HomeMy WebLinkAboutBLD-90-532 (21 M&N) 3 1
. .as, ' :"r 4�'0 TOWN ARMOUTH 6I< k j/aQ (q°
ICA •IATTACIIC 5 A
�,C W// Application for a Permit to Build No. 5-3°
UPON FINAL APPROVAL V' g/ a9 9 MAP 74 L� N ID
FEE MUST ACCOMPANY THIS APPLICATION. DATE Al ' 1 qd
The undersigned hereby applies for a permit to build a 2-9/Ce
according to the following specifi ations
1. Name of property owner 1kfronhti HANMAp 14 Tels.36i - 8i 7/
Address/7 % chi/ itis 5 Jlycv Ar /mr!
2.Name of Architect(if any) Tel.
3. Name of builderA< . • •dress /Cc SGi/ oAN /e., a wy
4. License None"1 S"O 9 Tel. 7 75-- 3 79,3`f
5. Name of Mason Address
6. License No. Tel. A
7.Construction address o2/ H '4- 1/.4a 4,,,,,_ l ��f
Flood D trict
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
Tye of room No.
10. Multi family 0 . 1 600, f s
11. Commercial Q(h-a /1 1 Kitchen
12. Other 0 Dining Rm.
1 6 ems' G Living Rm.
3. No. of stories
.Bed-1 ,r:Vra y a.14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 �a-c 'i ' Bath f/4LF 9{
15. Materials — Wood 0 Cement 0 Other 0 Deck
16. Type of heat — Oil 0 Gas ® Electric 0 Other ❑ 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 ❑ 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 Signatur: .r_ . . . r
PLANNING BOARD Address/a 0 Su A b4 A/ "p
Date Wp.r/ )<9 A ref ou I • A4) - •
�� BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: 1t0'i'� /c41/t/i)//41 y'CG BUILDING PERMIT ll:
ADDRESS: /79 Qi(;� tf A 5 �/i9 . / ¶
TELE. NO. :3C, l7/ DATE FILED:
BLDG. SITE LOCATION:V/ -/y A. . iclet4,U 14/.4) MAN: LOT#:
•
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 pr, DATE: gp r/9'(J N/A:
NDU 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 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.
CO S: 5/,/,3_,,,4y- r,N ;.r/7/ Ai ,Aron Poo/y? ►� / .v y
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$4176 j) -a /'.ct,c77szs ONL c- ,44 /7s-c1-7 /71000H, E.Z> ON To,o
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BIM/89
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ltiaso �-
7r;s A, AS
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: �/ �/
�/- l 'F Al 5 oAu AI WA/ -W• . 4n/foa �'
JOB LOCATION: STREET VILLAGE
NUMBER ., CoOWNER OF PROPERTY: TQh 0 M+2 M/a NN I '�g 41- _
CONSTRUCTION SUPERVISOR:Amiss/ �P/UN1 (313,0ONAME L?ENSE NO. 77 PHONE
ADDRESS: /6O 1.2A it/ /u4'• WPJ/ AWi'K/Df/
LICENSED DESIGNEE: /4/101 j r. �ti'ey a e95�
(IF OTHER THAN SUPERVISOR)
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.
EGSAS
SHALL BE SNAPPROVEDFOR
BYSEEING
BUILDI GALL
OFFICIAL DONE PURSUANT TO THE STATE
BUILDING CODE AND TH THE
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
S OF
COMMONWEALTH, EVENY
YTHOUGH HE,TTHE HLICENSE HOLDER,GISONOT DE ATHE PERMIT ND ALL EHOLDER R IBUTLONLY E WTHE
PURSUANT A SUBCONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER.
G
D2.15.3 ISCOVERY LICENSE HOLDER SHALL
WHICH AREICOVEREDIATELY OBYFY THEHE BUILDINGNIAL IN WRITING OF THE
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 STRUCTIONI,UCTION ALTERATION1,VISOR REPAIR,OIS TO REMOVALSOFERVISE DEMOLITI0NEASERSONS REGULATEDABYDIN SECTIONS109.1.1NOFRNTHE
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 CON
STROF THE
TE
G
DE. I UNDERSTAN
UIACCORDANCE
ANDECTION THE SPECIFICIINSPECTIONAAS CALLED FOR OFOR
THECONSTRUCTIONBY THE BUILDING
OFFICIAL.
F1 c�2�21<Gi
BUILDING OFFICIAL APPROVAL: