BP-397 BUILDING PERMIT
FIELD INSPECTION -�
Dartmouth Building Department Plat: 74
400 Slocum Road P.O. Box 9399 Lot(s) :5-2
Dartmouth, MA 02747 Lot Size: 40,001 •
Telephone (508 ) 999-0720 Zone Dist. :SRB
Issued Date: 11/21 /96 Permit No: 397
Project Location: 4 Knollwoodc rF°?1n
Number Street '' I—. L
� 5v
Subdivision Name:
Nearest Cross Street:
Applicant/Agent: James Silva
Contact Person Phone #: (508) 324-4637
Proposed Use: Residential
Residential, Commercial, Industrial, etc.
Permit Issued To: New Construction _
Type of Improvement,Add,Alter,New Coast.,Demo,Land/Move,etc.
16 ' x 12 ' shed ( 192 sq.ft. )
__ ._. Indicate no.-o bulrooms-and bathroom=_and abler_ro^_ms_—._. __ _ _
Owner(s) of Record: James & Linda Silva
Address: 4 Knollwood Drive, North Dartmouth, MA 02747
DATE TIME TYPE OF INSPECTION REMARKS INITIAL
I— ,9- 9= 97 /.;; 4?
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BUILDINGPERM I T
Dartmouth Bpi lain q Department Plot 7-+
4elw.f Slocum Pond-P. rt Bon r Det f i_ot ) i'iiiii7 i
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Dart month, NA 0 7c :' i Lot `ai ':'s t4ek :t} i
Tea i `'ph D n e "tM e 9--tt3lir:?` 9) (.5ii Inq Di (it. :ORB
--.is a mber cu. 4.=39e (t .+,e;-„d) ,. Per iait Pia. : f•.
Ic.s.tied Dat:eb i ..i L._....,y. C1 ern r.. lift-'-P.... ..._ ,.-
Pro iec t f )cations + kinotIwoc,d _Dri
S Utvi 1 V i ti 1 on NoInix:
)5i?..,c : .d Cr 0 o€ Ed neat
iippii cant/Agent t in 23t1ye
Ades$$ t st_ >Sln5 i_wiati_d_lr+iyfi_?,, 9°;(l ._ti h ,rsirl etoUCh ._i 3,R a?it'
I_ontastt: Person Phone ,'a : (sEe) :'it'-=tit iT _ _ _
Type of t.icenaak : Owner : (e) Conct Super+:,, License 4i$; i i
Architect : ) Engineer: ( ) Other:
Prcpol; d ((se: Pestilential
a xt..tits .144:bzsaxLr3 4'444444.4.:14,146 «cp.
Permit:it Issued "4o: S`S,itw 1 en'7sa1,:3' uction
TYR* 4 loal anens. idq. Altar, #ew fanst-, uaax. 4.P,ae'9Msrt. ..t4c,._—_------
b ii YY $„hiai!Q ;.
a diti< 4 nor.., vcd.-6dt% s., tll-r-toa% a.ftfi L^.}f97,-,, S•xe 4.-.•_...-••••_"•..' •.••_• •.�-•.~•••� ...1�_
Cii-' "irc?Z2 l 4
of 01'Ls i. : }'3y-SL?__r�..,._ Cost II Cont, , t3 tSi&Ai 4r9_
Cost ct-Other Cons t. ; TOTAL. I:->EEs 9 ._. g 00
align t7 r i . : Of Pecocd: ....___. after_ (r Lindy, t t 5 ,:e
Ad f}r es; : t' F nQkttoo $_-D qv'r', Nop E ,.,Dart mo ttCat,, Mice 2,1474..
Al i work idial I comply with ino tckii `itel Ed, 1.I46I_ Chap. J +a .-i rd ,_n,other appl appl icabie (i'lzi s, Law: or' codes and plans on f7. :0.
