Door & Windows 02.11.19ONE TWO FAMILY ONLY- BUILDING PERIVIIT
Town of Yarmouth Building Department
1 1146 Route 28, South Yarmouth, MA 02664-4492
01 NwP� 508-398-2231 ext. 1261 Fax 508-398-0836
'C No Massachusetts State Building Code, 780 CMR
KEN.. BuildingPermit.�4pplication To Construct, Repair, Renovate Or Demolish
a One- or Two -Family Dwelling
o� r
This Section For Official Use Only
Building Permit Number:
Date Applied:
Building Official (Print Name) Signature' Date ,
SECTION 1: SITE INFORMATION
1.1 Property Address:
1.2 Assessors Map & Parcel Numbers
Map Number Parcel Number
1.1 a Is this an accepted street? yes ow --no
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Area (sq ft) Frontage (ft)
1.5 Building Setbacks (ft)
Front Yard Side Y
Rear Yard
Required Provided Required ovided
Required Provided
1.6 Water Supply: (M.G.L c. 40, §54) 1.7 FIood Zone Information:
PublicZone: _ Outside Flood Zone?
I. Private ❑ Check if yes❑
1.8 Sewage Disposal System:
Municipal ElOn site disposal system
SECTION Zw PROPERTY O'WNERSii i
2.1 Owner' of Record: .
�IVe.�t. hF e t 1;4;1:1 Y''¢.�1��.5
Name (Print) k City, State, ZIP R
M:? W s YJs H 0PJL INA. 4 L4 ?- -Ss I r f k I
No. and Street Telephone Email Address U—)O rk
SECTION.3:.DESCRIPTION OF PROPOSED W6kie (check a1I that app y)
New Construction ❑
Existing Building,. Owner -Occupied ❑
Repairs(s) K
Alteration(s)
Addition ❑
Demolition JI
Accessory Bldg. L7 Number of Units
Other ❑ Specify:
Brief Description of Proposed Work': CG E,i t t rrr `
rr�" �t ' F
ov
471 F` eu At.c Ao 4L
SECTION 4.- ESTIMATED.+CONSTRUC'TJON COSTS. €
'
Item
Estimated Costs:
(Labor and Materials)::,
. ° ,Official -Use Oil
i �..: .. ... .. ;.
1. Building
S /2-000
: -1..- :Building Permit'Fee: S:' ' Indicate how fee: is determined:
❑,Standard City/TowhApplidation..Fee;
-
M.TotalPrdieat Cos?.- Item 6).xsnuhli tier.... X---
2: 0"r',Fees: $ - .
List: '
2. Electrical
$ ?'`0 C.,
3.
3. Flumbing
Ci
4. Mechanical (HVAC)
$
5. Mechanical (Fire
Suppression)
S
Total A]I Fees: $
Check -140.'. Check Amount: Cash
p Paid' nFull . ❑ Outstanding Balance
t:
uei
6. Total Project Cost:
S �' �U
YARMOUTH
OLD KING'S HIGHWAY
Feather River Doors 32 in. x 80 in. 6 Lite Clear Craftsman
Unfinished Smooth Left-Hand Inswing Fiberglass Prehunq
Front Door
American Craftsman 70 Series Pro Double
Hung White Vinyl Window with Buck Frame
and Colonial Grilles
I
J
IL
8