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BACKWASH OF WATER CONSTRUCTION OF THIS � � � , - l , X,� )i.17­<"'��,;"""L'�� � _�' �,� �, I , ,� 1, ­ I � z I "I I f ­>­,,�,Y,­­. ­I,,�, � � , , I - 1� 1, I i N�­ I I - . _Ilo .� ". 1, I -_ - - � k I I .� I i I ; I � I �, I I . � I � I t � I o I I I ; �1_ - I t I - I . ".1 , I I , . �, . . - � � � � , , ` t,� - PURFICATION OR SEPTIC SYSTrM MUST BE THIS SYST ZIS Kfr)T � 6 ',,71,,'�, .- n,,, " 11� -l", C7 , __ k._ $_ EM ,-: i '--- , � � � - w­ - _.. — __ - '�]No 000�' N- o � co P p C6 n � a � N I. l� 90 a woC. o' O ace/ m-= rm I N" FIRLE'" S"'OPPING1 RE-QUIFO-MENT Penetrations thru rct.,,)d walls amij floors shall be, seeled! vvfth a capx�ble of preventing the ��­ -,s and 1�01 gass'e's w1hen subiccted p a s c -c-'- f to 11h,c rnmquin:�.,,-,>kenf&s of the Test Standard specific StcPs P3 TMI-E-814. A Ccmj, Gli A YOUR AT T - 4us_ P_ KEPT HE SUILD';r -S OF T 'i 5c _&'7E AND "S PEQUIRED. TH-E "O"',!0FIETM ;S PoUf�­ -L TovM Of D�rtl'nouth An As S-uf'vey nriv,'�St I 0 Eu" Zy Dep-;_. prior Calling for a fbundna�don iff"Spe-ction or any f uttier construic-tion. FRONT ELEVATION NOT TO SCALE j MIN timil oil #42 SHANNON WAY ASSESSORS LOT 20-16 PLAT 74 SUB. LOT 9 COURTLYN PARK OWNER = LONG REALTY, INC. BUILDER = LONG BUILT HOMES 7 M# SMOKE DETECT07S 61- C_/ �r Iz- T / '' � � �a�f 45 rye. fa 1.;a ;ai .capa�. lva, o Pa,r�e`v acing tl-1 e ' d € F .ms`d aar i.7 VZs C .e t.�.......ic «•..r 6+w. z ai a 6 a i I D hV EN MEE 1 YOUR DribNING MUST BE K=PT AT T PE DL'IILDING DURING Tiv,= PRCGnEvS =)I= THIS WoR;a... @f5'J!'r, of Daftmtou,,h SCNQ L"' SIZE fit"vi''� DEPTH INSPECTIC:'<N IS PEOUIRED.EEPCRE THE C a+aCRETI_ IS P, CtSRsD. SUILMNNIG DE7-p:F',; pf4ENT TOW -In of DartmoLgh I 7-1 A lTC'' An Vey I must b@-- -n _ V Yg #42 SHANNON WAY `''. �ifl -°® �`. g° ASSESSORS LOT 20-16 PLAT 74 SUB. LOT S COURTLYN PARK x;.- cOns1�. RIGHT ELEVATION OWNER = LONG REALTY, INC. NOT TO SCALE BUILDER = LONG BUILT HOMES 17) .. a L�a3;?agi�Tii�3i�:z.-.: .,p¢x �^gro 1. mubmit" he _- en0tre.aio s t yLI rated we'll5 Er floc, t shall *�� b � uA waledl a c -a able of preventing ¢t .�._ LjS 2,foundation ¢ a� ee i n o � .� �..: i«SL`hb�. 6n�s is 4 f 9 vela q �' L ed the y pq ry # }F iE 7 _,3i e�.,i: i R GIs L3'f �:�i sue.'. d�k�`•G St,p ��`L•.'�ab.f�`L�.�$4c33 �.# a�ppv �!i>V tar ire 'S3G� S t� SUVI_ m a -SONS?-i U;;�: �AI� AND DEPTH I INSPECTION J'S =4iEQ�D1RED BEFORE THE COUNICRE,7TE IS POURED. BUILDING MEPARTMEN Tomm fl YOUR D11111 PVIN G A4UST BE KEPT ,AT THE U;L-:)i ` No DUFJ4ia T"H;; ;5 -, a I f li u l � p; r°i -_�v I ,` FleeIND — o -_ �'•� { j ���..