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HomeMy WebLinkAboutBLD-19-594 F•YA RECEIVED t office Use Only z R I2 —/3-cn) 59 0 3 ' ! AUG 22 2018 O _ 1 !g � �Amount ���:. ""Y"s c��' �' \ Permit expires 180 days from -- - .4 .. BUJ T. F Parn'TME Aye ] issue date av: """ffV// EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 CONSTRUCTION ADDRESS: 1 '15 KoLra, a $ Z-14.1- Jost � ..t2tL ASSESSOR'S INFORMATION: Map: 60 Parceia'7o OWNER IowAD V YO.Ait ► - t NAME `, , �\-1,, ,PRESENT . I PRESS /� {� L1 TEL. # `y/ CONTRACTOR: yftkielOU�-h &CLC a0t GADSLd.13tO Y &X '+ 't S'! DRESS TEL# ❑Residential 0 Commercial+ cEst Cost of Construction S A.VHome Improvement Contractor Lie.# II- Construction Supervisor Lie.# Workman's Compensation Insurance: (check one) 0 I am the homeownere0 I am the sole proprietor ❑ I have Worker's Compensation Insurance Insurance Company Name: l..0vQlrrLre tt%C1 . Worker's Comp.Policy# V/'/,y OCA-' ` '1.g aol g WORK TO BE PERFORMEDC.) aa' X 40 ' t �/ Tent Duration 3 (Fire Retardant Certificate attached?) aO SeRA e Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares ( )Remove existing (max.2 layers) Insulation Old Kings Highway/Histori/c�Dist ( )Replacing like for like Pool fencing 'The debris will be disposed of at /J�'("f . Location of Facility I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause or r ation�1f my license and for prosecution under M.G.L.Ch.268,Section I. Applicant's Signa e: • Date: 4/5/ QQQ Owners Signature(or attachment) Date: Approved By: 23 / Date: ) -3 l lk Building O -tial(or de ' EMAIL ADDRESS: Qrho ceAS;IR r- .[i-jvj _/) cam e:Lk '- cent Zoning Diss ' �a '�`� �-✓ Historical District 0 Yes s gar Flood Plain Zone: ❑ Yes gi110 Water Resource Protection District: Within 100 ft of Wetlaann s: ' 0 Yes §,-No 0 Yes no • .f^ tee Web Services . Page 2 oft Pr • s._r! zer'"'Zsi. xb'a" ' � w.y� 5 , ..,"c"snyi'��ta g ., -33 .-.,.a.t ...z-t ?1•+u�:. '3"2$tnu� -4;^•� k+ .-e..5c. _y _ a:er � - Part: 3 • �Y c�—R�v 5..-,t‘_— ..0.,r'..... k '--z—s 3 t 1/2:717- 4 -.. •-. -3- 'te e ' .r a .c �rR•.-. ''2.. ��..�s =vim ,r% 1 r > ,tea- * . - a r' +' - -+ '$ :-t ..,. tea- `_ r _ -, --r--. -.- sic- -.. 11:. _ A°-;- .- �' ` c= _ - a Y Tt -m_ -at _- My6'3'.z-a'+A ^i31._ - _ .. ._ - _ - -mac' V4 `� � -,-aa-a._ -- '.i -`jF OM1_ Sv—gni z' yam. a� - a �r'�+"'sr' �. � 4'_ S 3_ CXR�,... . L a _�"T+� '� _� - cam' c �'y '` _ ---„not. s4s+ � # - ' '` gr-soh Reply- . P.epiii ly'Al�':_I.ypiwaI [ Show Full Headers ] Copyright© unno.com(TM)All Rights Reserved.Terms of Service. privacy Policy. a. • i' //' o mail everyone.net/email/scripts/view.PVEV1=999172950598445 8/30/2001 : http:// - - —