HomeMy WebLinkAboutBLD-93-664 of;Yq _.. Soh
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s; vr. 11,0'. TOWN OF YARMOUTHr esti 9s
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etZ D g.- Applica -on for a Permit to Build No. e 7
UPON FINAL APPROVAL P 2 -Q, \MAP 33 LOT /4/
FEE MUST ACCOMPANY THIS APPLICATION. 'NDATE�/,d-/'l 19 53
The undersigned hereby applies for a permit to build 7/a//f3
according to the following specifications p)/ //93
1. Name of property owner 1 i1Gt0 rJ C • blah 14 /C"- Tel. 7 7&-Va 97
\ Address Ti fra>4.P (Afai7 Po/. w- !a i • (rig . 0,403
2.Name of Architect(if any) Tel.
3. Name of builder P n t Rbt92_ Woor. dad ddress .So 'he n vi i A , AN o26Gp
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
7. Construction address 41 NAA,rdd-t l)a. &`1, Pd . 1d lr-vc . � . U2( 7 3
Hood ..7._j-
9.
ict
8. Date of subdivision Approval plain zone G Zone
9. Private dwelling 0 Estimated Cost "W P DO NOT WRITE IN THIS SPACE
8-°271a
a ' ' Type of room No.
10. Multi family 0 g) 0 .00 /6 D a�/
• 11. Commercial ❑,�/p��p� � .A1C> s q-�� 04 14) Kitchen
12. Other ❑4M-A-sitAt ., j c�'`� Dining Rm.
✓�L:.-tAg OW Living Am.
13. No. of stories a0 .� Bed Am.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 _ /D - Crt)PGP Bath
15. Materials — Wood 0 Cement 0 Other 0 , v o age Deck
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
N 19. Storage shed — Size g X Shed rt? /
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.
LOT RELEASED BY \Signature J.r J. C 1/�C AL«-b._-
PLANNING BOARD \Address I7 ASA i0i v ( fl'7 Pet
Date -20. ya.r( . A . o2(, v
.BUILDING PERMIT APPLICATION SIGN OFF
\APPLICANT: QhOIIOA C • JCxl�l�ufic, BUILDING PERMIT //:
\ADDRESS:41 aAZ,(v Cia.j ?of TELE. NO. :'77Wa°(7 DATE FILED: a=a7-�j
\BLDG. SITE LOCATION: w-lQa O7(,13 MAPil: 33 Lou: 2 vi
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 TUE REQUIRED BUILDING PERMIT:
REVIEWED BY:
1. WATER DEPARTMENT DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: - N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT DATE: N/A:
INDUSTRIAL AND/OR COMMERCIAL PERMITS
5. WIRING INSPECTOR: DATE: N/A:
6. 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. ,may/ r„^ ,I�4/ c-S'+ •
CO`LMENTS: ,32-2& )$t i�GKS C >Ha /WV S r 3c s aiv
0 1 1-'4.4 .�2)Ce
ja.ey
BLM/89
PLOT PLAN
I
l �
• -~. FOR LOT I( ) + '
• Indicate location of garage or accessory building
Additions with dashed lines .
Sewerage disposal (cesspool) e _
Well i
•
(lot ft. rear) I ,
Abuttor's I Abut
Name - I Name
u
Lot n • - _ I • Lot n
REAR YARD
If this is a • If th
corner lot, w� l ft. corn
write in name �� writ
•
of seet. • 41• - _ I name
tr •
,; a ..othe
o
'Q 40- o stye
ov
W2 SIDE YARD HOUSE SIDE - YA C'J'
C f� FT. 0, • . Vic . .._ 4 T# >
Nr•
•
ra
•
So I aofy'o 1
SSET BACK ,-
• H
J . . .`i.f.ft. I vier
4J
' •.
C. 1
•
p.
