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BP-13960A 1, E 0, 4F mo I= -�.y- ti "WF `5 • KNOWN_ mooni { yr + f t 2 2� r• �. t I y:e 5y i. _t,d { -; �.*�. S , k # 5r .� # I f1 .f �- 4 � � d• � i i ; S .•3 J X� , 3 t; fi d }, s°�` hymn. On ti x. ./ i 1 j s + '% • � '':+ { " �"avow,5zs � .} }� h `s.' 'f' •tom." T++ K �L -+ ' S "'..`^""C "`""""S { a^�'j""' ...�^^.,z•-�•az+..-..t�.. ,,.....?"'""'Tez"' 1 '""hr .f`} a,�.,,,wS•`Y„t.�."T. `^^�>^t-.. �,�....p ...,,�.�y -. r'.4 �, 3 * 3 t , r { . y, ��. ) ry} J f � r...•rw-..r.�. 1 �..sa �'.,i,a...-,.c9 +Y�_^.,Ni'w'+^, Am WAR. Ows OWN 77 � s . •tf , •t' S Y�L�^ 0 r NOVA" AV Oq TV a PVT l T S .0 } r i• r,� - q, y f ,I Y f h sit oil, a v 7777 • AV 4. �_j 4,01 On T. Awn • F " w r •a c I , .!. ; i s - W 4ui ��4z 2c Pyf v� t y s b ac i.. 4 X f f ct Y,-, 7, j r Ir Is - V5 S,CALE; 'A.RiPRO -DATE RF WINSTON(PRIVATE-50'WIDE) LANE p Ayt: #CN 85.64g \ p 151 NO cU T ZON, L= 92. 2% R 6 9 qJ r 9 ( i l �XCS� " l � ( I I 36.�4' I I I I i I i LOT 1 I cn i i t 40,048 S.F. i� � Cnil I � . � + co { i m t ( i� ro i ZONE NO CUT ZONE m I CER TIr Y THAT THE FOUNDATION, L OCA TE'D AS SHOWN HERE -ON, IS IN COMPLIANCE WITH LOCAL APPLICABLE ZONING BY—LAWS WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUI EAlIENTS FOUNDA TI DN AS-BUIL T PLAN OWNER: SCO T T OL I VEIRA LOCATION: LOT 1 2248 ACUSHNc T AVE WINSTON LANE:' NEW B DFORD, MA NO. DART lOU T , hillA 02745 r ICHAE'L J, KOSKA & A SOCIA TE S TEL. (508)00;�X- 7400 CIVIL ENGINEERS & LAD SURVEYORS FAX. (508)697-1650 08 BROAD ST. BRIDE WA TER, MASS 024 _ SCALEA: 1 40' � E, 1 f',-,HOC DMA WN D'r A D "/Oa NO. 99- 1J9 DWG N0. 13� U FILE ; - WI N S TO N (PRIVATE-50'WIDE) LANE QG of PAvEM�NT 1 — NI 10'5444" E 85.64' _ is No CUT ZONE L=92.27 I � \ I 1 � I EXiSTr1�C I � COPY Lo NN I FEU 36.41 -, ND•4 T/ON` 40.1' rOF'9b i ' { I LOT 1 { 40, 048 S.F. I I = sv { NJ rn 1—�— of i r I I V Irn S 16 76 2D„ 4, 10 NO CUT ZONE .J I C � NO CUT ZONE m 0 0 1 r� I CERTIFY THAT THE FOUNDATION, LOCATED AS SHOWN HEREON, IS IN COMPLIANCE WITH LOCAL APPLICABLE ZONING BY-LAWS WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMEN TS. EGI SERED PROFESt4NAL LAND SUR VE FOUNDA T/ON AS-BUIL T PLAN OWNER. R: SCO T T OL I VEIRA L OCA TION: L 0 T 1 2248 ACUSHNET AVE. WINSTON LA4E NEW BEDFORD, MA NO. DAR TM00 TH, MA 02745 MI CHAEL J. KOSKA & ASSOCIATES CIVIL ENGINEERS & LAND SURVEYORS 98 BROAD ST. BRIDGEWA TER, MASS 02324 DATE. • 1/5/00 I DRAWN BY. AMD TEL. (50i&)697- 7400 FAX. (50j8)697-1650 SCAL-E.' 1 "=40' JOB NO. 99-139 DWG. NO. RESIDENTIAL 1999 SE:.MON 8 INSPECTOR'S REVIEW/COMMENTS RESIDENTIAL ❑ FOUNDATION ONLY $25.00 APPLICATION FEE IS NON-REFUNDABLE 199( 1. Date plan reviewed: 2. 30 days to review period expires: 3. OK to issue date: 4. OK to issue subject to requested submittals(see project review worksheet): 5. DENIED (see project review worksheet): 6. HOLD reason: 7. HOLD subject to Zoning Boar of Appea s action: >, 8. Comments: /_ L_ Date: Date: 7v-e- Date:/,�--/f -� 9 Date: 9. Inspector's Signature: SECTION 9-A.PPLIC.-ANT NOTIRC.4.TION Applicant informed of above Dat Time: / ! Clerk d 9 f, Comments: DARTMOUTH BUILDING DEPARTMENT DATE RECEIVED 400 Slocum. Road, P.O. Box 79399 Z Dartmouth, MA 02747 508-999-0720 FAX 508-999-0738 f� APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR -nVO FAMILY DNVELLI�-;G cone feview: Signature: CIA I — 'U V hate: j Energy Report: Signature. LV% / s (,,t Date: Fire Chief: Signature: Date: / --- Bo 4dHealthturADate: Conon Commission: Signature: �1 Date: Other: Signature: Date: Description of work being performed: SEGTIO`T 1 - SITE INFOR:«TION: ... NUMBER OF PLANS SUBMITTED: SITE PLAN SUBMITTED: X'Ves ❑ no 1.2 Assessors Plat & Lot Number: 1.1 Property Address: Plate Lot-3_--/-- Nearest Cross Street: % (/C A- X� d f2y Subdivision Name: 1.3 Historical District ❑ yes ❑ no Total Land Area Sq. Ft.: Has application been submitted to the Historic Corrnmission? ❑ yes ❑ no Date: 1.4 Water Supply (MGL c 40 5 54): 1.5 Sewage Disposal System: ,Municipal ❑ Private Well XMunicipal ❑ On Site DisposLal System r%N u: r...., .. _ .. SECTION 2 - PROPERTY OWN f 2.1 Owner of Record: 7 Name (print) 2.2 Author: zed Agent: Name (print: 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor Address Signature Telephone _ ).2 Registered Home Improvement Contractor: 1999 IORIZED AGENT RESIDENTIAL 199� NOTICE To LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that anv licensed', onstruction Supervisor. whether or not they have taken the permit are responsible for code compliance. (see Appendix of 780 CMR R5. 