BP-19829k
14 SHANNON WAY
ASSESSORS LOT 20-26 PLAT 74
FRONT ELEVATION SUB. LOT 20 COURTLYN PARK
SCALE 3/16" = 1' OWNER = LONG REALTY, INC.
BUILDER = LONG BUILT HOMES
'STOPMNIC,�
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During Construcn
s^ 3 2001
'ZEAN'T
THE coO x iE"-E IS POURED
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14 SHANNON WAY
ASSESSORS LOT 20-26 PLAT 74
SUB. LOT 20 COURTLYN PARK
OWNER = LONG REALTY, INC.
BUILDER = LONG BUILT HOMES
a
26'
i
TREX DECKING & TOP RAILS z
i 12'Xt 1' DECK
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• (4) CROSS HEADS ON FRONT BOTTOM WINDOWS COURTLYN2O' 1X4TRIMONALLFRONT WINDOWS 30-4046-18 BAY
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SCALE 3/16" = 1 RAILINGS BYCUs: oMER MAY3, ZOOi
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SCALE 3/16" =1' MAY3 200I
38 �
8
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L. ELECTRIC OIL TANK 10"-314"STONE
FOUNDATION .
I 4"CONCRETE SLAB 1 ,N---------- --
i
• MAY3, 2001
----- 14'10— — — — — — — — 232---------��
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RESIDENTIAL
_2000
RESIDENTIAL 2000
�-
. Sl CT1C>N 2 - hRQPEI2 i Y f4Y1 RS#itl.I �LI Iit7#t#7,1ti D :Ci"NT _ ..
2.1 Owner of Record:
Nance (print)
Contact Address Phone Number
2.2 Authorized Agent:
ism Lo ��i \ ��°- CA�asRwo.
�s�nl.,��c�'�S
C�81 �c9s •��40
Name (print)
Contact Address Phone Number
::>::::;::>::..::. ; ::::::>:.<::>::> ::.:::.>:>:::: SECTION.:..._CQhSTRi.CTIFI�-iSER'L:#CEs........
3.1 Licensed Construction Supervisor:
Not Applicable ❑
Licensed Construction Supervisor OpJ���
License Number
Address 0 �c.•i
Expiration Date
4tz-1m.
Signature Telephon eat -m40
3.2 Registered Home Improvement Contrac
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 CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND:
QU1'ESTIONS 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
809.1.1 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 licenscPd Construction
Supervisor, whether or not they have taken the permit are responsible for code compliance. (see Appendix of 780 CMR,rR5.2.15)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure toy provide this affidavit
will result in the denial of the issuance of the building permit. Signed Affidavit Attached: )(yes 1-0 no
new construction* ❑ addition ❑ alteration ❑ repairs
❑ chimney/ ❑ woodstove
P(energy report required) (energy report required)
fireplace
❑ deck ❑ pool ❑ accessory bldg. ❑ replacement window/door
❑ other ❑ demolition
(shed/garage) no. of windows doors
(specify below)): (specify below):
* If new construction, please complete the following:
Single Family:- no.,of bedrooms 3 no. of baths at -
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), el oil electricity, other (specify):
❑ HVAC (combined unit) - primary fuel, natural gas, propane, electricity, other (specify):
Air conditioning - (separate unit)
_
o None of the above to be provided
K Hot Water: Gas Electric Fuel Oi.SS Other
Brief Description of Proposed Work:
c� S
V `
Item Estimated Cost ($) to be completed by permit applicant
1. Buildin t14
at �. rrn
3. Plumbina
aa-II
4. Mechanical H AC
5. Total = (1 + 2 + 3 + 4) * Estimated Total $ PP ,'L,�� .
Signature oQown6> Authorized
C:1bldz.forms\Bld2app.res. Nvpd
Page 2
Rev. January 13. 2000
C \hldg_forms\Rldgann reswnd
Page 3
RP T—nn-13_.')IIM.
RESIDENTIAI. 200
❑ FO UNDA TfOINT- ONLY f.
$25.00 APPLICATION FEE IS NON-REFUNDABLE & NON-TRANSFEAA13LE
uuTH; •• >- DATE RECEIVED
,'��M, "9`• DARTMOUTH BUILDING:DEPARTMENT
400 Slocum Road, P.O. Box 79399 -
Z . t
Dartmouth MA 02747
508-999-0720 FAX 5087999-0738
APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO-FAMILY,DVVELLING"
Zoning Review: Signature:
Energy Rep
ort: Signature:
P�
Fire Chief. Signature:
Board of Health: Signature:_
Conservation Commission: Signature:_
Other: Signature:
Description of work being performed:
Date:
Date:5` , _ cl'I
Date:
Date:
Date:
NUMBER OF PLANS SUBMI ED: �� SITE PLAN SUBMITTED: *es ❑i=no
1.2_Assessors Plat & Lot Number: Ac
� I ^
1.1 Property Address:V Plat_ Lot -
Nearest Cross Street: ��(�(`;.,�_��
Subdivision Name: C,=;S%�},,
1.3 Historical District ❑ yes Ano
Total Land Area Sq. Ft.: Hc�S �Has application been submitted to the Historic Commission?
1 t
❑ yes �,no Date:
1.4 Water Supply (MGL c 40 § 54): 1.5 Sewage Disposal System:
❑ Municipal Private Well ❑ Municipal XOn Site1Disposal System
ion � I
I�
_Rev-.January 13___7.Of](1 l
C \hldg-fcnrms\B1deann.res.Nvnd
Paee 4
Rev. January 13. 2000
C:\bldg. form s\B I dgapp. res. wpd
Page I