BP-437 BUILDING PERMIT
EMBROIDEREY AFFAIRS
Dartmouth Building Department Plat : 77
400 Slocum Road—P. O. Box 9399 Lot (s) : 28
North Dartmouth, MA 02747 Lot Size : 8. 2 A
Telephone 508-999-0720 Zoning Dist. : SRA
January 6, 1995 (typed) Permit No. : 1137
Issued Date: / /0/qs Clerk: soh
Project Location: 2 Oakridoe Drive
Nueber Street
Subdivision Name : Hilltop Estates Lot 1
Nearest Cross Street : High Hill Road & Oakridoe DR.
Applicant/Agent : Doris Jenkins
Address : 2 Oakridoe Drive, North Dartmouth, MA 02747
Contact Person Phone #: ( ) 508-998-2355
Type of License : Owner: (x) Const. Superv. License #: ( )
Architect : ( ) Engineer: ( ) Other: ( )
Proposed Use: Residential
Residential, Commercial, industrial, etc.
Permit Issued To: To Occupy
Type of leer oveaent, Add. Alter. New Coast., Demo, land/Move. etc.
Home Occupation _ - _ --
indicate no. of bedrooms and bathreoee and other ooe..
Gross Area of Const. : Cost of Const. $ 200. 00
Cost—Other Const. : TOTAL FEE: $ 50. 00
Owner (s) of Record: Doris Jenkins
Address : 2 Oakridoe Drive, 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 authorize} agen
Signature of Owner/Agent : LUei. --. AAc, ,
Address:
********** * **t ***.- * *****************************************
Signature: ( . V
Approved/Issued By : I:vid J. Silveira, Title: Building Commissioner
COMMENTS: Not to occupy more than 1/3 if residence. Not to occupy any
out/ building. Not more than one non—occupant employee.
® RIGINAL 0 APPLICANT ❑ ASSESSORS ❑ CLERK 0 COPY
BUILDING PERMIT
FIELD INSPECTION
Dartmouth Building Department (� tt n Plat: 77
400 Slocum Road-P.O. Box 9399 11_�!_�t�J; ��j �� Lot(s) : 28
North Dartmouth, MA 02747 lJ ( �( IL`rry� �I ('r�� lI Lot Size: 8 . 2 A
Telephone 508-999-0720 Zone Dist. : SRA
Issued Date: 01/06/95 Permit No. : 437
Project Location: 2 Oakridge Drive
Number Street
Subdivision Name: Hilltop Estates Lot
Nearest Cross Street: High Hill Road & Oakridge Dr. ,
Applicant/Agent: Doris Jenkins
Contact Person Phone #: ( ) 508-998-2355
Proposed Use: Residential
Residential, Commercial,Industrial,etc.
Permit Issued To: to occupy
Type of Improvement,Add,Alter, New Const.,Demo,Land/Move,etc.
home occupation
indicate no.of edrooms and bathrooms and other rooms
Owner(s) of Record: Doris Jenkins
Address: 2 Oakridge Drive, North Dartmouth, MA 02747
DATE TIME TYPE OF INSPECTION REMARKS ' ;INITIAL `
MAY 2 2 2(,m � � G - l d c
BUILDING Pr1.1401IT
EMBRUIDEREY nr ni?s'
Dartmouth Building Department I P7 -. t : 77. F
400 'Slocum Road-P. O. Bon 9399
d Lit .s7 28
North Dartmouth,¢, MA 02747 t 3t R 0
Telephone t 9 @ `-'0 toning Dist ;.RA!
Ja€rubs t. i995 ttypjed4 Permit No. : '`"1w '
[ Issued Bate: _ ___ ( - i"}e__ Clerk: qb.
Project Location : _ r' t7a# r icig _Drive
1 tinatw s:r-ssg
a
Subdivision Mamez N l„rirn t tt is s , s ,. ➢ _
Nearest Crass Street : _ ......... .... ?'s1 #-isil Reac9�, �.4i,�kr,,�:i ,? . tits.
Applicant/ agent Cr_rr3i 3ankin , _
Address : a VykricirLt 1)s`ive Nor't r Drar,t,mour-h1 _MA 02747
Contact Person Phone 3t: I 54tici 4 � r ;tea
Type of License: Owner: (al Cunst. Suporv. License tt: i ?
