BP-2913 BUILDING PERMIT
%Fifth Edition ❑ Sixth Edition
SPECIAL PERMIT PER 780 CMR 114.0
Dartmouth Building Department Plat: 66
400 Slocum Road-P.O. Box 9399 Lot(s) :2-122
Dartmouth, MA 02747 Lot Size:40,175
Telephone 508-999-0720 Zoning Dist. :SRB
June 17, 1997 (typed) Permit No..: 4 7�`il
Issued Date: 7/$o/ 97 Clerk: BAS
Project Location: .3 Wabler Way
Number Street
Subdivision Name:
Nearest Cross Street:
Applicant/Agent: Bob Mullins of Cherryfield Development
Address: 8 Wareham Street, Middleboro, MA
Contact Person Phone #: (508) 946-9118
Type of License: Owner; ( ) Const. Superv. License #: (057185 )
Architect: ( ) Engineer: ( ) Other: (
Proposed Use: Residential
Residential,Commensal,Industrial,etc.
Permit Issued To: To Install
Type of Improvement,Add,Alter,New Const,Demo,Land/Move,etc.
Foundation only
indicate no.of bedrooms and bathrooms and other rooms
Gross Area of Const. : Cost of Const. $6,000. 00 _
Cost-Other Const. : TOTAL FEE: $ 50. 00 _
Owner(s) of Record: ASM Realty
Address: Hawthorn Street, New Bedford, MA
All work shall comply with 780 CMR 5th Ed. (MGL Chap. 142) and any
other applicable Mass. Laws or codes and plans on file.
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 un nd other agencies may have reason to STOP
WORK if items under their juris action a not ofhs anding the issuance
of this Building\Zoning Permit.
Signature of Owner/Age t: - /
Address:
*********************.***** * ***** *****************************
Signature:
Approved/Issued By: d •el S. Reed, Title: Local Building Inspector
COMMENTS: PLEASE P IIST PERMIT CARD SO THAT IT IS VISIBLE FROM
THE STREET. SCHEDULE APPROPRIATE INSPECTIONS AS •
REQUIRED. UPON COMPLETION OF WORK, FINAL INSPECTION
IS REQUIRED. wIr
0 ORIGINAL APPLICANT 0 ASSESSORS CLERK 0gØIFIIP ?' (
Y
TOWN OF DARTMOUTH 02913
BUILDING RECEIPTS
COLLECTOR'S OFFICE
Name: Property r. r �� Date: 17 /
/ i
Job Location: r _ - -
r White Copy-Collectors Office
Plot: - Lot: ) -1 Yellow Copy-Customers Receipt
y. Z n� Pink Copy-File Copy
Green Copy Building Department
Phone:
Description General Ledger#'s Refs# Amount
License&Permits-Building 01000-44105 i (1 %.
_
License License&Permits-Building Misc. 01000-44105 /
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:
„ .: TOWN OF DARTMOUTH
T. - t-- . n2302
BUILDING RECEIPTS
_N o TAX ! C U ESOLLECTOR'S OFFICE •
/ a�7 �J f
Name: � /c.,.•• /j' • ,•,- Property / / Date: / a /�”
Job Location: �" i tt J j t /
f• /),U, i / C I TOWN OF DARTMOUTH
COLLECTORS Oppose Copy-Collectors Office
Plot: `�� f� - Lot: _.. 7 JUN
Yellow Copy-f'stomer's Receipt
!� I t / JUN 16 19L7reen Cope P `v•'department
Phone: f�
P�rf.3.Cs 01 /
nnAA .
Description General Ledger#'s Ref.#
License&Permits-Building 01000-44105
License&Permits-Building Misc. 01000 44105 Li .!2
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
TOWN OF DARTIVIOUTH BUILDING DEPARTMENT
TELEPHONE 508-999-0720 FAX 508-999-0738
APPLICATION FOR ZONING AND BUILDING PERMIT
Instructions
The applicant shall complete this application to the best of their ability prior to submission,leaving no item unanswered.The
Department staff will be available during regular business hours to assist as necessary.N/A should be inserted for those sections
which do not apply.A properly completed application will help avoid unnecessary delays. Nor Fig fee s act ndoollable-
(for office toe only) _/"--1 :.. TION ONLY
�`Total Cost $ S Received By s/ �sr„� r_ / Date Rce'd >
Less Application Fee$ 11 y f
Total Permit Fee $ s^`L Permit# - Issued Date l 7- t 1/
G
100 LOCATION OF PROJECT TOTAL LAND AREA SQUARE FEET /'
VW
CURRENT ACCESSORS' PLAT brP LOT b2-/tea ZONING DISTRICT ✓ 2.8 2
OTHER ZONING OVERLAY DISTRICTSS,J, if applicable
TR/
NUMBER & STREET C�� �t7/�� L2caei2J, ` �
NEAREST CROSS STREET C/bo"Ater-2
/
,
SUBDIVISION NAME & LOT it /YC'/Yr-- /4/ ,/e
or BUSINESS NAME ��j///� 2 /PREVIOUS TENANT / OWNER f/l7/ f
200 RESIDENTIAL - PROPOSED PROJECT- one & two family residence only
- THIS SECTION NOT APPLICABLE
- Single family - number bedrooms number baths `
- Two family - number bedrooms unit I number baths unit 1
number bedrooms unit 2 number baths unit 2
- Accessory apartment Total gross sq. ft.
