HomeMy WebLinkAboutBLD-93-668 OF•Yqk 0k 2s1/2793
* _ v.- �'o TOWN OF YARMOUTH oKF Wain
` MATTAC\MSE S 4', ^ Q
.. cs,, �.. .„0$0 Application for a Permit to Build No. 6
UPON FINAL APPROVAL 6 frI MAP 3C LOT G
FEE MUST ACCOMPANY THIS APPLICATION. DATE September 1 19 93
The undersigned hereby applies for a permit to build q//fg3
accordin to the followings ifications / 3
g p iocese of Fall River �� �75-1311
1. Name of property owner d/b/a St. Pius Tenth Church Tel.
Address 47 Underwood St., Fail River, MA.
2.yame ofArchitect(ifany) Holmes & Edwards Architects Ziejmws /!G GLI NS TeL 471-7377
Collins Construction Co. ,Inc. Address 55 Highland Ave. , Fall River,MA.
✓.i. Nam@of builder
4. License No. 008915 Tel. 678-5201
5. Name of Mason Address
V
ense No. Tel.
ear—aPs,,: - :o • 17- & A8
nstructionaddressf�1vaaPr.
Flood Disict G 8
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost DO NOT WRITE IN THIS SPACE
10. Multi family ❑ $28,000.00 Ty a of room No.
11. Commercial l - /2� Raw �cv .LKitch@nfll j9 , /
12. Other ❑ g–erli",– 6 Dining Rm.
13. No. of stories �1 Living Rm.
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 Sid - ,` eF Bed Rm.
Bath
15. Materials — Wood 0 Cement 0 Other 0 p �Z ✓r'�"”"rte Deck
16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch
17. Garage — 1 ❑ 2 ❑ Family Rm.
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
2a 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.I.C.R. No. LINS CONSTRUCTION CO. ,INC.
LOT RELEASED BY Signatur 55 HigRmand n AvC.l,l as l Rei
MPLANNING BOARD Address
Date
•
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: Collins Construction Co. ,Inc. BUILDING PERMIT It:
ADtRESS: 55 Highland Ave. , Fall River,MA. TELE. NO. : . 678-5201 DATE FILED:
Our Lady u l Ulu ity1 sway Chapel
BLDG. SITE LOCATION: Bass River, MA. MAPIl: LOU:
I 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:
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/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: 1,L.7)& j)i4 6nclq-77c7y !7 9—ni
j- L 16—o w`O VAI-PeAt- /3'R-'e,??,&,C
30-Q w
•
. BLM/89
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: Collins Construction Co. ,Inc. BUILDING PERMIT if:
AbDRESS: 55 Highland Ave. , Fall River,MA. TELE. NO. : 678-5201 DATE FILED:
Our. Lai y u r Lhe Highway Chapel
BLDG. SITE LOCATION: Bass River, MA. MAPA: LOTH:
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:
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/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE
DISPOSAL SITE MUST BE SUBMITTED TO THE BUILLDDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING •
PERMIT.
COMMENTS: BLDG -?1,4TJLs-now ('{ .inr"
1- L I cv 4-0 J"fl-nen. i r,e,:E�
i s 313-Q w .t K
BLM/89 (/"
TOWN OF YARMOUTH ,
•, BUILDING DEPARTMENT .
CONSTRUCTION SUPERVISOR FORM
•
PLEASE PRINT:. '
Our Lady of the Highway Chapel , Bass River, MA.
JOB LOCATION:
. • NUMBER • STREETVILLAGE
OWNER OF PROPERTY: • Diocese of Fail. River d/b/a St. Pius Tenth Church ' •
CONSTRUCTION SUPERVISOR: . James H. C011ins 008915 678-5201
NAME LICENSE NO. PHONE NO. .
•
•
ADDRESS: 55 Highland Ave. , Fall River, MA. • •
•
LICENSED DESIGNEE: , N/A • (TG S 7 /S^ •
(IF OTHER THAN SU tISOR) LICE SE 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, REIOVAL 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 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 DEIOLITION 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 I:2•IEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS SUBSTITUTED
ON THE RECORDS OF THE BUILDING DEPART`:ENT. .
