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BP-73524 Permit No. BP-73524 BUILDING � ' cIs# ���7 tEo -: Commc ega1th of-Massachusetts Map J OWN OFDARTI OUTH Lot _0004 400 SlocumRLoad Dartmouth,MA ll2747 ib-Lots 0001E ' i'hone.;{�Og)A101$2�-,,,. I`ag'{508)91Q-1838 - E. Category:. _ ' i1HDITION' PEoject# JS 2015-000131' PERMISSIONIS E17EI RI b INTER TO: 0 Cost -$34000 00 Contractor = rcense Phone#. Fee $3S000 - JOHN CABRAL C$1 27 08)971-0149 Crinst~,Class Engineer n bi Phone# yLlere Group B3 • LotSlze(sq � M 6205$0 Applicant ,, A e#� gR -:6RB Ph_:n CABRAL BROTHERS CONSTRU N q t1fer Zone: ZONE �� ( 138)971=0t49 atii one 4O1�E / - OWNER: "J" New Const. 168 sq.ft. . EVANGELHO.S'i'LVFN F3: Mt.Cour NIA, DATER ATE ISSUED: a Date Typed:. 07.'16-2014 TO PERFORM THE FOLLOWING WORK: Construct a 12'x 14'kitchen/dining room addition PER PLAN P 'ect Loc lion: 18 PINE ISLAND RD Approved/Issued By: .Q41 ' DAVID B UNET ,LOC BUILDING INSPECTOR All work shall comply with 780 CMR 8TH Ed.(MGL Chap.143)and any other applicable Mass.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. c Signature of Owner/Agent: (---,� "Persons contracting with unregistered contractors do not have access to the guaranty fund(as set forth ina MGL c.142A)" Inspector of Inspector of D.P.W.Inspector Building Inspector Inspector of Gas Fire Department Plumbing Wiring Water 5eivice#: Footings: Underground: Oil: Underground: Service: Foundation: Rough: Rough: Sewer Service#: Rough Frame: Rough: Smoke: Insulation: Final: Final: Final: Cross Connection Final: Final: Board of Health E-911 Additional Comments: Planning Board letion,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 1 PHONE: 508.91Q-1820 1 9 TAX 'SS' i A'"a,, " , - °' ` Property Owner: :i i, Date: / ` �/`' .a P' Name: r , P Y Job Location: tit rt , #^. N L , C IC 1.,. t Lot: Description General Ledger#'s Ref. # Amount Building& Building Misc. 01000-44105 — — f- j "-- Electrical 01000-44106/,�) 1.1j0 7 i Plumbing & Gas 01000-44107 Trench Safety 01000-44129 ' . 8 Other Department Revenue 01000-42420 'F�i' ,___i_g) er;,,\.0 White-Collector's Office Yellow CopyCustomer's Receipt Pink BuildingDepartment ReceivedB r ,f ' ' P Copy Py V ;£, e# " THIS IS NOT A PERMITILICENSE FOR BUILDING, ELECTRICAL, PLUMBING OR GAS sT ��4 TOWN OF DARTMOUTH - BUILDING DEPARTMENT RECEIPT 3 2 910.1820- FAX: /508-910.1838 0 _ �., AV Name: (- I 1`/s r <% A�sjC v.d fop'erty Owner: ' ?( 4/.- 4'" Date: y f r Map: Lot:Job Location: �� /"'� `� ) �_ f Description General Ledger#', \)4 Re # Amount Building& Building Misc. 01000-44105k° /Y." / " A-. e 2) .fir Electrical 01000-44 .`i c� Q Plumbing & Gas 01000-44107 Trench Safety 01000-44129 # R�bi Other Department Revenue -.01000-42420 y f White-Collector's Office Yellow Copy Customer's Receipt Pink Copy-Building Department Received By/ �` / , i THIS IS NOT A PERMITILICENSE FOR BUILDING, ELECTRICAL, PLU ING OR GAS RESIDENTIAL ❑ Phased Approval(R106.3.3) $25.00 APPLICATION FEE IS NON RE-FUNDABLE-& NOr-IF ERABLE ' �TE RECEIVED ( \oUTHDARTMOUTH BUILDING DEPARTMENTT. =fit 400 Slocum Road ` _-' t -$ 10: 00 Dartmouth, MA 02747 ;'�o �'�-_- yam' S�, Phone: 508-910-1820 Fax: 508-910-1838 www.town.dartmouth.ma.us APPLICATI N TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING THIS SECTION,! OR OI?FICIAL=USE ONLY 'k l' 7.. ..5 RECEIVED BY: G� . BUILIKING PERMIT NUMBER, ' 3 .ii, ,....-, , , DATE ISSUED: JULSIGNATURE: ,C --� rP ..C�?rr DATE: U 1 2014 : 'Buildir6 Commissionerlinspector of Bu ldings h, t, k' _ u 4 .