HomeMy WebLinkAboutBLD-90-565 POSTED /
*44i- coof {�'o TOWN OF • ' MO_ UTH
;" MATTA.•CM[ S 441
e6;51Lo „>• f" Application for a Permit to Build Na ' �7�r
P�CZi _ d
UPON FINAL APPROVAL .J�� �� 1 MAP `f a LOT X/47
FEE MUST ACCOMPANY THIS APPLICATION. DATE Sr i 19 90
The undersigned hereby applies for a permit to build : �/i V/go
according to the following specifications e
1. Name of property owner "3 D,Te e Ro s.-'n4-/ Tel. 7 ) / SZf s'G
Address 49 e.fek c Ro. C4--es i yAa-10.771
2.Name ofArchitect(ifany) • Tel.
3. Name of builder Cie cg9 ST<r1 ve �.� Address 2 s ', y N's ,-•t RRc...fT
4. License No. 0i)73 / 7 Tel. CPC. 7,CC
5. Name of Mason _ Address -
6. License No. Tel.
7. Construction address 4 7 z4t,"c 2 0, 4-, y�'�..,-,---�
Flood / istrict
8. Date of subdivision Approval plain zone Zone
9. Private dwelling. Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family El 945 G o ,z - r
11. Commercial 0 /,u sT.�}L s,cy ii9hT
IN C'/2 Kitchen ,
12. Other 0 Sky j/_1/7- - Dining Rm.
13. No. of stories I' Living Rm.
5/at 3o y y7° Bed Rm.
14. Foundation - Full 0 Half 0 Crawl 0 Slab 0 Bath
15. Materials — Wood 0 Cement 0 Other 0 Deck "
16. Type of heat — Oil 0 Gas ❑ Electric 0 Other 0 ;rClosed porch
o— Family Rm.
17. Garage — 1 0 2 ❑ ' 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 Na 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 qm-
PLANNING BOARD Addr ss ,, eu . fl ' '
Date / oktvt Jk-
adci
er
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: y�
JOB LOCATION: 7 Y </iKe y a any
NUMBER �� STREET VILLAGE
OWNER OF PROPERTY: rt., /TDN ('r'o SS .h9.✓ {6 r
c1BS /7 896 7.166
NAME u
CONSTRUCTION SUPERVISOR: C� �rRA f�? ^� LICENSE NO. PHONE NO.
ADDRESS: Z S /1A5/ ^"ion. 'S 4-fir /3R•'owCTC/R ) /A:
LICENSED DESIGNEE: LICENSE NO.
(IF OTHER THAN SUPERVISOR) NAME
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
BUILDING CODEAND
GETHEADRAWINGSAS
SNAPPROVEDFOR
BYSEEING
BUILDI GALL
OFFICIAL DONE PURSUANT TO THE STATE
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
COMMONWEALTH, EVENY
YTHOUGH HE,TTHE HLICENSE HOLDERI,GISONOT THE PERMIT DE AND ALL EHO DERR IBUTLONLYE WTHES OF
PURSUANT A SUB-
CONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER.
D2.15.3 ISCOVERYEOFIANYSVIOLATIONS WHICH ARE COVEREDOBYFY THEHE BUILDINGNOFFICIAL 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 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 AND
SAID PERSONS, THEULES REGULATIONS. IN EVENT THE THAT LICENSEE IS NO LONGER
WORK SHALLIMMEDIATELYCEASEUNTILA SUCCESSORLICENSEHOLDERISSUBSTITUTEDG
ON THE RECORDS OF THE BUILDING DEPARTMENT.
I HAVE READ AND UNDERSTAND MY ESPONSIBILITIES UNDER THE RULES AND REGULATIONS FOR LICENSING CON
H
N
OF THE
THEUCONSTRUCTIONIINSPECTIONCPROCEDURES TANDETHEOSPECIFICIINSPECTIONABUILDINGTE
AS CALLED FOR BY THE BUILDING
OFFICIAL.
SIGNATURE: A./
BUILDING 0 FICIA(APPROVAL: