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Home My WebLink About2001 Sep 18 - Building Permit Application Sign Off, Plans � -.. i °., = ��pF'YAR�� TOWN OF YARMOUTH �, � � � �.. i� N „,..,�„, �T BUILDING DEPARTMENT ��...n..�'� BUILDING PERMIT APPLIGATION SIGN OFF ` .4 Applicant: Building Permit No.: Address: ��'��--� � / Tel. No.: ?�� Date Filed: 3�-C��X,� S�'� �,� Bldg. Site Location: Map No.: Lot No.: The following information oudines the procedural steps required to obtain a permit to build,alter,or add to a structure within the Town of Yarmouth. The Building Depaxtment will determine compliance to the following: (A) Zoning Requirements (B) Historical Districts (C) Flood Zones. 'The Building Department will be responsible for assisting the applicant through the following departments: RESIDENTIAL AND/OR COMMERCIAL BUILDING WATER DEPARTMENTc Determines Compliance of Water Availability. (applicant to obtain) ENGINEERING DEPARTMENT: Determines Compliance for Parlang and Drainage. CONSERVATION COMNIISSION: Determines Compliance to Wedands Acts;i.e.,If Lot(s)Border any Type . _ _ .. __ _ of Wetlands, Sfreams,Ponds,Rivers, Oceans,Bogs, Bays,Marshland,Etc. HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations;i.e.,Requirements� for Septage Disposal and other Public Health Activities. FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personai Safety,Property Protection;i.e.,Smoke Detectors,Sprinkler Systeins,Etc. ---------------------------------------- The follozving De�bartmenis must sign o,,�; in the res�iec�ive order,�brior to building ins1bectar issuing the required building�fierntit: R{'� D BY: C/� �. WATER DEPARTMENT: . ' DATE: rT,��'' UI N/A: 2. ENGINEERING DEPARTMENT: DAT'E: N/A: 3/CONSERVATION: DATE: N/A: Is� HEALTH DEPARTMENT: DATE: g /S �' N/A: INDUSTR AL AND/OR COMMERCIAL PERMITS 5. WIRING INSPECTOR: DATE: N/A: 6. PLUMBING INSPECTOR: DATE: N/A: 7. FIRE DEPARTMENT: DATE: N/A: PLEASE NOTE Adl stumps and/or brush must be disposed of at an a�»-oved site. ��+��.�+� - +*. w C�1�11�'�r'1\1 J: . .. , l�rti -� Sct ,��i5 Z't �c c �Oc�� C,q..�u�.� �►�ST �(oo� ✓'a�•—/�� t ap.� �C(dulL— m/,4y/Z,Gvw.— C`c�s�c�i 1Jaur� u,ap��y 'd— C�`'1-��Q c+�lf`� �� c r�'� 8/99 Applicant Signature Date i :��- � ' '` .o�''Yq�,� ONE & TWO FAMILY ONLY - BUILDING PERMIT �'�' ; � APPLICATION TO CONSTRUCT,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING p ` —y Town af�armouth Building Department � MA�TTACXE�,S �" ll46 Route 28 • Yarmouth, MA 026644492 . � ..�.,�o� �' . . , Tel. 508 398-223I x261 • F�. 