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HomeMy WebLinkAboutBLD-93-638 k4.: o TOWN OF YARMOUTH °K� � 7/9i ox y` O Pato. e �A _ mow:. /- �93 • MATT;c1;ii V,'t .0" ; Appliction for a Permit to Build No. 6 0UPON FINAL APPROVAL icd`t -93 MAP i.Q LOT S 3 FEE MUST ACCOMPANY THIS APPLICATION. DATE T993 The undersigned hereby applies for a permit to build .77 ‘793 � according to the following specifications al/93 1. Name of property owner .543mc-6Nc, :(11c15 a l3rrrfets Tel. 6/7-M'/-77/3 Address ssy /ckirs(nn s9' c...c./fhcm ms o',1/c'/ 2.Name of Architect(if any) Tel. 3. Name of builder D&.v,iY a.wP.. Addressswan /., cbcesl2&/e mc.. 4. License No. o yqq 58 Tel. 4777-70 Cy 5. Name of Mason Address 6. License No. Tel. 7. Construction address 3f2 A/ecv/ic.s1P slide A VF civic!' c-/inrw�, enc Ca?? ,FlDis 8. Date of subdivision Approval plaoinod zone v17-/.6 its 13 Zone 'c 9. Private dwelling 0 Estimated Cost 1 e q ,dd o,OT WRITE IN Type ofroomNo. 10. Multi family 0 /310oo- �l.,4 Zo ori' CA- -Z a 11. Commercial d --(Cog-J-2'1-4y Kitchen 12. Other 0 ""'u6 1" 16 9 6C Dining Rm. �� ` �� '2 Living Rm. 13. No. of stories oZ L ,��D Bed Rm. 14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 i G- °° Bath 15. Materials — Wood El/Cement 0 Other ❑ te-2 ,� a 4-L Deck 1 16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 3 / p o Closed porch 0,3 ' Family Rm. 17. Garage — 1 0 2 0 - T ' O D 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 street From rear lot line Side line 25. H.LC.R. No. Aft ' 1 * 0 �i c LOT RELEASED BY Signature (�,�v,/,' e. 4-2 PLANNING BOARD Address 3'z A/9•✓4c n'yo5%in' A v F. Date 7-$'-93 f ‘. • BUILDING DEPARTMENT , • CONSTRUCTION SUPERVISOR FORM 1. . PLEASE PRINT: ' • JOB LOCATION: W'ta/ ....it. a - : V (a-AC 1 / , 'R NUMBER • . • . STREET VILLAGE OWNER OF PROPERTY: ' Srgrncl-i/Vt' A'/c/S 4 (3au7G'tt/5 . CONSTRUCTION SUPERVISOR: /.JQ .',eY �&.•,,.e._ ' • • GYyeIS . 4/77-70?.-5' NAME •. LICENSE NO. PHONE NO. • ADDRESS: ft : i4-kit/iv L...,..4.-- Ares7r�c% /71 c-,- 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 COif'1ONWE.ALTH, 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 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, RECON- STRUCTION, ALTERATION, REPAIR, REMOVAL OF DE*IOLITION 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 I:n•IEDIATELY 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 CC: STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERST.'_ THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDIN OFFICIAL. .. INSURANCE COVERAGE: : I have a current liability insuraanye pclicy or its substantial equivalent which meets the requirements of MGL'th.152 Yes 0 . No 0 If you have checked vvss, please indicate the type c average by checking the ap_:cpriate bcx, 't A liability insurance pc:icy 0 Other type cf :.idemntty 0 Band 0 • OWNER'S INSURANCE WAIVER: I am aware that the licensee dces rct hive the insurance coverage required by Chap:er152 of the Mass. General laws, arc that my signature on th:s permit :-p:rcaticn waives this requirenier._ Check one: Ownerp Agent 0 SIgnatu:a ct 0..ner cr O..ner s agent 7 SIGNATURE: L', -,- - / -int -2„. � BUILDING OFFICIAL APPROVAL: APPLICANT: r' Lf,) Deaar,e BUILDING PERMIT #: ADDRESS: A 51,,E `,Nes ii2/PA // TELE. NO. : 4/77-775-4( DATE FILED: 7 /c'w9-- BLDG. SITE LOCATION: .31 AAL,75-%fie AvE MAP/t: /2- LOT/l: ,j S 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. TILE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN DIE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR ISSUING THE REQUIRED BUILDING PERMIT: REVIEWED BY: 1. WATER DEPARTMENT DATE: N/A: 2. ENGINEERING DEPAI " NT: DATE: N/A: 3. CONSERVATION: - /A DATE: p3 N/A: 4. HEALTH DEPARTMENT �, 4 DATE: -ya/g3 N/A: ' 1 ' RIAL AND/OR COMMERCIAL PERRMITS 5. WIRING INSPECTOR: DATE: N/A: G. 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: f Y- N=4 -- Dyck M�SZ nu(' e dre-v- So,�`r c ii. 4 d& p4 � r /%.Js - EjLDrr ) J3sy5 a Afa7 -Scum-cz, la pie ir05 - Ta/Sn. �it� ar Se.cv�0-h Tv ren �r 1,0/Ka Lorrve/ cc- fa�( tzFed/Y S ©p , -Dc- aen - 5GTle1y ///.a • o Td R,' Artttche 0 -rb f?ec.." i (-4-,/?.s -vr R«.', /�Tn an oQcFTers TJ A,� a.7r 4,ed w%�i //vrr.ewe c%lc. t ,.crime�, Pt n ro ' 5r2vcry 4' Di-c1e ilfvsr &c S Gc2 0yA Sr_ S9/ tree/ K2,even nm/89 7/1/43 Ptc PLOT PLAN ' FOR LOT # ' Indicate location cf garage or accessory building • Additions with dashed lines Sewerage disposal (cesspool) Well p .• I • I (lot ft. rear) I 4buttor's --- Abuttor's Vame I —1 Name Lot b I Lot O REAR YARD ! this is a y If this ' orner lot, 2p...ft. i corner lc trete in name I write in Lf street. I• _ name of . ,i T, other o C'i u s et. a ' I 'C _ r _ 1 1 I SIDE YARD SIDD/EK�Y BZ HOUSE p__g _C4�1 Q_ r _ 0 p - - • • . i • A CEJ I 4 . I _ , SET BACK (ii ..A .ft. �__r-- c 'O I • (1r" fes. L—ontace) \ / - 32 /1/e,ci11.-frepl //re_ 4-ve • \ / \ / (NAME OF STREET) \ / Suggested Affidavit for Honie Improvement Contractor Permit Application • For once Use Only NAME OF CITY/TOWN • Permit No. • Dote AFFIDAVIT • Home Improvement Contractor Law Supplement to Permit Application MGLe.142A requires that the"reconstruction.attention,renovation.renair.modernization.conversion.inprovement•removal.demolition. or const ruction clan addition to any pre-cxistint•ownertxcunied huildingcontainine at least one but not more than fourdwellino units....or • to structures which arc adiacent to such residence or building"be done by registered contractors.with certain'eteeptions,along with other requirements. nn • Type of Work: /er_ cfcnd•%z dec.(.< cn cK porc/1 Rcr:f Est. Cost 13 p cc Address of Work - 4 . AA Ac-n I . a V we 7- cnt Owner Name: Sly h.SW r res -J- Axo1he/S • Date of Permit Application: 2 — —7 ? • I hereby certify that: • islration is not required for the following rcason(s): ' • i "tl•ork excluded by law Job under 51,0(Y) 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: Date Contractor Name Registratio, OR: • Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: • Date O ncr Name COMMONWEALTH OF MASSACHUSETTS • : DEPARTMENT OF INDUSTRIAL ACCIDENTS • 600 WASHINGTON STREET James: Ca nvoei: BOSTON, MASSACHUSETTS 02111 . Corn:ssIone• . - WO,R�KERS' COMPENSATION INSURANCE AFFIDAVIT • 1, Ile vG (licensee/permiace) • with a principal place ofbusiness/residencee• �ac • ist ,s //Lrnr L✓✓ iE ccs7 ,./e fl7c 09 G cf9' (City/State/Zip) do hereby certify, under the pains and penalties of perjury, that: [ ) lam an employer providing the following workers' compensation coverage for my