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BP-2000-16160 Project Location: 6 GOLDFINCH DR Permit No. BP-2000-16160 GIS#: 3286:00 Ai Map: 0066 Commonwealth o f aadacI ette Lot: 002 Sub-Lot: 0072 TOWN OF DARTMOUTH Category: Alteration ` 400 Slocum Road,Dartmouth,MA 02747 Project# JS-2001-0047 Phone: (508)999-0720 Fax: (508)999-0738 Est.Cost $50 0.00 Fee: $30.00 BUILDING PERMIT Const.Class: Use Group: R4 Lot sq.ft) SRB FIELD INSPECTION Zoning: SRB' New Const.: N/A Alt Const: 496,sq.ft. Contractor License: Phone#: THOMAS A LIMA CS-069089 (508)991-8469 Engineer.• License: Phone#: t''L, Applicant Phone#: THOMAS A LIMA (508) 991-8469 OWNER: RODA ROBERT M& DATE ISSUED: 7 41"U V TO PERFORM THE FOLLOWING WORK: Add family room and storage/laundry area DATE --TIME--I TYPE OF-INSPE-^-TION&REMARKS- -_..__— --------- -INITIAL .?-cam/0: t/6 (C71-- �� U Sl/l0( /0. 11.9 Mod I ' ,� °Vg)-(A,,.� %� Permit o BP 2000 16160 CL# ; . 1 ,3286Ant► �E. .� Tocinete g,. .Q.d4QC B*I a Silk o4 i, ;Eoo7 • f a TOVVl 0FMI1Alum() TH Ga egory t :Alteration h4 $ 400 Slocum Road,Dartmouth;MA,'02T47 Project'# )JS 2001-004T Phone:(508),999-0720 Fax 508 999 0738 ;l ` Es)7 Cost $5000 00 ;fi r :.. i F L -. .. . , .Fee $3000 •. PERMISSION IS HEREBY GR N ' ; O �'- • CODst.Class:' * '' - ' - _ S ar ct�p� • < a y Use Group R4. > Contractor: ten e'QJ Rhone#: Lot Size(sq 'ft.) .49,'443 THOMAS A LIMA 90891/4 ,-1508)991-8469 Zoning SRB . Engineer: s r t- License t -1'`Pfjone#: Nun CODSt N/A c .• 7th- �u ; c• Alt.Const ' 496 sq ft. :�' 44;' � Applicant: "j' "i" ;.: f i p 'Phone#: or I' r& .. ice b e +M• i' �'{ Date Typed: �- 07 12 2000 ,__, ; THOMAS A LIMA _- '�- / (508)991-8469 OWNER: RODA ROBERT M'&LINDA J {"" -' DATE ISSUED: TO PERFORM THE FOLLOWING WORK: Add family room and storage/laundry area BUILDING PERMIT Project ocation: 6 GOLDFINCH DR Approved/Issued By: EL S.REED,LOC14L--JAL UTLDING INSPECTOR All work shall comply with 78 6TH Ed.(MGL Chap. 143)and any other applicable Mass.Laws or Codes and plans on file. POST TH/S CARD SO/T/S VISIBLE FROM THE STREET SCHEDULE APPROPRIATE INSPECTIONS AS REQUIRED. UPON COMPLETION OF WORK, FINAL INSPECTION IS REQUIRED. THIS PERMIT WILL EXPIRE PER 780 CMR 111.7(NOT MORE THAN 3 EXTENSIONS WILT BE GRANTED)OR ON ISSUANCE OF A REGULAR OCCUPANCY PERMIT. I hereby certify that the proposed work is authorized by the owner of record and I have been authorized by the owner to make this application as his agent and to receive this permit, I further understand other agencies may have reason to STOP WORK if items under their jurisdiction are not met; not withstanding the issuance of t�i��g/Zonin Signature of Owner/Agent: vwr ccl fomments: REPLACEMENT FEE WILL BE REQUIRED FOR LOST SIGNATURE CARD COPY TOWN OF DARTMOUTH i,537A BUILDING RECEIPTS COLLECTORS OFFICE t--1 . Name: ,.iL- PrOwner: Yjo er \ , ( Date: '7_7-6 i' Job Location: %� f 15/ i'• ,; -NR\74(iGC f ZCr0\'�' t F White Copy-Collector's Office r n Plot - f if. Lr Lot ri - c,Q� Yellow Copy-Customer's Receipt Li d ! \ Pink Copy-File Copy 3V -`Green Copy-Building Department Phone: ,f„ _ � , r /- C. Description General Ledger#'s Ref.# Amount License&Permits-Building 01000-44105 v("it-, ( ( j License&Permits-Building Misc. 01000-44105 License&Permits-Electrical 01000-44106 License&Permits-Plumbing&Gas 01000-44107 Other Department Revenue 01000-42420 IN. 1/J— ) This is not a Permit or License for Building.Plumbing or Gas Received By: TOWN OF DARTMOUTH 1.6160 r 81JIL►O.Nd RECEIPTS COLLECTOR'S OFFICE I f Name: i `.4 1, Property , •ice Date: /- t\ I Owner: ( L �c U Job Locations i. 7- , J - r -::l p »,t lr 2 o T 'g Of I'{'kNhite Copy-Collector's Office tG Plot Lot �' j_r �' coxYellowCopy-Customer'sReceipt (. ( I - O` / - Pink Copy-File Copy. 9 7 %J een Copy-Building Department Phone: ),9 4 -i F i 6 S1 Description General Ledger#'s ReL# t' Amount License&Permits-Building 01000-44105 License&Permits-Building