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e6):144""Alt", Application for 7rmit to Build No. C-5-11;0 q (919 0
UPON FINAL APPROVAL MAP 3/ LOT p 'J9
FEE MUST ACCOMPANY THIS APPLICATION. DATE t/ZZ 19 fa
The undersigned hereby applies for a permit to build 0-9/9.0
to the following specifications
// I. Name of property owner G co it/a-0 eta.°ctcC �- P4/ . 4 . Tel. 773---/2 S%3
Address 3G. tn,//pon c/ roc/
{Name of Architect(if any) Tel.
3. Name of builder _O w x/KA- Address
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel. �I
Construction address 5r��_ •• L.3 --Th � UU& &--„ a /ems.. (C"
Flood District a
8. Date of subdivision Approval plain zone, Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
10. Multi family 0 ---1 /0d , d7) Type of room No.
11. Commercial 0 Kitchen
12. Other 0 Dining Rm.
13. No. of stories Living Rm.
/-- Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 l J ` 0-1:1 Bath
15. Materials — Wood 0 Cement 0 Other ❑ / S v n - _Deck
16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch
30- �D Family Rm.
17. Garage — 1 ❑ 2 ❑ Sun room
18. Swimming pool - Size
9C!/Ly' WlT/*oVT Garage
1/19. Storage shed — Size r..4 X 17 Shed y,s- r /
20. Stove — Wood 0 Coal 0h1/T 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 lot line Side line
LOT RELEASED BY /Signature K7.vcr,•-i
PLANNING BOARD cZAddress
Date
t
BUILDING PERMIT APPLICATION SIGN OFF
PPLICANT: ei ei e C {-°OCK BUILDING PERMIT #:
$ESS: 3g 171 i/(/00/2d d //ee TELE. NO. : 77-5-5/.971..? DATE FILED:
BLDG. SITE LOCATION: (,VeS F �/t
Y / t0d: Gt MAP#: LOT#: / 9
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 /,65 „_t DATE: 6/_23/9V N/A:
INDUS 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 STOMPS 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:
BLM/89
e4-4'
1 , .�
' PLOT PLAN
FOR LOT #
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) ED
Well g
— oat • ft. read) �1 I — — — —
Abut or's 1_ �'- ih( $�� Abuttor's
Name i � bName
Lot # I Lot #
REAR YARD r�
If this is a I If this is
ici
corner lot, corner lc
write in name LIwrite in
of street. name of
,-, 0 e other
if! %o street. .
b
77 4
SIDE YARD SIDE YARD
HOUSE
FT. O • a FT{\ •
�/ 0 Y
SET BACK
ft. -
0
(lot ft. frontage)
\ / 3 6 -ht-e4‘ 7}yuk et COLA_
\ /
\ (NAME OF STREET)
\\ Information '
/
/ A Supplied by _ _It
/ \ /
MARK NORTH POINT
•
TOWN OF YAMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE f/p? i'/f 90 7
JOB LOCATION .3ND / �7,go /2 73e/ je c 5A ,��Dc- -
ER ET ADDRESS �o � SECTIO OF TOWN 77-7 /1 o ..S.3
"HOMEOWNER" C'� P e - A '. 1 Y 9 C-1 -- -- o
1 HOME PHONE r " PHONE
PRESENT MAILING ADRESS ,�/ayya C.-
0 a-6 73
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,
�TTACHED 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 PROCED S AND REQUIREMENTS.
( HOMEOWNER'S SIGNATURE
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.