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BP-82128 Permit No. BP-82128 BUILDING PERMIT GIS#: 4175.00 Commonwealth of Massachusetts May: 0479 TOYYNOFDARTMCV11OUTH Lot 0006 400 Slocum*Road,Da4`mouth,MA•02747 Sub-Lots 0012` Phone (508)9 0 1820 • Fag`(308)910-1838 Category: ALTERATION Project# JS-2017=000242 PERMISSION IS HEREBY GRANTED TO: Est-Cost: S14800 00 Contractor: License Phone it: Fee: S7S.00: , IAN E SOUZA Cs=103410 (774)451-4440 Cong.Class HI 1834 0 use Group:- R3 Lot Size Engineer Lusr . PI#tine# {sq.ft.) _ 48287:: SR> Applicant Phone#. Mid er-Zone N/A IAN E SOUZA Flood Zone. ZONE X (774)45l=4440 New Cont.:: N/A. OAR: KOOP DAVID It Alt.Coasts N/A Date Typed: 08-01-2016 DATE ISSUED: q�" f TO PERFORM THE FOLLOWING WORK: Finish off basement for layroom, office, and bathroom OC tion: 5 `f i EIROS LN Approved/Issued By: A MURPHY,Di. .' • ,R OF t PECTIONAL SERVICES All work shall comply with 780 CMR 8r"Ed.(MGL Chap.143)and any othe pplicabl ' .ss.Laws or Codes and plans on file. Schedule appropriate inspections as required. Upon completion of work,final inspection is required. 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 agent and to receive this permit, I further understand other agencies may have reason to STOP WORK if items under their jurisdiction are not met; not withstanding the issuance of this Building/Zoning Permit. 1 Signature of Owner/Agent: (D.:‘,.....71 "Persons contracting with unregistered contractors-d not have access to the guaranty fund(as set forth in MGL c.142A)" Inspector of Inspector of D.P.W.Inspector Building Inspector Inspector of Gas Fire Department Plumbing Wiring Water Service#: Footings: Underground: Oil: Underground: Service: Foundation: Rough: Smoke: Rough: Rough: Sewer Service#: Rough Frame: Insulation: Final: Final: Final: Cross Connection Final: Final: Board of Health E-911 Additional Comments: Planning Board Prior to issuance of Certificate of Occupancy/Completion,this card must be returned to the Building Department with all necessary inspections signed off. Department phone numbers are listed on the white"Required Inspections"document provided with the issuance of the building permit. POST CARD SO IT IS VISIBLE FROM THE STREET 0 TOWN OF DARTMOUTH BUILDING DEPARTMENT RECEIPT 82128 PHONE: 508-91.0-1820 FAX: 508-910-1838 i � l/t j �s'l 1. L Date: 24 e lam' Name: { Property Owner: Job Location: 5 ./ ' -e4t+ t,,_c4A-..R,.._- Map: 79' Lot: Description General.Ledger#'s Ref. # Amount Building & Building Misc. 01000-44105 70 . ' - Electrical 01000-44106 �� "at. ,,s S M Plumbing & Gas 01000-44107 p 1 , , Trench Safety 01000-44129 Other Department'Revenue 01000-42420 �„^rovurq v4 � t , i 1 White-Collector's Office Yellow Copy-Customer's Receipt Pink Copy-Building Department Received By .. 4 I,t i.,✓ L<-E- ' THIS IS NOT A PERMIT/LICENSE FOR BUILDING, ELECTRICAL, PLUMBING OR GAS `n TOWN OF DARTMOUTH - BUILDING DEPARTMENT RECEIPT 82230 PHONE.• 508.910-1 R20 FAX: 508-910-1838 r Name: )(-) Property Owner: C1ti e Dat f_40 Job Location: 5 tie 4 E,(3) 1 (`C,, . __.. Map: 17 li Lot: 6- ()— Description General Ledger#'s Ref. # Amount Building & Building Misc. - 01000-44105 C -- ; 4 Electrical 01000-44106 of OPHT 10 . A Plumbing & Gas 01000-44107 Trench Safety 01000-44129 iUG Other Department Revenue 01000-42420 , B White-Collector's Office Yellow Copy-Customer's Receipt Pink Copy-Building Department Received By " L'�`-` Y •{,gyp" THIS IS NOT A PERMITILICENSE FOR BUILDING, ELECTRICAL,`PLUMBING OR GAS RESIDENTIAL ❑ Phased Approval(R106.3.3) $25.00 APPLICATION FEE IS NON RE-FUNDABLE& NON:TRHA.NSFEMAULE ' DATE,RECpiVEi 1 f¢ ,uT H.'�;,: DARTMOUTH BUILDING DEPARTMENT * , la n 400 Slocum Road, P,O. Box 79399 01J,' ilo ^ ,� � ;' Dartmouth, MA 02747 .-• .. -sy': Phone: 508-910-1820 Fax: 508-910-1838 www.town.dartmouth.ma.us APPLICATION TO CONSTRUCT, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY RECEIVED BY: BUILDING PERMIT NUMBER: FM, DATE ISSUED: -/A SIGNATURE: DATE: Building Commissioner/Inspector of Buildings Zoning District: Proposed Use: Zone: 0 X © B 0 A 0 V Aquifer Zone: THE FOLLOWING AGENCIES SHOULD BE NOTIFIED: ❑Board of 0 Board of 0 Cons. 0 Demo 0 DPW 0 Elec. 0 Energy Report Appeals Health Commission Affidavit Card Sent: Cut Off Follow-up* ❑Fire 0 Gas 0 Planning 0 Sewer Card 0 Water Card 0 Zoning 0 Other Chief Cut Off Board Cut Off Cut Off *REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF A PERMIT. / DEPARTMENTAL APPROVAL /• ', -','1 ray.. V, oard of Health: Signature: :9 Date: ` �i ,--- Conservation Commission: Signature: Date: Other: Signature: Date: Signature: Date: Signature: Date: Brief description of work being performed: Cp sT crtcc a f APP-Oxl r ly CO` - 3,F o F 'F.'‘•J‘Skket tSPeSel-i rr A� A ito FASTr-52 DLL:,eltti , SECTION 1 -SITE INFORMATION t 1.1 Property Address: 5 ti r 0 E`L CEO S C.,AA-s Q 1.2 Assessors Map&Lot Number: Lot Area(sf.) Li Si 2 83 Frontage i5Cli Map .q c Lot - 1 Required Provided Front Yard ( 1.3 Historical District 0 Yes tto Side Yard i Rear Yard Year Built j ❑Altering more than 25%per side of building I 1.4 Water Supply(MGL c40 s54): 1.5 Sewage Dispsal System: Has application been submitted to the Historic Commission?! 0 Municipal el Private Well 0 Municipal l On Site Disposal System 0 Yes 0 No Date: I I ✓ i Revised 10111 ❑ CONSTRUCTION PLANS 0 SITE PLAN 0 ENERGY REPORT RESIDENTIAL .Y SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT l� i it nk 2.1 Owner Record: lJ �t=NN�FER T DAv fl �cxa� 5 HEDEiROS JVJ SU1-(373-38(02. Name(print) Contact Address Phone Number 2.2 Authorized Agent: ��-�St_yy�t) s ram e, Sc�v 2A EN t Name(print) Contact Addrss Phone Number SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor/Specialty License: License Number: CS-1034i 8 Company Name/Contractor Name: €, &o2A Address: 81/44 Loci t �HLc 12.0,4F DP TI-jc'Jrt 02.141 Expiration Date: • Signature: Q9cLw 'i �� Telephone: 119-"-\SH444Q 091 0S/ 200 3.2 Homeowner Exemption-One&Two Family Only Section 110.R5.1.3.1 Exception: FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT 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: SECTION 4-WORKER'S COMPENSATION INSURANCE AFFIDAVIT(MGL c 152§25) Worker's Compensation Insurance Affidavit must be completed and submitted with this application. Failure toprovide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: 13"Yes 0 No SECTION 5-DESCRIPTION OF PROPOSED WORK(Check all