HomeMy WebLinkAboutBuilding Permits (2)TOWN OF YAMiOiJTH F#ELD COPY
010 BUILDING 4//3-70 ��., �
PERMIT
DAT -March 12 2002 g�t B-02-761
APPLICANT George Davis Bu er ADDRESS New enture Urve , S. Dennis, $
(NO.) (STREET) (CONTR'S LICENSE)NUMBER
1
PERMIT TO ADDITION (_) STORY DWELLLINGO UNITS '
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATIONO Crescent Cit. Bass Rlyer, MA DINADISTRICT—
(NO.) (STREET) .i
q BETWEEN
m 1 SS STREET)
m
m SUBDIVISION 34 269
i
Q
U
0—BUILDING IS TO BE FT. WIDE BY
m
0
z
2 TO TYPE 5-B USE GROUP
R-4
AND
LOT BLOCK
FT. LONG BY
(CROSS, STREET)
LOT
SIZE
FT. IN HEIGHT ANU. SHALL CONFORM IN CONSTRUCTION
BASEMENT WALLS OR FOUNDATION
M. (TYPE)
O REMARKS: Remodel kitchen & enlarge dining room area. Remove and replace front entrance.
As per plans dated 2/27/02.
AREA OR
VOLUME
(CUBIC/SQUARE FEET)
60000.00 PERMIT 225.00
ESTIMATED COST E
OWNER Joe Jurgenson
ADDRESS 6 Brescent Ct. Bass Rj.VBI, 2�` BYILDING DE
A
INSPECTION RECORD
is
of r TOWN OF YARMOUTH Building Department BUILDING
_ _ _ , (508) 398-2231 ext.261 It.
NO ' _ _B-02-761_ _
a ISSUE DATE 3/14/02 _ PROPOSED USE _ _ _ _ _ _ _ _ _ = PERMIT
---------------
APPLICANT 'JOSEPHTJURGENSEN JOB WEATHER CARD
-----------------------------
----------------------------- ------------
ADDRESS ;00006 CRESCENT CT PERMIT TO ' Construct
-----------------------------' '------------'
AT (LOCATION) 100006CRESCENT CT ZONING DISTRIC RS-25
SUBDIVISION MAP LOT BLOCK 1034.269 I BUILDING IS TO BE
LOT SIZE CONST TYPE 5-13
addition/renovation
REMARKS
AREA (SQ FT) EST COST ($ $60,000.00 PERMIT FEE ($)
OWNER JOSEPH T JURGENSEN
ADDRESS 100006 CRESCENT CT BUILDING DEPT BY
USE GROUP R-4
CONTR'S
LICENSE 056130
CONTR'S NAME
George Davis
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.
ENCROACHMENTS ON PUBLIC PROPERY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION.
STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLLIC WORKS.
THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM INSPECTIONS REQUIRED FOR ALL
CONSTRUCTION WORK: 1) FOUNDATIONS OR
FOOTINGS. 2) PRIOR TO COVERING STRUCTURAL
MEMBERS (READY FOR LATH OR FINISH
COVERING) 3) FINAL INSPECTION BEFORE
OCCUPANCY 4) REFER TO DETAILED INSPECTION
crueni n e
APPROVED PLANS MUST BE RETAINED ON
WHERE APPLICABLE
JOB AND THIS CARD KEPT POSTED UNTIL
SEPARATE PERMITS ARE
FINAL INSPECTION HAS BEEN MADE.
REQUIRED FOR ELECTRICAL
WHERE A CERTIFICATE OF OCCUPANCY IS
PLE\UMBING AND MECHANICAL
REQUITED, SUCH BUILDING SHALL NOT BE
INSTALLATIONS.
OCCUPIED UNTIL FINAL INSPECTION HAS
BEEN MADE.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTIONS APPROV
WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INSPECTORS INDICATED ON THIS CARD
UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE
APPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION.
STAGES OF CONSTRUCTION Alanvr-
V
qZ
Use Group: R-4 Type: 5-B
1.1 Property Address:
o� r (A-
1.2 Zoning Information:
03-L—
e,
mat
Zoning District
Proposed Use
1.3 Building Setbacks (ft)
Front Yard
Side Yards
Rear Yard
Required
Provided
Required
Provided
Required
Provided
67
7
0-
1.4 Water Supply (M.G.L. c. 40.
Public V Private
2.1 Owner of Record:
ei\s orN
Name (print)
M
ailing Addr
Signature
Telephone
2.2 Authorized AgentWORGE DAVIS BUILD-211S
�EB 13 200Z
9 New Vent um-R�., 4ft 7
1 1
Name (pri )
D04s, MA 02660 (508 #��ailing
a
Signature
�po one
3.1 Licensed Construction Supervisor.
MIA
Not Applicable L)
GM7 Ls
License Number
9
New Vc. rlt,,; j,,, U L-M iD
L-L, I
Address
�02660
Expiratioi to
14�
Sig rature
AAA -
Telephone 117HK
I
ICYQ_
13.2, Reqistered, A6me Improvement Contractor: 1BA1670 �.dOP
Company Name
Address
Signature
GEORGE DAVIS BMDERS
qKew Venture Drive, # 7
kXqAj_ VA (503) 304-0832 ��
Telephone
le 1j
License Number
Expiration Djte 3 �.j
1'-)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure
to provide this affidavit will result in the denial of the issuance of the building permit.
