BP-13812RESIDENTIAL 1999
9. Inspector's Signature:
Applicant infornmelof
Comments: r l
Total Permit Fee: S
TOTAL FEE: Jrp
Permit Issued To -
?SECTiO'� � t�PPi;IC
Date:�� (r�
Gross Area - New Construction total sq. ft.
Gross Area - Alteration total sq. ft.
/7T
TSISKI
Clerk:
DE4-
I
FOUNDATIONONLY
RESIDENTIAL X
$2S.00 APPLICATIOt rEr IS NON-REFUNDABLE
DARTMOUTH BUILDING DEPARTMENT DATE RECE1vEc
^` 400 Slocum Road, P.O. Box 79399 7
Dartmouth, MA 02747 /
508-999-0720 FAX 508-999-0738
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE TWO FAMILY DWELL
DA'
'Zoning Review: Signature:
kl�nergy Report: Signature:
Fire Chief: Signature:
Board of Health: Signature:.
,Conservation Commission: Signature:
Other: Signature:.
Description of work being performed:
SECTION' 1-;>SITE I `FORITxTION
°i Date:
Date:
Date:
Date:.
Date:
Date:
199
"Nr,"n t,,rrs Hj--irr res nl— 1
RESIDENTIAL
1999
RESIDENTIAL
1999
___ _ or.c.�tvi7 �.-rtfVYEtt;Y-t1:"
2.1, Owner of Record:
MCI
Name (print)
2.2 Authorized Agent:
Name (print)
N��rN1 S�-D�aIZ�� %�R O2'1go
Soa) 95�-'706�
Contact Address Phone Number
G58 RoCkD � Axe
NFL. �E9�pR�1 M1� 02'l�0
Contact Address Phone Number
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor �� X License Number
Address
Signature Te
3.2 Registered Home Improvement Contra
g0 Expiration Date
- — 0
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 0 no
If yes, submit the
required affidavit!
Company Name
Address
Registration Number (if none, state "none")
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 .-Ishburton Place - Room 1301. Boston, .ifA 02108, /617) 727-8598
Owners Name (print)
Signature_
by sienine the above. the home owner acknowledges that there kill be no eligibiity to the Guaranty Fund
Date `
3.4 Homeowner Exemption - One R Two Family Only
FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT
109.1.1 Licensing of Construction Supen�isors: Except for those structures eovemed by Construction Control in Section 116.0. effective July 1, 1982. no individual
shall be engaged in directl} supentsing 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 entitle
Construction Supervisors. d Rules and Regulations for Licensing
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
eneages 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 heishe resides or intends to reside, on which
there is. or is intended to be. a one or rno 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.
Ifyou are apph ing under this section sign below:
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)
i ( new ❑ addition ❑ alteration
construction*
0 deck 0 pool ❑ accessory bldg.
(shed/garage)
* If new construction, please complete the following:
Single Family: no. of bedrooms
0 repairs ❑ chimney/fireplace
X�up 1a
❑ replacement window/door other at"*A
no. of windows_ doors_ (specifv below):
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):_
❑ Air conditioning - (separate unit)
❑ None of the above to be provided
o Hot Water: Gas Electric Fuel Oil Other
Brief Description of Proposed Work: �w, M 111A•c' Al t
9 ,M(v"
❑ woodstove
❑ demolition
(speciA- below):
Estimated Cost (S) to be completed by permit applicant
* Estimated Total
, as Owner of the subject property hereby authorize TA.M£S \A1c+`LL C
relative to work authorized by this building permit application.
Date
I• K6S5��j� 'c, ��OTLC�, 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.
Signature: Your =penalties of perjury.
our signature carries certain responsibilities. including but not necessarily limited to. general liability
Signature of Owner,,Aut orized Agent
ate
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RECEIVED
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BENCHMARK:
NAIL
ELEV 91.75 rl
I r. Pnpl!
T
cb-iyo Co
7?
243 7 P
AS —BUILT.'
I certify that the foundation
shown on this plan is
in FO UNDA TION, PLAN
compliances with the, ajbplicable
Zoning
'By—L ' aws in the;, ROLLING HILLS
Town of Dartmouth
LOT 121
Correia s Engineerirtg Inc. Dartmouth, MA.
8 Grinnell Street LAND SURVEYING
South Dartmouth, MA. Cl"L ENGINEERING prepared for
02748-2314 SUMMSIONS
Telephone(500) 996-60512 SHE PLANS Long Built Home s
Paz (508) 979-5949 AS —BUILT PLANS
Joseph E. Corr"a III pros. Joseph E. CmyeicL IV VP. Scale 1 " = 40' DEC 23,1999
_FILE # 9670202 J. E. C. III
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21' " 3'
DROP 2'2"
19'3 3'6 13
DROP 2-4"'
GARAGE
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DROP 2'
DROP 2-4"'
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24'
3068 ,
6 PANEL
DROP 4'2"
30' 18'
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FOUNDATION WALLS 3000 PSI
FOOTINGS 16"X10" \ LJSE (3) 2X6 HEADERS `f
DBL BOX ABOVE & BUILD 2X6 KNEE WALL
HANG JOISTS
BUILD 2X6 KNEE WALL
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14' 10, 14'
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W10X19 BEAM (l) PCS. (1) 46'-4' (1) 9'-8"
BEAM POCKETS I I J L J I J wH
36"X36"X12" DEEP COLUMN PADS I
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