/- Al
ccessory structure:
J /' ; �rf - Garage - detached - attached to dwelling, dimensions L W _
i 1 ;
I j Carport - detached - attached to dwelling, tensions L W
L:
141 \ 41 7- Shed - dimensions L W
;I � ' /
I., - Deck- dimensions L W
/
///,,,ddd, - Gazebo- dimensions L W
�,! - Swimming pool above ground in-ground Size
A Chimney number of flues
f1 t 1 1-- r. r/1�]
1
C Woodstove - used (will require inspection prior to installation), new (provide manufacturers
instructions). Location(s) (list)
C Fireplace(s) - (includes flue) List location(s)
Game Court-describe (include overall dimensions)
C Tent, Trailer(Mobile Home) or Other-describe
300 COMMERCIAL-PROPOSED PROJECT/USE-INCLUDING THREE FAMILY OR MORE AND EXEMPT USES
setrTHIS SECTION NOT APPLICABLE
(The following descriptions are based on the Massachusetts State Building Code Article 3,AS NOTED) (See the
Code)
C Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe
C Business - office, assembly with less than 50 occupants - indicate Medical or other professional (see Code
Section 303.0)
C Educational-structure for training including child day care for those over 2 years 9 months(see Code Section
304.0)
C Factory/Industrial - (see Code Section 305.0)
C High Hazard - (see Code Section 306.0)
C Institutional - hospital, nursing home, infant day care (see Code Section 307.0)
Mercantile - retail stores (see Code 308.0)
C Residential - three or more family, hotel (see Code Section 309.0)
C Storage- includes garages (see Code Section 309.0)
C Utility & Miscellaneous Structures - includes tents and .*gricultural structures (see Code Section 311.0)
C New tenant for any of the above, indicate above(see Code Section 119.0 and Zoning By-law section 35)
C Tent or Trailer - temporary purpose?
C Other
Describe the proposal briefly,INCLUDE n umber of dwelling units and bedrooms or occupant
also existing condition
as applicable,
400 TYPE OFA CONSTRUCTION OR WORK TO BE PERFORMED
en New Construction and/or Addition - total gross square feet /'/)2,1a14 ,ry c// —
(For commercial only total gross cubic feet) -indicate
It will be considered new construction if there an increase in square footage in addition to any alteration(s).
If project is an addition to existing structure- Total gross square feet of existing
C FOR COMMERCIAL ONLY
Will this project be subject to CONSTRUCTION CONTROL(over 35,000 cu.ft.)_Yes No. (If yes
see Code section 127.0). Designer to submit Code Synopsis.
Will this project require Peer review(over 400,000 cu.ft.) Yes_No (see Code A
APPLICANT TO PROVIDE Ppendix I)
2
Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration required.
Demolition - describe structure
Number of dwelling units Number of bedrooms A separate Refuse Disposal
Declaration required.
= Moving- (Provide copy of D.P.W. moving license) Type of structure
from where (plat/lot or address)
to where (plat/lot or address) •
Number of dwelling units Number of bedrooms per dwelling unit
Re-roofing - (for existing only, is included in new construction)
Number of square feet - Number of layers already existing
Number of layers when complete
A separate disposal declaration REQUIRED
= Replacement doors and windows- (for existing only) (only where doors and windows exist and will not be
enlarged) EGRESS dimensions must be maintained. Enlarged or new windows in an existing dwelling will be
considered as an Alteration, otherwise will be included in new construction. (see Code section 3401.1(1 for
residential and Article 8 ft:commercial) - - - -
Temporary structure-includes when allowed, trailers,tents and the like and only for limited periods of time.
Describe - ^--� -'� ....-••� .