Architect : 3 Engineer: 4 Other: £
Proposed Use ; Residn`}a -
fl..t .nxrar. i'a¢Wan�1at, Ina.nraaj.,__•t:�. --_..._ _�
Permit Issued To: To Occiila Type
n...._ ,.. _ con,
S K✓98 O} 3iLiAa aV OLdakka �aa, Rx4b„ [fBfN ¢"eR4Y., con, 8014 Ma:vi m C.r
s nallcata <.e. of naavW:.:be a..t# 1TSEiw.o>a anm Wc?.
GrO:c Area of Const. ; _ _ Cost of Const. $
Cost-Other Const. : _...,...._ ..._._._ TOTAL FEE: $._,...50r..°10 ..,.____._.__.
Owner (s) of Record: , DAri _?e;akim .__ _ ___._
Address : 2 fJ 2tedi 9 }rive, North Llartnnuth, t+i€i 4 .'i sJ
All work. shall comply with a?BO ENE 5sh Ed. (MGL Chap. 142) and any
ether applicable Mass. Laaws or codes and plans on file.
I hereby certify that the proposed work is authorized by the owner
of record and I nave been antheri ?ed by the owner to make this
application as his authorized agent.
Signature of OwneriNoent :
***-**** t****4W***it***-:�*N-****-k**t** ********JrW.*;y. s4****'k-***'.4s****1F-*�%:*
Approved/Issued by; .flayid .J. Silveira_, Title: Building Cosnmiosiciner
COMMENTS: Not to oc_-upy mere than 1 /3 if residence. Net to occupy any
out bu t ldins. Net mere than one nen-e cup3nt employee.
., q_it:[yi6.MAC :..d' PPL 1 CANT 114 ASSESOORS s'L.E IG .'i COPY
•
s,,ttou—To i PERMIT NO.
. TOWN OF DARTMOUTHCI DATE ISSUED f
tiryl APPLICATION FOR TOTAL COST %��"J
o0 �� LESS APPLICATION FEE 17-7 i/,-2
ce• 18e4• ' BUILDING PERMIT _,, -- -
FINAL PERMIT FEE
7
LOCATION OF BUILDING >/ A OiC 1_ lj -1K
•
./ 01 Number & Street a CiakYtA fiuQ. ddK 01.1 Zoning District
02 Cross Streets�y (between) and
03 Lot D Plat 7/' 04 Subdivision Lot
OWNERSHIP COST
05 ❑ Private (individual, corporation, 36 Cost of Improvement
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 ❑ Addition -Type of Room(s) 36.4 HVAC
09 ❑ Alteration 36.5 Other - Specify
10 ❑ Foundation Only example: elevator
11 ❑ Demolition (#of units if residential) 37 TOTAL * . en)
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
18 ❑ Garge 45 Total land area, square feet
18 ❑ Shea q
19 ❑ Carport
20 ❑ Swimming Pool SEWAGE DISPOSAL
In-Ground Above-Ground_
21 ❑ Woodstove 46 ❑ Public or private company
22 ❑ Fireplace 47 E -Private (septic tank, etc.)
23 ❑ Other- Specify
WATER SUPPLY
48 ❑ Public or private company r,
NON-RESIDENTIAL- PROPOSED USE 49 Cy?-Private, (well, cistern)
24 ❑ Amusement, recreational 25 ❑ Church, other religious PRINCIPAL TYPE OF HEATING FUEL
26 ❑ Industrial 50 ❑ Gas
27 ❑ Parking Garage 51 ❑ Oil
28 ❑ Service station, Repair garage 52 ❑ Electricity
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, towers56 Will there be an elevator? ❑Yes ❑ No
X 35 ❑ Other- Specify • .f
PARKING PER ZONING BY-LAWS
57 ❑ Enclosed 58 ❑ Outside
,UDT —to ocC (.)t° �""-cmm m,C At 4la.r� "fa e•P R,f'�16sr nJ C.t
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) DOYats ENIUNis a OHrte.)OGE D2. qq$- a3 S
NAME 'r MAILING ADDRESS TELEPHONE NO.
