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°��7.'f_ dikr.. TOWN OF e 1 OUTH °Kew Oa*
oy
H„ -N " 4"10
Application for a Permit to Build No. y04
UPON FINAL APPROVAL MAP LOT
FEE MUST ACCOMPANY THIS APPLICATION. DATE t 19 %D
The undersigned hereby applies for a permit to build 9/qS
according to the following specifications
1. Name of property owner �42Oe SLS--1/o4 Tel. R9y99Y�/
Address L9 C/;P4'nrd e51: Sr/---1-h
2.Name of Architect(if any) Tel.
3. Name of builder 3i3A1 /elf/cox) Address 79p4 D��i7/2�
4. License No. 0/ / 3 Tel. 37MS)3x/8/
5. Name of Mason Address
6. License No. Tel. /
7.Construction address �i9�e es feewa to '
CIS.
Flood !strict
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family ' 0 6 eZ: j� �- Op.- s/5g,u/ ,
11. Commercial 0 wpix#y/ Kitchen/"
12.Other A Pi Dining Rm.
13. No. of stories i Living Rm.
Bed Rm.
14. Foundation — Full ❑ Half 0 Crawl 0 Slab 0 Bath
15. Materials — Wood 0 Cement ❑ Other ❑ �5Deck
/S
16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch
Family Rm.
17. Garage — 1 0 2 ❑ 1 / 7 O Sun room
18. Swimming pool - Size
4t-5/ -Garage
19. Storage shed — Size ,/ y / d Shed
20. Stove — Wood 0 Coal 0 7 Alterations
21. Size of lot: No.of feet front //D r No. of feet rear //D a No. of feet deep //d /
22. Size of building: No. of feet front 4 r No. of feet side oZ 6 t No. of feet rear 1452 r
23. Distance from nearest building: Front 'D r Ft.side ,(4 0 Ft. side/c5/21e>/ Rear /O
24. Distance back from line or street 35-1 From rear lot line 36 Side line X365
LOT RELEASED BY Signature G,aa- _.) rJ
PLANNING BOARD Addre. u�
Date 0.5t-ett. .0f.e,� ���i a 6eie•
1 BUILDING PERMIT APPLICATION
APPLICANT://_ 1 U e c{Ltt 1�� BUILDING PERMIT C:
ADDRESS: Of et ,e5Itt+ 4z* 5.14, 01(0 TEL.NO.: 3,7•7ycsr DATE FILED:
BLDG. SITE LOCATION: GI/ L '4,ff a-c! c! MAP f: LOT I:
The following information outlines the procedural steps required to obtain a Permit to BUILD - ALTER - or ADD •
structure within the Town of Yarmouth. The Building Department will determine compliance to the following (A)
REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD PLAINS ZONING. The Building Department will be responsible for ass
the applicant through 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 Lands, etc.
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations, i.e.: Requirements for Septage Disposal
and other Public Health activities.
FIRE DEPARTMENT: Determines compliance tb State and Town Requirements for Personal Safety, Property Protectic
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 f c�/�• c1Z), DATE: 45/--c;26-420
O N/A
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT: DATE: 67),r/c10 9-177/7N/A:_
INDUSTRIAL 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 SU
TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING PERMIT. \/
COMMENTS:eV — OAC A, s. ! 0,0 i - Gi._r ,�L-*' .
3/14/85av
i
f PLOT PLAN
..." . _ . _. . _ _ _ _ _ . ._ . . . _ ..... . _ _.. .
FOR LOT #
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool)
Well g
I . I I
(lot fie ft. rear)
Abuttor's I Abuttor's
Name I Name
Lot # Lot #
REAR YARD
If this is a • If this is
corner lot, ° ft. corner lot
write in name CO&0CN 1(- �jl�/'ft�j write in
•
of street. r,: I �) n c name of
a • I /0 4e) b/9,p? 1 Z.1.7". other
b • t CC�11++ 'a ' street.
<S •
SIDE YARD SIDE YARD
HOUSE • •
40-31 _FT— • r 44, d ,.>_0 _ ET
•
b ' v Q
5.. I iid
h I ,QI 1
3 SET BAS ,
QJ Li
v II,
(lot //0 ft. frontage)
c° I. f-Pard s1 .
\\ // (NAME OF STREET)
\
/ , Information - llillth
/ \ Supplied by \alto %.
