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BP-26236IN == 1111 III=1111 SQ. IIIL= ®IIII®�111 III-1111-I�° -III HP fill n ___Hii D/F WIDE FAB TYPE EXTRUSION NOT TO SCALE LEDTO SLIP IIJ o LA R Es F� LME GAgNE T �vITH CUSTOM 3" moLr>0c� LED To �ZEMA1tJ CZI,, N X 8' W) i I 19{/l!1%lA%p ©o;.�Jal�l�JlltiU �j� g CLIENT DAB MOU N NIC�N T T SALES M G NOTES: DATE Z/II/OZ SCALE O„ DESIGNER rJDP L TPO OFFICIALPRESZNCE F �N JOB Number / TITLE 1 �I V DA MOU H, MA �T T S' GNS ORPRATEDB • ° • ;' ® :` REVISIONS 5/79/0Z .7A5 _ .. APPROVED BY DATE •s ®`, ®®®-®- ICI �, �-� 1 1 I • • • • ® • Joe"'; • � • • • ®• � d ® is \xaTE\dazc_hi9h.ca= Wednesday, Man 29, 2002 3:21:04 PM .. - composi^e�dDefault screeny� IJE\V D/F IIII rEZtJALLVj 1LLUMII�JA rED M000M50T SIC-it\�. EXT12UDED ALUM. CA5105T \V/ LEXAO FAGES AOP TRAIJSLUGEiJT viOAL C-I,FzApw)cs. DIC-I,ITAL MESSAqE; S" _ - 3 . ° • cE1JTEF- CGABIIJET pAIrJTED BLUE). io" 1-1. LE7r-F-S 8 -6 14„ BF-IGK BASE BLI OTP5-P-S, I LIIJE OF GOP�I , r it i - pMS -"00 R E I8 DARI OUTHIGH O� 3M IZ7 BLUE �_ _��— poLE SLIP covE� h 5 4 pM 66 0=1 _ IIIIIIII 6,_0„IlIiIIII _� 3„ IIII�I- E� I((E ® III IN SQ. IIII I •--a =H11 1111 IIII1111=" 6IIII II€ III=I111`--�II`�„ D/F WIDE FAB TYPE EXTRUSION NOT TO SCALE L>:P To sLlp IIJTo LARc>�AME cAB►rJET Dartmouth Building Department WITH cUSToM 3°' MOLDIrJc� L>P To (09 �EMAIIJ (ZI'° NX 8° \V)�' `�n��� This plan is endorsed as the record plan. The owner and/or applicant are responsible for MA Building Code 6`" edition compliance, not withstanding any errors or omissions in the application, plan, or accompanying documents. The owner /agent /applicant or architect/cngineer shall request inspections or submit _ reports, as may be required in a timely manner. PLAN AMENDMENTS MUST BE SUBMITTED AS POSSIBLE POYANTCLIENT DAF-TmOU•TH 1--11GI1-1 SALES C,M _ NOTES: DATE SEP 2 4 200� sy � .. ...�.._..,._. � o o a a s s t DATE Z II OZ SCALE %Z"=1'-O" DESIGNER �D _ / / THE OFFICIAL WEB PRES:NCE OF - P -. JOB Number/TITLE pA� MOU rl 1, MA POYANT SIGNS INCORPORATED. ® . _ _ ® ! __ REVISIONS 5/Z9/OZ JAS ® - - — s e _ ®®- I Tam-- - - ' � ® e ® � ®` APPROVED BY: DATE I:\NATE\dart_high..cdz III Wednesdays, May `29, 2002 3:21.04 PM - j COMMERCIAL 2002 COMMERCIAL SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Name of Construction Supervisor 4— /ro"�-;llv? C J,i111� t A;-T- License Number Address Expiration Date E;Z/ e-3 Signature Telephone .S-rffr) SECTION 4 VORKER'S COMPENSATION INSURANCE AFFIDAVIT MGLc 152 52 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 (MGL'152 Section 25A) Signed Affidavit Attached: ❑ yes ❑ no SECTION 5 - DESCRIPTION OF PROPOSED WORK check all applicable) new construction ❑ addition ❑ altercation ❑,repairs - ❑ accessory bldg. (shed/garage) other (specify Sec. 6): 0 demolition I�"gn ❑ replacement window/door no. of windows doors SECTION 6 - PROPOSED PROJECT/USE - INCLUDING THREE FAMILY OR MORE AND EXEMPT USES The,following descriptions are based on the Massachusetts State Building 6th Edition, 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 303.00) ❑ Education - structure for training including child day care for those over 2 years 9 months (see Code Section 304.0) ❑ Factory %Industrial (see Code Section 305.0) fi High Hazard - see Code Section 306.0 cw? Institutional -hospital, nursing home, infant day care (see Code Sect on 07 0) Ivlercantile'- retail stores (see Code Section 308.0) ❑Residential -three or more family, hotel (see Code Section 309.0) ❑ Storagre - includes garage (see Code Section309.0) ❑ Utility & Miscellaneous Structures - includes tents and agricultural structures (see Code Section 311.0) ❑ New Tenant - for any of the above, please indicate (see Code Section 119.0 and Zoning By -Law Section 35) ❑ Tent or Trailer - temporary purpose? ❑ Other:: Describe, the proposal briefly, INCLUDE number of dwelling units and bedrooms or occupant load as applicable, also existing :�ndition (if extra space is needed, attach an additional sheet): SECTION - 7 TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED ❑ New Construction and/or Addition (total gross cubic feet proposed) - indicate If the project is anaddition to existingstructure'- total gross square feet of existing:' ❑ Alteration of existing, no increase in gross square feet.. A separate Refuse Disposal Declaration is required. Will this project be subject to CONSTRUCTION CONTROL (over 35,000 cu. ft.) ❑ yes ❑ no If yes, see Code Section:116.0. Designer to submit Code Synopsis in addition to original plans. - Will this project require Peer Review (over 400,000 cu. ft.) ❑ yes ❑ no (see 110.1 Code '& Appendix I) APPLICANT TO PROVIDE PEER REVIEW AT THEIR EXPENSE. SEE 780 CMR. El Demolition*,- describe structure: ❑ Moving* - (provide copy of DPW moving license) * Type of structure: from where(plat/lot or address ) to where (plat/lot or address):. (P ) number of dwelling units: number of bedrooms per dwelling unit: c:\bldg. forms\bldgapp.com Page 2 rev. January 19, 2001 2002 ❑ Replacement doors and windows - (for existing only) (only where doors and windows exist and will not be enlarged EGRESSM dimensions must be maintained. Enlarged or new windows in an existing dwelling will be considered as an alteratioin, otherwise will be included in new construction. (see Code Section 3603.21 for residential and Article 10 for commercial). ❑ Temporary structure - includes, when allowed, trailers, tents and the like and only for limited periods of time. Descriibe SECTION - 8 MECHANICAL & 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): ❑ 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 SECTION - 9 SPRINKLERS AND/OR FIRE PROTECTION'" ❑ Required: plans provided plans not provided, "why? ❑ Not required, not to be installed, why? a, 4 SECTION - 10 REQUIRED OFF-STREET PARKING for Zonin and Architectural.Access ❑ Parking plan submitted to: Building Dept. Planning Board date submitted Number of spaces - indoors outside total provided Handicap spaces -required yes no if yes, how many as a part of the total required number Is Route 6 (State Road) entrance permit required? yes no if yes, has it been issued? yes 1II0 Submit copy of application and/or permit as soon as available. SECTION - 11 H)ENTIFI ATION - r ' . 11.1 Architect/Engineer - for overall design Company Name: ` Address: Plione #: Certified by State of Massachusetts as: Certification Number: Note: Signatures and seals on all 1p ans, affidavits. & other documents SHALL BE originals and not re roductli n p o s. 11.2 Architect/Engineer - project supervision and reports Company Name: Address: phone #: Certified by State of Massachusetts as: Certification Number: Note: Signatures and seals on all plans. affidavits. & other documents SHALL BE originals and not reproductiions. 