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BP-22378/yam IT 0 7 i 4 EPA u SJ 6d PI 41U t 0 0, Me 10 T Site @,g virl"S�n Con - Data. 25a' `vp" w s 5a o� I certify that the foundation shown on this plan is in compliances with the applicable Zoning By —Laws in the Town of Dartmouth Correia's Engineering Inc. LAND SURVEYING 8 Grinnell Street South Dartmouth, MA. CIVIL ENGINEERING 02748-2314 SUBDIVISIONS Telephone (508) 996-6052 SITE PLANS Fax (508) 979-5949 AS -BUILT PLANS Joseph E. Correia III Pres. & Joseph E. Correia IV VP. I N D Z Z N O 00 (A Z Cn O L=42.49' R=316.50 AS —BUILT FO UNDA TION PLAN COURTLYN PARK LOT 15 in Dartmouth, MA. prepared for Long Built Homes Scale 1 "= 40' NOV 26, 2001 FILE # 99-0186 JEC III Fenst set'eJ Ease:° to tin for Fi> —flF1 -TU #3QSHANNON WAY ASSESSORS LOT 20-22 PLAT 74 FRONT ELEVATION NOT TO SCALE SUB. LOT 15 COURTLYN PARK OWNER =LONG REALTY, INC. BUILDER =LONG BUILT HOMES gone thru refined vvan"ts u -i-." 2 morn shall be,r'- °a"v ! :,t i. feting t's- - � 1 C. u¢a`w F� 38s 6 Siops 4 NT 0 Kam- i s —: s0NC).TUF,E SIZE AVIC=T HE THE CONCRETE IS FOXURED, SE K pro$ pp��, a E'sa iJ F 9 Ti m 'O e",^::, a .:d s^. F is 4aR4# �r Date .,,� ✓ �� x, i y TURN',, !nAMPITMAIDUTH -EiC(DIAD P O `I$m i-� q4 � E � J lEN f g "fti SlUILDING CURING THE mmp I,3r� OF THIS FnwtIavi: ti"LCa,�,z Ldtal,:s n�rj fl,,.-, �s shall b ' C1PArs�,' x ,, _ `�&s I u air" 'S a a� `., , .'..s r ��v � a � ��?� � t.. . .� `r 'ha Est}.ur n.g .max o. �. -:vv kf '§. hs � e i „ , '- Test j Zp: ."1 F .'dam;ars • - Ri-F-Cf.-MICRETE IS POURED. s, )1P 3 of Dartmouth Ayy P:..S _-'lilt, zo c "1 1inz or e—p 1, prior any further- constr�ctt. n. EEEI LEFT ELEVATION " NOT TO SCALE ULO, '�� DETECT ® CEILHING Nn U,01-1 Or �.:.1n1�� With.' _3 __ s 0. C6 s.t.asX G.+ ✓ ..� � fug LI a. es mis;d t - i^.r "YS.'a. C 3j �•nox n+", eF"*—I 3 the 9 tj to tih�....li'10 Test � ond Yx Y i- _ t v fOi E °°• 8rr AS' f:a q Y�rar.�I pax ° � � ��: Y e � Doi �'� �`� u PfiOCZAESS OF THIS W�trK, Ts),., n of r;a t e�1 3 gig t� a4mL F (j Y - w # 30 SHANNON WAY ASSESSORS LOT 20-22 PLAT 74 SUB. LOT 15'COURTLYN PARK y RIGHT ELEVATION OWNER = LONG REALTY, INC. NOT TO SCALE BUILDER = LONG BUILT HOMES FIRE STOPPING RE 1 IR k',lE T to walls n fjc;0js `l b0l .� e.,.6,� r1 (Ur}7y�,,� of r fY.." sag' LS R�r T_ Y• iaA vin! "+mil' f6s �.+ ynb'r: with a mp a y�^� gien Ss 8 "C' f.P Eq y d;� i;e.99 e„3 .End f Y t E toi e a-+°- t ss 9�a •st 11c a �a.d ,. *�iei��ea ei 3a ..,aeVia.y..