HomeMy WebLinkAboutBLD-93-579 ' `, •;OF Y`��2' . Q 7!�it
,e o TOWN OF YARMOUTH a�-X130/fl
l MATTACNC S K 9
ea,,4 00510'" Application for a Permit to Build No. J-q
UPON FINAL APPROVAL I✓pci g-aJ MAP 4s'7 ' LOT FSP
FEE MUST ACCOMPANY THIS APPLICATION. DATE
The undersigned hereby applies for a permit to build 4'
according to the following specifications
1. Name of property owner Don atd PeoK_, Tel.3g 8- I)QO
Address fe PIza5044-F5-F t .Stic itttn .(>L«
2.Name of Architect(if any) 1 Tel.
a Name of builder u.noteAravar.-Tad-6 I Ame'v(Address eitteiroi IL l!-ttc (Da '3a-
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
7. Construction address iS P Liza-42,v& 5t . 5. U vue tktk 1-LA
St ,
Flood District ns_2-r8. Date of subdivision Approval — LiAiDlain zone Zone
9. Private dwelling 1 Estimated Cost X13 DO NOT WRITE IN THIS SPACE
/061-4/ m,J Type of room No.
10. Multi family 0 { g(p5.pg vf.u-Eu.t a"C,G.
1/02077-3 TtL.n�.Ott r
11. Commercial ❑ /gyp/93 x/ 93Kitchen
12. Other 0 c , r ar ��LL- Dining Rm.
13. No. of stories c,-S, W Living Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 f �! . 0-6 pip Bed Rm.
Bath
15. Materials — Wood 0 Cement 0 Other 0 " �Bgt• Deck
16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch
17. Garage — 1 ❑ 2 ❑ Family Rm.
Sun room
la Swimming pool - Size Garage
19. Storage shed — Size Shed
20. Stove — Wood 0 Coala0 Alterations
21. Size of lot: No. of feet frdnf a 00 / No. of feet rear a°0 f No. of feet deep 2.00'
22. Size of building. No. of feet front 2 0. No. of feet side 40 No. of feet rear
23. Distance from nearest building: Front 2,0 Ft. sideFt. side Rear
24. Distance back from line or street a0/ From rear lot liQ r 140 1 Side line (00
25.O RELEASED
No. ^ „ ' & ,iL
LOT RELEASED BY Signature �,/
PLANNING BOARD Address ' i �P//egszj&5i ` /
Date SD- !U✓✓f UJ i! 1/7¢ C9.�pCG��
7/aC/9 3
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r. - .�ty���r� -2;"4-00
1 ,ii . i i<:t )l4)) 1Jl)-,(h'e 14j. r�i..,4 BYO YO A C'
- - � �:J"�-�� �'A�sT< t � �� /` ';',-,2t. � AJ'. '� x "'��+,�r�1 w�F. i y"T,_� �.(l x c r 1.' 7
` REGISTERED' .2.1O- f �u}:s - • .rctcn DY - `�
APPLICATION ge- . APUCH071 INDUS: L INC. re
Date of Manufacture
•
NUMBER ..t11;
�( ,b�� r EVANSV;LLE, LVD ANA 47711
F121,.4 9�e, 'ns'1 St _ MANUFACTURERS OF THE F!NISHLD SERIAL#:
I'= tr T=NT FRCDUCTS D:3C,,.,,.: HE„Ein 20958 3!24/93
This is to certify that the materials 'dr.^cdiced have been flame-retardant treated (or are
{{�.� inherently noninflammable) i.ird vier, s ;fl
uped to:
P_'' NAME: - i1:. 4I. • - T' I fit Sli;ri iI11D2 CQfl _' TE 1TSi < ?ARTY INC
` CITY READING STATE PA
. - ..-;11-1)1
Certification is hereby made that:
The articles described on this Certificate have been treated with a flarne-retardant approved
- rt chemical and that the appiicr tion of said chemical was done in conformance v;iti1 California
• r Fire Marshall Code, ecual to or exceeds NF?A 701, C?„! 34 GOVERNMENT CERT:TIED LAB #3056
II, Method of application: LA;V1,P•.,t=-C U.L. -2 .
