The URL can be used to link to this page

BP-299 BUILDING PERMIT Dartmouth Building Department Plat : 79 400 Slocum Road-P. O. Box 9399 Lot (s) :6-8 North Dartmouth, MA 02747 Lot Size: 81, 896 Telephone 508-999-0720 Zoning Dist. : SRB September 27, l99 (t aped) Permit No. : 59 Issued Date: / / / l Clerk: JMH Project Location: I ' Medeiros Lane Humber street Subdivision Name: Sylvan Sprinos - Nearest Cross Street : off Collins Corner Road Applicant/Agent : Paul and Kimberly Alves Address: 786 Belleville Avenue. New Bedford, MA 02745 Contact Person Phone #: (508)-991-4272 Type of License: Owner: ( ) Const. Superv. License #: ( ) Architect : ( ) Engineer: ( ) Other: ( ) Proposed Use: Residential R.sldontlal, Ceaaerclal. Industrial. .to. Permit Issued To: New Construction Typo of lopro t, Add. Alt.r. Now Const.. Domo, Land/Novo. etc. fireplace_ & chimney/__2 Imaials f indicate no. of bedrooms and bathrooms and oth Gross Area of Const. : sq. ft. Cost of Const. $ 3, 000. 00 Cost-Other Const. : TOTAL FEE: $ 60. 00 Owner(s) of Record: Paul and Kimberly Alves Address: 786 Belleville Avenue. New Bedford, MA 02745 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 authori ed by the own r to make this All application as his authorized a nt. Signature of Owner/Agen : Address: '7t Al/jai' ✓� i , T *********************i ***v;***** ** * ************************* Signature: 7_ Approved/Issued By: eel S. Reed, Local Bu ing Inspector C MMENTS: ORIGINAL 0 APPLICANT 0 ASSESSORS 0 CLERK 0 COPY BUILDINGPERMIT 4 00 C 4 L t pt-!,.4,7>1-4 - flnn • 414 o' 217'. r -1 = 11444 . f..L.;"" t 2"LfLo4rI-3.121,74d _ , P p -•;- uVfitJ _ - .t14 1 1 V f;..-.4 n t 4 544'.21t 99,1 Type ,.„:" t_ z 1-4 s? r Lit 44 . F.,:5 t 5,,t4:4""A4r.717: 4 ft ri _z _„ . . Cr: -`,4 t . _ _ - ,er i e e . , . _ '4'. 7,1 "4",' 414 V:4 t.-4! h CHF? h E .. C.t--.4 ;El! ,24 t:t y 44c fe„, ;is= 47 • 4-,4 t"; t t,44 4 '% 1 4. o7irm.,o T, 9n e L4, c*WE t.4. , . •47 t3ESS 'laL LUL C®'— Nuui eBn equired approval Approvals received .lease (X) approvals Please (X) approvals and equired for this project Initial as received DATE INITIALS Zoning Building Comm. SEP 2 6 1995 Board of Appeals Water Card Sewer Card Board of Health Bond Selectmen Conservation Fire Chief Cross Connections Licensed Contractor I Controlled Const. Affid. �- Other information required 0(�� CV2/2 ,A.e,r— /v14- '''' ' „-- PERMIT NO. 9 ✓ 4'S.%t``f UC c 9 C 4;f � TOWN OF DARTMOUTH DATE ISSUED 4 "M- 75 0•,' 4 �ti TOTAL COST y yam:/ APPLICATION FOR LESS APPLICATION FEE %7C�� \eea-•sy BUILDING PERMIT �c- : ::',� FINAL PERMIT FEE .), 5 ili G E f1Op- LOCATION OF BUILDING I • 01 Number & Street k L-Z-- $ .-6---4---'' Q-)'t-e___- 01.1 Zoning District 5>eel 02 Cross Streets(between) and L Lot 6 — Plat 7, 04 Subdivision • -ey__,-� - ___- Lot OWNERSHIP COST 05 rivate (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 Oj,CONSTRUCTION 36.2 Electrical 07 Lit"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 IT Demolition (#of units if residential) 37 TOTAL 3/ f°L' 12 ❑ Moving (relocation) STRUCTURE STATISTICS 38 ❑ Wood Frame 13 Number of Bedrooms ..3 39 ❑ Masonry (wall bearing) 14 Number of Bathrooms (Total) dZ /,� 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 _ 17 IT Garage '18 El Shed 45 Total land area, square feet /' �, .4 7/{ 19 ❑ Carport 20 ❑ Swimming Pool SEWAGE DISPOSAL ,. In-Ground Above-Ground 21 oodstove i , 46 ❑ Public or private company 22�eplace 4- C ,wV 47 ITisrivate (septic tank, etc.) 23 ❑ Other- Specify � `' WATER SUPPLY 48 ❑ public or private company NON-RESIDENTIAL - PROPOSED USE 49 O'Private, (well, cistern) 24 ❑ Amusement, recreational PRINCIPAL TYPE OF HEATING FUEL 41- 25 ❑ Church, other religious • • 26 ❑ Industrial 50 ❑ Gas r 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, towers 56 Will there be an elevator? ❑Yes ❑ No 35 ❑ Other- Specify PARKING PER ZONING BY-LAWS 57 ❑ Enclosed 58 ❑ Outside /< 59 Does this building contain asbestos? ❑ YES ❑ NO If yes complete the following: Name & Address of Asbestos Removal Firm: t 7 7 IDENTIFICATION - To