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N%'CZ `" Application for a Permit to Build No. 0117
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UPON FINAL APPROVAL A3hMAP 5-3 LLOT D- z
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FEE MUST ACCOMPANY THIS APPLICATION. DATE 1 ' 13 19 VThe undersigned hereby applies for a permit to build `i' 13I qv
according to the following specifications
t Name of property owner 4'1)100 t D * Wl\Th h tut/ /'1/JS e 6/ Te1398" /5V9
Address Co CC/tit dr1 el). 5Y
2/.Name of Architect(if any) Tel.
fr Name of builder ,E 122.2_uLELpa.8f21 '--/ Address 3G 9e ze&,1 p P • S • cl•
4. License No. 'Tel.
5. Name of Mison Address
6. License No. Tel.
I Construction address s4V 9p Ne DA 1) n S, V '
Flopd District
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 1, f 0 .
11. Commercial 0 Kitchen
12. Other 0 ' . Dining Rm.
Living Rm.
13. No. of stories lap. O'o 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
182Swimming pool - Size i i Garage
v19. Storage shed — Size 5'X'& Shed SDW/p' /
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 Jot line Side line
gleuJ e/fncL= \,
LOT RELEASED BY /, gnature $�„ ---7.5‘0.,,,,T/
PLANNING BOARD Address (',ae41 Rb'
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Date ,C , Itz r -:Att.,/
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TOWN OF YAMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE 7- 9- 90
JOB LOCATION .3'D 98/1/1 /1/1 Rn S ' y4f ' nc6/1
NUMBER STREET ADDRESS SECTION OF TOWN
"HOMEOWNER" 'DwJ) +A4X'ANVJt/ n1/ a.y 39�f/a-V9
NAME HOME PH NE WORK PHONE
PRESENT MAILING ADRESS Pn Roo/ 4/ S i c�Ah/xg<i1`A
c/Nr/linr/7 .77(9 (PAO y
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 pROCOMRES ND A �EQUIREI4ENTS.
HOMEOWNER'S SIGNATURE 1) Z 4 f �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.
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: FD(4)(114) m% T' e / BUILDING PERMIT ll:
ADDRESS: JPO &2//V I7 � S'i u , TELE. NO. : 3 rite/9j DATE FILED: 7- 0".
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BLDG. SITE LOCATION: Sj) ?dive vn it) t Le , MAN: S 3 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-
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: �j
1. WATER DEPARTMENT C��jy�,�<a ��( DATE: 7-/O-7o N/A: 1. /
2. ENGINEERING DETMENT: v DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT ie ,e DATE: 77/1,9 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
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COMMENTS: /{I 62- a/& %Q .c7ci) 7// 2e9f n4/.4.
BLM/89
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21 PLOT PLAN
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FOR LOT #
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) ED
Well 0
.S 500
aPlrcp I PQ' (lot ft. rear) I - - — —
Abuttor's 1 Ski I Abu ttor's
Name I Name
Lot # I Lot #
- REAR YAR •
If this is a • ¢t5 P If this is
corner lot, —0 — is ..ft. corner lo
write in namewrite in
of street. I name of
a= I . other
• b street. .
fd
4
SIDE YARD SIDE YARD
ft 6 D/ FT. HOUSE 40 FTS{ •
b
SET BACK Q.
-
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ft.
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(lot ft. frontage)
\ / 61S . . -� ,4- 4 ,
\\ / (NAME OF STREET)
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MARK NORTH POINT
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