(lot ft. frontage)
'
•
\, / \ Li leArlIYIA ? UA /I-c Li 'R01 . .
l/ (NAME OF STREET)
/ \ •Information CR1�1Ct C• VOA '
/ \Supplied by �� �
/ 1
•
•
FILE ��c.5avo CENSUS TRACT # wR�
CLIENT: Attorney Lester J. Murphy DEED BOOK 4150 PAGE 132
' . OWNER : ,ally V. Silver hutler,_ Pru,tee PLAN BOOK PAGE LOT
APPLICANT : urchard C. & MarlIne M. Nahkala ASSESSORS PLAN PLOT
•
•
MORTGAGE INSPECTION PLAN OF LAND
YARMOUIH •
MAY 24. 1985
SCALE : 111= 60' , •
I !,
•
•
1 1`�I {
• 13
•
• LOT 14
/20,344�s . F . ,
j V
•
Q M
147 .
V A.l 1 STORY
•
SHOD .
,I 41 Q
•
161 , 84 '
•
P A R` -1111 I-D G E yIA 'LJL EDIY CO ,A •
•
•
•
•
•
•
I CERTIFY TO ATTORNEY LESTER J . MURPHY, BANK OF BOSTON AND ITS TITLE ;
INSURANCE COMPANY , THAT THERE ARE NO VISIBLE ENCROACHMENTS, OR EASEMENTS 1
EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION, a
fi
THE LOCATION OF THE DWELLING AS SHOWN HEREON '
IS IN COMPLIANCE WITH THE LOCAL APPLICABLE • �p`�NOf NUJ4
ZONING BY-LAWS WITH RESPECT TO HORIZONTAL ' KENNETH � \
DIMENSIONAL REQUIREMENTS. r/i P.
• ig FERREIRA
2811e.
THE DWELLING SHOWN HERE DOES NOT FALL WITHIN WITHIN �g�
TOWN OF YAMOUTII • R:.
. . 0. BUILDING DEPARTMENT 'i
. - HOMEOWNER LICENSE EXEMPTION r
. a.
PLEASE PRINT: i
DATE ?^ al-5 3
\JOB LOCATION Li' ( �A2c(•l d sje Ua11 p4 ea .. ' ,C• la . Deli • O? 73
NUMBER SIRE T ADDRESS SECTION OF,TOWN I
"HOMEOINERS Qt\ct,id e• IvJYC,_ `77NJ-9 7 -7 90 /`1 7 .1
NAME HOME PHONE
/ ,/ WORK PHONE .
\PRESENT MAILING ADRESS CM ( �cca J�(Lt7 p
•
cryo � , oZC73 •
CITYTTY OR oR TOWN STATE ZIP CODE +.
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER-OCCUPIED
DWELLINGS OF SIX UNITS OR LESS AND TO ALLOW SUCH HOMEOWNERS TO ENGAGE AN IN- .
DIVIDUAL FOR HIRE W110 DOES NOT POSSESS A LICENSE, PROVIDED THAT THE OWNER
ACTS AS SUPERVISOR. (STATE BUILDING CODE SECTION 109.1.1)
DEFINITION OF HOMEOWNER:
PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICHIHE/SHE RESIDES OR INTENDS TO RE-
SIDE, ON WHICH THERE IS, OR IS INTENDED TO BE A ONE TO SIX FAMILY DWELLING,
ATTACHED OR DETACHED STRUCTURES ACCESSORY TO SUCH USE AND/OR FARM STRUCTURES.
A PERSON WHO CONSTRUCTS MORE THAN ONE HOME IN A TWO-YEAR PERIOD SHALL NOT BE
CONSIDERED A HOMEOWNER. SUCH "HOMEOWNER" SHALL SUBMIT TO THE BUILDING OFFICIAL,
ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT HE/SAE SHALL BE RESPONSIBLE
FOR ALL SUCH WORK PERFORMED UNDER THE BUILDING PERMIT. (SECTION 109.1.1)
•
THE UNDERSIGNED "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE STATE
BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGULATIONS.
TLE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH - ••
BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIRE.ME•NTS AND THAT HE/SHE "
WILL COMPLY WITH SAID PROCEDURES AND RE
QUIREMENTS.