applicable) ❑ Deck 0 Pool 0 Repairs IS Alteration 0 Chimney/Fireplace 0 Woodstove/Pellet Stove ❑ New Construction* 0 Accessory Bldg. ❑ Roofing/Siding ❑Other (Energy report required) (Shed/Garage) (Specify below) ❑Addition 0 Replacement window/door 0 Demolition (Energy report required) No. of windows Doors (Specify 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): ❑Boiler(heating)-fuel gas(natural or propane),fuel oil,electricity,other(specify): 0 HVAC(combined unit)-primary fuel,natural gas,propane,electricity,other(specify): 0 Air conditioning-(separate unit) • 0 None of the above to be provided 0 Hot Water: Gas Electric Fuel Oil Other SECTION 6-ESTIMATED CONSTRUCTION COST Item Estimated Cost($)to be completed by permit applicant 1. Building $B 2. Electrical '3,cXa 3. Plumbing %3,000 4. Mechanical(HVAC) A 500 • 5. Total=(1 +2+3+4) - $)y 600 SECTION 7A-OWNER AUTHORIZATION • (to be completed when owners agent or contractor applies for building permit) (Please Print) i, ,as Owner of the subject property hereby authorize 3 RU c . ScXv"zA to act on my behalf,in all matters relative to work authorized by this building permit application. -712 ' lc Si na re of caner Da SECTION 7B-OWNER/AUTHORIZED AGENT DECLARATION I, `Zsu , ,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 the pains and penalties of perjury. 0Jru�, & 7/24 ZOt(a Signature of Owner/Authorized Sdgent Date SECTION 8-OFFICE/INSPECTOR'S NOTES Less Application Fee: $25.00 Remaining=Balance: $ Total Permit Fee:$ E Other$Amount$ • Gross Area-New Construction total sq.ft. Gross Area-Alteration total sq.ft. Permit Issued to: SECTION 9-ADDITIONAL COMMENTS/SKETCHES betti 9 Massachusetts - Department of Pubkr Safety Board of Budding Regutauons and Standards titput outt 4*tittitti t 4 44401 License, C$-103418 AI .„ IAN E SOUZA 84 tAscv UttIeKdwoo North Dottntooth34A I ,If Expo-atoll. Corer 04/05/2017 Unrestricted Butkitngs of any usc group%stitch contain kss than 35,000 cubic fix((99 I in)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is CAM)for revocation of this iirente t*S ticvnung informatiort-tout- wviv,f01,ivf,Gov/0PS 08-04-'16 09:12 FROM-Ed of Health/ConCom 508-910-1893 T-899 P0001/0001 F-576 LirnaSea Approval(R106.3.3) ` ` ° �, S25.00 APPLICATION Ft E IS NONAE•FONDABLLr &NO i . `;iN ; s ' ���) `,,,41. i DARTMOUTH BUILDING ` i�; ,. DATE�El��v . , % r DEPARTMENT Oil J. � r)i '400 Slocum Road, P.O. Box 79399 /��/I °' Dartmouth, MA 02747 �.o'er�, �,6 , : :.1 • `` ` Phone: 508-910.1820 Fax: 508-910-1838 ��� � 46.f } www.town.dartmouth.ma.us APPLICATION TO CONSTRUCT, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION FOR OFFICIAL USE ONLY ECEIVED BY: � BUILDING PERMIT NUMBER: DATE ISSUED: -____ yNATURE: DATE: Building Commissioner/Inspector of Buildings ling District: Proposed Use: Zone; 0 X D 8 0 A 0 V Aquifer Zone: F.FOLLOWING AGENCIES SHOULD BE NOTIFIED: , 0 Board of O Board of O Cone 0 Demo 0 DPW 4 Affidavit 0 0 Energy Follow Report Appeals Health Commission A Card 3enC � Cut Off �- ,Fllow.up' O Fire 0 Gas 0 Planning O Sewer Card O Water Card ti Cut Off O Zdrn Chief Cut Off Board Cul Off f���#i ,4 ., Q Alhet o.y 'REQUIRES INSPECTOR'S REVIEW BEFORE THE ISSUANCE OF APE ' • ' r `' ------_ - DEPARTMENTAL APPROVAL .. d of Health: s � Signature: DD Z. 8 v f3/ ),6 nervation Comm ission: Signature: Date: °r: Signature: Date: Signature: Date: • Signature: • Date: description of work being �gnformed: p rU 5 - �?S1et�C'rIOr C3 Aa�' .XI G 1 �✓ T 3,9 1 ik } is':AA eu-r • c O F. - SECTION 1 •SITE INFORMATION roperty Address: M E`1' AN 0 1.2 Assessors Map&Lot Number. .ot Area(sf.) q S) 284 Frontage 1.50' Map '3 q Lot - I?"