HomeMy WebLinkAboutBLD-93-649 ps o TOWN OF YARMOUTH Ore-W2093
o '' c.
�t -y. OKfrW 4�2
" ' ,a� ` �J Application for a Permit to Build No.
t--
UPON FINAL APPROVAL .D.1°85 MAP hi 8' LOT )(-7q
FEE MUST ACCOMPANY THIS APPLICATION. DATE :l23 19 V)
The undersigned hereby applies for a permit to build O/a'�0 93
according to the following specifications
1. Name of property owner /e7r/ F 5nwrf icT I ' lay
Address 6 (nit entnrr HS; SD VannutAD
2.Name of Architect(if any) l �� Tel.
a Name of builder /Ala a-s - £ddress (Pilfer #n 40r) A49
4. License No. Tel
5. Name of Mason Or sae Address -
6. License No. Tel.
7. Construction address S Cot 1 , al PA nlo i] i�), (5n . V rmoUfij
District AA,
8. Date of subdivision Approval plain zone Zone
9. Private dwelling V '"'` Estimated Cost' f- DO NOT WRITE IN THIS SPACE
10. Multi family 0 /A 4,4;6j6 a -�3.3 Spc/p -feelee'F Type of room No.
11. Commercial 0 . Kitchen
12. Other ❑ ^r '� P�POS�/ i�q3 Dining Rm.
13. No. of stories / ' Living Rm.
194 Sr' Bed Rm.
14. Foundation — Full 0 Half 0 Crawl Slab 0 41s- Bath
15. Materials — Wood M Cement 21 Other IN , 99, t' Deck
16. Type of heat — Oil 0 Gas f& Electric 0 Other 0 a ��� Closed porch
17. Garage — 1 2 ❑ 7�{• n a Family Rm.
-/o • -tif. Sun room/,c/t/ V
18. Swimming pool -'Size / 6 °
• -° " Garage )0°1R
19. Storage shed — Size No Shed
20. Stove — Wood 0 Coal 0 /1/0 Alterations
21. Size of lot: No. of feet front /Mb ' No. of feet rear /DD '33' Y No. of feet deep /./O '
A-er
22. Size of building. No. of feet front 6 3 i No. of feet sidexyhtay ' gig No. of feet rear O s I
23. Distance from nearest building: Front - sv� Ft. side Ft. side Reay t -
heir C /o'o
f" .'
24. Distance back from line or street hr-- 191g I( From rear lot line P/� Side line R;y4t-a1/'V
25.
RELEASED
No. ��rr��
LOT BY Signature (" i.
PLANNING BOARD Address
Date
917e— x /93
BUILDING PERMIT APPLICATION.SIGN OFF
•
LL
APPLICANT: For/ P S/y/nrJ� BUILDING PERMIT'll:,/
ADDRESS: 8 apt 290A0,7 2?", TELE. NO. : g97-`toy/ DATE FILED:
BLDG. SITE LOCATIION: 0 af/yA amok/ ?? r MAP!!: 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 COMMERCIAL BUILDING
WATER DEPARTMENT: DETERMINES COMPLIANCE OF WATER AVAILABILITY.
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, MARSH
LAND, ETC.
HEALTH 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.
THE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR
ISSUING THE REQUIRED BUILDING PERMIT:
REVI BY:
V. WATER DEPARTMENT �it A (LC.Can DATE: 2'g-a.3-ct2, N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
4. HEALTH DEPARTMENT DATE: v-1 3- 9 N/A:
I STR 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. A
COMMENTS: G- CJ ? F-ar^SR-- Abb1T)o&) OA) -11-2)711C'ir--, 13if -Q3&
BLM/89 002. fia a/73
•
THIS STATED Uo (or U) VALUES OF ANY ONE ASSEMBLY, SUCH AS ROOFING/CEILING, WALL OR FLOOR,
MAY BE INCREASED AND THE Uo(or U)VALUE FOR OTHER COMPONENTS DECREASED,PROVIDED THAT
- THE OVERALL HEAT GAIN OR LOSS FOR THE ENTIRE BUILDING ENVELOPE DOES NOT EXCEED THE
TOTAL RESULTING FROM CONFORMANCE TO THE STATED Uo (or U) VALUES.
