The URL can be used to link to this page

Home My WebLink AboutBLD-93-578 (water damaged plans) t .t: 'a Io TOWN OF YARMOUTH oke 7/30/93 • MA�YTA�MC $ J fie �, ., .,,,, g __ Application for a Permit_to Build__ No. L. �_ Wig— UPO FINAL APPROVAL I Cl `%JV� MAP /-7cr LOT -ei-Scee FEE{MUST ACCOMPANY THIS APPLICATION. DATE J+ 22 1993 Tr he(undersigned hereby applies for a permit to build 1 _ according to the following specifications 1. Name of property owner Janet Robbins W.362-5255 i Address 14 John Hall Cartway Yarmouthport- , Mass , 2.Name of Architect(if any) Tel. 3.Name of builder Randy Smith Address PO Box 76 Dennis, Mass. 1 4. License No. 007437 Tel, 385-5125 5. Name of Mason Address 6. License No. Tel. 7. Construction address 14 John Hall Cartway Yarmouthport, Mass F ood District n 8. Date of subdivision Approval plain zone x/, Zone• UG �(} i 9. Private dwelling a Estimated Cost DO NOT WRITE IN THIS SPACE --i 10. Multi family 0 elf Ho ✓Orr Rs-n;7- Type of room No. Y $18,750.00 • Off CC / 11. Commercial 0 ' 6 / 6 -Sr l4itetre aoserr I 12. Other 0 ' is' Dining Rm. 13. No. of stories // rl° Living Rm. Bed Rm. 14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 Bath /A 15. Materials — Wood E3 Cement 0 Other 0 Deck 16. Type of heat — Oil 0 Gas M Electric 0 Other 0 Closed porch Family Rm. 17. Garage — 1 0 2 0 Sun room 18. Swimming pool - Size ' Garage 19. Storage shed — Size Shed 20. Stove — Wood 0 Coal 0 Alterations 21. Size of lot: No:of feet front " No. of feet rear No. of feet deep 22. Size of building. No. of feet front No. of feet side No. of feet rear 23. Distance from nearest building: Front Ft. side Ft. side Rear 24. Distance back from line or sheet From rear lot line Side line 25. H.I.C.R. No.101449 LOT RELEASED BY ' Signature PLANNING BOARD AddressPo Box •.76 4•Courier Drive Dennis, Mass Date APPLICANT: Janet Robbins BUILDING PERMIT 1): p'2 /P• ADP,RESS:�14 John Hall Cartway TELE. NO. : 362-5255 DATE FILED:7/22/93 BLDG. SITE LOCATION: 14 John Hall Cartway MAPII: LOT!/: 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 DETER- MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH THE FOLLOWING DEPARTMENTS: RESIDENTIAL AND/OR CO1fl1ERCIAL BUILDING • UATER DEPARTMENT: DETERMINES COMPLIANCE OF WATER AVAILABILITY. 'ENGINEERING DEPARTMENT: DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE. , vONSERVATION COMMISSION: DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E. : IF LOT(S) BORDER ANY TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH LAND, ETC. IIEALTII•DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E. : REQUIRE- MENTS 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. TILE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR ISSUING THE REQUIRED BUILDING PER?IT: REVIEWED BY: �� / <� '/ 1. WATER DEPARTMENT (f�Il (', CL(/��c fi �'v , DATE: 7/A3 /9 N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: 3. CONSERVATION: l j' )/ DATE: N/A: HE4. ALTH DEPARTMENT' � DATE: •, L /"73 N/A: ZIRIAL 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/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING PERMIT. COMMENTS a,er- 6K 2'a7- // /vac rinucdrol r 65? Aaterzfvt7` • ArteCp, - ReT ^t.. ifrUjj etc cY e rtAt.- $G �,1 e o,v: 5 , divG - o f' �.e/4-r7 ,, RceS'/Ness °VI- l n e-Whe/GAS ,oh,Or/o,y CF �aheinc.,- fxnniziOX- Po Order no,y WnI-G4S n' a- • mittP4-cv, ,1 =1/oarsrst: C rE u en 3.' /G'd41G. I2rsiT /I-Qp4IcSin ov 4,) 'au'SHa7, Cz:L,oc nialdirw l BLM/89 71p tiet TOWN OF YARMOUTH ' • BUILDING DEPARTMENT ' CONSTRUCTION SUPERVISOR FORM . O. PLEASE PRINT: JOB LOCATION: 14 . John Hall Cartway Yarmouthport • NUMBER . STREET VILLAGE , OWNER OF PROPERTY: ' Janet Robbins CONSTRUCTION SUPERVISOR: Randy Smith 007437 385-5125 NAME LICENSE NO. PHONE NO. ADDRESS: PO Box 76 4 Courier Drive • Dennis, Mass - ' LICENSED DESIGNEE: . , (IF OTHER,THAN SUPERVISOR) NAME LICENSE NO. 2.15 RESPONSIBILITY OF EACH LICENSE HOLDER: 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 COMONWEALTH, EVEN THOUGH HE, THE LICENSE HOLDER, IS NOT THE PERMIT HOLDER BUT ONLY A SUB- CONTRACTOR 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 ANY LICENSEE 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 3E 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, RECON- STRUCTION, ALTERATION, REPAIR, REMOVAL OF DEMOLITION AS REGULATED BY SECTION 109.1.. 