BP-2001-21753iJJl\%—,AJJ
SECTION - 12 ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost ($) 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 1 A - OWNER AUTHORIZATION to be completed when owner's agent or contractor applies for building permit)
(please print)
I,Of &-,dA2 , as Owner of the subject property hereby authorize
to act on mybehalf, in all matters relative to work authorized by this building permit application.
?./
Signature of Owner Date
SECTION 13B - OWNE A TH RIZED AGENT DECLARATION
4 AF ,eMEil , 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.
Signed under paingane Itie of perjury.
of
. Owne ADate
SECTION 14 - INSPECTOR'S REVIEW/COMMENTS
1. Date plan reviewed: 5. DENIED (see project review worksheet):
2. 30 days to review period expires: Date:
3. OK to issue date: OCT 16 2001 6. HOLD reason:
4. OK to issue subject to requested submittals (see project Date:
review worksheet): Date: 7. HOLD subject to Zoning Board of Appeals action:
8. Comments:
9. Inspector's Signature: l Date:_ OCT 6 2nG1
SE TON 1 - APPLICANT NOTIFICATION ,
Applicant informed//of above_ +' Date: 61 Time:; Clerk:
Comments: LC /A I<
t �, r
`
SECTION 16 - FE ERMIT NOTES
Total Permit Fee:
Less Application Fee: $ 25.00
Remaining Balance:
Gross Area - New Construction
Gross Area - Alteration
Permit Issued To:
o.e c
r�
7
I-Y, /1*114�-/Jm
COMMERCIAL 2001
$25.00 APPLICATION FEE IS NON-REFUNDABLE & NON -TRANSFERABLE;
DATE RECEIVED
,. DARTMOUTH BUILDING DEPARTMENT
400
io a Slocum Road, P.O. Box 79399
Dartmouth, MA 02747
508-910-1820 FAX 508-910-1838
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A COMMERCIAL BUILDING (includes 3 or more farmily dwellings)
THIS SECTION FOR OFFICIAL USE ONLY
RECEIVED BY:
BUILDING PERMIT NUMBER"
DATE SENT FOR REVIEW:
DATE ISSUED•
OK TO ISSUE - SIGNATURE: 1 DATE: OCT I S 2001
Building Commissioner/I s ector of Buildings
Zoning District: Proposed Use: Zone: ❑ C ❑ B ❑ A ❑ V Aquifer Zome - -
THE FOLLOWING AGENCIES SHOULD BE NOTIFIED:
❑ Board of ❑ Board of ❑ Con. ❑ Demo A DPW ❑ Elec. ❑ Energy Repmrt
Appeals Health Com. Affidavit Card SentCut Off Follow-up*
❑ Fire ❑ Gas ❑ Planning ❑ Sewer Card ❑ Water Card! Water Division ❑ Zoning ❑ Other
Chief Cut Off Board* / Cut Off / Cut Off Cross Connection Review*
* REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT
DEPARTMENTAL APPROVAL -
Zoning Review: Signature: s Dat
Energy Report: Signature: _ Date:
Fire Chief: Signature: Date:
Board of Health: Signature: Date:
Conservation Commission: Signature: Date:
Other: Signature:
nn }Date:
Description of lVork Being Per orm1, � il-U S'- ,
SECTION 1- SITE INFORMATION
1.1 NUMBER OF PLANS SUBMITTED:
1.2 SITE PLAN SUBMITTED: ❑ yes O no
1.3 Property Address: e� ll &, T-4Ie.4 PiCi U -
1.4 Assessors Plat & Lot Number:
r
Nearest Cross Street: L-A&Ale
B?AIiE a 2e�#
�on
ol
PlatLoNNa6ge: t S
Total Land Area Sq. Ft.:
1.5 Water Supply (MGL c 40 § 54):
L�i'Municipal ❑ Private Well
1.6 Sewage Disposal System:
'Municipal 0 On Site Disposal
System
SECTION 2 - PROPERTY OWNERSHIP / AUTHORIZED AGENT
2.10 rner of Record: ANinP-C.
5�60? P
! cam. F'�?�
Co,��y��� S'T= .0k� Bar
-f,49���'`c'.