>y' :� a4. lE - - E - 14. Y, m ID.Y, # 30 SHANNON WAY ASSESSORS LOT 20-22 PLAT 74 SUB. LOT 15 COURTLYN PARK REAR ELEVATION OWNER =LONG REALTY, INC. NOT TO SCALE BUILDER =LONG BUILT HOLIES 2 15--,1 — 1 --1 13'9 62 1 38 74 5'1 ---I j12'Xl0'DECK 1, 7'3 — --I - 66 303-2 3-6 2'8 2432 F I I W1830 (—W3015 W1230 W3330 VENT D`�/ CW2430o'DW24" D1318 CRNGE3 815 S8 36 LS36\ 8D- ul KITCHEN_]BATH ®ccD0 (LINO) (LINO) LO ca I co IB36 IB36 CD LU I- co 4'6 2668 2668/ 1(2) 2X10 INVERTED 4) - Tl T 2668 -; F IF- STOP14' H'10 Ul r ura I - �Jvv a�llz Penetralt'10'ls 01 prV p -Q se'aled %Jith a r -zled C A l IP CA �7 pas -- - Standard spccKic to 0 .3 i ps for Fin0 e (OA z DINING] LU (HDWD) CV J v OF v v 3 WITHIN CEILING (4) WINDOW CROSSHEADS ON FRONT IX4 TRIM ON FRONT WINDOWS 7 FRONT DOOR ENTRANCE TRIM F/V/S/L 3'6 HEADER WITH PLYWOOD FILLER WITHIN CEILING 3'10 (LINO) 5068 F- 1(2) 2X8 HEADER RI (2) 1314 X 9 1/4 LVL HEADER & REMOVE (1) PLATE ALL EXTERIOR HEADERS = (2) 2X10'S EXCEPT AS NOTED, ALL INTERIOR HEADERS = (2) 2X8'S EXCEPT AS NOTED. A- 7 c" a pecticra cpj� CV x 00 0 a: rIZ PUILDI�,, PT 0 -7ZS, - - r U_rHf1"o 'i ' F ;m A t cl C N V - SIZE A D SSA P Tit 71" TN--"oNl,�REouIj-jrr -c ll'� C�-*,CRETE IS KaLl�-Q- VU'lLVlIfN!G DEPAJ711"MIM-411' -�i('-wsn 1MOUth 2446 2446 1 BRICK PORCH ] 2446 2446 I- 1� /) 66 --1 81 318 4A 6'6 3'6 21'8 14'4 NOT TO SCALE --- 36' R 3, 2001JA 12'5 8'8 8110 2'4 T9 Z4 2442 2442 5'6 3'2 318 2432 + 2432 - Zo CV A A A N '^l vJ LL O v v v A A A LU ICY/)y C// LL w v v IVI BEDROOM (CPT) _00 UH 0 3'2 — T- CO cO �o N � M 2668 6068 O P.E. S.D. 10' 4' BEDROOM 2 (CPT) A ui F .. UST O FAN FAN BATH 142u�lo MASTER (LINO) m BATH z o w � m 13 (LINO) o z J mW Z U�00 z d. to 10 z 12 0 J 2668 2668 P.E. (CPT) s.D. RAILING I (OAK) 3'10 3`10 64"X79" CIRCLE TOP 00 11 6'1 wic (CPT) SCUTTLE 2468 14 ALL EXTERIOR HEADERS = (2) 2X12'S, ALL INTERIOR HEADERS ARE NON-STRUCTURAL r r r r T BELOW PEAK P.E. S.D. r r A A r j W MASTER BEDRC?OM.a 4 �g , d., ..•�. . ra a-0- mall be _ pt gam, �y p �^y {�,+sp ! € 1y� py-q 9i Al: bi .'al 1 a� t4 a6 iM �' �.,ar �.,Y4 as of a� i�"...�Y,011ting Oe f LL 6- 0 1 /,, n i B ¢s n. dS� t L � 0.z A.0 eSs'i, �.'i g^�, 5. '3 :a s I_> Sa-=�sGG$E'� \f iL v Sea) ^ AS S v" ,¢ `fir lhn -, natfi Sal .rL �`. ��.y .��R1. 