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�,? �•� Application for a Permit to Build No. 9gli
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UPON FINAL APPROVAL MAP A 8 LOT A
FEE MUST ACCOMPANY THIS APPLICATION. DATE a - 9 9w
The undersigned hereby applies fora permit to build // 0/ i "
according to the following specifications
1. Name of property owner 2'II 121Lw ge. S \ . /Mc- Tel. 35'4 .7 i5)
Address sat MA/n1 Cr -C14 (3 m Al AST ) sO 4
2.Name of Architect(if any) Nq)t.. Tel.
3. Name of builder S PLIC • Address 2'4 6 1v1 A-I tc7 51 3, If 2.
4. License No. Tel.
5. Name of Mason Address
6. License No. Tel. ' )ifizr
7. Construction address , 9ruv lA AI i g - ;?
Flood Distr'
8. Date of subdivision Approval plain zone Zor1 •
9. Private dwelling Estimated Cost D NOT WRITE IN THIS SPACE
�1 . - of room No.
10. Multi family 0 (5'000 --- �"_ _ /�'�'
11. Commercial ❑ �Q ffc 4 Aet9 IM-4.4.Qjt- luYe�ioti 4K '1o2 Kitchen S Z
12. Other ❑r_rtra j .-- ioi+ ciJo woos to F°x ' Dining Rm.
13. No. of stories ' ��a fa e Living Rm.
^ r Bed Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 fig 8- Bath
15. Materials — Wood 0 Cement 0 Other 0 Deck _
16.Type of heat — Oil 0 Gas 0 Electric 0 Other ❑ 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 ❑ Alterations , Je
21. Size of lot: No. of feet front No. of feet rear No. of feet deep
22. Size of building: No. of feet front No.of feet side No.of feet rear
2a Distance from nearest building: Front Ft. side Ft. side Rear
24. Distance back from line or street From rear lot line Side line
LOT RELEASED BY Signature 7
PLANNING BOARD Address 2-`{(a Y 1��►Iotau, S r
Date 50
TOWN OF YAMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE II I IQ O �1
JOB LOCATION g'• 1 1 QJ,A, P� Sti, ren 0
NUMBER STREET ADDRESS ECTION OF TOWN
"HOMEOWNER" -P c O ? E I RJ L.L a 3- 7 2_-
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADRESS 2__.'-}C:, \\A.0 0 AA, S fi
S v \ian-rn clot MA- a zG 4' %--/
CITY OR TOWN STATE ZIP CODE
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER-OCCUPIED
DWELLINGS OF SIX UNITS OR LESS AND TO ALLOW SUCH HOMEOWNERS TO ENGAGE AN IN-
DIVIDUAL FOR HIRE WHO DOES NOT POSSESS A LICENSE, PROVIDED THAT THE OWNER
ACTS AS SUPERVISOR. (STATE BUILDING CODE SECTION 109.1.1)
DEFINITION OF HOMEOWNER:
PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICH HE/SHE RESIDES OR INTENDS TO RE-
SIDE, ON WHICH THERE IS, OR IS INTENDED TO BE A ONE TO SIX FAMILY DWELLING,
ATTACHED OR DETACHED STRUCTURES ACCESSORY TO SUCH USE AND/OR FARM STRUCTURES.
A PERSON WHO CONSTRUCTS MORE THAN ONE HOME IN A TWO-YEAR PERIOD SHALL NOT BE
CONSIDERED A HOMEOWNER. SUCH "HOMEOWNER" SHALL SUBMIT TO THE BUILDING OFFICIAL,
ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT HE/SHE SHALL BE RESPONSIBLE
FOR ALL SUCH WORK PERFORMED UNDER THE BUILDING PERMIT. (SECTION 109.1.1)
THE UNDERSIGNED "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE STATE
BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGULATIONS.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH
BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE
WILL COMPLY WITH SAID PROCEDURES AND REQUI' 4..1* S
HOMEOWNER'S SIGNATURE , , , £ .40rAlth.
APPROVAL OF BUILDING OFFICIAL
NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED
TO COMPLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION CONTROL.