I New Construction No. of Bedrooms No. of Bathrogms
I Existing Bldg. Repair(s) Alterations Addition
Accessory Bldg. [J Type
Demolition V
Other Specify:
Brief-OBscription of Proposed Work:
Item
Estimated Cost (Dollars) to be
completed by permit applicant
1. Building
2. Electrical
Go 0
5. Fire Protection
7. Total Square Ft. (new houses& additions)
/ � Check Below -|
� /
0
,� Filing
(if applicable)
Old Kings Highway &Historical
Commission approval
(if applicable)
.00owner ofthe subject property
hereby authorize
my behalf, in all matters relative towork authorized by this building pmnnd application.
.
Signature ofOwner _
y-
|. 'eoOvvne
hereby declare that the statements and information on the foregoing application are true and accurate,
to the best of my knowledge and belief.
Signed under the pains and penalties of
/Afir-7 A I
I - -r-,bate
°FYAR TOWN OF YARMOUTH
0 H
`H„;„... BUILDING DEPARTMENT
BUILDING PERMIT APPLICATION SIGN OFF
Applicant: / -*- _� j Building Permit No.:
Address: t CA (jt Tel. No.: ��� y' & ate Filed:
Bldg. Site Location: So- -f- Map No.: 3 7 Lot No.: .2
The following information outlines the procedural steps required to obtain a permit to build, alter, or add
to a structure within the Town of Yarmouth. The Building Department will determine compliance to the
following: (A) Zoning Requirements (B) Historical Districts (C) Flood Zones. The Building Department
will be responsible for assisting the applicant through the following departments:
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT: Determines Compliance of Water Availability. (applicant to obtain)
ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage.
CONSERVATION COMMISSION: Determines Compliance` to Wetlands Acts; i.e., If Lot(s) Border any Type
of Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc.
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
for Septage Disposal and other Public Health Activities.
FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal
Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc.
----------------------------------------
The following Departments must sign off, in the respective order, prior to building inspector issuing the required
building permit:
REVIEWED BY:
1. WATER DEPARTMENT: DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT: DATE: N/A:
INDUSTRIAL AND/OR COMMERCIAL PERMITS
5. WIRING INSPECTOR: DATE: N/A:
6. PLUMBING INSPECTOR: DATE: N/A:
7. FIRE DEPARTMENT: DATE: N/A:
PLEASE NOTE
All stumps and/orb h ust be disposed of at an a oved ' e.
CO NTS: �, �t�i Qe c. a lot 4/ e,"a
* r 86 0j, Lu
8/99 Applicant Signature Date
�FY"R TOWN OF YARMOUTH
MA BUILDING BUILDING DEPARTMENT
CONSTRUCTION SUPERVISOR FORM
PLEASE PRINT: r�
Job Location: L C_� CA �-� \' 'oe-�
Number Street Village
Owner of Property:
Construction Supervisor:
Address:
'*_S i s H e j-%
Licensed Designee:
(If other than Supervisor) Name
2.15 Responsibility of each license holder:
Venture
US1eQ3i--)
No. Phone No.
License No.
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 subcontractor 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 Anylicensee 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, reconstruction,
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.
2.17 The license holder shall be responsible for requesting all required inspections. Failure to do so may
be deemed a violation of the permit conditions.
I have read and understand my responsibilities under the rules and regulations for licensing construction
supervisors in accordance with section 109.1.1 of the state building code. I understand the construction
inspection procedures and the specific inspection as called for by the building official.
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the -requirements of MGL Ch.152
Yes .4 No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Cha 152 of the Mass. G neral Laws, and that my signature on this permit application waives this requirement.
\ Check one:
Signature of Owner or Owner's nt Owner ❑ Agent-
Signature: Building Official Approval:
For Office Use Only
Permit No.
Date TOWN OF YARMOUTH
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c. 142A requires that the `reconstruction, alteration, renovation, repair, modernization, conversion,
improvement, removal, demolition or construction of an addition to any pre-existing owner -occupied
building containing at least one but not more than four dwelling units or structures which are adjacent to
such residence or building' be done by registered contractors, with certain exceptions, along with other
requirements.
Type of Work:
Address of Work
Owner Name:
Date of Permit Application: l a i'l c> i
I hereby certify that:
Est. Cost (OU , vOv . '
Registration is not required for the following reason(s):
Work excluded by law
Job under $1,000
Building not owner occupied
Owner pulling own permit
Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH
UNREGISTERED CONTRACTORS FOR APPLICABLE HOME
IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION
PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the owner:
'-)b eO�'hs-�N )on 33')
Date ContractoV,14arne Registration No.
M
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above
property:
Date
Owner Name
�1
The Commonwealth of Massachusetts
Department of Industrial Accidents
oxce o//AWOS91SOis
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit
Applicant information: PieasePR11QTTebitc.
es,�s
location:eS�-�`�
O �} phone #
❑ I am a homeowner performing all work myself.
CD I am a sole proprietor and hase no one working in any capacity
I am an employer pro,, iding workers' compensation for my employees working on this job.
m an • name:
9 New Venture Drive, # 7
address: nnli, MA 02WO (508) 394-N32
city phone #•
insurance Co ��5���� C_11s`�CA�4 poliev# W C-\/ 3ocx'S��
I am a sole proprietor. general contractor. or home"er (circle one) and have hired the contractors listed below %%ho hale
the following workers• compensation polices:
company n
address:
cif phone oh
insurance co policy #
city, phone #•
insurance co pofi y #
D
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a floe up to $1.500.00 and/or
one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a floe of S100.00 a day against me. I aederstaad that a
copy of this statement may be forwarded to the Ofrice of investigations of the D1A for coverage veriUeadoo.