- . Zoning District: Proposed Use: Zone: ❑X El B CI V Aquifer r� Zone: � THE FOLLOWING A NCIES SHOULD E NOTIFIED: DPW �` a Board of 0 oard of o s# . El Planning-r'. ©Address n '- -G Engineering El Crops Appeals Health` Commission Card Connection rt. Fire .EI Gas ❑Electric El Other 'EI Water Card ,, _ -❑Sewer_Card. Chief - Cut Off Cut off Cut O— Cut Off DEPARTMENTAL APPROVAL(S) Board of Health: ignature: V /� Date: n ''� - / 7 Conservation Com is r '�/ ignature: _ Date: D.P.W.: Signature: Date: Fire Chief: Signature: Date: Other: Signature: Date: , , Brief description of work being performed: / /7--y U t) - SECTION 1 -SITE INFORMATION ` it Property Address: /�. -/- .v& 1.—�� ZifiiCa I d 1.2 Assessors Map&Lot Number: Xnt ct Person:`> j/ �'- ,i/a , Map Lot tPh7one Number: S 1.3 Historical District ❑Yes El No /Water Supply(MGL c40 s54): Sewage Disposal System: Year Built ❑ Municipal El 0 Altering more than 25% per side of building "Private Well ID On Site Disposal System Has application been submitted to the Historic Commission? 0 Yes 0 No Date: • ,L-r ( / e &L!JJ) Revised 5/13 Ir ' TRUCTION PLANS 0 SITE PLAN © ENERGY REPORT //?& '-Gd..G1s/— Jf-c.57;&01 t,21 _ , i RESIDENTIAL SEETION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT _ y1 Owner Record: 'T Ui) r EAg)6gi / P// rsZ-4�D Rd ?4,95 - ' Name(print) Contact Address Phone Number 2.2 horized Age Name (print) Contact Address , A5 7 / GIPho Number ;' , SECTION 3-CONS?RUCTION.SERVICES `" s z : "I 3.1 Licensed Construction Supervisor/Specialty License: License Number: es - /o S-Z 2 7 Y^ nat Company Name/Contractor Name: rj � , S- S'i, ��GI-�Ui ( ,/9 i Z_ ,/ 1% Address: 86 ,7 � _ ____5-.. � '7, ,iz ,f Expiration Date- " Signature:(.. ,., Telephone Z 6 c *7 /p/l/i / Z/ Z6/. ---- 3.2 Hpfn wner 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*OOMPENSA "ION INSURANCE AFFIDAVIT(MGL= 152§241"' Worker's Compensation Insurance Affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: ❑Yes ❑ No "SECTION 5-DESCRIPTION OF PROPOSED WORK(Chaa all applicable) O Deck 0 Pool 0 Repairs 0 Alteration 0 Chimney/Fireplace 0 Woodstove/Pellet Stove v ❑ New Construction* 0 Accessory Bldg. I!7Ad/dition 0 Roofing/Siding 0 Replacement window/door - (Energy report required) (Shed/Garage) (Energy report required) No.of windows Doors ❑ DEMOLITION (specify): 74 . (4,5 feL_/GS-7- Z) G: 6i 5)5 n, A-cr- Location of debris removal (per MGL C.40 Sec 54): bumpster on site 0 Dumpster On Street , / _ ,�^ Facility Name: r Location: A/6z, 'J't—G et_ J) *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): ❑ HVAC(combined unit)-primary fuel,natural gas,propane,electricity,other(specify): ❑Air conditioning-(separate unit) ❑None of the above to be provided 0 Hot Water: Gas Electric Fuel Oil Other ®:SECTION 6-E :TIMATED CONTRUCTION COST Item Estimated Cost($)to be completed by permit applicant 1. Building 2. Electrical 3. Plumbing 4. Mechanical (HVAC) 5. Total= (1 +2+ 3+4) i'/ ?? �� , SECTION 7A-OWNER AUTHORIZATION {to be domple€,ed whe i ownet`'S;,agent*r cor tii ctor applies fot building permit'. (Please Print) _ ✓ I, STEval F` rV/nll76LNO , as Owner of the subject property hereby authorized/k( 4— to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Ow er Da te ate SECTION 76-,OWNER/AUTHORIZEI AGEN LECL i ATIQN. , as Owner/Authorized Agent hereby declare that the statements and information oryfihe foregoing application are true and accurate,to the best of my knowledge and belief. Signed er the pains and penalties of perjury. __407/2 Signa a Owner/Authorized Agent Dat SEC N 8 •OFF1GEflNSPS 1OR*S OTES j Less Application Fee: $25.00 Remaining Balance: $ Total Permit Fee:$ 6 Other$Amount$ Gross Area-New Construction total sq.ft. / Gross Area-Alteration total sq.ft. - /� �, 2 j Permit Issued to: ! lS A '-- !, .