t hereby cactity that the .re,pos mar) is author Ized by the owner of , d ore? anti
have bean ; uthorizeri by the owner to mai this appiiC;lien 3_ ;its agent and la
recei ye th2s, permit, I jirtier understand other a en ,ies may have reasys to STOP
W)f'l( if ;It under their ,juristict"ii,ftn are nt3.t7 nett es:Li:statding the issuance
of this [at rdin = rn Tuing C ere t. �f /2/ 7 r
]i gnat li.r F of Owner/fig Eici t o 1 e ,r, 79 Ty`.,� /t.,e,
e*ak4*s? 8 k*'.k*-R F#:r.'1.R'*it'F3E?+.$iy*• *iss i $s3 '1l'{j*'-%31. im3efi'i*K*R}''Shiisms# Y 3,i..K..#Yr*sat
t-a) sixcf it9is s ac .1 By liii el S. Tie„irt I it i a it<a Idi prit t t ,`a t
PPliftfaiTS Pik 1i,F t?--4 i PE 31111 T 2'$ M) O 1t-M i t 9" '{ti t i I`n I Hi,t- s Atiik
Till: STREET
�_1 OR IC i+'.ii=T. : 6 iiPP4. ItAN€ , l r-1; t obi(b ii t !E4:;r: -.f COPY
�. � ��
STOW O DARTMOUTH
BUILDING RECEIPTS
NO TAXI ISSUES COL LECTOR'S OFFICE
Name:
s..�` y �+..�1 �;-2-1_+Z.., Prop
JobL "atf Owner:erty _�'' -_ --Yy :- r_ Date: - r-
oc on / r l
Plot: ,r., White
f f Lot: f Copy-Collector s Office
f -- Yellowp
_ Pink C Copy-Customer's Receipt
Phone: opy-File Copy
-- Green COPY-Building Department
Description
Amount
01000-44105
License&Permits-Building Misc,
01000-44105
TOWN OF
01000-44106 t y
License&Permits-Plumbing&Gas
01000-44107 i `,
Other Department Revenue �i
01000-42420
Thi i t a Permit or License for Buildin Plumbin or Gas
f --.
Received By: A_' ,\"-- -4-zc_W �_.
TOWN OF DARTMOUTH .
00067
N 0 TAX I SS U E BUILDING RECEIPTS
SCOLLECTOR'S OFFICE
I ,-
Name /frvicez '3 Property ,.� Date / -/7 5 i - ,
Owner:
Job Location: , L / r 1 ,"
White Copy-Collector's Office
Plot: -' - :� ; / Lot: / Yellow Copy-Customer's Receipt.
/ r - Pink Copy File Copy
CGONNW}DAlt11/446VIWartment
Phone:1 , _ 2 TAX COI.I.FCTOR'S OFFICE
h4,,‘ NOV 1't8 1996
Descri}�tion General Ledger#'s Ref.# Amount
License&Permits-Building 01000-44105 MRS 02
License&Permits-Building Misc. 01000-44105 < 0f Ct—J
License&Permits-Electrical 01000-44106
License&Permits-Plumbing&Gas 01000-44107
Other Department Revenue 01000-42420 /
1 l.,
This is not a Permit or License for Building,Plumbing or Gas Received By: ✓0--_ <.a E17_ �7 L t C .
-10
RECEIPT FOR PERMIT
/ TOWN OF DARTMOUTH 2
/ PERMIT NO
x` Noy U p4---
t /
Date // - 02/ ' 9 6 .
Received From --1---72 -d ,k41--
Owner -.41--d---rvt-e-�
Location �¢ a- -1'//�. �-r'"
Type
Amount Paid C; \
Received By /9 " )/ ,C4A-' c__
TOWN OF DARTMOUTH BUILDING- DEPARTMENT
TELEPHONE 508-999-0720 FAX 508-999-0738
APPLICATION FOR ZONING AND BUILDING PERMIT
lasavctions
The applicant shall complete this application to the test of their ability prior to sobmiivan.•lnrmg no item unanswered.The
Department staff will be available during regular business hours to assist as necessary.WA should be inserted for those sections
which do not apply.A properly completed application will help avoid unnecessary delays. N s Plus ties S refs■iattle-
(for office mse ociy) i
Application fee Sac j C received by Y ; Date
i° C1 w
1 Total Permit Fee S Permit# �� / 7
U 100 LOCATION OF PROJECT p
CURRENT ACCESSORS' PLAT 7' / L S R- ZONING DISTRICT C 6
iOTHER ZONING OVERLAY DISTRICTS ,..if applicable
NUMBER S. STREET 'V /fNdy44/C'= ¢ V�
NEAREST CROSS STREET //C2Teri ,44n-'4-4e. 4-1154i?
SUBDIVISION NAME & LOT#
or BUSINESS NAME
PREVIOUS TENANT : OWNER
- 200 RESIDENTIAL - PROPOSED PROJECT - one & two family residence only
7. THIS SECTION NOT APPLICABLE
_ Single family - number bedrooms number baths _
- Two family - number bedrooms unit 1 number baths unit I
number bedrooms unit 2 number baths unit 2
= Accessory apartment Total gross sq. ft..