employees working on this • job. Insurance Company Policy Numbier [ti/1 am a sole proprietor and have no one working for me. J I am a sok proprietor, general contractor or homeowner (circle one) and have hired the can:r cors 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 Numb:: 0 I am a homeowner performing all the work myself. • NOTES.Please be aware that while homeowners who employ persons to do maintenance, construction or repair work on a dweiiin; of not more than three OEMs ip which the homeowner also resides or on the grounds appurtenant thereto arc not Ecocr:ily considered to be employers under the workers' Compensation Act(GI. C. 152,sec 1(5)). application by a horeowaer for license or permit may evidence the letr.i status of an employer under the Workers' Compensation Act. I untie ::and that : cpv of this statement will be forward::: to the Dep ernen:of industri:i Acddentf CFee ofinsu etc for cnverace ane ;':: failure under ;• ,� �5A'cf.Ma 152 car. lead to Ga;.: failure :n se:_:c npve :.� s recti^r_ h: impos;tr.. of criminal pen- tics con•isc-c of. rine of up in S'e r^1 00 ar,d.•c: :m;rsonmc:: of up too-: y4 red d.v pe-... . in the :arm of: : work: Ord:: and fine of S'.00.00 : day:Erin::me. C: ,. 6/ -l0te� ' C laver / , 19 92 .310 CMR 10.99 Form 2 • DEP File No. �-' (To be provided by DEP) Commonwealth City Town YARMOUTH • —' - of Massachusetts Applicant Stigmatine Fathers & Brothers • Determination of Applicability Massachusetts Wetlands Protection Act, G.L. c. -131 , §40 and the Town of Yarmouth Wetland Bylaw From Town of Yarmouth Conservation Commission Issuing Authority To Stigmatine Fathers & Brothers Same (Name of person making request) (Name of property owner) Address 32 New Hampshire Avenue. Address Same West Yarmouth, MA This determination is issued and delivered as follows: t by hand delivery to person making rearrest on August 10 . 1991 (date) CZ by certified mail, return receipt requested on (date) Pursuant to the authority of G.L. c. 1 31 , §40. the Town of Yarmouth Conservation Commission has considered your request for a Determination of Applicability and its supporting documentation. and has made the following determination (check whichever is applicable): Location: Street Address 32 New Hampshire Avenue, West Yarmouth, MA Lot Number: 53 1. G The area described below,which includes all/part of the area described in your request, is an Area Subject to Protection Under the Act.Therefore, any removing, filling, dredging or altering of that area requires the filing of a Notice of Intent. 2. E. The work described below, which includes all/part of the work described in your recuest, is within an Area Subject to Protection Under the Act and will remove,fill,dredge or alter that area.There- fore. said work reautres the filing of a Notice of Intent. Effective 11/10/89 2-1 LI._-0' The work described below, which includes all/part of the work described in your request, is within I the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under the Act.Therefore, said work requires the filing of a Notice of Intent. . This Determination is negative: 1. 0 The area described in your request is not an Area Subject to Protection Under the Act. 2. 