� �j`".7/ • I ,[�/2 'R. .1N SECTION 9 ESCRIPTIONI F WO1 BEINL PEI MEf ; /. Z cj c� ,j />ni -7-7 4, ,_' 5 i otrj 5/941 — /) /0/(1. ,3/7,41,1, ' NereAkr (2c S /%s r,AePArns ,4) /A,)/ a. /6/KReiSc, �Ijw/ly fi A Cal) �s�u' Permit No. BP-73524 Project Location: 18 PINE ISLAND RD Commonwe sachusetts 4041.1414,,,,as:::0,,,t i �. * G ,. , ,, ,,x k4„:1,,,..„,..,,pc, -,:::-..:4*- a, ; .. :...,. .- .,..,-;,...,3:4,:-:-..,,..4,--;---;..,-,!:---.:) , % fik % ill a*'F `fi .•. G = - ' -` :. L � `; y , ., :rR .o-..-- Gam` Contra o e: ''one#: ,_ . , JOHN sle— >94-5583 mz .Enginee ::::::: ' v ' ; hone#: ,a z "- xsti - 8.' S 7�'4�2i "� . x �`p.{` � gut^u Applicant: , Phone 1 z , x` � I a t (508)971-0149 4 -: � ��' OWNER: . 4 ` �`�.- , �, .., 4 EVANGELHO ST DATE ISSUED: TO PERFORM THE FOLLOWING WORK: p5 Construct a 12'x 14' kitchen/dining room addition PER PLAN DATE TIME a TYPE OF INSPECTION&REMARKS INITIAL-���1 D i/7-/�P 2 C�u� e-�. 07-16-' 14 15:52 FROM-Ed of Health/ConCom 508-910-1893 T-308 P0001/0001 F-987 scalUGIVIIMI CI Phased Approval(R106. 3)'`- • • $25.00 APPLICATION FEE IS NON RE•FUNAABLIr&New. t."j LRe> iti� ` ' tiles�4!}1 i!c, i ATE RECEIVED _ t \ DARTMOUTH BUILDING DEPARTMENT - �, ' ��•� '•�T, fi''? !,�. i 400 Slocum Rood ZAI� ���� _9 �, k.� . , Dartmouth,MA 02747• �', �o' 00 ' �'� Phone' 508-910-1820 Fax; 508-910.1838 • www.tawn.derlmouth.ma,us APPLICATI•N TO CONSTRUCT,REPAIR,RENOVATE OR DEMOLISH A ONE OR'NVO FAMILY DWELLING �Y..yr`; /i ,l:. y' rt�SF t.G,S't .a -!'^1; •a•. .'elf - .4 _ iTT- - ! rr r, .'i -,-ii�Cv;.>.[ /�1• : r,��y`,t r f t+ 'Y: c a r u`12 ti'`21 •' . ^`�t', `•' t *.t �;rl<"��''�:S.> . 1,�' .i�Y' N:1'�-J f' a�'�Y,.Tr`" .{.p,'{�' '�;� ji." - _::i' .,.n,-. _ �•�i #.>�'<, a �. �.� -rY,;s)k ��.�. ,r;_):ry >r;�L� '� �;::w•3', ;,�;,-�,.�r�,c,<<`,s+..�,>��'�-�c3,s<,fkr:=�-�'f`+`,ti.-�.�, �. �.,�,:1_. - ".; ,Lai �:�<c-4><.i��s ��' r �. ...3�iti 6. 4. �K•J' ,Y s���,;ss r't� c=;<• '�.<.�.;2�>F_?.,. :.. �•�� w.- r. t,-��,f�; h r • v D �'`r' 4 E �{�l,k �f}�w �I l.1f i tt v,r. r:;:4 : p ,ati' r:r.a.rr F,;� Y1x r' --T '� Wd - �S �?- ,..=sT,4;A,-it r. 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Signature: Date: grief description of work being performed: <g XI t /r 427 Z76 ..: .l, , :'t .,,,;t,:•;. ,, ..,.'L,4�r...,$,:o.a,.,,i.:-'L Y•.;:,C,b4tti �:�4 ,7}-,11�F�''i; ,,,,-.1r l r 1 V y,C .�µv.,y:C 4,. /� �'T:{$:a‘i; Y'!'•y "..Y _ .. ., .rrn�t _ _..,,���..I_�I.1��!.I,r,�It��:^,E'`,:`5r`; ���f ; �i'�i.,.��l-: r f h.G S.,� A�i �:�i4�S'i'/ 't , v Property Address:/,_f PeA1 ''L-4Q 4n, .. 1.2 Assessors Map&Lot Number: r t nt ct Person �-at/ y, `� . ,�. Map 3 Lot • O one Number: �' "` .._--, ' ' 1.3 Historical District 0 Yes O No - Year Built Water Supply(MGL o40 s54): Sewage Disposal System: • CI Municipal 0 Municipal -. 0 Altering more than 25%per side of building l Private Well 14n Site Disposal System Has application been submitted to the Historic Commission? Q Yes d No Date; ir ram! .r 6 rPrC CO g w > Revised 5►13 Z6t7-1 1000/T00@d 80P-1 8E8T-0t6-80S 1daG '8pjg glnom3.taQ-WOd3 8E:ST f7t,-9t-L0 05-09-'14 10:20 FRON-Ed of Health/ConCom 508-910-1893 T-269 P0001/0001 F-844 RESID!VII Phased Approval(R906.3 3)•r.: $23.00 APPLICATION FEE IS NON BE•FUNDABLE'&N;lc BAB _ '+ EI r 'our,; .. :�j1t l 'a'�1;! Cl o r>I+fit RECEIVED i:o l��rrrt�4\ DARTMOUTH BUILDING DEPARTMENT °' I:PT, '•' ' =!'== ,• 6, 400 Slocum Road ?DI" my _9 i �'''=� y! Dartmouth,.MA 02747 �' 00 °D • • • fi6fi4 .'' Phone: 50&910-1820 Fax:. 508-910-1838 "� www.town.dartmouth.ma.us • _ APPLICATI•N TO CONSTRUCT,REPAIR,RENOVATE OR DEMOLISH A ONE OR���,_�..,.�; :•x3.�.�,rs; .'.,,:r�: Y, TWO FAMILY DWELLING � • 1'+(f}, i:v,, a;f'i3:ist }gw-,ys/ ry - �1t?: 1p' 'F. f .J• ')-�>( � t'.. - _"" ,.FI E �R''� d!r �tiA'.��t�''1,�, "`:ri�n eTrl�.?`r ,�1%}•..,. �r•�"•�-� t. .�r,$ - ,. A. 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Date: - •�f description of work being performed; / /�y f o T7G ltf psi c1r - f 'r Property Address: A./et 't'-/u, ��� 1.2 Assessors Map&Lot Number: .font ct Person: i /' = �i/t-A-/e gAIQ� Map Lot - - - oneNumber: Sr� ; S • 1,3 Historical District 0 Yes 0 No Vater Supply(MGL c40 s54): s ; Sewage Disposal System: Year Built - (I Municipal 0 Municipal 0 Altering more than 25%per side of building Private Well 6 On Site Disposal System Has application been submitted to the Historic Commission? . 0 Yes 0 No Date: IT ,�d1 r(a 7'_ I - rrrrr,. Revised 5/13 i ItMassachusetts -Department of Public Safety Board of Building '-g ations and Standards Construction 7 per i )r License: C ,10522 JOHN CABRAL 86 MCCABE ST DARTMOUTH MA 03 Fxpiratio� Commissioner 0610 21201 5 t1 l 1 ��re O)'emorrteeerli of C-MaJJr(eluJellJ °` Office of Consumer Affairs&Business Regulation = OME IMPROVEMENT CONTRACTOR registration: 176705 Type: xpiration: 9/17/2015 Partnership CABRAL BROTHERS CONSTRUCTION JOHN CABRAL 86 MCCABE ST DARTMOUTH, MA 02748 4 Undersecretary i4 • • • • a STEVE F. EVANGELHO /� LANDSCAPE DESIGN AND CONSTRU TION PROPOSAL 18 PINE ISLAND RD. ' NORTH DARTMOUTH, MA 02747- 21 ,E www.evangelholandscaping.co Page No. of Pages Ph. (508) 995-504 fl00 NAME/NO. w, LOCATION f- .__ „d - \--‘ - 2 ---- HONE DATE We her by submit specifications and estimates for:, -1\'‘' ' 1 .C:1 — ci ' ' 41,4," /CI, . ' 9 (� �1 , JJ 1 16 L J..__ irni ......._ 3/0 ,.... _ ____ �____ __ 1 pk) 4, LPL i > n %1 or '► \ -Hritaa, tr P k , ''* 11111116.. : ( Z ft i /Q P:1,11.,&-. /-4"e ',.'" ' WE PROPOSE hereby to furnish material and labor-complete in accordance with these specifications, for the sum of: dollars($ ). Payable as follows: All material is guaranteed to be as specified.All work to be completed in a workmanlike Authorized manner according to standard practices.Any alterations or deviation from above specifica- Signature Lions involving extra cost will be executed only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents NOTE: This proposal may be withdrawn or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance. by us if not accepted within days. Our workers are fully covered by Workmen's Compensation Insurance. ACCEPTANCE OF PROPOSAL— The prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date Signature Date_ Mir I ` 7,3 ,AGO .7 s ad 7z Li IMPERVIOUS CALCULATIONS 3�aEpT Owners Name: Street ot:h• sfir ' .�� t Y . L.6 �e f=E- / ddres �� / ?-try ( O 17 Lot Size: sq.ft. "d DIMENSIONS AREA IN SQ. FT. EXISTING IMPERVIOUS Structure House * (include all roofed area) 2 jrc ` /3 jX/$` JG `XZ3` /3 79 Cj '-T GG Z i Garage 7 / ')C Z, ' s-a8 Barn Sri) . Cl /G !� Shed 1 (Under 120 sq. ft. is exempt) Shed 2 Pool with Apron (In-ground) Patio Cement Slabs Gazebo Greenhouse SO X /L' ' 9 _ . GO) 5 Other Other Driveways: Paved/Cement ZG / X66 /66e Sp ' , G0 Ze Gravel Z h 'X& ' Square Feetj76a % 66 Walkways: Gravel f6 'al 700 Z 57, Sr.er ° Gd 7� Paved/Cement Dry Laid Brick/Stone Total Existing Impervious Square Feet: PROPOSED IMPERVIOUS House Addition /2 y/SL ' /6 8 .. 6G<j z Shed Barn Pool (In-ground) Pool Apron (In-ground) Other Total Proposed Impervious Square Feet: IMPERVIOUS REDUCTION IF ANY Removing Removing 2 Total Removal Proposed Square Feet: Total Projected Impervious Square Feet: Percentage is calculated by dividing structure sizes(impervious areas) by the lot area. *If irregular shape show details on back. / B 7 / Sc t U D/qr/ 000 o o 0 0 0 0 o V o o 000 0 �O bNN kr) - 7-1 5 2 N N r ". 