61 Signature tam / i XQ 1 a.� DATE
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 knowledge.y�
Signature �' `v o<^`( DATE 1A/93—
Owner or Agent
69 BOARD OF HEALTH REVIEW DATE
Inspector or Authorized Person
COMMENTS:
70 DPW -WATER Service No. SEWER Service No.
To be completed upon issuance of permit- (if applicable)
71 I will post permit and a dress so as to be visible from street.
Signature p(v_�v051-ia,o DATE //SK
Owner or Agent
72 I have received list of required inspections
Signature DATE
Owner or Agent
73 FOR 1IESIDENTLAL PROJECTS OTHER THAN NEW DWELLINGS:
Are you a Home Improvement Contractor subject to the registration law(780 CMR-6)? YES NO
Are you claiming an exemption from the law by homeowner sign-off? YES NO (if yes,submit required signed affidavit)
Contractor's Signature: Date
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND
(780 CMR-6) QUESTIONS or COMPLAINTS?
Call or write: Home Improvement Contractor Registration
One Ashburton Place-Room 1301
Boston, MA 02108
617-727-8598
Owner's Signature: Date:
1
RECEIPT FOR PERMIT
our® TOWN OF DARTMOUTH 3-7
PERM NO.
L _ No A�
oa--
_ i
Date ✓ ` l - 9 �--
E
Received From l�
i
Owner '.eint- - `
Location t 0Oaf✓t4I '
f
Type �f1 me weupth
Amount Paid _ /��" 1,�/
Received By /w 74 )2 _
1
RECEIPT FOR PERMIT I
TOWN OF DARTMOUTH 6 9/
R T O.
6 4
_y_; No
i Date
Received From k -' � Uri-;
Owner QQ
de:J(4-4 lee `�„� ---
Location �J . ¶a 1'k1-e"
--
Type C AC_ � / /
Amount Paid 5�. C�1C4) : 71- Y /
Received By -4-i lif��L" fi"
•
COMMONWEALTH OF MASSACHUSETTS
t'' DEPARTMENT OF INDUSTRIAL ACCIDENTS
600 WASHINGTON STREET
James Camooeu BOSTON, MASSACHUSEI IS 02111
omm'sslone'
WORKERS' COMPENSATION INSURANCE AFFIDAVIT
I,
(1 icensee/permi flee)
with a principal place of business/residence at:
(Ciry/State/Zip)
do hereby certify, under the pains and penalties of perjury,that:
[ ] I am an employer providing the following workers' compensation coverage for my employees working on this
job.
Insurance Company Policy Number
[ ] l am a sole proprietor and have no one working for me.
[ ] I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below
who have the following workers' compensation insurance policies:
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
0 I am a homeowner performing all the work myself.
NOTE: Please be aware that while homeowners who employ persons to do maintenance,construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally
considered to be employers under the Workers' Compensation Act(GL C. 152,sect. 1(5)),application by a homeowner for a license
or permit may evidence the legal status of an employer under the Workers' Compensation Act.
I understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' Office of Insurance for coverage
verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to $1500.00 and/0 imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of S 100.00 a day against me. /`t/
Signed this 'T' day of µ o 19 %
Licensee/Perminee Licensor/Perminor
II. TOWN OF DARTMOUTH BUILDING DEPARTMENT
1 TELEPHONE 508-999-0720 FAX 508-999-0738
TO: C117?
Fire Chief Dist. 1, 2, 3 ❑ Board of Appeals
Tax Collector ❑ D.P.W. Engineering
Board of Health ❑ D.P.W. Water/Sewer
❑ Conservation Comm. I Cross Conn./Water Div.
❑ Selectmen-Licensing Planning Board
r�
Town Clerk �jl
❑ 9-1-1 Police Department
The following is forwarded to your office for your information
only - no response is required. PLEASE PRINT
The Building Department is in receipt of an application for
Plat 77 Lot c! , Address -, /i,? tri , >'" ,
by .s-ts le inY-nS to �"* ( (2tL' ,
CONTACT PERSON&TELEPHONE/1 demo,construct,altar,occupy,etc.
a(n) {/ 1 lCw //L<<? C'
The plan was received by this office on - - -
date
This office will review said plans and subject to availability of potable
water, where required, the provisions of Zoning By-law per MGL Chapter 40A and
MSBC 780 CMR 5th Edition will have available to issue or will deny a permit for
the above-mentioned work within 30 days of date of receipt.
