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BP-324-96soart�crt tvic is & PRIMARy FUEL _ 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) I = HVAC (combined unit) Primary fuel, natural gas, propane, electricity, other (specify) Air conditioning - (separate unit) I� _ None of the above to be provided I Hot Water Gas Electric Fuel Oil Other 900 SPRINKLERS FOR STRUC TURES OV ER ER 7500 SQ UARE ARE FEET and certain multifamily Q mrly . residential Required, plans provided, —plans not provided, why? Not required. not to be instalIed.'Whv'? 1000 REQUIRED OFF-STREET PARKING - for ZONING & ArchitecturaI Access NOT TPLICABLE = Parl:inz Plan submitted To = Building Department = Planning Board Date submitted Number of spaces indoors outside tots, provided Iiandicap spaces re -wired i ves _no. If }es. how many' as a part of the total required number. Is Route 6 (State Road) Entrance permit required? yes no _. If ves has it been issued yes = no Submit copy of application and/or permit as soon as available. 1100 IDFN I'IFIC:%,TTON t print or type except as noted) Current OR address ��cr�,.�.� vv ��-c,�.-�-��c..'' 1��• ,� � � �� phone = Z 2,0 Z If corporation. officer in charge ArchitectTngmeer for overall design C'ompanv name Address Phone number Certified by State of Massachusetts as Certification number NOTE Signatures and seals on all oians, affidavits and other documents SHALL BE originals and not reproductions. Architec ngineer proica super -vision and reports Company name Address Phone number Certified by State of Massachusetts as Certification number . NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not reproductions. General Contractor (if Homeowner, state homeowner here then complete section 1300) Compan i Address Phone number 9 % ^ Li 3 3 Construction Supervisors license number C— d NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not reproductions. s#s�sszs#xxzs3zszzzzzz#zsxzzzzz##zz#zzszzz#z#zsz#z##se###s.ssss#:rs#s###ssssa:#s#ss#s#z#zz#xzszszsszszsss 1200 FOR RESIDENTIAL REMODEL WORK ONLY Are you a Home Improvement Contractor subject to (780CMR - 6) ? Yes _ No _ If no go to next section? Are you claiming exemption from the requirement? Yes _No _If yes, submit the required affidavit! Remodel contractor name lease print) Address Registration number (if none state "none") Phone number PERSONS CONTRACTING «KITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTEE FUND'. QUESTIONS OR COMPLAINTS call or write: Home Improvement Contractors Registration One Ashburton Place - Room 1301 Boston. -MA 02108 (617) 727-8598 Owners name (print) Signature Date 1300 OWNER SIGN - OFF I, the undersigned, am the owner of record or authorized lessee (provide documentation) and I have reviewed the application herein submitted. I state that to the best of my knowledge and belief that the information provided in this application is true and correct and that the permit requested be issued. Further I understand that the permit will expire in six months, from the date of issue, if no work is begun or six months after the last inspection if work has begun and that the permit may be extended for six months if no wort: is anticipated if I request such an extension in writing. I understand that the permit may be extended only three times by written request. I understand that once the permit expires a new application may be required, including fees and current other requirements (including Zoning), Name Signature The above signature is my voluntary act and is signed under the pains and penalties of perjury. Date 0 �i'ho is authorized to pickup the pe it at the Building Department? 1piease printl =jtn,Q'�n Address �r:crr�ot1 . a,S, ctP,aK _ Phone 2 cf 3 2 1400 HOMEOWNER EXEMPTION ONE & TWO FAMILY ONLY FOR HOME ONiNNERS WHO INTEND TO PERFORl11 AND BE RESPONSIBLE FOR THEIR OWN PROJECT 109.1.1 Licensing of Construction Supervisors: Except for those structures governed by Construction Control I j in Section 127.0, 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 Home Owner performing work for which a Building Permit is required shall be exempt from the provisions of this section: provides that if a Home Owner engages a personks) for hire to do such work ,that such Home Owner shall act as supervisor. For the purposes of this section oah•, a'Home Ownt:r" is defined as follows: Person(s) who owns a parcel of land on which he: she resides or inwixds to reside. on which there is, or is intended to be. a one or two family dwelling, attached ,7rdet2ched structures accessory to such use and/or farm structures. A person who constructs more than one home in two-vear period shall not be considered a Home Owner. If you are applying under this section sign below: `&nature your signature carries certain responsibilities. including but not necessarily limited to, general liability ............ d�'I'ICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that anv igensed Construction Supervisor. whether or not they have taken the permit are responsible for code compliance. (see of section 1 �z�:sszszzzzzzzssszszsssszsssssxszsssssszsssssszssssssszsss:ssssssszsssssssssszssssssssssasszzszzssssss. ii-oo COST Cost of Improvement 5 & 0.. Items to be installed but not included in the above cost: Electrical 5 !� b Plumbing HVAC Other I TOTAL , $ 1-hy following section for official use only. i INSPECTORS, RmEW Date plan reviewed 30 days to review period expires OK :o issue date _ Atteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration required.` Demolition -'describe structure Number of dwelling units Number of bedrooms A separate Refuse Disposal Declaration required. = Moving - (Provide copy of D.P.W. moving license) Type of structure from where (plat/lot or address) to where (plat/lot or address) Number of dwelling units Number of bedrooms per dwelling unit = Re -roofing - (for existing only, -is included in new construction) Number of square feet Number of layers already existing Number of lavers when complete A separate disposal declaration REQUIRED _ Replacement doors and windows - (for existing only) (only where doors and windows exist and will not be enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelling will be considered as an .alteration. otherwise will be included in new construction. (see Code section 3401.10 for residential and article 8 for commercial) Temporary structure - includes when allowed. trailers, tents and the like and only for limited periods of time. Describe 500 CONSTRUCTION PLANS A nP A1/ None submitted. Whv`' Al aw Submitted. usually three sets required.- Four sets for food servicetuses. Number of sets submitted 600 SITE PLAN Mot required, why? Submitted When! - Previously, date With this application 700 UTILITIES Water supply - required yes no, public . � yes _ no, on site well. yes existing? VeS no If required and not existing have necessary permits been issued? no _ yes. date (1I.G.L. Chapter 40, section 54 provides that no building permit may be issued unless a water supply, when required, is available. See Code 780 CMR section 114.1.2) Sewage disposal - required ® yes no. public sewer o Yes no private septic - on -site V yes no. Submit copy of permit as soon as available. Woodstove - used (will require inspection prior to installation), new (provide manufacturers instructions). Location(s) (list) Fireplace(s) - (includes flue) List location(s) = Game Court -describe (include overall dimensions) = Tent, Trailer (Mobile Home) or Other - describe_d/_ 300 COMMERCIAL - PROPOSED PROJECT/USE - INCLUDING THREE FAMILY OR MORE AND EXEMPT USES = THIS SECTION NOT APPLICABLE (The following descriptions are based on the Massachusetts State Building Code Article 3, AS NOTED) (See the Code) Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe _ Business - office, assembly with less than 50 occupants - indicate Medical or other professional see Code Section 303.0) i i = Educational structure for training including child daycare for those over 2 years 9 months (see Code Section 304.0) Factory i Industrial (see Code Section 305.0) = High Hazard (see Code Section 306.0) _ InstitutionaI - hospital, nursing home, infant day care (see Code Section 307.0) - Mercantile - retail stores (see Code 308.0) _ Residential - three or more family, hotel (see Code Section 309.0) - Storage - includes garages (see Code Section 309.0) _ Utility & Nliscellaneous Structures includes tents and agricultural structures (see Code Section 311.0) New tenant for any of the above, indicate above (see Code Section 119.0 and Zoning By-law section 35) Tent or Trailer - temporary purpose? Other Describe the proposal briefly, INCLUDE number ofdwelling units and bedrooms or occupant load as applicable, also existing condition 400 ',TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED New Construction and/or