HomeMy WebLinkAboutBLD-90-665 rMO
TOWN OF ' RMOUTH
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%,4�.M�tWO Application for a Permit to Build No. GC'
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UPON FINAL APPROVAL ?V MAP PAGE i<9 LOT /o/
FEE MUST ACCOMPANYTHI'S APPLICATION. DATE 44:"v /sr 19 90
The undersigned hereby applies for a permit to build ////wee`
according to the following specifications ������90
1. Name of property owner %7-,Pic-.c A,-- ..‹. Tel.@08j344-46/6
Address gmc-.a.or�AJ yce„c
2.Name ofArchite fany)fr3A 'r 4ssoc• /,csrtwc-c Tel. x'oao 393
3. Name of builder - A s Address .pr) r3ox /2� ccwassErM,4
4. License No. ifaTel. (G/7) 363 - /994-
5. Name of Mason c- -°KA'rv,-v 7W-5 niwe Address
6. License No. Tel.
7. Construction address Pa a-dia t 1190-e-A /Q---d 919
Flood District
8. Date of subdivision Approval plain zone Zone
a Private dwelling lEr Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family ❑ fi/o, 000 —
11. Commercial ❑ °- Oc
12. Other 0 SKitchen
Dining Rm.
13. No. of stories / 3Living Rm.
Bed Rm.
14. Foundation -Full 0 Half 0 Crawl 12'Slab 0 Bath
15. Materials — Wood O Cement 0 Other a Deck
16.Type of heat — Oil 2-Gas 0 Electric 0 Other 0 Closed porch
Family Rm.
17. Garage - 1 S-2 ❑ Sun roomimq
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 ,°O No.of feet rear /0 o No. of feet deep /2-0
22.
2-
22. Size of building: No. of feet front FR No.of feet side 2-n No. of feet rears 4-
23. Distance from nearest building: Front 5/' r Ft. side z. ' Ft. side 17' Rear z6=f1
24. Distance back from line or street C<°-`¢ From rear lot line 2 e 16 Side line zee
LOT RELEASED BY Signature l& il A x k kA 3..-
PLANNING BOARD Address fro /'8
Date a,?'.4�5c?- /OA 0202,'
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT:
JOB LOCATION: ec cA,°za_,j yO.e.0 t_sC YA. mcneir,•/
NUMBERSTREET VILLAGE
OWNER OF PROPERTY: `5s.T,Q/Cf� /
CONSTRUCTION SUPERVISOR: ' //GG/dM .o, EG��a
c22SC.1st (2, ')3a3-1994
NAME LICENSE NO. PHONE NO.
ADDRESS: "oe") ,R,,X /2R c7.0,0-70a.SSe r /YJ,6. OROar
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 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 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-
STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTANI
THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING
OFFICIAL.
SIGNATURE: La.), J
BUILDING OFFICIAL APPROVAL:
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: f°AT.e/C4 MC.Cs)� BUILDING PERMIT 0:
ADDRESS: YO.e.0 TELE. NO. :( te?)391-40/6 DATE FILED: Nov //990
BLDG. SITE LOCATION: .5'AMh O4,G'45-,:7 LOU: tea/
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 SYSTEI
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 DEPARTMENTDATE: lliyle , N/A:
I STR 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. \ ��A
COMMENTS: ADC- —mwiv,r ��-ear/ is 571-cr y /V20 %C17
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BLM/89
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OF 1010 COMMONWEALTH AVE �E�q1 •
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MASSACHUSETTS BOSTON,MASS.02215 i V•. .
ENCLOSE CHECK OR MONEY ORDER .
LICENSE
EXPIRATION DATE 06/30/1991 CONSFR. SUPERVISOR
FOR REQUIRED FEE,
MADE PAYABLE TO
RESTRICTIONS 5644 `S EFFECTIVE DATE LIC-NO. e
• -"COMMISSIONER OF PUBLIC SAFETY” -
NONE 06/30/1989 018404 E
(DO NOT SEND CASH).
•
WILLIAM N DIGREOORIO � •i�1ll
SS 4$ 021-26-5620 POBX 128
PHOTO IBLASTWEI OM ONLY) FEE: COHASSET MA 02025
100.00 NOV 3 O 19°9
HEIGHT: NOT VAw UNTIL SIGNED BY LCENSEE AND OFFICIALLY I
STAMPED-OR •SCNATURE OF THE COMMISSIONER .
DOB: D.P.S. -
. 05/18/1935 (..7i 4
THIS DOCUMENT MUST BE
SIGN NAME IN FULL-ABOVE SIGNATURE LINE
CARRIED ON THE PERSON Of• ^ ^ Of LICENSEE
• IHE HOLDER WHEN ENGAO- • ,2,}}} I/ //
OTHERS-RIGHT THUMB PRWT EO IN THIS OCCUPATION ^ e• C•/!///I C .NM45gNER
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• ALTERNATE COMPLIANCE: SECTION 20093
THIS STATED Uo (or U) VALUES OF ANY ONE ASSEMBLY, SUCH AS ROOF/CEILING, WALL, OR
FLOOR, MAY BE INCREASED AND TIIE Uo (or U) VALUE FOR OTHER COMPONENTS DECREASED,
PROVIDED THAT TIIE OVERALL HEAT GAIN OR LOSS FOR TIIE ENTIRE BUILDING ENVELOPE
DOES NOT EXCEED TIIE TOTAL RESULTING FROM CONFORMANCE TO TIIE STATED Uo (or U)
VALUES.
ENVELOPE ALLOWABLE Uo (PER TABLE 2009.1)
(Aw •0.05) + (Ac •0.651 + (Aoo 0,40) + (AoR 0.033) + (Mr 0.041+ (Arm,' (LOS) = AL-LoW„p,,F,
6014CC .3
(333 42).05).4.( 93 xct 4+(= 0.40)+( Q.c33)+-(0-10 x o,os)+ — xo.06) 214'3.
•
)06,81 Au.owAet PER TABLE. 2009.1
•ELECTRIC RESISTANCE HEAT U-VALUE WALLS = 0.05, U-VALUE WINDOWS = 0.40
•
ENVELOPE ACTUAL Uo (USING ACTUAL VALUES OF DESIGN OF ENVELOPE)
(Aw Uw1 + (Ac Ucl + (AOD UOD) + (AOR Um) + (AOF UOF1 -L (AOWF 1.30wF) '— A A
(335 x .o t)t(93 x , OO'+1 x - ).,.(;SL e . 51)�I2/a x,owz`+/ -- x
a�. 4/ . 53-vg i 6,� rt?2 J
9 - 7s
97. s ACTUAL
.
COMPARE VALUES T«s-
THE •- VALUES FOR ENVELOPE ACTUAL MUST BE LESS THAN OR EQUAL TO . VALUE
OF ENVELOPE ALLOWABLE TO PASS. n
PASS FAIL
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