BP-53324FIRST FLOOR
1 . 7
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LEGEND
BASEMENT
O ADDRESSABLE HEAT DETECTOR
AS ANSUL SYSTEM
O ADDRESSABLE SMOKE DETECTOR
FAC P FIRE ALARM CONTROL PANEL
S� ADDRESSABLE DUCT SMOKE DETECTOR
EMI REMOTE TEST SWITCH
aADDRESSABLE MANUAL PULL STATION
LJV HORN/STROBE, WP DENOTES
WEATHERPROOF
The following descriptions are based on the Massachusetts State Building 6th Edition, Code Article 3, as noted. See the Code.
Assembly - restaurant, lounge, theater, school, etc. (see Code Section 303.0)
Descriabe:
❑ Business office, assemblywith less then 50 occupants -
pants indicate Medical or other professional
p (see Code Section 304.00)
❑ Educat.ion - struction for training including child day care for those over 2 year 9 months (see Code Section 305.0
❑ Factory7lndustrial (see Code Section 306.0) )
❑ High Hazard (see Code Section'307.0)
❑ Institutional = hopsital, nursinghome, infant day care see Co y ( de Section 3013.0)
❑ Mercantile -retail stores (see Code Section309.0)
• Residential three or more family, hotel (see Code Section 310.0)
❑ Storage -including garage (see Code 311.0)
❑ Utility & (Miscellaneous Structures - includes tents and agricultural structures (see Code Section 312.0)
❑ New Tenant - for any of the above, please indicate (see Code Section 110.0 and Zoning By -Law Section 35)
• Tent or Trailer - temporary
Purpose?
11 Other,
Describe the proposal briefly, INCLUDE number of dwelling units and bedrooms or occupant load as applicable, also existing
condition Crf extra space is needed, attach an additional sheet):
,;::- �.
❑ New construction and/or Additional (total gross cubic feet proposed) - indicate
If the project is an addition to existing structure - total gross square feet of existing:
❑ Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration is required.
Will this project be subject to CONSTRUCTION CONTROL (over 35,000 cu. ft.) ❑ Yes ❑ No
If yes, see Code Section 116.0 Designer to submit Code Synopsis in additional to originalplans.
Will this project require Peer Review (over 400,000 cu ft.) ❑ Yes 0 No (see 125.0 Code & Appendix 1)
APPLICANT TO PROVIDE PEER REVIEW AT THEIR EXPENSE. SEE 780 CMR.
• Demolition* describe structure:
❑ Moving* - (provide copy of DPW moving linense)
*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:
❑ Replacement doors and windows - (for existing only) (only where doors and windows exist and will not be enlarged) EGRESS
dimensions must be maintained. Enlarged or new windows in an existing dwelling will be considered as an alteratiran, otherwise will
be included in new construction. (see Code Section 3603.21 for residential and Article 10 for commercial),
❑ Temporary structure - includes, when allowed, trailers, tents and the like and only for limited periods of time. Descriibe:
SECT[QN 8,=:MECHANICAL=& PRINIARY,FUEL
F
0 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):
❑ HVAC (combined unit) - primary fuel, natural gas, propane, electricity, other (specify):
❑ Air conditioning - (separate unit) fY)
❑ None of the above to be provided
• Hot Water: Gas Electric Fuel Oil Other
w _ SECTION 9 ;:;SPRINKLERS A ND/QR FIRE, PROTECTION
In Required: plans provided plans not provided, why?
❑ Not required, not to be installed, why?
:SECTION;10 REQUIRED OFF-STREET PARKIN G(_farZohing'and;Architectural'iccessj._
❑ Parking plan submitted to: Building Dept. Planning Board Date submitted
Number of spaces indoors outside Total provided
Handicap spaces - required yes no if yes, how many as a part of the total required numberr
Is Route 6 (State Road) entrance permit required? yes no if yes, has it been issued? yes no
Submit copy of application and/or permit as soon as available.
SECTION 11 ENTIFICATION
11.1-Afebitect/EngineeT - for verall design -1-ii-5{ ,,112- '
Company Name: //U/ S
Address = 7 .,—
Phone #:
Certified by State of Massachusetts as:
Certification Number.