- ENOIRd Provided _ it Yard Yard 1.3 Historical District CI Yes t vo r Yard Year Built 0 Altering more than 25%per side of building ster Supp�ly,�(MGL c40 s54): 1.5 Sewage Dispsal System: Has application been submitted to the Historic Commission? 0 licipal F3Private Well CI Municipal ti3On Site Disposal System CI Yes Ci No Date; 3 r % r.c 1$--_ '.. " . 3 3`afg..,9- Revised 10/11 CONSTRUCTION PLAN ■ SITE PLAN ENERGY REPORT C t uE o N y r it -Q — s,n N --1 if) O' 0 Q 0 EL 1 Extstb9 P nug 1 j w.f.., uAndom - ti w i i a,.' 1 S .9 Q "°c'rr 66.lOT W LC g QJ /� fi mz o ft S w3 m , W m mpm w a 1 ; 3Q m '�� Q n n IT X / ' mm ms Q �i ZI al O OFWI,j d iV S ®-I Iis g S I (.1 it HIsiiii 1 I i Z z ! f �� , .9.. n� Q Q 6 i U- oO L � .5 _- �z o E ,, -.8 e w c 2 C> 4 c u I ECI Q s c � v c J id- E 0 y u m O O® 2 ° 4_ a u OI Pa- 2� a-m ri a N ^0 pT E .. k 15( reW _I= , g W J J i W mQrQ Za z W J-, v _� u O N Y r T U 7, N 1^ U VJ O L II_-1 0 .III-.Z •i ..5-,b .0, �7 or Stinting Existing I I ` W 91111SIX3 3�- ' � r Z ti m elk 5-43 vy .9 W q a l a aA O ro tp I y Q 0 � Q Q 6,i au ,z ? U iJ°�° � 'iL 2' LL'ill 3 _B Q pp In W wm R S. y3 m �Y \ E'3 � � mQ W �i 4 1 m H m x 0 W W i y I�I II rl a m iq \� it, 1� 11 1 w w3 io �` Rio I 1 I o 8 wa .� e 82 ww a o 4. E 3 o ti -. E 1 1 i 3 Q OI `cL —1 = m� (j K it 0 u 'dQ •0 12 I-- u° > z 0s 0 ,r1)° 2 r 2Cj W `E- � 111 pS = Q W "- S Cn v !L E 00 y @ O L v0i O v 0 @ ••G N �: O�GQ Vs' r 1J_m 1 is - N o 3 ' i' O q , y y �' k ,'4 2f� a W -��^ = E..W n °��J.- W mQ pJ i-Q Z Z W a ��� Gnrin �rir�t'ri�/�rr',' Office of Consumer Affairs&Business Regulation:(, License License or registration valid for individul use onl ti HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:only j4 Registration: 183430 Type: Office of Consumer Affairs and Business Regulation Expiration. 10/13/2017 Exp 10/13/2017 Individual 10 Park Plaza-Suite 5I70 IAN E.SOUZA Boston,MA 02116 IAN SCOzA 84 LUCY LITTLE RD DARTMOUTH,MA 02747e :Undersecretary SOU ? Not valid without signatuiv Permit Not BP-82128 Project Location: S MEDEIROS LN Connonwe : � ;° sachusetts ikolzeikm 01, TO. M fi UTH --two p kirmkftwtkitimookimpomi :.i, ,,s,4 i3- a4 :f--4' ' , '1'4' ''' N ,� ,� rekar< d 116 Ott irimatpaital I >u -----T—D4,71.7 0 j,':._Aliktrit ' ''14tt tvryriuo4toturektrtqatat,,,i„,,,1 teoarink,-,r4 T...,,,,,,,....,,,,,....-, iiirlakttAgritia 17 ..! �, ef . r 1,*A4-it- , .v.y: , 4 i , ,- - LI.,. v ii s'4' I .: , 1 :-.74,,,...,,',1'i;-;:it Arp, i .:•:,,f i r-l_k, id ki - ; �r� Contra a�� / - � �� d � E _ one#: „ , 1 IAN E , i. �� '�14)451-4440 d ; • �. 'Phone#: a itibikatzpl- Applicant. ....,,,, ,,,,,,, Y Phone#: 3'd 4 ; IAN E SOUZA 4 (774)451-4440Ittlat , ,n OWNER: : ).71 L_--:' KOOP DAVID& CO `� eq 6 7L,..,,,,` 6 DATE ISSUED: �� OLIN�b P e TO PERFORM THE FOLLOWING WORK:: Finish off basement for media/playroom, office, and bathroom DATE TIME TYPEOFIN ECTION�&r MARK 11VI i YE1I 6., �k, 7 C �? 