6'3"`7n 1; 4a :� a. a1'�xIG 5 3 ;Dill v v ps5 •�,.. To. � F�yC a�;�US� tg - =-814* a0a PRENDA ` COURTLYN PARK 15 SECOND FLOOR 2442 2442 64"X79" 2442 3'6 6`6 4'4 3'8 4' 4'� NOT TO SCALE 14'4 7�a 36' your" NAUST BE KEPT ;I pi TV,- t:pUILDING DURImG TFI� � Etw 04° THIS WORK. 4 . L�EP;��'a'��=-NIT �I �15,� i i j 4 as T, .l.� `+ r� l sa V f�j t--" e1". CCU"`'s 1 tion. EE KE T AT THE GL11LDINon DU�I`�IC TFI . N .fig p..P pog+ a �THISYS:.J 1-1eK . d' R _NT SO SIZE AND OU S 1 � $" EC iif)N IS REC�UI I L«, D".t',. Tp E Ct7No:� r ETE IS POUPi 7:D- 1711.L:'t,1��!C CrPrc�iTa�ENT '�nlrar7l of Dertrnouth t� V 2442 - 6r6 36 x3 » 14 93� �DECEMBER 3, 2001 1 24'10 4'8 6'6 I� a ; a 14'8 5' 5'2 a _ BILCO „�;, Sig 1� — — — SASH------ SASH ----,_I I I I - --- --- — --------I_ I — 1\\— — — Q \� I 3 I FOUNDATION WALLS 3000 PSI DROP 4'-2" „ „ ;d. FOOTINGS 16 X 14 ELL SUMP DBL BOX &HANG JOISTS I I PIT OIL TANK BOILER P.V. FORM 3" BELOW T.O.F. I a I .< �` F;3 _ ,= , � ^ 1 N 4 err o a sbe® .=.e (3} 2X6 HEADER I I£Ia5pe �t., o' I I ° T.O.F. 169.10 e— Z a sLL J GRADE 157.00 I I r I 1 BASEMENT I I I I I T MAINS OF CN i 13' 10' 13, I 1 I — � W10x19BEAM 35'-7" 1 2X6 P.T. SILL ON TOP OF BEAM I IPont" l :7 / E 1 I--- --- --------I-------1--------- �___====-1----------------- BEAM �� 12X6 KNEE WLL A36"X36"X12" COLUMN PADS POCKET I I COLUMNS x ,E IILQIN C� G I s IRI THE 6" WIDE ( I r :lE 5 Ski OF T1-118 V', ,f , a IC I I ��gg p A Pe-netl�ua.tia es hiru all--.' wain an'll w ,,rates, t, (, �a',!' b I I T?rf ` fat„ x'+ ::Fa sealed ma3t., G�1. I' Ca , aaE +.++r3 3�.be+.,, o3 zi e , =..inei t191w - a „��py,, �` ' , r e I ..,.d I sONIO-`i U S-1'7E AND DEPTH M g^�, x:eV v+'AB,, 2+4.o�a,.+¢cw ' va'Las l.9 , I. enJ I I: O ^.�-viL.. s�$,�d i.+ -.da .` 4v�. 5... r.^ � YY�,iaaE �3...=z. I I :+ , �ciku'i .3. �9Es Oa €xw �bsi Standard spec2Pr.niT10s41 � r- � 0U1- E DrI.= O FOB b Ig 0 a' S Ada ?-9 - THE COI CIRZ,, E IS a° OUFZD. ,► ( { w I ! I PRRNDA o (3) 2X6 HEADER v UP COURTLYN PARK 15 I '.7 1 IF OUNDAVON , I I I {{ 4" PERIMETER DRAIN Sp O - DBL X(1) P.T. & (1) K.Q. 6" FORM 5-5" BELOW DROP 4'-2" 10- 3!4„ STONE T.O.F. TO INVERT4„CONCRETE SLAB LECTRIC .a� s — — — — — — — — a a .. `. - — — — — — — — — — — 26 10 NOT TO SCALE 36' DECEMBER 3, 2001' 4 i. 2'10 8' 18' (2) ZXt2 P.T. GIRDER 12" SONO'S li' 4'8 6'6 1 } } uP PRENDA } COURTLYN PARK 15 } } SONO TUBE LAYOUT } I------------------ -- —-------- e — — — — — — — — — — — — — — — — — — — — a — — — T— } } } BRICK PORCH I{ � 12" SONO'$ } _ I 1 NOT TO SCALE N DECEMBER 3 2001 T F 5 Ull T E_ '�w nu r —Fr A � 4R, N 'ItT rl�,IOJJ JU An As Bvj.7`l- loe Dept. prior to callir$ g for o I ' YOUR DRAWING WST Est I ??" } 'a THr-- BUILDING C :IF II`I THE z } I SS OF T W 3 VORK, 0 sOM Ti.