HomeMy WebLinkAboutBLD-90-582 POSTED 6,147C ?//ilyD
'r I, o TOWN OF Y RMOUTH D1` rem) 9/"f10
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4 ..,�>• Application for a Permit to Build No. �� 2
UPON FINAL APPROVAL �� i --�'.�MAP 'TO X ( LOT S
FEE MUST ACCOMPANY THIS APPLICATION. DATE 1p el0
The undersigned hereby applies for a permit to build as
192,
according to the following specifications II 9/2.4q°1. Name of property owner I et to ln\P lio gilt "TraS4- I Tel. 39`I
t'30gh
Address ((nSnuwv1l( Vona Rd•j I- lh nnLin1VN44 n3.04" .
2.Name of Architect(if any) Tel.
3. Name of builder E • A• . .-. tat • •dress 17.0.anx, 1901 ON b nnkISj YY)K
4. License No. OVac' Tel. Cefl 4- -2,o9Q '
5. Name of Mason Address
6. License Na i/ Tel , /
7. Construction address . 1.accre arl vP_ r -"brit v-e_ 0 . n -vv)o cttl-•I
Flood 1 5 ! r District
8. Date of subdivision Approval loll li plain zone Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 (01 000 06 -
11. Commercial Lye/Lett t ,�y�yam, C Kitchen
12. Other /et#1 a/ Dining Rm.
-
13. No. of stories Living Rm.
0..5 , 0-0 Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 Bath
15. Materials — Wood ISL Cement 0 Other 0 Deck
16. Type of heat — Oil 0 Gas 0 Electric ❑ Other 0 Closed porch /
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 I 50 No. of feet rear 1(-Vx No.of feet deep 34.5
22. Size of building: No. of feet front I a No.of feet side I 0 No. of feet rear I
' 23. Distance from nearest building: Front (fit Ft. side \Qnt- Ft. side (phi- Rear (0bt-
24. Distance back from line or street Sq From rear lot line/moi . . Side line 1"5 3
LOT RELEASED BY. Signatureg
�.�L��w L(�
PLANNING BOARD Address 2.4 S (nootS. ).0. 2nX �StL
Date 1.Oe5-1- 1)eh n*S ) 814 101610
TOWN OF YAP.MOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
' Please Print: `/ DATE: 1I)OIC()
JOB LOCATION: L04- S rdgp IAk Frr�r LV P ')fl Y A r-M O A
ER f i I VILLAGE
OWNER OF PROPERTY: L_ecLti)dtf'YItuNIe rnj -171(5 E
CONSTRUCTION '\ •
SUPERVISOR: EU,q W . t i'. • -i•03`).%0c cq�-3 0
NA, II�� , I uPHO
ADDRESS: 6. ?)ox d, 2 ScIOo\ SrL bemS l W1 {4 C e-670
NUMBER) STREET' CITY/TOWN STATE ZIP CODE
LICENSED DESIGNEE:
(IF OTHER THAN SUPERVISOR) NAME LICENSE 4r
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 buildings 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 subcontractor 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, reconstruction, 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 construction supervisors in accordance with Section 109.1.1
of the State Building Code. I understand the construction inspection procedures
and the specifi inspectiona�call-. or by the building official.
•
SIGNATURE: • :. �(\) .��,1 ••
•
(LICEN ED'CCNSTRUCTI N RVISOR)
BUILDING OFFICIAL APPROVAL:
BUTLD1tiG PERMST APPLICATION SIGN OFF
APPLICANT! LUVIYAW‘Naltrnakirrtk4 BUILDING PERMIT O:
ADDRESS* 10VhI6 ,)�,p 1(, ; /14
TELE, NO. : -2jR4-.O9Q DATE FILED: g 76 (cia
BLDG. SITE LOCATION: � Q(C�q 1. r_ '1 u€ MAPA: c% LOTH: 5 -
THE FOLLOWING INFORMATION OUTLINES!!lTHE 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 REQUIREM ITS (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 DEPAR T: DATE: N/A:
3. CONSERVATION: ♦ A✓ DATE: %//t/to N/A:
4. HEALTH DEPARTMENT0.41F /77 DATE: 7,/re N/A:
INDUS V LAL 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:
BLM/89
/�)/96-