7' M N ",-.2,,N "• y a - N M O� ,�. *: .y�000 N x M el p G a a 7 ti- 0.' O O s w *` gam, m m _ �O v q 11°. :.�000 O •�_ .b N d �,` O OOO V =do.� �r C A sd A ~ OH co O 0-: ® q UOO ;. 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Oye.0'.0 C 2.O CD C a (D 0 oo N p'y �bA NsaN(0' YC 0BOO4 \ �,p,p ec O7y on O a A, an ZF-i t0o oo..,oo A oo A o "� zw nFo rO + oa OO + + � ca 0 �fiaZ. co 1, O0 K7 R .:c n F+ F+ra �-+oCD y - A_ O VNi OW,oNOA ' Z7 rn ri '�,.. w' R'¢ka:, O O GC ON F.G G N ,O,O Ui0 JI b .- O k? n b F+W,o 4 '':. W oo A F+ F+ to r+,p O O �w'. O O, 01 Os b . N A A y O kti- O U U A O O '� F+ - m is;. .. NN Ot"'t a <S k N '�- cr �+ OvpNA +i. irk^ �,. `3 ,.- lt W OWON-� s' ; (A O00,0, F+ xrs F+ ^y, CW Crow w `+ Io N "'" cmoo 3T0N I: co :10 z n A o 4 13 0 o _ F+ O -x (.0t,` O . xiy o a C - A ti N ?ry O F+ Jr / Ne - si0e�� Checklist 2014 JUL 16 Ali 9: 17 Wind Speed (3-second gust) 110 mph Wind Exposure Category B Number of Stories (Figure 2) ( storied _<2 stories Roof Pitch (Figure 19) tO,IZ <12:12 '1—� Mean Roof Height (Figure 2) 7�ft. <_33' Building Width,W (Figure 4) 14 ft. <_80' Building Length, L (Figure 4) / ft. <_80' F. Building Aspect Ratio (L W) (Figure 4) // ' (�<3.0:1 General compliance with framing connections? (Table 2) Type of Foundation (Figure 5) L. Nei . Foundation Anchorage Proprietary Connectors Uplift. (Table 3) U=Z1 fplf Lateral n. (Table 3) L= If Shear e;J`( ' , i. '. (Table 3) S ZpIf 5/8"Anchor Bolts , -Bolt Spacing (Table 4) '71 in. Bolt Embedment (Figure 5) 2___.in. Washer Size (Figure 5) $in.x3in. x 'n,thick /, Floor framing member spans checked? (IRC or WFCM) le- SPA- ZX4., Maximum Floor Opening Dimension (Figure 6) u/J'ft. <12' Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall (Figure 7) _ft. _<d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall (Figure 8) AJ4'ft. <d Floor Bracing at Endwalls (Figure 9)...... .tat1...Z.6 • Qom• Floor Sheathing Type (/RC or WFCM) ,C Floor Sheathing Thickness (IRC or WF9M) ,/ 1' in. Floor Sheathing Fastening (Table 2), l .( ... ( ...[.2.... r.' Wall Height Loadbearing Walls (Figure 10) gift. <_ 10' Non-Loadbearing Walls (Figure 10) r b 'ft. <_20' Wall Stud Spacing: (Figure 10) /6 in.<24" o.c. Wall Story Offsets (Figures 7-8) ik 0-in. <d Wood Studs /_' I Loadbearing Walls (Table 5) 2x - 46 ft. 6'in. Non-Loadbearing Walls (Table 5) 2x - esS'ft. G in. _ Bracing Gable End Walls WSP Attic Floor Length (Figure 11) IZ ft. >_W/3 Gypsum Ceiling Length (Figure 11) i 2 4 ft. >_0.9W Double Top Plate // Splice Length (Figure 13) 4r Splice Connection(no. of 16d common nails) (Table 6) _ Loadbearing Wall Connections Z Uplift. (proprietary connectors) (Table 7) U=1 ZJ lb. Lateral (no. of 16d common nails) (Table 7) 2— Non-Loadbearing Wall Connections Uplift. (proprietary connectors) (Table 8) U/61 lb. Lateral (no. of 16d common nails) (Table 8) 2-- Wall Openings Header Spans (Table 9) 5 ft. i. n.<_ 11' Sill Plate Spans (Table 9) 31 ft.U in.<_ 12' Full Height Studs(no. of studs) (Table 9) `-- Connections at each end of header or sill ,� J� Uplift. (proprietary connectors) (Table 9) Alb. Lateral (proprietary connectors) (Table 9) / lb. Wall Sheathing Minimum Building Dimension, W > :' Sheathing Type (Table 10) ri 6 Edge Nail Spacing (Table.10) 4,6 in. Field Nail Spacing (Table 10) , ,, in. Shear Connection (no. of 16d common nails) (Table 10) //EL Hold Down Capacity (Table 10) Percent Full-Height Sheathing (Table 10) Ib Maximum Building Dimension, L Sheathing Type (Table 11) .. d'Y Edge Nail Spacing (Table 11) 6 l in. Field Nail Spacing (Table 11) 2"in. Shear Connection (no. of 16d common nails) (Table 11) Hold Down Capacity (Table 11) Zilb, Percent Full-Height Sheathing (Table 11) 5- % Wall Cladding Rated for Wind Speed? �cU2,SL�I (') �, ae'u ic2c� Roof framing member spans checked? (IRC or WFCM) /'- S�� c-XC Roof Overhang (Figure 19) / ft.