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HomeMy WebLinkAboutBLD-93-620 1 - �__ 0::+414.. © K Faw . `- p fa TOWN OF YARMOUTH_ 0 ,, 1 _y; g7/15 �VMATTAG C[5 Application for a Permit to Build No. 6020 e UPON FINAL APPROVALL 1! MAP /v LOT Z l - y FEE MUST ACCOMPANY THIS APPLICATION. DATE _ , V/ ' /193 93 The undersigned hereby applies for a permit to build according to the following specifications IP 7/T 3 1. Name of property owner 4015 [LL per wPi• T el. Address 07 in/And 4d f(N yan . 2.Name of Architect(if any) Tel. a Name of builder .�'vrj. 4- dLel"se.AI Address Or f wji.L/l fief JJA. .1; 4. License No. _O(S'y 9/4 Tel. 74.1• a 41,y r 5. Name of Mason Address 6. License No. Tel. 7. Construction address ay -2's /4 N J Ref GO • Flood .. District a Date of subdivision Approval plain zone fel a tlo ) zone 0e: 9. Private dwelling 0 ' Estimated Cost.. -eve" D( NOT WRITE IN THIS SPACE 7-13-g3TT7e5,T'''je, Type of room No. 10. Multi family 0 / 2/0d •00 17/3/93 11. Commercial ❑ Kitchen 12. Other ❑ c S cry Dining Rm. 13. No. of stories . ao-e )4e P Living Rm. 14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 a7 �` "fret., Bed Rm. 15. Materials — Wood 0 Cement 0 Other 0 Deck 9-3S ". . 16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch 17. Garage — 1 ❑ 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. //1/e 90 LOT RELEASED BY , Signature t beA, t One/ PLANNING BOARD Address a r A ndi6pA a2 Date '/pt navr; z T /W Off DS 17*3 �'Mv.wa•- APPLICANT: An sr j BUILDING PERMIT i': 4 ADDRESS: 27 . JANJ 171 TELE. NO. : Nil. a[))rDATE FILED: BLDG. SITE LOCATION: rq,nn t MAP /: JO LOU: 7 f ^ y 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 COI,DIERCIAL 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 LIFE 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 II ' Ah ,„9 DATE: 2 - 13 N/A: 2. ENGINEERING DEP tTMEN' . - DATE: N/A: 1,Z CONSERVATION: Ia I, DATE: 3 N/A: 4. HEALTH DEPARTM: 'f tin/10 • _ DATE: \ 7�M N/A: INDUSTRIAL 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: , .C '-_ -c , . • ,a', -� 1 ^�.✓ I�)d—,gin_ A4c'_T=.R- err AIITcr 14e -, - d--. F, `-. is 1G cm .- -.Kvc • BLM/89 94,4„, s f I „ it " - • _ COMMONWEALTH OF MASSACHUSETTS -__st�' DEPARTMENT OF INDUSTRIAL ACCIDENTS t -‘C(11 11 600 WASHINGTON STREET James J Camooei: BOSTON, MASSACHUSETTS 02111 . r...ommrss,oner WORKERS' COMPENSATION INSURANCE AFFIDAVIT • 1, rt./eh /% AL,Fsen/ (licensee/permittee) • with a principal place of business/residence an a8' aAAdel 17,1 Rd nievaar'h PonI JintS oOG745- (dry/sum/Zip) J"( ry/Sum/Zip) do hereby certify, under the pains and penalties of perjury,that: [] I am an employer providing the following workers' compensation coverage for my employees working on this job. • Insurance Company Policy Number • am a sole proprietor and have no one working for me. [ ] I am a(-soa proprietor general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance policies. ------...