other 0 demolition (shed/garage) no. of windows doors (specify below): (specify below): * If new construction,please complete the following: Single Family: no. of bedrooms no. of baths Two Family: no. of bedrooms unit 1 no. of baths unit 1 no. of bedrooms unit 2 no. of baths unit 2 ❑ Furnace(hot air)-fuel gas(natural or propane), fuel oil, electricity, other(specify): ❑ Boiler(heating)-fuel gas(natural or propane),fuel oil,electricity, other(specify): ❑ HVAC(combined unit)-primary fuel,natural gas, propane, electricity,other(specify): O Air conditioning-(separate unit) ❑ None of the above to be provided ❑ Hot Water: Gas Electric Fuel Oil Other Brief Description of Proposed Work: Cows;2vci— 4 4 e. S 9/l aq x a,s ' /4 j14-ckc-e( .:::::::.::.:.: ..... .::.:. ,;.: .:: :: SECTI£li�T �ESTI'Ll;�'I'EI)Cfl\8TI1E.c'£I£?N.Cf1 .:.. S�'S..:.: .. . Item Estimated Cost($)to be completed by permit applicant I. Building 2. Electrical 3. Plumbing 4.Mechanical(HVAC) 5. Total=(1 +2+3 +4) *Estimated Total $ 9607 /2) .... , 1 ; :: i::;iiMAR::.::z.::: ">> < » > ?>?<> >»s ><> » <itsEGTIO 4*fl:TNEALI'H( {[ 719.N: > ::..: ::: :.: ::: ii: ::: . :::: (to be completed whets ewvuer'sagent n-caatrartar.<altpltes fo ttud2dtng peim1t): ::`>:>;< (please print) I, ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date r §Et!.et(7 '7BQXt trt/1[1 'Hf)ItiZ p.:AGEIT`AY.EctA t:ATIO I, Tii-o i F. l >f,r,.5 c Li-e�— , as Owner/Authorized Agent hereby declare that the statements and information /7.4ir the foregoing application cdre true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. ri` 11—- r �/ /00 Sig ure of Owner/Authorized Agent Date C:\bldg.forms\BIdnapp.res.wpd Pane 3 Rey.January 13.2000 RESIDENTIAL 2000 :SECTION:$ TNSPECTOR'SREVIEW M/COMENTI 1. Date plan reviewed: 4/. '/—'00 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: Date: 8. Comments: 9 Inspector's Signature: SECT'1ON 9 vi*P :'T MJTW'IC4TIO\ Date: Applicant informed'?f above Date: , ": ;: ;>: ::':::::::: i f Time•, _$7. f Clerk: �P Comments: 'i l ' ¢' if ` Total Permit Fee: $ j OD Less Application Fee: $25.00 Remaining Balance: $ TOTAL FEE: �"t ,--y`s, Gross Area-New Construction total sq. ft. 0C) C.' Gross Area-Alteration to ,// c2"7 Permit Issued To• 2,6 SEE t'ION 11 :ADI),ITIO\AL CU70)g+TS/SKETCH C&71- ----er--e- 2.91_,,?97-4—%- 2L i/%'''. lx--- 6,:pi,....g...„.........4_ Q.,„„7,...,,,,...„2,,;'- , k....„z C:\blds.forms`:Bldeapp.res.«pd Page 4 Rev.January 13.2000 Project Location: 37 SUNDANCE RI) Permit No. BP-2000-14833 GIS#: 4285:00 Map:: 0079: (.o/nmonwea o a3dachu3e Lot 0048 Sub Lot , o04g TOWN OF DARTMOUTH Category: New 400 Slocum Road,Dartmouth,MA 02747 Project# JS-2000-0159 Phone: (508)999-0720 Fax: (508)999-0738 Est Cost =_,. $9500.00 Fee $9 00 BUILDING PERMIT Cthist.Class. Use Grout): R-4 'LotSize(sq`ft.) 1.81A FIELD INSPECTION Zoning: SRB y New'Const.: 600 sq.ft. Alt,Const: N/A ," Contractor: License: Phone#: Engineer: License: Phone#: Applicant: Phone#: € €�i‘/t s , 'Pjl;; BOUSQUET DAVID F (508) 995-2178 OWNER: BOUSQUET DAVID F 2 DATE ISSUED: "I '7— f TO PERFORM THE FOLLOWING WORK: 24' x 25' single story garage IDATE I TIME _ TYPE OF INSPECTION&REMARKS INITIAL v M0/ I - V 0,1 //.'00 ,4 �� , vim-. M . Cr. 4� SEP 1 8 2000 � ., � 49n4..._ // a) Id; A , . 0 �. ---j The Commonwealth of Massachusetts sue (7' f Department o De art Industrial Accidents P RI _-1 Office of Investigations _�.___=�4 600 Washington Street ,� ;:y� Boston, Mass. 02111 �r�� Workers' Compensation Insurance Affidavit ame: LJ Au i et (- o U V e--(— ' / v location: ;* Sc)7 S vi, d-i4 t2 Ce_ g C c ty Aft_t✓►2 o cJ tt k_ Y1 /f Q3-7 el 7 phone# ,S7 E- - /c 1:.5- at 7 k am a homeowner performing all work myself. Ej I am a sole proprietor and have no one working in any capacity O I am an employer providing workers' compensation for my employees working on this job. company name: address: city: phone#: insurance co. policy# O I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city: phone#: insurance co. policy# ff ‘i#Z., �/O/0/�'.,Z,'0A'/////'"Z3//' �//// ' / company name: address: city: phone#: insurance co. policy# Failure to secure coverage as required under Section 25A of N1GL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I¢o hereby certify under thee pains and penalties of perjury that the information provided above is true and correct. Si ature Q uT� / u ate ,?/a,//Oct Print name A v ( 7 c) S v-c -i - ne# - 5 - 17 �� � .so Fr ��s- a (? official use only do not write in this area to be completed by city or town official city or town: permit/license# ['Building Department Licensing Board A 0 check if immediate response is required ❑Selectmen's Office ['Health Department contact person: phone#; nOther (revised 3/95 PM) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. j � �/yt, e /�/..im "/ %f!!07/ /i% ��� %%// ,%//%/% %.