.;IL-C-43oC6D NYC-374- es-S;7 -
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Type, color and weight of canvas/vinyl: I5 oz GOY!._ES Bio TOP VINYL LAMINATE White• Description of Item certified: (I) 00 x 40 Century Top 4oc ,
Flame Retardant Process Used Will Not Be Removed By
Washing And Is Effective For The Lila Of The Fabric j
JOHN BOYLE&CO. • /�/�//11 I
-` Name of Applicator of Flame Resistant Finish
Signed: c+---� // �', iL. I
TH E
E \NT DE'ART MENT—ANCH R
STATESVILLc, NC f O. INDUSTRIES INC.
LOUIS R. BROWN
cal ',:Y. ?,�r( --tt',. .••, -t.,-0,7 �,;,h�'.. - rL t4.7 at„u.�•r`—nt�i,% �,y-p'% .. r=r, i`;,L•(l-r- yr ,�,; ”`
:V F't '1 1 '1( �'�+_li l i-1 ^"� T`.,�L`.r 1� 2_�l Nl „s�F�C��L'
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-- - _ FOR LOT n L°1—FG . ( Xkp 30
Indicate location cf garage or accessory building •
Additions with dashed lines
• Sewerage disposal (cesspool)
Well p •
TourN Woad?.
I (Ict..c90Q . .ft. rear) I
4buttor's -
_ ?
Vame $teOeVt _- - Abuttor's
Name
Lot a FnK � . . Lot #
REAR YARD
:f this is a 2 If this
• �rer lot, ..... .� .. .ft. corner lc
.t..-rite in name 1� • write in
if st=eet. ( •
name .of
I ^ otheru 0 o sstreet.
to 6-01
SIDE YA=:\ SiDE YAR
HOUSE _
0 4Kid
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Aa ' • - , •
SET BACK '
o /j c
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0
(" a07. .7j°! '...ft. frontage)
/
/ `�3 -P�eaS�4 4- 5+.
. / (NAME OF STREET)
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• TOWN OF YAMOUTII
BUILDING DEPARTMENT
HOMEOWNER LICENSE . a "TION
PLEASE PRINT:�
` A
DATE `o l l(�
JOB LOCATION _44,. / ? PI eaS Sf - Bass 12;0-0-1 -
NUMBER . STREET ADDRESS n SECTION OF;TOWN
"HOMEOWNER" Pecks / ✓` s— g. 16l.O .l
NAME /1 ` HOME PHONElWORK PHONE
PRESENT MAILING ADRESS 44 2 IeQ tk - a •
•
CITY OR TOWN STATE ZIP CODE
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER—OCCUPIED •
DWELLINGS OF SIX UNITS OR LESS AND TO ALLOW SUCH HOMEOWNERS TO ENGAGE AN IN—
DIVIDUAL FOR HIRE WHO DOES NOT POSSESS A LICENSE, PROVIDED THAT THE OWNER
ACTS AS SUPERVISOR. (STATE BUILDING CODE SECTION 109.1.1)
DEFINITION OF HOMEOWNER:
PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICH IIE/SHE RESIDES OR INTENDS TO RE—
SIDE, ON WHICH THERE IS, OR IS INTENDED TO BE A ONE TO SIX 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. SUCH "HOMEOWNER" SHALL SUBMIT TO THE BUILDING OFFICIAL,
ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT HE/SHE SHALL BE RESPONSIBLE
FOR ALL SUCH WORK PERFORMED UNDER TIIE BUILDING PERMIT. (SECTION 109.1.1)
TILE UNDERSIGNED "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE STATE
BUILDING CODE AND OTHER APPLICABLE CODES, BY—LAWS, RULES AND REGULATIONS.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH
BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE
WILL COMPLY WITH SAID PROCEDURES AND REQUIREMEN S.