500 CONSTRUCTION PLANS .Fsofh Edition
06th Edition
= None submitted. Why?
of the State Building Code
I Submitted, usually three sets required. Four sets for food serviceyuses. Number of sets submitted
600 SITE PLAN
0 Not required, why?
_ Submitted When? - Previously, date G With this application
700 UTILITIES
Water supply - required_yes_ no, public ? _yes _no, on site well? _yes_ no,
existing? _yes_no
If required and not existing have necessary permits been issued? _no_yes, date
(M.G.L. Chapter 40, section 54 provides that no building permit may be issued unless a water supply, when
required, is available. See Code 780 CMR section 114.1.2)
Sewage disposal- required_yes no, public sewer_yes_no
private septic - on-site_yes _no. Submit copy of permit as soon as available.
800 MECHANICAIS &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
900 SPRINKLERS - FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential
Required, plans provided, ;plans not provided, why?
Not required, not to be installed, Why?
1000 REQUIRED OFF-STREET PARKING - for ZONING &Architectural Access
NOT APPLICABLE
_ Parking Plan submitted To = Building Department .-, 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 C. If yes has it been issued yes no
Submit copy of application and/or permit as soon as available.
1100 IDENTIFICATION(print or type except as noted)
Current owner- name �,f // ,2/T�'
address vy�l l2;1.a. /T ✓4' 2.
phone# D'
If corporation, officer in charge
Architect/Engineer- for overall design
Company name
Address
Phone number
Certified by State of Massachusetts as
Certification number
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions. -
4
Architect/Engineer-project supervision and reports -
Company name
Address
Phone number
Certified by State of Massachusetts as
Certification number
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
General Contractor(if Homeowner, s/i' �!l1�state homeowneromne/ here then complete section 1300)
Company name �(' ry.4 � , .
,Address 1JoP477
Phone number 97/,
Construction Supervisors license number �LC2/9c
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
*s****iiiii************tiiiifiiiitifiiiiiiiii.ifiiiiififiiiiiiififiiitiifiiiitiiifii\iifiiiiiti*iiiii iiii
1200 FOR RESIDENTIAL REMODEL WORK ONLY
Are you a Home Improvement Contractor subject to(7SOCMR-6) ? Yes_No_If no go to next section!
Are you claiming exemption from the requirement? Yes No_If yes, submit the required affidavit!
Ren.odel contractor name(please print)
Address
Registration number(it none state"none")
Phone number
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE
GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write:
Home Improvement Contractors Registration
One Ashburton Place - Room 1301
Boston, MA 02108
(617) 727-8598
Owners name (print) .4110
Signature
Date 2
1300 OWNER SIGN- OFF
I, the undersigned,am the owner of record or authorized lessee(provide documentation) and I have reviewed
the application herein submitted. I state that fo the best of my knowledge and belief that the information provided in this
application is true and correct and that the permit requested be issued.
Further I understand that the permit will expire in six months, from the date of issue, if no work is begun or
six months after the last inspection if work has begun and that the permit may be extended for six months if no work is
anticipated if I request such an extension in writing. I understand that the permit may be extended only three times by
written request.I understand that once the permit expires a new application may be required,including fees and current
other requirements (including^ Zoning).
Name . 7 'n-e S' et,/ ..
Signature
The above signature is my voluntary act and is signed under the pains and penalties of perjury.
Date d/G-92
•
Who is authorized to pickup the permit at the Building I.ggp�r�mep?2 e nrinr�cd , �,7#f'
Address Phone r37�/ (?
1400 HOMEOWNER EXEMPTION -ONE &TWO FAMILY ONLY
FOR HOItIE OWNERS 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 Control
in Section 127.0, 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 regulaions promulgated by the BBRS entitled
Rides akd Regulations for Licensing Construction Supervisors.
Exception:Any Home Owner performing work for which a Building Permit is required shall be exempt from
the provisions of this section; provides that if a Home Owner engages a person(s) for hire to do such work ,that such
Home Owner shall act as supervisor.
For the purposes of this sectiou only,a"Home Owner"is defined as follows:Person(s)who owns a parcel of land
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 use and/or farm structures. A person who constructs more than one home in
two-year period shall not be considered a Home Owner.
