BP-166001
V1200�3
4
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i
srietratiorts thru rated walls and floors shall bo
scaled with a material capable of preventing the
oWassage of flames and hot gasses when subjected
fithe requirements of the Test Standard specific
r Fire Stops ASTM-E-814.
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13:liit ':l: vey must be
Nil:.
ittld to the ��:i'ding
e prior to caLing for
fal '
I 4tion inspection or
" tAer . construction,
i
- ( SC�NO-TUBE SIZE AND DEPTH
PE CTION fS REQUIRED BEFORE
7 E CONCRETE IS POURED.
n �(
O =3UILDING DEPARTMENT
_ Town of Dartmouth
R RAWING MUST BiEl KEPi
AT 1 1HE 8U1,LDING DURING THE
PROGRESS OF THIS WORK.
UILDING DEPARTMENT,
e n of Dartmouth 7
1 V ri
5'-OII I�,I;On i�
TOWN OF DARTMOUTH BUILDING DEPARTMENT
This plan has been reviewed and accepted as a record copy of work proposed
to be performed in compliance with 780 CMR 6TH Edition. The owner,
applicant/agent and/or architect/engineer is responsible for insuring final
compliance with the above -mentioned code notwithstanding any errors or
omissions in the record plan. Any change in owner, license contractor
or engineer ust be reported to th' office immediately. Any change in
plan must b ubmitted*to this o de in a ny manner.
Signature 1
Date
. � 1
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N 08*-54'-30" W
151 rm,
7'
s
_77777!f71
Jh;s ud
C1 Site
Plan Do L
Duri;l,:y L
, Comsdm. -,Lion
DInte OCT R I ?nnn
290.79
WiLCOX FARM RESIDENTS
' PEDESTRIAN EASEMENT
N 86!-01'-48" E
N 293.110'
67-187
TOP OF FOUNDATION = 52
DRAINAGE EASEMENT (PROPOSED T.O.F. = 53.0)
S66.
233.98'
S 8T-39'-17" W
FOUNDATION
AS -BUILT PLAN
PLAT 43, LOT 3-6
WINSTON LANE
DARTMOUTH, MASSACHUSETTS
SCALE: 1 0=50' DATE: OCTOBER 21, 2000
PREPARED FOR
ICHAEL & SUSAN . GADOURY
PREPARED BY
Doucher & Heureux7 InC.
--CIVIL ENGINEERS LAND SURVEYORS
648 AMERICAN LEGION HIGHWAY, SUITE ONE
WESTPORT, MASSACHUSETTS 02790
tel. (508) 636-5905 — fax. (508) 636-2477
FILE: 1180-02
LOT 5
LIMIT OF FOOTING
NOTE:
PROPERTY LINE INFORMATION WAS TAKEN FROM A PLAN ENTITLED
"DEFINITIVE PLAN OF LAND IN DARTMOUTH, MA OF WILCOX FARM DRAWN
FOR GEORGE COLLIAS 'SHEET 2 OF 2 SCALE: 1 "=40' Ppviqpr) DEC > 1997
3 7.65'
N 81*-36'-26" E C)
C)
rn
.6'
C>
ls�-- Cl.
50.00,
S 87'-39'-18" W rri
z
PREPARED BY, MAUK BOUCHER & HEUREUX, INC.
z
30.00,
N 43*-03'-06" W
MARK A. BOUCHER, P.L.S.
MA. REG. NO. 41246
SITE BENCHMARK:
TO' "SPINDLE OF FIRE
HYDRANT ELEV. = 51.14 (NGVD)
LOT 7
L= 18.43' LANE
DA = 42* -14' -18"'
R= 25.00'
tl (Hn?) 0
' 4
RESIDENTIAL
2000
RESIDENTIAL
2000
2.1 Owner of Record:
Name (print)
2.2 Authorized Agent
yJ W AIM n IGKE.)t
Name (print)
3.1 Licensed Construction Supervisor:Li
i
Licensed Construction Supervisor
Address i9 n deV t t_[_I L ems —
Signature Telephone
3.2 Registered Home Improvement ntractor:
99q- tit t
HOc'Aw sn Q W
Contact Address Phone Number
p0 wf< mos sat�8"16
Contact Address Phone Number
Not Applicable ❑
License Number 44*T1
Expiration Date
0310410C.
