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Home My WebLink AboutBLD-93-605 cr7/9193 `, $c= rr -• TOWN OF YARMOUTH °SFE'" 0/ cilt iii HATTACM 5611 �J lii ° °° Application for a Permit to Build No. 6 Ar- UPON FINAL APPROVAL y--1 i3 MAP £fl' LOT f I FEE MUST ACCOMPANY THIS APPLICATION. DATE 8/919 93 The undersigned hereby applies for a permit to build FIN/79 according to the following specifications 1. Name of property owner T/'a-r1 S,d'r► -`t- Tel.37R AQ3I Address i / 2.Name ofArchitect(ifany) 4' t--f• A nv Com- T 1..a,37 COQ 3. Name of builder Co- •ddress 77 4 - 1--1 4. License No. co,f'"'' /a TeL est V- -2,7/ S +-t-- , 1i ut. o t. 2. 5. Name of Mason 49 ra--fri-Jo-v4Address g (ear' W 1)u 21 t°''erdJ14, 6. License No. 0 34 3 7 0 Tel. && 8 9'4/7 77j 7. Construction address 30-co-n---53 cic t c. Pct-rt—t _. Flood District 8. Date of subdivision Approval • • plain zone Zone 9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE Coxless--ow Qarno L Type of room No. • 10. Multi family 0 J2) 0 o a gcoG Coinzet-/UM- 11. Commercial * 71/ 7 5r Kitchen 12. Other ❑ Dining Rm. �1 �'3� LivingRm. 13. No. of stories -c j 16 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 AA G Closed porch • 17. Garage — 1 ❑ 2 ❑ Fatuity 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 _a 0 • U No. of feet side 37- 1 No. of feet rear Aa (46 23. Distance from nearest building: Front rt.side Ft. side Rear 24. Distance back from line or street From rear lot line Side line 25. H.I.C.R. No. LOT RELEASED BY ge,t/ 1-' PLANNING BOARD Address 17 'Wash V- Date (1o^^ 1114m4.-. APPLICANT: �/�. �' L,e./ 0 BUILDING PERMIT f: ADDRESS: 7 7 4 �.f/ 1Q,p�Q,}µ...rerc t a,,.. n .Yk1S-STELE. NO. : 8�19—ist, DATE FILED: BDG. SITE LOCATION:Shy/3 gettek4u. T.ariR- MAPA: • LOT//: 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. . TILE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR ISSUING THE REQUIRED BUILDING PERMIT: REVIEWED BY: n ' 1. WATER DEPARTMENTr� .F c-09 p^i .V I- DATE: 2-1 --9 3 N/A: 2. ENGINEERING DEPARTMENT: I DATE: N/A: 3. CONSERVATION: �_ DATE: N/A: 4. HEALTH DEPARTMENT ' f,(4J(4 /ILO DATE: j-�a- S2 N/A: J INDUSTRIAL/OR COMMERCIAL PERMITS 5. WIRING INSPECTOR: ,� //,./:" DATE: AUG - 9 1993 N/A: G. PLUMBING INSPECTOR:/ t�/ 41 , DATE: �' -9 -92, N/A: 7. FIRE DEPARTMENT: / i„ tw r / DATE: F/ f 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 SUANCE OF ' IE BUI NG PERMIT. COMMENT •� :/mow A::s\��9.h._ �r..:�*/��A_. • Ypp - gs,pv Srto/d,. rev,LJ BLM/89 • BUILDING DEPARTMENT • CONSTRUCTION SUPERVISOR FORM PLEAE PRINT: .� JOB LOCATION: O/�J•C•C(ts.. L-&tt. v NUMBER • • ' . STREET VILLAGE OWNER OF PROPERTY: ' �7-u-a--vt' et . . • ' CONSTRUCTION SUPERVISOR: l ' ' O'o .i .1e 0,2 d o? 7 l b . AME . LICENSE NO. PHONE NO. ADDRESS: J S t .-- ins . , LICENSED DESIGNEE: . r " (IF OTHER.THAN SUPERVISOR) NAME LICENSE NO. .• 2.15 RESPONSIBILITY OF EACH LICENSE.HOLDER: . . 