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BP-34146RESIDENTIAL 2004 ❑ FOUNDATION ONLY $25.00 APPLICATION FEE IS NON-REFUNDABLE & NON -TRANSFERABLE RESIDENTIAL 2004 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: Date: 8. Comments: 9. Inspector's Signature: Applicant informed of above Date: Time: Clerk: Comments: Total Permit Fee: $ 6.07. 00 Less Application Fee: $ 25.00 // Remaining Balance: $ no TOTAL FEE: W 7. Ov Gross Area - New Construction total sq. ft. Gross Area - Alteration total sa. ft. 1,o07, ❑ FOUNDATION ONLY $25.00 APPLICATION FEE IS NON-REP7JNDABLE & NON -TRANSFERABLE CAbldg.forms\Bldgapp.res.wpd Page 4 Rev. January 1, 2003 CAbldg.forms\Bldgapp.res.wpd Page 1 Rev. January 1, 2003 RESIDENTIAL 2004 RESIDENTIAL I 2004 V �m SECTION2PRCiPER1'1<ONERHIP -I�L1THdi2IZEDAGENT? e .10 A �. _gym ro� ro: 2.1 Owner of Record: �`713 17, 7c i I»c -� �a ►��- i-�OLve S 1 i 0 r C.M STie'-l", -Pd4mau -1� Mom_ Name (print) Contact Address �D S `���J C3e79 P one Number 2.2 Authorized Agent: Contact Address Phone Number Name (print) SECTION 3'�, ONSTRZICTION ERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor 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 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, MA 02108, (617) 727-8598 Owners Namt.-�prin = J/1Yi'i 4 / Signature C by signing the a ov ,` he on5abwner acknowledges that there will be no eligibilty to the Guaranty Fund Date 1 4- 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 j 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 un is sec 'on signbE Signature: YourVignature 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 hey have taken the permit are responsible for code compliance. (see Appendix of 780 CMR R5.2.15) 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: ❑ yes ❑ no ❑ new construction* ❑ addition ❑ alteration ❑ repairs ❑ chimney/ ❑ woodstove (energy report required) (energy report required) fireplace ❑ deck ❑ pool ❑ accessory bldg. ❑ replacement window/door ❑ other ❑ demolition (shed/garage) no. of windows_ doors_ (specify below): (specify below): If new construction, please complete the following: Single Family: no. of b drooms Li 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) - fue�l gas (natural or propane uelectricity, other (specify): ❑ HVAC (combined unit) - primary fuel, natural gas, propane, electricity, other (specify): Air conditioning - (se crate unit) ❑ None of the above to e provided ❑ t Electric Fuel Oil u it Other Brief Description of Proposed Work o%-��� fYt�r1 /kttL�i+Md�r �- o'Z ("cc crn.-d�a _2'-1 t .3,1 30' I Phimhino Item I I Estimated Cost ($) to be completed by permit applicant * Estimated Total $ a 76), Cd 0 b ©C✓ , as Owner of the subject property hereby authorize srs el tiv t5rk authorized by this building permit application. Date as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. /_ I, Q L1 Signature of Agent Date C:\bldg.fortns\Bldgapp.res.wpd Page 2 Rev. January 1, 2003 C:\bldg.forms\Bldgapp.res.wpd Page 3 Rev. January 1, 2003 11 Fi:@ COpy fte Men Kept on V LOT 3A 380097 SQ. FT. 8.73 ACRES (2WX7 SO. Fr. CMMVJS UPLAND) 11 EXISTING STING FOUNDATION T.O.)F.= 1 A15.7 L-201.78' Fire Copy f a A 'w �m,"'; F- w -; M ;'o-j -,Va R E c U. it ii:; AC�npryWTI-i. WIS. N!'