#`R'r SIZE ANIC E- T H I -; ECTION IS RE-QUIR ^EFO:'f ��E CO�lCRETE IS E�t�IRE�i. Ta �G l� r IJ:�t3II�4'! 1'd�,f�T Ili Tiiw'e i o5 f2 _ FIRE STOPPING lhall be -nett+ .ions tr�r« rated , �.! o r v take a : yt•!" �' Iti..3 [� n :nag Ste.. of �i'.,.r a' dra r 13 k ' � I-" b ridare sp d ngria..ia^.t f. (g ib Y S<Ji a.�a,.'.. e � ,q •may I. wv "v+u^a, 4�` P.'tS R 1, y €t`€°.. III .I i q 'Z t —_ pa�#�u g 5�'".j ya r,F.+9' a� �5.+. {}'`.��� q{p�—� t'3 a�—N i _•._.__._—� _....- IREl L... -S { O 8 0 Q Y4Y 4e° - Ems. 0.0.! F im._—.o�. 1neT trfis ZIv°f Rf 'ter �•5 ��� f j the ✓9�i k..E+1 Pc f T1 „7771 i€ er fia . KIN LLJ .. ; i (\•�� � � gip' < , F� � r� � ' � ��� �• IJ! ,V � •°S�e5.3`i �^a� �,..t:,�aa.�xzE�€�� no CC UO ads-- . - —�� — -- -- -- Townr¢ � f. SON04UPM- SlZL:7 AND DEPTH THE COS, P T IS of b i -- I Zi Y \V � v 7= 0 go z C) cn LL. 0 C9 d2 Ld�( 0 :z 0 <i 00 V H NN 00 0- cn Z 34 0 La 9-1 st, SQnis 00 CL/ 0 -,QT LLI Z i-4 031 cr ul af p j-4 to gf C� C--V, cc CL F-4 (0 LLJ >e 0 Z. z F4 t-4 LL 0 0 Fz N P--i 4 Cf X, t4 cl� 0 x `A L 0 w :2f CD c -4 dt dd iCJ �. l;x 40 To- 6 d) �y Co :7 Cf 9 < Lu CK X, 0 x X 0 0 > An J lu 4 P) - "A LU acloon inspec-tion �,r "I'thel, co;� -JtLC4 r '.. i -;, . SONG -TUBE S122 AND Dr-7H IN PZCTIONi IS REOUMrD. WE MNICRETE IS POU;IED. r,'-J?LDWG DCMARTMENT Of Dartmouth T ST KEPT Tot ti mal YOUR DrWJW%NG Ne AT THE C-MILDFIG DWIPiG THE NA- OFTHISWOM ZO, STOPPING Rf:-()lj!P,,EMWENT s a ,)q thru raftied wallis a-P-i h 11 Pcinc' 1�s E �p- mv • ! aa.i -,mb wh e n; P, 3- a -.kj i L i to t, �-3 P 4, for i-E V 0 X 2 v YOUR DMUST SQNQ T1►1.7Z SE- Ak "' t THC-* BUILDING r H Iry P=C 1 ION PS }'EQ' • "' eons -ss QTh'! ,^.r -C0;'C.: Ts: I FE DO ar�r.�J3�+pk GR Town Of Dartmr,?Ah 11 °1 kZpr�r �;� ii�c Td-;TP:.l il! l� 0 2 FIRE 107PR 4 G F; 'J!R NT t .a , - 3.�istiY}s li ratede - e_:,€ . r - L {�'�c . i ic;f. 1 ?yyq7d r i€?f S" 'i f{ �i _ r , '^t L " 4 >L 3L t6ir� I Y 1 1 YEF 1 1i.�,r. <_-"t'U ; .�a �.rt6.:1� I I j �•R• °A1','. v s c cL a r � ••c� � s ui �' � . 7- = Ca Z t �. I . •fit �T ; . �i 1- a I 1 � � -':2f V4 L4��� yyl • - t1I Ci ' i' � 0 CCDr' - a V � v c7 V x a J� i �I xI Q Q GU 44 "F 'r pr€� cc r M �p 'did ::� gY .ii Ei •a �1 l J' P4e•, Y P y/ i .ss t<y i to I H I i �-O ��o:o O10'(-o "o oer '� �J_I ►�3 r f H i a 00 ><>�2x;x��c I 11 � Co' � (� I oO'c�Q j Co � Co xx< mo Cof �< j) x co � of ,- I _ a—\J o O p�V J O r 1 -mil X r (\.IiM (VI ( 1 i ' (vI(V i ' CO llJ C/-I w i I I j Offal �i I �, �� C ca LL 17, X c'� >y "Jj�cj rj I� ATYPICAL )OFT. X IZ.FT. P.T. DECK �aA 77 r iT"N J r Ily I STD, � _ i l-:��. t'�. �. �.4 �. a .s�� � - t I i I fb- ructon any farther cm u�A-, be 'z."x q'r Top � o rs RAILS S'ET5P C.K ,"` FROM POST --_—f i -Y4 X DECKING IL' OVERi�f�NC� ! I - ( I rFL.ST- � XSX i6 O.C.I � I I � I i 3/g TFkRouGW �QERT� l I ' C,IU T4ta� 1-PC4 CAPS \J I FIRES-F0P£3'4tC,Fn+�e'na4�rx�4rjT ( tI 11 €a[ � i AY F11GUIN S a "ur cu ad E 8i�sFla 5!4';Au i j I /?-�+�" ,6�v �� 6eP."'ia.a�� � '.•i g r-d^ �^ c��n �.�e=. B� g,�'3 $ 3�4> ,,§ I I � '�(r ... �r +h6.. to E j, gil� rOgUi rilSrit 01 Ne.0- Test Standard specific of j( 1 8 -� I f I ON I INSPECTION S R Q I EBEFORF- T RIDlNtt�EPF�i Pd;iT STAI R S TO BE 1-0 C AT F. `( Q� I-k I T R;a:er a # Dartmouth i � � I I 1 - I ( �scT Ia B_) act iI1 _::l FT k I I Al e� �`�rd' MSS07TS➢s:'o' 'o5'a,';e. .. 'a, 4'_,€:e, p �ssa' ..n .,t if . -- 3 RVILDIN -s ofTown of Dart, *wt) _ I __ Yp WALL-PLy. ✓ I S LLFL T' v�lti I T '_.�--I---=--i-I------I-;------l-i--�----I_ l � - I _0V.E?,"Wq _ LA`lOUT I i I A r= SIZE AND URED - -- - �. . A RA I SR. ic�T R•C_U '. of Dart I ,. s 6Yatstdt$s HAS LESSll ZI b Pens r`aton thru r tr3d wall; an floors shall b r� ! � sealedAS ail a.. mwta,:_' 14al capable of r o-von ing t1c � r� q,"t.4,P4 ^^'� gq.�t y �..1 �." "`9 �"'99, '� :?"= , v-..r .. "- g as'ii •s e..�� — — —. — — — — — — — — — — — — — — — — — —_ Q eh �a ,.: >, u 85 0?� �* a-d h.ct ar um vvh n c subjected I I I IY E1R[�RA? 1�S Ai�E i�aTQc.� fR_��oR�C.I_ - - - - - - op PZER i1 - � a - li u `�N�� �`l�I�'�5 -�30� �t�C_�1�S L,�- - ��i--I- __ 1 �oo�' _- � � F oti-� � Roy u BOVE.FINIS �a GRAD_ F _ Bv1Lo I F067 V41DR FOR FRORT EXTRNCN T-T. - 4 i T � R I'A 1� LIST ON BACK 0F PLAN OUR D �ATTHE P�p�:NG+ MUST UE -P REM, _. A-wiMESS O4-I:'PlS 44 `i✓f'@K. 9 3tiNc �z�x.>''u.' 4s, ,.a s C.s .6 a.`y 6 mks `., Town of Dartmouth J RESIDENTIAL 2001 RESIDENTIAL 2001 SECTION 2 - PROPERTY OWNERSMP AUTHORIZED AGENT 2.1 Owner of Record: \k Q ?7e!v�b?Z1 kAk ©;P—"( tAS Name (pri„t) Contact Address Phone Number 2.2 Authorized Agent: �.rJB �Q - Yr. Lor\r6s W,0 Contact Address Phone Number Name (print) SECTION 3 - CONSTRUCTION SERVICE 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor O License Number(21S Addres 1,4xb, Expiration Date ( ISignature 05 �'e` elephon� s' 3.2 Registered Home Improvement Contracter. 