//// #42 SHANNON WAY ASSESSORS LOT 20-16 LAT 74 SUB. LOT 9 COURTLYN PARK LEFT ELEVATION OWNER = LONG REALTY, INC. NOT TO SCALE BUILDER = LONG BUILT HOMES u i i FURE ST-0-P---7",N!G REQU'!RE,`!'uiJl Penstras.ions, thru r::�led rmills and fl,00r-3; 3hall be apable of ors Pc the cL seals", i &jbjete f'Sgasses vvnen assa70o;ad ard� specillic A- t�jn ts Stand ;iion' of the eS T ip, q-tcp s ASTI ILA Emil IT F= F REAR ELEVATION NOT TO SCALE #42 SHANNON WAY ASSESSORS LOT 20-16 PLAT 74 SUB. LOT 9 COURTLYN PARK OWNER = LONG REALTY, INC. BUILDER = LONG BUILT HOMES J A C p I Fus 'z Mpn YOU P, " "3 r AT TH MUST E'E J'Ep E culmi )URN10 1 �1'710c"'nzss OF t' THF DE.,'7),ARTlV, ENT "'IZE AND DEPTH 3NMTJO-1�1 �IEQUIPMD er�FoRr. 'ME co.%xmE 13 PoUqS,-, !7JU!LDflN,'3 EPART;,�Zf�!T Toymof Dertrroswh An As pail-t"'. �Jlg- -r,r for a frkm.daticaa ins pectioll 011* my f ur cor,,structiolm P Ce) 16' II II II II 11 II 11 II li II II rl II II 16'XI0! DECK 11 II II Ir II II 11 II 12' II II II I 71 5 4II 14-- 1 I I I V II n 7[-- 6068 U1 -7 H SLIDER F3,—: 1 N u uj [(2) 2X12 HEADER 3 co & PAD DOWN II C11 LO C) II FL-1 WN -G- I (HDWD) C? X 117/8 LVL U) 04 HEADER WITH THE W8XI8 CC) STEEL BEAM SET ON TOP 04 X W8X18 14711/4-1 — — — — — — — — — — — ----------- cD ALL INTERIOR & EXTERIOR HEADERS = (2) 2X12'S EXCEPT AS NOTED A A 0 W LIVING n -j (HDWD) m 2'4 0 Lu Tj R LX 0 I CO IL N V V ri V • FRONT DOOR ENTRANCE TRIM • SHUTTERS ON BOTTOM WINDOWS • CROSS HEADS & TRIM ON DORMER WINDOWS 2852 3,11, -1" — 67 m ENT P-meti—ati-ohas. thiiu rat.od' wails an,-J! IN(mrs shall be cap-b", of preventing the, -'sGr %,j"- n subjected P , 113, �""i �Jl I ot r;! to ithia ft Test Standard spedfic frog Fire .0ps ASTM-E-814, 22' 8'8 '- 1-7— 6110 36"X36" GARDEN WINDOW VV2730 r7 0 �731 — CM430 B36 A I r 13D60 LS3\6 A 1(2) 2X12 HEADER & PAD DOWN 3" KITCHEN [tAUK-FAST I (LINO) W (LINO) !t C1 IB33 IB33 u- 18'CEILINGS ON BOTH FLOORS 2852 3068 1 i I 2852 P.T. PORCH 2852 6'6 66 6'6 34' co D C11 0 cc\01 O 2852 '+� 41 YOUR DRAY Vi;';,i,1:; ATTHE 13UILDW,�-,: UP? ING TH, Z- OF TFqs t V I L D �'N' p gig D" Town of r-,"utm0'i-n- TO Pik E C Om 2'"We SONO-TUa- !SPECTIO'N IS FUEQUR`DDEFCN THE CO'NCRETE IS 171.7)URS-I.D. P I J I L D IN IGN oD K- P A R`7 RENT f f. Alm, U t I I F cll-,-,-' An As ar D,-Pt. orlor, to c-Ain', cci- 1c, -",fb-r 2- fc-und— ion inspectic rq at or zoir fiAft --y therconstr-t*l--,,n. C, x j('0 1 C�"1 14 Z�_ P, r L-n I NOT TO SCALE 36'4 CEMBER 21,2001 1 11,10 2'4 - 96 10'4 61 5110 2846-2 612 34 2432 -51 5 4'11 2846 00 co [BATH A co (LINO) (o A A Lo BEDROOM 3 co D (CPT) LINEN u- 0 0 11068 2%668 v v (P—E SCUTTLE A A co 00 (.0 (P—. E'� A Co co W (CPT) (o w C'4 P.E. co to 10 'o 'o 04 2668 u- 18'CEILINGS ON BOTH FLOORS MASTER BEDROOM 0 