2.15.1 THE LICENSE HOLDER SHALL. BE FULLY AND COMPLETELY RESPONSIBLE FOR ALL WORK FOR WHICH HE IS SUPERVISING. HE SHALL BE RESPONSIBLE FOR SEEING THAT ALL WORK IS DONE PURSUANT TO THE STATE 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, REPAIR, REMOVAL OR DEMOLITION INVOLVING THE STRUCTURAL ELEMENTS OF BUILDING AND STRUCTURES ONLY PURSUANT TO THE STATE BUILDING CODE AND ALL OTHER APPLICABLE LAWS OF THE CObe1ONWEALTH, 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 LICENSE HOLDER SHALL IMMEDIATELY NOTIFY THE BUILDING OFFICIAL IN WRITING OF THE DISCOVERY OF ANY VIOLATIONS WHICH ARE COVERED BY THE BUILDING PERMIT. 2.15.4 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 &MENDED, SHALL 3E SUBJECT TO REVOCATION OR SUSPENSION OF LICENSE BY ,THE BOARD. . 2.16. ALL BUILDING PERMIT APPLICATIONS SHALL CONTAIN THE NAME, SIGNATURE AND LICENSE NUMBER OF THE CONSTRUCTION SUPERVISOR WHO IS TO SUPERVISE THOSE PERSONS ENGAGED IN CONSTRUCTION, RECON- STRUCTION, ALTERATION, REPAIR, REMOVAL OF DE*!OLITION AS REGULATED BY SECTION 109.1.1 OF THE CODE AND THESE RULES AND REGULATIONS. IN THE, EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISING SAID PERSONS, THE WORK SHALL IrEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTED ON THE RECORDS OF THE BUILDING DEPARTMENT. I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND REGULATIONS ,FOR LICENSING CCN STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTAN THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING OFFICIAL. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL'th.152 Yes :3 . No ❑ If you have checked vis. please incicte the type c average by checking the ap::cpriate bcx. . t' A liability insurance pc:icy ❑ Other type of :..demnity 0 8cnd 0 • OWNER'S INSURANC'c WAIVER: I am aware that the licensee does rat have the insurance coverage requires tv Chapter 152 of the !Hass. General t-•ws. anc :Rat my signature cn t`:s permit ::p:i�:icn wanes this re;uiremer.t 4 / - ► - Check or,e: Owner . Agent ❑ Signal re of Owner cr Owners Agent GNATURE: . BUILDING OFFICIAL APPROV TOWN OF YARMOUTH BOARD OF HEALTH CI ADVISORY LETTER #25-A TO: COMMERCIAL/RESIDENTIAL BUILDERS DISPOSAL WORKS INSTALLERS • FROM: BRUCE MURPHY, HEALTH AGENT FORREST E. WHITE, BUILDING INSPECTOR DATE: MARCH 5, 1987 REF: DISPOSAL OF STUMPS & BRUSH FROM BUILDING SITES NOTE: THIS ADVISORY LETTER SUPERSEDES ADVISORY LETTER #25, DATED AUGUST 23, 1985 ON NOVEMBER 18, 1986 THE BOARD OF SELECTMEN VOTED TO PROHIBIT ALL STUMPS AND BRUSHES LOADED BY MACHINE FROM BEING PUT INTO THE LANDFILL, EFFECTIVE JANUARY 1, 1987 PLEASE BE ADVISED THAT, AS OF THIS DATE, WHEN APPLYING FOR A BUILDING PERMIT THE APPLICANT MUST PRESENT AN AUTHORIZED STUMP/BRUSH DISPOSAL RECEIPT INDICATING WHEN ALL STUMPS AND BRUSH, CLEARED FROM THE LOT(S) , HAVE BEEN DISPOSED OF, AS IT IS NOT • REQUIRED THAT ALL SUCH MATERIALS MUST BE DISPOSED OF IN ACCORDANCE TO REQUIREMENTS OF THE DEPARTMENT OF ENVIRONMENTAL QUALITY ENGINEERING (DEQE) , UNDER THE