Misc. 01000-44105 !: fj. } License&Permits-Electrical 01000-44106 ' License&Permits-Plumbing&Gas 01000-44107 Other Department Revenue 01000-42420 This is not a Permit or License for Building.Plumbing or Gas Received By: RESIDENTIAL 2000 0 FOUNDATIONI,I'NLY $25.00 APPLICATION FEE IS NON-REFUNLASLE ac NON-TRANSFERABLE syov�rti:;y, - _ . -_ DATE RECEIVED-/_ �sN., DARTMOUTH BUILDING DEPARTMENT ,' � 400 Slocum Road, P.O. Box 79399 e. rl i \� � Dartmouth, MA 02747 508-999-0720 FAX 508-999-0738 APPLICATION TO CONSTRUCT,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SF,O'I?IO1 FOR OFFICIAL USE ONLY yR.E. iVEyDIIBIY:yy Iy y'I"- ♦� i3UI�LyDIING.] :DAFESE I L+ORRI IEW: {'VIYlttEllt.. DATE TSSCIEI?; ::. !OIf TO ISSUE SIGNATURE 3 ]. DATE adding Cmmtiussioner/lnspectoro ildiags; ,. :Zoning District ` Proposed e, ^" ' Zone Ct 13 I]A U Y Outside'Flftod torte CI Aquifer Zone TIIE FOLLOWING AL `CIES S.IIOULD BE NOTIFIED.; .F Board of: II Board a£ OCao Cam Ll Dema CI DPW C ter• I3 Energy Report Appeals Iiealtfi Affidavit Card:Sent Cut Off Foitowup ;CI Fire ©Cas t Planning Board* 0 Sewer Card Q Water Card r.qZoning f7 Other :Chief Cut Off /Cut Off t Cut'Off Rower REQUIRES INSPECTOR'S.REVIEW BEFARIE TIIE ISSUtNCa-OFq PERM j' . DEP:IRTM ENTAIL r1L APPRQV Zoning Review: Signature: O fS Date: Energy Report: Signature: 0ic, Date: Fire Chief: Signature: Ji/r4- Date: Board of Health: Signature: /V)7/4 Date: Conservation Commission: Signature: AJ/4 Date: Other: Signature: Date: of work being Description performed:PgP I d• . :` SECi'ION I -SITE INFORMATION NUMBER OF PLANS SUBMITTED: - v'/ ' / SITE PLAN SUBMITTED: 0 yes "kn0 1./ 6 ( OL� rri t.c-J( �R t tf E 2 Assessors Plat& Lot Number: ].] Property Address: T Plat lei, Lot - rV Nearest Cross Street: SoN c >8l nb `1jg ( Il,E Subdivision Name: Seti S�% i :: /9cf2K 1.3Historical District 0 yes Io Total Land Area Sq. Ft.: G CZ-L sq�'T Has application been submitted to the Historic Commission? ❑yes giro Date: 1.4 Water Supply(MGL c 40 § 54): 1.5 Sewage Disposal System: 0 Municipall_Private Well 0 Municipal Athn Site Disposal System C:\bldg.fornrs\Bldeapp.res.opd Page I Rev.lanuan 13,2000 RESIDENTIAL 2000 SECTION:: ::PROPERT-VEOWNER811IR:iAttlitORIZED::AGENT:::::::::::::.:::.:::::.:::::.:::•::::::.:.:::::::::::.:::::::::...:::::::::::::::::::::,::::::::::::::::::::::::::::::::.::::::::::::::::::::::::::::: 2.1 Owner of Record: 1/4/ 7072 5-eS77/ -.. .e..Haefe/S- o—o& 97,6 9/ Name(print) Contact Address Phone Number 2.2 Authorized Agent: Name(print) Contact Address Phone Number . . . .. ....... .... ... . . .. . . . .. ... „.. . .. .....„,„, ....,...,„....,.,„,„,............,„......,.„..„........„..............„....„.....„,.. . Licensed Construction Supervisor: eth,,,,,,qi Li'vt,..4,, Not Applicable 0 Licensed Construction Supervisor License Number a G9 0 9-9 Address Z cs c- ty ti•rot e: if <7- SrP<,,--( ki 0.1 T; Expiration Date , - I -2,5-- 2-00 t Signature " 71.4.4.44A. : Telephone Tel t—1.-c(Cet 3.2 Registered Home Improvement Contractor: Not Applicable 0 Are you a Home Improvement Contractor subject to(780 CMR-6)? 0 yes 0 no If no,go to the next section! Are you claiming exemption from the requirement? 0 yes 0 no If yes, submit the required affidavit! Company Name Registration Number(if none, state"none") Address 13' 3 Po:Residential Remodel Work Only .ignature Telephone Expiration Date • • PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND: QUESTIONS OR COMPLAINTS call or write: Home Improvement Contractors Registration, One Ashburton Place-Room 1301. Boston. ALL 02108. (617) 727-8598 Owners Name(print ------- Lefe- i Signature by signing signing the above,the home owner acknowledges that there will be no eligibiltv to the Guaranty Fund Date 6-.2 6.