! do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Signature i Dan _ 7 ( (n 0 I
Print name r,)e_jpr4 t? %,�N Phone# �9y-043
official use on1v do not write in this area to be completed by city or town official
city or town: YARm&rm _ permitAicense # —Building Department
OLicensing Board
oSelecO check if immediate response is required 261 0Hcalt Deeen's rtmOffiee
Health Department
contact person: phone #; _ (508) 398-2231 ext. rJOther
Information and Instructions V#
Massachusetts General Lays chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the 1aw", an employee is defined as every person in the service of another under any
contract of hire, express or implied, oral or written.
An enrpl( ever is defined as an indi\ idual. partnership, association. corporation or other legal entity, or any two or more of
the foreuoing enuao*ed in a joint enterprise. and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual . partnership, association or other legal entity, employing employees. Howeverthe
o%\ ner of a dwelling house haying not more than three apartments and who resides therein, or the occupant of the
dv,ellinR house of another who employs persons to do maintenance , construction or repair work on such dwelling house
or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
%1GI_ chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionall\. neither the commonN\ealtll nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter haze
been presented to the contracting authority.
Applicants
Please till in the workers' compensation affidavit completely, by checking the box that applies to your situation and
suppl\ ink_ company names. address and phone numbers as all affidavits may- be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The
affidavit should be returned to the city or town that the application for the permit or license is being requested.
not the Department of Industrial .-accidents. Should you have any questions regarding the "law" or if you are required
to obtain a \%orkers' compensation police. please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of investigations would like to thank you in advance for you cooperation and should you have any questions,
please do not hesitate to give us a call.
Tile Department's address, telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Ifflco of Imsdadsos
600 Washington Street
Boston, Ma. 02111
fax #: (617) 727-7749
phone #: (617) 7274900 ext. 406, 409 or 375
i�
TOWN OF YARMOUTH
1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETrS 02664-4451
Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-2365
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
BUILDING
ELECTRICAL
GAS
PLUMBING
SIGNS
Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at
Work Address
is to be disposed of at the following location:
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
to 11-flo
,Xlzz\x�l - Signature of Ap 10
nt Date
Permit No.
GEORGE DAVIS
BUILDERS
9 New Venture Drive, Unit #7, South Dennis, MA 02660
phone (508) 394-0832 • fax (508) 394-5460
Town of Yarmouth Building Department March 1,2002
Main St
South Yarmouth,MA 02664
Dear Sir,
Per Our Discussion on February 28`", I would like to amend the construction cost for our
project on 6 Crescent Court in South Yarmouth. The actual "construction" cost will be
$50,500.00. Not included in this figure are the demolition fees, architectural fees,
building permits, dumpster fees, portable outhouse fee, and the final cleaning. Again, the
amended cost is to show the actual amount of the remodeling or construction to be done
at the above mentioned address.
Thank you for your consideration on this matter.
Respectfully,
George Davis
The following is a break -down of costs that are not construction related:
Bouse House $225.00
Demolition $4900.00
Permits $275.00
Dumpster $900.00 L /
Architectural & conceptual drawing fees _
$3700.00
/r6,
We Make Your Dream HOMES Come True!
Property ;.oca6;w: 6 CRESCENT CT MAP ID: 34/ 269/ / /
Vision ID.- 4919 Other ID: 29/ Z001/ / / Bldg #: 1 Card 1 of 1 Print Date. 02/27/2002 14
CURRENT OWNER
TOPO.
UTILITIES
STRZIR AD
LOCATION
CURRENT,,
IS SSMENT
URGENSEN, JOSEPH T
JURGENSEN, BARBARA
ILL & DALE COUNTRY CLUB
ARMEL, NY 10512
Description
Code
Appraised Value
Assessed Value
815
YARMOUTH,
RESLAND
RESIDNTL
1010
1010
105,400
106,300
105,400
106,300
SUPPLEMENTA L DATA
ccount# 0533400
Subdivision 180
Phot
Ward
Precinct
GIS ID.
VISI
Total
211,700
211,700
RECORD OF OWNERSHIP
B%VOLIPAGE
SALE DATE
v11 SALE
PRICE
KC
PRE
VI ES ME
HIST
R
URGENSEN, JOSEPH T
12/27/1991
Q
I
175,000
1N
Yr.
Code
I Assessed Value
Yr.
Code
Assessed value
Yr.
I Code I
Assessed
2001
2001
1010
1010
105,400
106,300
ZOOO
1000
1010
1010
96,100
82,600
TOW,
211.700
Total
178,7001.
Total:
EXEMP77ONS
OTHER
ASSESSMENTS
This signature acknowledges a visit by a Data Collector or Ass
Year
AvelDescription
Amount
Code
I Description
Number
Amount
Comm.Int.
APPRAISED VALUE SUMMARY
Appraised Bldg. Value (Card)
Appraised XF (B) Value (Bldg)
Appraised OB (L) Value (Bldg)
Appraised Land Value (Bldg)
Special Land Value
Total Appraised Card Value
Total Appraised Parcel Value
Valuation Method:
1
Cost/Market Vi
T
NOTES
EST 9 ROOMS
VW DWN RUN
0180
et Total Appraised Parcel Value
BUILDING PERMIT RECORD
ITICRANGE
HISTORY
Permit ID
Issue Date
npe
Description
Amount
Ins . Date
% Com .
