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Home My WebLink AboutBLD-93-722 =of 3/4/tAC K Fe° ..A's „ � , TOWN OF YARMOUTH q f jJgi cs;:c. W ' Application ter a Permit to Build No. 7aa q/a 3f93 nn UPON FINAL APPROVAL MAP al LOT !�� FEE MUST ACCOMPANY THIS APPLICATION. DATE 5/ t' 197-3 The undersigned hereby applies for a permit to build 9//3,/Fa according to the following specifications 1. Name of property owner it_tt-it.; /9- f i I,' 4 Tel. Address '-z%-n-&'Y / / '• • ameofArchitect(ifany) D Tel. Al3. N �'w ame of builder NeAA'r & Il eesou rt es iuo Address 9.5gA A9)11 2/ • MAfsXf ie)a 4. License No. 0 ya3as Tel. 617"R3ti-75D 9 5. Name of Mason Address 6. License No. Tel. /�_ 7. Construction address Flood �la J istri 8. Date of subdivision Approval plain zone Zone %" - 9. Private dwelling 0' ''''' stimated Cost `t; O NOT W IT IN THIS SPACE 10. Multi family . ❑ `cS 700 770,33 � ype of room No. '11. Commercial 0 i i r . i Ea � , 11 Kitchen 12. Other 0 �7 /r'O / 0� 5 Dining Rm. 13. No. of stories M- (� t Living Rm. Bed Rm. '14. Foundation — Full ❑ 'Half.El-.Crawl ,=Slab.6:t1 Bath / 15. Materials — Wood 0 Cement 0 Other 0 Deck 16. Type of heat — Oil 0 Gas 0 Electric 0 Other 036'CrD Closed porch Family Rm. 17. Garage — 1 0 2 ❑ - Sun room 18. Swimming pool - Size t ." --- , y •It>,; , Garage 9 19. Storage shed — Size Shed 20. Stove - Wood 0 Coal ❑ . , ,y 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 • 2Arte PLANNING BOARD / Add ss ))r Date ,pp BUILDING PERMIT APPLICATION SIGN OFF APPLICANT: (VeAieWfl7'PRReSDureeS BUILDING PERMIT 1/: ADDRESS: M P/Ain Si-. (/)n ROAfie)0) m4 • TELE. NO. : 607-934/-45R5-- DATE FILED: 9/ 53 ACRoSS -f'Ro/\\ 6% Ni9&n.s BLDG. SITE LOCATION: CROwef } Rd 5-Mti A) X20 MAPA: 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 4'0,A..d_ (T. ( L r DATE: -4.3. -ov -s N/A: '2. ENGINEERING DEPARTMENT: t DATE: N/A: 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT ; u,( 6_4_4_. DATE: 9 /23 4,3 N/A: INDUSTRIAL AND/OR COMMERCIAL PERMITS . 5. WIRING INSPECTOR: / / DATE: --23--9' N/A: 6. PLUMBING INSPECTOR:711c (/7�` s DATE: , 3 N/A: 7. FIRE DEPARTMENT: / f 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: IANA--rI) __ (mi.) .-ten , — -pc> . Tl'Ait ,71E4L-77-/. t-b47*skE ill-F1' '°' � ► - S/ s . - PP l b!/-Ere c ,s Ccx/77tcr— 17P . So A. r� CA-->/14Cap,-imrll '/'cg/07e:C7 od6'WC Ste,- Buil 89 t,tirBLM/89 • TOWN OF YARMOUTH BUILDING DEPARTMENT • CONSTRUCTION SUPERVISOR FORM ' ' PLEASE PRINT: ' CorrlgioA Cdn1 CROl Fneil;fy 9c7-37, _�`Ross.. fR°" 5% • Hig9iP CRowe I R - A , S't • • JOB LOCATION: Rt I ON 9.0 • NUMBER . STREET . VILLAGE ' OWNER OF PROPERTY: ' 10W h • l`TI •• '9Malou.kK CONSTRUCTION SUPERVISOR )6.1„N. �? RYA 3• ' •• 668" 97PL•7l(?) • NAME . . LICENSE NO. PHONE NO. • . • ADDRESS: S;)6 fkiln 211 MArSk-Fie h MAa. - �[ LICENSED DESIGNEE: j\ pJ P p f PJ Q / 0Q6-- (IF OTHER.THAN SUPERVISOR) NA. 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 ' COteiONWEALTH, 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 DEMOLITION 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 IMMEDIATELY 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 .ICENSING CC:I• 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 cavae, liability insurance pclicy or its substantial equivalent which meets the requirements of MGLth.152 Yes 4• . :: No ❑ If you have checked Is please indicate the type e:verage by checking the ap-rcpriate bei. •-....:•:,.;:;:.(••:-;" " A liability insurance pcliey Other type of :.:demnity 0 •••• Bond '1 ••••• -- OWNER'S INSURANCE WAIVER I am aware that the rcensee dcti not have the insurance coverage requires tv Chaprer152 of the Mass: General Lws. ane that my signature on ms permit clic:tics waives this requirement • - . • • Check one: • Owner° Agent 0 • Signature at Omer a Owlets Agent • SIGNATURE: • . BUILDING OFFICIAL APPROVAL: PLOT PLAN • ' " FOR LOT () 11 (3T a0 • Indicate location of garage or accessory building Additions with dashed lines Sewerage disposal (cesspool) Well 0 • I • I (lot ft. rear) Abuttor's I Abu Name INam Lot n • I • Lot REAR YARD If this is a • If t corner lot, ft. • corn write in name wri of street. '‘.. I nam 4- �, • othe o sire '0 .—r.--",,,,,i; z_ ' SIDE YARD SIDE YARD • 0 FT. 0 . • 0 FT.0, 0 • ' ^' . SET BACK • . .c .ft. JJ I I . cp (lot ft. frontage) .• • \ / ///i G 6/hs C.-/10 1.0 e// ?0,90/\ / \ / (NAME OF STREET) \ / / Informed b C/07?2,/k/19/ seye reers / \ Supplied by