BP-677 • CURER]
BUILDING PERMIT
FIELD INSPECTION
Dartmouth Building Department Plat : 71
400 Slocum Road-P. O. Box 9399 Lot (s) : 77
North Dartmouth, MA 02747 Lot Size:
Telephone 508-999-0720 Zone Dist. : SRA
Issued Date: 06/16/92 Permit No. : 677
Project Location : 674 Old Fall River Road
Number
Subdivision Name:
Nearest Cross Street : Hixville & Faunce Corner Road — ---
Applicant/Agent : Cheryl Banville
Contact Person Phone #: ( ) 508-998-1082
Proposed Use: Residential
$$$$$$nt$e1. Coseerdlal, Induslrtal. eta.
Permit Issued To: New Construction
Typo of lesrereont, Add, Alter, New Cont., Dose. Lod/Novo, etc.
10' X 10' Deck ( 100 sq. ft.
indicate no. and bathr•eee. and ether roes.
Own-errtst of Record: Cheryl Banville
Address: 674 Old Fall River Road. North Dartmouth. MA 02747
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BUILDING PERMIT
Dartmouth Building Department Plat : 71
400 Slocum Road-P. O. Box 9399 Lot (s) : 77
North Dartmouth, MA 02747 Lot Size :
Telephone 508-999-0720 Zoning Dist. : sra
June 15, 1992 (typed) Permit No. : 677
Issued Date: 6 / 16/ 1992 Clerk: LLS
Project Location : 674 Old Fall River Road
Nimbler
Subdivision Name:
Nearest Cross Street : Hixville & Faunce Corner Road
Applicant/Agent : Cheryl Banville
Address: 674 Old Fall River Road. North Dartmouth. MA 02747
Contact Person Phone #: ( ) 508-998-1082
Type of License: Owner: (x) Const. Superv. License #: (
Architect : ( ) Engineer: ( ) Other: (
Proposed Use: Residential
Rol a.nti.1. Commercial. Industrial, etc.
Permit Issued To: New Construction
Type of Improvement. Add. Alter. Now Comet.. Demo. Lana/Norm. etc.
10' X 10' Deck
indicate no. of bedrooas and bathrooae and other reludi_ _ _ -- -.--_- - -- -- -,--
Gross Area of Const. : 100 soft. Cost of Const. $350. 00
Cost-Other Const. : TOTAL FEE: $ 40. 00
Owner(s) of Record: Cheryl Banville
Address: 674 Old Fall River Road. North Dartmouth. MA 02747
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 authorizege-lasmt.
Signature of Owner/Agent : C / �
Address :
************a**************************** *************************
Signature: �-���
Approved/Issued By: William A. Braga, Local ®Building Inspector
I =
COMMENTS:ORIGINAL 0 APPLICANT 0 ASSESSORS CLERK 0 COPY
I NG PERM I
Dartmouth ButLuang Uepw r iragn$ 1 At ; 71
4-0,?4 Slocuoi Road--P. 0, Bon 9344. L.aat A 5: t 77
wo;-th 'Dart mfitith, M ) 087-47 Lot 9 7F ;
etC:[home 50 r9 C3 9 72_'e'r I i !i'13:eCr Dl St.:,
.: : -'•
+ _rre 15, 1892 (typed) Permit PIO. : 677 •_ .._
> s s"ed I•:t 4 t ___i._..1.1';-'__. 19Q2 -::erg( .—_U S� _._
Pre ct L neat ion. _674 Fa/ 1 _,r£e_wec_Ap&,!
titer fag..ee4:
ll)u,El' t ;lon idd' C3
Nearest Crass litreet s Hi: 1 . n_a_;_'_`tine _CAA
( pp1ic?nt 1441ent7 ._.m..C'4,rv1 BanJ4 t I� ri _._.. _. may
Bcid'-e5..= • _47L fJsr` FeII B1yor. ;rs;ada_ Nnrt'', E.e kaout!t' hip
Coot act Per5 ,n Phone it ( )f y`e o= License: Owner: `+<i. Const, Super». License ti. )
architect ( s t nt treet•, { I °ther;
Proposed Ilse ..._. Rbg - Lnen+ i.60 _.. � .
