HomeMy WebLinkAboutBLD-19-274 (€/ct ete/ / 717
//(
. V M ?Ah r
sod )Nbg Ivan (rich 0fet(
' • ONE &TWO FAMILY ONLY-BUILDING PERMIT
Town of Yarmouth Building Department /a
1146 Route 28,South Yarmouth,MA 02664-4492
508-398-2231 ext. 1261 Fax 508-398-0836
Massachusetts State Building Code,780 CMR
Building Permit Application To Construct,Repair,Renovate Or Demolish \ :'-
a One-or Tivo-Family Dwelling __
•. •;: ':.:.'llrisSectionForoffrcialuseouty • : t't E C. i, t .
$uildMa—Penhit Nuinlieri', APpli '
y, � , <. :'• •: ,, .� -... 2018
• Building Offiaiel{Prin4Namej '::.'..•. igdature ,• q4� �r•�fr{k'y
. • , ' t 1N
SECTION 1:SITE FoItt1fAnoN.-: •. .. uv 1r
C.-
�'V
1. ' �ne Address:„` 1.2 Assessors Map&ParcelNnmper�S,.3 , f
WCJt �% QC 1C_ 2 tC-'er tA
1.1a Is this an accepted street?yes no Map Number Parcel umber
1.3 Zoning Information: 1.4 Property Dimensions: •
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) .
Front Yard Side YardsRear Yard
Required Provided Required Provided Required Provided
* 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Ptel HAR
ts
Public iiPrivate❑ ZO°e' — ckeft yoeod❑Zone7 Municipal❑ On site disposal system ❑ • Sy
Che,•... .: Cf1ON2..PROPERTY.OWNERSHIPi•. ''.''•',' ''.• : • , ' ...
* 2.1 o riofReco d: r MA, oz67r
•
tchatzc sr)5 i-koi ' y P�
Name(Print) City,State,ZIP
S7 '((Ayr Woods est-2®8-8622 vr$7tlJlef-oAde a CorAcetsf Oe7
No.and Street Telephone Email Address
DES Q r,. o pply)
:.;,'':'�: :"5EC)i'loi,Q 3v . C>ztiPTYb�Q>~kItOPOSEb`vV RTCx, checl(9El tliatAa <.-
New Construction❑ Existing Building Owner-Occupied,9' Repairs(s) ❑ Alteration(s) .21 Addition`❑
Demolition ❑ Accessory Bldg,❑ Number of Units_ Other ❑ Specify:
B 'efDescriptyionaofProposeedc�dirork=: ' r 6..; Cr) it - Free Ia. ' 5-4
tt4tdr F CM.) L.,I.I S f . (it(CC : in. in r r.. r' ! °,l i-.._E)
':sEt=i i*ii: TA TEpcoSiTflv sis:-;;",), :;:c 4 l: t :- f •1.3 2018 I
Estimated Costs: ?;;; •' "" ",!'/'�h'ici91`i)'e;0ia1y%�{k'' 'n rt•:--,,,-.---.
Item •si,'; 1.;:Qt.: ,i' .r/i,,,Y S' ,-:.,}:'-at mein;tStq'4l- 4 PArti Mat4T.
(Labor and Materials) , ' '�' . •.
1,Building • $am'aq ( is Building Peiiniti!ee:.$'14"rS?:.�.Indicate hQW 14 dete1ih1Eed:,• -----
�LSta 'dard`Ci ('TorLa'A is �e ^ lx+,!!"`. .;� ::
Si 2,Electrical . $ t c ,.I?P.1_ x mu 4::,.;) ' • i ; :,.
