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BP-14933R= 1573.35' WINSTON LANE SCALE: 1 " - 40' 40 0 20 40 80 FEE L= 148. 25 ' S 82-54'-25" E LeiP'l — — — 64 07' q'Z 0-0 -a �� .o j _ BUILDING W C NAIL SET IN 24 TREE Q SITE BENCHMARK: � of r SETBACK LINE'S ` ELEV. - 84.17 (NGVD) MARK A. OT 4 tA- Q °..° w \ �o' BOUCHER' c sE�R cmO 412 J m ` MARK A. BOUCHER, P.L.S. DATE V In LOT 3 6° MA. REG. NO. 41246 'l' 78,024 S. F. �, o in j--J (1.791 Ac.)Ln I EXISTING BARN � I z PARCEL "B" (OPEN SPACE) i TOP OF FOUNDATION = 78.9 3 7- 4 4' E 120.3' (PROPOSED T.U.F. = 78.2) FOUNDATION 5 82°- _ ! =908, AS -BUILT PLAN EYISPNG H{1USE PLAT 43, LOT 3-3 WINSTON LANE DARTMOUTH, MASSACHUSETTS 0 1 Qc�N `'- EXISTING o o SCALE: 1 "=40' DATE: MAY 1, 2000 HOUSE o NO BUILDING ZONE PREPARED FOR �" � . _ 15 � BENJAMIN BRAYTON SHED = 2 4 w N N 6.,PREPARED BY s9_77- "NOBOUCHER & HEUREUX, INC. BUILDING ZONE � W ° 146.28' PLAT 43, LOT 2 CIVIL/ENVIRONMENTAL ENGINEERS, SCIENTIST.. N 86°--19 —32" W LAND SURVEYORS AND PLANNERS 648 AMERICAN LEGION HIGHWAY WESTPORT, MASSACHUSETTS 027!-:l.7 TEL: 508-636-5905 FAX: 508-636-2477 FILE: 1108-0' RESIDENTIAL 1999 SIE CTIO1f $ - INSPECTOR'S REVIEIVJCOM, IEi�"iS 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 work -sheet): Date: 5. DENIED (see project review worksheet): Date: 6. HOLD reason: Date: 7. HOLD subject to Zoning Board of Appeals action: Date: 8. Comments: 9. Inspector's Signature: Applicant informe of above Comments: a40o Date: Clerk: SECTION' 104 & ICE1t s ECI'OR'S COTES Total Permit Fee: S Less Application Fee: S 25.00 Remaining Balance: $ TOTAL FEE: Gross Area - New Construction total sq. ft. Gross Area - Alteration total sq. ft. Permit Issued T SECTION RESIDENTIAL ❑ FOUNDATION ONLY $25.00 APPLICATIONt ,rEE IS NON-REFUNDABLE DARTMOUTH BUILDING DEPARTMENT DATE RECEIVED N 400 Slocum Road, P.O. Box 79399 RECEIVED ':3 • - �. Dartmouth, MA 02747 � l 1"Ps /9<3 ^^' 508-999-0720 FAX 508-999-0738 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWE:LLING Zoning Review: Signature: _ _Date: Energy Report: Signature: Date: Fire Chief: Signature: Date: Board of Health: Signature: Date: Conservation Commission: Signature: Date: Other: Signature: Date: Description of work benzg perfor»red: s dl_hc� o7il SECTION 1 - SITE INFORMATION NUMBER OF PLANS SUBMITTED: SITE PLAN SUBMITTED: ❑ yes ❑ no 1.1 Property Address: LOT 3 Nearest Cross Street: T'{je j„p (Z Raaot' Subdivision Name: W. /C d )L Total Land Area Sq. Ft.: TO 0C%79.,,,0 1.4 Water Supply (MGL c 40 5 54): ❑ Municipal ❑ Private Well 1.2 Assessors Plat &r/Loolt Number: Plat-- ' Lot �21 1W 1.3 Historical District ❑ yes ❑ no Has application been submitted to the Historic Commission? ❑ yes ❑ no Date: 1.5 Sewage Disposal System: 0 Municipal 0 On Site Disposal System RESIDENTIAL 1999 SECTION 2 P'ROPIERTY .AXITHORIZED AGENT 2.1 Owner of Record: r3L°icJ a.M t � d/ ►'Ci �C /�! v" 1.�.-i � �r �� ) . �U 13oA 134,7 Ale-we,,TIT `f�l �F � -- 232z, Name (pant),,. Contact Address 0";_0Y4 Phone Number 2.2 Authorized Agent: Name (pr.nt) Contact Address Phone Number 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor License Number Address Signature Telephone 3.2 Registered Home Improvement Contractor: Are you a Home Improvement Contractor subject to (780 CMR-6)? ❑ ves ❑ 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 Adc' ess Expiration Date Not Applicable ❑ Registration Number (if none, state "none") Signature Telephone Expiration Date 3.3 For Residential Remodel Work Only PERSONS CONTRACTING «'ITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FLTND: QUESTIONS OR COMPLAINTS call or write: Hone Improvement Contractors Registration, One .-lshburton Place - .Room 1301, Boston. MA 02108, (617) 727-8598 Owners Name (print) Signature by signing the above. the home owner acknowiedees that there will be no eligibiity to the Guaranty Fund Date =.4 Homeowner Exemption - One & Two Family Only FOR HOfEOW\ERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR Ow'N; PROJECT 109.1.1 Licensing of Construction Supervisors: Except for those structures govemed by Construction Control in Section 116.0. effective ;uh 1. 1982. no individual shall be engaged in direcd% 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 b} the BBRS entitled Rules and Regulations for Licensing Construction Supervisors. - Exception: Any Homeowner performing work for v,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 ork. that ch me caner shall act as supervisor. For the purposes of thi tion oni a r meow ` ",ism fined as follows: Persont s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended e. a one rn� iami llin� r-detached structures accessory to such use and;'or farm structures. A person who constructs more than one home in %o-year pe d ail not �fisi� ed a Homeowner. If,,ou are app(Jing uncj#f> its ztion our s re carves certain responsibilities, including but not necessanh limited to. generai liability RESIDENTIAL NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any license(� Construction Supervisor, whether or not they have taken the permit are responsible for code compliance. (see Appendix of 780 CMR R 5.2.15) 1999 SECTio�Ni 4 » WORKER'S CONIPENSATI©N INSURANCE AFFIDAVIT: (MGL c 15Z'§ 2 � Workers Compensation Insurance affidavit must be completed and submitted with this application. Fare to orovide this affidavit i will result in the denial of the issuance of the building permit. Signed Affidavit Attached: A yes C' no SECTION 5—DESCRIPTION OF PR4P©SED tVORK.(eheek all applies Ie) ❑ new ❑ addition ❑ alteration ❑ repairs ❑ chimney/fireplace ❑ woodstove construction* ❑ deck ❑ pool ❑ accessory bldg. ❑ replacement window/door ther ❑ demolition (shed/garage) no. of windows_ doors_ (specify below): (speciN below): * If new construction, please complete the following: Single Family: no. cf bedrooms no. of baths Two Family: no. of bedrooms unit I no. of baths unit I 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) ❑ None of the above to be provided ❑ Hot Water: Gas Electric Fuel Oil Other Brief Description of Propofid Work: e Item I Estimated Cost ($) to be completed by permit appliicant f on 4. Mechanical (HVAC) 5. Total = (1 + 2 + 3 + 4) 1 -Estimated Total S * (please print) 1. 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. A Anent PA Date