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HomeMy WebLinkAboutBLD-93-580 t TOWN OF YARMOUTH re- Qfy' Y- NMATTACME $ eCet ...�o• 0/ Application for a Permit to Build No. 64, UPON FINAL APPROVAL "---VAP i MAP i LOT g' 2 4— FEE FEE MUST ACCOMPANY THIS APPLICATION. DATE - 3 A99 19...? The undersigned hereby applies for a permit to build /92 according to the following specifications 3 1. Name of property owner Nr L ad MG NDIZ ' Tel. 77/-0091/ Address 4"/ 4DA/Pcs a w. Ysta0tocmi /44. 2.Name of Architect(if any) Tel. 3. Name of builderTHeTNy.Z/ ct(r1'rf Address 96-5- ' 2i I32 rI y.4//Ms 4. License No. D i D 5-3 s Tel. 7 7/ - `/ / `/2_ 5. Name of Mason I __Address 6. License No. Tel. '/ 7. Construction address yy $b2V7< ea/ w �Q Flood • District Dr yo , . 8. Date of subdivision Approval plain zone —LC Zone 9. Private dwelling 0 Estimated Cost Qb-'•9t �OT WRITE IN THIS SPACE 43)./ Type of room No. 10. Multi family 0 a yoo. 4_ . I Io 11. Commercial 0 rt "J >0_14 Kitchen 12. Other Est -0,2'c« a r, LA4ri 44c'er zip Dining Rm. 3iv rig Living Rm. 13. No.of stories . , Bed Rm. 14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 f©' or bilin-4 Bath 15. Materials — Wood 0 Cement 0 Other 0 S6--,c..eD Deck Witte - I 16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 As--100 ,3d Family Rm.-Closed porch�' 17. Garage — 1 0 2 ❑ Sun room 18. Swimming pool - Size Garage 19. Storage shed — Size Shed ' 20. Stove — Wood 0 Coal 0 Alterations 21. Size of lot: No. of feet front 95-E No. of feet rear /20 ' No. of feet deep / 30 ' 22. Size of building. No. of feet front No. of feet side No. of feet rear 23. Distance from nearest building: Front i°° Ft. side 96 Ft. side Rear 70 24. Distance back from line or street V5— From rear lot line 5/C ' Side line_ 30 25. H.I.C.R. No. ! oB232. ---- 1:--01-FIE L Eta-ED BY Signature rt� � AR�7�4 PLANNING BOARD Address 95 /Th /3a N,-,adv,5 6I4. Date I APPLICANT: 4:C12! / ,C7-r? ( 4/G BUILDING PERMIT ADDRESS: 9 kr 132 l/y,-.,(41A5 TELE. NO. : 77/- / Y2_ DATE FILED: 7 "3d - 73 BLDG. SITE LOCATION: 4&'9 Aym ds /Z° w, yde&drW4,MAPI/: yG LOTi/:L`ZS' 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 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 DEPARTMENT I JA , - - •DATE: pgm N/A: INDUSTRIAL AND/OR COMMERCIAL PE' ITS 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: �� PC-101705W t C kL . b U...a wM•/AI7w// ST/rjr, ,7 aw 3 �7�/`VzckSfOaj.r���in�I/nom gt>6 Reeau i2E CIDss Secrab ED en a5 Bx�.7� /hSaudepx G, BLM/.:9 LG.LP- ./tom/�� FOR LOT n E — • Indicate iocatsn cf garage or accessory building Additions with dashed lines • Sewerage disposal (cesspool) a Well p . I I • (Int /20° 20 ft. rear) • I 4buttor's . ....__. - 3 Abuttor's vame - _ --- . . Name Lot # .. . . .. .. _. I - Lot fl REAR YARD :f this is a ��� If this is orner lot, ft. cotter ic• +^te in name write in If street. • /g/ r I i(?�°7 name 'of carer a o u sweet. K/a Ira-% yo SIDE YAR.^. ray SIDE Yn;: HOUSE w Qs 4 r ' • I VII- SET BACK • a I ft c I • CC - (1^ �p - / Vfa- frontage) • \ /97)19/7/s Ai) \ / \ / (NAME OF STREET) \ / / / \ \ c__.,cry_`.. .moi:�...// /� i turf • .pr / \ � , i .e / Suggested Affidavit for Home Improvement Contractor Permit Application For Office Use Only NAME OF CITY/TOWN Permit No. Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c.142A requires that the"reconstruction,alteration,renovation.repai modernization.conversion,inprovement,removal,demolition. or construction of an addition to any preexisting owner-occupied building containingat least one but 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: Vec,c R.i#Lncc.cf,6.dr Est. Cost frFor . a Address of Work 99 4V4115 /?D w. 7544 deOvni Owner Name: /r'nGt.v /G/aD€5 Date of Permit Application: 7- 30 - 73 • I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law _Job under $1,000 _Building not owner-occupied _Owner pulling own permit _Other (specify) Notice is hereby given that: 