Addition - total gross square feet (For commercial only total gross cubic feet) - indicate It will be considered new construction if there an increase in square footage in addition to any alteration(s). If project is an addition to existing structure - Total gross square feet of existing = FOR COMMERCIAL ONLY Will this project be subject to CONSTRUCTION CONTROL (over 35,000 cu.ft.) Yes No. (If yes see Code section 127.0). _Designer to submit Code Synopsis. Will this project require Peer review (over 400,000 cu.ft.) Yes ' No (see Code Appendix 1) CANT TO PRO - APPLICANT VIDE OK to issue subject to requested submittals (see project review worksheet) date DENIED see project review worksheet date HOLD reason date HOLD Subject to Zoning Board of Appeals action Comments Inspectors signature Date Applicant informed of above - Date ' time staff (fax, phone, in person) zazxzzzzzzzzszz:zszxz:zszzzzsszzzszsz*xzzszzzzzzzzzzzzzszzzsssssszsssssssssss:::s:s:sss:ss::zzzzszzsszzzzz Over six months since approved for issue - DEEMED abandoned! Advise applicant. Hold 90 days for return then dispose if not picked up. Inspector Date Advised applicant Date Time staff (by phone, fax or in person) mzzzzsmzzzzzzzzzzmszzzxzssmssszszzzzzzszsz*sszssz:zzzzs*zsssssssszzzsssssssssszzszzzzzszzzzzzzzszzzzsszm OFFICEUNSPECTORS NOTES TOTAL FEE Gross area - new construction Total Sq. Ft. alteration - Total Sq. Ft. , Permit is issued to Comments/notes on permit - w t � 1600TO 7`IiEAppLIG4NTMZVEBBAL AND 1PMOVAL --- Date of Application submission Plat Lot Street Aquifer Zone Owner , Owner mail address Owner phone # - 7 0 =iiz:ziiiziiziiiilsisi!!tili!=fist#i=sisiiii=fisisiiisfi#ii#!f#!#ii!lisissiiiifff!##iff##Hiss!!=fsliiisz OTIIEit INVOLVED AGEVCIES -The following agencies require separate jurisdictional permits or approval for Your proposed project. CONTACT TREM FOR REOIITRE I MEMISSIONS. ®TAX COLLECTOR = Approved = HOLD By . ` f.. . Date / C Conservation Comm _ Approved By Date Q D . P. LV. water - Approved By Date CI D.P.W. sewer - Approved Bv Date 7 D.P.W. cross connection = Approved `Date ❑ D.P.W. engineering Approved - Dace Q Board of Health well = Approved Date 0-arL: of Health septic 7Approved Date u Buar d of Health food service = Approved — g ?IRE DISTRI CJ�ell) Date. A - pproved Date Planning Dent _ Approved - Date Approved Date Approved Date C,,rn^,en Ls ___=====s=====____=====iis=====_______=====s Prnlect summary new construction/ alterntionidemo sewage disposal - public,private [Alter -,add interior wallsi [add rooms/ [add footprind water supply - public private well (pooii jgarzze.,shedl [game court] [food service/ Descmbe , �i✓ .................. I-o the %arious departments: This notice has been forwarded to you for your information and any appropriate action. Should you have any [uesdons please advise. If any reason to withhold the requested permit is found. please advise. Your assistance and cooerstion is appreciated. he Building Department Date sent for review "� •-�� By �:D 'TOWN OF DARTMOUTH BUILDING DEPARTMENT TELEPHONE 508-999-0720 FAX 508-999-0738 fief: :' APPLICATION FOR ZONING AND ` _ v.I , G PERMIT U j 1fl i - The applicant shall complete this application to the best of their ability prior to submissuinAeaving no item 'manswered. The ._ Department staff will he available Burins regular business hours to assist as necessary. NIA should be inserted for those sections which do ant 2ppiV. A properly completed application will help avoid unnecessary ddays. Nn&= FW=g fee s x=t (for office use only) h Application fee S ®1r=ctived by � Date ✓� `"„/ � - Totai Permit Fee S Permit # 100 LOCATION OF PROJECT CURRENT ACCESSORS' PLAT LOT ZONING DISTRICT OTHER ZONING OVERLAY DISTRICT'S ,..if applicable F. NUMBER & STREET i ke-0- Ile NE. -!.REST CROSS STREETi- SUBDIVISION NAME & LOT # or BUSINESS NAME PREVIOUS TENANT ; O«TIER � I .00 RESIDENTIAL - PROPOSED PROJECT - one & two family residence only THISSSSECTION NOT APPLICABLE "Sinule family number bedrooms number baths Two famih• - number bedrooms unit 1 number baths unit 1 number bedrooms unit ' number baths unit Z - - - Accessory apartment Total gross sq. ft.. _ .accessory structure Garage - detached attached to dwelling, dimensions L W Carport detached - attached to dwelling, dimensions L W - Shed - dimensions ; L W Gazebo - dimensions L W _ Swimming pool above ground in -ground Size total square feet = Chimney # of flues