- Accessory structure
Garage - detached - attached to dwelling, dimensions L W
J _ Carport • detached - attached to dwelling, dimensions L W
TC Shed - dimensions L /( w /v
Gazebo - dimensions L W
_ Swimming pool above ground in-ground Size total square feet
Chimney -#of flues
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)
Tent, Trailer (Mobile Home) or Other- describe
300 COMMERCIAL-PROPOSED PROJECT/USE-INCLUDING THREE FAMILY OR MORE AND EXEMPT USES
THIS SECTION NOT APPLICABLE
(The following descriptions are based on the Massachusetts State Building Code Article 3,AS NOTED) (See the
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 303.0)
Educational-structure for training including child day care for those over?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)
C Storage - includes garages (see Code Section 309.0) •
T. Utility & Miscellaneous Structures - includes tents and agricultural structures (see Code Section 311.0)
T. Nea 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 number-of dwelling units and bedrooms or occupant load as applicable,
to existing condition
400 TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED
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 I)
APPLICANT TO PROVIDE
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 lavers 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 he maintained. Enlarged or new windows in an existing dwelling will be
considered as an Alteration. otherwise will he included in new construction. (see Code section 3401.10 for
residential and Article 8 for commercial)
Temporary structure- includes when allowed. trailers, tents and the like and only for limited periods of time.
Describe
500 Ct�t�STRUCTION PLANS
7I None submitted. Why? SAr ED
VV = Submitted. usually three sets required. Four sets for food servicekuses. Number of sets submitted
600 ITE PLAN
❑ Not required, why?
_ Submitted When? _ Previously, date 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 MECHANICALS & PRIMARY FIE,
Furnace(hot air) - Fuel gas (natural or propane), fuel oil, electricity, other(specify)
= Boiler (beating)- 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. Cplans provided, ::plans not provided, why?
XNot required, not to be installed. Why?
1000 REQUIRED OFF-STREET PARKING - for ZONING & Architectural Access
11 NOT APPLICABLE
: Parking Plan submitted To = Building Department : Planning Board Date submitted
Number of spaces - indoors outside total provided
Handicap spaces - require(' _ 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 _.
II Submit copy of application and/or permit as soon as available.
110 IDF:NTIFIC1TION (print or type except as noted)
`VV�� urrcnt owner- name 4ri/((' /gM.6.S ^-^l � L �/1/b 9• J/L✓
address y
1 :�c4-o,)0 yS 71 Je
i phone = ti37 ail-V63-.7
I If corporation. officer in charge
Architect'Engineer - for overall design
Company name
Address
Phone number
Certified by State of Massachusetts as
Certification number
1 NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
Architect/Engineer- project supervision and [sports
Company name
Address
Phone number
Certified by State of Massachusetts as
Certification number
•
NOTE Signatures and seals • ffidavits and other documents SHALL BE originals and not
reproductions.
General Contra -'r[if Homeowner. tate homeowner here then complete section 1300)
Company nam.
Address L/ kit/art 4.•-•001/4•• ..T 421 t/Q. 04412;if gs'`? 04/4'
Phone number .-57, 1/14.5-7
Construction Supervisors license number
NOTE Signatures and seals on all Sans. affidavits and other documents SHALL BE originals and not
reproductions.
1200 FOR RESIDENTIAL REMODEL WORK ONLY
Are you a Home Improvement Contractor subject to(780CMR -6) ? Yes_No_If no go to next section!
Are you claiming exemption from the requirement? Yes _No _If yes, submit the required affidavit!
Remodel contractor name (please print)
Address
Registration number(if 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)
Signature
Date •
•
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 to the best of my knowledge and belief that the information provided in this
application is true and correct and that the permit requested he 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
anncipated if I.request such an extension in writing. I understand that the permit may be extended only three times by
written reff11nest.I understand that once the permit expires a new application may be required,including fees and current
other regqiirements (including Zoning).
ame es 4.,;✓/L trff-
y E �ignature
e above signature is my voluntary act and is signed under the pains and penalties of perjury.
Date //—/5 —q(
vs
a e onnu 4 G
Rho is authorized to pickup the permit at the Building Department" :please Donn G//vpet �i.. SiG t/,ry
Address `I (.{21. e;. :` 2. Phone ;3 a N-` 7' '7ti./
1400 HOMEOWNER EXEMPTION - ONE &TWO FAMILY ONLY
FOR HOME OWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT
I09.1.1 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 regulations promulgated by the BBRS entitled
Rules and 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 personas) for hire to do such work ,that such
Home Owner shall act as supervisor.
For the purposes of this section oak,a "Home Owner" is defined as follows: Personas) who owns a parcel of land
on which he:she resides or intends to,eside.on which there is. or is intended to he. 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
XOTICE 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
if section )
1500 COST
Cost of Improvement $ / S—Qa
Items to he installed but not included in the above cost: Electrical 5 C
Plumbing —C. —
HVAC — u —
Other — C7
/
TOTAL S 0 VD
ie following section for official use only.