•-••• • • ••- :It ,(/0 NL Name of Contractor _ Insurance Company/Policy Number . .._ .. . it Name of Contractor - Insurance Company/Policy Number . •. It • Name of Contractor Insurance Company/Policy Number - 0 I am a homeowner performing all the work myself. NOTE:.Pleue be aware that while homeowners who employ persons to do maintenance,construction or repair warts on a dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not gnerally considered to be employers under the Workers' Compensation Act(GL C. 152.sect. 1(5)),application by a homeowner fora license or permit may evidence the legal sums of an employer under the Workers' Compensation Act. I understand that a copy of this statement will be forwarded to the Department of Industrial Accidents'Office of Insurance fornverage verification and that failure to;enure coverage as required under Section 25A'of.MGL 152 can lead to the imposition of crimiJ penalties consisting of a fine of up to $1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Oder and a fine of S100.00 a day/against me.p Signed thist, {� n /� ��/Yyrt day of ?r//3 ) 19 9Y Lice s:eiPcrmin.. LicensoriPermittor ' i I sFq . Galt 6F iicti • • ` 4 A • io.57b 5,F. N \• a, 3 A 72.5±, • rn ; t a7y ��� : o M � p � �� i ;3 4 t . 0 hl +`n n1 O ,4„ 6 ,, y N A DV 7 _ N Tc • p T a \-k "as `� a ti Q . , a I 'Su a "7.040 vn ►,% a . x• '9 7-A � pt. M C • 8•A 1-- } % . r; PREPARED FOR THOMAS POWERS1 CERTIFIED PLOT PLAN Toy OP Fauvo, 'S • 4. 5 • ii ABOVE- HIGH PT. IL) echo, LOCATION. YARMOUTH, MASS. @ EL, io . 23 • SCALE ►•x`40 DATE AP2..•' •(1187 REFERENCE: LOT 4•AF V 1 + 1 1 1 ,.( db�` - - 3 1 - - .4 Seitc 61 b\ A 1` /it vv, . . 6e, iv x /7 I.Ank I roI, 0 3e'T°nio — — — — --$ P/F u ox . 1 p — Ilt<wArer McTet rrir Pec K I . \ -3/1 ' --), { f Tera=t, LOT NO. : z1-4 ADDRESS:l-e-@v-1}-Beteh-Road OWNERS NAME: Radio City Ocean Club SEWAGE PERMIT NO. : 87-43 NEW: X REPAIR: DATE ISSUED: 2/26/87 DATE INSTALLED: 4/17/87 INSTALLERS NAME: Ger-Dan. Inc. INSTALLATION OF: Tit1P 5 WATER TABLE: FINAL INSPECTION BY: DRAWING OF INSTALLATION ON REVERSE SIDE: X 41 ti Ln 1 /Fir LP 74,E za .. :ac!-A:fr.'9::',7"':-•`.i.-a::7-,7 t'd:6cYi: ...-: r. ::.:_ .+;.,i...t< :-;ir.r4 71-1.4•••••••:.;;;7,7:.,-..:r 1 5;114 ,i .4 at: 2.` 9-I,. +f ..1 1-..k vT. 1�+ r' I %' :. • at i ,.f ,J yu. • r ! 'iii ..i .Ii •:, • I �;1 I a�F , ifl 'r t'w'• C. t1y. ti tit If1kST*- V�4S• Mat , ,,; 4 - 4 :..i .,..„,....,....2.,,.,... SERVICE NO. IIF.:.t:�-'.7�.:-'v)fs;�atn',:L''i*f,:' :?, 330 k'.i-r.',;,t':'ti+i'°i,1eiVl�ri rSY,i,^lti.,- NAME / Russell D Wright ,la' ;:,iVin,;,7,11. :';ry`,;y 2-18- 2 • aty i; •�� STREET / .:'.r,` .;�,, • • 77 N9CL�� Pic. O !4� n.`_��s VILLAGE r� Pad((U t' /J('t• •:.f� a'J•`.�•.I'• _ SLC . 1,;..,I.-.‘i j',o'.t.I:i�' �!'•'i: METER NO. D Q 'Ta e. ie.. 0 7c � •Ci95 '6 ., • , e '--- �J.edi 9 Li// 41 Attu .A eel ,• •:, Si• ciA, v.S bv d 2 /1 — -- - —