•
ENVELOPE ALLOWABLE U0 (PER TABLE 3109.1
Lw 0.03.)+(Ar 0.65')+(A000.40)+(Ana 0.033)+(A0F 0.051+(Acuff 0.08) = Allowable
�4;sbf 61,q e, /6*aq q. 7
�x 0.08')+( x 0.65•)+( Z/x 0.40)+(x 0.083)+ /ax 0.05)+(,x 0.08) = _
•
/f3' thAllowable Per Table 3109.1
*ELECTRIC RESISTANCE HEAT U-VALUE WALLS = 0.05 U-VALUE WINDOWS = 0.40
ENVELOPE ACTUAL Uo (USING ACTUAL VALUES OF DESIGN OF ENVELOPES)
LwUw)+(A,U„)+(A)oUou_Ao_URJ_L"oFU F____ wt) = ACTUAL
23•C.,- P. 99 /. 3PC 6.27 q, a
3( 3G x o7)+( x�+e x s +( 96 x.e7a +�x,oyG +( Cx X) =
•
r3. l ACTUAL
COMPARE VALUES •
THE VALUES FOR ENVELOPE ACTUAL MUST BE LESS THAN OR EQUAL TO THE VALUE OF
ENVELOPE ALLOWABLE TO PASS
•
•
Q PASS 1I FAIL
G^5BRSICH)Z.O32 4 015
•
PLOT PLAN
FOR LOT # '
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool)
. Well
(lot /00 ft. rear) I
Abuttor's I Abutt
Name I at Name
Lot # .,I •
1' Lot #
REAR YARD `,�
If this is a ) 1-‘4-1 ad
ad of GY. If tl •
corner lot, h 1 ft. ��` corn-
write in name /2. •
ad �- write
of street. !. - ,1 name
,. .I / i 1 w •
..other
w ••. U NI \ . r / a stree
q
I �a
SIDE YARD . .i' I SIDE YARD
/ HOUSE ,//, i/ '
• 0 /D i N FT. 0 •
°�I 0�7 Qi FTO
4—r ‘ / \
•
4 .
SET BACK ' �.
its •
• ft.
I
`t
I
40,
(lot /6 9 / ft. frontage) ' •
•
•
\ / 5' �a titiil a)Ceh 2 . .
\ / So re),
e a zo 67/
\ / .
•
•
\ / rmation
G X77
/ / / \\ •
\ •S oplied by ! nt/ ( . gine)/`l-
/
TOWN OF YAMOUTH .
BUILDING DEPARTMENT
. . flt. _HOMEOWNER LICENSE • m i TION -
PLEASE PRINT:
•
DATE gib 0i Ørince. c4
�J�/�JOB LOCATION f f 'aan 7ff, 5D , /'!f/ o6j7ER STREET ADDRESS SECTION OF;TOWN
"HOMEOWNER" elf./ , ? 55.na r - `-- ,31it="k ei , . .
NAME /f HOME PHONE WORK PHONE
PRESENT MAILING 9 4ARESS i O'Co n aO,
so rnov/- 7 : - / . _ 'M9) � 'a6 C
$
CITY OR TOWN STATE ZIP tODE
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER-OCCUPIED
DWELLINGS OF SIX UNITS OR LESS AND TO ALLOW SUCH HOMEOWNERS TO ENGAGE AN IN- •
DIVIDUAL FOR HIRE 1.1110 DOES NOT POSSESS A LICENSE, PROVIDED THAT THE OWNER
ACTS AS SUPERVISOR. (STATE BUILDING CODE SECTION 109.1.1)
DEFINITION OF HOMEOWNER: .
PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICH HE/SHE RESIDES OR INTENDS TO RE-
SIDE, ON WHICH THERE IS, OR IS INTENDED TO BE A ONE TO SIX FAMILY DWELLING,
ATTACHED OR DETACHED STRUCTURES ACCESSORY 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 TUE 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 109.1.1)
THE UNDERSIGNED "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE STATE
BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGULATIONS.
