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N """"`""'� Application for a e mit to Build No. 3�6
UPON FINAL APPROVAL ,4 d MAP J.S LOT G - I' D
FEE MUST ACCOMPANY THIS APPLICATION. DATE lv// W 199°
The uatpdersigned hereby applies for a permit to build ���/
acc ding to the following specifications
Name of property owner /S�y�(Hon�CJ A o/.S Tel. 7 7S-`!7 21S-
Address
3Address 97- Mari) 40 Wes7 \ne,ctou7H
2. ameofArchitect(ifany) Tel.
4. Name of builder AAd dress
4. License No. Tel.
5. Name of Mason Address
6. cse No. Tel.
f/. Construction address 417, Noir PI 4nb Weir *1tstaur 1i
Flood District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost / DO NOT WRITE IN THIS SPACE
n/ Type of room No.
10. Multi family 0 /A'U9
11. Commercial 0 Kitchen
12. Other 0 Dining Rm.
13. No. of stories Living Rm.
8• G� 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
17. Garage — 1 0 2 ❑ Family Rm.
Sun room
18. Swimming pool - Size Garage
�/
19. Storage shed — Size /0 y i az Shed m'y'ja-'
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 Ft. side Rear
24. Distance back from line or street From rear lot line Side line
/
a _PLALOT RELEASED BY Signature `� Anta7 tat-
PLANNING
NNING BOARD Address IL No,tr) 4,q*'
Date fif/ iT \114no✓TN Ha-s c
APPLICANT: le/l tiMp�l1 D,/$n / S • BUILDING PERMIT i1:
ADDRESS: • L`) . Noltrl+ GAP . u/. \/4ThtNITELE. NO. : '71S - `F72,c DATE FILED: eh-t5'
BLDG. SITE LOCATION: MAP!!: 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- V
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 DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: - / N/A:
4. HEALTH DEPARTMENT A DATE: G/d�7n N/A:
IND STR AND/OR COMMERCIAL PERMITS/
5. WIRING INSPECTOR: DATE: N/A:
6. PLUMBING INSPECTOR: DATE: N/A:
7. FIRE DEPARTMENT: 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:
BLM/89
' 9,- "yyo5G
TOWN OF YAMOUTH •
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE (o'S' c)
JOB LOCATION yZ Noirif 4AP &ST VA end UT /-I
NUMBER STREET ADDRESS 1 / SECTION OF TOWN
"HOMEOWNER" t'//6Al 5 D✓sJV /-S 775 - �/7L
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADRESS i(1Dt1 iS fe942)
Wain Mil 1 WdU7'If �i455 62 [ 7.3
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 WHO 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 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.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH
BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE
WILL COMPLY WITH SAID PROCEDURES
REQUIREMENTSS.
HOMEOWNER'S SIGNATURE a( �fGG{Yt�-
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.
•
PLOT PLAN
/0
FOR LOT #
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool)
Well fo ilf31ncas ic; 9 A Ko/ircHAVO
I
I (lot 9 IF ft. rear) I
- - - - - - - -
kbuttor's a
/ I Abutter'
Vame G it Name
Lot #nnD �.� $1/' ,�r1k SMED 1 iY Fr?° say�� Lot #P-
/A5 Roca 'cK r 4
REAR YARD ARS AdatAIKI
Lf this is a G"-. hrri - • .c7 If this
:orner lot, 1' , . .ft. corner
write in name t�' . write
Df street I4 pig name of
L
} elt� '��C other
o
o street. .
1:1 �y
p
SIDE YARD SIDE YARD
HOUSE
,c,_2p _
IT.,_ 0 ' 0 FT 1
•
�J
Q l
r . 1
SETBACK
T I ft.
•
, I
V-
(lot go ft. frontage)
•
/ Y;%-C-72&14- LeL
\ / (NAME OF STREET)%L'
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/ \ Information--------- ---. �!�
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MA K NORTH POINT •