Loading...
BP-43507SECTION ,8 -'INSPECTOR'S REVIEW/COMMENTS, 1. Date plan reviewed: 2. DENIED (see project review worksheet): Date: 3. HOLD Reason: Date: 4. HOLD subject to Zoning Board of Appeals action: Date: Comments: ITotal Permit Fee: $ �Q O C) TOTAL FEE: /,� 0. 0 G I Permit Issued to: :CTION'-10 :OFFICE(l SPECTC Less Application Fee: $25.00 Other $ Amount $ Gross Area - New Construction total sq. ft. Gross Area - Alteration total sq. ft. i,- Al L y s 2 �i �rO�/L�t�7suzw �►��w���i/� • R1 6) 7S SIC) SECTION '11 -ADDITIONAL COMMENTS/SKETCHES C eel ❑ SPECIAL PERMIT (Per 780 CMR 111.13) $25.00 APPLICATION FEE IS NON BE-FUINDABLE 8 NON-TBANSFEBABLE urn i cv��� i , v�.-i.�.,y ��... _ � _ —• -• — •-----• , O.K. TO ISSUE'- SIGNATURE: BATE::' Commission Affidavit Card Sent Cut Off Follow Ups ❑ Water Card ' ❑Zonin ❑ O ❑ Planning SewerCard g ther - `Chief : Cut Off Board Cut Off ` Cut,Off . 'REQUIREStINSPECTOR'S REVIEW BEFORE "THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL „ Zonin _Review-. Signature: -- 4 Date:zoo Energy Report: Signature: Date: Fire Chief: Signature: Date: Board of Health: Signature: Date: Conservation Commission: Signature: Date: Other: Signature: 4 Dat . Brief description of work being performed. SECTION 1' SITE INFORMATION . 1.1 Property Address: j�� s2W(i �I-. Rd 1.2 Assessors Map & Lot Number: Nearest Cross Street: r c fi L-%l LA LG Rc! • Map oe Lot Subdivision Name: 1.3 Historical District ❑ Yes ❑ No Total Land Area Sq. Feet: Has application been submitted to the Historic Commission? ❑ Yes ❑ No Date: 1.4 Water Supply (MGL c40 s54): 1.5 Sewage Disposal System: ❑ Municipal ❑ Private Well ❑ Municipal ❑ On Site Disposal System ❑ CONSTRUCTION PLANS ❑ SITE PLAN ❑ ENERGY REPORT kR 2 2006�� f7CQIr1CdIT1 A 1 W U J LL O n. O U SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner Record: " CT-. - >?�e'I' Name (print) Contact Address Phone Number rized Agent: 2.2 u T-o,-rVJe�' t Name (print) Contact Add ss Phone Number SECTION 3'- CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ j Licensed Construction Supervisor. ri1ti {ti. I'cc - c5 License Number: % Address: C� 1 1 , rYl-� Expiration Date: I !(% k 6 Signature:dJyri Telephone: dif— 0 3.2 Registered Home proveme ontractor: Not Applicable ❑ you ou a Home Improvement Contractor subject to (780 CMR-6)? a Yes ❑ No _ _ If No, go to thh next section! Are you claming exemption from the requirements? D Yes ER No If Yes, submit the required affidavit! Company Name: Vni " r -j Registration Number (if none, state "none"): Address: `F r Signature: , Telephone: Expiration Date: 3.3 For Residential R model Wo, my 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 s ❑ 1 am a Homeowner performing all the work myself. Owners Name (print): Signature: By signing the above, the homeowner acknowledges that there will be no eligibility 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 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 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 NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any licensed Construction Supervisor- whether or not thev have taken tha ns rmit nra rasnnncihla fnr nnria cmminlinnca tcaa Annanriiv of 7Rn r'.l\AP PI; 9 1 Fl SECTION 4'- WORKER'S COMPENSATION INSURANCE AFFIDAVIT (MGL c 152 § 25) Worker's Compensation Insurance Affidavit must be completed and submitted with this application. Failure to this /ovide affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: E Yes ❑ No SECTION 5'-DESCRIPTION OF PROPOSED WORK (Check all applicable) ; ❑ Deck ❑ Pool ❑ Renairs ❑ Alteration ❑ Chimney/Fireplace ❑ Woodstove/Pellet Stove ❑ New Construction* fi7 Accesso Bldg. ❑ Roofing/Siding /Sidin ry g g g ❑Other (Energy report required) (Shed/Garage) F© LmdC77-tort (Specify below) ❑ Addition ❑ Replacement window/door ❑ Demolition (Energy report required) No. of windows _ Doors _ (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 ❑ 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 ❑ Air conditioning - (separate unit) ❑ None of the above to be provided ❑ Hot Water: Gas Electric Fuel Oil Other Description of proposed work: C-Tryd r SECTION 6 = ESTIMATED CONSTRUCTION COST Item Estimated Cost ($) to be completed by permit applicant 1. Building — 0 2. Electrical 3. Plumbing 4. Mechanical (HVAC) 5. Total= (1 +2+3+4) k : , SECTIO A - OWNER` AUTHORIZATION' (to be completed when owners agent or contractor applies for building"permit ) (Ploe int) l P I, , C , as Owner of the subject property hereby authorize `zN1f7T?A/C/9 to on my matters relati a to work authorized by this building permit application. �,Ialt�ll r3 A k Si b na ure of ner Date SECTION 76 = OWNER/AUTHORIZED AGENT DECLARATION , = I, rX C_ fcS , as Owner/Authorized Agent hereby declare that the statements and information on the fore rig plication are true and accurate, to the best of my knowledge and belief. SignedM a ,d en I ies f perjury. � Q � a Signature of Owne Authorized g t Dat Ni 1� 1� y. J�zJ�yf• ' �i:l rho ^�st r F Ttli;N�s�[•,, , i. ♦ / �.. � r ��'�MJ`�a rt h�� �'�7`E.rb�.lF.rw'-,k5+�� �sS I. ♦ f „t' ?t t ` + i S '"�ii t�( 1 c�, Kr+'ti 1�•rYry'..Rt> _..,`t4 fs TIC it f `�''+� f NG a �?,ry 4q T • • • H � �"k � a. •� ; { t. ": � r7M `�' � � }j r rrf"•'���t � 'xt �a„ � s h'�t, t' �v Yr` �x ,, � • � yr„yt Tr %�.,�y {r�rtlrT}> �'�1T�^" r{ � $S$ +�sfgt �a'S1°y_rn5�n1� m., •stl�.;.��iJuy t • {'Y fi t,i,�+'. �+"r rid.+. y'r7' ra at-+'�,��i, �#n� �v,�'''xs�i ' "`tt"cr Aa � �� �^:�r i �xx �j "r y� r #'r#'! y �Yx) l # •'� 1� v.•; S p 7.hY � 1�t ..yy�� r4°4S ^ 7E4A i�{P f {P I(ySj •k �'1F3Vrir •'y -rt4 }�r vn� r� (� t3F `y�. '�`•jq {ai�•+•c>Q �'� �}�'��,tif • • � a df tYj"rf�rr }4ryr,, lro f� h.'�'(f£F {s fr�„+r t��� 13•,✓7«1T � { tr r < s �+ {ra: b�C` <L,N�r"e1YtFrr�-•' ^•�` .. �^'rr. ht+_. �," � � �}k,��t"� Nj •,^ip i jr ,��. �s a � t.r.:�— � n+t 4 JIr rc'"! r _ • ��Flti f � \ wi u S, 7 �a r.{ y. 1 t Yfi � � ... — �. rvl �i r oq O n{� t.rrr�, t — — � — w...��.r...r 4125•bY�#§�,i �tGrr Nt�ti �u .•v.-... ''�N ra F�(°A.i 36�f s# — • .. +i — — �'_MTi ; a 1Si:,LH"r'° y �+r; i •}2.. ,t �, Fa-IAYrt? � <.eR afyT �aSnd 4. �Z r . . � a"A °h ii; a�.^ ✓ r'X"or<a.a •a. hi .. War ��?,`99 f3Ss a � �!r"m t ^�i s ('�f J .. •. t� tjl f.r�f,#„W f�,+C�p .y?�•� •..qs�",�h va!1. 1•.;:SI,...:i4j+{. r:k_ w� `# r • • • 1 IAky+ev 7Fi#t iti`7 REMAINS 1� FOUNDATION !� •:v,ilrke',t;a; ryi, i.. 'tin a3 i�i-. ! • f �{ ui<a�y � y�# {ftx � J tar?rt� "eta) ss 4`• d +� � j4 •.i � i �tr�} � t • • 1 •• k° �sd<x" • � ,w p � tt•;. • a�nysn'Sr fi 7 . • J�.4!'•�;;,,•r; }r, s7t�tt� •e / , � � r a�'ti1�;s'4 v: ' t•rr Y.���;+ 4 5}��. � � r < ' ff4 tv<�S}trtx: u• — � '>M ^,fir I rr'g. ri ryt • • ¢ifl t✓ ., \ #��,�ryyi"�M wI • ~�� •t�tLl�rrr 7_'yf;; .• ref, d r,•'t.'3 • F}aaMlJrlr �ry4�i+#eil� �•� • { t'" � j � s'•iiS# r - � tt�rF^%6ti ati r 1 • �r 7 �• 9' 6• 4L6• 6T•0' 25LV �LRE OF STGIE ROWA" C.W `/ LFC OF FWMl9 AR/i7G - _ _ _ � — 717P OF f01,4bA110N 67A2 h b 6w 6w 4+-2• 4%-2' t eoT mA in n Cr E0A2 FOUNDATION EAST ELEVATION — 4 FOUNDATION NORTH ELEVATION e01•0• — — 70P OrF 110AT10N ,,mPd I In EOf. OF 1 OOTIM N. WA2 FOUNDATION WEST ELEVATION FOUNDATION SOUTH ELEVATION IMP Or w m e2v. 4".15 TOP Cr rctmmT011 0". SIA2 P-4• FOUNDATION DETAIL 7 e• FOUNDATION PLAN RLE O W1SE•SURMA•10NES - ARCHITECPS 24 CENTRE STREET NEW BEDFORD. MA 02740 TELEPHONE (5M) 997-iM FAX M) 9974M CONSULTANTS ADDITIONS AND ALTMIIONS FOR MRY F01H AND JADE TUCK2" Ill SLADE'S CORNER ROAD SOUTH DARTMOUTH, MA TITLE BARN AND POOL HOUSE SCALE: 1/9" = r-0" DATE: MARCH 13, 2006 DRAWN.CTW REVISED: u7;7:\:I�:CH2L1 •i: a•7