• TUE 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 t r% RE .✓V
APPROVAL OF BUILDING OFFICIAL
NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED
TO COMTLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION CONTROL.
INSURANCE COVERAGE:
I have a current f,ability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes &We No ❑
If you have checked ves, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy ID Other type of indemnity 0 Bond 0
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. G , eml Laws, and that my signature cn this permit application waives this requirement.
. • park one:
I,.` . ..4 .ad Owner Agent 0
. Signature of Oe ner or CUvner i A;ent
CEILING ASSEMBLY .
NJM: SINE.Hiceilimmxpires PCILPL TOTAL R=
• este ari � ar `• 'IP TOP SURFACE II= WINDOWS:
vartirg.' ,...
R=0.61 Fd{IJIF2ID'iQI1tL R= 30.0
.� el., 9" FIBERGLASS Lh 0,033
t ; rINSULATION
rt C)V- R=30
c.1
S \=SHEETROCR DOORS: ,
art -'. W R= 0.45 ,
! li —BOTTOM SURFACE
._ R= 0.61 •
:
1/2"-.PLOD,OD INSIDE SURFACE WALL ASSEMBLY REAR ELEVATION
R= .0.1.62 - R= 0.68 ACILF�L TOTAL R= /
'I, I U G.W.A. I�o�,O�
WOOD X , \ }" SHEETROCR =
SHINGLES:4 R= 0.45 I 'IU L I= 12.5
R= 0.87 7.N S I Lk 0.08 WINDOWS:
OUTSIDE" 1 IL-3}" FIBERGLASS I I ROD ICOL R= 20.0 Set /
A _ moi+ INSULATION
SURFACE g
R=ll EIECIREC HMT I. 0.05
R= 0.17 , .
�, r:
t(': SL'Q. FACE RESISTANCE
CA t C'I =R= 0.61 FLOOR ASSEMBLY
J\ I, .—FINISH PLUM PLIITOTAL R= DOORS:
_ ' R= 0.91 U=
TWO BEADS I/ • FdiI.1IF�D'IQIPL E� 20.0
CAULKING l / I(-----1 I" PLYWOOD w 0.� RICH SIDE ELEVATI
UNDER PLATE ; SUBFLOOR /
– 'i \ R= 0.62 � 4. 02 k /4 d " S. f x f
OUTBID L i „ i , i ! ! /
SURFACE 1 f, " V v ,/U' ,i✓(/L L•C G u j // a'�a
R= 0.17 /r WINDOWS:
//-6!" FIBERGLASS
�' �. INSULATION FOUNDATION X 7
CONCRETE . I ; / R= 19 WALL ASSDLBLY
FOUNDATION \' SURFACE RESISTANCE
ALL (may be used instead I DOORS:
1 of floor insulation) 4,1/.1,
R= 1.32 = 8" R= 0.61 ;c-f,L TOTAL R= LEFT SIDE ELEVATIC.
1.48 = 10". U=
i_ r I T: 1L R= 25 //C W�../
'YSIDE SURFACE U= 7.08
1Y= 0.68
1/8" sH:..TROCR WINDOWS:
X
+. t / Y=0 .32
„' STYROFOAM 4j(
. f;
� ' ~=7 .71 DOORS: (V
. , I
. At I t i . • 1 7 . . i P. , . ., I
=ES: '
PETY!. L .TLi INSTALLED STCEf 11
•
WI:: 3W- TO ..E USE: .,..,.,....._.....»- . _ , . i
rCL_3 ,:ALL .=.2:= / ep ,p , / j
, . ,
WI: ;W :IRE•,= • . s< .4, '/
1 , s ^ 1l
�.er+ 5 ; a cq
u� t '►� ' t PRao c
1' Ao10►, io+n
cp
NE' I;
•
0 1 t
m
• ON X }�A��a�S �(p'' O.C. kr--' 14 t -L-- ..-
r
r.
