BP-897 BUILDING ERmiT
4,
❑ Fifth Edition 0 Sixth Edition
Dartmouth Building Department Plat: 79
400 Slocum Road-P.O. Box 939 ) :48-29
Dartmouth, MA 02747
Telephone 508 999- U Zoning i ti
June 18, 1997 (typed) Permit No. :
;f
Issued Date: // / �/7 Clerk: BAS
Project Location: 26 Sundance Road
Number Street
Subdivision Name:
Nearest Cross Street:
Applicant/Agent: Joseph Carrier
Address: 26 Sundance Road, Dartmouth, MA 02747
Contact Person Phone #: (508) 998-1932
Type of License: Owner: (x) Const. Superv . License #: ( )
Architect: ( ) Engineer: ( ) Other: ( )
Proposed Use: Residential
Residential,Commercial,Industrial,etc.
Permit Issued To: To Install
Type of Improvement,Add,Alter,New Const.,Demo,Land/Move,etc.
21 ' x 52tlabove ground swimming pool
indicate no.of bedrooms and bathrooms and other rooms
Gross Area of Const. : Cost of Const. $1,270.00
Cost-Other Const. : TOTAL FEE: $ 25.00
Owner(s) of Record: Joseph Carrier
Address: 26 Sundance Road, 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 agent and to
receive this permit, I further understand other agencies may have reason to STOP
WORK if items under their jurisdi.t on are not me , not withstanding the issuance
of this Building\Zoning Permit. r
Signature of Owner/Agent:
Address:
********************* *** ** ** **********************************
Signature:
Approved/Issued By: oel S. Reed, T'tle: Local Building Inspector
COMMENTS: PLEASE P ST PERMIT CARD SO THAT IT IS VISIBLE FROM
THE STREET. SCHEDULE APPROPRIATE INSPECTIONS AS
REQUIRED. UPON COMPLETION OF WORK, FINAL INSPECTION
IS REQUIRED.
1,4
0 ORIGINAL 0 APPLICANT 0 ASSESSORS 0 CLERK
----
TOWN OF DARTMOUTHecti n
NO TAX BUILDING RECEIPTS
ISSUE COLLECTOR'S OFFICE
Name: Property � Date: , t ,_
Owner: 1 6 , - t 11 . �, ,` ,7
Job Location:
White Copy-Collector's Office
Plot: �' .-- Lot: - ..., r�
Yellow Copy-Customer's Receipt
' , Pink Copy-File Copy
Green Copy-Building Department
Phone: . TOWN OF DARTMOUTH
. , .
' t
CO CT1R:S i1FFI1 E m>. z t%;r
Description General Ledger#'s Ref.# JI�fV Amount
i s 1997
License&Permits-Building 01000-44105
License&Permits-Building Misc. 01000-44105 07 , ,
License&Permits-Electrical 01000-44106
License&Permits-Plumbing&Gas 01000-44107
Other Department Revenue 01000-42420
This is not a Permit or License for Building,Plumbing or Gas. Received By: , ,----
•
TOWN OF DARTMMIOUTH BEING DEPARTMENT
TELEPHONE 508-999-0720 FAX;S08-999-0738
APPLICATION FOR ZONING AND' INE1IT
Instructions
The applicant shall complete this application to the best of their ability prior to submission,leaving no item unanswered.The
Department staff will be available during regular business hours to assist as necessary.N/A should be inserted for those sections
which do not apply.A properly completed application will help avoid unnecessary delays. Nolo Mfg fees net ref ndiie-
(for office me UNDATION ONLY
Total Cost only) $ Received By Date Rec'd Q .
Less Application Fee$_ ?a„ �j
Total Permit Fee S® Permit i I '7 Issued Date 6 j /- ` /
100 LOCATION OF PROJECT TOTAL LAND AREA SQUARE FEET
CURRENT ACCESSORS' PLAT ' LOT 1,7 "7 ZONING DISTRICT 5/Q.--
OTHER ZONING OVERLAY DISTRICTS , if applicable
NUMBER & STREET � �0 CifLo
NEAREST CROSS STREET
SUBDIVISION NAME & LOT#
or BUSINESS NAME
PREVIOUS TENANT / OWNER ./✓- a C`
200 RESIDENTIAL-PROPOSED PROJECT - one & two family residence only
THIS SECTION NOT APPLICABLE
Single family - number bedrooms number baths
Two family - number bedrooms unit 1 number baths unit 1
number bedrooms unit 2 number baths unit 2
Accessory apartment Total gross sq. ft.
