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�4°'�•"��- Application for a Permit to Build No. IIILLL 9
Pai F,,,_--go ' 21 T /Cs a--
UPON FINAL APPROVAL MAP LOT
FEE MUST ACCOMPANY THIS APPLICATION. DAT 0 '' a%
The undersigned hereby applies for a permit to build i /
according to the following specifications /1 a 9'a
1. Name of property owner " ttl//// H N0 Ag 1,d I Tel. '
Address /O'/ SEA U/6W AVENUE
2.Name ofArchitect(ifany) Wt.t/ /AM Llvnib Tel.
3. Name of builder will !Am 1.-r01r5Tjg Address /OY 5V9UiErett ,4 uC
4. License No. Tel.
5. Name of Mason Node Address • •
6. License No. Tel. ,
7.Construction address /DV 5'69 11/7 Avalu&
Flood / District /,a5
a Date of subdivision Ap royal (f/V�N� plain zone vK1V�"W� Zone
9. Private dwelling I, Estimated Cost DO NOT WRITE IN THIS SPACE'
r3 OD e Type of room No.
10. Multi family ❑ D
/ f ffAJD_I•CRP JPAHP
11. Commercial C9' Kitchen
12.Other ❑ Q o Living Rm.Dining Rm.
4tc) �
13. No. of stories NON Al
a Bed Rm.
14.
— Full rt
f
wl
15. Materials Foundation ood GYCelme❑nt ❑aOth❑er ❑Slab 0
5.14- Al S Deck •
16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 • 5 i 6, 0 Closed porch
17. Garage — 1 ❑ 2 ❑ Family Rm.
Sun room
18. Swimming pool - Size 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: No. of feet front No.of feet side No.of feet rear
23. Distance from nearest building: Front Ft. side Ft. sidre! Rear
• 24. Distance back from line or street On ft From rear lot line lift Side line d it
SA), � � 'n ' .
LOT RELEASED BY Signa u ,/
PLANNING BOARD Address J&m'f7T 7 °I 1
Date P4. ,9oXsw5D va,frrnotz" a
. 0266V
PITS
,BUILDINNGG PERMIT APPLICATION SIGN OFF
APPLIC`1NT: PITS74' 1,44lV ziagg0g5ING/PPEERMMIIT II::
ADDRESS: /D4f"St!//60 6 TELE. NO. : v/�/�4/6%a
DATE FILED: '000
BLDG. SITE LOCATION: /0 SOM5 jJ AM, MAPA: JQ LOT/I: 7703-
THE
703THE 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: N/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 SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING
PERMIT. g J�, F m e
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TOWN OF YAMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE V U// 4301590
JOB LOCATION I0 ` ei, 00° " ' clpiVuE V1912 M&4
OMNI'
L n STREET ADDRESS SECTION OF TOWN
"HOMEOWNER" to/N fNT /7N9HeltA/OME - tI aN WO 39g 67 69
NAME PRESENT MAILING ADRESS I� 591.4a1/ /1/4510_2s. are. 1/T"^ J '!
mrd Oz-66c�
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 REQUII S
'
HOMEOWNER'S SIGNATURE 1111/24.49, Gfr
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.