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HomeMy WebLinkAboutBLD-90-484 , 6,1-22‘ *As' . �.o%. TOWN OF YA ' MOUTH © K tnati q-713 MATTA�M[ 5 �+ J • 7 V / rCt4.0..,,••�`6 Application for a Permit to Build No. UPON FINAL APPROVAL , MAP S 3 LOT "5 FEE MUST ACCOMPANY THIS APPLICATION. DATE 7 1,9 Co ' The undersigned hereby applies for a permit to build /0/90 according to the following specifications t//o/9d 1. Name of property owner i 'vC— uSu� .�•r,.�..�� Tel JPY--z2& S=F' Address ! l .4 TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: JOB LOCATION: /p ccerecf ,51701.1/Kr--.0v NUMBER TREET VILLAGE OWNER OF PROPERTY: fkgef rA-c ;//L/y/�. `e tfer CONSTRUCTION SUPERVISOR:Are dc.d/4 on 94' 2-3 89*SO P a NAME LICENSE NO. PHONE NO. ADDRESS: PC 136X' <‘Az3 -.47-14 p/t:to-fi . ty LICENSED DESIGNEE: (IF OTHER THAN SUPERVISOR) NAME LICENSE, NO. 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 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 CO] 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 BUILDIN OFFICIAL. ` SIGNATURE: 1 "{ A, gif BUILDING OFFICIAL APPROVAL: r' 1- . ,_. A. • • FOR LOT # ` _S \ Indicate location of garage or accessory building M Additions with dashed lines Sewerage disposal (cesspool) i1 (ipt Well 0 24_.# P00% Yr. I ft .rear) I Abuttor's �� `� ' �` I - Abuttor's • Name ;� Name Lot # fly ;!)�,G I Lot # A Com-170 ' REAR Y RD If this is a 1 If this is. corner lot, ft. corner lo write in name write in of street. (.+ 1 name of • I , I • a other . 0 I Fa street. . Ft, • • ' SIDE YARD SIDE YARD .l HOUSE ft FT. 0, • 0 FT �Q • 4 • I • 43V1 s . 1 - "1, 4 K \ . n t13 SET BACK I O . ft. (lot . P� S /7'ce n 9e) / tie . / / ,�,�'-r.P S9,-eceT / (NAME OF STREET) • /> < Information / \ \ Supplied by Gln MARK NORTH POINT • t BUILDING PERMIT APPLICATION SIGN OFF AY'PLICANT: (),Sim L/ c ' ,a c 1 BUILDING PERMIT #: ADDRESS: 3P (i JA.4h 7. TELE. NO. : 36'5,3557 DATE FILED: BLDG. SITE LOCATION: / /6 PA.,. (5 *LP a ' ` S 3 Lou: f— 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 deC DATE: /A-6 N/A: /' S 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. COMMENTS:7,LDG - -E x C -En r Ci) > 5ThS, b y17 N. S6rgyc, c516'2, W Hawn- ,(--, HE .7's .00 ' J oLe 2 Rom Qin Rom Ebcu DF ejenrft ? c o prsv' C-6" 6 (4) 0,7i; /IA 3 di-- BLM/89