3'10 - v (CPT) v v to (o A A DN A ALLEXTERIORHEADERS = (2) 2X12'S U) co BEDROOM 2 to to LL (CPT) 0 0 co W- KUPIEC MANNA v zo (OAK) v v COURTLYN PARK 9 ACCESS C, E S S SECOND FLOOR "A" DORMER "A" DORMER k— 2'4 x ACCESS ACCESS 5'8 3'10 .61 518— 4'8 — I & IX4 TRIM 30310 30310 13'10 [NOT TO SCALE 3'10 34' 16'4 1 DECEMBER 21, 2001 co 'cr co N 00 v a M As M, be ust j, )r 'undstiOn ir- ectiorl o- ful'"fler 00ristruction. SONO-TWE'E S,ZE AND OR�"h INV:5'PECTION IS REOUIRED ('TTQPr-` THE COP:IRETE IS P01 nl-,Q- Tovn� o" Dertmoutn 'rM i S 5� Han r YOUR DRMYFING MUST BE KEPT A. THE SUILMING DURING THE PROOPEESS 07-'7HIS WORK. SU-ILDING, DERVARTME—z.11T Town (.,)" Dar-�m-�., 26'8 FIRE T liq REQ �7I57R p$��y�y @h bw,. �w 3. 8�4 �A fm.S 3 7 P �. etra�9��ions rats; `valgS and tl00;s shall �€'a���l s �9thru 63 `v�Bi ( S,y °�. YR�^� ®9 �aS ;K'.i9 mat r i! Capable Of PreAvrenting the y t0 3 Of $4 s pi�s �$ hot a'9 . i ss Eh"# t c ,sse- ge,',-en 1 g the rcaqua� fa, -01tS 04 thO Test Standard Specific Fire Stops T-E-814. 18'6 - - - - - - - - - - - - - ... ... q V O ... 0 r — — — — — — — — — — — — — — -- a.. SUMP ELL FOUNDATION WALLS 300DPSI — — — — PIT 1 I FOOTINGS 46"X10" 4" PERIMETER DRAIN n 1 fl" - 3/4" STONE I cn 4" CONCRETE SLAB 9I 1 U. M a BASE 0 O N I a V V 1 I 13" 8' I ( W10X19 BE --------- -- DN CM n n n 8X8 FLUE FOR FUTURE -' WOODSTOVE p 1 I I O I I L3- 1 I BOILER v cg o 8X8 FLUE —r a V Csi I c' co1 1 a. 2'4 ��--- — — — — — — = — — — — — — — — — — — — 34' NOT TO SCALE 36'4 5'4 �r 2' (- � 1 26 2'81 2'2 loll SASH— — -- —1-SASH _17 ------�- - - L--, O 0 VENT I I M 1 � a 6" FORM 4'-9" BELOW DBL BOX & HANG I `� T.O.F. TO INVERT FLOOR JOISTS 1 I � I cv T.O.F.149.90 NfENT GRADE 147.00 a I 1 13' 1 1 I AM 33'-4° I T I a: ---------------------------'BEAMPOCKETS � o 36"X36"X12" DEEP COLUMN PADS 9" HIGH I 1 3 1/2 " LOLLY COLUMNS 6" WIDE I I b„ DEEP 1 ( 1 1 a 1 Cl CDI ( 0 o 1 I KUPIEC / MANNA IvI COURTLYINI PARK 9 I 1 FOUNDATION I ELECTRIC vo v_ a 1 `e) a a9a gECEMBER 21, z - M - 3 ggq IN, T _L_j ,rli A i 1. prior �n or SONO rz Sig A AND D pTIj I aSPECTl4 IS FFf Ji PED BEFORE; 'THE 00%mCRETE ;S POI:.is�8• ED. III -DING DEFT ;`,P� NTNT TO n of Def 3 jou*I- 14' P CO i istra�*lons thru rc!"Z�r vmallls and fJOC.,,s shall b-,,-, !mtvdl c a 0revntng thoiedvii1h ep,1pei gasscs 'wih-sn subjectc--1 c)f fl�F, and hoi o, lLhe requim4nents Of the Tost St-andard specific Fire Stops ASTNI-E-814. N-N Ari As 1.31 mi ?.cd to t--,- Dqpt. prior to c-- Hn n- for a fouadation. firisr--tectio.-il or anY furth.