BLD-90-631 • OF.yg4 R Pomo Qh�sd
ett�. '„it o . TOWN OF YARMOUTH o C pm05
t,• MATTACMC $ At'es) • • I �,�
,4•°°M°n°•vg; Application
for a Permit to Build No. 6'3
UPON FINAL APPROVAL ) COO LOT g Y
FEE MUST ACCOMPANY THIS APPLICATION. DATE 0
The undersigned hereby applies fora permit to build Ala ]'IS
according to the following specifications /°A cJjj
1. Name of property owner a-/ c Eta) S /al TW Tel.398 Z G38
Address ZS y/ftG'G-.Cffoo,c ,Co , .C, /drd/e✓T/f 7
2.Name of Architect(if any) Cc) -cc a es fl .5sSoc.'4fls Tel. �f
AAkn) • 7JT. r dILe /13). ,.9 So. AR,�iq{77x4
3. Name of builder "—"-' Address a1 , .
4. License No. - Tel. � �3 /
5. Name of Mason D SS 79 ��77 Address
6. License No. Tel.
7. Construction address 7-S 1 / Z- at€ az 7E0, .C. f/.9174e.ea �/
Flood , District
8. Date of subdivision Approval / 7 5 plain zone C Zone f o
,4ov 7'..g°✓ DO NOT WRITE IN THIS SPACE
9. Private dwelling Estimated Cost
Type of-room No.
10. Multi family 0 Kee ooc7 324 SFS-ta0, sr I
11. Commercial 0 A , i- - — Kitchen
12.Other 0 - 7 lip, (o 0 Dining Rm.
13. No. of stories a- S�G�2 Living Rm.
3 ' � p BedRm.
14. Foundation — Full 1ff Half 0 Crawl 0 Slab ❑ 7Bath
15. Materials - Wood 0 Cement 0 Other 0 Deck /
16.Type of heat— Oil 0 Gas 0 Electric 0 Other ❑ iel *orc /
17. Garage - 1 V2 ❑ 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 Go 9 7 No. of feet rear /o o No. of feet deep /2-0 1
22. Size of building: No. of feet front Zy f No. of feet side Z8 1 No. of feet rear t-y f
23. Distance from nearest building: Front Ft. side Ft. side Rear
.24. Distance back from line or street " yo ' From ear lot line So ' Side line C.71
7
LOT RELEASED BY • Signature ire
�.
PLANNING BOARD Address 0 y O . 7S113-Date , / ..tio C1/2€ A�?/ 6th,
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT.: c (CGArA.) ,C3. / G BUILDING PERMIT #:
ADDRESS: 7S Z� .nVOCY2 2e1 J ,TELE. NO. : . 8 z .79 DATE FILED: ' /
BLDG. SITE LOCATION: „.4747,e- ..9r e /A MAP!!: LOT!: .4
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 A., &A.,/ / _ - '' DATE: /61/1/7/1190 N/A:
2. ENGINEERING DEPARTMENT: / v DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT /a 4 DATE: /o/,c/cio N/A:
//WS '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 PRIORyTO ISSUANCE/ OF THE BUILDING
COTS: / 4g vtay' 41 C ada'i 40P -74 tr9h/ cc/de J noa s oo/ '
PL-PC- VA," Ar, 6Nlfha 6/2B.4.1^/ reins C 2• /
4) .9-o Midi', t2^-on- 73 6#€
3'' 67ehoe f.n na'. .9„ BEt-ou red
BLM/890 l 1 42-bo
AilP7/go OEi¢
TOWN OF YARMOUTH
BUILDING DEPA=IT
CONSTRUCTION SUPERVISOR FORA
•
Please Print: DATE: CS-Cr ' r/ %,
JOB LOCATION: Z /4 Z - aloo jz . ', �1ic/. �1T/
NUM E.- s. RE-. , / V' LAG
C.vNER OF PROPERTY:
CONSTRUCTION
SUPERVISOR: lif//LL/ - C . C Gc -.• 0/0 a, . 3‘e-8/3/
NP . LICENSE , /�J - PHONE
ADDRESS: AO , i � / • -t/• ieAfi"T .Lt. 6ZCp 5
:'EER SIR= CITY/MOWN STA ZIP COD
LICENSED DESIGNEE:
(IF OTHER THAN SUPERVISOR) NAME LICENSE
2.15 RESPCNSIBIIflY 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 Camcnwealth, 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 buildinc
permit. •
2.15.4 Any licensee who shall willfully violate Subsections 2.15.1, 2.15.2
or 2.15.3 oz any other Section of these Rules and Regulations and any procedures,
as amendedShall be* subject to revocation or suspension of licence by the •
Board.
