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HomeMy WebLinkAboutBLD-23-000869 p1'.Y.444 i Office Use Only - . H M`^mATTACM isc jAmount %,4 ..t�..Q GCF ,d 1 Permit expires 180 days from jissue date EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146Route28 RECEIVE ') South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 AUG 8 2022 CONSTRUCTION ADDRESS: I J 7,5 r ___.__..______._-. RUII DING DEPARTMENT ASSESSOR'S INFORMATION: BY -------- �• Map: Parcel: i -, OWNER: 1 Et j�( ,1'r ���u A, &r 'bLa, l , )NAME PRESENT D S t� TEL. # CONTRACTOR: o1 \ .. etet.A., x NAME /)/.,ond et- cJ(/.X7t a..3/ .8 SAILING ADDRESS TEL.# ❑Residential ❑vCom(meercial ( 7` Est. Cost of Construction$ Home Improvement Contractor Lic.# Construction Supervisor Lic.# Workman's Compensation Insurance: (check one) ❑ I am the homeowner ❑ I am the sole proprietor ❑ I have Worker's Compensation Insurance Insurance Company Name: L(7U l et 1^S \ii\A-,..4_4 c Worker's Comp.Policy# /d 4i9 /d//O WORK TO BE PERFORMED it A'1 7xh T Tent O Duration 3 (Fire Retardant Certificate attached?) © �® Woocj Stove Siding: #of Squares c.� 1 X (J�.1) q Replacement windows: # Replacement doors: # Roofing: #of Squares ( )Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing *The debris will be disposed of at: Location of Facility I declare under p- ties of p- .ury tit e state, ents herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cau for denial o evo•. in o m license and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Si,; atur _' L �� Date: Owners Signature(or attachment) Date: a/= As. Approved By: Building Official(or desip0 Date: �� EMAIL ADDRESS: Zoning B Historical District: ❑ Yes Flood Plain Zone: ❑ Yes Eo ( Water Resource Protection District: Within 100 ft.of Wetlands: 0 Yes �!o 0 Yes ❑ lam/ semis ree Web Services Page 2 of 2. c9- c• � • ' rti'^"�'.`, 3zT-�. :_� ..w-r..v-' > �• ' =-x�.- +3-ik- . • • �*-_ ..�,a.�'__ .._. �v�+�-..'.-�� ��.ar"��`-�"•� :,--.�...u._�' _- ..,▪ � --r._.:�._$��=:__.;•.fir='-'``=a.• :':,.nt^�. ". s;.a.:• .€;�s�.��'"'-Fa ar�= Part: 3 ��-'�- -�. �-�_:.x"'>�'" ..�� ..=-k,. "ice-Ym,t.# ���."'�-�. "•*"- � •ter-�.. t�� '3: • ' ^' ,�- •'�-� ",��"� �:yam' �.�-a-� �"'��' �-^� ����_ �—�--x�n���a ,77 • _ � _�--3h���sue- ��Y' �-�•' '�--� =� _ '-�,��� =�"���`'��-�:g 4-14 �� �� ��_- '�-ma`s.�•� �� c,-- i _� _�� �- "-r—�1:c �-ry� �---� ��..`- • '�... � ,-ram -•a;- _ � Reply Reply All:. Forward. I Show Full Headers ] Copyright© Junno.com(TM)All Rights Reserved.Terms of Service. Privacy Policy. http://junno-mail.everyone-net/email/scripts/view.pl?EV1=999172950598445 8/30/2001