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-.. rit,. 'Uf tL:UilC.i }Pt ;iVlt 1`a :..to De eXc.Q..v,t:u. i t SJm Lri'4:..'i..VUUTI1ng ,Area
., .
o shown an plan, and backs illed ,vsth rl� 'lean qr ravel or, coarse dncl
as specified in 310 CPT ,1 .2 5(
7.
Washed crushed,t Shall ` - of iron fins and dust.. stone .;,y,aBW be f, t.
-
m a Septic tank ,distribution box . etc.,
P t .shiall :be nuftactured by Rotondt � .
cons 'Inc. or approved equal, and installed per manufacturers spee`ific tlon .
rout.shol.{ h US he to provide a ,,.,ater tight seal at,,ali joints where pipe
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ZONING
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enters or leaves a concrete :truc,.�re
Cutlet distribution � i . , v s t
d t ibutiort line.. sham be - 6, Lei .:.far a minimum taf the t�+,a feet;
•fi�..jt ,
their length
/.0�11 NG ` IS S B
SINGLE RESIDENCE
of asspecified, in 3,10 CM0 15.232(3), .
10.
A Beard of Health certtficote of Compliance as `required by 310 Gf R 15.021
i a . Pwv LOTFRONTAGE GE i
_ 150.00
must be obtained by contrattcar a �cn completion of fr�rk.
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IistritJiation lines to be capped at outlets.
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800 MECIIANICALS & PRIMARY FUEL
Architect/Engineer - project supervision and reports
_ Furnace (hot air),. Fuel gas (natural or propane), fuel oil,electricity, other (specify) _
:- Company name
Boiler (heating)- Fuel gas (natural or propane), fuel oil, electricity, other (specify)
Address
HVAC (combined unit) - Primary fuel, natural gas, propane, electricity, other (specify)
Phone number
- Air conditioning - (separate unit)
Certified by State of Massachusetts as
None of the above to be provided
Certification
ficatton number
- Hot Water Gas Electric Fuel Oil Other
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals andl not
900 SPREgC ERS - FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential
reproductions.
Required, --plans provided, _plans not provided, why?
General Contractor (if Homeowner, state homeowner here then complete section 1300)
- Not required, not to be installed. «hv?
Company name FNnRTI INAS RROS TNT'. _
Address 67R ne nt Straat � P O 80X 349 Easton, MVA' 02334.
1000 REQUIRED OFF-STREET PARING - for ZONING & Architectural Access
- N'OT APPLICABLE
j
Phone number �nA--qA—FIRS
,
- Parking Plan submitted To _ Buildin De artment = Plannin Board Date submitted
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Construction Supervisors license number #058684 f RfIRFRT V DOANE l
Number of spaces - indoors outside total provided
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals andl not
j
reproductions.
Handicap -paces - required _ ves _no. If yes, how many as a part of the total required number.
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Is Route 6 (State Road) Entrance permit required? ves = no _. If ves has it been issued ves = no =.
1200 FOR RESIDENTIAL REMODEL WORK ONLY
Suhmit copy of application and/or permit as soon as available.
Are you a Home Improvement Contractor subject to (780CMR - 6) ?Yes No If no go to next section!
1100 IDENTIFICATION (print or type except as noted)
'
Are you claiming exemption from the requirement? Yes �No �If yes, submit the required -affidavit!
Current owner- name COWAAL REALTY TRUST
I
Ren_-)del contractor name (please print)
_
address 078 DEPOT STREET P.O. BOX '349 EASTON , MA 02334
Address
phone ## (508) 238-5566
Registration number (if none state "none")
If corporation. officer in charge
Phone number
Architect/Engineer -for overall design
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE
Company name
GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write:
Home Improvement Contractors Registration
Address
One Ashburton Place - Room 1301
Boston, MA 02108
Phone number
I _ .
(617) 727-8598
Certified by State of Massachusetts as
Owners name (print)
Certification number
Signature
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
Date
reproductions.
I, the undersigned, am the owner of record or authorized lessee (provide documentation) and I have rev' ewed
this
the application herein submitted.:. I state that to 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 be gun 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 b
written request. I understand that once the permit expires a new application may be required, includinfees and current
other requirements (including Zoning). g
Name WALTER R. ENDRIUNAS
Signature ;
The above signature is my voluntary act and is signed under the pains and penalties of perjury.