Date Comp.
Comments
Date
ID
d. I
Purpose/Rest
998104
2/24/94
5,000
6/15/95
100
1/1/95 DECK
6115/95
RD 01
easur+l Visit
LAND
LINE VAL UA TIONSECTI
N
B#
Use Code
Description
Zone
D
ronta a
Depth
Units
Unit Price
1. Factor
S.1.
C. Factor
Nbad.
Ad .
Notes- AdYS ecial Pri in
Ad'. Unit Price
Land Va
1
1
1010
1010
SINGLE FAM
SINGLE FAM
40,000.00
0.36
SF
AC
1.23
15,000.00
1.93
1.93
7
7
1.10
0.10
0070
0070
1.00
1.00
OPO
2.61
2,850.00
- Total Card Land Units
1.28
AC
Parcel Total Land Area
1.28 AC
Total Land Value
LATION FOR PERMIT COST
TYPE OF ROOM, ETC
O P'S
KITCHEN
DINING ROOM
LIVING ROOM
GREAT ROOM
COMPUTER ROOM
DEN
OFFICE
FAMILY ROOM
BED ROOM
BATH
STORAGE AREA
MUD ROOM
DECK WITH ROOF
DECK OPEN
PORCH OPEN
PORCH CLOSED
SUN ROOM HEATED
SUN ROOM UNHEATED
LAUNDRY ROOM
GARAGE
DEMOLITION
SHED
SWIMMING POOL INGROUND
DIMMING_ POOL ABOVE GROUN
FIREPLACE
LAUNDRY ROOM
ADDITION
ALTERATIONS
REROOFING
WINDOW REPLACEMENT
FOUNDATION
NO
TOWN OF YARMOUTH
c BUILDING DEPARTMENT
o; _
r\AttA n s[
�•«••BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF
TRANSMITTIAL SHEET
Building Site Location:
Map No: Lot No:
r
Proposed Improvement: ;
F`
Applicant:_ 7
` Date Filed:' Address: f
The Building Department will be responsible for assis g tfT i6ot ca by dispatcyour plans and or application to the following
applicable departments.
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WITER DEPARTMENT:
Determines Compliance of Water Availability and or existing location.
ENGWEERING DEPARTMENT:
Determines Compliance for Parking and Drainage.
CONSERVATION COMMISSION:
Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of
Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc
HEXL- H DEPARTMENT:
Determines Complianceto State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
FIRrDEPARTMENT: ,,/
Determines Compliance to State and Town Requirements for Personal
Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc.
REVIEWED BY:
1. WATER DEPART )ENT:
DATE: N/A:
2. - CNGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT: DATE: N/A:
INDUSTRIAL AND/OR COMMERCIAL PERMITS
S. WIRING INSPECTOR: DATE: N/A:
6. PLUMBING INSPECTOR: DATE:
7. FIRE DEPARTMENT: DATE: N/A:
COMMENTS:-Y,''-
RECEIPT OF COPY:
PLEASE NOTE
SIGNATURE OF APPLICANT:
DATE:
white copy — Building Dept. - Yellow Copy — Health Dept. - Pink Copy — Engineering Dept. - Goldenrod - Fire Dept/Consemation °
. I V
Lo-r 271 Mgf -IY .1
LOT NO.: / ADDRESS: -14
Tit 'SL.�thtxr—qc�
OWNERS NAME: r9;j`
l SEWAGE PERMIT NO.: NEW: REPAIR:
DATE ISSUED:- a DATE INSTALLED:
j INSTALLERS NAME.: ,�, �� 1 p
INSTALLATIONI OF:
WATER TABLE: FINAL INSPECTION BY: �L
I
I
DRAWING OF INSTALLATION ON REVERSE SIDE:
L
r4,30 -55"28
04•iff 110711
A �q
CSC
Go
V1, 4s,
THE
LO
00
I 1,AJ IMP, ()o
-,v
CRE "NT
0.
0, 1.94.0 COURT
5 T 200.00
L 22. 00'
LOT 6
11y
A. Lo 71 3
Z0.1VE. "R-z5,, Thtv MORTGAGE INSPECTIC )OP ZO.VE. "All"
'joW,-+ 70-VTM--LARMT-VJR— — RE(;IS*fTZY QVINER:
DEED REF --CV- 6V-716- —BUYER. JVsEr1L T—,t--.BAMARA B- dWULN�EN—
DATE- -101-01-�QJ PLAN REF. -k C—JRZ�L-A — — —SCALE- I = -50'
-L
I HEREBY CERTIFY TO
THAT THE BUILDING of
YAN E SURVEY
LOCATED 0-N THE GROMID AS PAUL CONSULTANTS
SHORNAND THAT 17S POSITION [ROCSCONFORM A
TO THE ZONING LAW SETPACK REQUIREMENTS OF 711T Id1 ROUTE 141)
TO'w?f OF _A141) THAT .12 MARMNS MIU-3. MA 02848
WIT11111 THE SPECIAL FI,0011 IWARD TFL- 4213-0055
IT DOES__—_-- LIE -;-�-ffc-st IV, -
AREA &!3 SIJOWN ()!4 711E H U D. M. Ar DATED r FAX: 420-5553
11411- PLAN ?46T VAIIE FROM AN jumr?4 7771 Dr(,
L r�, ------ SjftVEy. NOT 70 QL_tlSrD r9ft fkj;QL$ E1C.