MASSACHUSETTS GENERAL LAWS: CHAPTER 111 - SECTION 150A. WITH REGARD TO DISPOSAL SITES, ALL SIGNED DISPOSAL RECEIPTS WILL BE FORWARDED TO THE HEALTH AGENTS OF EACH RESPECTIVE TOWN, AFTER THE ISSUANCE OF THE BUILDING PERMIT. AFTER ISSUANCE OF A FOUNDATION PERMIT, AND PRIOR TO OBTAINING A BUILDING PERMIT, THE SIGNED STUMP/BRUSH DISPOSAL RECEIPT, {THICH INDICATES THE SITE OF DISPOSAL, MUST BE SUBMITTED TO THE BUILDING INSPECTOR. IF THE APPLICANT DOES NOT HAVE A SIGNED RECEIPT INDICATING LOCATION OF DISPOSAL, NO BUILDING PERMIT WILL BE ISSUED. ANY QUESTIONS, RELATIVE TO THE AFOREMENTIONED, MAY BE DIRECTED TO EITHER THE BUILDING INSPECTOR OR THE HEALTH AGENT. MAP: PARCEL: LOADS: DISPOSAL DATE(S) : • CONSTRUCTION SITE: - PRIVATE DWELLING : MULTI-FAMILY: COMMERCIAL: OTHER: • OWNER OF PROPERTY: T i / .0-44 I TELE: 0298 209-3/ � _ ,_ • NAME OF CONTRACTOR :� CLEARING SITE: TE E: .. DISPOSAL SITE FOR STUMP BRUSH:a ✓ 1 il:fi Arte p -• SIGNATURE OF GATE ATTENDANT AT DISPOSAL SITE DATE: X4/g, n COMMONWEALTH OF MASSACHUSETTS Rtt .r t. . c - DERAIL:hiFh r OF INDUSTRIAL ACCIDENTS �1 _... • ' 600 WASHINGTON STREET James Campoei: BOSTON, MASSACHUSEi IS 02111 • ron:m.ss•oner • - = WORKERS' COMPENSATION INSURANCE AFFIDAVIT • • • 14' . (licrnscc/p rmi[tcc) • with a principal place of business/residence at: • / (City/State/Zip) do hereby certify, under the pains and penalties of perjury, that: . A.a. [) I am an employer providing the following workers' compensation coverage for my employers working on this job. Insurance Company Policy Number [ ) 1 am a sole proprietor and have no one working for me. ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contactors listed below who have the following workers' compensation insurance policies: isi6 9 6v Name of Contractor InsuranceInsurance Comey Number Name of Contractor Insurance Company/Policy Numb:: • Name of Contractor Insurance Company/Policy Numb:: 0 I am a homeowner performing all the work myself. . • NOTTh.Please be aware that while homeowners who erpioy persons to do maintenance, ccestruczion or repair work on a dweiiinc of not more than three units in which the homeowner also resides or on the grounds appurcnaet thereto are not centrally considered to be employers under the abrken' Compensation Act(CL C. 152.sect 1(5)), application by a homeowner for a license or permit may evidence the lecal sums of an employer under the Workers' Compensation Act. I unden;and that : copy of this statement will be forwarded to the Department of Indus..:.:Aeddenn. O lce of insur.nc for coverage verification and thatfailure • _ :a;ture to secure covc.�c as recuired under Section 25A'o; MCI.. 152 en lead to ;..: imposition of cert.^:: per.altics consrscne of: fine of up to 51500.00 anc'or imprisonment of up to one year and dvii penaides in the form of:Ste:Work Order and a fine of 5100.00 a day azainst me. Sizne_ this • pre dav or , 19 43 . • '.ire- . ......::_e ....._..so..P........._.