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HomeMy WebLinkAboutBLD-90-566 .•s; R-% TOWN OARMOUTH © Kam 9 /(K/Q° H MATTACMC[5 A� (D c,4 at••s& Application for a Permit to Build No. 6 UPON FINAL APPROVAL V- �l ' lq v MAP g6 LOT -T72-7322 FEE MUST ACCOMPANY THIS APPLICATION. DATE 19 The undersigned hereby applies for a permit to build 9/'V 76 according to the following specific o 1. Name of property owner // • / /� ,11 Tel. ^ 7� Address /, - Q=�� • 2.Name of Architect(if any) /% Tel. 3. Name of buil er Address j° '/5 y &11/1-1/24494 /We 4. License No 9OO 7 Tel. 56 g ` - 3 i 6' 5. Name of Mason �.c¢ /.-r Address 6. License No. Tel. 7. Construction address(.6/ lo) �2 4i -it U Ar- •ood District 8. Date of subdivision Approval plain zone Zone 9. Private dwelling er--- stimated Cost DO NOT WRITE IN THIS SPACE ,, Type of room No. 10. Multi family 0 (�' -fid 11. Commercial 0 Kitchen .. 12. Other El r____44_, Dining Rm. 13. No. of stories Living Rm. 14. Foundation — Full ❑ Crawl 0 Slab 0 ��- CB)-z) h Ba Rm. 15. Materials — Wood Petiment CieLgther 0 Deck 16.Type of heat — Oil 0 Gas L9' Electric 0 Other 0 Closed porch 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 ! n1 -No. of feet rear No. of feet deep 22. Size of building: No. of feet frdnt 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 r r lot line 4 Side line LOT RELEASED BY Signature PLANNING BOARD Address / a I Com. .� _ Date .bz, . _ ' _ 1 aG i' ' TOWN OF YARMOUTH BUILDING DEPARTMENT CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: JOB LOCATION: �� STREET VILLAGE NUMBER /al" ?9 OWNER OF PROPERTY: �--�^/!/ (f /�IG�I�j '/ alga!? LTA CONSTRUCTION SUPERVISOR: / G94m S /' IWaif LICENSE" N 7 36 BONE NO. 5 NAME ADDRESS: /Dg O `%,C7so'r ^ oci y - J�j � LICENSED DESIGNEE: fly}-SS LICENSED me ' / av009 (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 BUILDINGIS CODE AND HETS LLABEN ESPONSIBLE IBLEVFOFOR BSSEEING BTHATIALT ALL OWORKIIS 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 CODE COMMONWEALTH, EVENYTHOUGH AHE,TTHE HLICENSE HOLDER,GIS NOT AND PERMIT EHOLDER R IBUTLONLY BLE WS OF THE A SUB- CONTRACTOR OR CONTRACTOR TO THE PERMIT HOLDER. G DISCOVERY2.15.3 EOFIANYSVIOLATIONS WHICHrAREIATELY COVEREDOBYFY THE THE BUILDINGNCIAL 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. TAIN THE RE AND LICENSE ER T2.1 . ALL BUILDIG PERMIT HE6CONSTRUCTIONNSUPERVISOR WHO CISITOSSUPERVISE SHALL NTHOSE PERSONS UENGAGEDIN CONSTRUCTION,IRECON F 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 CON- OF THE DE. I UNDERSTAN THEUCONSTRUCTIONIINSP IN IONCPACOR' DURES AND ETHE OSPECIFIC N IINSPECTION AAS CALLED TE NFOR G OBY THE BUILDING OFFICIAL. � .� SIGNATURE: ( J G BUILDING OFFICIAL APPROVAL: " . .. • • -.---- 321-cam 10I-er �I- fel " (2-6 �'- '2 I / --- --- I I NI t AI ,.n. Sr X X, _1 , ,,, . .. ,,,,. . . ,o, . _ i. . . . _ _,,._____. .-, . _ I I �nL J (� �1' I L. ' I I HI— I C + ' II '� II I. 1 I ❑ • ' I � . it 1R II Ij J ; I �~ 0 1=UTU1�t � I. rt-Ili-Ids-- , I—U-f-uf�•� E'_ekDF ooF-1 11 / I LATH- II Frtr�r%=,;-f 1L_ J. _ _ :