-,r comt-ruction,' SCINO-TUCE Irq 0 ';.,'ZE AND . SPECTiON IS P'IEEC'�R Z-D BEFORE THE CON'CP.77E L�l - IS POURED. BU1Lr,,,`NG r":-PAIR-CMENT Romm ,h l"OUrt IVUST S!E KZr- g- AT THE BUILNNIG DUR THE Town of A Do rvy, f T,, ggnn Vale 2 Nj k . _—_ _ ._ tiIN AN � � 1• A,r ;,� - i (01 ri t t _ ` - to 4-1 a-4 • c j i 2 — - __ V -- — — --- - TO i o Ilk - a Qp Ab r RES OFAEPT MI "..^� ..6.. _JCS ' -S� 1,� • t' - -. _.. _-_. �_ ---- -- �_ •-.+Uy... _ _ .- TF tmn c CL co Town of cyl go f lt� � �� � •_ —� - - -- - ' - - - - -= �-- `' -- -Q�''.--fin-- -- - - .__.. �- �. -- � -- -- ----- • -�Z- --- -- ---. _ _ � _ i M I I, �18 m ti� l EE.� dd QJ . VZ va) en / ISd NoT.Lvol nod '31-3voN00. 1 � 15 (_�f Y C1 Ya pq Taal Li Z •a 6U �R .. of dn'` ,22 "63>\o W M M Sin l )VAS 1�wmo'0 1�1riWzxbW HlrM a�-��a ,8z o1 ,6Z �Na1��r�a \CIo3 WT;�, \�51S 31XorM Was Qlw c1 -AO N�1dS WnWzX�t�l. '�J21g ,,� f{lYM s�tt�d'►d �l A'� �?j b x n �.� - �-� S���KtiN VNX"1I-A3 lK3W:ASbg NI No11b-7nSNI 61-b 0' O ,.0-,9 ly ..S1'104 2101IDN"'d wnShcl�D .1�/, 2i��.�1?lb9 2iI�! 2I1tdJ�1 4t1IM a3a�t�oo '!.'1d XQO ?/, 'JNIGIS UN3N )10 aooM W 31 StiS - -I A `80s*.-3.L X-_:l, 'lV'JT6 kL O?r st � -9p ��'' 011- . VO1 f L. �•32.. ,1 t,.y:. 8 y"c�g"ygq �T.. pgy,, ^p g+�,i '"7 1 � sr —Du^ o INNS "log t pun e11 f,. . 'JNIddt1�.LS �On�dS I,�X�,i ' 1�131S�S kjNl'1�I� , 21 Snon1.NDA.1144.oS �ql� S y S3-1tiJ11IHS 1'141kdS'v Sze # Sd I'l H 1T.M lklcl Xao g/s '�'o ,,bZ ssnZ1S Aoo'A Tt Iaf11Sb-nNVW..- -=Ildd ', W�,l.SilS J00�1" '1d�7dJ�_L t,9 X„� -�. 7 �3Qd3N MOgNIM 1121 'D'0 I'll Zl8l.LAdb „9X� �sl �) CI I�1 ?��WboCl �SnoH 90a _... ns- �'g� Y v26 x R ,Is g3 E g¢ .a s : r- a� sO � _. p�t� r� � try r >,' Y[� �� *' go. � ; �L �„'a _ e �a� mid=k a - e �� ,S Sa ,� j;'a i x �, �;:.� � a i fir.. , v.7 � ," , .3 ,., E — ""`' ax �a 3 #',:, # #: S.l "., , , 8,1 L t �>�`'s Z 5�� i:a"An.w at :v' .. a �.y flame,s+� � a _- e.., .. •a..!.. , A.� 4..�a� ,:` sir^.;, w -. hot �^,e.r'$ �' _ daar2 d- 4s 4. <E3 i.., F ... y s� ryyq{ de !°.awl notY aaS—dEw �..,. �. a:. till .. -.,, .X,x: vry quire tY"€US 135 i 5"d g^1 O mod. d O� i� � i3 `a a forFir "I �? �i r. insp ation any fla er a -L Ld d� w u1 tj vOIIOiUar �� o � n P'EOTI�JI� @ I c s LI fir y, 7 j '• i :YY °. x J p p T a I r Ott is 1: a I I j E-- z v 'Tn Dar �.'a1-4 t5 -- ;� # a :d a I4. a y J J - di YOUP t MIWING hAU T BE KZ-P'i' ! a`l ttt 11 o AT THE BUILDIMO DURING THE o cJ l I PROGeR m OF THIS WORK. 0 OBUILDING Drc-PA a cJ ) 1` J ill TOV M Of Dr r, ° " I u Z� OI ti : tL o Q Lu -C, a69Ir cJ ! -Z \A fi b vi Ei \ N I �� _x ! -- rY,i-r E • I - _ . j --- X, �. cJ U a x z 4 y a. i� to `o Ocl- �l U� 0 j0 !O o�cO'CD O OIG) �j�1_t ( ; i �! I61{�Ir I�I1 I p o cAl� 00!00 °Go-0 !