<2' or U3 Truss, I-Joist, or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift. (Table 12) U=703Ib. Lateral (Table 12) L=47&lb. Shear (Table 12) S= %.7lb. Ridge Strap Connections-Tension (Table 13) , T 7 plf Gable Rafter Outlooker (Figure 20) 6'ft. ft.<2'or U2 Outlooker Connections at Non-Loadbearing Walls Proprietary Connectors Uplift. (Table 14) U= lb. Lateral (Table 14) L= lb. Roof Sheathing Type (IRC or WFCM) .004 Roof Sheathing Thickness ''in. 3/8"wsp Roof Sheathing Fastening (Table 2)2C k. 4. ,� �,?!,-o v The Commonwealth of Massachusetts It1=11VINIONIMIN evil Department of Industrial Accidents yes 4.d 1H_-- Office of Investigations = r= i�""" ' 1 Congress Street, Suite 100 �H�. .rYIN ®.... .aura. tit ' . l Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): le5✓�, ,� v rj f 'i l _____ Address: ge /1,4f [ j �r City/State/Zip: -; 1 IT . d- Phone #: S-22 0 ei 7 / G / V 5 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.pt I am a sole proprietor or partner- listed-in tile atta`c ed sheet. 7. El Remodeling ship and have no employees `- � e e dub=comer tors have 8. Demolition working for me in any capacity. l[lti_ Pl e ai'd have workers 9. El Building addition [No workers' comp. insurance comp. insurance. required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their 11.0 Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs - insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: f�15 - - 1 ��- ID Policy#or Self-ins.Lic. #: t� 3 —2 .e (, Expiration Date: &/S/zG% /. Job Site Address: /8 R,4_,�---7 5 t (2 d City/State/Zip: ,.71 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi nder the pains and penalties ofyer'ury that the information provided above is true and correct. Signature: _-- - ___tDate:�� ._71___._ ____.Z�O.�- Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every 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 of 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, §25C(6)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,MGL chapter 152, §25C(7)states"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 have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of • insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space 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. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 7-2010 Fax# 617-727-7749 www.mass.gov/dia a &j'-7 / ri/ V o RESIDENTIAL ❑ Phased Approval(R106..1.3) $25.00 APPLICATION FEE IS NON RE-FUNDABLE &N G F_ ERABLE r : pUTy- ` - _ TE RECEIVED ff'�-� �� DARTMOUTH BUILDING DEPARTMENT - _ (. C fp yi: _:,t it _ ,. 400 Slocum Road t ;> - P° _ t� ,1 = ni i! ryh ro VL _ C' Dartmouth,.MA 02747 - 5 r Phone: 50B-910-1820 Fax: 508-910-1838 .fh« www.town.dartmouth.ma.us t. APPLICATI N TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 11" is SECTION FOR OFFICIAL 1 SE ONE Y' ' -- ---- - - ' - ---7.9....V g RECEIVED BY: BUtWIN�G PERMIT NUMBER RATE ISSUED., .. ,/ SIGNATURE. DATE, v , iIdrhg CommiisionerlInspect f$u tngs t zp tX UB EIA C V Auifer Zone p Zone -0Pr- csed ie Zorirc Distric THE FOLLOWING A NCIES SHOIJLd E NC TIFIEO DPW ❑Boers#of 0 oard of cans: ❑Planning C ;fiddress Engineerir C}Cross A edls Health Crrmmissloti card " Connection CI Fire Gas. 0 Ele is ❑Other U Water Caret 0 fiver Card Chie€ Cut Off . Cut Off -Cut Off CutOff DEIFTMEiITALl�' ti� -sY Board of Health: Signature: Date: tlCc� �erM tF ro►, (a �ivti.