December 24, 2001
To: Building Department
Town of Yarmouth
South Yarmouth, MA
From: Mr. Joseph Jurgensen
10 Crescent Court
Bass River, MA
Re: Agent Authorization
Project Address Same
To whom it may concern,
Please be advised that George Davis, Builder, is authorized to act as agent on my behalf
with regard to the project under review in this building department.
Thank you,
0'6� Date December 24,2001
Wfoseph �)'nsen
f
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code
MAScheck Software Version 2.0
CITY: Hyannis
STATE: Massachusetts
HDD: 5973
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE: Other (Non -Electric Resistance)
DATE: 2-14-2002
DATE OF PLANS:
Permit #
Checked by/Date
TITLE: Jurgensen 6 Crescent Court, South Yarmouth
Required UA = 110
Your Home = 99
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
--------------------402 38.0 0.0 12
CEILINGS 45
WALLS: wood Frame, 1611 O.C. 675 15.0 3.0 0.400 39
GLAZING: Windows or Doors 98
FLOORS: Over Outside Air 72 19.0
-------------------------------------------
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 1250 of the design load as specified in
sections 780CMR 13.10 and J4,4'.
Builder/Designer
Date
Massachusetts Department of Environmental Protection
PY
` Bureau of Resource Protection - Wetlands C(O
y WPA Form 2 — Determination of Applicability
8
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling out
forms on the
computer, use
only the tab
key to move
your cursor -
do not use the
return key.
— I�
From:
YARMOUTH
Conservation Commission
To Applicant
Joe Jurgenson
Name
Six Crescent Court
Property Owner (if different frorn-applicant):
Name
Mailing Address Mailing Address
South Yarmouth MA 02664
City/Town
State Zip Code City/Town
1. Title and Date of Final, Plans and Other Documents: -
State Zip Code
Sketch showing proposed enclosure of deck
Title Final Date (or Revised Date if applicable)
2. Date Request'Filed:
1-24-02
B. Determination
Pursuant to the authority of M.G.L. c. 131, § 40, the Conservation Commission considered your Request
for Determination of Applicability, with its supporting documentation, and made the following Determination.
Project Desc('iption (if applicable):
To enclose a portion of an existing deck.
Project Location:
Six Crescent
Street Address
Assessors Map/Plat Number
South Yarmouth
Cityrrown
Number
WPA Form 2
Rnv 09f00 Page 1 of 5
M
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the
Wetlands Protection Act and regulations:
Positive Determination
Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of
Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) has been
received from the issuing authority (i.e., Conservation Commission or the Department of
Environmental Protection).
❑ 1. The area described on the referenced plan(s) is an area subject to protection under the Act
Removing, filling, dredging, or altering of the area requires the filing of a Notice of Intent.
❑ 2a. The boundary delineations of the following resource areas described on the referenced
plan(s) are confirmed as accurate. Therefore, the resource area boundaries confirmed in this
Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Ad
and its regulations regarding such boundaries for as long as this Determination is valid.
❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination,
regardless of whether such boundaries are contained on the plans attached to this Determination
or to the Request for Determination.
❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to
protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work
requires the. filing of a Notice of Intent.
❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will
alter an Area subject to protection under the Act. Therefore, said work requires the filing of a
Notice of Intent.
❑ 5. The area and/or work described on referenced plan(s) and document(s) is subject to review
and approval by:
Name of Municipality
Pursuant to the following municipal wetland ordinance or bylaw:
Name Ordinance or Bylaw Citation
WPA Form 2 Page 2 of 5
Rev 02=
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
} WPA Form 2 — Determination of Applicability
L, k Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not
subject to the Massachusetts Wetlands Protection Act:
❑ 7. If a Notice of.Jntent is filed for the work in the Riverfront Area described on referenced plan(s)
and document(s), which includes all or part of the work described in the Request, the applicant
must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more
information about the scope of alternatives requirements):
❑ Alternatives limited to the lot on which the project is located.
❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any
adjacent Ipts formerly or presently owned by the same owner.
❑ Alternatives limited to the original parcel on which the project is located, the subdivided
parcels, any adjacent parcels, and any other land which can reasonably be obtained within
the municipality.
❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate
region of the state.
Negative Determination
Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the
Department is requested to issue a Superseding Determination of Applicability, work may not proceed
on this project unless the Department fails to act on such request within 35 days of the date the
request is post -marked for certified mail or hand delivered to the Department. Work may then proceed
at the owner's risk only upon notice to the Department and to the Conservation Commission.
Requirements for requests for Superseding Determinations are listed at the end of this document.
❑ 1. The area described in the Request is not an area subject to protection under the Actor the
Buffer Zone.
❑ 2. The work described in the Request is within an area subject to protection under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but
will not alter an Area subject to protection under the Act. Therefore, said work does not require
the filing of a Notice of Intent, subject to the following conditions (if any).
❑ 4. The work described in the Request is not within an Area subject to protection under the Act
(including the Buffer Zone): Therefore, said work does not require the filing of a Notice of intent,
unless and until said work alters an Area subject to protection under the Act.
WPA Form 2 Page 3 of 5
Rev (YJIf1f)
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
4, Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cunt.)