_ �XiXx�X cc °o 00 co:�loo w Sim LL n! i n! N I rd i R f c� l R11 n� � c�J p ji p ,.cal i p r-2 ! , 'j, Mci 1 + , cal (j � aJ 1 c�l f ctl 01 C/-! Ld '• ' ' i j Q Q' co bi 0 `0 C-Q c9'c° co ca LL O >C �'>< pO ``�`s (TYPICAL 10 F: X f aFT. R T. DICK) _ I �I`` �VERHANC� C_A? 2°x m F. 5, TOP 4 �SOTTG 1-� ILS RAItS SF,Clki%"FR0 -1 POST OEcY,-R G i' oV ER H p,NG ST= Z"x 8'X 16"o.C. I T41,Qgq BOLTS SIMM9 H2.5 HURRICANIE_ 'TIES 4X4 STMIPSA VA LW -CAPS /—INSTA+ L FLASMNC n r r-, I F JOIST ,rim"r' R Pion OM Uri Kept inn Construtlain Wring 5F ,III � � FT. SONG-TUDE SIZE AND DEPTH ITUR DRY she;,, G MST BE KEPT 3PECTiON 3S REQUIRED RIFORE AT THE P�°ELD@( sO DuF',iF�G TF'� THE CONCRETE Iw POUR ED. Pr, j�,IE `C OF ` !--!iS V`VOPX. LID O DERAFTNPENT 3 C C'e ARTNAMN . 7m n o O b w .- -, W MAMMA TV— _ _ 1 I i I— 10 i x - _ i 5©.c - - - - - { co a Z,.x _ _ _ x i X6 , { DEC i�. G ?'Y A" L EX TN To P ( T • L q 1 - DLL 2" X S" GT RDE T-4LS CN E I T ZIJ 'ra -ST YA `P. t ��. OVERI�ANG LAYaUT i l I I' i t-- -- - -- --- -- I----- - --- p o �j i t �r R! n p C Rtry� p t' Ii t+LPA��_S 4\4. t`(V l� _ U :�.� r A _ IZ b f� .s,_ - - - ---{- - -- -+- -- - -� - - INEC�I SfiiFWY� LE_ z �F SS pp ,�yy °d, 1 bu— ndatio '3 maps to o { I {/ BADE _ . 1E -GUARCIRAILS-AH NOTREW D FRONT t 5Tt' R o zER d � � _' � "_ C R _ S 1 a — -.- czECT I O SIDE -6%Z FOOT ABOVE FDAISHED' — -- BUILD dog v4zc� FOR Fca r�rR c �T — i Fi , �Itm `TI�&o SIZE �YND MEF ;�'-, /� T [^ jAL LIST '�` j'� j� �°'� fir OF PLAN y �. (Penetrations C i ,R .a x + 1100 s'pjj, floors 'NS?'ECTION IS "`*'�' �s".!.�§x�av �etd.8 G s� = != �seedledi32x7' l �, 2 Ashaff� be Z i B 11, WI LDING pg 1 W q s� C��� ��:, #�' �3 � ,,€: s.,�+�I�� I�I..Il�szt���' �I"iE �"t, &`, �sC� the yet e .. € ., e„ d`s i E srMtNT, .$ ge2s , - n .4 C ce $6� i9 � � k � "' �$ 3 "'$ 33'*', •+—u pry.S e.�3 S.eF +. i - h.� .,=o4i�aCtiS O �:!'c: g xyd',`" �S' may: �. Ir ENT:} fi...., �.. ;� T# imn of Dartmoutta ; . RESIDENTIAL 2001 RESIDENTIAL SECTION 2 - PROPERTY OWNERSHIP AUTHORIZED AGENT 2.1 Owner of Record: At C. AbE6 1SE.v1 ��FoR,41 �Pe o 2.'i �ls Name (prlT Contact Address Phone Number 2.2 Authorized Agent: Isa Cv wUT_-S Ntc�Dwk:�-_->'61'� PkF \tA RJ�V;azl Vol C)IW IAA Tr'S -E��_A o Name (print) Contact Address Phone Number SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor License Number C''j Address L Expiration Date Q5 f l --` Signature Telephone �_ 3.2 Registered Home Improvement ntracto : Not Applicable Are you a Home Improvement Contractor subject to (780 CMR-6)? ❑ yes ❑ no If no, go to the next section! Are you claiming exemption from the requirement? ❑ yes ❑ no If yes, submit the required affidavit! Company Name Registration Number (if none, state "none") Address Signature Telephone Expiration Date 3 1�For Residential Remodel Work Only PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND: QU:�S 7IONS OR COMPLAINTS call or write: Home Improvement Contractors Registration, One Ashburton Place - Room 1301, Boston, MA 02108, (617) 727-8598 Owners Name (print) Signature by signing the above, the home owner acknowledges that there will be no eligibilty to the Guaranty Fund Date 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_ Control in Section 116.0, 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 Homeowner performing work for which a Building Permit is required shall be exempt from the provisions of this 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 land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two familv dwelling, attached or detached structures accessory to such use and/or 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 necessarily limited to, general liability 2001 ection that an licensed Constructiion ' NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations s y 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 AFFIDAVIT (MGL Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide thlis affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: Xyes El no SECTION 5 -DESCRIPTION OF PROPOSED WORK (check all applicable) new construction* ❑ addition ❑ alteration ❑ repairs ❑ chimney/ ❑ wo(odstove (energy report required) (energy report required) fireplace ❑ deck ❑ pool ❑ accessory bldg. ❑ replacement window/door ❑ other Eldetmolition (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 1 no. of baths unit 1 no. of bedrooms unit 2 no. of baths unit 2 ❑ 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): —propane, ❑ HVAC (combined unit) - primary fuel, natural gas, electricity, other (specify): ❑ Air conditioning - (separate unit) -0 None of the above to be provided A Hot Water: Gas Electric Fuel Oil (�tg Other Brief Description of Proposed Work: �T o FC FC TtC �r � r SECTION- 6 ESTIMATED CONSTRUCTION COSTS - Item Estimated Cost ($) to be completed by permit applicant 1. Buildinwq. 2. Electrical Qad �O 3. Plumbin �.� 4. Mechanical HVAC 5. Total = (1 + 2 + 3 + 4) t6 * Estimated Total $ �� QQO . SECTION 7A - OWNER AUTHORIZATION = (to be completed when owner's agent or contractor applies for building,permit) _ r (please print) I, 'F.-`..