BP-40207RESIDENTIAL
RESIDENTIAL
FOUNDATION 0 YLY
1. Date plan reviewed:
2. DENIED (see project review
worksheet):
3. HOLD
reason:
Date:
Date:
' Total. Permit Fee: $_ZQ c O a I Less Application Fee: $ 25.00 I Remaining Balance: Ste . o 6
TOTAL FEE: /a G . 00 Gross Area -New Construction total sq. ft.
Gross Area - Alteration total sq. ft._
Permit Issued To�0 c) & V /2 Ti d n/ d .V C S/ JA/ A C G o ef /J /f n.r G /r Aftl T Al > �Q
Chi/7 m/7-CC $%Arz X U/c /7 lw 9 Gn✓� e'
$25.00 APPLICATION FEE MNON-REFUNDABLE & NON -TRANSFERABLE
''- DARTMOUTH BUILDING DEPARTMENT''0,pp=,
f pr
�j(y,l 400 Slocum Road, P.O. Box 79399y JUL j,r
\:F Dartmouth, MA 02747 "��
508-910-1820 FAX 508-910-1838
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
Zoning Review: Signature: C%a DatjUL 1
Energy Report: Signature:Q Date:
Fire Chief: Signature: Date: "!
Board of Health: Signature: Date:
Conservation Commission: Signature: Dater
Other: Signature:_ Date:
Description of work being performed: --
NUMBER OF PLANS SUBMITTED: SITE PLAN SUBMITTED: ❑ yes -_ ❑ no 1
L
l 1.2 Assessors Map Lot Number:
1.1n Property Address: �C eo.Je zc-(—V-k(-*—
Ma Lot -
Nearest Cross Street: 01 v 1 J 1 o' o
Subdivision Name: 1.3 Historical District ❑ yes ❑ ne
Total Land Area Sq. Ft.: Has application been submitted to the Historic Conunission?
❑ yes ❑ no Date:
1.4 Water Supply MGL c 40 § 54): 1.5 Sewage Disposal System:
PYIVC#.Ve, lti ✓lva7'� s ric
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RESIDENTIAL
PR
2.1 Owner Iof Record:
Name (print) go, Contact Address (V o �u i ,., o ,� MeonNumber
2.2 Authorized Agent:
�a
Name (print) Contact Address Phone Number
ucON SERVT&S�
Ti V
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor Do vna-- C,k Cn License Number O ZO 7
Address 7 �GY LM_1e n/o Do, F ^^ow� Expiration Date
Signature TelephoneSOF 96j S y5"$ J� - / 3 - Z o U-
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
PEIkSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND:
QUESTIONS OR COMPLAINTS call or write: -
t Home Improvement Contractors Registration, One Ashburton Place - Room 1301, Boston, MA 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 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 ofbuildings
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 ifa 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 certain responsibilities, including but not necessarily limited to, general liability
RESIDENTIAL
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)
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 ❑
n
0
❑ 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 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
13 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):
El HVAC (combined unit) - primary fuel, natural gas, propane, electricity, other (specify):
Air conditioning - (separate unit)
11 None of the above to be provided -
Hot Water: Gas Electric Fuel Oil Other
Brief Description of Proposed Work: ,
Item Estimated Cost ($) to be completed by permit applicant
1. Building- - - -
15. Total = (1 + 2 + 3 + 4) I *Estimated Total $ I
000
(please print)
1, , 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
1, NI/0 uee J /C 5C � en, C.-, 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.
SLder the pai an enaltie of perjury
Oofwe Authorized .
Agent Date
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Page 3
Rev. January 2005
BARRY
R.
McGE9
N4.34606
�i
R-40.00
V=-53*07'3
37.09,
L
R=60.00
L=74.09'
D=70'45'03"
ESTATE LOT "A"
7.22f ACRES
O 8
N ry.
� =o
J
R=60./
L=74.09'
D= �•44'29"
'Z
WELL
245.8'
F,r�S�N
�FO�kO
gTON
TOP OF FOUNDATION
EL.= 135.8
n
ESTATE LOT "B"
6.91 f ACRES
TP
PROPOSED
SEPTIC AND
RESERVE AREAS
GENERAL NOTES:
DOES NOT LIE IN A FLOOD HAZARD ZONE.
AS SHOWN ON F.I.R.M. 2500510020C.
ZONING DISTRICT: SRB
60 0 30 60 120
GRAPI fl C SCALE
(1" = 60')
Proposed House Location Plan
Prepared For
Donald Deschene
Located at
Paradise Lane
Dartmouth, Massachusetts
Date: June 24, 2005 Scale: 1" = 60'
PREPARED BY
PROFESSIONAL ENGINEERS
and LAND SURVEYORS
N S I T E 1563 Fall River Avenue
Seekonk Professional Center — suite 4
EnnineednOServices. LLC Seekonk, Massachusetts 02771
Phone: (508) 336-4500
Fax: (508) 336-4558
R=40.00
L=37.09'
Q=53'07'
60 0 30 , . , 60
TOP OF FOUNDATION 1 120
Fk/SIN EL.= 135.8
c�NogT° GRAPHIC SCALE
ESTATE LOT *A"upy
7.22f ACRES
FRI
((�fit, �!
S 8� L Ge;y at Thb Endlcmd
Flan 111411w Do Kept 0:1 CNizs
85.8
TOP OF Fn11NDA110N
4S—BUILT
DESIGN
98.0
ESTATE LOT "R"
6.91 t ACRES
5 13 43 5g„ W
245.8' / As -Built Foundation Plan
R=74.09 R=60.01 �o�NOFwPrepared For
L=74.09' a
D=70'45'03" D=70'44'29" � ��" Donald Deschene
a^ Located at
Paradise Lane
Dartmouth, Massachusetts
Date: August 15, 2005 Scale: 1" = 60'
ARADISE IVA.�EI PREPARED BY
�NIN PR PROFESSIONAL ENGINEERS
and LAND SURVEYORS
GENERAL NO N S I TE 1563 Fall River Avenue
DOES NOT LIE IN A FLOOD HAZARD ZONE. Seekonk Professional Center — suite 4
AS SHOWN ON F.I.R.M. 2500510020C. enaneerinasenices uc Seekonk, Massachusetts 02771
Phone: (508) 336-4500
ZONING DISTRICT: SRB Fax: (508) 336-4558