❑ 5. The area described in the Request is subject to protection under the Act. Since the work
described therein meets the requirements for the following exemption, as specified in the Act and
the regulations, no Notice of Intent is required:
Exempt Activity (sle applicable statuatory/regulatory provisions)
❑ 6. The area and/or work described in the Request is not subject to review and approval by:
Name of Municipality
Pursuant to a municipal wetlands ordinance or bylaw,
Name Ordinance or Bylaw citation
D. Authorization
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on a by certified mail, return receipt requested on
February 12, 2002
Date Date
This Determination is valid for three years from the date of issuance (except Determinations for
Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not
relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances,
bylaws, or regulations.
This Determination must be signed by a majority of the Conservation Commission. A copy must be sent
to the appropriate DEP RegionalAffice (see Appendix A) and the property owner (if different from the
February 7, 2002
Date
WPA Form 2 Page 4 of 5
Rwv f1I=
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Appeals
The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the
land upon which the proposed work is to be done, or any ten residents of the city or town in which
such land is located, are hereby notified of their right to request the appropriate Department of
Environmental Protection Regional Office (see Appendix A) to issue a Superseding Determination of
Applicability. The request must be made by certified mail or hand delivery to the Department, withthe
appropriate filing fee and Fee Transmittal Form (see Appendix E: Request for Departmental Action
Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business days from the date of
issuance of this Determination. A copy of the request shall at the same time be sent by certified mail
or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant.
The request shall state clearly and concisely the objections to the Determination which is being
appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not
on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental
Protection has no appellate jurisdiction.
WPA Form 2
Rev 09/00
Page 5 of 5
:Y
TOWN OF YARMOUTH 6 ?
c BUILDING DEPARTMENT
O. .JJH
BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF
TRANSMITTIAL SHEET
Building Site Location:
Proposed Improvement:
Applicant:
Map No: 11 Lot No: 07
0 _ f5
Address: C1r; sit r '1 Tel.No.: riF ' Date Filed: �y
The Building Department will be responsible for assisttmg kel'p"ddf-by dispatc � your plans and or application to the following
applicable departments.
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT: Determines Compliance of Water Availability and or existing location.
ENGINEERING DEPARTMENT: Determines Compliance for Parking and Drainage.
CONSERVATION COMMISSION: Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of
Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
FIRE DEPARTMENT: Determines Compliance to State and Town Requirements for Personal
Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc.
REVIEWED BY:
�1. WATER DEPARTMENT: � DATE: 02 - /g- 02—N/A:
2. ENGINEERING DEPARTMENT: DATE: —N/A:' C-4..--
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT: DATE: N/A:
5. WIRING INSPECTOR:
6. PLUMBING INSPECTOR:
7. FIRE DEPARTMENT:
COMMENTS:
RECEIPT OF COPY:
INDUSTRIAL AND/OR COMMERCIAL PERMITS
DATE: N/A:
DATE: N/A:
DATE: N/A:
PLEASE NOTE
SIGNATURE OF APPLICANT:
41 Gt)t
/J
White copy - Building Dept. - Green copy - Water Dept. - Yellow Copy - Health Dept. - Pink Copy - Engineering Dept. - Goldenrod - Fire Dept/Conservation
.I"'- , , - A v - S ��6
•04
N�o•��'Zf) �
faa U1—
U
ti
,I
w
L01,
U
CRESC LW T
_J1900 COURT
,15
�tl? • •.
- 2U0. 00
ZU 1
�., LOT G ;` - N I -__11C L - 22. 00'
yQ LO 7' 3
LO 7'
RE -IF ZON,67 R-Z5" Thtr i�IO UTG AG E INSPECTION BanIs for1s U�t On{7 N1;FLOOD ZO'
er.
RECISI-RY QVINER:—
DEED REF 6071.6- — -- _RIPER. ,l05ML T_rV_,8IR13ARA 17 dlr. -UZ
DATE' -lel- 9/°J — — — — PLAN REF. _L (7,3222i — — SCALE- I' = 50 E•"T -
1 HEREBY CERTIFY TO ,t�S1L'11%ISit{.L% �51._ .'!'4._
----------------- THAT TFIE BUILDING ► 'w Oj 'Lr. YANKEE SURVEY
SE10�'N ON T111S FLAtt is Lor.ATEb ON TIIE GROUIID AS pAUI `�_ CONSULTANTS
SHORT( AND THAT ITS POSITION DOSS __ CONFORM
TO 'IHE ZONING LAW SETPACK RERUIREMVITS of 711= ' �� T,+Ew Idl ROUTE 149
TOVIN OF .�AT_� �,�1.'I[�---------------- -AND MAT - N0. 12?99 c.(ARSTONS 11iU,4. b(A 02046
IT DOES --_--- LIE W1711111 VIE SFECIAL FLOOD HAZARD ' � �r , •, TF1: 428-0055
AREA AG SMOMI ON "ME; HUD. MAP VATED-6/luoo__ ��� s FAX: 420-5550
Z5UU15 () '6 ,� ao
�, Q' - ------ 1 NIA tLAr MIT VA I i R04 At+ t tvuFN ��� 1 DI'�:
rii t vbi �FR_ L SURVEY, t+vi To Qr, VST.orgR TkM; 5 c1C.