bed/completed by all applicants PLEASE PRINT // f, � 60 Owner (print 7`Cc Lik z/� �� 't`� `t—' 76 Ad (s C(� c�7`f� N ME MAILING ADDRESS TELEPHONE NO. �;'�, �wC,---r , DATE 61 Signature G 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. Signature DATE 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 per it and address so as to be visible from street. Signature DATE t Owner or Agent F,' 72 I have received litof required inspections Signature it. DATE Owner or Agent 73 FOR RESIDENTIAL PROJECTS OTHER THAN NEW DWELLINGS: •.a 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 p 617-727-8598 Owner's Signature: �N'\ , t L �\11\`�'� Date: 1 RECEIPT FOR PERMIT 61r 0 oUTN•rl TOWN OF DARTMOUTH ✓ / / c6 �1a PERMIT NO. o o =L=A� �ry�{((/r / sr. y' •is.• • / ! /.(''. t.,r�Gl t Date/ !f / ; _. r Received From t f / > (' .!� t .:/ �t ('./--f<' 1 jJ. Owner I y Location f'.. F fP Type __ Amount Paid ----:/,,,).. ,-•.. -:., 4'` _l-."/Li ,..; i �r /F .F 4 Received)By 44,.! t 6' �" 1 1 -2 RECEIPT FOR PERMIT , TOWN OF DARTMOUTH 3 .1:thot3TH.4, le.:1Vii, PERMIT NO. ,! 40 -------.'----- . .7i.-- - i Date )12.LA___c___ /,‘,2),__Lx___I Rived From ;1- Owhtir d.,-4-61.--.2,,,,,_ Q.._ •,-.7y Location iit.L...--(,&._ --t....7 -.9-----4 ,A; c.e..-4, f.,__ -, ---e•"' Type A.-.. - ( . / -- 1 Amount Paid - c--.)---- ceived By ' BUILDING DEPARTMENT TELEPHONE 508-999-0720 FAX 508-999-0738 TO: X Fire Chief Dist. 1, 2 6) ❑ Board of Appeals / 11 /X f Tax Collector El D.P.W. Engineering Board of Health D.P.W. Water/Sewer Conservation Comm. ❑ Cross Conn./Water Div. Selectmen-Licensing ❑ Planning Board ❑ Town Clerk ❑ 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 t Lot C �k- , Address )1I - by UL x, CONTACT PERSON&TELEPHONE# demo.construct,alter. occupy, etc. 1 a(n) G' /, krc-- 'I-t , - �4 ea—_e _ . Theplan was received bythis' office on c 41 C) - -5 l • — 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 MSEC 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. APPL CANT.TELEPHO.E IPIPAIP PRI\Tl SIGNATURE DATE LICENSED CONTRACTOR'S\A.%1ETELEPHONE(PLEASE PRINT) DATE _= The Commonwealth of Massachusetts ' %+V, _ �.. f a Department of IndustrIal Accidents Office ofI glloos g _'-. 600 Washington Street *\ 47 Boston, , Mass 02111 `" Workers' Compensation Insurance Affidavit 4nnlicanttniormation. ,.E� :,._ -..-c: _- 'leasee=W:4t►gt# ;,, : .. ...:w: : name: location- city/ Phone# [, I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an empioyer providing workers' compensation for my employees workingon this job. company name: address: city: phone#, insurance co. noiiev#= • 0 I a.n a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below wha ha ' the following workers' compensation polices: company name: address: . city: phone#- -_ insurance co. policy#" company name: address: city: phone*. - insurance co. Qoiicv#:. Attsch idditionil ihtet ifaecessan- -"=-.:r==`"¢-i - �•.'� 4 -. - - _ - -- -_ .. .•- . - �:..: __ ;;ate,:: -� :tis#=T Failure to secure coverage as required under Section 25A of ii1GL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one.ears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a day against me. I understand that a cops of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herein cenify�under the p • s and penalties of perjury that the information provided above is true and correct. S i orature ,P, ;�. 0 ate Print name - Phone# ,' official use only do not write in this area to be completed by city or town official t V city or town: permit/license# (Building Department 41 QLicensing Board `-. [i check if immediate response is required Selectmen's Office r- `: DHealth Department 1✓ contact person: phone#; DOther t- Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as even• person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership. association. corporation or other legal entity, or any two or more c the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer. or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter hav: been presented to the contracting authority. •:t',r- ,..iS^ � "ia.