The applicant has been advised that your office as indicated above may
require them to apply for licenses or permits subject to your jurisdiction and
that they should contact your office, as indicated, for specific information.
It is not necessary to respond to this notice unless there is a specific
issue at hand or you wish to forward material or information required for
permitting. When required, an Occupancy Permit will not be issued until all Town
Agencies have had the opportunity to "sign off" that the work under their
jurisdiction is complete to their satisfaction.
To The Applicant:
Be advised that this notice will be sent to the Agencies checked above as
they may have separate jurisdiction for your project. Any questions about the
Agencies Regulations & Policy should be addressed to the individual Agency.
Your signature acknowledges your receipt of a copy of this notice.
2o'Q.s Sthw4 t\S
APPLICANT/TELEPHONE(PLEASE PRINT) SIGNATURE DA E
LICENSED CONTRACTOR'S NAME/TELEPHONE(PLEASE PRINT) DATE
DEPARTM.NOT 11.18.9a
7.
` - 'r m �` ° . S • 'a'� > y at4er'�V, 4.+T t 4+r.',`si'Ld4x*o d„A.)t` -`f4k= #r}Y3z&l • . , i L, Y("Y 4 a V -17- o'rap ' * � y� 4 ) ‘ : ,t
;f'' d' n "''AS 7/ '0 . t kk 18 144 ti y ,, r .a 4? $ A,F
11 4, 1 r 9"
e r ,p a�' a '
$ 6. d 1: 5h
'-cr.'f td+, r- * x r -Y a. , 2, -,
x �- A i '
ll
v f ' y�� yy,,S i.,fi 4 9� r 's t N FT )•r F y tjN�y F��}�'C+` �*
t t o"ir } :i. jet ...-- • • 1,,...P. v ,r r }�wi 4s ..T , ..f
�tG n.S.Y t � L hy.� Q :2"i 5Y 7 Y e;yy.,A',.'= Y .. h .,e4- -y'ilk
0 q.., „,,\„i t x � lc.-, -' ;
� �t▪ $fie < �w2ra-� r x 'St 9' r Y�6 i Yt rar t ='/: - • 4 cat..,-. � ,.9' T Y'^ $ -r£,s'
t• 1 t 3 3t h bS s .� -2 Ever ♦ • }t "Y.fe > m' * e r• ,J> 2 v}.
�„LT],.� r -s$ 1 ;t ' < e 3v . ,! ,_.E. e d�tt, f w3`)� # '- - x„`'11 l41 t.,- 't-}
',yC.�z'�.� k"7 �" 7 '� 'A "; -. AS, ' c5 '�S�, at v 'paY i ` it 'F' @ 11r 'C },-r.�"s� ''
4'`*,.Cwt y..;.,.r y "".4-1.p. 3x.1- c re z+r h i,a 5 �<m ) ;„LA-- )4 Yea:„. .n. seq.£s , , g%o^y r r tf y is,� ' `s
).2Y -A* s n k • Y ET )�,u 41`it a .ei ♦ $ e i.. x ..fet -sr a'=.,+ .1 i; ?
a"' :Ia • o S ,.,st'•�' !+ a a7 •£- tom,, . Yt 'm*'t i n r `. ,x '`f.-
.*-`'1 s • v'1. r f' .j *--4 4i ii. ' r' 4r'4yh 04.4frh-+• .•m',e� fl ?tr, 4'.:4 hg t'e}, ir .-1'4t- ,i\.,�; ��
�' �;� ` S`.4� u `'`t r - _ - 1i x'^'sy� i' r y .+ 'I�'„"'}t�' , ,4 t';, ) s ' ' �`r" l �.