HOMEOWNER'S SIGNATURE I3 0 / 61
APPROVAL OF BUILDING OFFICIAL
NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED
TO COMPLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION CONTROL.
INSURANCE COVERAGE:
I have a current j�',ability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes C�' No O
If you have checked yes. please indicate the type coverage by checking the appropriate box
A liability Insurance policy 12'- Other type cf indemnity 0 Bend 0
OWNER'S INSURANCE WAIVER: I am aware that the licensee does net have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owner 0 Agent 0
. Signature of Owner or Oxner s Agent -- . __ ____ -- -
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Suggested Affidavit for Home Improvement Contractor Permit Application
For Office Use Only cloak NAMEI OF I'OWN
Permit No. co 1 C{✓vvtou l/7
Date
Ai-HDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c.142A requires that the"reconstruction.alteration.renovation.repair,modernization.conversion.inprovement,removal.demolition.
or construction of an addition to anv pre-costing owner-eccunied building containing at least one hut not more than four dwelling units....or
to structures which are adjacent to such residence or building'be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work:Cagfet. f1or1 of 'ferwpienrt 'tent Est. Cost SO
Address of Work Y5 Qlecgo,a+ S7(. So, Yet vivo tt14
Owner Name: 71)MQ id e—p -
•
Date of Permit Application: .11/4611
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law
L.-lob under 51,000
_Building not owner-occupied
_Owner pulling own permit
_Other (specify)Tenn VAit/
Notice is hereby given that: 1
OWNERS PULLING THEIR OWN•PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL
c. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the owner: •
Date Contractor Name Registration No. •
OR:
Notwithstanding the above notice, I hereby apply for>a permit as the owner of the above property:
7/4 43 �J .S1 d /Y'/r
Date Owner Name
APPLICAN��Tjj�0,n (J '7 eC. C. BUILDING PERMIT /i: /y
AUDRESSU wog Pk'Ocgh C t St c X1/61f TELE. NO. : 3Ig^ 1/9(J DATE FILED: l4:4:5
BLDG. SITE LOCATION: /t '/ MAP//: 3 7 LOT//: 16,
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THE FOLLOWING INFORMATION OUTLINES THE PROCEDURAL STEPS REQUIRED TO OBTAIN A PERMIT TO BUILD,
ALTER, OR ADD TO A STRUCTURE WITHIN THE TOWN OF YARMOUTH. THE BUILDING DEPARTMENT WILL DETER-
MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD
PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH
THE FOLLOWING DEPARTMENTS:
"' RESIDENTIAL AND/OR COMMERCIAL BUILDING
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WATER DEPARTMENT: DETERMINES COMPLIANCE OF WATER AVAILABILITY. •
ENGINEERING DEPARTMENT: DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE. '
CONSERVATION COMMISSION: DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E. : IF LOT(S) BORDER ANY
TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH
LAND, ETC.
HEALTH. DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E. : REQUIRE-
MENTS FOR SEPTAGE DISPOSAL AND OTHER PUBLIC HEALTH ACTIVITIES:
FIRE DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REQUIREMENTS FOR PERSONAL
SAFETY, PROPERTY PROTECTION, I.E. , SMOKE DETECTORS, SPRINKLER SYSTEMS
ETC.
THE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR
ISSUING THE REQUIRED BUILDING PERMIT:
REVIEWED BY:
1. WATER DEPARTMENT DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEl'ARI'MENT'/// DATE: 7/414$1:5N/A:
6 TRIAL AND/OR COMMERCIAL PERMITS!
5. WIRING INSPECTOR: (((/// DATE: N/A:
G. PLUMBING INSPECTOR: DATE: N/A:
7. FIRE DEPARTMENT: DATE: N/A:
PLEASE NOTE
ALL STUMPS AND/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE
DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING
PERMIT.
COMMENTS:
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