INSPECTORS' REVIEW
Date plan reviewed 640V 1 8 1
996
30 days to review period expires Qe..2. / r- 9
OK :o 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 Date140It 1 R 1996
Applicant informed of above - Date time_ staff (fax, phone, in person)
Sills****iSsi**!****itft•itsiisstitis.tsii!lttsftYkislitisYiY*ilt**iiiii#iiifitlsfit*******sistis**********
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)
ssssssssssssssssssssssssssssssssssssssssssssssssssss ssssss****sss******svvvvv*ssissssssa sssssss ssss s ssss
OFFICEUNSPECTORS NOTES
TOTAL FEE 50 av
Gross area - new construction /a - Total Sq. Ft.
alteration Total Sq. Ft.
Permit is issued to
Comments/notes on permit /. // Xn i 2— -p 19
1600 TO THE APPLICANT/REFERRAL AND APPROVAL
Date of Application submission i//.5/j
Plat Lout ,(// a�I / .
/ _'4„. " """— -6 Aquifer Zone_
Owner_
t—ik..---
Owner mail address yi.�(
Owner phone N
OTHER INVOLVED AGENCIES -The following agencies require separate jurisdictional permits or approval for your
proposed project. CONTACT'IHEM FOR REQUIRED SUBPALSSIONs_
COLLECTOR = Approved = HOLD By Date
ps.x
nservation Comm = Approved By
•
Date
❑ D.P.W. water = Approved By —
Date
—
❑ D.P.W. sewer = Approved By
Date _
❑ D.P.W. cross connection _ Approve
Date _
❑ D.P.W. engineering = Approved
Date
•• oard of Health well = Approved
Date
soar: of Health septic 7 Approved
Date
u Board of Health food service = Approved
Date
&hRE DISTRICT (I - II . III) = Approved
,��/c,� Date
//a Planning Dept _ Approved
�/ Date
()th,r _ Approved •
Date
1):^;r _ Approved
Date
( •..rn,ment5
Prniect summary new construction/ alteration/demo sewage disposal - public:private
[[Alter add interior wallsj [add rooms) [add footprint! water supply - public:private well
pond [garngeished) [game court (food service-
Describe
.r _
Eo the various departments:
This notice has been forwarded to you for your information and any appropriate action. Should you have any
aestions please advise. If any reason to withhold the requested permit is found. please advise. Your assistance and
ioper_zion is appreciated. O
e Building Department
I / l�w//,7
/ By y-� J
Date sent for review / r 4 �"
. •
470.444-94" LOT Z
40.001
•
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tPtit.1/4::44
710,1
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co
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Eaysn UG Z
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ef,
•
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4.1,7 4 4 3(44; •
rp
pik.'4 TOWN OF DARTMOUTH
iv .1U
N II vOr. 11 RECORD PLAN
A Copy Of This Endorsed
Plan Must Be Kept On Site
During Construction
Date NOV 18 19%
I '
1600 TO TIIE APPIZC.tNTTBEFI AND APPROVAL /�J' _...
Date of Application subtnissjon //�✓//
Flat 7f7/7 Lot at ( /� / . Aquifer Zone_
Owner
Owner mail address L .C.
Owner phone n
OTHER INVOLVED AGENCIES -The following agencies require separate jurisdictional permits or approval for your
proposed project. CONTACT THEM FOR REQUIRED SUBMISSIONS.
' COLLECTOR = Approved = HOLD By Date oy�a- �
onservation Comm = Approved Byi' j��A �J/ A��� �"� "/��itL
Date
•
D.P.W. water = Approved By 6
Date��--/S '94-
a D.P.W. sewer = Approved By Date
a D.P.W. cross connection = Approved Date
a D.P.W. engineering = Approved / Date /yard of Health well Z Approved I t Date/ 1!
Loam of Health septic - Approved Date _
3oard of Health food service = Approved Date
FIRE DISTRICT lI - II- IIII = Approved Date
Planning Dept = Approved Date
other _ Approved '
Date
41:^:' . Approved
Date
( '. r„-eats
Prniecr summary new construction/ alteration/demo sewage disposal - public/private
:Alteradd interior walls] [add rooms] [add footprint! water supply - publiciprivate well
pooh [ga1rai e.•shed] (game court sericei
Descrbe
the %arious departments:
This notice has been forwarded to you for your information and any appropriate action. Should you have any
sstions please advise. If any reason to withhold the requested permit is found. please advise. Your assistance and
'peration is appreciated.
: Building Department // .� {� /
Dare sent for review l/ j J n !�
By r