= Accessory structure:
Garage - detached - attached to dwelling, dimensions L W —
Carport- detached - attached to dwelling, dimensions L W
Shed - dimensions L W
Deck- dimensions L W
= Gazebo- dimensions L
/Swimming pool • •ov .and in-ground Size ' `° `f l2�. �7 V(
72. Chimney - number of flues
1
FLWI W ILI+IALWILIoni, new (provide manufacturers
instructions). Location(s) (list)
C Fireplace(s) - (includes flue) List location(s)
C Game Court-describe(include overall dimensions)
C Tent, Trailer(Mobile Home) or Other-describe
300 COMMERCIAL-PROPOSED PROJECT/USE-INCLUDING THREE FAMILY OR MORE AND EXEMPT USES
- THIS SECTION NOT APPLICABLE
(The following descriptions are based on the Massachusetts State Building Code Article 3,AS NOTED) (See the
Code)
Assembly - restaurant, lounge, theater, school, etc. (see Code Section 302.0) Describe
- Business - office, assembly with less than 50 occupants - indicate Medical or other professional (see Code
Section 303.0)
- Educational-structure for training including child day care for those over 2 years 9 months(see Code Section
304.0)
Factory/Industrial - (see Code Section 305.0)
- High Hazard - (see Code Section 306.0)
Institutional - hospital, nursing home, infant day care (see Code Section 307.0)
Mercantile - retail stores (see Code 308.0)
Residential - three or more family, hotel (see Code Section 309.0)
- Storage- includes garages(see Code Section 309.0)
- Utility & Miscellaneous Structures - includes tents and __gricultural structures (see Code Section 311.0)
- New tenant for any of the above, indicate above(see Code Section 119.0 and Zoning By-law section 35)
- Tent or Trailer - temporary purpose?
E. Other
Descrilx
also the proposaltio ��.INCLUDE r.umber of dwelling units and bedrooms or occupant load as applicable,existing
400 TYPE OF CONSTRUCTION OR WORK TO BE PERFORMED
G New Construction and/or Addition- total gross square feet
(For commercial only total gross cubic feet) -indicate
It will be considered new construction if there an increase in square footage in addition to any
alteration(s).
If project is an addition to existing structure-Total gross square feet of existing
E FOR COMMERCIAL, ONLY
Will this project be subject to CONSTRUCTION CONTROL(over 35,000 cu.ft.) Yes
see Code section 127.0). Designer to submit Code Synopsis. No. (If yes
Will this project require Peer review(over 400,000 cu.ft.) Yes No (see Code A
APPLICANTTO PROVIDE ppendix I)
Alteration of existing, no increase in gross square feet. A separate Refuse Disposal Declaration required.
= Demolition -describe structure
Number of dwelling units Number of bedrooms A separate Refuse Disposal
Declaration required.
i Moving - (Provide copy of D.P.W. moving license) 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
- Re-roofing - (for existing only, is included in new construction)
Number of square feet _ Number of layers already existing
Number of layers when complete
A separate disposal declaration REQUIRED
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 Alteration, otherwise will be included in new construction. (see Code section 3401.10 for
residential and Article 8 fc_ commercial) -
_ Temporary structure-includes when allowed, trailers,tents and the like and only for limited periods of time.
Describe I will be using the
500 CONSTRUCTION PLANS ❑5 t h Edition
06th Edition
_ None submitted. Whv?
_of the State Building Code___
= Submitted, usually three sets required. Four sets for food service\uses. Number of sets submitted
600 SITE PLAN
❑ Not required, why?
Submitted When? = Previously, date ❑ With this application
700 UTILITIES
Water supply - required_ yes no, public ? _yes _ no, on site well? yes_ no,
existing? yes _no
If required and not existing have necessary permits been issued? _no_yes, date
(M.G.L. Chapter 40, section 54 provides that no building permit may be issued unless a water supply, when
required, is available. See Code 780 CMR section 114.1.2)
Sewage disposal - required_yes _ no, public sewer yes_ no
private septic - on-site _ yes _no. Submit copy of permit as soon as available.