Note: Signatures and seals on all plans, affidavits & other documents SHALL BE originals and not reproductions.,
11.2 Architect/Engineer - project supervision and reports
Company Name:
Address:
Phone #: _
Certified by State of Massachusetts as:
Certification Number.
Note: Signatures and sear/-s on all plans. affidavits & other documents SHALL BE originals and not reproductions.,
11.3 General Contractor'
Company Name: F� /! �/?el
Address: 3 a L�-/ ir�a 1 ✓�Ge/r����/% 7it3
Phone #:
Geastrmet License Number.ZZ
Note: Signatures and seals on all plans, affidavits & other documents SHALL BE originals and not reproductions..
COMMERCIAL
Item Estimated Cost ($) to be completed by permit applicant
1. Building
2. Electrical
Z... Plumbing
4- Mechanical (HVAC)
5. Off -Street Parking ,
& Total = 0 + 2 + 3 + 4 + 5) Estimated Total Cost Including Labor: $
-
(Please Print) AA ��%, .
I. 4 �f • 0A) L ' `, as Owner of the subject property hereby authorize L,
to act on m behalf, II matters relative to work authorized by this building permit application.
Y g P PP
Signature of O ner Date
t.. ! N (S 0-0 4 11 as Owner/Authorized Agent hereby declare that the statements and information
on the foregoing application are true and accurate, to the best of my knowledge and belief.
Signed under tpe pains and penalties of perjury.
Signature df Owner/Authorized Agent Date
'@_ HOLD reason:
Date:
2. HOLD subject to Zoning Board of Appeals
Action: Date:
3_ Comments:
4_Comments:
5. Inspectors Signature:*�__
Date: -
Applicant informed of above: Date: Time:. Clerk:
Comments:
Less Application Fee: $25.00 Remaining Balance: $
Total Permit Fee: $
Other $ Amount $
TOTAL FEE: %�� Gross Area - New Construction total sq. ft.
/ Gross Area - Alteration total sq. ft.
:Permit Issued to:
�GJ.VV t�1'YLiaFliii/li WJLJL 13 222 19JL-1`UfV"A14LJE A 1dQD1N=1'13111\ISFIF]AABLE+
DA ET E RECEIVED
DARTMOUTH BUILDING DEPARTMENT
400 Slocum Road, P.O. Box 79399
2 y ` Dartmouth, MA 02747
Phone: 508-910-1820 Fax: 508-910-1838
www.town. dartmouth. ma. us
APPLICATION TO CONSTRUCT, REPAIR,' RENOVATE OR DEMOLISH A COMMERCIAL BUILDING (incciudina3ormorefemiwdwem..1
DEPARTMENTAL APPROVAL
Zoning Review:
Signature:
Date: JON ® 9 2008
Energy Report:
Signature.-
Date:
Fire Chief:
Signature /1. e �, — .o
Lt,
Board of Health:
Signature.
f
Date:
Conservation Commission:
Signature:
Date:
Other:
Signature:
Date:
Brief description of work being performed. 17j/
1.1 NUMBER OF PLANS SUBMITTED: 1.2 SITE PLAN SUBMITTED: ❑Yes ❑ No
1.3 Property Address: _5G - 1.4 Assessors qpp & Lot Numbcar:
Nearest Cross Street:
:..Map W Lot -�S}-
Business Name:/'3� Pd �n�S147
/ 1.5 Water Supply (MGL c40 s5):
Business Phone #: ��` / ��✓' �dy ❑ Municipal ❑ Privattr Well
Total Land Area Sq. Feet:
1.6 Sewage Disposal System:
❑-Municipal ❑ On Sittte Disposal System
SECTION 2 = PROPERTY OWNERSHIP/AUTHORIZED AGENT
-2.1 Owner Record: _ j _ VU C? St r
S�(X/a tYl �4,
Name (print) Contact Address Phone Number
2.2 Auth rized.Agent: -
C-
Name (print) a Contact Address Phone Number
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