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: 7- 30 -93 f4 4 4.7 io3F Date Contractor Nam Registration No. OR: • Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name ; `_ COMMONWEALTH OF MASSACHUSETTS r' = E tar-i.' • • DEPARTMENT D T O F INDUSTRIAL ACCIDENTS 600 WASHINGTON STREET • V� ramps CamopeI BOSTON, MASSACHUSETTS 02111 ' ro n:ssone WORIL'ERS' COMPENSATION INSURANCE AFFIDAVIT • t. I, I IuO is.._. •S Li _ r t k .r. _ y; a t.._ -nu t QIh (licensee/permirte 4 . • with a principal place of business/residence an t . G� + Ira- ( f, or -�C'i'( ' , (City/Bute/ZijC) do hereby certify, under the pains and pen of perjury, that: [ 1 am an employer providing the following workers' compensation coverage for my employees working on this job. '41C"-� — Q la C 1. \ sat: 2 3 . Insurance Comply Policy Number • ( ] I am a sole proprietor and have no one working for me. ( ] I am a sole proprietor. gener.J contractor or homeowner (circle one) and hive hired the contractors listed below who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Policy Number ... .. Name of Contractor Insurance Company/Policy Number • • Name of Contractor Insurance Company/Policy Number 0 I am a homeowner performing all the work myself. • N'OTE:.Pleue be aware that while homeowners who employ persons to do maintenance. construction or repair work on a dwciiin; of not more that three waits in which the homeowner also resides or on the grounds appurrcaant thereto are not centrally considered to be employers wader the workers' Compensation Act(GL C. 152.sect. 1(5)). application by a homeowner for a license or permit may evidence the kcal sutus of an employer under the'Workers' Compensation Act. I und:^:and that : copy of this statement will b: forwarded to tete 1partme.^.t of industrial Accidents' C:ice of insu t'ic for overact vent e::ion ane that failure to is:ure coverce as rot-sired under Section 25A'of MGL 15- ...: lead to the i-po:iu:n of crimi.. :enables Cent:::ne oil fine of up to s:500.00 and or imprisonment of up to one yea:and dvii penaities in the corm.. of:5= ork Order and 2 fine of 5100.00 : day againet rat. Sicard this 1 scav or Qa : 19 e1� L/" / /4� r L -,— tt...n.a. .N.r. a 1 rreal �. DEPARTMENT OF PUBLIC SAFETY aNsmm�po seblIdi COMMONWEALTH rsrsohrrrttr SIa1rBd/dlsQ ``{prey OF ONE ASHBORTON PLACE .,,aal= �Ofe�pp +�f ' MASSACHUSETTS - ....__ BOSTON,MA 02108 -10/111...u. /�/�n � LICENSE CAUTION EXPIRATIONDATEVF••;74.1 CONST R. SUPERVISOR FOR PROTECTION AGAINST TIES/RICiI41 9 5 EFFECTIVE DATE LIC-NO. THEFT,PUT RIGHT THUMB 1 2 06/30/1993 010538 PR BOX NLICENS . I NONE BOX ON LICENSE. F TIMOTHY R LUZIETTI BLASTING OPERATORS R 79 ARBOR NAY SS U 042-30-7845 i HYANNIS MA 02601 E1,EO�+IMUSTINCLUDEPHOTO. PHOTO(BLASTING OPR ONLY) FEE:/� Y `� g4� 100.00 NOT VALID UNTIL SIGNED BY LICENSEE ANO HEIGHT: STAMPED OR SHINATUREOFTHE COMMISSIONER Jul 0 61993 DOB: , ' 07/01 /.1938. � AL ! / i ;� ;- f��("`�� IIp�E�tS THIS DOCUMENT MUST BE 4 SION✓ A i •OTUR m CAIS DOCUMENT UST BE / SgNATURE OF LICENSEE 1J'=/ THE HOLDER WHEN EN.- �) ISSIONER OTHERS RIGHT THUMB PRINT OAOEDM THISOCCUPATION. on j I `-.. . • I 1 . . I . r I 1 . '` ' _ 92tOrrrinViffEIP°P'�Onierdt I ( '+p' ear Registration 108238 f' E9. int tI t Type - PRIVATE CORPORATION I 3 � Expiration 08/14/94 • �"w.F Timothy R. Luzietti , Timothy R. Luzietti 1 L y, f�,� ' 955 Rt. 132 I , i —A-DMI�NISTR=ATORrL Hyannis NA 02601 i •t �te e natenureaa oft aclzuaelia wwgi HOME IMPROVEMENT CONTRACTORS REGISTRATION ' ettifte Board of Buildillig Regulations and Standards ' -.,,� One Ashburton Place - ;Room 1301 \ Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR -----TiegisLretlon' 100230 $•- Expiration 08014/.94 • Type - PRIVATE CORPORATION • !$ Timothy R . Luzietti Timothy R . Luzietti ' 955 Rt . 132 1 • & , Hyannis MA 02601 ; ii �I / . 4 RI > S % _4 I 1 1- -7 I ( i c fi465 2 x 2f ` c�E � S' 2 'G1N%'���s • �' t �Xb 2X1 Jas � i�s Gia 5 " l 5 jiver Y ._______ re l- /or 5,047-0.E_ ° �,c/c9 se y