Y...,z rUri,
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)
l_ HVAC (combined unit) - Primary fuel, natural gas, propane, electricity, other (specify)
— Air conditioning - (separate unit)
None of the above to be provided
- Hot Water Gas
Electric Fuel Oil
Other
900 SPRINKLERS _ FOR STRUCTURES OVER 7500 SQUARE FEET and certain multifamily residential
- Required, plans provided, -plans not provided, why?
- Not required, not to be installed, Why?
_
1000 REQUIRED OFF-STREET PARKING- for ZONING & Architectural Access
- NOT APPLICABLE
- Parking Plan submitted To - Building Department - Planning Board Date submitted
Number of spaces - indoors ----'
outside total provided
Hgndicar spaces - required_ _ ye_ no. If yes, how many as a part of the total re
Is Route 6 (State Road gained number. _
Entrance permit required? yes - no -. If yes has it been issued yes = no -.
Submit copy of application and/or permit as soon as available.
1100 IDENTIFICATION(print or type except as noted)
Current owner- name ®_ "
k fr ,l'e r''.
address
phone# g— 7
If corporation. officer in charge
Architect/Engineer- for overall design -
Company name
Address
Phone number
Certified by State of Massachusetts as
Certification number
NOTE Signatures and seals on all laps, affidavits and other documents S
reproductions. HALL BE originals and not
4
Architect/Engineer-project supervision and reports
Company name___A✓ C
Address
Phone number
Certified by State of Massachusetts as
Certification number
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
General Contractor(if Homeowner, state homeowner here then complete section 1300)
Company name
Address
Phone number
Construction Supervisors license number
NOTE Signatures and seals on all plans, affidavits and other documents SHALL BE originals and not
reproductions.
1200 FOR RESIDENTIAL REMODEL WORK ONLY
Are you a Home Improvement Contractor subject to(780CMR-6) ? Yes No If no go to next section!
Are you claiming exemption from the requirement? Yes_No I f yes, submit the required affidavit!
Re&xdel contractor name (please print)
Address
Registration number(i(none state"none")
Phone number
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE
GUARANTEE FUND! QUESTIONS OR COMPLAINTS call or write:
Home Improvement Contractors Registration
One Ashburton Place - Room 1301
Boston, MA 02108
(617) 727-8598
Owners name (print)
Signature
Date
1300 OWNER SIGN- OFF
I. the undersigned,am the owner of record or authorized lessee(provide documentation)and I have reviewed
the application herein submitted. I state that fo the best of my knowledge and belief that the information provided in this
application is true and correct and that the permit requested be issued.
Further I understand that the permit will expire in six months, from the date of issue, if no work is begun or
six months after the last inspection if work has begun and that the permit may be extended for six months if no work is
anticipated if I request such an extension in writing. I understand that the permit may be extended only
written request.I understand that once the permit expires a new application may be required,including fees ands times
current
oth r requirements (including Zoning).
Name I L ��1/4 Ca �` ,\e
Signature `
he above s :no 're is my voluntary`act and is signed under the pains and penalties of e
Date & Qi�i f p (Jury.
Who is authorized to pickup the permit at the Building Department? (please orinti
Address Phone
1400 HOMEOWNER EXEMPTION - ONE &TWO FAMILY ONLY
FOR HOME OWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT
109.1.1 Licensing of Construction Supervisors:Except for those structures governed by Construction Control
in Section 127.0, effective July 1, 1982, no individual shall be engaged in directly supervising
construction, reconstruction, alteration, repair, removal or demolition involvingthe str�"ctu petsoents f engaged in
buildings or
structures. unless the or she is licensed in accordarce with the rules and regulation; promulgated by the BBRS entitled
R:.les and Regulations for Licensing Construction Supervisors.
Exception:Any Home Owner performing work for which a Building Permit is required shall be exempt from
the provisions of this section; provides that if a Home Owner engages a person(s) for hire to do such work ,that such
Home Owner shall act as supervisor.
