HomeMy WebLinkAboutBLD-90-483 of:Y44.. o
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.. s for. TOWN OF YARMOUTH Orel) ?Ili"
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4*• •1 0- Application for a Permit to Build No. y 3
UPON FINAL APPROVAL ,---- /E MAP r�� LOT
FEE MUST ACCOMPANY THIS APPLICATION. DATE ti u is—e •• q
The undersigned hereby applies for a permit to build a 9'/% (�
v
according to the following specifications I
1. Name of property owner Ai r. r, i a / r eS e Tel. 9 g ' 7.4 43
Address 70 0o& Oft Rouble f Dr_ Sar
2.Name of Architect(if any) Tel.
3. Name of builder �a v i 6f/ U o-Ph a3 eL Address 38 So vt P,` Rd lel 4 a/Pee
4. License No. DS On 9 4 Tel. 47 7 ` / a 70
5. Name of Mason Address
6. License No. Tel.
7. Construction address 7(7' 004 of 'o 0 vto{ C Dr. S .. y¢r.
Floo District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling i Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 0 0 0
11. Commercial 0 Kitchen
12.Other ❑ I PP- S F Dining Rm.
13. No. of stories / •/ Living Rm.
d Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab De Ir2, Bath
15. Materials — Wood Pf Cement 0 Other 0 `\ Deck
h 016.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch I
17. Garage — 1 0 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 /00 No. of feet deep 1?0
22. Size of building: No. of feet front No. of feet side 16-;� No. of feet rear
2a Distance from nearest building: Fronta- Ft. side CO Ft. side 4C, Rear* `�'�
24. Distance back from line or street 39 From rear lot line 44> Side line
0i(
SZ___LOT RELEASED BY Signature 4/e01
PLANNING BOARD Address 3 8 O k e_S' of fricisfipeQ,
Date 0ab4cq
• \1
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: /� /� { 7�r
JOB LOCATION: 70 O u k (/ P R D V hd i U!- 3_ 7q r- m
NUMBER �1 STREET VILLAGES
OWNER OF PROPERTY: M •IC C Ct Lc( b r e-s ee /� `/'�,�7 7 / r�
CONSTRUCTION SUPERVISOR: b U ; 4 H �h 43 r LICENSEoo 9 PHONE NO.
NAME ADDRESS: 3 8 3--c; vt. e IRO/. /IA 4S { ' Pee- 6 cM14 Ce9
LICENSED DESIGNEE:
(IF OTHER THAN SUPERVISOR) NAME LICENSE NO.
2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: tpa V ; Of AiL '17 Y1 4C, L
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 BUILDING
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 SUB-
CONTRACTOR 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, RECON-
STRUCTION, 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 CO1
STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTAI
THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING
OFFICIAL.
(ThSIGNATURE: CtA-44
BUILDING OFFICIAL APPROVAL: �/ v
1 •
\a PLOT PLAN
FOR LOT # 41 '
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool)
. Well 0
(lot. .r[.O. Q ft. rear) I
Abuttor's I Abuttor's
Name I Name
Lot #(r® I Lot #5,8
REAR YARD
If this is aIf this i=_
corner lot, ./.5e'••:-$. .. ..i ...ft. corner Jo
write in name write in
•
of street. i,, i._ 1 1 I name of
.,-1. N *' u'4 I � a, other
r'.r� 1 street. .
ro • wv" b
4 •
•
SIDE YARD SIDE YARD
HOUSE w�
l' i_ ,_ FT_ (> „ ,0_OL®_ FTt> .
. ... ..4 k 0 . •
ib sr
SET BACK W ,
.3.P. .ft. '•r ^P12'. C rfr
I . -
I
0 •
(lot.. /00 ft. frontage)
,P` db -1 of B 0 u h c:4 ,S .
• / (NAME OF STREET)
/ Information t' J a v j O/ Wuc4.ie C,
/ \ \ Supplied by
MARK NORTH POINT
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT:1)q (/; S 1V v b1 q9 JC L BUILDING PERMIT I/:
ADDRESS: 70 0,4- nc2nr, rots 'Dr ts
geTELE. NO. : 35 -9'4 3DATE FILED:AUS 3 4790
BLDG. SITE LOCATION: /V O0-L pc to ut4G1$'ay SMAP#t: 80 LOT/l: -!`
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 DEPAR 1 DATE: �' y N/A:
elf �� ERl/7 ga C
�!IUSTR -• AND/OR COMMERCIAL P T
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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