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`�4° -- Application for a Permit to Build No.
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UPON FINAL APPROVAL / /9 MAP LOT
FEE MUST ACCOMPANY THIS APPLICATION. DATE fine:
19 /a
The undersigned hereby applies for a permit to build ‘/ O790
according� to the following spec cations 'ol.U� f0 a� /9d Los
-1!Nameofproperty owner It 'wAssuc. Tel. 451-oboe)
Address SoLtru Q' Lae-rour;oay. tri- o&on .
2.Name of Architect(if any) Tel. —
ame of builder awumC. . Address
4. License No. Tel.
5. Name of Mason _Address
6. License No. Tel.
Construction address ►'k? FNa ae",a- -2b ) Se.rl4 \J, L n.ma) VAA-
Flood District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost / DO NOT WRITE IN THIS SPACE
10. Multi family 0 4 30o QI/ Type of room No.
11. Commercial 0 Kitchen
12. Other 0
_ Dining Rm.
13. No. of stories
/S Living Rm.
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
\A9. Storage shed — Size S x lb Shed r`,1''/ o /
20. Stove — Wood 0 Coal 0 Alterations
21. Size of lot: No. of feet front 162.04n No. of feet rear
L. 'testi 0i No.of feet deep I 0 a, 31.
22. Size of building: No. of feet front 8 No.of feet side x -N-ad-4 No. of feet rear . .z-,_-, _
23. Distance from nearest building: Front 29 Ft. side l4 p+ Ft. side Rear L
24. Distance back from line or street 6 0 ' From rear lot line G ' Side line L i'
LOT RELEASED BY Signature f.Z- =.. — .es
PLANNING BOARD Address 4/ - `o
Date N n "�r.
•
PLOT PLAN
• -
FOR LOT # 8 C
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool)
Well :' a : '•`,
I (lot.. . 1 cf?..4.3.1:1 .,. .ft. rear)
buttor
Abuttor's I 's
Name I 4::
Lot # $' D5 5 FT /
�
Snc��t-_ S s let> *(0) 9 c.,
TntJK REAR YARD
If this is a •
® If this is
corner lot, << ft. corner lot
write in name write in
of street. , I name of
i.; I ), )• a other
•
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v street. .
TS
ro
4 I:e -
SIDE YARD SIDE YARD
HOUSE
0__Z _FT* 0 4I_�l.3i _ FTt •
• a •�
to I r
N. I N
C. SET BACK
• 31 ft.
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I
Co
(lot (O2,t11 ft. frontage)
-
/ -PINE 6,P--Ova A-1 J
/
/ (NAME OF STREET)
Information
/ / Supplied by COw ,/l foLtY E. /142774/ cie,
/
MARK NORTH POINT j
TOWN OF YAMOUTH •
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE G 19 [qo
JOB LOCATION %3a. ID.�[t r?-4). Sod;z4 '44244 -0Q-MA
NUMBER STREET ADDRESS SECTION OF TOWN
"HOMEOWNER" -Li2ADLi-'1 hit gni& • 2.O3 CoCS oo00 2o3 2afs t0Y q 1 x 14')
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADRESS it LJA.SS u C-
SO
So UT CrusP.4ZN6k2i 0-r oi.,en2
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 AND REQUIREMENTS.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIALA/�22`,�E
NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED "'
TO COMPLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION-CONTROL.- _
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BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: Nj 0 g. w aar. BUILDING PERMIT #:
ADDRESS: It WAssuca,.. S. `&tfSZUNb)R-t e • TELE. NO. : 2°3. 6.5900os DATE FILED:
•
BLDG. SITE LOCATION: 132 T?,,p (oma Rp,S,yoa...o✓n.)MAP#: LOT!!:
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 DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT DATE: 6/j cyfre, N/A:
I US IAL 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:
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— MO RTGAGE ' .. PURP.OSES ONLY -/—
NOT T. 0.';.DE • USED TO DETERMINE P''ROPERTY ' LINES�
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F0 R F E N C ES LAN D .S C A P I -N G • E T.C .'
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/ CERT/FY THAT THE STRUCTURE AS "CEFTI FIED PLOT PL All
SHOWN ON TH/SPLAN/S LOCATED ON
. THE GROUND AS DEP/CTED, THAT IT OF LAND /N
CONFORMED TO THE BUILDING AND
ZONING BY-LAWS OF THE TOWN OF • ' • la • LAS
S y4 rnrxr N , MASSACHUSETTS SCALE In = aQ• 3-At 1. ri 19 a 4-
WHEN CONSTRUCTED AND THAT/T/S , -
'SITUATED WITHIN A SPEC/AL DELTECH ASSOCIA TES /NC,
FLOOD HAZARD REA. ' ZO?JE A8`
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