. $b0 •-'p.�j'ota'ProleatCASCjtein.:6'x;mti(tipIier:_r'".`:'. ',i
•
•
.. SECTION 5:.CONSTRUCTION SERviCEs . .. ... • •
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder List CSL Type(see below)
•
• No.and Street Type.,. ." . Dentiption
U Unrestricted(Buildings up to 33,000 eu.R)
R Restricted 1,t2 Family Dwelling
City/Town,State,ZIP M Masonry
•
RC Roofing Covering
• WS Window and Siding
• SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
mc Registration Number Expiration Date
• EEC Company Name or HIC Registrant Name
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT'(lVLG.L.G 152.§25C(6)) •
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.
Signed Affidavit Attached? Yes ❑ No ❑
• SECTION 7a:OWNER,AUTHORIZATION TO BE COMPLETED WREN •
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ..
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
•
•
• Print Owner's Name(Electronic Signature) Date
• • • SECTION lb;OWNER'OR AUTHORIZED AGENT DECLARATION • • •
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
u>z application is tnteand�to the best of my knowledge and understanding.
Print Owner's or Authorized Agen N /ame(Electronic Signature) ate •
. • • ..
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will have access to the arbitration
program or guaranty fund under M.G.L.c.142A Other important information on the HIC Program can be found at
www.mass.aov/oc4 Information on the Construction Supervisor License can be found at www.mass.gov/ins
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) • Habitable room count
Number of fireplaces Number of bedrooms •
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Ginn
3. "Total Project Square Footage'maybe substituted for"Total Project Cost"
•
The Commonwealth of Massachusetts
•
' t0:"—. el Department ofIndustrial Accidents
011,1=: •
_Salk_ a 1 Congress Street,Suite 100
`= _ " Boston,MA 02114-2017
.'--��, www.mass.gov/dia
d�
Workers'Compensation Insurance Affidavit:BuSlders/ContraMors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information '1/4-- ;
� Please Print Legibly
Name(Business/Organization/lndividual): t \��'1a'id 5715
Address: S'7 WRsr (j,-ogsV v
p��QQ iff,4 oab7s .
City/State/Zip: yGh2 PUr'l' Phone#: OA? 'ZD r-%3a
Are you an employer?Check the appropriate box: Type of project(required):
1.01 am a employer with employees(lhli and/or pan-time)." 7. 0 New construction
2.01 em a sole proprietor or partnership and have no employees working for me in 8. RRemodeling
any capacity.[No workers'comp.insurance required.] 9. Ell Demolition
3.0 I am a homeowner doing all work myself[No workers'comp.insurance required.]: 10 Q Building addition
4.4184.7::homeowner and will be hiring contractors to conduct ahl work on my property. I will 11.�Buildicat repairs or additions
that all contractors either have workers'compensation insurance or are sole
proprietors with no employees. 12. Plumbing repairs or additions
5.0 lam a general contactor and I have hired the sub-contractors listed on the attached sheet 13. Roof repairs
These sub-contactors have employees and have workers'comp.insurance.: 14.0 Other
6.0 We ere a corporation and ha officers have exercised their right of exemption per MGL c.
152,§I(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that cheeks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
=Contractors that check this box must attached an additional sheet showing the name of'the subcontractors and state whether or not those entities have
employees. If the sub-contactors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. '
Insurance Company Name:
Policy#or Self-ins.Lk.#: • Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certiiitio a p•ins and allies of pe ury that the information provided above is true and correct
Signature: \` ,/t///f Date: /`�/1,
.„,,,,..._,....
_. _ _
Official use only. Do not write in this area,to be completed by city or town officiaL
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
•
•04-Y:9;4 TOWN OF YARMOUTH
• ;' BUILDING DEPARTMENT
�' 4' 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext. 1261
% 1ra:
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE: K/101/041
JOB LOCATION: /l /n 01/041 ,Jo �RA Si Warr f 6.c0 auk S y* nAa P° '-
NAMESTREET ADDRESS SECTION OF TOWN
"HOMEOWNER" \CU d 57,19.12— co-tr.-Jaz?.%6 2:7-
NAME HOME PHONE WORK PHONE
PRESENT G ADDRESS 5-Z W e c�
s r c. Oroz;P-3
�aRmov77, f oyer rr,4, o a& 7S—'
CITY OR TOWN STATE ZIP CODE
The current exemption for'Homeowner'was extended to include owner-occupied dwellings of one or two units
and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such
homeowner shall act as supervisor. (State Building Code Section 110 R5.1.3.1)
Definition of Homeowner.