✓,// �% // � vim � /// � � �i ,� ,� � � . ///%"�//,5��.',lk /,i/,,/ //,/r '�,�/�� .�,i�ir!/. /////,/i�� City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. r��j�ZZ / i���%/;,;�i O,AAA%/iA y., A A At//jA/ ,WA /.: /j//:r��j % �'Y/Q � ���a��j%a���ia//fir., %/�/���,,/��i/�/j/, ,.c. / ,.cO�i,,/������, /,y,/ ��!��%L/,�/,////,/v��'l��y�"�jr ���1///,rf6�/v //r;�/.,GD� �G�yt�i,,�'��i,,,� �Ba�"��,�at�„y///f�!�/,/�/�.,. The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 310 CIIIt 10.99 DEP Ele No` 15— 982 Form 5 (To be provided by DEP) City/Maim Dartmouth IT Applicant David F. Bousquet commonwealth fM&welts AMENDED of Xa:r.BachUsettB Order of Conditions Massachuetta Wetlands Protection Act Q.L. C. 131, 540 and the Dartmouth Wetlands Protection Bylaw From Dartmouth Conservation Commission Issuing Authority To David F. Bousquet David F. & Lisa M. Bousquet 31Name oif�Ap licant) (Name of property owner) Address /Dartmouth, MA 02747 Address This Order is issued and delivered as follows: ❑ by hand delivery to applicant or representative on (date) by certified mail, return receipt requested on April 30, 1997 (date) This project is located at The property is recorded at the Registry of Bristol Book 3232 Page 172 certificate (if registered) The Notice of Intent for this project was filed on 9/21/92 (date) The Request for an Amended Order of Conditions was filed on 3/21/97 (date) The public hearing was closed on April 29, 1997 (date) Findings The Conservation Commission has reviewed the above-referenced Notice of Intent and plans and has held a public hearing on the project. Based on the information available to the Commission at this time, the ConnniS Sinn has determined that the area on which the proposed work is to be done is significant to the following interests in accordance with the Presumptions of Significance set forth in the regulations for each Area Subject to Protection Under the Act (check as appropriate): Public water supply + Flood Controlg Land containing shellfish Private water supply Storm damage prevention Fisheries Ground water supply Prevention of pollution T Protection of Wildlife Habitat Total Filing Fee Submitted NA State Share . (1/2 fee in excess of S25) City/Town Share Total. • Refund Due S —0— City/Town Portion S •—O— State Portion! —0— (1/2 total) - (1/2 total) Effective 11/10/89 5-1 1 AMENDED uiavl.0 r. liowiquet ORDER OF CONDITIONS - Continued: FILE NO. 15- 982 Therefore, the Commission hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the regulations, to protect those interests check above. The Commission orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control. General Conditions 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. . 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes, ordinances, by-laws or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this order unless either of the following apply: (a) the work is a maintenance dredging project as provided for in the Act; or (b) the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance and both that date and the special circumstances warranting the extended time period are set forth in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles or part of any of the foregoing. 7. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or, if such an appeal has been filed, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of the recorded land/ the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, the Final order shall also be noted on the Land court Certificate of Title of the owner of the land upon which the proposed work is to be done. The recording information shall be submitted to the Commission on the form at the end of this Order prior to commencement of the work. 9. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection, File Number 15-982 10. Where the Department of Environmental Protection is requested to make a determination and to issue a superseding Order, the Conservation commission shall be a party to all agency proceedings and hearings before the Department. 11. Upon completion of the work described herein, the applicant shall forthwith request in writing that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. 