� p� , as Owner of the subject property hereby authorize1�FS to a behalf, in ma ers relative to work authorized by this building permit application. �K C9====1QSignature of Owner '. Date ECTION B - OWNE A TH RIZED AGENT DECLARATION - -• = :." a Owner uthorized Agent hereby declare that the statements and infformation on the foregoing application are true and accurate, to thof my knowledge and belief. Si d un , r the pai and enalties of perjury. Signature o ner cauthorized A - Date C:\bldg.forms\Bldgapp.res.wpd Page 2 Rev. January 19, 2001 �J C:\bldg.forms\Bldgapp.res.wpd Page 3 Rev. Jamuary 19, 2001 � RESIDENTIAL ----------- 2001 RESIDENTIAL — T-------_ SECTION 8 - INSPECTOR'S REVIEW/COMMENTS — --- -- -- ❑FOUNDATION ONLY - $25.00 APPLICATION FEE IS NON-REFUNDABLE ac NON-TIMANsrazRABLE 1. 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: S. Comments: 9. Inspector's Signature: • Date: /— PPLICNOT NOTIFICATION 9 Applicant info pedof above Date: m : h9 Cler . Comments: SECTION 10- OFFICEVNSPECTOR'S NOTES Total Permit Fee: $ � TLess Application Fee: $ 25.00 ' Remaining Balance. $ 1 � TOTAL FEE: 6: CD Dross Area -'New Construction total sq. ft. Gross Area -Alteration total sq. ft. Permit Issued To l /a w" SECTION 11 -ADDITIONAL COMMENTS/SKETCHES /0 DATE RE(C ..ENED DARTMOUTH BUILDING DEPARTMENT, N:. 400 Slocum Road, P.O. Box 79399 Dartmouth, MA 02747 - ...... -' 508-910-1820 FAX 508-910-1838 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING :THIS SECTION FOR OFFICIAL USE ONLY 4 Cn ♦ t RECEIVED BY. BUILDING PERMIT W DATE SENT FOR REVIEW = NUMBER E = DATE ISSUED. =t 7­1 OK TO ISSUE -SIGNATURE. - DATE ^= ' -; B 1di g Co missioner/lnspe" or B ildings , ,f... . =- Use:Zone: ❑ Zone 'if, Zoning District: roposed one: R C ❑ B A ❑ V Outside Flood-, __❑ THE FOLLOWING AGENCIES SHOULD BE NOTIFIED, ❑ Board of ❑ Board of ❑Con Com ' ❑ Elec Energy Report _0Demo,:,,,;❑DPW Appeals Health '." Afi'idavitr Card Sent Cut Off Follow up* z,, y{ ,,. x, S .e, 1 ❑ Fire+ ❑Gas ❑ Planning Board* ❑Sewer Card [7 Water Card ❑ Zom,ng '❑ Other Chief cut`Off % Cutoff - L Cut Off Review S . * REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPAR MENTAL APPROVAL _ r ~ .. ,; Zoning Review: Signature: J�%�-� Date: � Energy Report: ��� Signature: b Date: Fire Chief: Signature: ,Q/-� _. —Date:/— Board of Health: Signature: Date: Conservation Commission: Signature: IDate: Other: Signature: IDate: Description of work being performed: V u � r �' SECTION 1-SITE INFORMATION ... _ r NUMBER OF PLANS SUBMITTED: ?) SITE PLAN SUBMITTED: Wyes ❑ no 1.2 Assessors Plat & Lot Number: 1.1 Property Address: �l�N o1J ValV� Plat_ Lot�ZOZ_-�L_ Nearest Cross Street: 1.3 Historical District ❑ yes ;no Subdivision Name: C4U0.TC i�1�1R� Has application been submitted;tto the Historic Commission? Total Land Area S Ft.: q �Q, ��8 ❑ yes l &no Date: 1.4 Water Supply (MGL c 40 § 54): 1.5 Sewage Disposal System: Municipa�(Private Well ❑ Municipal', 17flOn Site Disposal System — D, a - Rev. January 19, 2001 C:\b1dg.forms\B1dgapp.res.wpd Page 1 Rev. January 19, 2001