b t T< -"�fi` a'ry„ Kea+ -.y'' ..ems T.t,yr.Ae3t^. _ .. ,Y 1`e r i + ,2-f.. "f�•a :E r M'X^
'a_d▪ a l *C-. t _.�� Z y`Y ate k t r K V • �-,-.: ,•; P �tJ-9 f i -
ss >Li 416,.... r t .�aCvv` � +t y,< 3 2s°�^°4'r, +rst�e,`rt. a" 4 `
Cy' n Y -- 7 s v. .-7.. Jar X? 3k rt r tiai ;• ita` E' 'darn.T i, .,
ib. y v 3 [ -P, K 2�a�y -' 4_,,t r 8$w.< -i -� eii r C ""..GG_. � 5_ p f '40 •7, r� ¢l a,==
* ''F') 't + S',,, 'Tz" • t c+ �` *kF'.S/' to sN y a 2 �# t S K- s..174, ; � ' .� -
a 3•tt' MS--t,.. a}< „` r •. � "; S ,+,�Ky�-x.'.5: � .,,,„4 s... t a L1+4 rT �P:-
r t� �a,,,"''F yp y �Yx7^ +. 1 �,ld, { ` ,a•9�. :5.:'�'�1�t .5 "`tt A..s�s6;r y,�y '�•?; �`
�..�`i$'e .ttr ltrf•4. $F1 y -. d J T�Y.,X 1}.' '� Ti.. _�" i 'i .t4_134.7�� r i. S ' �T. l A`i �+}j'�I.+E .G ,y.,11 #Y( tA.
3 u j <r''t!'`,` '1 7 1 4 Yttin 9, A' .,"k5.''iF" fiC F -. .s 8 3 "�'� `: .s'' r
? lale).• r $� tk s at Qht _.� ;rt4t. •
7 - E1 (4 : S r `rsifki T. 'Y a 4eY t �t lC_
_.:.,•c4 it: ..,
J1/4:4_, (-4'
a5a,�^!c ;y c>k„„ '� A „ r� • art° •3d 3`�: `..t ( ,z .tx ` 4 . . p ,.
..
^,e 'al -`sy' -. r]C z. ,i t i .j, n14" ,e-'- Szt-.t It a} i i'c.
t� *I' -'ft a `�" }.'I`� % -. 's�&'R T r w 9F: `.1 ,�..\q�`',-y� '. L-^+4 ua, 5 �s +t
u'A-i3 s M. t )>3a .ts`�xl.n x µ" meva �, ,r-fir:
�, 'ru y".(`` - -- M1 t yy: Y '� �3Ct. `: 1 , ;r,,.R - k �?. 9 .,,v."i''...? s,,, 4 - w
.'.1.e+' 4'r�`rt. +0�' rQ _,``' . e s, kct ai-,(c ?t. `—,_ .-` +s •w -' a..�t t7`.
„'� .� � �c.[[ 7:.$'Y+�'� t -� 7 rq',j,;r �y� c �v �.� C p yt tSi : ..
s
``i e X 5 g t+aet1 a to •). . 2;f:A ,Yt F �.�y` --.'f. "s')ri 3" , . • i'
4 - �L 4Y,�,` `r,�'t ~ , h'�' �9'�' y'`s.C�rt2' s▪ Y "do • �`;.� {4•
le
li
.,1, ,e'i „. a. 'a• 5 41,y rtiytr 'tm ▪IS^ t .c -ryfa, y:f r �> i �'�
.a`y .µ. 4 a'` -� a:rµ` c - - , d t�'wtc-J il ,. ',bar, Yr _:.
�� D ,s_'" ' 3Y ,1.3'!� f is .q-n' ,,4,§ nye, �' y. �i ,�, ate . .
i`°9,?. 'S rfa-�.:I"� �T t'y� :+a .'T^7Y� E� �sr �,.3x, ay.-�
_1r fir` ' . fix"- r s - , tom ��, Q t • . .
t` . : F t ;«r ,, JKt .447,3%.' ti : rw. .y- `_, ;,'"1' -r. :t �� t:ts ' Jr a. 5 -r
s { _ .F a-^r r "'*-'.*7v„.iiiI K- •a .t `"fit -/,
z „ad.• rK't� ` T t �}�._"+ �.d. ,aa A'
•�j; ?,3- t .. :' T t 'Yi?��'1{,� "rs .^y?�y �v,
Cyi f 'C.Y V -.Y L�JY ,_, .C +�"^� sr T� l�
-A `ref'wa • `3'.LQ1 p ,a., s- t. rve .,M f a✓j.. .j�}; .kw -
- xe..�'4 t .