2.16 All building permit applications shall contain the name, --signature
license number of the construction supervisor who is to supervise those persons
encac d in construction, reconstruction, alteration, repair," removal of-demolition
as regulated by Section 109.1.1 of the Code- and these Rule=_ and.- Rec^ lat4 o s:= :::- "-
In the event that such licensee is no longer -super✓ising--said--:persons; --t^e -=-: ---
work shall immediately cease until a succesor - license holder-is substituted_ a =-=
cn the records of the building dela tment. =_
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PREPARED FOR : a_c721a. Izdii4
CERT/F/£D PLOT PLAN
• LOCATION.• 5l1T4 '.A 1cL T%-\ •
SCALE: 1"• $c,' DATE xC "7, 191c
REFERENCE: LOT 4
P. B. 113 P. iv J .,.,.,._,.,M1.., •
L. C. P. �•
?t,i01.1 ,4 4,0$,
FLOOD ZONE '(� ' ,::f EN'Er^,fii !f: ' `..*•"''
/ HEREBY CERTIFY THAT THE BUILDING 113 1I1141EY
SHOWN ON THIS PLAN IS LOCATED ON THE ? s, 1,737 o ti ' • .
GROUND AS SHOWN HEREONMAND THAT/T q • Tr 4, e e�
�S CONFORM TO THE ZONING 02. q'
BY-LAWS OF THE TOWN OF 1 \EP 1cL114�-1 °Ci.. '���
WHEN CONSTRUCTED.
WELLER & ASSOC/ATES
7/4 MAIN STREET _/(11,7±'
YARMOUTH, MASS.
•
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LOT 4
1 1,971 sp 4011
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14AZELMcog. 120A-17 .
PREPARED FOR : 41._cclt1/4 iztn4
CERTIFIED PLOT PLAN
LOCATION: Ta ' acti ciJn \ •
SCALE: I '' 3d DATE cc---t `i 191
REFERENCE: LOT 4 •
P. B. 113 P. 1 %7 .m.....,•t...
it-
:�'w.0-•
FLOOD ZONE C ' ' EVERETT A:' c7...::;.:.'
/ HEREBY CERTIFY THAT THE BUILDING a (/TChl r i
SHOWN ON THIS PLAN IS LOCATED ON THE ' m 1787 ;
GROUND AS SHOWN HEREON AND THAT IT q ed; rEV•4 0: ;
ODES CONFORM TO THE ZONING : t ?, ,A,
BY-LAWS OF THE TOWN OF D-Ir U\4 t'+.:.,.` I' JJ
WHEN CONSTRUCTED.
WELLER & ASSOCIATES
7/4 MAIN STREET / //Y .
YARMOUTH, MASS. — T
. PLOT PLAN
' w FOR LOT # n
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool)
. well 0
/ I
(lot . o° ft. rear)
0
Abuttor's I Abuttot
Name IName
Lot # A '5 I Lot #
REAR YARD ? s
If this isa � >l ' If this
corner lot, , ft. corner
write in name write
of street. I name c
i a other
¢' • d• N street.
ami v
•
4 I J
stizet�'w4Ry
SIDE YARD ter: j SIDE YARD
ft .2.
/ / FT. novS� • I 4]— � 2 /_ Ern!�
0
. N
. �
SETBACK
'T`
V-
/ r
(lot 4 °d ft. frontage)
\ / / � '�l ZC'CNt00f2. /OD i
\ Jii /
\ / (NAME OF STREET)
/ �\ Information "/
/ \ Supplied by -sari —i Ad A.
MARK NORTH POINT
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: 3;
JOB LOCATION: - - f_ M - = 9SC $�"FinaaY4
NUMBER STREET VILLAGE
OWNER OF PROPERTY: _ - ��/ _ //� '
CONSTRUCTION SUPERVISOR: , //cN ,45;;;A1740155 7
NAME fLICENSE NO. yy� - PHONE NO.
ADDRESS: /j �f/�C Ref�z/ ✓;�#_,Nc /// 52-
LICENSED DESIGNEE:
(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
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 BUILDING
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 SUB-
CONTRACTOR 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 NU ER 0:
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 RULES AND REGULATIONS. IN THE EVENT THAT SUCH LICENSEE IS NO LONGER SUPERVISI:
SAID PERSONS, THE WORK SHALL IMMEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTE:
ON THE RECORDS OF THE BUILDING DEPARTMENT.
I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND REGULATIONS FOR LICENSING
STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERS
THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILD
OFFICIAL.
SIGNATURE: , Ale/ Ism.
BUILDING OFFICIAL APPROVAL:
G:/dit.vJ`-Scy`/1 1.v c'/n, y /N_sp./47. SCJ_
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_c QOZ_ J - / _ �� / .��t — S 1/4/41
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