�fen- 1.f — Keel 14--1 S k it ? ,'C as ormission: Signature: ( . (k - qua A i o we�-(o hem y D.P.W.: Signature: Date: Fire Chief: Signature: Date: Other: Signature: Date: /�/ Brief description of work being performed: 44 /V /77?L A Co/ 77 Property Address: /� '7.vG ' . 1 f L � 1.2 Assessors Map&Lot Number: �nt ct Person: j� j / ,i,iC- �, Map Lot - one Number: , &e �' .S, 5 4l C� . 1.3 Historical District 0 Yes 0 No i1.4 Water Supply(MGL c40 s54): Sewage Disposal System: Year Built ❑/'Municipal 0 Municipal 0 Altering more than 25%per side of building !�1 Private Well ❑ On Site Disposal System Has application been submitted to the Historic Commission? ❑Yes 0 No Date: rojil l�. 611 / & L ) Revised 5/13 COF�'STRUCTION PLANS 123 SITE PLAN 111 ENERGY REPORT PREVISIONS I DATE I 12'-0" EXISTING l 12'-0" ADDITION I N ADDITION WINDOW SIZES AND LOCATIONS TO BE VERIFIED BEFORE ORDERING LEFT SIDE ELEVATION FRONT ELEVATION ALL CONSTRUCTION SHALL STRICTLY COMPLY WITH THE 8TH ADDITION OF 780 CMR MASSACHUSETTS STATE BUILDING CODE FOR ONE AND TWO FAMILY DWELLINGS, AND ANY LOCAL, STATE OR FEDERAL REGULATIONS. z O 0 O wQ - 0 Oat Q z O Qz J � w _ O W z Z Q CL OO W t- 0 `SCALE 3/16" =1'4r rDRAWN BY MN [DATE 3-29-14 A-1 1 of 4 I REV;:SIONS I DATE 1 EXISTING FLOOR PLAN C c ADDITION WINDOW SIZES AND LOCATION TO BE VERIFIED BEFORE ORDERING ALL CONSTRUCTION SHALL STRICTLY COMPLY WITH THE 8TH ADDITION OF 780 CMR MASSACHUSETTS STATE BUILDING CODE FOR ONE AND TWO FAMILY DWELLINGS, AND ANY LOCAL, STATE OR FEDERAL REGULATIONS. 'z .o a O r 1. o�< �z o .w O (.9w� z Q0-ry > Oo < w r- 0 SCFaLE 3/16° = V-0' DRAB vvN BY MN DATA 3-29-14 A 2 2 of 4 CONT. RIDGE VENT 0 STORAGE TRUSSES r E co ilk R-38 INSULATION ri r t - � 4 } : M8TiNG WALL TO I i 4�E'REMOVED f 5 Y r 314" T & G SUBLOOR a �r 4 FLUSH W/ EXIST. � - �_ II - _ C 47 - 4 INSUL. 2 X VS AT 12" O.C. JOIST HANGERS 3" CONC. SLAB OPTIONAL, HEIGHT TO BE DETERMINED 6 MIL. POLY V.B. AND 8" CRUSHED STONE 12'-0" ADDITION ROOF PITCH TO BE VERIFIED 91 ADDITION SECTION TRUSSES TO BE DESIGNED SO THAT ADDITION FACIAS ARE AT SAME HEIGHTAS EXISTING HOUSE FACIAS CONT. SOFFIT VENT 2 X 6 STUDS AT 16" O.C. WITH 1 / 2" ZIP SHTG. AND ZIP TAPE, SIDING TO BE DETERMINED BY OWNER R-19 INSUL. SNG. P.T. 2 X 6 SILL WITH SILL SEALER ALL CONSTRUCTION SHALL STRICTLY COMPLY WITH THE 8TH ADDITION OF 780 CMR MASSACHUSETTS STATE BUILDING CODE FOR ONE AND TWO FAMILY DWELLINGS, AND ANY LOCAL, STATE OR FEDERAL REGULATIONS. REVISIONS DATE .j F- w z z 0 C) w U) z 01< C) t.!_ 0C� Z QQz F- _J _t -__{ co D w -" O o W 2i z Z E. < m ly, > 00 ui -v- 0 'SCALE 3/16' =1 *-0" IbRAWN BY MN rbATE 3 - 29 -14 A - 3 3 of 4 3/8,� I I I I o � ---1 2 Q 3h i I�J� . I i zzo STAGGERED NAIL ( I FRAMING MEMBE PATTERN I EDGE INTERMEDI II o° o° o° o° o° o° o° o° o° PANEL EDGE PANEL ' }----- O i -i CD w z Q " MIN. _ N N +- � r- " MIN. 0 PANEL NAILING PATTERN - TYPICAL NOT TO SCALE c T c cY ESS TING STONE ON 6 MIL. ONCRETE SLAB ITION WALL TO BE AINED, TOP OF 4ISH FLOOR TO BE IP OF EXISTING ;H FLOOR FOUNDATION PLAN 1) FOOTINGS TO BE MIN. 4`-0" BELOW GRADE 2) WALLS BELOW GRADE TO BE COATED 3) ANCHOR BOLTS AT 48" O.C. AND PER CODE AT CORNERS WITH 3" X 3" X 114" PLATE WASHERS ALL CONSTRUCTION SHALL STRICTLY COMPLY WITH THE 8TH ADDITION OF 780 CMR MASSACHUSETTS STATE BUILDING CODE FOR ONE AND TWO FAMILY DWELLINGS, AND ANY LOCAL, STATE OR FEDERAL REGULATIONS. REVISICONS DATE z z O z 0 LL Zi 0 O'l < F-I O a 0i + <A z O!Q3: CI) '�O W� W Z Z F--- CL � `Q f III 00 r 0 SCALE 3/16• -1'-0w DRAWN BYj MN DATE 3 - 29 -14 Ai - 4 4, of 4 ."j f 'to 1_0 M ter_ 1A 41' Ql/ 91 a. or 0. WIN. � I .�-" __,i.._ _- ....._.. .. ..� _._ _._�.._. _.__--..a•.-- _._ter _.,__. _-�.._�.�r.••.