Root= RAF+eE5
N ax to -k
a40•
E —.await '15452
to t7e,adee� a
�Xl:i-► it
a j
OS ifi As4eyd W i f h a.
o
Z
.1.. ,7
I
c C2 (aloe tc.ips '�
8 CA.erasWO"
• s4..4 itaocw
ti
ti
xa_
o
m
lel XV/ -le+ C5110--okb x / 6
2 :ea Cnn♦:wc : , „ VT/arca '
exAiic
1 _ :N�ids Gatto Cottat_e
& x l° 1L01 4C. -
`v SiNInt ;es
A 4c/40 s'c 1: PA O Felt
Skil ex“kioft
I
11n11+rtUm clrrYWooc i
EX4-e
�h��e
fit, inso (s4ion � _�� __ Jit .
me{ 6aftir
l.111111'r1`l1111111 a s altagatib, • Nat:::
Ct. s 'Afcsu
;u thea tee i ?
kY clop R •-- �' I Aticeac.� 14'f:::::::::::::] I\
oeh r ee4t
jChsemer,T .
v !/�/ itrL
Fa.:.Ffy .`M
u
r Rod :- U ►E w
'Cos 5iclirig
Cedhx Sn;ng ',rb 0\ u. mkt to be an45
wewf heX / IV' O6.
•
�/ 51,etva ed wea s." 4rio Flea
.,..-� 11 exteaioa Gcruaood &Am;nA d
re...7 , • . ,: coocatikectiwettei, TYVeK '' p!/.a
. : =
R a T
P.+►oekO A C
efl 4 3lSente4T
w t
• - _. .• w. .__ _ ax l0
TelreArov y'x s.,jot,
ravKea
Fehr titeiit
Suggested Affidavit for Home Improvement Contractor Permit Application
For Office Use Only NAME OF CITY/I'OWN
Permit No.
Date
•- • AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL e.14:A requires that the"reconst ruction.alteration,renovation.repair.modernization.conversion,in provement,removal,demolition.
or construction of an addition to any preteisting owner-occupied huddinG containing.at least one hut not more than.fourdwellinG 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: it-ea-op #' AD Su X /Ccni Est. Cost / cvc7
Address of Work V (4-pr b ,e•
15
Owner Name: ant- /, SinAve.r
Date of Permit Application: 8/P-3 /43
•
I hereby certify that:
•Registration is not required for the following reason(s): •
_Work excluded by law
_Job under 51,000
ca(ding not owner-occupied
ner 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:
Date Contractor Name Registration No.
OR:
Notwithstanding the above notice, I hereby applyyff r a permit as the owner of the above property:
aDate , Owner Name.
' l
•
•
y ' --• COMMONWEALTH COMMONWEALTH OF MASSACHUSETTS -
*4,44, -- - DEPARTMENT OF INDUSTRIAL ACCIDENTS
600 WASHINGTON STREET
James J CamDoeL BOSTON, MASSACHUSETTS 02111 •
•
Cpmm55ipn2r WORKERS' COMPENSATION INSURANCE AFFIDAVIT •
✓, luta-c S�.h-a- T
(licenseelpermittee) -
• with a principal place of business/residence at - - - - - - .. -
C'�pT cate IC--3,
(City/State/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
[ ) I am a sole proprietor and have no one working forme. • - - - -- ---- -
•
• [ ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below
who have the following workers' compensation insurance policies: -••.• •
Name of Contractor Insurance Company/Policy Number.. .
•
Name of Contractor - Insurance Company/Policy Number - - • _ -•
Name of Contractor Insurance Company/Policy Number
1 am a homeowner performing all the work myself.
NOTE.P1eue be aware that while homeowners who employ persons to do maintenance,construction or repair work on a
dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally
considered to be employers under the Workers' Compensation Act(CL C. 152,sect. 1(5)),application by a horneowoer for a license 4
or permit may evidence the legal status of an employer under the Workers' Compensation Act
' r
I understand that a copy of this statement will be forwarded to the Department of Industrial Accidents' Office of Insurance for coverage
verification and that failure to;court coverage u required under Section 25A'of MGL 152 can lead to the impoiition of criminal penalties
• consisting of a fine of up to 51500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine or S 100.00 a day against` me.
tt-S ed this <•r (Iwai day of 879 , 19 73
Li ccr:sec/Per mine Licensor/Permit:or
•