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Home My WebLink AboutBLD-93-623 4a 77 Ala TOWN OF YARMOUTH oKrea c'/t7/93 HATTACHCES t4.....,,,g.- Application for a Permit to Build No. 6073 UPON FINAL APPROVAL MAP Ia- . LOT g -3 FEE MUST ACCOMPANY THIS APPLICATION. DATE t^ 19 73 The undersigned hereby applies for a permit to build 'y A9 `/i according to the following specifications // � ?ivy 1. Name of property owner aZiolin ecohc'.,d& Tel,77s t70,7 Address /7 Co/an-01J "At,' w, yetnfrguen /rim• 2.Name of Architect(if any) //g- Tel. a Name of builder r/n7A�T1s/ Address /s 7?r3/.ffer v % ‘9109f e 4. License No. O '(2-J y Tei. 7/77-37C 5. Name of Mason CA"- Address 6. License No. /V-9- Tel. 7. Construction address /9 COnimfie1 09-fr A , yme-fi 71 .aa District 8. Date of subdivision Approval plain zone e^ et a Zone -►zS 9. Private dwelling Ere Estimated Cost eipe ' O NOT WRITE IN THIS SPACE 10. Multi family 0 ' /O6O< ',. S 43 Pte. °' re.``7i_ xpe of room No. fi To �'�� Wei 47-3.:Ric? et.. hie_plr t 2 1 11. Commercial 0 /D 'crO Kitchen ergs//'J /or") 7--,0 clap 12. Other 0 0e0-4Dining Rm. Living Rm. 13. No. of stories 3 se,0-0 14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 a 0-0 .1),c a Bed BathRm. 15. Materials - Wood ® Cement 0 Other 0SE---Cr13 9/4L Deck 16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch 17. Garage — 1 0 2 ❑ Family Am. 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. E. No. /0143'Y �2 �i4� /� LOT RELEASED BY Signature PLANNING BOARD Address /C 7&,sser -Pi- Date /1-7,52#475 mom- OyCyy y77 -77i r d /l°13 a j "-APPLICANT: 7%;;;;074,/ 6jgy BUILDING PERMIT #: ADDRESS: IS T0/O/.rvc/ J7 ,n.'SeP TELE. NO. : r/77-J71y DATE FILED: 611-7-Z7 BLDG. SITE LOCATION: /J' c4A/Af Wr54wv4.1IIAP1/: • LOU: 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: (2: CONSERVATION: B DATE: -&-^/S -g3 N/A: 4. HEALTH DEPARTMENT ( /) , DATE: !lej/el N/A: INDJS`TRInL 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. �J COMMENTS: JUDO / (Ake, � TF/1 4.7 / Tr £z/t 5;39C./N&47-rt vr9-,Z ,fig--At a /gym-it c .Z 6 " • a A BLM/89 /9 3 OP-. • _ 1 , FOR LOT rl Indicate lccatcn cf garage or accessory building - Additions with dashed lines - Sewerage disposal (cesspool) a Well 0 (lot ft. rear) I 4buttor's I a Abutter's Vame I Name} Lot # I Lot # �� REAR YARD =f this isa �v If this is crner lot. 1 ft. corner 1.c4to in name write in Lf street. • I name .of I - cther u S u sr_eet. • U T r • v SIDE YARD ya SIDE YARD G�Ocs'_o NOISc . a _ !�z _ I I SET BACK JJ O I C I ( et e L—ontace) • - • \ / CO/m/f41 9V G✓. Yarn,ia \ / \ / (NAME Or STREET) \ / - i r- \ e- / / \ / — • TOWN OF YARMOUTH • • ' • - • BUILDING DEPARTMENT - - '.... ,_:...CONSTRUCTION SUPERVISOR FORM .. PLEASE PRINT: q. JOB LOCATION: // . GOAI/Wi.) • 44> t)e) Vah/yie€6/‘ /s;,k. • OWNER OF PROPERTY NUMBER Jo/clr!%L / r�res-ho STREET VILLAGE • CONSTRUCTION SUPERVISOR: Ts;;orly• 4I-A1• ' 0% ZJY • yJ7--3�1y . NAME LICENSE NO. . PHONE NO. • . . • . • 7?, Z'ijPr' 9i'. ADDRESS: /1 ,nt- 'e9 . ,%..o- . 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 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 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 AMENDED, SHALL BE 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 DEIOLITION AS REGULATED BY SECTION 109.1.: OF THE CODE AND THESE RULES AND REGULATIONS. IN THE EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISING SAID PERSONS, THE WORK SHALL I:L*tEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTED ON THE RECORDS OF THE BUILDING DEPART`ENT. . I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND REGULATIONS \FOR LICENSING CCI- 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 currentJiability insurance pclicy or its substantial equivalent which meets the requirements of MGLth.152 Yes 2J . No ❑ It you have checked yes, please indicate the type cwerage by checking the apprcpriate box. • A liability insurance pc:icy �. O:her type of :.ndemnity❑ Bond ❑ . OWNEp'S INSURANCE WAIVER: I am aware that the licensee does rot have the insurance coverage required by Chapterlg2 of the lass: General Laws, ano that my signature cn th:s permit application waives this requirement • Check one: • ' ' Owner0 Agent (,;J..---- Sig cure or Owner r Owners age • SIGNATURE: BUILDING OFFICIAL APPROVAL: , • 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 e.142A requires that the"reconstruction,alteration.renovation.repair.modernization.conversion.inprovement,removal.demolition. or construction Man addition to any pre-existing owner-occupied building containing at 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: /tit, STet/rl %'roti ,o923rn,6:Vaiew9 Est. Cost/Odd Address of Work 47 C4' A',OgJ • Owner Name: rr/!/A rein J I Date of Permit Application: cP 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 ofthe owner: Date Cont ctor Name Registration No. OR: • Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name • • • 'I v tV : y` Ar 7v• 7is"Mrfra-,., v k 4 . 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