If you are applying under this section sign below:
Signature
Your signature carries certain responsibilities, including but not necessarily limited to, general liability
t;;;;;; ; ;;;; ; ;; ; ; ; ; II; ;;; ;;;;; ; ;;i;;;;;;;;;;;;;; Y ;;;;;;;;;fi;
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
2.15.2 of section 51
;;;;i;;;;;;;;;;;i;; ;; ;;;;;Y;;;; ; ; ; ;; ;;;Y;;;; ; ; ;; ;; y ; ; ;;;;;;;;; ;
1500 COST
Cost of Improvement S /e��
Items to be installed but not included in the above cost: Electrical S C�
Plumbing
HVAC
Other
TOTAL $ dj&•t ct2. &c
6
The following section for official use only.
INSPECTORS' REVIEW
Date plan reviewed /
30 days to review period expires
OK to issue date
=i OK to issue subject to requested submittals (see project review worksheet) date
DENIED see project review worksheet date
HOLD reason date
HOLD Subject to Zoning Board of Appeals action
Comments
Inspectors signature Date
Applicant informed of above- Date time__staff (fax, phone, in person)
YfYYiiiYfti;YYififfi f i f i fYf i tYfYififYtYifY Y Y*flan**** Y f
Over six months since approved for issue - DEEMED abandoned!
Advise applicant. Hold 90 days for return then dispose if not picked up.
Inspector Date
Advised applicant Date Time staff_ (by phone, fax or in person)
f5Y5YYffffff***ffYff***YYf*ffffffYYYfffffYffffYYff*****fffff******YffYff*f YYY f fY*f Yf f f ff Y f ff Y***f Y Y*f f Yf
OFFICEUNSPECPORS NOTES
TOTAL FEE
Gross area - new construction Total Sq. Ft.
alteration Total Sq. Ft.
Permit is issued to
Comments/notes on permit
1600 TO THE APPLICANT/REFERRAL AND APPROVAL
Date of Application submission
Plat _Lot_ Street Aquifer Zone•
Owner
Owner mail address
Owner phone f
;;;;i;;i;;;;iR;i;;;i;;;i ; i ;; iii;ii;i i i i i; i i i itii;;i;i;i ;i iiififi;ii; i man
OTHER INVOLVED AGENCIES-The following agencies require separate jurisdictional permits or approval for your
proposed project. CONTACT THEM FOR REQUIRED SUBMISSIONS.
0 TAX COLLECTOR 0 Approved E HOW By Date
❑ Board of Appeals 71 Approved By Date
❑ Conservation Commission G Approved By - Date
❑ D.P.W. Water Approved By ❑ D.P.W. Sewer C Approved By Date
❑ D.P.W. Cross Connection a Approved By Date
❑ Treasurer(Bond) ❑Approved By Date
❑ D.P.W. Engineering C Approved By Date
1 Board of Health (well) 0 Approved By Date
❑ Board of Health (septic) Approved By Date
❑ Board of Health (food service) C Approved By Date
❑ Planning Board (parking) C Approved By Date
❑ FIRE DISTRICT (I - II - III) LT. Approved By Date
BUILDING DEPARTMENT APPROVAL:
❑ ZONING
❑ BUILDING INSPECTORBUILDING COMMISSIONER
❑ CONTROL CONSTRUCTION AFFIDAVIT
t;;;;;;i;;i;;;tii;i;;iiii;i;iiiiii;i;i;;iiii;ii;;ii******************;;;i;i************;i;;;;;;;;;;;i;;;
PROJECT SUMMARY:
new construction/ alteration/demo sewage disposal - public/private
[Alter/add interior walls] [add rooms] [add footprint] water supply - public/private well
[pool] [garage/shed/deck] [game court] [food service]
Describe
;i;;iii;;i ;;;;;;; i; ; ; i; ;; ;;t i;;;i; i ; ;i i i ;;;;i; iti;ifi;i;fi ; i ;f;i;;
To the various departments:
This notice has been forwarded to you for your information and any appropriate action. Should you have any
questions please advise. If any reason to withhold the requested permit is found, please advise. Your assistance and
cooperation is appreciated.
The Building Department- Date sent for review By
8
TOWN OF DARTMOUTH
REQUEST FOR ASSIGNMENT OF HOUSE NUMBER
Owner(s) of Property ,E_ce lcy
Present Address ,sli'/�C ffe:.4 '7
Telephone Number c`iG �-i%C
)
n , Fl 3.
