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BP-92714
Mvmaeowner Ecempfion � 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 shalt be exempt from the provisions of this section; provides that if a Homeowner engages a prel;son(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 es 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 pefson who constructs more than one home in ;a two-year period shalt not be considered a Homeowner. If you are applying under this section sign below: Signature: Worker's Gompensation Insurance Affidavit must be completed and submitted with this application. Failure to provide this affidavit wri:Gl result in the denial of the issuance of the building permit. Signed Affidavit Aftached: CI Yes ❑ No Ci deck n Pool C] New G0.6struction* (Energy report required) Repairs Cl Accessory 13Iclg. (Shed/Garage) 3 DEMOLITION (specify): Ly Lacatior, of debris remove! (per MGL C.40 Sec 54): 0 Alteration CI Chimney/Fireplace CI Addition (Energy report required) 0 Dumpster on site Facility Name: Location: If new construction, please conmplate the following: ►ingle Pam1ly: No. of Bedrooms No. of Baths Roofing/Siding CI Woodstove/Pellet Stove 17 Dumpster On Street wo amilW No of Bedrooms Unit I No. of Baths Unit 1 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 (he-ztirig) - fuel gas (natural or propane), fuel oil, electricity, other (specify): ' HVAC (cc-nbined unit) - primary fuel, natural gas.. propane, electricity, other (specify) Air condit~oning - (separate unit) None of i ie above to be provided Q Replacement window/door No,, of windows Doors 1 f n • �W V . ' �I• �^ `�1 ��` i" �ii OPT �z ,Y; `!! �1� '� 1 t :i ! el i •� 9�i �. .�It[ ` ? ��1 j, 1pi ECI [04- 400 Slocum Road Dartmouth, MA 02747 Phone: 608-%910-41820 Fax: 508m910A838 'r ww,w,town•dartmouth.ma:us buomageawsom F ,, L •i Ml��� RWAIR. REMOVATE OR DEMOLISH A ONE OR TVVG FAMILar I ELLQNO .-% M4. 1 � r' J,-•♦•• • ' • � • � 13� l � i •F r` .'.C:[ 4• •- A •: C.. 1 J v t��. .+,.t� � 1 ,,{�^ ti•y1 - rf1 �'•'r�•`f'••'� •Ni••�,.r•1•r i•`•.. •►a �. • A cf��` �J .y %+.D1w eft•• J-•'-«.•�+_`R• �rl�l��'Zr•J1�•.'�SG.•tV7� • �.17� ,�'.Li�•�'.►•.rCS•+..wi•law +Sr�.MYI 4�l t•' . 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