5-2 I AMENDED ,xiviu r. ILJU4UcL uRDEt OF CONDITIONS - Continued: FILE NO. 15- 982 12. The work shall conform to the following plans and special conditions: Plans: Title 8 Da,�ted Signed and Stamped by: 1 /95 "As-Built" shcxaing 24'pool The above plans are on file with the Dartmouth conservation Commission. Special Conditions (Use additional paper if necessary) 13. Prior to the start of construction the following must occur: a - The holder(s) of the Order of Conditions or their representative shall notify the Conservation Commission office of the starting date of construction. Unless specifically indicated to the contrary by the Commission or its agent, an on-site meeting between the Conservation Officer, the contractor, and the holder of this Order of Conditions, shall take place on site prior to the star of work. b - All siltation control measures shall be installed prior to any excavation or tree stump removal. The siltation control measures shall be approved by the Conservation Officer prior to any other activity on site. c - When deemed necessary by the Conservation Commission or its agent, the applicant shall have on hand, at the start of any soil disturbance, removal, or stock-piling, a minimum of fifty (50) hay bales and sufficient stakes for securing these bales. Said bales shall be used only for the control of emergency erosion problems„ and shall not be used for the normal control of erosion. d - This order of Conditions shall be recorded within fifteen (15) days of receipt in accordance with condition #8. e - The name and telephone number of a contact person in charge of activity on site shall be submitted to the Conservation Commission. 14. No activity shall occur prior to obtaining all necessary and required permits, licenses, and approvals, and until copies of the same have been furnished to the Conservation Commission. 15. Any design modifications, alterations, amendments, or additions to the approved Plan of Record, which fall within the jurisdiction of the Conservation commission, shall be subject to the approval of the Commission. Requests for any changes shall be made in writing, and shall be accompanied by two (2) revised plans. 16 . No modification of surface features, drainage or topography shall be permitted, except as indicated by this Order of Conditions. 17. Contours shall remain unchanged except as permitted by this order of Conditions . 18. There shall be no construction other than that proposed by the Notice of Intent and included on the submitted plan. 19 . Immediately upon completion of the exterior construction, grading and landscaping shall be carried out in order to minimize erosion. 20. All wetlands and Buffer Zone areas shall be kept clear of rubbish, debris and construction material. 5-3A nmmavuzu ORDER OF CONDITIONS - Continued: FILE NO. 15-982 21. All exposed soil or subsoil shall be stabilized using mulch or other appropriate erosion control measures such as jute netting, and/or replanted with vegetation such as grass, ground cover or shrubs so as to minimize erosion and siltation. 22. No runoff shall be caused to drain onto adjoining property or upon any public way. • 23. All excavated material not used to establish final grading shall be removed from the site. 24. The Inspector and/or the Commission members shall, at a reasonable time, have the right to enter upon the land for the purpose of the inspection and/or the taking of pictures. 25. When the Plan of Record has been prepared and stamped by a Registered Engineer, a Registered engineer shall certify, in writing, that the project has been completed in accordance with the above Order of Conditions before the Certificate of Compliance will be issued. 26. All facilities and equipment shall be continually operated and maintained so as to comply with this Order of Conditions and M.G.L., C 131, S40, the Wetlands Protection Act. 27. Certain conditions, such as maintenance or monitoring, are on-going and do not expire at the end of three years, or with the issuance of a Certificate of Compliance. 28. This Order of Conditions shall apply to any successor in interest of the applicant, or successor in control of the property. The applicant shall furnish a copy of this Order to any subsequent owner at the time that ownership is transferred. 29 . Any changes required by any other board or authority may require a new filing with the Conservation Commission. 30. The Conservation Commission and/or the Town of Dartmouth shall not be responsible or liable for the construction, the operation, or the maintenance of any part of this project, and does not warrant the safety of the same. 31. During construction, any fill and/or construction materials shall be stored in upland areas. 32. If changes to the approved plan-of-record on file with the Dartmouth Conservation Commission are required by other regulatory agencies, any such changes shall be submitted for approval in accordance with Conditions #14 of this order of conditions. 33. Any construction in the flood plain shall conform to the Massachusetts Building code, 780 C.M.R. , §2102, the Design Requirements for Construction in Floodplains. 34. It shall be the responsibility of the applicant or the applicant's representative to continuously maintain all siltation barriers required by this order of Conditions until the commission approves or requires removal of said barriers. 