Pass t "stood T1); },s+ya L:L lst riusa to i ,.......
e4W o£`xpz�assRmesi, vt- . F«:? Yca Consc,. i f_srvd `!a s ;r.,Y�
t0' x rl'*' : Deck -
•-._- -Ia4f<aSR Na..!04 bode-son sad fMCttrean H'-4 O<fier ro:,aa_ •-•••• •��_....__--___.__—._._v.._._._.—_._ _. _ _.—...
Gross Fir- a of: Const. 1O£ sq_ ft; Cost of rConst.
C 4,3t-Othor Const ; TOTAL FCi z trf'e. eta —
Ore .- 6 4 f'1 f r r r,+ti+��6 r4 41 r tt`'
011 1 d=:or k shall camp':.y w,l.th. 700 ClIR ' th Ed= .i^r L Crt pa 142:' e tci ny
,..77Lh.car Maus. Laws or codes and plans r ' fii i e.
I herr=by certify thst the proposed rice. is authorized by the
r*ncr
�... record and I. have been authorized by the owner to make this
ip} i -,c:at ion as hit <_ atheri etL_aige.nt,
r:. tcnat Lire :if OWnt_ri' 3e i;.P w-+=. _ me .:4
AddrPSS
A.* ****w *1tiF ***44R*******;)4'1tid*:v.q St***iir.it•iRiC*.*-***.****** ..
rfr-r;'.•ovea/ Ni; >d Sy: W, 11 d: A.. Craer_a; t oca1 ,:•t=r 1 tr.;i::i,a Inspemtor:
h.s'r f. . 3_ L,ANt Fk7y� A JSf_Fi'3Orc^, L4- CLERK Li COP
Required approval Approvals received
please (X) approvals Please (X) approvals and
required for this project Initial as received
DATE INITIALS
Board of Appeals
Water Card
Sever Card
Board of Health
Bond
Selectmen
Conservation
Fire Chief
Cross Connections
Licensed Contractor
Controlled Const. Affid.
Other information required
E
CAt
RECEIPT;FOR PERMIT G� P
�� TOWN OF DARTMOUTH
/ PER IT O.
i 4.ey� Now*ih e-•/f/ %��
� 43i
Date /�ti.it c c. / l� 102
1 Received From E A/.S c� `/ y i -2i
Owner _„d < t-,
Location /i yr Set `7.(.�e 40,,ufc,
Type _"r .r_,v- Ca--u t c4
AmountPaid 2' 1.,-e-.C-L.-v(-
Received By (! G u ^c 2_�
RECEIPT FOR PERMIT GG
TOWN OF DARTMOUTH O / 7
PERMIT NO.
,.", No//7-6s—Y , /SA, ,
ktourit
Date / / 1�. ��/ ;
Received From Y_YGt - C// ° !
Owner — --./ y r
/
Location f0 2// l�'V`.n"C�.C�C
2 ; tit e-44H,/J
Type a� 'cGL.�/
Amount Paid / Q <�� �� G/} •
Received By l _A if14 r. if C 64 tam.,
,y
7
h tilit.'q,... PERMIT NO. G ` 7
"� ``` ,.. TOWN OF DARTMOUTH
7d: , /
� `� �` J'` DATE ISSUED to i '1'
iro%�y
� 21 TOTAL COST iM
\ APPLICATION FOR rr' �' LESS APPLICATION FEE aJ /
it. SS) BUILDING PERMIT
„Ift64,.- • FINAL PERMIT FEE /. Cleta
LOCATION OF BUILDING
// _ y� Jr>/
01 Number & Street ?t (VFW rot/ J9'/vc'v / 01.1 Zoning District±3"241
02 Cross Streets(between) and
�,
etIot 7 7 Plat 7/ 04 Subdivision Lot
OWNERSHIP COST
05 . 'Private (individual, corporation, 36 Cost of Improvement cf _��
non-profit institution, etc.) 36.1 To be installed but not
06 ❑ Public (Federal, State, or local government) included in the above cost
TYPE OF CONSTRUCTION 36.2 Electrical
07 �❑❑ ,New Construction �� 36.3 Plumbing
08 L+d'Addition -Type of Room(s)jck /6 X/d ' 36.4 HVAC
09 ❑ Alteration 36.5 Other - Specify
10 ❑ Foundation Only 37 TOTAL example: elevator ���
11 ❑ Demolition (#of units if residential)
12• ❑ Moving (relocation)
STRUCTURE
STATISTICS 38 ❑ Wood Frame
