HomeMy WebLinkAboutBLD-93-584 - -f tettFEW
ie ms's , o TOWN OF YARMOUTH oK
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t • Application for a Permit to Build No.
UPON FINAL APPROVAL V. Q-7l. 1AP V- 6 LOT
FEE MUST ACCOMPANY THIS APPLICATION. DATE rt___ASTIS
The undersigned hereby applies for a permit to build • 1/ /93
according to the following specifications Ate/
I /+ it/93
1. Name of property owner MM. -r l(\(^S Abe I Cot-we ra .. Tel. 710-3Y02t
Address .Z8 Ca-a..p St-aat West y 1.-^0x1';.
2.Name of Architect(if any) Tel. �i
a Name of builder Mike I`1!�1c,Cid&key Address 7D 1/v40-jo+• 49. &i )(Ina
4. License No. Tel. 39g 2)-77
5. Name of Mason Address
6. License No. Tel. �/
7. Construction address r286 Co-i.p &4'-.cf' Weil- Yose,or
Flood District
8. Date of subdivision Approval plain zone C Zone R-#0
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
Doa o� Type of room No.
10. Multi family ❑ 2� ,41 a-5 f
11. Commercial 0 ,S-h.tp .f ►.C►so� Kitc``hddn
12. Other 0 met-.f. Oen,& Dining Rm.
13. No. of stories Living Rm.
Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 Bath
15. Materials — Wood 0 Cement 0 Other 0 Deck
16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch
17. Garage — 1 0 2 ❑ Family Rm.
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 No. of feet rear No. of feet deep
22. Size of building. No. of feet front No. of feet side No. of feet rear
23. Distance from nearest building: Front Ft. side Ft. side Rear
24. Distance back from line or street From rear lot line Side line
25. H.I.C.R. No. /03, .RC //
LOT RELEASED BY Signature <i
PLANNING BOARD Addre- ar° .• ,. . .. '- %c, -
Date 7-22 AT ate.e,yAr o.,A"
•
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' ' Stiggested Affidavit fOr Home Improvement Contractor Permit Application . I
• Foiomce Use only. N/1ME OF $ITY/IOWN
Ferran Na p-t-µr a✓ ! '
-Date -
• , .
. AFFIDAVIT `' '.
• ' Home Improvement,Contractor Law - „
Supplement to Permit Application ,
MOLe.142A requires that the"reconstruction.alteration.renovation.repair.modernization.conversion.Inprovement.removaLdemolitlon.
or construction of an addition to any pre<cistine owner•occuoicd building containing at least one but not more than fourdwtlline units....or
•to structures which are adjacent to such residence or budding"be done by registered contractors.with certain esceptions.along with ocher •.
requirements. .
•'. Type of Work: 04 1*—V, 4- he kao - Est_ Cost'aCOv .
Address
p?�e ,(,pkc✓1nn .�(�r¢tea f' .
. Owner Name: Mt.. k /141-.c /Me/ 6n-etA.
Date of Permit Application: Vv/y a A /Pt:
. •I hereby certify that:
• Registration is not required for the following reason(s): I
•
. . . v
_• Work excluded by law •• . . • .
i
_Job under 51,000 ; . ••
Building not owner-occupied ;
_• Owner pulling own permit __._
_Other (specify) . ,
Notice,is hereby given that: -
•
..:OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED` 1
•
CONTRACTORS FOR APPLICABLE HOME IMPRO VEMENT WORK DO NOTHAVE • •'
ACCESS TO THE ARBITRATION i 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: t
• 74203 •
It .e ' C C4J/<e t jo 3 2 a
Date
/7,/,' / e Registration No.
OR: �I�I
Notwithstanding the above nonce, reby apply for a permit as the owner of the above property:
•
Datb Owner Name .'••
TIIIELE0 MOLE IEz<t?IQVEt tL1 ini:.