11.3 General Contract Company Name: Address: (xr Phone #: Construction Supervisors License Number Note: Signatures and seals on all plans, affidavits. &, other documents SHALL BE originals and not reproductions. i, c:\bldg. forris\bldgapp.com Page 3 rev. January 19, 2001 COMMERCIAL 2002 CO10 MERCIAL 2002 $25.00 APPLICATION FEE IS NON-REFUNDABLE & NON -TRANSFERABLE SECTION - 12 ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (S) to nearest dollar. To be completed by permit applicant 1. Building 2. Electrical 3. Plumbing 4. Mechanical (HVAC) 5. Total = (1 + 2 + 3 + 4) Estimated Total Cost Including Labor: $ SECTION 13A - OWNER AUTHORIZATION to be completed when owner's agent or contractor applies for buildingpermit) (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. , s C� Signature of Owner Date - SECTION 13B-OW'NER/AUTHORIZED AGENT DECLARATION I, re,l� fCW'� , 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. . Signe i er the p ns and pe hies ' , Id 7 d 7— Si dtti-reof 0 ner/Agent 42 Date SECTION 14 - INSPECTOR'S REVIEW'/COIINIENTS 1. Date plan reviewed: 5. DENIED (see project review worksheet): 2. 30 days to review period expires: Date: 3. OK to issue date: , SEP 2 4 2nn 6. HOLD reason: 4. " OK to issue subject to requested submittals (see project bate: review worksheet): Date: 7. HOLD subject to Zoning Board of Appeals action: S. Comments: 9. Inspector"s Signature: Date: o 02 SE Ti N 15 - APPLICANT NOTIFICATION Applicant informed of above Comments: Date: Time: Clerk: SECTION 16 - FEE/PERNIIT NOTES Total Permit Fee Less Application Fee: $ 25.00 "Remaining Balance: Gross Area - New Constructiony Gross Area - Alteration Permit Issued To: DARTMOUTH BUILDING DEPARTMENT DATE RECEIVED - 400 Slocum Road, P.O. Box 79399 Dartmouth, MA 02747 508-910-1820 FAX 508-910-1838 APPLICATION TO CONSTRUCT, EPAIR, RENOVATE OR DEt\IOLISH A COMDIERCIAL BUILDING (includes 3 or more familyadwellings) THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: , BUILDING PERMIT NUMB R: DATE SENT FOR REVIEW: DATE ISSUED: ^�Jr r OIL TO ISSUE - SIGNATURE: DATE: W2 4--`- 2002 ' Building Commisser/Inspector of Buildings Zoning District: Proposed Use: Zone: ❑ C ❑ B ❑ A ❑ V Aquifer Zone THE FOLLOWING AGENCIES SHOULD BE NOTIFIED: ElBoard of ❑ Board of 0 Con. ❑ Demo ❑ DPW ❑ Elec. ❑ Energy Report Appeals Health Com. Affidavit Card Sent Cut Off Follow-up* ❑'Fire ElGas ❑ Planning ❑ Sewer Card ❑ Water Card ❑ Water Division ❑ Zoning 01 Other Chief Cut Off Board* / Cut Off / Cut Off Cross Connection Review* * REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT L APPROVAL a2-- ZomnR Review: Sign t t Energy Report: Signature: Date: Fire Chief: Signature: Date: Board of Health: Signature: Date: Conservation Commission: ' Signature: Date: Other: Sic -mature: Date: Description of Work Being Performed: SECTION 1 - SITE INFORMATION 1.I \UMBER OF PLA\S SUBMITTED: 1.2 SITE PLAN SUBMITTED: ❑-yes ❑ no / 1.3 Property Address: $S$- . �Jr41��yyf'IQ {�t 1.4 Assessors Plat & Lot Number: . Nearest Cross Street: Bits. Name:-Dml r A 41h Phone#q6Ja_7UQ Plat- Lot Total Land area Sq. Ft.: 1.5 Water Supply (NIGL c 40 § 54): 1.6 Sewage Disposal System: El i%lunicipal ElPrivate Well ElMunicipal ❑ On Site Disposal System SECTION 2 - PROPERTY OWNERSHIP / AUTHORIZED AGENT 2.1 Owner of Record: ` —DA4wwSA14 ��, ��d ` S --?IArkRrv`• 6 `Z76 Name (print) Contact Address Telephone 2.2 Authorized Aeelit: c J( ((4c, 64YAW1 Name (print Contact Address 'Telephone c:Abidg. forms\b1dgapp.com Page 4 rev. January 19'. 2001 c:Abldg. lomis'.bltlg.ipp.roui . ��" 6rJ Page I rev. January 19, 2001