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", i'.M1: ,4 •~ '+, i•1.1 IV '^,.,.�',''II t '�i }i•'��awc'-_=N .x•.�'n�:t;�'''''�7 C-4 U C-' O O . :-""�E4: Y^=a4@�:..�" y�2ms' 1TJ�.-;.:• Permit No. BP-82128 BUILDING PERMIT GIs#: 4175.00 Commonwealth of'Massachusetts Map; 0074 TOWN OF DARTMOUTH" Lot: 0006 400 Slocum Road,Dartmouth MA""02747 Sub-Lot: 0012 ' Phone:($08)910-1820 •._Fax:(508)410«1838 Category: ALTERATION Project# JS-2017-000242 PERMISSION ISHERERYGRANTED TO: Est.Cost: $14800.00 . " Contractor: License Phone#.• Fee:"' $75.00 IAN E SOUZA CS-103418 (774)451-4440 Const.Class:: HI 183430' Use Group: R3 Engineer License Phone#: Lot Size(sq.ft.) 48287 Zoning: SRB Applicant: Phone#: Aquifer Zone: N/A:.' IAN E SOUZA (77 45]-4440 Flood Zone: ZONE"X' "4) New Coast.: N/A Ow1vEx: Alt.Const: N/A KOOP DAVID& Date Typed: 08-01 2016 DATE ISSUED: ' 14 "; TO PERFORM THE FOLLOWING WORK: Finish off basement for layroom, office, and bathroom � ." oc'don: 5 . i EIROS LN Approved/Issued By: i f, 'A s MURPHY,D I• :ff R OF 1 ,PECTIONAL SERVICES All work shall comply with 780 CMR 8TH Ed.(MGL Chap.143)and any othe pplicabl ss.Laws or Codes and plans on file. Schedule appropriate inspections as required. Upon completion of work,final inspection is required. 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 agent and to receive this permit, I further understand other agencies may have reason to STOP WORK if items under their jurisdiction are not met; not withstanding the issuance of this Building/Zoning Permit. Signature of Owner/Agent: "Persons contracting with unregistered contractor -d not have access to the uaran fund as set forth in MGL c.142A)" Inspector of Inspector of D.P.W.Inspector Building Inspector Inspector of Gas Fire Department Plumbing Wiring Water Service#: Footings: Underground: Oil: Underground: Service: Foundation: Rough: Smoke: Rough Roughs:{ �.,'(;)'` Sewer Service#: Rough Frame: .. +7 T �- s/ f° < / Insulation: ` '`^ Final: Final: F•ina: / [,�L'� `- rt @ i li! �J 1 Cross Connection Final: Final: / . _)7 0 b:Z,. v.r;k3vt Board of Health E-911 Additional Comments: Planning Board Prior to issuance of Certificate of Occupancy/Completion,this card must be returned to the Building Department with all necessary inspections signed off. Department phone numbers are listed on the white"Required Inspections"document provided with the issuance of the building permit. POST CARD SO IT IS VISIBLE FROM THE STREET IAN EVERETT SOUZA ,q+ Lucy Little Road No. Dartmouth, MA 027--7, TE-L:(77+) -t51- EMAIL: isouza770kotmail.com FfROF05EZ) BASEMENT FLOOfR PLAN SCALE: I/4"=I'-0" Froject: Fropa5ed �inisheci basement 5 McJcrl'o5 Lane, Dartmouth MA Freparcli For: JenniferDavid � Koap 5mCjcr1'o5 Lane Daftmoutk5 MA Scale: A CJ' 511OWN Issue Date: 7/23/2016 Revisions No. Date I Description PROPOSED WALL LEGEND %llrrr�rrrrrrr/ PROPOSED 2 "x&" LUMBER WALLS e I ro 11 O.C.1 PROPOSED 2 "x4" LUMBER WALLS WITH R-13 F15ERGLASS BATT INSULATION EXISTING 2 "X4" LUMBER WALLS TO REMAIN I 5keetT*I t1c: rroposcJ basement Floor Layout Flan Ai•1