►-� ; _� .+- ., �}`��y .'Qt. oo� oo� if 4j l000 u C> 10 fill L.J Z: C-D uj V) 4Ln < do= No w ca cl w u C-D w 12'-0" EXISTING oil -11-0-1 12'-0" ADDITION LEFT SIDE ELEVATION ADDITION WINDOW ' SIZES AND LOCATIONS TO BE VERIFIED BEFORE ORDERING FRONT ELEVATION ALL CONSTRUCTION SHALL STRICTLY COMPLY WITH THE 8TH ADDITION OF 780 CMR MASSACHUSETTS STATE BUILDING CODE FOR ONE AND TWO FAMILY DWELLINGS, AND ANY LOCAL, STATE OR FEDERAL REGULATIONS. RF-VISIONS DATE U) z 0 F-- d W J W z oQ �- O n < a n � z w OQ I J�\% U / _I W-0 C9 W Z Z �-- 0 00 Q W r 0 SC?� IF 3/16'=1*-0* DR?ZWN BY MN DATTE 3 - 29 -14 A-1 1 1 of 4 EXISTING FLOOR PLAN W ADDITION WINDOW SIZES AND LOCATIONS - TO BE VERIFIED BEFORE ORDERING nvvll I IvI'I Ir_ILv%a" r-L-P%iy ALL CONSTRUCTION SHALL STRICTLY COMPLY WITH THE 8TH ADDITION OF 780 CMR MASSACHUSETTS STATE BUILDING CODE FOR ONE AND TWO FAMILY DWELLINGS, AND ANY LOCAL, STATE OR FEDERAL REGULATIONS. RP-IASIONS DATE v ) z 0 0 rz (0 Q ��-- p 1 Q cr. Q `Q Z (0 < i- 1W O 1'ro W �Z z-- < tL iW r- C) SCAVE 3i16• = r-V DRAi',&'N BY MN DATE_ 3 - 29 -14 A - 2 2 Of 4 R`_VAsIONS DATE Ilo {{ iio {Iw it iiw {I I{ {{ z z {{ i{ {{ a a {I w it iI w 1I > II 11 > LUL D UBLE EDG NIL SPACINGPANEL WHEN THIS EDGE RESTS ON FRAMING USE 8D NAILS AT 6" Q.C. w Z a¢. SEE BOTTOM PLATE DETAIL PANEL NAILING PATTERN - TYPICAL NOT TO SCALE 8d @ 6"-12" o.c. 2 ROWS 8d @ 4" o.c. IN EACH WOOD PANEL 2X6OR2X4 STUD WALL WOOD STRUCTURAL PANEL, UPPER 2 X 6 BLOCKING WOOD STRUCTURAL PANEL, LOWER WOOD PANEL SPLICE DETAIL w PROVIDE BLOCKING AT 4'-0" O.C. BETWEEN TRUSSES AND JOISTS FOR FIRST 2 BAYS TRUSSES AT 24" Q.C. WITH 5 / 8" ZIP SHTG. AND ZIP TAPE, ROOF SHINGLES TO—� BE DETERMINED EXISTING ROOF TO BE REMOVED, NEW TRUSS ROOF TO NE INSTALLED CONT. RIDGE VENT ROOF PITCH TO BE VERIFIED 0 Iv — STORAGE TRUSSES co R-38 INSULATION i (D F=- w EXISTING WALL TO V BE REMOVED 3 / 4 T & G SUBLOOR 2 FLUSH W1 EXIST. II 2 X 8'S AT 12" O.C. JOIST HANGERS 3" CONC. SLAB OPTIONAL, HEIGHT TO BE DETERMINED 6 MIL. POLY V.B. AND 8" CRUSHED STONE 12'-0" EXISTING I_ 12'-0" ADDITION ADDITION SECTION TRUSSES TO BE DESIGNED SO THAT ADDITION FACIAS ARE AT SAME HEIGHT AS EXISTING HOUSE FACIAS CONT. SOFFIT VENT 2 X 6 STUDS AT 16" O.C. WITH 1 / 2" ZIP SHTG. AND ZIP TAPE, SIDING TO BE DETERMINED BY OWNER R-19 INSUL, SNG. P.T. 2 X 6 SILL WITH SILL SEALER ALL CONSTRUCTION SHALL STRICTLY COMPLY WITH THE 8TH ADDITION OF 780 CMR MASSACHUSETTS STATE BUILDING CODE FOR ONE AND TWO FAMILY DWELLINGS, AND ANY LOCAL, STATE OR FEDERAL REGULATIONS. Q w 0 i- U W (n OQ 0 O Q F- Q z w O<z w O V w zZ�. MALE 3/16" m l -T DR:,1yVN BY MN DATrE 3_29_14 A-3 3of4 IF R"VISIONS DATE 5 I I a `„ 3- /8--I wQ , Iw� 3/ Wz O I i w J I VJ (� 0 Ql F- (?zo i i wz Q STAGGERED NAIL I I FRAMING MEMB d-?l- PATTERN I EDGE INTERMEDI �F MIN. = I i NN e° o° o° o° o° e° o° o° o° PANEL EDG PANEL 3"MIN. l 1 2" DBL. NAIL EDGE SPACING DETAIL PANEL NAILING PATTERN - TYPICAL PROVIDE MIN. 3'-0" WIDE ACCESS z NOT TO SCALE TO CRAWLSPACE FROM EXISTING BASEMENT, LOCATION TO BE DETERMINED WITH OWNER --! z 0 CD -- N ! n t[ 8 CRUSHED STONE ON 6 MIL. < POLY V.B., CONCRETE SLAB j E VENTS OR SASH OPTIONAL 1 LOCATIONS TO BE o VERIFIED WITH OWNER N TOP OF ADDITION WALL TO BE Q SITE DETERMINED, TOP OF ILL ADDITION FINISH FLOOR TO BE { 8" FLUSH W/ TOP OF EXISTING I HOUSE FINISH FLOOR :z a co LL o ocr.Q Q21 (119 "' ,Q z O Q �. 14'-0" MATCH EXISTING w � 0 O CD W FOUNDATION PLAN `z Z �-- 1) FOOTINGS TO BE MIN. 4'-0" BELOWGRADE ;Q 0. 2) WALLS BELOW GRADE TO BE COATED Q 3) ANCHOR BOLTS AT 48" O.C. AND PER CODE AT CORNERS w r- 0 WITH 3" X 3" X 1/4" PLATE WASHERS SCALLE 3116" =1'-T DF2Ai,AA,N BY MN DATF_ 3 - 29 -14 A -- 4 4 of 4