For the purposes of this section only,a "Home Owner" 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 dwellin , attached
or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in
two-year period shall not be considered a Home Owner.
If you are applying under this section sign below:
Signature
Your signature carries certain responsibilities, including but not necessarily limited to, general liability
NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any
licensed Construction Supervisor, whether or not they have taken the permit are responsible for code compliance. (see
2.15.2 of section 51
1500 COST
Cost of Improvement
S
Items to be installed but not included in the above cost: Electrical S
Plumbing
HVAC
Other
TOTAL S 1.
The following section for official use only.
INSPECTORS' REVIEW .
Date plan reviewed /
30 days to review period expires
OK to issue date
OK to issue subject to requested submittals (see project review worksheet) date
DENIED see project review worksheet date
HOLD reason date
HOLD Subject to Zoning Board of Appeals action
Comments
Inspectors signature Date
Applicant informed of above- Date time staff (fax, phone, in person)
Over six months since approved for issue- DEEMED abandoned!
Advise applicant. Hold 90 days for return then dispose if not picked up.
Inspector Date
Advised applicant Date Time staff (by phone, fax or in person)
OFFICE\INSPECTORS NOTES
TOTAL FEE -
Gross area - new construction Total Sq. Ft.
alteration Total Sq. Ft.
Permit is issued to
Comments/notes on permit P6--2
1600 TO THE APPLICANT/REFERRAL AND APPROVAL
Date of Application submission j /1 7
Plat "7 7 Lot Street Z Ca 5`l`;ry.,?,, XfE Aquifer Zone
Owner LI C -- J 11. (��� ri €"--
Owner mail address C 4' .-.
Owner phone# / / 1
:sssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss::ssss*sssssssss:ssssssssssssss
OTHER INVOLVED AGENCIES-The following agencies require separate jurisdictional permits or approval for your
proposed project. CONTACT THEM FOR REQUIRED SUBMIS IONS.
ea TAX COLLECTOR := Approved HOLD By Date
❑ Board of Appeals 7, Approved By Date
yConservation Commission C Approved By Date
❑ D.P.W. Water 11 Approved By ❑ D.P.W. Sewer = Approved By Date
❑ D.P.W. Cross Connection Approved By Date
❑ Treasurer(Bond) ❑Approved By Date
❑ D.P.W. Engineering Li Approved By Date
7 Board of Health (well) Approved By Date
❑ Board of Health (septic),zr pro Date
Board of Hea (Yood service) = Approved By Date
❑ Planning Board (parking) = Approved By Date
® FIRE DISTRICT (I - II - III) Approved By Date
BUILDING DEPARTMENT APPROVAL:
❑ ZONING
❑ BUILDING INSPECTORBUILDING COMMISSIONER
❑ CONTROL CONSTRUCTION AFFIDAVIT
PROJECT SUMMARY:
new constructions alteration/demo sewage disposal - public/private
[Alter/add interior walls] [add rooms] [add footprint] water supply - public/private well
[pool] [garage/shed/deck] [game court] [food service]
Describe
ssssssssss:ssssssssssssss*ssss:ssssssssssss
To the various departments:
This notice has been forwarded to you for your information and any appropriate action. Should you have any
questions please advise. If any reason to withhold the requested permit is found, please advise. Your assistance and
cooperation is appreciated.
The Building Department- Date sent for review -/, 7 By
8
IOW ill 1LIEAPPLICANT/REFERRAL AND APPROVAL
Date of Application submission » /��G�7 ,
L-
Plat'i 27
Lot' Street 2Z(friC I(in c-:2.; /�ee
-,-- Aquifer Zone
Owner ,� �h
Owner mail address e'' _
Owner phone# e7. /?3
OTHER INVOLVED AGENCIES-The following agencies require separate jurisdictional permits or approval for your
proposed project. CONTACT THEM FOR REQUIRED SUBMISSIONS.