TO Huntington Avenue tt,t1 NAt.ic IMPIi6VEMENT INC. :_
MA 02154 (5C3)3^u8.7277 i °;•jifrdl l ve/iue
•
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• •- BUILDING DEPARTMENT _ - `"
CONSTRUCTION SUPERVISOR FORM . -
PLEASE PRINT: ' ' ' `:
• JOB LOCATION: aro . Cy rwn U W �� '
NUMB ' 1" J n STREET VILLAGE
OWNER OF PROPERTY: ' ,t.. 4- �HS . . 4b0/ Coh1-e.+w .
•
CONSTRUCTION SUPERVISOR: MZ([.e. MG c(Ufi�¢y /o3SaG t e39g 7 77 •
. '. NAME f� / -. LICENSE NO. . 1 . PHONE NO.
ADDRESS: 7f) IclvM�iw, -tct�. A .: cps/ •f4 kJ; .
LICENSED DESIGNEE:
(IF OTHER THAN SUPERVISOR) NAME LICENSE NO.
THERM ROME IMPROVEMENT INC.
2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: 70 Huntington Avenue
So. Ynrmni tthh� q l� '��"_"'�
2.15.1 THE LICENSE HOLDER SHALL BE FULLY AND CO1�3LETELY RESPOYSTBt FB 4.LJ.Willa3C OOR7WHICH HE
IS SUPERVISING. HE SHALL BE RESPONSIBLE FOR SEEING THAT ALL WORK IS DONE PURSUANT TO THE STAT
BUILDING CODE AND THE DRAWINGS AS APPROVED BY 'THE BUILDING OFFICIAL '
2.15.2 THE LICENSE HOLDER SHALL BE RESPONSIBLE TO SUPERVISE THE CONSTRUCTION. RECONSTRUCTION,
ALTERATION, RE?AIR. REMOVAL OR DEMOLITION INVOLVING THE STRUCTURAL ELE ENTS;OF BUILDING
AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LAWS OF THE
COMMONWEALTH. EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB-
CONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER. 1 i
2.15.3 THE LICENSE HOLDER SHALL IMMEDIATELY NOTIFY THE BUILDING OFFICIAL IN WRITING OF THE '.,
DISCOVERY OF ANY VIOLATIONS t"dICH ARE COVERED BY THE BUILDING PERMIT. I 1
2.15.•: ANY'LICENSEE WHO SHALL WILLFULLY VIOLATE SUBSECTIONS 2.15.1. 2.15.2 !OR 2.15.3 OR ANY
OTHER SECTION OF THESE RULES AND REGULATIONS AND ANY PROCEDURES; AS AMENDED) SHALL 3E SUBJECT
TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD. I.
2.15. ALL BUILDING PERMIT APPLICATIONS SHALL CONTAIN THE NAME. SIGNATURE AND LICENSE NUMBER 0:
THE CONSTRUCTION SUPERVISOR WHO IS -TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON-
STRUCTION, ALTERATION, REPAIR. REMOVAL OF DEMOLITION AS REGULATED BY SECTIO 109.1.: OF THE .
CCCE AND THESE RULES AND REGULATIONS. •IN THE EVENT THAT SUCH LICENSEE IS Nci LONGER SUPERVISE
SAID PERSONS, THE WORK SHALL IMMEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTE:
ON THE RECORDS OF THE BUILDING DEPAR:ENT. 1 •
I
.._.. • 1
I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND REGULATIONS :FOR LICENSING
STR_CTION SUPERVISORS _s ACCORDANCE WITH SECTION 109.1.1 0: THE STATE BUILDING CODE. I UNDERS:
THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED; FOR BY THE•BUILD'
OFFICLaL. ! -
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INSURANCE CCVERACE: •
I have a current fiab:ity Nc ranee pc:icy cr s sut:::n:ial equivalent which meet: req irements ci MCi C:t.152 •
•
Yes 22' .
If you have -.Necked_ ease ine:c :e the -e c-i•:•erzge by checking the ::::::::nate bps. 1
A liability insurance pc .-y Cher type of :acemn:ty 0 Send 0
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