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 1Z106(4NWP OJSTC*A >foAlV63 Registration Number (if none, state "none")
Address fO &A NL3 94AC4-1
Signature Telephone I Expiration Date
3.3 For Residential Remodel Work Only
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND:
QI jESTIONS OR COMPLAINTS call or write:
Home Improvement Contractors Registration, One Ashburton Place - Room 1301, Boston, MA 02108, (617) 727-8598
INt
� Owners Name (print) A
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 Super -visors: 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 ofthis.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 drily, a "Homeowner" is defined as follows: Person(s) who owns a parcel 9f land on which he/she resides or intends to reside, on which
there is, or is intended to be. a one or two family dwellino, 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
I Your signature carries ceria
l
C:\bldg.forms\Bldgzapp.res.wpd
responsibilities. including but not necessarily limited to, general liability
Page 2 Rev. January 13. 2000
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. Failur to provide ttttis affidavit
will result in the denial of the issuance of the building permit. Signed Affidavit Attached: yes ❑ no
L(new construction*
(energy report required)
❑ addition ❑ alteration ❑ repairs ❑ chimney/ ❑ wroodstove
(energy report required) fireplace
❑ deck ❑ pool ❑ accessory bldg. ❑ replacement window/door ❑ other ❑ &molition
(shed/garage) no. of windows doors (specify below): (specify below):
* If new construction, please complete the following:
a
Single Family: no, of bedrooms 4 no. of baths 2 f 2
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)
❑ done of the above to be provided
®/Hot Water: Gass Electric Fuel Oil Other.
Brief Description of Proposed Work:
Item Estimated Cost ($) to be completed by permit applicant
1. Buildim!
15. Total = (1 + 2 + 3 + 4) I -Estimated Total $ 103g cy�co
(please print)
I, N�i4 , 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
I, WIUAAM 01(MA-4 , as Owner/Authorized Agent hereby declare that the statements and infformation
on the foregoing application ar true and accurate, to the best of my knowledge and belief.
Signature of Owner/Authorized
C:\hldg. forms\Bldgann.res. wod
lties of perjury.
Page 3
Date
Rev. JJanuary 13.2000
RESIDENTIAL
2000 RESIDENTIAL
1:1 FO UNDA TION ONLY
$Z5.00 APPLICATION FEE IS NON-REFUNDABLE & NON-TnnNsrERA
0 H., REC ED
DARTMOUTH BUILDING DEPARTMENT DATE
0 400 Slocum Road, P.O. Box 79399
Dartmouth, MA 02747
7' 1
508-999-0720 FAX 508-999-0738
000,
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A gn OR TWO FAMILY DWELLING'
-7en;ngPf!V1eW: Signature: em 4M Date:
Energy Report: Signature: -A k- Dat
Fire Chief: Signature: Date: 6
Board of Health: Signature: Da
onservation Commission: Si -nature: DP/-ae'
Other: Signature: 41111T
n )-7(1,_Q_i ert;6�_ X 4 Date: q)
Description of work heingperformed:
A014) 41
I NUMBER OF PLANS SUBMITTED:
1.1 Property Address: (Or 16 W102MAJ Lfwf
Nearest Cross Street:
Subdivision Name: W I LC, 0 P% FAV14M
Total Land Area Sq. Ft.: Mo
1.4 Water Supply (MGL c 40 § 54):
Municipal 0 Private Well
SITE PLAN SUBMITTED: byes 0 no
1.2 Assessors Plat & Lot NuM er:
11 Plat Lfb L- t— (, 0 -
2000
1.3 Historical District 0 yes Pno
Has application be submitted to the Historic COmfinission?
0
0 yes Zn Date:
1.5 Sewage Disposal System:
0 Municipal W/On Site Disposal! System
C;1b1d2A'orms\B1dgarp. res,x% pd Page 4 Rev. January 13, 2000
C:\b1dg.fbrms\B1dgapp.res.%vpd—
Page I Rev. Janftlan 13, 2000