® TAX COLLECTOR = Approved 72. HOLD By
Date
❑ Board of Appeals Approved By
Date
Conservation Commission l Approved ByGAVVI
la`v'`�„ Date '.ta
❑ D.P.W. Water Approved By c D.P.W. Sewer = Approved By Date
❑ D.P.W. Cross Connection = Approved By
Date
❑ Treasurer(Bond) ❑Approved By
Date
❑ D.P.W. Engineering ._i Approved By
Date
i Board of Health (:yell) ^ Approved By
Date
❑ Board of Health (septic) . Approved By
C- ti - Date
Board of Health (food r ce) Z. Approved By
Date
❑ Planning Board (parking) = Approved By
Date
® FIRE DISTRICT (I - II - III) Z Approved By
Date
BUILDING DEPARTMENT APPROVAL:
❑ ZONING
❑ BUILDING INSPECTORBUILDING COMMISSIONER
❑ CONTROL CONSTRUCTION AFFIDAVIT
PROJECT SUMMARY:
new construction/ alteration/demo sewage disposal - public/private
[Alter/add interior walls] [add rooms] [add footprint] water supply - publiciprivate well
[pool] [garage/shed/deck] [game court] [food service]
Describe
**
To the various departments:
This notice has been forwarded to you for your information and any appropriate action. Should you have any
questions please advise. If any reason to withhold the requested permit is found, please advise. Your assistance and
cooperation is appreciated.
The Building Department- Date sent for review 4�/Z/�� -
•. ,
NUMBER FEE
TOWN OF DARTMOUTH
33 Board of Health $50.00
SWIMMING POOL PERMIT
Type of Pool: Aboveground Pool
Location: 26 Sun Dance Road
Owner: Joseph T. Carrier
Contractor: Namco Pools
Date: June 13.,..1997
This pool must be constructed as described in the applicati for the swimming pool construction
permit.
71/ • • •4.C12L-- 1047444%.„.
pector cit....,
t' 4-
Si ature of Applicant lrn el44A..1.4--U.AI'VI Dartmouth Board of Health
, ,
0-9
Mr.Joel S. Reed
Local Building Inspector
Dartmouth Building Department
400 Slocum Road — P.O. Box 9399
Dartmouth, MA 02747
November 18, 1997
Dear Mr. Reed:
On June 19,1997, I was issued a permit by your department to install an above ground
swimming pool. (PERMIT #897; PLAT :79 LOT: 48-29) The pool was installed the beginning
of July, and the electrical inspector approved everything on his end. The reason I didn't proceed
to call you was due to the fact that we had a leak coming from somewhere. It made no sense to
have you come by until we solved the problem.
I had several expert opinions all lead to the same conclusion—we must have termites
eating at the liner from underneath. So we proceeded to follow this path (i.e. drain the $400 of
water just spent, and remove the liner to have the pest control people get at it.) The pool
company said this was entirely my problem since it was due to insects.Well,guess what? After
removing the liner, we find out that there is not a bug in sight!!!The only conclusion at this
point is a faulty liner. So after a small battle for a half an hour, the pool company agreed to order a
new liner.
In the meantime, the pool is totally vulnerable. No water or liner to hold it up.We had
great weather all weekend with the exception of a freak wind storm that decides to hit on the
Saturday night. Guess what?The entire pool wall was collapsed and the metal tore in several
places. The pool is useless. Now we need to get a new one. Insurance will help pay some of the
costs,but we can't afford to do this now until the Spring.
So I am hereby officially requesting an extension on this permit. I plan to have this
done sometime in late April. The pool company will not be the same. This time we're going to
use Aaron Pools to install it. The pool size and where it's going will be exactly the same as on the
plan. I hope none of this is a problem?If so, could you call me at 998-1932 to let me know what I
have to do?Thanks.
tl
Warmest regards, iLEt
77,'N F r Cr:rkTH
Joe Carrier LigiJ EJ
26 Sun Dance Road G y Of This Endorsed
No. Dartmouth, MA 02747 ` z•T1 Must Be Kept On .
508-998-1932 Du NOV tTUCt n
ct -
Mr.Joel S. Reed
Local Building Inspector P ctor .. -
Dartmouth Building Department
400 Slocum Road — P.O. Box 9399
Dartmouth, MA 02747
April 27, 1998
Dear Mr. Reed:
On June 19,1997, I was issued a permit by your department to install an above ground
swimming pool. (PERMIT #897; PLAT :79 LOT: 48-29). (We already requested an extension
back in November of 1997.)