508 398-2365 ( ) ( ) �� J Use Group: R-4 Type: 5-B 1.1 Property Address: 12 Zonin Information: _ _ _ � �y ��. oning District Proposed Use 1.3 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Requ' ed Provided Required Provided �� f r o� d ' �� ` 1.4 Water Supply(M.G.L.c.40.S 54) Public Private 2.1 Owne�of Record: � � � �� f �`�� Name(pnnt) -� Mailing Address / �o � V � Signat Telephone 2.2 Authorized:Agent: D � (� � a � `/�� 5 (U� Lr-=�� Name(print) i' g Address � 001 `' Signature Telephone y 3.1 Licensed ConstructionCSvup,ervisor:�� Not Applicable ❑ �% C.r n � /�J/ � License Number Ad s (� vl/ � �� C � �. �� Expiration Date ignature Tele hone Company Name p Q L �� Not Applicabie ❑ � Ad ss License Number �/� � 1� � � ��-�f3 « � Expiration Date � Signature Telephone O 9- 15-99 1 of 2 OVER F � � . , , : � . .,.. g[ ..::.� . . . . .. . 3 , � . .)� � .. �}�� .J.�...�:..i.o-.c. � . . : .'' . : ' �� Workers 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 .......... , ..��,..rx:. ... , , ...��. , . . ,,.,:.:,.�. ...�,e: �.. .:� ..,,.. � . �. .. � New Construction ❑ No.of Bedrooms No.of Bathrooms '" Existing Bldg. ❑ Repair(s) Q Alterations ❑ Addition Accessory Bldg. ❑ Type Demolition Other Specify: Brief Description of Proposed Work: l�,�P� G �� ` .3� / '�D / D � Item Estimated Cost(Dollars)to be CheCk Below completed by permit applicant 1_ Building ❑ Conservation-Commission Filing 2. Electrical (if applicable) 3. Plumbing/Gas 4. Mechanical(HVAC) � ❑ Old Kings Highway&Historical 5. Fire Protection Commission approval 6.Total=(1 +2+3+4+5) (if applicable) 7.Total Square Ft.(new houses$additions) ? L� �: a � � � �� , - �� ` �'hi�� . . � ;2� I, , as owner of the subject property hereby authorize �� i'�'"% /G�l��y to act on , my behalf, ' II matter lati to wor authorized by this building permit application. �_. . s��// Sign e of er Date ��3��'�#�:��'.....,. F7� , �t� z,�; `� I, � � L , 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. � � �� Print name � � Si nature of Owner/Agent Date 9- 15-99 2 of 2 i � f�c� q c Y W� wr.+t- 1 G.-� - �-:' � AM -� c_o-r o ; a. a- �;_ I " Y \ ' ��I I � �� i>� � � .o� N /� : � _ n no J � �/ , . \ � � . \ � � _ , �,�-�� "�'° '� Q q� ` � � � ._ � �, �o,t � M � i_o"i 13 . °��.� -.�o . N '"1 i 4z,�t�sF. N '� � � �9 _ � __ � � . � � , � � � �� y � � ; � �� << � ; � � �hr ,�6 �,1� � � U V� _ . � � . PREPAR£D FOR � N1►G�-}pAE.L ��Ia,LL �J-o5� C£`"RT/F/E�D PLOT PLAN N�- T�P �F r-�►�oq�� s Z.�' LOCAT/ON• hIES-T �d.�Mc�-�i-1 �`�� -1E �14i-1 P��l t �'F . SCAL E� �I '°�_ DA TE �-G-L�1 , Ti.�F_ 1"z.L�.D � �L• 44•� • R£F£R£NGE� LOT 13 . �� d-�,FI P `�' ��P�tH �F Mq~ �'' . � , •�,� , �� FL 000 ZONE �:- •o y, = /� EYE�ETT N. G, �y / H£R£BY CERT/FY THAT TH£BU/LD/NG � ; la ,��,u, �Y �j ;{•• SHOFi�N ON TH/S PLAN/S LOCAT£D ON THE " ' � ' '� GROUNO AS SHOWN H£R£ON AND THAT/T � `� ' ' �'F��r ��'•� *��";�' . . /-. �'''=�� CONI�ORM TO THE ZON/NG � � �STERy�4f ��f BY-LAWS OF THE TOWN OF -�GKj-�k�►1�i�-� NO s�Kv�� :� . wHEN CONSTRUCTED. � L OW & W£L L£R. lNC. � T/4 .MA/N STREET � �� . YARMOUTH� MASS. A E i�� \ � 3 �; ` �, o a � � � , a � � � Q � 0 o Q �, � � � � � ZU`�' a. 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