HomeMy WebLinkAboutBLD-93-690 of( /al WLc4
'qF Igict A "41 r 4-TOWl4 OF YARMOUTH at` EEtJ V1C/93
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- ,,* .*fl.% Application for a Permit to Build No. O9d` '
UPON FINAL APPROVAL / -/3_ 3 MAP t•{V LOT L /
FEE MUST ACCOMPANY THIS APPLICATION. DATE 0/.> 5- 19 9'3
The undersigned hereby applies for a permit to build V/3193
according to the following specifications 9/,3/q 3
1. Name of property owner Aloo�w�r7 ) •7y0�'//1(C-C1 Tel.240-0,9_.97
Address , - - er r
r
2.Name of Architect(if any) Tel.
3. Name of builder Annrrer', P ,a n' c- Lt Address:i5- Sk en;/, s P/. Serarwwr
4. License No. tO/'/,37/ Tel. 71- . 2 2
5. Name of Mason Address
6. License No. Tel.
7. Construction address /qo rO/r✓RaoII 57`- S, �/urviz mtit.
Flood �/ District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling O. Estimated Cost DO NOT WRITE IN THIS SPACE
10. Multi family 0 /51.0 ^ /'�( ,'ya-' " Type of room No.
11. Commercial 0 dvn i'.ete P;tee1''0)4- &„_� Kitchen
ore/ /fes 2,ii 9t . 5• rr,� An DiningRm.
12. Other ❑ ��il«... /d x 3r/
13. No. of stories ,c.4v��L �tr`z- `S' ty Sg %i Living Rm. L
Bed Rm.
14. Foundation — Full [21 Half 0 Crawl 0 Slab 0 Bath
15. Materials — Wood 0 Cement.® Other 0 9�/O Deck
16. Type of heat — Oil 0 Gas 0 Electric,�J Other L- �s Closed porch
17. Garage — 1 ❑ 2 ❑ Op ._ 0252 da Family Rm.
Sun room
18. Swimming pool - Size /S (9/ rico Garage
19. Storage shed — Size Shed
20. Stove — Wood 0 Coal 0 Alterations
/
21. Size of lot: No. of feet front /00 .s No. of feet rear /O 2 No. of feet deep 7> 3
i
22. Size of building. No. of feet front go No.of feet side at/ No. of feet rear /6
23. Distance from nearest building: Front �-c' Ft. side )6 Ft. side )00 Rear 4C-29 0
24. Distance back from line or street / 0 From rear lot line / VT Side line G o
25. H.I.C.R. No. //���
LOT RELEASED BY Signature amaePi7,) f.. sire« •
PLANNING BOARD Address 9 5- S ft-c> et do ,-/
Date g/9.' c�ev r nje,re.7-4 7. I ,r era,€
TOWN OF YAMOUTU
' BUILDING DEPARTMENT
' ' HOMEOWNER LICENSE E aITION
PLEASE PRINT:
DATE 3)J c/4 -
JOB LOCATION /947 ry]ey ,ry Sy , So u fLf Ifdu, ou 9.4
NUMBER STREET ADDRESS SECTION OF;TOWN
"HOMEOWNER" 444reLe.) ) rervia LL:
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADRESS a g 510 pr✓rin Ed•
�(// CITY 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 WIIO 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 WHICH HE/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 WH0 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/SHE 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.
TUE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH
BUILDING DEPARTMENT MINIMIM INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE
WILL COMPLY WITH SAID PROCEDURES AND REQUI' aI TS.
HOMEOWNER'S SIGNATURE (lte ece-v.) /l' t.�c
ac
APPROVAL OF BUILDING OFFICIAL V
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 COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes ❑ No
If you have checked ves, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy 0 Other type cf indemnity 0 Bond 0
•
OWNER'S INSURANCE WAIVER: I am aware that the licensee does nct have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature cn this permit application waives this requirement.
r
owner ene:/ x ate-ceD / Leta
Agent ❑
Signarxe of OFner or
a
Suggested Affidavit for Home Improvement Contractor Permit Application
For omce use Only • NAME OF CITY/TOWN
Permit Na (/dt+.✓—nLc,O it 74 if
Date /
• Al•1-1DAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c.142A requires that the"reconstruction,alteration,renovation.repair,modernization,conversion,inprovement,removal,demolition.
or construction of an addition to any pre-existing owner-occupied budding contain ine 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: Psouit /,o}l P /yf fie,i>R ��/bArg Est. Cost )Sao, "
Address of Work )70 0/cl nice ,14 Sy-, Cn, rill nc{frk
•
Owner Name: /Ind,lely, ?o'er, 1v,r' Lt_
Date of Permit Application: V2-g-/9 ?
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law
_Job under 51,000
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 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:
cr/a./p 3 41:11iQr.Og •,r-C/Clcj
Date Ownc a