The permit is due to expire on May 19, 1998.
Due to unforeseen circumstances, the installation crew will not be able to perform
their duties in a timely manner. They will be able to complete the job sometime in late May
or early June,which will put us past the expiration date.
I hereby request one more extension of the permit.
py
I hope this is not a problem. Thanks for your patience and understanding.
FILE E�
Sincerely,
(s)
COS L A 7b
.Joe Carrier A Copy Of This Endorsed
26 Sun Dance Road i-z n Must Be Kept On Site
No. Dartmouth, MA 02747 rinikututjfin,
508-998-1932 Z e
V .
BUILDING PERMIT
FIELD INSPECTION
Dartmouth Building Department Plat: 79
400 Slocum Road P.O. Box 9399 - - --. Lot(s) :48-29
Dartmouth, MA 02747 tit 1 : '�" 1. Lot Size: 135,344
Telephone (508) 999-0720 Zone Dist. :SRB
Issued Date: 06/19 /97 Permit No: 897
Project Location: 26 Sundance Road
Number Street
Subdivision Name:
Nearest Cross Street:
Applicant/Agent: Joseph Carrier
Contact Person Phone #: (508) 998-1932
Proposed Use: Residential
Residential, Commercial,Industrial,etc.
Permit Issued To: To Install
Type of Improvement,Add,Alter,New Const.,Demo,Land/Move,etc.
21 ' x 52" above ground swimming pool
Indicate no of bedrooms and bathrooms and other rooms
Owner(s) of Record: Joseph Carrier _
Address: 26 Sundance Road, Dartmouth, MA 02747
DATE _ TIME TYPE OF INSPECTION REMARKS INITIAL
7 J 1/ -e :
-7- <9'q- `2Z--41(4 /1/4?-,1---x.'1.,;:i __ ZZ7y,fj.a
/; 7,/ ?
7 /q 91
_ ,/,,9-1j-n_ /261--e', &!->-, ":2 --
,_ '�
si t
BUILDING PERMIT
❑ Fifth Edition ❑ Sixth Edition
Dartmouth Building Department Plat: 79
400 Slocum Road-P.O. Box 9399 Lot(s) :48-29
Dartmouth, MA 02747 Lot Size: 135, 344
Telephone 508-999-0720 Zoning Dist. : SRB
June 18, 1997 (typed) Permit No. :
Issued Date: (.// / 2'7 Clerk: BAS
Project Location: 26 Sundance Road
Number Street
Subdivision Name: _
Nearest Cross Street:
Applicant/Agent: Joseph Carrier
Address: 26 Sundance Road, Dartmouth, MA 02747
Contact Person Phone #: (508) 998-1932
Type of License: Owner: (x) Const. Superv. License #: ( )
Architect: ( ) Engineer: ( ) Other: ( )
Proposed Use: Residential
Residea4'ist,-Commer4,ial,Induetriad,-ete:
Permit Issued To: To Install
Type of Improvement,Add,Alter,New Const.,Demo,Land/Move,etc.
21 ' x 52 '1 above ground swimming pool
indicate no.of bedrooms and bathrooms and other rooms
Gross Area of Const. : Cost of Const. $1,270.00
Cost-Other Const. : TOTAL FEE: $ 25 . 00 _
Owner(s) of Record: Joseph Carrier _
Address: 26 Sundance Road, 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 agent and to
receive this permit, I further understand other agencies may have reason to STOP
WORK if items under their jurisdi ,t on are not me , not withstanding the issuance ,
of this Building\Zoning Permit.
Signature of Owner/Agent: _ (L
Address:
********************* *** ** ** **********************************
Signature:
Approved/Issued By: oel S. Reed, T'tle: Local Building Inspector
COMMENTS: PLEASE P ST PERMIT CARD SO THAT IT IS VISIBLE FROM
THE STREET. SCHEDULE APPROPRIATE INSPECTIONS AS
REQUIRED. UPON COMPLETION OF WORK, FINAL INSPECTION
IS REQUIRED.
0 ORIGINAL 0 APPLICANT 0 ASSESSORS 0 CLERK 0 COPY
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