-a tyro 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 Supervisors: Except for those structures governed by Construction Conurol in Section 116.0.effective July I, 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 gotisitus efth 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 only,a"Homeowner"is defined as follows: Person(s)who owns a parcel of tznd on which he she resides or intends to reside,on which there is.or is intended to be.a one or two family dwelling,attached or detached structures accessory to such CSC andror 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: Signature: Your signature carries certain responsibilities,including but not necessanls iiing.ed to.amerai liability C:\bldg.forais 1 Bldgappses.wpd Page 2 Rev.January 13.2000 4 C.'b 1dg.forms'Bidcapp rcs‘‘pd --.- _________ RESIDENTIAL 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) SECTION 4 WORKER'S COMPENSATION INSURANCE AFFtWtAVIT'.(MCI.c 152§2S) Workers Compensation Insurance affidavit must be completed and submitted with this application. Fail re to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: yes ❑ no SECTION 5 DESCRIPTION OF PROPOSED tvo.iiie(cheek all applicable) ❑ new construction* 0 addition ation 0 repairs 0 chimney/ 0 woodstove (energy report required) (energy report required) fireplace 0 deck 0 pool 0 accessory bldg. 0 replacement window/door 0 other 0 demolition (shed/garage) no. of windows doors (specify below): (specify below): * If new construction, please complete the following: Single Family: no. of 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 ❑ Fumace(hot air)-fuel gas(natural or propane), fuel oil,electricity, other(specify): ❑ Boiler(heating)-fuel gas(natural or propane), fuel oil,electricity,other(specify): O HVAC(combined unit)-primary fuel, natural gas, propane, electricity,other(specify): 0 Air conditioning-(separate unit) O None of the above to be provided O H t Water: Gas Electric Fuel Oil Other rief LDescription of Proposed Work: /gap I •7Isy;L/ �c1'-1 'sub sn4+ 11c— A4.64 Lau()MY f44Er_ SECTIONT-C ESTIMATED CONSTRUCTION COSTS Item Estimated Cost($)to be completed by permit applicant I. Building 2. Electrical 3. Plumbing 4. Mechanical(HVAC) 5 Total=(l +2+3 +4) *Estimated Total $ / 000: OOI SECTION 7A-OWNER A rmAil TION (ta be completed when owner's agent nr cwitraetur a ies fur building perm )". (please print) " I, b.er4 7— f4 ,as Owner of the subject property hereby authorize �g p PA_ c j wt to act o my behalf " I matters relative to work authorized by this building permit application. ,, 'a-DC�O� - 26 - Leo6 Vv Signa ure of Owner ' Date // SE N 7BO CTIO - 1i'NFRWAUTIUORIZED T D AGENECLARATION t 4, (-o vh qS L r&n q , as Owner/Authorized Agent hereby declare that the statements and information v on the foregoing application are trite and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. 1- � G - 26 -co(/ Signature of Owner/Authorized Agent Date C:\bld_e.(orms\Bldeapp.res.wpd Page 3 Rev. anuary 13,2000 J • ■ RESIDENTIAL 2000 • •..... . • • . •.••• •••• • . , , , SECTI . . . . . . . . . . . . . . . . . . . . „ . . . . . . I. 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): 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: r1110 SECTION 9-APPLICANT SOTInCATION Applicant informed of ove2z 7)/ Date: dir Time: /0 1g-in Clerk: AF Comments: g ,*z) • Total Permit Fee: $ Less Application Fee: $25.00 Remaining Balance: $ /11 TOTAL FEE: -267--2;;3- Gross Area-New Construction total sq. ft. Gross Area-Alteration total sq. ft. Permit Issued To 111:; --AL-1'2742---Met/,S C:`,111dg lorms1131,12app rcs»pci Page 4 Rev January 13.2000 I CURRENT MESSAGES DAD. MESSAGE BY )0e1 f 6 yb�c/11tn6Gl Ol ' /l/, Dai (Poo a7- —Pc(on i. (9, rcow\ %h basewzcnm / s q /"arced rahc-ti W;741-1 '2_A-- /‹..4t., 'va l/ , I Ii , , 1 , , , ..i.,: :„ ... ,_ ... .. . - ...., . , - "y1 Is E rim ? Vt• ...\\ C', CM k INC.. \ t w ,-.\-- ii,1\ I V C N V I\ M r3 c' , I e' !CA N p a O\ c s DI _ .-1- W� ct "!F, li -\ Z �� �� b „....._ N, 1, / .. _. k N — E 3NS z z— , � La t c4.. 03 t i,