0 The work described in your 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. I. The work described in your 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. 4, 0 The area described in your request is Subject to Protection Under the Act, but 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: • Issued by TOWN OF YARMOUTH • Conservation Commission Signature(s) (i. - ...../..vd feer 1. /19.1,14E, ,y • This Determination must be signed by a majority of the Conservation Commission. x On this +TLr� gay of .0 • 19 /3 , before me personally appeared ," , . ---7:-.)7,-„,, i.d.„,r , • , tome known to be the person described in, and who executed, the foregoing instrument, and acknowledged that hers`e executed the sI me as hislher free act and deec. C. harp! P ) ,7,) f,ta/?ia 7. /.... !. 074ir: i.. .9, ,,D Not‘ry PublicMy commission expires This Determination does not relieve the appl'eant from complying wan a4 other applicable federal.state or local statutes.ordinances. bylaws or reputations.This Determination sna::oe valid for three years term the date of issuance The applicant,the owns'.any person aggrieved Cy th:s Deterrnmancn.any owner of land tuning the land upon wni:h the proposed work is to be cone.or any len res'oents of me city or town m wnicn sucn tend is located.are nerepy notified of tnev right to request the Decanment of Environmental Protection to issue a SJDersedin;.tetermmation of Aepntaotilly,crowoino me recuest is mace oy cell leo mail or hand delivery to the Department,w to the apt cpnate bhr;tee and Fee Transmnal Fcrm as provided in 310 ChIFI t0.0:n7f within ten days from Ins cats of ssuenx of this Determination.A:coy of ice request shah at Me same time De sent oy certified mart cr nano°silvery to tna Conservation Commission and the a'pl:cant. 2•2A • j i - 1036711 -n7D BOSTON, MASSACUUSETTS BANK = _ I _ - DATE .fi IPAY TO THE`-7 j/ ,- " , I ' ORDER OF ._ aft _ ; ;y�OO.00 "" I yCNE HUNDRED DOLLARS AND 00 CENTS__; _ 300 . 00 / N -A - • •UR R I l T .0 - - '- _ - _ •_-' NOT VALID OVER$1,000 i . , I n10 L036.7 L Li" 1: 2.110 700 781: : 771,1000055i" 211' —' ( . . . • • • • , ..„.......„,.....%.„.„,,„....L i /l p • "•4. BY' DATE (�✓ SUBJECT J!' ` .• /�(J' � .�� SHEET NO._ (" r� OF ,' CHK D. BY DATE YARZMDUT+4M•PIC JOB NO. __7L % 1)-4/I� bP$ Je QJi.[,Iu& rcaA Tti1[L SAIF ,W%lt.Q" ,, ' !9x to foir(Plzst. arty 2f 2y�fours t Imi sotJ gr .^(p•I�¢ _ I� {-c�loG POST 8A3E Zxe, P-hry -s' _ IIIIIF sit.4 F}-I TICS ' a.� letiieR, II Ear• ', Z V► Y (na<<v cokrnaaoaS - ; * 2 -tf'4+d P't.AMS I --r- ; '1J ► /PY">0 cONc'Futp `� "� gar {oxln PosT , SoHo-rat (3CCOr.;) X II'(0"I,or.lb I oc3 POR_ SIDe • tJ o-re l t 2"ra SorjoTi/ees vset, Folz Per4_ SUPIbRT 4, Fia,a,s r,t Aecw-rna-Tvt -v beTA IU,J v, ..„H. FovtitlG 1)6rAil- rAFrog_ Gera iL. ' . NOTV,5 SPeclnc Tior4s I. ASI, vJogr MANcI'IIP =H4t_L ae IN Au_o'ePANce "/The PwVIslor1S, OF .:. . . _. Ti+e. MAssAtritis TTs STATta PJILPINCq Lope 'S • , 2. ALL. sIMPSoN '17cNti- Tib Col cormec-Tots 'sFtc.Inet) ' stiAtLi ; . Be lHsTAu er' Peg_ HANUPAc1Eugeiz Ke6iIJII M ' 14-is • • j, ��1N OF `ui @ MICHELE cyo a S 8 Np•cac.:44 " • KSTRUC(URAL fSS10NAL 0- MICHELE C. TUDOR, P. E. •, Consulting Structural Engineer r,D,,n.9 ,p_e_- ,„„.. • , 123 Cottonwood Lane•CenteMlle,Massachusetts 02632•(50B)771.7601 '/ " ' 3 1