Name (print) I
Contact Address Telephone
2.2 Authorized Agent: 671V10,4-/lJ L.. EG.L ����
/.� �L�e 7 GgZZ 00
00,
Name (print)
Contact Address Telephone
9
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2001
LUNS FRU TION SERVICE
3.1 Licensed Construction Supervisor:
Not Applicable ❑
Name of Construction Supervisor e
License Number
Address
` DZ Expiration Date 3
Signature D!-(a3, zos3
Telephone
SE TIO 4 - WORKER'S C RIPENSATION INS JRANCE AFFIDAVIT NIGLC 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 PROP SED WORK heck all ap 3ficable)
new construction ❑ addition ❑ alteration ❑ repairs P t] accessory bldg. (shed/garage)
❑ other (specify Sec. 6): 0 demolition ❑ sign ❑ replacement window/door no. of windows
doors
SECTION 6 PROPOSED PROJECT/IrgF - nvPr rTnllxl . •,•..,,, .....__ _• __ _
- -� ••••s ueJ��lp«ons are cased on the Massachusetts State Building 6th Edition, Code Article 3�as :oted.SSee t/ie 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) 6i ►,
❑ High Hazard - (see Code Section 306.0)
❑ Institutional - hospital, nursing home, infant da
❑ Mercantile - retail stores (see Code Section 308.OI(egt�'0)
❑ Residential - three or more family, hotel (see Code Section 309.0)
❑ Storage - includes garage (see Code Section 309.0)
❑ 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
j condition (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 an addition to existing structure - 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 1)
APPLICANT TO PROVIDE PEER REVIEW AT THEIR EXPENSE. SEE 780 CNIR.
❑ Demolition* - describe structure:
❑ Moving* - (provide copy of DPW moving license)
* Type of structure:
to where (plat/lot or address): from where (plat/lot or address):
number of bedrooms per dwelling unit: number of dwelling units:
COMMERCIAL
❑ Replacement doors and windows -(fore xistin only) 2001
g y) (only where doors and windows exist and will not be enlarged) g ) EGRESS
dimensions must be maintained. Enlarged or new windows in an existing dwelling will be considered as an alteration, otlherwise 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. Describe:
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
❑ Required: plans provided
❑ Not required, not to be installed, why?
plans not provided, why?
- 10 REOUiRED OFF-STRFFT Peuur,vr !f 7,.-:--
❑ 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 no
Submit copy of application and/or permit as soon as available.
ECTiON - 11 IDENTIFICATION
11.1 Architect/Engineer - for overall design
Company Name: r-65'/ e
rj /
Address:����"Il'� Q C1
Phone #: 26 A'—��20 Zf
Certified by State of Massachusetts as: ��tl T _
Certification Number:
Note: Signatures and seals on all b� la_ ns, affidavits & other documents SHALL BE originals and not reproductions.,
11.2 Architect/Engineer - project supervision and reports
Company Name: S' A L
Address:
� N
Phone #: Nsm 7M
Certified by State of Massachusetts as: y VA o�
P
Certification Number: H OF
Note: Signatures and seals on all plans, adavits & other documents SHALL BE originals and not reproductions.
11.3 General Contractor
Compan
Address:
Phone #:
Construction Supervisors License Number Q jj Q
Note: Signatures and seals on all plans, affidavits & other documents SHALL BE originals and not reproductions.
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N/F RAYMOND ROSE
PARCEL "C"
FOUNDATION AS -BUILT PLAN
SCALE 4" = 4 C7 APPROVED BY DRAWN BY
DATE 1_16-02 REVISED
ANIMAL R17'�CUNJPGUE OF NEW BED
KENNETN' R. FERREIRA ENGINEERING, INC. DRAWING NUMBER
46 FOSTER STREET, NEW BEDFORD. MA. 02740 ISE 5852.3-A
(DRAFTING FORM NO. 101-63
T65
T64
o m
(11 tp
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T64
T65
T56
T55
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T5
T36.
T35.
T3Z
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0
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T3!
T3
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46' } 12' 29'
Scale: V = 0.1250"
ANIMAL RESCUE
NEW BEDFORD,MASS
TRUSS ERECTION NOTES:
REFER TO "HIB-91° SUMMARY SHEET FOR ERECTION GUIDLINES,
INCLUDING BOTH TEMPORARY AND PERMANENT BRACING RECOMMENDATIONS.
ALSO SEE INDIVIDUAL TRUSS DESIGN SHEETS FOR TOP CHORD,
(BOTTOM CHORD AND WEB BRACING REQUIREMENTS
V-1cor i VL-
SPECIALTY TRUSS
FEBRUARY 19,2002
❑ APPROVED ❑ Approved except as noted
Resubmission r°Quired.
Approved except as noted
Resubmission not required. ❑ disapproved,
See accompanyi?g letter.
STEPHEN KELLEHER ARCHITECTS
P.O. BOX 107 hMATTA; v;SETL MA 02739 (503) 758-6ij5
Checked by Date 3- 6 -0-zl
This approval is for general arrangement only and dies not
relieve the con,ractors from any obligaiion of the contact. for
the responsibility of error, for accuracy of plan Vs. fie!d
dimensions, for quantitiesanddetails nor correct inter station
Of plans and specificafions. ��`
FILE COf'ti
266, 22e Avenue
rusaur�ts D.L.D. «ta La Guadeloupe
(Beauce) Qc
GQM 1 GO