Person(s)who owns a parcel of land on which be/she resides or intends to reside,on which there is oris intended to
be,a one or two family attached or detached structure assessory to such use and/or farm structures. A person who
constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall
submit to the building official,on a form acceptable to the building official,that he/she shall be responsible for all
such work performed under the building permit.(Section 110 R5.1.3.1)
The undersigned 'homeowner' assumes responsibility for compliance with the State Building Code and other
applicable codes,by-laws,rules and regulations.
The undersigned 'homeowner' certifies that he/ she understands the Town of Yarmouth Building Department
minimum inspection procedures and requirements and that he / she will comply with said procedures and
requirements.
HOMEOWNER"S SIGNATURE. ‘C--iii
APPROVAL OF BUILDING OFFICIAL
INSURANCE COVERAGE:
I have a curren 'ability insurance policy or its substantial equivalent, which meets the requirements of MGL
Ch.142. No
If you have thee.ed 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
,: , of the Mass.General Laws and that my signature on this permit application waives this requirement.
it. , Check one:
Signature of Owne r Owner's Agent to wner Agent
hhomeowmlicexanp
of 4R,,_ TOWN OF YARMOUTH
!p BUILDING DEPARTMENT
o �'_ y 1146 Route 28,South Yarmouth,MA 02664
/ 508-398-2231 ext.1261 Fax 508-398-0836
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L.Chapter 40,Section 54 and 780 CMR,Chapter 1,Section 111.5,
I hereby certify that thedebrisresulting from the proposed work/demolition to be
conducted at S ''W
Sal 4St UDC& Ctcc\t
Work Address
Is to lie disposed of at the following location: IbOn Olt c CflS CCb1e..
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
IRC12 t'S 193in
Signature of Appli tion Date
Permit No.
Jt==jk TOWN OF YARMOUTH
3, tii% HEALTH DEPARTMENT
? :: - L .%s
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: j 'j4 ///�
Building Site Location: 5 7 WznT (�ti06d s, 0IOJ1k 4 bIC)
Proposed Improvement:/ -4 #r5 cere..t t- Q wbr\t. rrt' S)59 R.484i `^n
Cwovlc ttc.S crtn ``do7c- reac4i
Applicant: \-) CcSVc: J314SClCar Tel. No.: •kb?-9 22-
Address: Cr) (L4ST U,bSZ3 Date Filed:7 - C p l 21-
**If you would like e-mail notification of sign off please provide e-mail address: VS'SI ti f Q1CbK 0 SC e. Caw aM2-
he `/
Owner Name:
Owner Address: Owner Tel.No.:
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e.,Requirements
For Septage Disposal and other Public Health Activities.
/
Please submit three (3) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) —
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: Par\ ,-----m-eDATE: 7 —C — ( O
PLEASE NOTE
COMMENTS/CONDITIONS: / �p
LIJCi✓CC �c.-S (Ink (�Ic J
—r4.E3 c J ikv ini..r N0,.., ft, ,_,,,,,,,/, —
Sears, Tim
From: Se'arslrr�Tim
Sent Mbn/iay„July 16, 2018 9:36 AM
To: rr inbletondc@comcast.net
Subject: Si Westwoods Circle
Richard,
I have reviewed your application for 57 Westwoods Circle, and we are going to need a floor plan of all the floors with the
smoke detectors marked to code.
Please submit updated plans for review.
