HomeMy WebLinkAboutBLD-93-585 ` _. .. =13/4447.; : rrkb ' TOWN OF YARMOUTH op, r.,,rw
e6,,"4 :r` Application for a Permit to Build No.'f
E
UPON FINAL APPROVAL MAP (Oa LOT Ga'
FEE MUST ACCOMPANY THIS APPLICATION. DATE - •as 19 93
The undersigned hereby applies for a permit to build 1 / A.
` 93
according to the following specifications
1. Name of property owner Toyrt FyPeww 01e&e-y Tel. 35VS 2/
Address Y6.s' IIasial7...,,,a- Sari rati+.cI
2.Name of Architect(if any) Tel.
3. Name of builder M t kg- MtC(..s Ice y G Address 7 D U..svli:�to «. 4.-•e
4. License No. Tel. 390 -72- 77 Sads Y4,..
4
5. Name of Mason Address
6. License No. Tel.
7. Construction address 116s' bony (mow77).......t
d
FlG District x_40
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 Wit aD kg/41115
Kitcn
S4i.. 50
11. Commercial 0 �r �' h"'" 1 c�
12. Other o e� 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 ❑ Closed porch
17.Garage - 1 0 2 SamroRm.
Suunnroom
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 Frim r=ar I. , in, Side line
25. H.I.C.R. No. !D 3 ,
f
LOT RELEASED BY Signature /�� / i�r►d` ,/
PLANNING BOARD Address 7!� via.. �0�
Date 7.2a-n c ' ' �iwc..a.
Suggested Affidavit fOr Home Improvement Contractor Permit Application . .
• • Yoe Office Use Only NAMvt OF CITY/TOWN '
Perrssit No. 'Ale* e's� • l ' • "'
Data ' . • •
.._. . ,
..r —�
• AFFIDAvIT
• • . Home Improvement Contractor Law •
, Supplement to Permit Application .
• MGLc.142Arequires that the"reconstruction,attention.renovation,repair,mod eMita tion,conversion,inprovement,removaI-demolition,
or construction of an addition to any preecisting owner occupied building containing at hist one but not more than four dwelling units....or
.to structures which are adiacent to such residence cm wilding"be done by registered contractors.with certain exceptions.along with other • '
requirements. _ . . � .
Type of Work: C th.-p I- 1,42n90 S Est. Cost' VSO. °I) •'
. Address of Work )i' C . ko-ra,y pas, A/ I/,..1t,..0 •
Owner Name:' veyLL �fYu..- CI rtae0.hy '
•
Date of Permit Application: 2 — 62 �'-S3 ( • - ,.
'I hereby certify that: •
• Registration is not required for the following reason(s):
Work excluded by law ' .
_Job under S1,000 ____
. Building not owner•occupied ' I '
_Owner pulling own permit ,• •
_Other (specify) .. . I
Notice,Is hereby given that: •
. - .',OWNERS VU1:LING THEIR OWN.PERMIT OR DEALING WITH UNREGISTERED' 1 '
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE . •e-� • '
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL'
. c. 142A. 1 •
Signed under penalties of perjury:
I hereby,apply fora permit a t c .. �� • r: • ,
7 - .•--sem /I �fi.� ., io Spa ‘
Date Co:dacior • .me Registration No.
4
OR: l .
Notwithstanding the above notice. I hereby apply for a permit as the owner of the above propenv:
Date Owner Hume . '
TRIMS NODE II?flYfBEIaT Si:. • ..r• 'o NNW IMPROVEMENT INC.
TO Huntington Avenue rlr; ttvenJR
CS. 'i(Gii4itk1tit, HA 02f84 (603)303-7277 It. n;,,,r;d - 00511 .;hl =nn9'7
• •• BUILDING DEPARTMENT •. . • •
•
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: ..D' �1
• JOB LOCATION: 1•f6J kewCj 9ot.yok �{.w•a. Vuut• Yaa-.•,:u. • '
NUMBER _ • V q�. STREET • . . VILLAGE •
OWNER OF PROPERTY: ' J FI' lygok- �A / .
