HomeMy WebLinkAboutBLD-90-710 o, W. rte,.
$�— O TOWN OF YARMOUTH ii/i09 °
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kaVM.T,.c�E s6; pplication for a Permit to Build No._7 0
PIL
UPON FINAL APPROVAL 12 -4-90 MAP 73 LOT N62 N .?
FEE MUST ACCOMPANY THIS APPLICATION. DATE %a-I / 19 90
The undersigned hereby applies for a permit to build 1a/5!/9a
according to the following specifications
1. Name of property owner c w 9-,, C c Ya f snot. 4 Tel.
Address la 3-ri nfp ) ()>..arN SL
2.Name of Architect(if any) Tel.
3. Name of builder_igLari A 4rre. Address V1 pijr,/ O47 CCTe / p. )1/4710(
4. License No. oy S3/ 4' Tel. 3 qtr -cob 9
5. Name of Mason Address
6. License No. Tel. ,
7. Construction address ars,. ....-..—__..---_,
Iood District x«+0 4,
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
to Type of room No.
10. Multi family ❑ l e>�jo S' •t o
11. Commercialr/,) / c_ ��c--c2
aU Ci- Kitchen
12. Other 0 mGz e v-cT Dining Living m.
13. No. of stories V/1m.
I()) � Bed Rm.
14. Foundation — Full 0 Half 0 Crawl ❑ Slab 0 Bath
15. Materials — Wood uYCement [Other 0 Deck
16.Type of heat — Oil 0 Gas ❑ Electric 0 Other ❑ Closed porch
Family Rm.
17. Garage — 1 0 2 0 Sun room
18. Swimming pool - Size Garage
19. Storage shed — Size Shed
20. Stove — Wood 0 Coal 0 Alterations 1---
21.
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
23. Distance from nearest building: Front Ft. side Ft. side Rear
24. Distance back from line or street From rear lot line
Dn
M; Side line
LOT RELEASED BY Signature I �f±2„-
PLANNING BOARD Address 41 i 3; y C'1`rr Is. 0Pnx)Sperd
Date
TOWN OF YARMOUTH
BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: n'
JOB LOCATION: 1.76941>v5 *Crowe)( & ' Mgfl �3 4 V o2•
N1M ER STREET ,y VILLAGE
OWNER OF PROPERTY: J N � ,I P i/10-0 .. ON)N&ri S !t.
CONSTRUCTION SUPERVISOR: fl yv hG, , re. c9 ?/Q 391,-000
��77 AME LICENSE NO. PHONE NO.
ADDRESS: 4z M i f(i aa >' 01 21 e. D Pn n iS ,(Ed,
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 COP
STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTAP
THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDINC
OFFICIAL. ^ (�
SIGNATURE: ci.Q , raliks
BUILDING OFFICIAL APPROVAL:
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