HomeMy WebLinkAboutBLD-93-807 • k4 Tr :48 TOWN OF YARMOUTH gee'
OA; C I /0/31/43
• MATTACME 5 41
Y a 7
ca...n., Application for a Permit to Build No.
� �''
Al �o,aa-93
UPON FINAL APPROVAL MAP %7 LOT Yi
FEE MUST ACCOMPANY THIS APPLICATION. DATE l4-k-"4 19 43
The undersigned hereby applies for a permit to build /d/s2 a/9-3
acyording to the following specifications /O/a9 /g3
1. Name of property owner SSS4-N CT> .SCJ,•
_0 , Tel. lt1-8'1'k,
Address 13 W. (4-0,F72,7 u*'w 3 On . 39,y,ara y f74
91ame of Architect(if any) Tel.
3. Name of builder CE 1+AJ &. 2�,t CF2, Address CaPirric. Ps P g
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
14:Construction address 13 W. C-? pat j ES► d 12o. 317,76/21n62-174
oin District t
8. Date of subdivision Approval plain zone �b
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE —�
Type of room No. I
10. Multi family 0 f/l,30b . Ob 1 0
11. Commercial ❑earv'/ze-/cc( 9` Kitchen
12. Other ❑ • �-®''` tet.-, i4,-Act,/
Dining Rm.
1 i ;-• Living Rm.
13. No. of stories �-i to 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 ❑ Sun room
18. Swimming pool - Size Garage
19. Storage shed - Size Shed
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 FL side Rear
24. Distance back from line or street From rear lot line Side line
25. H.I.C.Fi. No. Ll/�,,
LOT RELEASED BY Signaare. tia41 /1-'1�,'lX�'�( 4-i(.4LA(s1NIN/g BOARD ��� ►/Addres/it r t✓_ 4,_,%c1/4/Datef= ,h 11 L (�(,1..r., : LC 1 J-o: a_� s D;la [y
TOWN OF YARMOUTH
BUILDING DEPARTMENT
4
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE W."
10114103 �
JOB LOCATION 1 '3 onEinkr u ST&i2i) 1Lf). VO . `147/20`DUmA
NUMBER STREET ADDRESS SECTION OF TOWN
"HOMEOWNER"(It1 -kJ Cr �2s1QP�. &IL/41'7' , --
NAME HOME PHONE WORK PHONE •
. PRESENT MAILING ADDRESS t3 W. ( 0N f•Gf',.
5a. \162s nbz>T1--1 AM55 . b2/0(/
CITY OR TOWN STATE ZIP CODE
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER-
OCCUPIED DWELLINGS OF ONE OR TWO UNITS AND TO ALLOW SUCH HOMEOWNERS TO
ENGAGE -AN INDIVIDUAL FOR HIRE WHO DOES NOT POSSESS A LICENSE, PROVIDED
THAT SUCH HOMEOWNER SHALL ACT AS SUPERVISOR. (STATE BUILDING CODE SEC-
109.1.1)
DEFINITION OF HOMEOWNER:
PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICH HE/SHE RESIDES OR INTENDS TO
RESIDE, ON WHICH THERE IS, OR IS INTENDED TO BE, A ONE OR TWO FAMILY
ATTACHED OR DETACHED STRUCTURES ASSESSORY 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/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 REGU-
LATIONS.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF
YARMOUTH BUILDING DEPARTMENT MINIMUM IN ' ON PROCEDURES AND REQUIRE-
MPNTS AND THAT HE/SHE W L L C+MPtY ITI SAID P OCEDURES AND REQUIREMENTS.
HOMEOWNER'S SIGNATURE f d
APPROVAL OF BUILDING 0 • ICIAL
•
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 Yes, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy 0 Other type of Indemnity 0 Bond 0
OW ER'S INSURANCE-WAIVER:1I am aware that the licensee does not have the insurance coverage required by
ster 42 o t e Mass. G . ws, and that my signature on this permit application waives this requirement.
(I G .
Check g:
Owner Agent ❑
ature of Owner or Caner 5 Anent
tar
•
Suggested Affidavit for Home Improvement Contractor Permit Application
For Office Use Only NAME� Y 'Ot,F�CITY/TOWN
Permit No. O no 1.60.0I
Date
AN-IDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGLc.1424 requires that the"reconstruction,alteration.renovation.repair,modernisation.conversion,inprovement,removal.demolition,
or construction of an addition to anv preexisting owner-occupied hmidinr containing at least one but not more than four dwelling uni ts....or
to structures which are adjacent to such residence or budding"be done by registered contractors,with certain exceptions,along with other
requirements. t,
Type of Work: 1(2.414/M&Li t\Ik ,�� ' 1 Est. Cost t,&Z> ) Z)
L
Address of Work 13 W' �- � La—e—b 7Gt i ,. ay,
Owner Name: 0.51-1-N.) /s . 171C—S)-72 4GP
, A
Date of Permit Application: 10( 11-061,5
•
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
NOwner 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 abo • notice, her by p. .r a permit as the owner of the above property:
/Oh V /9 4 / It
Date , Owner Name
- • Application to
—1 PM�fP//,..l ,ltt
_y ,* UPP VIPICS M>P ��,! • i • .
� GY° °;.,,1 Old Kings Highway Regional Historic District Committee
-4-4 n ) in the Town of Yarmouth for a
'E__ w
z cz ;:
CERTIFICATION OF EXEMPTION cm
x o ITS
- m,- 9-1 CI:
,Application is hereby made, in triplicate, for the issuance of a certificate of exemption under Sectio 6.and That hter 470,
''Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on_ppans, drawing ,yr photo-
graphs accompanying this application. m3 D 1 1
• nc
, I LjC3.-_ .
TYPE OR DATE I PRINT LEGIBLY 1 w'
• ADDRESS OF PROPOSED WORK 13 W. 61., 1 I (,+3 - Ai Jr T' (cfl`SASSESSORSMAP NO, /p�q. •
OWNER - Y),-'}M 6'` - c—)17?-.4-3- C_; TO . ASSESSORSPLLOT NO. Yl .
HOME ADDRESS • .)IV)1%` [i i '' -f' TEL\, i` TEL NO. 31 1--1-.S9C;(0
AGENT OR CONTRACTOR .1-)470 Cr: .91"):1-27 75; a
ADDRESS ani- •)C-. ;\:7 tAtr3Dti"_ TEL. NO. i }r}i 1).7 h;)Va
This •
isapplication is for exemption of proposed exterior construction on the ground that:
El (1) It will not be visible from any way or public place.
W (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.
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T` It !lic -,.-'") _i c_I Ei 1• Dr: .! - C'--moi, ( i '
t- I42D ' CAt(uuCcp 4AFcmtiT /MAUNEDI/
Soar^be,orr lirefor Commitee use. Owner-Contractor-Ace : / .
Kef cOVSD Willi JC CL' ENUATLO`t TitAT COLOR BE CHANGED/TO K:+EATHERZD WOOD" .
r
Received by H.D.C. The Certificate is hereby ""`
,
/.•`
Date /°/;//7t t
_ t. L .
/ "--7---' APPROVED
Time 3-315 •�"•...`�- . •
Y R UTH COMMITTEE
By C+� Date • C (t W OKHRD /94_
•
A ct;oved : -ee ca:ccar'es of viork e':it'ed to .e\e r"..:::c.^. are i._.:_• 7:t
D.saiaprc•:ed i_ back of this form.