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BP-25160SECTION 8 - INSPE TOR'S REVIEW/COMMENTS 1. Date plan reviewed: 2. 30 days to review period expires: 3. OK to issue date: 4. OK to issue subject to requested subtnittals(see project review worksheet): Date: 5. DENIED (see project revieN xorkshcet): Date: 6. HOLD reason: Date: 7. HOLD subject to Zoning Board of Appeals action: Date: S. Comments: 9. Inspector's Signature: Date: i SECTION -A PL T NOTIFICATION Applicant inforruedof above Date: U Time: Clerk: Comments: SECTION 10- OFFICEVNSPECTOR'S NOTES 2 Total Permit Fee: S 1,30. J( Less Application Fee: S 25.00 Remaining Balance: S TOTAL FEE: J3v 00 Gross Area - New Construction total sq. ft. 0Z Gross sAArea - Alteration total sq. ft. Permit Issued To•? SECTION 11 - ADDITIONAL COMMENTS/SKETCHES 130, C^.bIdg.torms'�.BId,_app.res.wpd Pace 4 Rev. Jamiary 19. 2001 i L1 PUUI UAIIUl lVLY $25.00 APPLICATION FEE IS NON-REFUNDABLE & NON -TRANSFERABLE - -- .. DATE RECEIVED DARTMOUTH BUILDING DEPARTMENT 400 SlocumRoad, P.O. Box. 79 399 y_ ,Dartmouth, MA 02747• .. , 508-910-1820 FAX 508-910-1838 t APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: BUILDING PERMIT DATE SENT FOR REVIEW: NUMBER: DATE ISSUED• OK TO ISSUE SIGNATURE: 2 DATE 7,,; Building Co ssioner/Inspe "tor of)euild' gs Zoning District: roposed Use: Zone: C ❑ -B ❑ V Outside Flood Zone- ❑ Aquifer Zone THE FOLLOWING AGENCIES` SHOULD BE NOTIFIED.- 0 Board of ❑ Board of ❑Con. Com. ❑ Demo ❑ DPW ❑ Elec. ❑ Energy Report Appeals Health Affidavit Card Sent: Cut Off Follow-up* ❑ Fire ❑ Gas ❑ Planning Board* ❑ Sewer Card ❑ Water Card ❑ Zoning ❑ Other Chief Cut Off / Cut Off / Cut Off Review* * REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL Zoning Review: Signature: Date: �J Date: / o ' Energy Report: LO Signature: Fire Chief: Signature: Date: mN .. 1 S 0 Board of Health: Signature: Date: Conservation Commission: Signature: v V Date: Other: Signature: Date: Description of work bein; performed: C. SECTION 1 - SITE INFORMATION NUMBER OF PLANS SUBMITTED: 3 SITE PLAN SUBMITTED: ❑ yes ❑ no - n 1.1 Property Address: Ills ROA, 1.2 Assessors Plat &-* of Number: Plat Lot - Nearest Cross Street: 1.3 Historical District ❑ yes Ano Subdivision Name: Has application been submitted to the Historic Commission? Total Land Area Sq. Ft.: ❑ yes ❑ no Date: 1.4 Water Supply (MGL c 40 § 54): 1.5 Sewage Disposal System: I<Municipal❑ Private Well ❑ Municipal XOn Site Disposal System 0 C:`bluc.torms,B;�uapp.res.�cpd Page I Rev. January 19, 2001 RESIDENTIAL 2002 SECTION 2 - PROPERTY OWNERSHIP AUTHORIZED AGENT 2.1 Owner of Record: ,)ayes >yY1`"Pi c, ?(,C,.A+ w.Ar CIC10 - 3s I ► Name (print) Contact Address Phone Number 2.2 Authorized At-,ent: Name (print) Contact Address Phone Number SECTION 3 - CONSTRUCTTON SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor 7 t'=---T icense Number Address _ xpiration Date Signature 1 �.2 Registered Home Improvement Contractor: Not Applicable ❑ Are you a Home Improvement Contractor subject to (780 R-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 { ERSONS 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, AIA 02108, (617) 727-8598 gi Owners Name (print) 'M� ` XA44--;M Signature by signing t above, th ome cner acknowledges that there will be no eligibilty to the Guaranty Fund Date 4S�: 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 forthose 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 Nvith 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 beloN Signature: our signature carries c ain respo i rties, including but not necessarily limited to, general liability RESIDENTIAL 2002 