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,4 .e.: `G +-' Applicp ion for a Permit to Build No. 193 P
UPON FINAL APPROVAL q-jq '9C) MAP 66 L Fa
FEE MUST ACCOMPANY THIS APPLICATION. DATE __� 19 7D
The undersigned hereby applies for a permit to build , 7//9/70
according to the following specifications
1. Name of property owner WI UrC2 DOM ri A V V/9794 39js 63 6o
Address /'I boufr k 4AiC 141/
2.Name of Architect(if any) // Tel.
3. Name of builder_ 0 LA' 8E4 Address
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel.
7. Construction address .117111 I LI0(l& A) 0)
Food District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling ❑ Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 JR-, arra. — '
11. Commercial 0 f/ N/sb' c tot' a✓F_`� Kitchen
12. Other 0 —S-2-t
SF Dining Rm.
'fes Living Rm.
13. No. of stories I
TV-. -Fr° Bed Rm. 2
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 oficiAlishie. ALia Closed porch
17.Garage - 1 0 2 �^�? Td g E Family .Sun unrRm
room
18. Swimming pool -. Size Fitresiler.� 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: Na of feet front No. of feet side No. of feet rear
2a Distance from nearest building: Front Ft. side Ft. side Rear
24. Distance back from line or street From rear lot line Side line
LOT RELEASED BY Signature V D+l .Q
PLANNING BOARD Address « Q``¢- �Aut-f- - . 1
Date CrJ7,D_/ nkAalt .A 7v14. 6 g9 73
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANTA)41 rift, Do MA- BUILDING.PERMIT It:
ADDRESS: IH C)0/4/e- j&4w e., TELE. NO. : 34$6360 DATE FILED: 7// //0
BLDG. SITE LOCATION: MAPA: LOTH: .5" 3
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 y DATE: '7///96 N/A:
II • iSTR 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 /SJIBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING
COMMENTS: 1500- I1 g 12 Gt7 i n bo c- c' To lgai-T re;Pt- OSa cs c IJZ42 m rs
a> G?i f r $/ate COL `S Ta (Q- ,r4 o u o H9 u P
3> Ewc1G y Co DE f2 T v?O To .L i. /1747
(Li ).0
I
BIM/89
O1 746/n
TOWN OF YAMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE 7- lid - 90
JOB LOCATION /7 SOV E LANE WEST YA2mOCI rH
NUMBER STREET ADDRESS SECTION OF TOWN
"HOMEOWNER" WAI-TE2 v- MA12f1-p) tPomAi N .398-&3/a0 1418"73 9 6
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADRESS /'/ DOVE 1-4 WE
WAST VAR-mount MA 002673
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 REQQUIREMENTS.
HOMEOWNER'S SIGNATURE /2)Lc t�J hc� (Q
APPROVAL OF BUILDING OFFICIALIA
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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