35. Unless alternate erosion/siltation control measures have been approved by the Conservation Commission or its agent, all exposed soils exceeding a 4:1 slope shall be stabilized using erosion control blanket/netting within 48 hours of soil disturbance, and shall remain in place for the duration of the project, or until vegetation has been re-established. 36 . Any soils exposed by construction activity or disturbed in any other manner shall be, upon completion of construction, immediately stabilized with indigenous vegetation. Plantings may include, but not limited to grass seed mixture for approved lawn areas, indigenous shrub and tree species, or indigenous herbaceous cover species . All plantings shall be approved by the Dartmouth Conservation Officer. 5-3B I AMENDED David F. Bousquet ORDtR OF 'CONDITIONS - Continued: FILE NO. 15-982 37. Once plantings become established, all hay bale silt fence and snow fencing, or any combination thereof required by this Order of Conditions shall be, upon approval of the Conservation Officer, immediately removed. 38. The Commission reserves the right to require additional protective measures for the resource areas should a site visit indicate the necessity for those additional measures. • 39. In the event the proposed pool is drained, the water shall be hauled out by tank truck, or, allowed to stand without chemicals for a minimum of seven (7) days before being allowed to drain. 40. All work as approved by this Order of Conditions shall comply with the Dartmouth Aquifer Protection Bylaw. 41 . There shall be no further encroachment towards the wetland area 42. In the event the proposed pool is drained, the water shall be hauled out by tank truck, or, allowed to stand without chemicals for a minimum of seven (7) days before being allowed to drain. • 5-3C David F. Bousquet ,. AMENDED ORDER OF CONDITIONS - Continued: FILE NO. 15- 982 Issued By the Dartmouth Conservation Commission Signature( s ) p„,:,,,' IX4-6:11e"4.1'k ---. -----s-----"-- This Order must be signed by a majority of the Conservation Commission. On this 29th day of April 19 97 , before me personally appeared George Levesque , to me know to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as bis/her free act and deed. L14 �,' - 6/12/2003 Notary Public Rita Costa My Commission Expires The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the Department of Environmental Protection to issue a Superseding Order, provided the request is made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form as provided in 310 CMR 10.03(7), within ten days from the date of issuance of this determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. This Order of Conditions, unless specifically indicated to the contrary, is issued pursuant to both the Massachusetts Wetlands Protection Act and the Dartmouth Wetlands Protection Bylaw. Therefore, in addition to the appeal process specified above for the appeal of an Order of Conditions issued pursuant to the Massachusetts Wetlands Protection Act, any person aggrieved by this order may also appeal this Order of Conditions in accordance with Section 1.08 of the Dartmouth Wetlands Protection Bylaw. Detach on dotted line and submit to the Conservation Commission prior to commencement of work. To the Dartmouth Conservation commission Issuing Authority Please be advised that the orderpot conditions for the project at File Number 15- 982 has been recorded at the Registry of Bristol, book ,page has been noted in the chain of title of the affected property in accordance with General Condition 8 on , 19 . If recorded land, the instrument number which identifies this transaction is If registered Land, the document number which identifies this transaction is Signature Applicant 5-4A rev. 5-3-94 NCO/RC ,... 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Zoning Review: Signature: Date: Energy Report: Signature: Date: Fire Chief: < , Si nature: Date: Board of Health: o r` R ignature: (�� - e Date: d 274 r CO Conservation Commission: Signature: Date: Other: Signature: Date: Description of work being performed: (M5 _) T1 IT` : '' > ::::': : : :. NUMBER OF PLANS SUBMITTED: SITE PLAN SUBMITTED: 0 yes 0 no 1.2 Assessors Plat&Lot Number: 1.1 Property Address: 3 7 Su , plat Lot IG ——_ - veareat Cross Street: Coil; S 00,4 nevi_ . Subdivision Name: 1.3 Historical District 0 yes 0 no tal Land Area Sq. Ft.: �� A�4rS Has application been submitted to the Historic Commission? 0 yes 0 no Date: 1�1 Water Supply(MGL c 40 § 54): `,/ Sewage Disposal System: 0 Municipal .Private Well 0 Municipal Z On Site Disposal System C.`.blde forms\Bldgapp.res:spd Paae 1 Rev Januar). 13.2000 .14 v •� 4 3 _W i 4 e wwp�2 swoop spow" d5 wo SIMMONS cp .mow LD S 2 .