HomeMy WebLinkAboutBLD-93-772 ^- G'`?o TOWN OF YARMOUTH etc F '
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V, ..no• 6 /.% Application for a Permit to Build No.
UPON FINAL APPROVAL / MAP Ili-I .5 /Oct LOT '-�
FEE MUST ACCOMPANY THIS APPLICATION. DATE /07/0--'291l3
The undersigned hereby applies for a permit to build /y/ -'.3 .
ac rding to the following specific ions • /9
1. Name of propertyy,,66wner //An!C_/ 1. ' nY) l� // T Rea I7
Ldddress ”/ We,T rinnivh led- / p''"i-
2.Name of Architect(if any) / Tel.
3. Name of builder c'che 115 19bavf Address
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel. �r
L'CConstruction address 91/ �5T V JI
m lo'd led (4at+-
Flood / District
8. Date of subdivision Approval plain zone C Zone R.A.q
o
9. Private dwelling Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 pa.
cra
ea woos • c**&E/w Fi uC��vat / - 1 a- ct hl
11. Commercial ❑ d - - moo/ Kitchen
12. Other 0 ChiliiDining
°/Q Living Rm.
13. No. of stories Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 Bath
15. Materials — Wood 0 Cement 0 Other 0 Deck
16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch
Family Rm.
17. Garage — 1 0 2 0 Sun room
18. Swimming pool - Size Garage
19. Storage shed — Size Shed
20. Stove — Wood 0 Coal El' 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 Fro rear lot line Side line
25. H.I.C.R. No. 7 �yC]� �
LOT RELEASED BY Sign/time �(lfAtc
PLANNING BOARD ../Address ✓ 9g/ ,IIT eittri o Pi id-
Date yip(itrtO.c Pi It 1- {'Y/4-
PLOT PLAN
't
.J •
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• FOR LOT # . '
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) ® •
, Well
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(lot ft. rear)
Abuttor's I Abul
Name I Name
Lot # ' I • Lot #
Cinda473b0k REAR YARD
If this is a • if t
corner lot, Chin ft• • corn
write in name I writ
of street. t4-03u2': I name
� a .•othi
-0- ) stre-
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SIDE YARD . SIDE YARD
• HOUSE
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fi FT. t) . . 4] -- - - - LIT.i)
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SET BACK . .
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(lot ft. frontage) .•
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/ 991 0.05-T i at941 KOV/2-- • •
/
/ (NAME OF STREET)
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/ \ \ Information •
DI9tne, I T hh0
/ \ Suaplied by
PP ica Ion to - -
,o.tea, . - `` 5'.r;" :71'- -4t.3..;-;7--1-•.: -.i.),._.Ii• io''{.;.•'ff;v?,tcs-ii_?:_.•-•: - - • - -.-• _
ear, •
`�-- ,/,-; •'.,r4- OId.Kin sHt hwa ,Re—tonalaistonc:.Districi'Committee"-
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:CERTIFICATION-.,.•._: . OF,EXEMPTION : --- . . :: - -,;-= "---- . -:" .._ ,
Application is hereby made, in triplicate,for the issuance of a certificate of pzerription under Section 6 and 7 of Chapter 470,
• ;' Acts and Resolves pt Massachusetts,"1973, as amended for proposed work as described below and on plans,drawings,or photo -
graphs accompanying this application ., • = ,. -
• TYPE OR PRINT LEGIBLY F �;\(F DATE /` " '
•
• ADDRESS POSED •` W' o �j• "- �� " ASS ORS MAP NO. `'I8Z
DEC 3 P j
OWNER / (�• tel • ' ii m� • ASSESSORS LOT NO. f /S-
RMOUTH
HOME ADDRESS
O/911-4CItERK &OF /TREASUFFI: TEL.NO: -36 /9 / �
AGENT OR CONTRACTOR Sn474e- • •
ADDRESS TEL. NO.
This a • ation is for exemption of proposed exterior construction on the ground that:
(1) It will not be visible from any way or public place.
0 (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission.
- - (Check applicable box)
PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and,if an addition is involved, show-
ing location of existing building. • ,
�jWk . . Ciiini� /S to he- bud 17`" cfm & /Z.
OF �� • S7 15 o X91( /n �j ireeiT
/9h2 chimney *c Fe- CQI7neCTPJ, • Fi c -n lounnc2i
lBeloti+> 57tolit le lel.
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SIGNED ()„,,,TC9-44-441--t- (""4•41-11---"
•
• ' _ Owner-Contracto -Agent
Space below line for Committee use. -- --- __-_-_ .-- - - - - qq
r - _ Evil
�� PPROV
v •
Received by H.D.C. The C r t Is r . / 446/0-72 • YARMOUTH COMMITTFr
OKHRO -
:._
Date
// ---- --
Time ...er - '.. . .r : . /�; -
Jrr / ._ is / - , i• /Itrif 741'
v ate
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- '"-1-7:7;7":-.-- -"---- 71:;"...7f7:—.--,rl - -77.7-7 -1,
7.7 Hy`----r ,W� _---_ -_ __• • _- _:1:1 :,.z.aL�. .... •
Approved ��ll�2r.11 '$
- - v The categories of work entitled to exemption are listed on
=W h w .k .,-ew..-r • �""+• car i
- _ Disapproved ._ ••'UUUU•3,-.71.-y,L.,4A,+,r;�+. + -:"St.-.5 _�tryy the back of Ibis form:-•— " _"----' -<:�Y• �,-.r.+, ,r�:
-:.. 7'i.'.ti - ::fes - .:`i"f� _ L_ ..9{..fCli,AT•i^:r_:-- _ -�:.. -. - S" __ - "`TYi.:+u]_ _. ___.
