HomeMy WebLinkAboutBLD-90-689 , o TOWN OF ' • RMOUTH 1 (/ 0.0/TO
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�,4 .���L S� % Application for a Permit to Build No. 4g9'
UPON FINAL APPROVAL P ' H
/ MAP F P LOT Vi 1 i
FEE MUST ACCOMPANY THIS APPLICATION. DATES ei 19 90
The undersigned hereby applies for a permit to build /I/a3nd
according to the following specifications ///a 70
1. Name of property owner HA \JIM 1 c�7 e LOTS Tel.
Address 4,4-7- 6n42rtvoc - ---e?.J RS
2.Name of Architect(if any) NC- Tel.
3. Name of builder /v Ors GC (Co Ulf Address /orSZa t..rJ L, )&lJlC,(�-
4. License No. M 0 0-? '? 0 Tel. SG 3 -,t)-07 ..)--
5. Name of Mason N 2 Address
6. License No. AJ (CTel.
7. Construction address Salle sr 64.ca-Gve,sThi,l (7 d
Flood District
8. Date of subdivision Approval plain zorre— Zone
9. Private dwelling f9' Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family ❑ c c o-0 , cnJ 0�
11. Commercial 0 / Kitchen
12. Other ❑ 2aae jec,54 PRcL 716 Via_ Dining Rm.
13. No. of stories / Living Rm.
Bed Rm.
14. Foundation — Full 124Ialf 0 Crawl 0 Slab 0 Bath
15. Materials — Wood UP-Cement 0 .Other 0 Deck
16.Type of heat — Oil 0 Gas 0 Electric 0 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 u ' No. of feet rear / 4 No.of feet deep A'A
22. Size of building: No. of feet front .6JL . a No. of feet side J 8 V No. of feet rear6c5 6''
23. Distance from nearest building: Front A) ft Ft. side SS' Ft. side r'ire Rear cli^
24. Distance back from line or street 7.3- From rear lot line Side line
LOT RELEASED BY Signature g2. -.> el/
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PLANNING BOARD Address / �/
Date Val v L9 t1c S S
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: Mn. J. P /RJ 0L' 4TS
JOB LOCATION: V t (.O4ectV' W O ,..j C'J
c Ye HO s(
NUMB.E$ STREET VILLAGE
OWNER OF PROPERTY: t/Il lit M f 0 �I /��S
CONSTRUCTION SUPERVISOR: (jut?/C n�5 CO O /uff O O 0--7 ? O V'6 el—cl Q ? e_
Luck
NAME LIICCEENSE N�O�.. PHONE NO.
ADDRESS: CS Q/� / YO-41-10071, 1ta-s S
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 CO/
STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTAP
.HE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING
OFFICIAL. //
SIGNATURE: 6/J—nLe /2'�� %l
BUILDING OFFICIAL APPROVAL: i