Building Site Location:
Proposed Improvement:
Applicant;
8
TOWN OF YARMOUTH
BUILDING DEPARTMENT
UILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF
-, TRANSMITTIAL SHEET
yLe4 C „I (V �Map No: 3 V Lot No: �—
f h
�??gdss'7
Address: ��� �� �� p6-1 4 —7 �Tel.No.: y0 �z Date Filed:
The Building Department will be responsible for assisting A app 1 y dispafckrEg your plans and or application to the following
applicable departments.
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT:
Determines Compliance of Water Availability and or existing location.
ENGINEERING DEPARTMENT:
Determines Compliance for Parking and Drainage.
CONSERVATION COMMISSION:
Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of
Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc
HEALTH DEPARTMENT:
Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
FIRE DEPARTMENT:
Determines Compliance to State and Town Requirements for Personal
Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc.
REVIEWED BY:
1. WATER DEPARTMENT: DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION:
4. HEALTH DEPART
5. WIRING INSPECTOR: DATE:
6. PLUMBING INSPECTOR: DATE:
7. FIRE DEPARTMENT: DATE:
COMMENTS:
RECEIPT OF COPY:
PLEASE NOTE
SIGNATURE OF APPLICANT:
N/A:
DATE:
White copy — Building Dept. - Yellow Copy — Health Dept. - Pink Copy — Engineering Dept. - Goldenrod - Fire Dept/Conservation
Building Site Location:
Proposed Improvement:
Applicant:
TOWN OF YARMOUTH
BUILDING DEPARTMENT
ING PERMIT APPLICATION DEPARTMENTAL SIGN OFF
TRANSMITTIAL SHEET Map No: 3 /u
Lot No:
It L - /1
,99g4ST7
v V
Address: Q,t,) 41 7-7 Tel.No.: �-Py083ZDate Filed: lY
The Building Department will be responsible for assisting t e app 1 y dispaicUg your plans and or application to the following
applicable departments.
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT:
Determines Compliance of Water Availability and or existing location.
ENGINEERING DEPARTMENT:
Determines Compliance for Parking and Drainage.
CONSERVATION COMMISSION:
Determines Compliance to Wetlands Acts; i.e., If Lot(s) Border any Type of
Wetlands, Streams, Ponds, Rivers, Oceans, Bogs, Bays, Marshland, Etc
HEALTH DEPARTMENT:
Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
FIRE DEPARTMENT:
Determines Compliance to State and Town Requirements for Personal
-----------------------------------------------------------------------------------------------------------------------------------------------------
Safety, Property Protection; i.e., Smoke Detectors, Sprinkler Systems, Etc.
REVIEWED BY:
1. WATER DEPARTMENT:
DATE:
N/A:
2. ENGINEERING DEPARTMENT:
DATE:
N/A:
3. CONSERVATION:
DATE:
N/A:
4. HEALTH DEPARTMENT:
DATE:
N/A:
INDUSTRIAL AND/OR COMMERCIAL PERMITS
S. WIRING INSPECTOR:
DATE:
N/A:
6. PLUMBING INSPECTOR:
DATE:
N/A:
7. FIRE DEPARTMENT:
DATE:
N/A:
PLEASE NOTE
COMMEN
�t /}�f
/(� ��'A/
✓
C j
'/0'OOVS
3lo-6 _ 3r
3 =k4o
RECEIPT OF COPY:
SIGNATURE OF APPLICANT:
DATE: -3 13 O c ,
White copy — Building Dept. - Yellow Copy — Health Dept. - Pink Copy — Engineering Dept. - Goldenrod - Fire Dept/Conservation
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
• • (Print or Type) �y�
00� ° j ,MA Date 20 . Reoeipt# Permit# G —Ua -3 / b
Building Location 6 C CDC Acfl�Owner'sNameND �-"7u
Map: Lot: Zone: Type of Occupancy
hfL�
O i
CD
New ❑ Renovation ❑ Replacement t/
Plans Submitted: Yes ❑ No ❑
..................
Installing Company Name
Address t
EstimateValueof Work:
Business
Name of Licensed Plumber or Gas
Checkone: Certificate
Corporation k ,
❑ Partnership
❑ Firm / Co.
INSURANCE COVERAGE:
I have a curren iability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checked fires, please indicate the type coverage by checking the appropriate box.
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Checkone:
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of
my knowledge and that all plumbing work and installations performed under the permitis or is application will be in compliance with
all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of th "MlWiSnear4P
f
By Type of License:
Plumber Siglu r or Gas er
Title /oA Gasfitter
Master License Number_ _
City /Town Journeyman _
APPROVED (OFFICE USE ONLY)
Revised 05/17/00
BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO.
APPLICATION FOR PERMIT TO DO GASFITTING
NAME A TYPE OF BULIDING
LOCATION OF BULIDING
PLUMBER OR GASFITTER
LIC. NO.
PERMIT GRANTED
DATE 20
GASINSPECTOR
"a)9�-j-(-05'�- --)
I &
a
C
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print `orT,ype) �'(� C�
` vI Q-r��" ` ; MA Date" - qL 20DV_ Receipt# Permit# U
Building Location -e-e `j0 Alt- l ' Owner's Name
Map: Lot: Zone: Type of Occupancy
New ❑ Renovation ❑ Replacement O' Plans Submitted: Yes ❑ No ❑
FIXTURES
,I
IIIIIII
IIIIII��
Installing Company Nam Checkone: Certificate
Address CP2� trl 9 �1 i\ r� da Corporation 13a uEl
Estimate Value ofWork:
�Ell Partnership
Business Telephone [ k�r I ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter "C'.c..o " o
INSURANCE COVERAGE:
I have a curren lability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Checkone:
Owner❑ Agent❑
Signature of Owner or Owners Agent
I hereby certify that all of the details and information I have submi (o ntered) in above application are true and accurate to the best of
my knowledge and that all plumbing work and installations pe rmed un rthe permit issued for this application will be in compliance with
all pernt provisions of the Massac usetts State Plumbi Co a and h pter 142 Ge I aws.