inaligak �nr- Yy 3.apt c -t•.:, - a l..0 Ti :k" i•®•/ A"'`T
` N/ '' {:.t ,t. •�+t.ny,: ",a s";'_' -,c„T i . '°,r1 s (• ys. : 9 >+.'�F Savy
Ak
,,,y,..C ---tc },X YC.A rF � '- 1 s t X3 .. , 1- ra , �' te_ .i. =a' fi ;-,"e .t ,t.
Pi
_ -'-' t..L.1 '.a. YT. r + 3�1v}ic w - .=:'-a4 '� 7.
r 1 `- -, 1. -r - -*. ) .
74,
Ara 'N L - 1` iwr d" yt. y i : i�. v t x ,tt. :
S-. S +sl T `4-Cy,,::01 re '7, S `'.y p 5 V�s • v' - 1+0 '-A
It
�s � - ,,i ✓ ;� -� {_`.
+ w
: ae .daC ._ @ -
- C .yt -:'
.. s'yµ
THE COLLECTOR'S OFFICE
DATE: , / 7J
U
TO: ILDING DEPARTMENT
cc A
FROM: COLLECTOR'S OFFICE c on n
RE: PAYMENT OF PAST DUE TAXES ` ro m
C
PLEASE BE ADVISED THAT ON THIS DAY 5j/i19(THE TAXES FOR
n
PROPERTY LOCATED ON°20alattej4 PARCEL #t- 77- c4 6
HAVE BEEN PAID. THE PERMIT WHICH HAS BEEN REQUESTED MAY BE
ISSUED. IF YOU HAVE ANY QUESTIONS CONCERNING THIS PLEASE CALL.
cc:DEBORAH L. PIVA
TOWN COT,T,FCTOR
TOWN OF DARTMOUTH . . BUILDING DEPARTMENT
TELEPHONE 508-999-0720 FAX 508-999-0738
TO: 77-0.2 Pa'
Fire Chief Dist. 16 3 ❑ Board of Appeals/e// , �y
Tax Collector ❑ D.P.W. Engineering
Board of Health ❑ D.P.W. Water/Sewer
❑ Conservation Comm. ❑ Cross Conn./Water Div.
❑ Selectmen-Licensing 0 Planning Board
❑ Town Clerk SA 9-1-1 Police Department
The following is forwarded to your office for your information
only - no response is required. PLEASE PRINT
The Building Department is in receipt of an application for
Plat 77 Lot , Address t-/dj
by -a-t s In Y.n S to o"C'r,Ppti/
CONTACT PERSON&TELEPHONE. demo.construct,,;air,occupy,etc.
a(n) ?/o G
The plan was received by this office on - /% 'Mc
date
This office will review said plans and subject to availability of potable
water, where required, the provisions of Zoning By-law per MGL Chapter 40A and
MSBC 780 CMR 5th Edition will have available to issue or will deny a permit for
the above-mentioned work within 30 days of date of receipt.
The applicant has been advised that your office as indicated above may
require them to apply for licenses or permits subject to your jurisdiction and
that they should contact your office, as indicated, for specific information.
It is not necessary to respond to this notice unless there is a specific
issue at hand or you wish to forward material or information required for
permitting. When required, an Occupancy Permit will not be issued until all Town
Agencies have had the opportunity to "sign off" that the work under their
jurisdiction is complete to their satisfaction.
To The Applicant:
Be advised that this notice will be sent to the Agencies checked above as
they may have separate jurisdiction for your project. Any questions about the
Agencies Regulations & Policy should be addressed to the individual Agency.
Your signature acknowledges your receipt of a copy of this notice.
IS APPLICANT/TELEPHONE(PLEASE PRINT) SIGNATURE DA
LICENSED CONTRACTOR'S NAME/TELEPHONE(PLEASE PRINT) DATE
DEPARTM.NOT 11.18.94