()
HOMEOWNER'S SIGNATURE ���. G 1' `a.1Jc.0-L-
APPROVAL OF BUILDING OFFICIAL
NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED
TO COMPLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION CONTROL. ,
INSURANCE COVER".G_:
I have a current liability insurance policy cr its substantial equr`✓a!ent which meets the requirements of MGL Ch. 142.
\ Yes ,i No 0
If you have checked vas please indicate the type coverage by checking the appropriate box.
f
A liibi! y Insurance policy I J Other type cf indemnity 0 Ecnd 0 1
5
OWNER'S INSURANCE Y :IVER: I am aware that the licensee does have the insuranceca ice required hy
Chapter 142 Cf ,. . :aro General Laws. and that raj signature cn this permit application waives requirement.
-. /� n C•eek Cne:
L! a e c: L ► l " JC.�C Owner, Ae: t IT
Suggested Affidavit for Home Improvement Contractor Permit Application
For Office Use Only NAME OF CITY/TOWN
Permit No.
Dal
AFFIDAVIT
Home Improvement Contractor Law
• Supplement to Permit Application •
MGL c.142A requires that the"reconstruct ion.alteration,renovation.reoa ir.modernization.conversion,inprovement.removal.demolition.
or construction of an addition to any pre-existing owneroccumed buddingcontaining-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 aceptions,along with other
rtqutrement_s.
\ Type of Work: S.)'\ GC, /� (� Est. colTh DOD . • -
- \ Address of Work4r1 Do 'VA R C)aQAalshh1 �Cd • •-Ot4 , • pain3
t Owner Name:R\7.kn4rA C �1akV JDG—
Date of Permit Application: tr' a-1—%'3
I hereby certify that:
•
Registration is not required for the following rcason(s):
Work excluded by law
_Job under $1,000
Building ngt owncr•occupicd
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 of the owner:
Date Contractor Name Registration No.
OR: •
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property:
On ncr Name
t
1
•
! - .`� COMMONWEALTH OF MASSACHUSETTS
• a 2:„
o
DEP'ARTMEN'T OF INDUSTRIAL ACCIDENTS
�. 600 WASHINGTON STREET
James J CanineBOSTON, MASSACHUSETTS 02111 • ,
Gomm:ss,oner WORKERS' COMPENSATION INSURANCE AFFIDAVIT • '
\ I, 1 i . C • ' g _
(licensee/perminec)
• with a principal place of business/residence at:
•
\(4'\ fa2 A'dsa ( )oi 0Q1All Rd . etc) Hoyt . - 02 (-,-.7'3
(City/State/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
le lir Ai-, (4..9)4 !A t:.2..1,• •
[ ] I am a sole proprietor and have no one working for me. ,
( lam a sole proprietor, general contractor o omeowner circle one) and have hired the contractors listed below
who have the following workers' compensation insu . - policies: . • • • -••• _ • •••
Name of Contractor . Insurance Company/Policy Number . .
Name of Contractor Insurance Company/Policy Number •
/
Name of Contractor • Insurance Company/Policy Number
LLYram a homeowner performing all the work myself.
NOTE:..Pieasc be aware that while homeowners who employ persons to do maintenance.construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not Generally
considered to be employers under the Woricrs• Compensation Act(CL C. 152,sect. 1(5)). application by a homeowner for a license•
or permit may evidence the legal status of an employer under the Workers' Compensation Act.
a
I undc^;and that a copy of this statement will be forwarded to the Department of Industrial Acddena'Office of Insurance for coverage
verification and that failure to;enure coverage as rcouired under Section 25A'of MM.152 can lead to the impoiition of aiminal penalties
consisting of a fine of up to 51500.00 and/or imprisonment of up to one year and d.v penalties in the form of a Stop 'Work Order and a
fine of 5100.00 a day against me.
Sicned this •-- day of , 19 1
L I'.- ;:c•- wM 1'40I ••vw.:w Aly Lic.,So:;PermlrzJr ,