-. ._ ." 4i_ `Y';• "=+=;ter ;;'. ..tr,ax••p,-.; -a - -T:;d.', _ , -=ai.}kFe:id,?---'''i:
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TOWN OF YAMOUTH
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BUILDING DEPARTMENT
•c
'HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE (� Ij /� nt/�/� �/J,�
JOB LOCATION / / / ��`"_"3✓ /i/ ,0712 i "/ /'ted
NUMBER S' 2EET ADDRESS y7 CTION OF;TO
"HOMEOWNER"J)/1r//e% M2y1 5% n 3b /5'�/ Seine
NAME HOME PHONE ^� WORK PHONE
PRESENT MAILING ADRESS 111---
CX?O'S--
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 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 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 WHO CONSTRUCTS MORE THAN ONE HOME IN A TWO-YEAR PERIOD SHALL NOT BE
CONSIDERED A HOMEOWNER. SUCH "HOMEOWNER" SHALL SUBMIT TO TILE BUILDING OFFICIAL,
ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, MAT IIE/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.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH
BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIRDiENTS AND THAT HE/SUE '
WILL COMPLY WITH SAID PROC • i.___— AND REQUI• aINTS.
HO."{S'OWNER'S SIGNATURE ,�'•�`�^G^I'i(4,(,(/- / ��G✓"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 COV AG_:
I have a current ...ability insurance policy its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes L No ❑
If you have checked ves, please indicate the type coverage by checking the appropriate box.
A liabii;;j Insurance pcticy [8 Other type cf indemnity 0 Bond 0
OWNER'S INSURANCE WAIVER: Iam aware thatthe licensee does rot have the insurance ca •age required by
Chapter 142 of the Mass. General Laws, and that my signature Cn this perm application waives this requirement.
Check one:
Owner 0 Agent IT
_yl ....] c: Oe,1Cf cr C' ner S :cent
Suggested Affidavit for Home Improvement Contractor Permit Application
•
For Office Use Only NAME OF CITY/I.OWN
Permit No.
Date
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c.142A requires that the"reconstruction.a iteration.renovation.repair,modernizes tion.conversion,inprovement,removal,demolition.
or construction of an addition to any pre-erstinq owneroccuoied huildine_containinG ai least one hut not more than four dwelling units....or
to structures which are adjacent to such residence or huildine"be done by registered contractors,with certain exceptions,along with other
requirements. �,(� �{/
Type of Work: (I,$,� l3& /c cblafile / w/r/(lam
('� / at. Cost (DOD �
Address of Work ( 7/ &/�T w{0 14 /ea (/4tL 1f_
Owner Name: Dmile l � -ii;r) J '7
Date of Permit Application:
I hereby certify that:
Registration is not required for the following rcason(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: •
Nottwwii hstanding the above notice, I hereby apply for a permit as the owner of the above property:
DatOwner Name
..'WOOD STOVE INSTALLATION CHECKLIST
• -permit •
• A building permit is required for the installation of any solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and not to the stove construction.
Stove 1./-------
A.
//A. NewUsed
B. Type/radiant Circulating
C. Manufacturer para 095c7Ce- Lab.No. •
Name/Model No. Collar size £1 ��
Dimensions/Height ,� Length _45 Width
Chimney
A. New I3kJ2r Existing
B. Size(flue area)
C. Other appliances attached to flue(Number and flue size)
D. Prefab(Manufacturer—n and type) n^ /'
E. Masonry/Lined Fiue liner V
Unlined (type 8 manu5ac:uter)
F. Height(refer to diagrams) siPPEdic Nir cap
p
a
cvEZ to I / 1 ov5: !O • I 112`t MIN.
—Fa 2 AIN 2 MI�.171.-4-I .
I _ ,- ,ulf1l. L___,! �d j la' MIN.
.�, (FUE /Ltii
t PC
_ c 4!CE
Q( X� 1-0 irf HEARTH
•
CHIMNEY HEIGHT
Hearth(ncn•cemeustible)
A. Materials
(5—�Cc'flcorccnsrucaon �in!ce2 ('iincicere
C. Minor cimens!cns(refer;o ciaeram)
earances?andWall Protection(see stove!nstailatic�ce_r cssc^art) •
T?`Type cfWail prctec:tcnproviced OJt1CtLflt fatvici 7lor)
E. ie rances(refertodiagrams) 573IZ is In _13t1SCiul&777 •
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FIREPLACE CORNER • WALL/CENTER
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