Thank you
Timothy Sears CBO
Building Inspector
Town of Yarmouth
508-398-2231 Ext. 1259
mailto:tsears@yarmouth.ma.us
1
I 20'-7
' I
UNFINISHED
STORAGE 12''13•
/~ i
f
'L.-3• : r
`I i I / 0_6 UTILITY SOFFIT
HEIGHT in 6' 8'�l
2'-6' \ FINISHED SPACE II'-4•
-• HEIGHT = 7 6"
4'14' ceN4' i L J
L Passage
4.':-4 I,
F j Opening L
UTILITY G'-5• I 4-a
ROOM ♦ mOf
—7—
uTIISnr
HEIGHT - 6' 13'
FINISHED SPACE 7•
HEIGHT 7' 6"
`1-3• I
aT,S/ca2Q I
,�^EXISTING�—J
_1
_......
,,
vL`I
. G -Perimeter Walls ore of 2'x4' Construction 0 16'
O.C.
-Vapor Barrier Between Foundation Wall & Framing
-R13 Paperface Insulation Around Perimeter
EXISTING -R13 Poperface Insulation in Partition Walls for
OFFICE Sound Deadening
-Existing Center Bearing Beam & Columns
Unchanged
-Existing Floor Joists & Insulation Unchanged
EXISTING EGRESS__
WINDOW \
•
Client Nane
Contractor Signature Client Signature
felFile No.
SINGLETON RESIDENCE Designed Date
Edd
BASEMENT REMODEL
Revisions Scale: I/8 1' •
atilin G ERvi CIRCLE
57 WEST WOODS
Fernald Building wxr.remNdeuedny us Is08)1eoe06 YARMOUTH, MA sheet 1 of 1
5- 7 W.-eo-e?- Votes
• ,. / ° pO e3-
• 11 S IMekit- l/V
6.1
(`t 1 �}' !� Master Supe
wa 12°
vaulted ceiling
AUS 02 2018 Ian
n n ��
t.„,,DING DEPAhI N-'CNT -_-�j Wie in viP ynO6
I�
Ii Ili I
A ling. i. I
♦ I
Un n 1 Livingi8°X 14° {
.4
vaulted ceiling
Master
V Bath
CIO
ic%o! SL our1
y Dining
tt. ,
JUL 0 6 2018 — _
HEALTH DEPT. �o f
O ,
•
r— --r
Kitchen ci f=amily' Breakfast
the 4-- 4Ntio -,1 itx 14°
try tray ceiling
Townhomes H ,1 ceiling �� I
KINGS WAY I II
t
u Yam
:filth onth Pott I I 1
� ,,, plan _, rn .
riAf
xt '- � 1�Sn. .c - - * s x' - ` S. R e
'
.^..
Garaget:Q „` , t
sY ;5it 4Il4,wn P ,:t,,`. etk
r � .
.rcPzeirill , l• tr .
,it [ , ,„
Sr^at1 '"nyy"i' °
4. J P • r
't.;:, , .1;e: a'3i4G 4 s 4^ .+,P First Floor
Thr dnnensi°ns,size,configuration,optional urns end other ief rmetinn on the Ili
•
t y '
pdRs
--i
1 1
1
Loft
I2 ox no
Open to Liv(ng below
bath
•own Guest bedroom I
12°x l2°
Open-co Fader
•
L
4
Second Floor
dans are meant to he illunrj in only.As Wilt comhtiom of each hone nmy vary.
v
e) .g;g '
k yi ' .1__.-- --,---..„ - --I
SITLA.-( VLA ( ,_
3 4 . \
-6-4)
chin015),R
________
(---
a 1-,C2 ��
51-0063 t
L (
ist
PC\VN
V
TOWN OF YA RMCUTH
REVIEWED FOR BUILDING AND ZONING CODE COMPLI-
FI L E COPY ANCE ERRORS OR CM AISSIONS DO NOT RELIEVE THE
APPLICANT FROM THE RESPONSIBILITY OF'AS BUILT
COMPLIANCE.
DATE:±_29____:.
!S
BUILDING FFICIAL