BP-29737i
f
LOT 309
INVERT SCHEDULE
LOCATION
DESIGN
AS -BUILT
AT HOUSE
91,70
91-080
INTO TANK
91.45
91955
OUT TANK
91,20
91,30
INTO D-130X
90,97
90*94
OUT'D—BOX
90.80
90*78
EN OF Fl41D
90.50
90*62
I CERTIFY THAT THIS SYSTEM HAS BEEN
BUILT N SUBSTANTIAL COMPLIANCE WITH
THE DESIGN PLAN AND MEETS ALL
APPLJGABLE LOCAL AND/OR STATE REGULATIONS
S1 C
13 Welby Road dotes M�1;: 2.�, f9.99
New Bedford. IAA 02745
(508) 998-2125 dR71y17: R%�l)
C1vi1 and Environmental Engineering FAX (508) 998-7554 c%4ed.•
Land Use Planning o�p��. S,,/IOG
project:
LOT 310
SOUTHWIND WAY, FOX RUN TERRACE
DARTMOUTH, MA
Client..
MICHAEL AND BEATRIZ
SMALDONE0 eo�
droning of/e: of . 1
SEPTIC SYSTEM AS -BUILT drt�aing nu ns:
FA 1-3-1
RE, SI[DENTIAL
SECTICIN Z -PROPERTY OWNERSHIP I AUTHORIZED `AGENT'`
Contact Address
2003 RESIDENTIAL. 2003
Phone Number
Contact Addre
ss Phone Number
Address
Telephone
Signature
3.2 Registered Home Improvement Contractor:
Are you a Home Improvement Contractor subject to (780 CMR-6)? 0 yes ❑ no
If no, go to the next section!
Are you claiming exemption from the requirement? 0 yes ❑ no
If yes, submit the
required affidavit!
Company Name
Adc"Lress
Signature
Telephone
3.3 For Residential Remodel Work Only
Expiration Date
Not Applicable ❑
Registration Number (if none, state ❑ noneo)
Expiration Date
PERSONS CONTRACTING WITH UNREGISTERED CONTRACT
ORS DO NOT HAVE ACCESS TO THE GUARANTY FUND:
QUESTIONS OR COMPLAINTS call or write: 727-8598
i Hoy;7.e Improvement Contractors Registration, n One Ashburton Place -Room 1301, Boston, MA 02108, (617)
0w>ners Name (print)
Signature
by signing the above, the
home owner acknowledges that there will be no eligibilty to the Guaranty Fund
DatLe
3.�- Homeowner Exemption - One & Two Family Only
_p
FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT
governed b Construction Control in Section 116.0, effective July 1,1982, no individual
109.1.1 Licensing of Construction Supervisors. Except for those structures g yonsrucr demolition involving the structural elements of
supervising persons engaged g
shall be engaged in directly sup g ed in construction, reconstruction, alteration, repair, removal o p g g
s and re ulations promulgated by the BBRS entitled Rules and Regulations for Licensing
bu i
g
1din s or structures, unless he or she s licensed in accordance with the rule g
Construction Supervisors. p provides that if a
which a Building Permit is required shall be exempt from the provisions of this section, p
Exception: Any Homeowner performing work for wh g
p
Ho, eowner en ag es a erson(s) for hire to do such work, that such Homeowner " shall act as supervisor. ides or intends to reside, on
For the purposes of this section only, a H
m g"Homeowner" is defined as follows: Person(s) who owns a parcel of land on which he/she res
'
attached
or detached structures accessory to such use and/or farm structures. A person who constructs
winch there is, or is intended to be, a one or two fa
dwelling,
more than one home in a two-year period shall not be considered a omeowner.
If:you are applying under this sec ' n ig e w•
Sz,anature:
Your si
carries certain responsibilities, including but not necessarily limited to, general liability
ture
x new construction, lease complete the following:
If n p
Single Family: no. of bedrooms no. of baths
bedrooms unit 1 no. of baths unit 1
Two Family: no. of no. of be
drooms 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):
❑ Air conditioning - (separate unit)
❑ None of the above to be provided
❑ Hot Water: Gas Electric Fuel Oil Other
Brief Description of Proposed Work: 4,p�T'* GU+T-\ �'� C} t 001v o-
Item
1 R»ilrlinor
?. F1Prtrirnl
I Mimhin or
d 1VMPrhnnirnl (T-TVAC )
Page 2 Rev. January l , 2003
n.���r,a,� �,,..,�,��Rlr�cYanr� rP.0 WnCi g
C:\bldg.forms\Bldgapp.res.wpd
Rev. January 1, 2003
RESIDENTIAL
2002
RESIDENTIAL
KIMINI'll,
❑ FOUNDATIC-i��V ONGY
$25=00 APPILECRTEGM F13E ES M7 i�,t�,�,7
L I L., %-., I I I %." I *
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A-0 L4 L,%.ol o
C:\7:)Idg.forms\Bldgapp.res.wpd Page 4 Rev. January 1, 2003
C:\bldg.forms\Bldgapp.res.wpd Page I Rev. January 1, 2003