By
1 ^ Sig ure of Licensed Plumber
/ / I Type of License: Master ❑ Journeyman ❑
ity /Town
PPROVED (OFFICE USE ONLY) LicenseNumber
Revised 05l17100
I
BELOW FOR OFFICE USE ONLY
FINAL INSPECTION SKETCHES PROGRESS INSPECTION
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME 6 TYPE OF BULIDING
LOCATION OF BULIDING
PLUMBER
PERMIT GRANTED
DATE 20
PLUMBING INSPECTOR
+ Lo-r 271
LOT NO.: / ADDRESS:
Tot 'Y�.,�thtln-�y
• I OWNERS NAME:
I r
SEWAGE PERMIT NO.: NEW: REPAIR:
DATE ISSUED:�S/ a DATE INSTALLED:
j INSTALLERS NAME.:
INSTALLATION OF:
WATER TABLE: FINAL INSPECTION BY:
I
j.
DRAWING OF INSTALLATION ON REVERSE SIDE:
r
/&,Y 3 .;1- Mewl
n?; 2112990 07:57
L
-IV
THE
-1:'
Z�•04
NUo.�' 2U F
110 U_ T
LOT
'V
�1
�a
LU 7' dycl
;�--
-2 9p [)a
0 0 U'
v44
C>?F,.SC LW T
CO UR7'
2U
NUZ'ZU 1 L - 22.00'
RE-F ZOW "R-Z5" Thti MORTGAGE INSPECTION Plan Is For
Bank Ua= OnIT
17,0017 ZONE'
;UWN1 — — REGISTRY UVINER: _51111WFLC_J,W_.——
—_J_O_
DEED REF S'IE 6046 —BUYER. JOSEFH._ T ,le-ii4RHARA R
dWUZV, EJV — —• _
- — --
DATE- 121-04Y — — — — — PLAN REF. _G (Z_3,3.2ZcY__,4_ —
SCALE- I
I HEREBY CERTIFY TO 1 S1L`11f ISi(1.(i SS1-- ��1'4.- �1 --
THAT THE BUILDIFG °' ,
YANKEE SURVEY
SH_15ii ON TIIIS FLAN t5_ -Off Oil VIE GROUND AS �� PAUL r_
CONSULTANTS
SHOWN AND THAT ITS POSITION VOFS __ CONFORM
TO THE ZONING LAW SETHACK REQUIRi WIlTS OF 711= rniTNEW -
te3 ROUTE tog
TOWN OF ___�ARA( 1,'I'(f _________-__._ _ -AND THAT � No. J2198 /s
MA"TONS 11IU'R. 1dA 020411
IT DOES ------ LIE WITHIN ME SFECIAL FLOOD IW ARD � �� , �. f
TFL• 428- U055
OATED_6,lu�S't__ Nos
AREA 45 SHOWN ON THE JI U 5
FAR: 420-5553
,���i
TWA
QGI/j 1 HIS tLA �T WADE F ROu A. i t UuFN __
tii C'dAbif 14 #'R_- t_ ------ S'JRYEY. NOi 70 gE_USf.17 FQR FENCF$ EiC. 7''1 Dry'
Property Localilk: 6 CRESCENT CT
Vision 1& 4919
Story
/ood Shingle
MAP ID: 34/ 269/ / /
Other ID: 29/ Z0011 / /
N UClAIL
1
Element
at & AC
sme Type
ths/Plumbing
iling/Wall
omS/Prh1s
Common Wall
all Height
I CONDO/MOBILE HOME DATA I
uw„v, i',wi
2
4
arpet
oor Adj
nit Location
eating Fuel
4
lectric
umber of Units
eating Type
7
4,lectr Basebrd
umber of Levels
C Type
1
4one
Yo Ownership
Bedrooms
athrooms
4
1 Bedrooms
Bathrooms
COSTIAURKET
VAL
nadj. Base hate
60.00
otal Rooms
ize Adj. Factor
0.97613
rade (Q) Index
0.97
ath Type
itchen Style
dj. Base Rate
56.81
INOW
u t
1978
ff. Year Built
1981
mil Physcl Dep
19
uncnl Obslnc
Econ Obslnc
Specl. Cond. Code
Specl Cond %
0
0
MIXED
1010
SINGLE FAM
100
Overall % Cond.
mod
8
OB-OUTBUILDING & YARD ITEMS L
/XF-BUILDING EX
i
Code Descri LionI LIB I Units I
Unit Price I Yr.
D Ri
M.Cn
FPLl PUPLACE 1 ST B 1
2,200.00 1981
1
100
EOS jEncl Oats Shwr B 1 1
I I
0.00 1981
1 i
100
SIB Base, Semi -Finished
WDK Deck, Wood
12 1,392 1,3921 56.81
0 1,392 835 34.08
0 436 44 5.73
1,800
0
79,080
47,436
2,500
M. 1 Card 1 of 1 Print Date: 02/27/2002 14
0