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. I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND REGULATIONS ,FOR LICENSING CON- STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTA:;; 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 MGLth.152 Yes a . No ❑ If you have checked v`s, please indicate the type cwerage by checking the apprcpriate box. 1 A liability i urance pclicy Lax O;her type of :ndemnity 0 Sand 0 ' OWNEt SU NCE WAIN R: I am aware that the licensee deet: have the insurance coverage required by Chapte ct a Mass.,Ge rat Laws, aria that my signature an this permit :c:icatian waives this requirement /L/,/Cy.////� eck one: Own . Agentg Signa re •i Ow et or Owner s',gent SIGNATURE: BUILDING OFFICIAL APPROVAL: Suggested Affidavit for Home Improvement Contractor Permit Application • For orrice use only NAME OF CITY/I'OWN Permit No. YARMOUTHPORT • Dole AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL a 142A requires that the"reconstruction,alteration.renovation.repair,modernization.conversion.inpmvement,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 to structures which are adjacent to such residence or building"be done by registered contractors,with certain exceptions,along with other• requirements. , Type of Work: finished basement Est. Cost $18, 750.00 Address of Work 14 John Hall Cartway Yarmouthport Owner Name: Janet Robbins Date of Permit Application: July 23, 1993 I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law _Job under 51,000 _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: July 23, 1993 Randy Smith 101449 Date Contractor Name Registration No. OR: • Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name • � • COMMONWEALTH OF MASSACHUSETTS • ;e^' = c= DEPARTM N'T OF INDUSTRIAL ACCIDENTS . 600 WASHINGTON STREET • tames Camopa BOSTON, MASSACHUSETTS 02111 • Co m ss one WORKERS' COMPENSATION INSURANCE AFFIDAVIT • 1, Randall H Smith (licensee/permittce) • with a principal place of business/residence an. • • • 4 Courier Drive PO Box 76 Dennis, Mass (City/Start/Zip) do hereby certify, under the pains and penalties of perjury, that: [ ) I am an employer providing the following workers' compensation coverage for my employees working on this job. • • Insurance Company Policy Number f) I am a sole proprietor and have no one working for me. ( ), I am a sok proprietor, central contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compcn ztion insuranc policies: Name of Contractor Insurance Company/Policy Number Name of Contactor Insurance Company/Policy Number • Name of Contractor Insurance Company/Policy Numb:: Q I am a homeowner performing all the work myself. NOT•.Pleuc be aware that while bomeowoen who employ persons to do maintenance.construction or repair work on 2 dwei:in: of not more than three units in wpica the homeowner also resides or on the grounds appurtenant thereto are not generally considered to be empioyers under the workers' Compensation Ar.(GL C. 152.sect. 1(5)). application by 1 homeowner fora license or permit may evidence the legal status of an employer under the Workers' Compensation Act I under::and th:: : cep.•of this s::r..^..en:will be Forwarded to the .tie::.^.'^en:of Industrial Accident:' O:^c: of insua.^.c for coverage verint.:::on and that (a:iure ran m:::re covc.zze Its recuirce und:: Section 25A'of MCI. 152 can lead an ,,.e im:ova:n of criminal penalties consisting of: fan:Of up to 5't"n 00 a d O:im7rso----t or up to one year and SW pen:itiia in the .arm.. of:_ : Work Order and fine of 5100.00 : day against • Sic:r_d anis 7'i . • / dr: of jr:Lr : 1993 �/ Il / •