2.15) SECTION - WORKER'S COMPENSATION ii�StIRA1vC�.AF��DAVt ;f1�1GL:c 15� yS 25} Workers Compensation Insurance affidavit must be completed and submitted with this application. F it re to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: yes D no SECTI©N 5 DESCRIPTIOi OZ{ PROP©SED iypRl{ {check allaPpliea e . Contact Address Phone Number tnewctioe�[] ddition D alteration ❑repairsstru1�3'chimney/fireplace ❑ woodstove w99S-Mys �� 2C>SSi{flS rl/<CS /11(�,36,-6FK0 Contact Address Phone Number Are you a Home Improvement Contractor subject to (780 CMR-6)? Dyes ❑ no requirement? If no, go to the next section! Are you claiming exemption from the re q Dyes ❑ no If yes, submit the required affidavit! Company Name Address I Signature F 3 Fir Residential Remodel Work Only Telephone Not Applicable ❑ License Number Expiration Date Not Applicable ❑ Registration Number (if none, state "none") Expiration Date PERSONS CONTRACTLNG WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND: QUESTIONS OR COMPLAINTS call or write: Horne Improvement Contractors Registration, One Ashburton Place - Room 1301, Boston..tfA 02108. (61=) 727-8598 Owners Name (print) Signature by signing the above, the home owner acknowiedees that there w ill be no eligibiity to the Guaranty Fund Date ` 3.4 Homeowner Exemption - One & Two Family Only FOR EOWNERS WHO TO JECT 109.1.1 Licensing of Construction Supervisors: ors: Except for those ostructu structures o%tem d by ConAND BE shallControl to Section LE FOR THEIR Ow-, o116.0. effective 1uh i shall be engaged in d,recth supervising persons engaged in construction. reconstruction. alteration. repair. removal or demolition invol ine the structural elements of bwldines or structures.. 198... no individual 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: Am HomeOwner performing work for which a Building Permit is required shall be exempt from the provisions of this section: provides that if a Homeowner eneages 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 hvshe resides or intends to reside, here is. or is intended -% be. a one or two family • dwel�in�. attached or detached structures accessory to such use and or farm structures. .4 person who constructs more han one home in a nva-ycar period shall not be consider/e�d a Homeowner. tde, on which ryou are apph ing under this section sign below: // ignature: c—� 7 our signature carves certain responsibilities. including but necessani} limited to. general liability [9 deck [pool ❑ accessory bldg. ❑ replacement window/door ❑ other (shed/garage) no. of windows_ doors_ (specify below) * If new construction, please complete the following: Single Family: no. of bedrooms no. of baths — Two Familv: no. of bedrooms unit I 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): 1& Boiler (heating) - fuel gas (natural or propane), fuel oil, electricity, other (specify): ❑ HVAC (combined unit) - primary fuel, natural gas, propane, electricity, other (specify): X Air conditioning - (separate unit) ❑ None of the above to be provided e. Hot Water: Gas Electric Fuel Oil Brief Description of Proposed Work: Other Item I Estimated Cost (S) to be completed by permit applicantt 5. Total = (1 + 2 + 3 + 4) * Estimated Total S /60, C% ems o , o !�) (please print) L 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 ❑ demolition (specify below). - �L�.,w<� ,n-u»��ttxtatilt30RiZED`:�GENTt)ECL�CLA't1()�I I' as Owner/Authorized Agent hereby declare that the statements and on the foregoing application are true and accurate. to the best of my knowledge and belief. information Signed under the pains and penalties of Signature eiIAuthorized Agent Date