/ \ 1
MARK NORTH POINT
/ •CEILING ASSEMBLY 1 GWA
•
• TOTAL R = I
�• U: WINDOw$•
—TOA SURFACE
R• 0.61
' 9"FIBERGLASS
_ INZULATION
• R• :9
�' •/ I" fit its 1 n i i
\---SHEETROCK DOOMS
1' R • 0.45
pl BOTTOM SURFACE _
I R• 0.61 •
1/2" PLYWOODINSIDE SURFACE REAR ELEVATION
.R * 0.62 R • 0.68
WALL ASSEMBLY GWA. •
%4 In -
• It" SMEETROCK TOTAL R = .
SHINGLES R ' 0 •
.45 •
iR • 0.8T
U = tiIN6030 :S
I FIBERGLASS 307.
OUTSIDE � INSULATION - `
SURFACE j'"'• Rill
R. 0.17 1C .
:
SURFACE RESISTANCE
R• 0.61
ims DOORS:
•
I. FINISH FLOOR '
R• 0.91 '
' I'.,I 3c/ FLOOR ASSEMBLY
• H 00D TOTAL R =
i t SUBFLOOR RIGHT SIDE ELEVATION
R• 0.62 U =
' I' G.W A.•
PUTSIDE
•
•
SURFACE I' u
Ui FOOD
IR: 0.17•
I WINDOWS:
• ' - 1/2" FIBERGLASS
n- :l; • 1 '• . • INSULATION FOUNDATION
CONC. , • R Il WALL ASSEMBLY DOORS:
FOUND. WALL : ,• •: SURFACE RESISTANCE ( MAY BE USED
r ' R= 0.61 INSTEAD OF FLOOR
INSULATION ) LEFT SIDE ELEVATION
••• • .' TOTAL R =
•
U =
' G.W.A. •
INSIDE SURFACE
1 '. 'f-R ' 0.66
•
WINDOWS:
•i•; 3/8" SMEETROCK 6•14' 41/
R • 0.52
j• r• 1" STYROFOAM
•
. R• 5 DOORS:
,NOTES: INSULATION SECTION
PERMANENTLY INSTALLED STORM
WINDOWS TO BE ' USED aLOCATION:
GROSS WALL AREA = -34O -cr. TOWN:
WINDOW AREA = ' cS'
CLIENT; ' DATE:
DOOR AREA = _ __ _
7. F - NESTR T 0 . /3 r SHEET
TOWN OF YARMOUTH .
• . . BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM /J
Please Print: // DATE: L/o?y,/�9 D
JOB LOCATION: NU,/ CI �7'o;4, 1 5� ' S. l4h "ny,!-u� b ��
i ER / STREET S.
VILLAGE
OWNER OF PROPERTY: .DJf U C ZAP p 1 d O .0
CONSTRUCTION /./)A
, ' . •
SUPERVISOR: 3%/!p(.//A/•ant) O/.tel .-,g'-"CS:)50/ .
p Ne�`�'F' L� � E / PHONE
ADDRESS: 96 C,...`, i V o R» e �. 4�Ar), hS } Tia e 5 4 A/ .
ER STREET CITY/TOWN' STATE ZIP CODE
LICENSED DESIGNEF:
(IF OTHER THAN SUPERVISOR) NAME LICENSE # .
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 buildings and structures only pursuant to the State Building Code
and all other applicable Laws of the Commonwealth, even though he, the license
holder, is not the permit holder but only a subcontractor 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, reconstruction, alteration, repair, removal of demolition
as regulated by Section 109.1.1 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 department.
I have read and understand my responsibilities under the rules and regulations
for licensing construction supervisors in accordance with Section 109.1.1
of the State Building Code. I understand the construction inspection procedures
and the specific inspections as called for by the building official.
SIGNATURE: 4,,,,.,_e ,g,
(LICENSED CONSTR "CTION SUPERVISOR)
BUILDING OFFI APPROVAL: dift4Z
SEWAGE PERMIT NO.7 6 7 WATER TABLE 10 s it/a G1r{nrl�gf��
LOCATION NO: STREET G V . C/.t Pheor�,( S
/ ADDRESS.
tINSTALLERSter.NAME & ADDNw"r .11 t# . 4 e-
h C(
C'-t3 pa ,c- er.
DATE PERMIT ISSUED II l 3 O7 / 7 •
' DATE OF INSTALLATION (7/ /1 l ? r
' DRAWING OF INSTALLATION ON BACK •
• • •
•
•
•
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