.Zs. OIL a 9F14 s'-we: 11-100, 12 Werby Rood New Bedford. MA 02745 aWm- 8-10--04 (508) 998-2125 dVWII.. Os o Civil and Environmental Engineering FAX (508) 998-7554 checked- bff Lund Use Planning LOT 3, PARDON HILL DARTMOUTH, MA Client. I V, 4 HOWES RESIDENCE ".w .... v,. sheet I Of FOUNDATION AS —BUILT a,-win_q number.' I FAB- 1 D I Pi'# 2: 42 1 � r + � p 1 A i iWAlzovi- 1?y DARTMOUTH FIRE NSTRICT 1 10 BRIDGE ST. DARTMOUT.H, MA 01146 508 - 996-1596 IS �.eA3nw3e4 fir.. f. +5f rta)-)"6 11 V . (.00 f-� 'ice er,!otA, r4A . 6ao- `q�-o992,, tzz- +�.� I FILL k,:Vr. YOUR DpAw*Q MUrzT BE KEPT AT THE SUILDINa DURING THE 5 OF THIS WORK. LIUl1.DNG DEPARTMENT lb" of C?artmtniEf� Tovm 0C QARAW- T) RECORD PLAU A MY 01 'DIs Ery et c Plan Muls Be 1erPt Dn L"1#e DUT123 #r C11 SONO-TUSE SaR AND DEPTH tttSPTHEONCRETE IS POURED- ION IS REQUIRED RE T'UILDING DEPARTMENT of DrTIM01 h FIRE STOPPING REQUIREMENT Penetrations thru rated walls and floors shall be seated With a material capable of preventing thz passage of flames and hot gasses when subjected to the requirements of the Test Standard spedfic for Fire Sty ASTM-E-614. An As Built ;Our. vey iu-ust b sL bniitted to the Buffli1I1j�', Dept. prior to callina for a found-ation inspection or any further construction. /3 y `•f 3D x j-y 7d,0 �3 /41 M i I ' o 1 =�/ X 7 1 I •uor��n� uoo i3�n3 dine 10 LIono;)C�5LIi tioi�L'j�un0i � aoutt z) o� jolad 'IdQ Illy q ismu IbA xr,.'S IlItIq W uv 't v9-"J-sV cdots wu jol a P��pu�S obi to slu�ea{nke, ®y3 oy ccn� ! E�L� S0 3�75'ra�j psig1s U3gm $E#as�{Gi:�{' Z1£31eU1 � 41IM Pe{�®S 6u{ivaAojd p of suo{ Quod i 11� saoo{} pug spd�a� Pol� nab li lft i l r�NIddt3i$ EA UcId tpua' Sj.10 M03 V 0 LWVOu4120 INBA LOM3d VNIG 11M '(31*1 lOd GI 5,L3ballo3 V, -avosdsa a Y 3TS91 VI aoNo i trwasiva in •NwoM SMI io esssom 3Nl oNium ONIC!"UrM ?MI IV jeN 78 MKTda UMM Wo a�i3 L G J-r •�G prong Ip AS LL aa�tr.��ar� iraxuannC br'I 'Iq 3[3taapas4 'sCT �w C0� d� E1I till ?,)CvQ ,v (v1 k N MOITS '1 Q � `I YLS AHI �bfil I/ ,� %' �'y9 fi� .�d „"�' R"4+i' Q8 i°x � "� q'�d � Y� '�+� �+ � p' �,r {�) � i' f�lf • °-'" ! �,, k s i Z;1 V IN 01 OA,\�, C4! uwf fpov)6� 6 6 M /e, a fAkW4 0 QL S.-I -L I al HLE G` r0ONO-TUGE SIZE AND DEPTH IKWECTION IS REQUIRED BEFORE THE CONCRETE IS POURED. r-JILDING DEPARTMENT d Dm"010 VOW Dw-lwta WJUT Vg- w-T C THE BUMIDING DUIRtNG THE F'�S OF THIS WORK t4XLMG DEPARTM"— , " of Dmtroton TorRI 01.6' MRIC11TH RECORD PLAII A Copy 01, his Endrurt--d pion viust Be Kept On Site Dori J, ustr 'a Iction An As Built Survey mil%- bg submitted to the Baildng Dept. prior to calling for,. a foundation inspection or any further construction. FIRE aT _QEPING M!gLUIBLkEN, T Ponetratiorls thru rated walls and floors shall be sealed with a material capable of preventing thr. p�ssage of flames and hot gasses when subjecteC tojhe requirements of the Test Standard epeortic for Ftm Stope ASTM-E-614. /3yq 6 1A el VA, awo iba ,rA -0992. 'Y"k. (W21,11,1 A k x yk }t qry is �f r i { , e i 1 pp V ..tip W x k �AAj, A.i1 0 e� f- `/joA 4 ^ ol + qy p R\ ` r•Y 0' x: 4 u , i! al t ` f r 11nn y M c. �q F �r. 1: n p. k ;k NNOTICh An As Built Survey must be submitted to the Building Dept. prior to calling for a foundation inspection or anp further construction. �I F FIRE STOPPING REQVIAEK*f4T Penetrations thru rated walls and floors shall be sealed with a material capable of preventing thr: passage of flames and hot gasses when subjected to the requirements of the Test Surd epic for Rm Stope ASTM-E-814, ! t pn bite Plan, WIUSI B i e. 3 f. h� i T f P �.T i k,: 4 W R D M V!UG T V KllW fit' THC MMOING OUR1Na THE Pr or- THns wroRtc CUM DEPARTM=(r &oNo-TUM SUE AND DEPTH Jr,17WECTION 13 REWRED BEFORE THE CONCRETE IS POURED. GUIDING DEPARTMENT Town of Dw"oudh