13 Number of Bedrooms 39 ❑ Masonry (wall bearing)
14 Number of Bathrooms (Total) 40 ❑ Structural Steel
Full-Tub 41 ❑ Reinforced concrete
3/4 - Shower 42 ❑ Other- Specify
1/2 - Toilet Only
RESIDENTIAL-PROPOSED USE DIMENSIONS
15 ❑ One-Family 43 Number of stories
16 ❑ Two or more families 44 Total square feet of floor area, all floors,
Number of units based on exterior dimensions / -Z) Sfr
17 ❑ Garage 45 Total land area, square feet
18 ❑ Shed q
19 ❑ Carport
20 ❑ Swimming Pool SEWAGE DISPOSAL
In-Ground_Above-Ground
21 ❑ Woodstove 46 ❑ Public or private company
22 ❑ Fireplace 47 Q Private (septic tank, etc.)
23 ❑ Other- Specify 2G CR
•
j' X bry WATER SUPPLY
48 ❑yublic or private company
NON-RESIDENTIAL - PROPOSED USE 49 WPrivate, (well, cistern)
24 ❑ Amusement, recreational PRINCIPAL TYPE OF HEATING FUEL
25 ❑ Church, other religious e
26 ❑ Industrial 50 ❑ Gas
27 ❑ Parking Garage 51 ❑ Oil
28 ❑ Service station, Repair garage 52 ❑ Electricity h `'
29 ❑ Hospital, institutional 53 ❑ Coal
30 ❑ Office, bank, professional 54 ❑ Other - Specify
31 ❑ Public utility
32 ❑ School, library, other educational TYPE OF MECHANICAL
33 ❑ Stores, mercantile 55 Will there be central air conditioning? ❑ Yes ❑ No
34 ❑ Tanks, towers 56 Will there be an elevator? ❑ Yes ❑ No
35 ❑ Other - Specify
PARKING PER ZONING BY-LAWS
57 0 Enclosed 58 ❑ Outside
59 Does this building contain asbestos? ❑,YES NO If yes complete the following:
Name & Address of Asbestos Removal Firm: " ` •
IDENTIFICATION -- To/be completed by all. applicants PLEASE PRINT
60 Owner (print) / YY, )4,777//e__
/ ME C MAILING ADDRESS TELEPHONE NO.r, e
61 Signature/LJ- ����� DATE S
Builder's
62 Contractor (print) License No.
NAME MAILING ADDRESS TELEPHONE NO.
63 Signature DATE
64 Architect or Engineer (print)
NAME MAILING ADDRESS TELEPHONE NO.
65 Signature DATE
CERTIFICATION TO PERFORM WORK
66 I/We hereby appoint
NAME ADDRESS
as my/our agent for the purpose of applying for and obtaining a building permit for the work to be done described in this
application.
Signature DATE
ADDITIONAL INFORMATION
67 Has A-1 or Determination been issued by Conservation Commission? ❑ YES ❑ NO
Submit copy of notification 'sent to DEQE and the State Dept. of Labor Industries and result of air sample analysis after
asbestos removal is complete:
+ 68 Owner or Agent - I certify under peril of the penalties of perjury that the information herein is accurate to the best of
my knowledgg�>
Signature C DATE
Owner or Agent
X69 BOARD OF HEALTH REVIEW Q C. RJ DATE
Inspector or Authorized Person
pCOMMENTS: r '2 lria 1 ftc✓� 12-72_ S
70 DPW - WATER Service No. SEWER Service No.
To be completed upon issuance of permit- (if applicable)
�p71 I will post per d address so as to be visible fro street.
I/� Signature �1� fn- DATE
Owner or t
72 I have received list of required inspections
Signature DATE
Owner or Agent
23
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