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) SECTION 4 - WORKER'S COMPENSATION INSURANCE AFFIDAVIT (MGL c-152 § 25) - 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 SECTION 5 - DESCRIPTION OF PROPOSED WORK (check all applicable) ❑ new construction* �ddition ❑ 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 bedrooms no. of baths Two Family: no. of bedrooms unit 1 no. of baths unit I 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): ❑ Air conditioning - (separate unit) ❑ None of the above to be provided ❑ Hot Water: Gas Electric Fuel Oil Other Brief Description of Proposed Work: ovA- I(.1.� s, W1�SEc.I 10a SECTION - 6 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost ($) to be completed by permit applicant 1. Building 2, Electrical 3. Phtmbin 4. Mechanical HVAC 5. Total = (I + 2 + 3 + 4) * Estimated Total $ a .OV SECTION 7A - OWNER AUTHORIZATION (to be completed when owner's agent or contractor applies for building permit) (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 SECTION 7B - OWNER/AUTHORIZED AGENT DECLARATION `- I, 3gmes (2-pt2�A�f'4�tL , 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. 7A/64. , Signa re of OwnerA thorizedAge Date C:=bldg.fonns\13ldgapp.res.wpd Page 2 Rev. January 19. 2001 C:AbldL,.fonns\R1d1,nnn row —d D--- , EXISTING HOU' NEW DOOR EN MASTER BEDR NEW WALK-IN NEW 2X8 DOR RAFTERS AND STRUCTURAL JOIST TO BE SIZED BY GENERAL CONTRACTOR EXISTING 2X' WOOD GARA( WALLS roc;► o !��vJ �.V,�; s aQ� U��,c, i��,� >J�" �.v; L,is 4-I 1 STALL 9E Sz �AjF('. os . vg1. GARAGE SECTION 1 I2T,VY I Hsi Till' �Iw SCALE 3/16"=1'-0" 60137004S 1-D TVif Snit t "601L MY W 2X6 r�,_ 2X fERIOR WALL FORAGE AREA rl into h — '' 1 s D.R. FREDERICK M. N U LAW y 1 24405 �o ISTt;��� ',��QNAt ENG NEW SKYLIGHT T.O.W. TO HOU i CV -H 00 �t- Dr. Frederick M. Law I . E. Structural Enineer Zi Swift Road So. Dartmouth, Mass. 02748 �" wsi I.­)o PRATT RESIDENCE SO.DARTMOUTH, MA I SECTION AND PLAN PRA M I y�rrick Pe meY'S cel ( Ip' FIGS COPY PRATT DORMER ADDITION &RENOVATION 165 ROCK O'DUNDEE ROAD, SO. DARTMOUTH, MA gas 5uz vw&. Foss Samv> ENLARGED PLAN SCALE 1/4"=1'-0" Ile L.,VL., @_Ie0,(, RAL JOIST TO EXISTING fRUCTURAL JOIST 2Efl-BY @FFf9 9;OR T-790 TD bkCK RIDGE BOARD DORMER FRAMING (�?jl O.G ; NEW BATHROOM WINDOW 21'-9"t i NEW DORMER ADDITION i 00 T J� Y �J j T T iT r J II r� r J Y EXISTING GARAGE T-T � J J �' >� I�71 II r 14 1 DORMER ELEVATION PRATT RESIDENCE SCALE 1 /4"=1'-O" SO.DARTMOUTH, MA DORMER ELEVATION PRATT.dwg ADS cro.k.e: Y D"`06 ,9 02 A-2 SAS NOTED I � J J �� J� T —LJ �-2i-JjjjJ-8j i I MAIN HOUSE ��. !Y 'Jr ® r ��r l NEWDORMER I I f TVFJTF ray ADDITION -i 71 �j r J _•JJ i _JT �� —L li ��7 EXISTING GARAGE Ali FT �I SIDE ELEVATION PRATT SCALE 1/4°.1'-0" RESIDENCE SO. DARTMOUTH, MA SIDE ELEVATIONS PRATT4wg ADS Lbe6 E: K 7-06/19/02 A-2' 1 AS NOTE [0 BATHROOM ELEVATIONS SCAL _ 318"=l'-0" EXISTING NEW DOC MASTER E INTO NEW NEW 2X6 RAFTERS ALL INWI R-VALUE! MEET 5V LOCAL C NEW SNEL 5Y5TEM STEP UP MASTER 5EDRO0 5ATN STR CTUF JOIST TO SIZED 51 GENERAL CONTRA( EXISTING WOOD GARAGE WALLS NEW DORMER SHINGLE TO Mr EXISTING NEW DORMER ADDITION 2X6 CONSTRUCTIOIS T.O.W. TO NOU& NEW 2X(o INTERIOR F 1 COP) WALL 16"O.C. STORAGE M00 AREA 5/8" TYPE X SNEETROCK 0V�,) 2-1�Ik <1 L,VI - t 7� z. LA, C,WAYE VQ ?� �;►J�vJ LVL;S hR� GQOLIA! LVLtCA d`(' vsSJa,St (.-A osTALL! P'LZ. MS( • RE COO 4t,Jatlia)b. GARAGE SECTION FREDERECI( M. 1 ALE 3/16"=1'-0" LAW TT 1JU DCP-liC� ►�ti►JC� go"'-go"'-'�,�24T A&Q v, -TO Tel SYi3U1LTJ11J" C vc , ��SE�� Dr. Frederick M. Law P. E. L _ Structural Engineer / Swift Road So. Dartmouth, Mass. 02748 DORMER FRAMING ELEVATION SCALE 3/16"=1'-0" CLOSET PLAN SCALE 3/16"=1'-0"