Date 11/20/97
Who is authorized to pickup the permit at the Building Department? iplease onntROBERT V DOANE
.-address 287 Highland Ave Phone_(7811 963-2479
,
1400 HOMEOWNER EXEMPTION - ONE & TWO FAMII,Y ONLY
FOR HOME OWNTERS WHO I.NTEND TO PERFOILi1 AND BE RESPONSIBLE FOR THEIR OWN PROJECT
109.1.1 Licensing of Construction Supervisors: Except for those structures governed by
in Section 127.0, effective �Construction Control
July 1, _198_, ne.no individual shall be engaged in directly supervising person 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 m the BBRS entitled
R:.les and ^egulations for Licensing Co.- Supervisors.
Exception: Any Home Owner performing work for which a Building Permit is required
q 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 sectior. nly, a "Home Owner" is defined as follows: Person(s) who owns a parcel of land
on which hershe 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
;iwo-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, szxszzxzx:xszaszszsmssssszzsxsstsssssssssssss:sssszssssssxsmzssssssssssssszsssssstssgeneral
sssliability
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NOTICE TO LICENSED CONTRACTORS: The BuddingCode v• provides in the Rules and Regulations section that any
licensed Construction Supervisor, whether or not they have taken the permit are responsible for code com pliances (see
2.15.: of Sector ��
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1,500 COST
Cost of Improvement
S
Items to be installed but not included in the above cost: Electrical 5
Plumbing
HVAC
Other ,9
TOTAL
i
Altemuon of existing, 'no increase in gross square feet. A separate Refuse Disposal Doe-claration required.
- Demolition describe structure
Number of dwelling units Number of bedrooms A separate R),efuse 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-roori g - (for existing only, is included in new construction)
Number of square feet Number of layers already exi:�ting
Number of layers when complete
i
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 existiing dwelling; will be
considered as an :-alteration, otherwise will be included in new construction. (see Code seection 3401.10 for
residential and Article 8 for commercial) -
_ Temporary structure - includes when allowed, trailers, tents and the like and only for limiited periods of time.
Describe
500 CONSTRUCTION PLANS
= None submitted. Why?
Submitted. usually three sets required. Four sets for food serviceluses. Number of sets submitted
it
600 SITE PLAN
❑ Not required, why?
K Submitted When? = Previously, date 1 1 / 10With this application
700 UTILITIES
i
Water supply required _yes _ no, public? yes _ no, on site well? yrs 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 eater 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 availatble.
I
= Woodstove - used (will require inspection prior to installation), new (provide manufacturers ' >
instructions). Location(s) (list)
Fireplace(s) (includes flue) List location(s)
Game Court - describe (include overall dimensions)
i
Tent, Trailer (Mobile Home) or Other - describe
300 CO''IUOIERCIAL - PROPOSED PROJECT/USE - INCLUDING THREE FAMILY OR MORE AND EXEMPT USES
TIIS SECTION NOT APPLICABLE
(The following descriptions are based on the Massachusetts State Building Code Article 3 AS NOTED) (See tEe
Code)
Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe
I
j
Business - office, assembly with less than 50 occupants - indicate Medical or other professional (see Code
Section 303.0)
Educational - 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)
= High Hazard (see Code Section 306.0)
Institutional - hospital, nursing home, infant day care (see Code Section 307.0)
Mercantile retail stores (see Code 308.0)
- Residential - three or more family, hotel (see Code Section 309.0)
Storage = includes garages (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, indicate above (see Code Section 119.0 and Zoning By-law section 35)
_ Tent or Trailer - temporary purpose?
Other
Describe the proposal briefly, INCLUDE - umber of dwelling units and bedrooms or occupant load as applicable,
also existing condition
40J TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED
c New Construction and/or Addition - total gross square feet
(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
= 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 ( Appendix PP n
APPLICANT TO PROVIDE
The following section for official use only.
INSPECTORS' REVIEW
Date plan reviewed
30 days to review period expires
OK to issue date
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 NDV 2 4 1997
e
Applicant informed of above - Date time staff (fax, phone, iin person)
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Over six months since approved for issue - DEEMED abandoned!