CONSTRUCTION SUPERVISOR: I►l�k� I \Gll�le ��/0 �t J? 7a•7p'
�/ // NAME (� / • LICENSE NO. . PHONE NO.
ADDRESS: 7 Ftua.Qr.�(�Wk / ( 1�a.i ��, 4.cc •
LICENSED DESIGNEE: .
(I? OTHER THAN SUPERVISOR) NAME LICENSE NO.
2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: tflnrl0 HL E iMPADYEMENT IAC,
• %0 Huntington Avenue
SLI. n••:nn nn
2.15.1 THE LICENSE HOLDER SHALL BE FULLY AND COt•13LETELY RESPONSIBLE FOR`'9(Y.L4-Vokt TOR7WHICH 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, RDMOVAL OR DD!OLITION INVOLVING THE STRUCTURAL ELEIENTS OF BUILDING '
AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LAWS OF THE 1
COMMONWEALTH, EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB- !
CONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER.
•
2.15.3 THE LICENSEE HOLDER SHALL DCIEDIATELY NOTIFY THE BUILDING OFFICIAL IN WRITING OF THE
DISCOVERY OF ANY VIOLATIONS WHICII ARE COVERED BY THE BUILDING PERMIT. •
2.15.S ANY LICENSEE WHO SHALL WILLFULLY VIOLATE SUBSECTIONS 2.15.1. 2.15.2 OR 2.15.3 OR ANY
OT- ER SECTION OF THESE RULES AND REGULATIONS AND ANY PROCEDURES, AS AMENDED; SHALL 3E SUBJECT
TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD.
•
.15. ALL BUILDING PEFJ!IT APPLICATIONS SHALL CONTAIN THE NAME. SIGNATURE AND LICENSE NUMBER 0:
THE CONSTRUCTION SUPERVISOR WHO IS TO SUPER:'ISE THOSE PERSONS ENGAGED IN CONSTRL'C.ICN, RECON-STRUCTION, .ALTERATION. REPAIR. REMO:•AL OF DD!OLITION AS REGULATED BY SECTION 109.1.: OF THE
CODE AND THESE RULES AND REGULATIONS. -IN THE EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISI:
SAID PERSONS. THE WORK SHALL I:_YEDIAIELY CEASE UNTIL A SUCCESSOR LICENSEE HOLDER IS SUBSTITUTE!
ON THE RECORDS OF THE BUILDING DEPARTMENT.
I HAVE READ AND UNDERSTAND :!Y RESPONSIBILITIES UNDER THE RULES AND REGULATIONS .FOR LICENSING t
ST :CT:ON SUP=RVISCRS ' ACCORDANCE ::IT: SECTION 109.1.1 ^
` 0? Tt:.. STAT:. BUILDING CODE. I U::DE35:
THE CONSTRUCTION INS- • ON PRCC DUKES AND THE SPECIFIC
INSPECTION AS CALLED FOR BY HE•3UiLD:OFP:CLAL.
INSURANCE CtVERACE: ••
I have a r_::e.^.t !3 '�
7Y :ity ins;: _. _ peat; Crs subs::n::�
If Ye No r_ va ent which :Peet: the re�uirer-erts cf:dC�05.152
you have _._._cxcd_ _s_ inc:ca._ ..._ rice _ ::e^_ye _
by checxo^q ;n. ___.__:ra:e box.
Gt
A liability insurance ; .!:ir .-
Cher type of '.:eemn;ty 0 Mend• Q
C'.vHE:V: Inst],.>;C' 'NAI ES: ! cr :way VI:: •• _ -to's.
Iyy��lr`ic:e:i.- :��o ::� L'•vs. :r.: .._. -v _ ac_ :o:e:cq: rec.::ee _.
/ -.-.