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„3 For Residential Remodel Work Only PERSONS !CONTRACTG WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND: QUwSTIONS OR COMPLAINTS call or write: Home Improvement Contractors Registration, One Ashburton Place - Room 1301, Boston, MA 02108, (617) 7274598 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 family 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 ` NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any licensed ConSttruction 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 C 152 25 a a44 ..��: Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to rovide p p pp p this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: )yes ❑ no SECTION 5 -DESCRIPTION OF PROPOSED WORK (check all a 1lcable rnew construction* ❑ addition ❑ alteration ❑ repairs ❑ chimney/ ❑I woodstove (energy report required) (energy report required) fireplace ❑ deck ❑ pool ❑ accessory bldg. ❑ replacement window/door ❑ other Cl demolition (shed/garage) no. of windows doors (specify below): (sppecify 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): XBoiler (heating) - fuel gas (natural or propane), el 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 17 Hot Water: Gas Electric Fuel Oil �S Other Brief Description of Proposed Work: S e SECTION - 6 ESTIMATED CONSTRUCTION COSTS =' T Item Estimated Cost ($) to be completed by permit applicant` 1. Buildiniz 144, oco 2. Electrical of 3. Plumbin 0 0-� 4. Mechanical (HVAC)6p(� 5. Total = (1 + 2 + 3 + 4) * Estimated Total $ SECTION 7A - OWNER AUTHORIZATION . _ ' t (to be completed when owner's agent or contractor applies for building perms) r (please print) I,� 'C \Mvs�, , as Owner of the subject property hereby authorize A 41a � to at n half, in a ma ers relative to work authorized by this building permit application. L ''``A , Signature of Owner Date x, SECTION 7B - OWNERAUTH6RtZED AGENT DE LARATI O N t a Owner uthorized Agent hereby declare that the statements anell information on the foregoing application a e true and accurate, to the est of my knowledge and belief. Si n under the pains and penalties of perjury. Signature o wne Authorized Agent Date, C:\bldg.forms\Bldgapp.res.wpd Page 2 Rev. January 19, 2001 C:\bldg.fonns\Bldgapp.res.wpd Page 3 _ Rev. Januarv_19t2001 _ L RESIDENTIAL 2001 SECTION 8 - INSPECTOR'S REVIEW/COMMENTS Id-1. Date plan reviewed: I" 26 -0) 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: 8. Co-mments: 9. Inspector's Signature: Date: " SECTION 9LICANT NOTIFICATION Applicant informed of bov Date: Clerk: v Comments: AW &1�� SECTION 10- FFI ESNSPECTOR S NOTES - / Total Permit Fee: $ , Less Application Fee: $ 25.00 Remaining Balance: $ �( TOTAL FEE: f Gross Area - New Construction total sq. ft. Gross Area - Alteration totals . ft.q Permit.Isysued T/o• SECTION 11 ADDITIONAL COMMENTS/SKETCHES C:\bidg.fe-,rns\Bldgapp.res.wpd Page 4 Rev. January 19, 2001 RESIDENTIAL 2001 ❑ FOUNDATION ONLY $25.00 APPLICATION FEE IS NON-REFUNDABLE & NON-TRANSFEIS::ABLE DARTMOUTH BUILDING DEPARTMENT DATERECEIVED 400 Slocum Road, P.O. Box 79399 Dartmouth, MA, 02747 �fifi. ='` 508-910-1820 FAX 508-910-1838 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING x ', T CTION FOR OFFICIAL USE ONLY _ z. RECEIVED BY: - r BUILDING PERMIT DATE SENT FOR REVIEW. .. 5 NUMBER. r DATE ISSUED' . _.; - ,- OK TO ISSUE SIGNATURE DATE""` Building Com signer/Inspector of ui�iags t w # r _ n :. Zoning District =x B roposed`Use::.Zone:..; ❑ A ❑ V Outside Flood Zone ❑ Aquilfer THE FOLLOWING AGENCIES SHOULD BE NOTIFIED " r . :_, �j :. �'� fi.� ? r_ r 'fir ' __ �_s •t r.% � , 3 Sc ❑ Board of ❑ Board of ❑Con Com ❑ Demo ❑DPW ..� �Elec❑ neigylteport z 3 Appeals Health f Y .` z Affidavit :� Card Sent. 'OffFoillow-up* F wCut � A '£ ❑ Fire ❑"Gas h� ❑ Planning Board* ❑Sewer' Card ❑Water Card Zoning ❑`Other Chief Cut Off x / = w* - Cut Off /Cut Off: Revie , *-REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. DEPARTMENTAL APPROVAL Zoning Review: Signature: Date: Energy Report: c'� /� Signature: e nature: Fire Chief: ' Date: rr Board Health: Signature: of Conservation Commission: Signature:' Date: Other: Signature: Date: Description of work being performed: ' - SECTION 1-SITE INFORMATION = n,. NUMBER OF PLANS SUBMITTED: SITE PLAN SUBMITTED: )<yes ❑ rno 1.1 Property Address:*3p ��Ap�k� 1.2 Assessors Plat &Lot Number: Plat �j �} _ Loth s Nearest Cross Street: 1.3 Historical District ❑ yes ]g(no 6Q'C\-ZAJQL (3 Subdivision Name: 1rJ Has application been submitted to the Histcnric Commission? Total Land Area Sq. Ft.: ❑ yes l;,no Date: 1.4 Water Supply (MGL c 40 § 54): 1.5 Sewage Disposal System: ❑ Municipal Private Well ❑ Municipal XOn Site, -Disposal System C:\b1dg.fbnns\B1dgapp.res.wpd Page 1 Rev. January 19, 2001