Advise appl<lcant. Hold 90 days forreturn then dispose if not picked up. ,
Inspector Date
Advised applicant Date Time staff (by phone, fax or in person)
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OFFICEVNSPECTORS NOTES
TOTAL FEE Q
Gross area - new construction Total Sq. Ft.
alteration Total Sq. Ft.
Permit is issued to
---
Comments/notes on permit
C¢
####Y####Y#YYYYYYY#YYYYYYi#tYtssYYsss##s###########Y##YY#YY###Y#YY#YYYY#YYY#YY#YYYYY*Yssstsssss#ssYYYY##
1600 TO THE APPLICANT/REFERRAL AND APPROVAL
Date of Application submis on4AIA 7
Plat Lot
eet quifer Zone
Owner
Owner mail address
,
Owner phone #
OTHER INVOLVED AGENCIES -The following agencies requires arate jurisdictional permits or approval for your
proposed project. CONTI'A THEM FOR MIED SUBNmMONS.
is TAX COLLECTOR �— Approved HOLD Date
❑ Board of Appeals Approved By pate
❑ Conservation Commission r roved By Date
❑ D.P.W. Water Approv By 0 D.P.W. Sewer _ Approved By Date
❑ D.P.W. Cross Conne on u Approved By Date
❑ Treasurer (Bon ❑ Approved By Date
113 D.P.W. E, ee rtn
Approved
g -- B
App
yAA
Date
7 Boarc of Health (well) Approved By. Date
❑ bard of Health (septic) Approved By Date
❑ Board of Health (food service) Approved By Date
❑ Planning Board (parking) Approved By Date
N FIRE DISTRICT (I - II Approved By
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BUILDING DEPARTMENT APPROVAL:
❑ ZONING
❑ BUILDING INSPECTORBUILDING COMMISSIONER
❑ CONTROL CONSTRUCTION AFFIDAVIT
PROJECT SUMMARY: ###**
new constructioni alteration/demo sewage disposal public/private
[Alter/add interior walls] [add rooms] [add footprint] water supply public/private well
[pool] [garage/shed/ k] [game cou ] [food service]
Describe gf
To the various departmeg
This notice has been forwarded to you for your information and any appropriate action. Should you have anv
questions please advise. If any reason to withhold the requested permit is fo nd, please advise. Your assistance and
cooperation is appreciated.
The Building Department - Date sent for revie
w By
G.
TOWN OF DARTMOUTH DG D. P RIME :
TELEPHONE 508-999-0720 FAX : 508' 99-0738XX
APPLICATION FOR ZONESIG AND BUILDING PERMIT
I�'uehom .
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 in_Rerted for those sections
which do not apply. A properly, completed application will help avoid unnecessary delays. Isfe: FMag Aims mi
(for office use only) U5UNDATION ONLY
Total Cost $ Received By Date Rec'd
Less Application Fee $
Total Permit Fee s Permit # Lwned Date
100 LOCATION OF PROJECT
TOTAL LAND AREA SQUARE FEET 56g 7
CURRENT ACCESSORS PLAT & LOT �f���—�ZONIN DISTRI
OiL
THER ZONING OVERLAY DISTRICTS if applicable
NUMBER & STREET REED S T R 9 % ROAD
NEAREST CROSS STREET STONEWALL AVE,
SUBDIVISION NAME & LOT# DARTMOUTH LANDING #106
or BUSINESS NAME
PREVIOUS TENANT / OWNER INTERSTATE REALTY TRUST
200 RESIDENTIAL, - PROPOSED PROJECT one & two familyresidence only
THIS SECTION NOT APPLICABLE
Single family - number bedrooms number baths
I
Two family - number bedrooms unit 1 number baths unit 1
number bedrooms unit 2 _ number baths unit 2
Accessory "
g q.
Accessory structure:
apartment Total toss s ft. it
Garage detached - attached to dwelling, Cimensions L W
Carport - detached attached to dwelling, dimensions L oV
Shed - dimensions L W
Deck - dimensions L W
Gazebo - dimensions L W
i
_ Swimming pool above ground in -ground Size
Chimney - number of flues