House Location: Plat ' " Lot - �7
��Subdivision ,`,/i� �f,� ���� Lot
Corner Lot ? Yes No
Street ;?,,,.7,/� , l;f y / .X b,�G/ /�•.��
Single Family .— Multi Family Condominium # of Units
Site Plan Submitted ? Yes ` No Date Submitted
Signature of Owner
House Number Assigned #3 WARBLER WAY Date Assigned 6-24-97
Date Assessors Notified 6-24-97 Date Building Dept. Notified 6-24-97
Date Owner Notified
2 CA
i et Supertinterrdent, D partment of Public Works
•
Dartmouth Building Department
400 Slocum Road
P. U. Box 79399 Sd8-999-B7c8
Dartmouth, MA 02747 • FAX 8999 73a
STATEMENT - OF REQUEST FOR SPECIAL
PERMIT PER 780 CMR 114 . 0 PERMITS
I /Q471 jj/f hereby request a
' PLEASE PRINT
Foundation Only Permit pursuant to 780 CMR Section 114. 8. 1
understand that I assume all responsi 'Dility for proper placement of
said foundation in accordance with 780 CMR 114. 8 Approval in Part
and Zoning and will , if required, make any necessary corrections
for failure to comply with the applicable code and regulations
including but not limited to removal in its entirely of said
foundation.
Foundation located at : Fz(ay 2 of-/0J( /°". -G "�� ^0/./.1/r�0•
Signed under the pains and penalties of perjury as applicable in
the Commonwealth of Massachusetts.
SIGNATURE OF OWNER OR AU ? ZED AGENT DATE
BUILDING- PERMIT'
SPECIAL PERMIT PER 780 CIMIR 114.0
FIELD INSPECTION
Dartmouth Building Department Plat• 56
400 Slocum Road P.O. Box 9399 ILot( s) : 2-122
Dartmouth, MA 02747 ' Lot Size: 40, 175
Telephone (508 0 YLone Dist. : SRB
Issued Da ? /i / 7 2 Permit No: _
Project L, do • 3 Wabler wav
Number Street
Subdivision Name:
Nearest Cross Street:
Applicant/Agent: Bob Mullens of Cherryfield Development
Contact Person Phone #: (508 ) 946-9.:18
Proposed Use: Residential
Residential, Commercial.Industrial. etc.
Permit issued To: To Install.
Type of Imcrovomo_I,Add Ali„,, C'ur I. 1} ,. 7_„„diMavr._
Foundation only
Io'irate no.of bedrooms and bathrooms and other roams - -
Owners) of Record: Cherryfield Development
Address: 8 Wareham Street, Middleboro, MA
DATE TIME TYPE OF INSPECTION REMARKS 1 INITIAL �I
I
i �
�� BUILDING PERMIT
%1Fifth Edition ❑ Sixth Edition
SPECIAL PERMIT PER 780 CMR 114.0
Dartmouth Building Department Plat: 66
400 Slocum Road-P.O. Box 9399 Lot(s) : 2-122
Dartmouth, MA 02747 Lot Size: 40, 175
Telephone 508-999-0720 Zoning Dist. : SRB
June 17, 1997 (typed) Permit No. : 0171
Issued Date: 7/3t// 92 Clerk: BAS
Project Location: Wabler Way
Number Street
Subdivision Name:
Nearest Cross Street:
Applicant/Agent: Bob Mullins of Cherryfield Development
Address: 8 Wareham Street, Middleboro, MA
Contact Person Phone #: (508) 946-9118
Type of License: Owner: ( ) Const. Superv. License #: (057185 )
Architect: ( ) Engineer: ( ) Other: (
ngin• Residential
Residential,Commercial,Industrial, etc.
Permit Issued To: To Install
41111
Type of Improvement,Add,Alter,New Coast.,Demo,Land/Move,etc.
Foundation only
indicate no.of bedroom,and bathrooms and other rooms
Gross Area of Const. : Cost of Const. $6, 000.00
Cost-Other Const. : TOTAL FEE: $ 50 . 00
Owner(s) of Record: ASM Realty
Address: Hawthorn Street, New Bedford, MA
All work shall comply with 780 CMR 5th Ed. (MGL Chap. 142 ) and any
other applicable Mass. Laws or codes and plans on file.
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 un nd other agencies may have reason to STOP
WORK if items under their juris lotion a not,-met: of wiithhstanding the issuance
of this t Buire of wrier/Zoning Permit L--Q,-i"/ � '
Signature of Owner/Agent. ���lc �'". �
Address:
Signature: y,
Approved/Issued By: el S. Reed, Title: Local Building Inspector
COMMENTS: PLEASE P ST PERMIT CARD SO THAT IT IS VISIBLE FROM
THE STREET. SCHEDULE APPROPRIATE INSPECTIONS AS
REQUIRED. UPON COMPLETION OF WORK, FINAL INSPECTION
IS REQUIRED.
0 ORIGINAL 0 APPLICANT 0 ASSESSORS 0 CLERK 0 COPY