HomeMy WebLinkAboutB-03-408TOWN OF YARMOUTH Bu• mg Department BUILDING
)8) - 231 ext. 61
PERMIT NO ' _ 8-03-408 _/'PROPOSED'
pERMIT
ISSUE DATE ; _ _ - - - - -02_ _ SE _ _ _ _ _ _ _ _
- - - - - - - " JOB WEATHER CAR1Y
APPLICANT William & Terry Mc -
--------- -- - - ---
ADDRESS '1 Mildred Road PERMIT TO Repair
AT (LOCATION) 100030ARLINGTON ST jAjA ZONING DISTRICT R-25 ---I ]
SUBDIVISION MAP LOT BLOCK 1028.29 BUILDING IS TO BE USE GROUP R-3
LOT SIZE I I CONST TYPE 5-13 CONTR'S
022316
reroof, going over one layer of existing roof.
REMARKS
AREA (SO FT) EST COST ($ $1,000.00 PERMIT FEE ($) $25.00
OWNER William & Terry McMahon
ADDRESS 11 Mildred Road, (i ti V' BUILDING DEPT BY
U
INSPECTION RECORD
LICENSE
CONTR'S NAME
Moskaluk, William
FIELD COPY
..Note
Progress
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Office Use Only
OCT 2 3 02 l e .
Pyrtpr't expires 6 moaths.from
By issue -date.
EXPRESS BUILDING PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route.28
South Yarmouth, MA 02664
(508) 398-2231 Ext. 261
CONSTRUCTION ADDRESS: 3 o A * /3 19Q-1 i Iry g T-N .STe -ec-r -W.
ASSESSOR'S INFORMATION:
Map: Parcel:
OWNER: GcJi//�'i9wl �`-T�2,t';/ �aL%�h�Lie�,r / 2u,�li�taTni /"!►9 '>6�-�'7�1-39Sy
NAME PRESENT ADDRESS TEL. . #
CONTRACTOR: _ Gc/ i /l %N r, /1? a S,e�ip l �k 8 111//joD og i V c 12(,4)i ,v ,T N 140 7g z X2 3
NAME MAILING ADDRESS TEL.#
1 Residential ❑ Commercial Est. Cost of Construction S
Home Improvement Contractor Lie. # 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: Worker's Comp. Policyl#
WORK TO BE PERFORMED
❑ Tent (Fire Retardant Certificate attached)
Duration
❑ Siding: # of Squares
❑ Replacement windows: #
❑ Replacement doors:
I Re -roof # of Squares Y
/ () Stripping old shingles* wing over layers of existing roof
)The debris will be disposed of at: _ -7d w inL) � p
r \ Location of Facility
I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief I understand that any false answer(s)
will be just cause for denial or revocation of my license and for prosecution under M.G.L. Ch. 268. Section 1.
Applicant's Signature
Owners Signature (or
Approved
Building Official (or designee)
Date:
3/01