� -+y.�'�YYcK,, :.. �,,,*s•;w'. � s��,.V �• ;: z �,-- � ':i...a�ss "-r-„ .ar �: f ..,.. .- -f•;4 sK� 1ppiicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. -- _- City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided dtspace at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Offi_e of Investigations would like to thank you in advance for you cooperation and should you have any questions. please ;o not hesitate to give us a call. Tie. Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7 7 49 phone #: (617) 727-4900 ext. 406. 409 or 375 f THE COLLECTOR 'S OFFIcE DATE: 34, c" TO: BUILDING DEPARTMENT FROM: COLLECTOR'S OFFICE RE: PAYMENT OF PAST DUE TAXES PLEASE BE ISED THAT ON THI DAY 0 (g`.��THE TAXES OR PROPERTY LOCATED ON °�� PARCEL HAVE BEEN PAID. THE PERMIT WHICH HAS BEEN REQUESTED HAY BE ISSUED. IF YOU HAVE ANY QUESTIONS CONING THIS PLEASE GILL. cC:DEBORAH L. PIVA TOWN COLLECTOR I v rrIr yr L#I' I I . /VIVv I n ovIWIIVV 1JCIrHri I IVICiV I TELEPHONE 508-999-0720 FAX 508-999-0738 • TO: X `• Fire Chief Dist. 1, 2, 3, El Board of Appeals Tax Collector D.P.W. Engineering _— Board of Health D.P.W. Water/Sewer ElConservation Comm. Cross Conn./Water Div. • Selectmen-Licensing ❑ Planning Board ❑ Town Clerk ❑ 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 9 Plat / I Lot 6 , Address Ate,-u-_ by �� L v, to CONTACT PERSON&TELEPHONE IA demo,construct.,alter, occupy, etc a(n) vrt- ne--�y � � tc Q. The plan was received by this'office on" 9 - o .5 • dstr 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 +**.04vidual• Agency. • Your signature acknowledges your receipt of a copy of this notice. .PPLICA\T.TELEPHO\E iPJ r,+cp PRINT SIGNATURE DATE LICENSED CONTRACTOR'S♦& METELEPHO\E(PLEASE PRI\T1 DATE THE COLLECTOR 'S OFFICE DATE: TO: BUILDING DEPARTMENT FROM: COLLECTOR'S OFFICE RE: PAYMENT OF PAST DUE TAXES PLEASE BE SED THAT ON THIS D 9-„2 (.1\ THE TAXES FOR PROPERTY LOCATED ON � - C� PARCEL # la- f HAVE BEEN PAID. THE' PERMIT WHICH HAS BEEN REQUESTED MAY BE ISSUED. IF YOU HAVE ANY QUESTIONS CONCERNING THIS PLEASE CALL. cc:DEBORAH L. PrVA TCWN COT.T TCTOR TOWN OF DARTMOUTH BUILDING DEPARTMENT TO: / Board of Health • X ,7i (, � Fire Chief Dist. 1,` 2, 3 �I_1 ' Conservation Comm. ❑ �' ' 4 � DPW Engineering �❑ ❑ - /Selectmen-Licensing W Water/Sewer ❑ Board of Appeals EllanningBoard ❑ Town Clerk / X Tax Collector i / 9-1-1 Police Department -1-1 Cross Con n./Water Dxv. The following is forwarded to your office for your information only - no response is required. The Building Department is in receipt of an application for Plat 7C Lot l.^ '' , Address by �� C.`,C1, to cCONTACT ERSON&TELEPHONE#e / demo,construct,aka, warm ecb---"+,,. e..c�G , L.<c� (1�;c—c, The plan was received by this office on ,-i- 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 re Permit will not be issued until all Town Agencies have had the ncy 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 s7.ould be ressed the individual Agency. Your ignature o 1 /acknowledges your receipt t is noticeof a copy of q/9_S-- . c�,rrra z moNE l DATE BuILDING pERmIT FIELD INSPECTION Dartmouth Building Department 4Ifmtr1.Fi Plat: 079 400 Slocum Road-P.O. Box 9399 Lot(s) : 006-8 North Dartmouth, MA 02747 Lot Size: 81,896 Telephone 508-999-0720 Zone Dist. : SRB Issued Date: 10/19/95 Permit No. : 299 Project Location: 18 Medeiros Lane Number Street Subdivision Name: Sylvan Springs Nearest Cross Street: off Collins Corner Road Applicant/Agent: Paul & Kimberly Alves Contact Person Phone #: (508 ) 991-4272 Proposed Use: Residential Residential, Commercial, Industrial,etc. Permit Issued To: New Construction Type of Improvement,Add,Alter,New Const.,Demo,Land/Move,etc. fireplace & chimney / 2 flues indicate no of bedrooms and bathrooms and other rooms Owner(s) of Record: Paul & Kimberly Alves Address: 786 Belleville Avenue, New Bedford, MA 02745 DATE TIME TYPE OF INSPECTION REMARKS I INITIAL ' e o.� 41'5" �/ � �s"-�- i/�v(J u ::.t.•C�- .�t!/LG'— �L.26scr =.ram-a`r- eri?:6 //41( �, uuuLJU Lei IJ �