I HAVE READ AND UNDERSTAND MY RESPONSIBILITIES UNDER THE RULES AND REGULATIONS ,FOR LICENSING CC:I-
STRUCTION SUPERVISORS IN ACCORDANCE WITH SECTION 109.1.1 OF THE STATE BUILDING CODE. I UNDERSTAN
THE CONSTRUCTION INSPECTION PROCEDURES AND THE SPECIFIC INSPECTION AS CALLED FOR BY THE BUILDING
OFFICIAL.
INSURANCE COVERAGE: •
I have a current liability insurance pclicy or its substantial equivalent which meets the requirements of MGLth.152
Yes ;$ ' . No 0 CERTIFICATE ON FILE AT BUILDING INSPECTOR OFFICE. •
If you have checked vis. please imitate the type cverage by checking the ap-rcpriate box.
l ,
A liability insurance pc:icy NT Other type of :.idemnity 0 Band 0 •
OWNERS INSURANCE WAIVER: I am away that the ecensee dcett not have the insurance coverage require:: ty
Chapter 152 of the Mass. General Laws, ana that my signature on this permit :pp:ica:ion waives this requirement.
Check one:
Owner- Agent 0
Signature of Comer cr Omer s Agent ����
SIGNATURE:Z7L--W 1���1 BUILDING OFFICIAL APPROVAL:
` ' _ .c COMMONWEALTH OF MASSACHUSETTS •
e' DEPAR:MEN''T OF INDUSTRIAL ACCIDENTS
•
600 WASHINGTON STREET
James Campoeu BOSTON, MASSACHUSETTS 02111 •
Comn:sstonet WORKERS' COMPENSATION INSURANCE AFFIDAVIT •
I, James H: Collins President of Collins Constructinn Cn. ,Tnr.
(licensee/permittee)
• with a principal place of business/residence at:
•
55 Highland Ave. , Fail River, MA. 02720
(City/Sure/Zip)
do hereby certify, under the pains and penalties of perjury,that: - -
[4 1 am an employer providing the following workers' compensation coverage for my employees working on this
job.
Liberty Mutual Insurance Co. Certificate on file at Building Inspector Office
Insurance Company Policy Number
( j I am a sole proprietor and have no one working for me. • .
•
[ ) 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 - . . -
I
•
Name of Contractor Insurance Company/Policy Number _
0 I am a homeowner performing all the work myself.
NOTE.Please 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(GL C. 152.sect. 1(5)).application by a homeowner for a license
or permit may evidence the legal status of an employer under the Workers' Compensation Act
I understand that a copy of this statement will be forwarded CO the Department of Industrial Accidents'Office of lnsurance for coverage
• verification and that failure to secure coverage as required under Section 25A'of MGL 152 can lead to the imposition 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 of 5100.00 a day against me.
Signed this 1st. day of September , 19 92
l&
L' ..seeiPermi,.ce LicensoriPcrmiaor
PLOT PLAN
FOR LOT # •
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool)
Well
(lot • ft. rear)
— — — — - - -
Abuttor's ' I Abutt
Name . I Name
Lot # ' I • Lot #
REAR YARD
If this is a If "LI '
corner lot, ft. corn-
•
write in ,name, writ
of street. I name
• I a othe
• 0 o stree
CC, .. . . to
•
taw
SIDE YARD fRe SIDE YARD
HOUSE
0 •
' FT. 0, •,
g .
0 FT
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j N
. , . ! .
. H1
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t
• 1 ; . Q a.
4 SET BACK V
.
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(lot ft. frontage)
•
/ 6T a—Fe
\ / (NAME OF STREET)
•
/ Information t—?
6.1 la-M
/ \ Supplied by
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AFFIDAVIT
ii
As a result of the pr ip9s of,MGL c 40, 554, I acknowledge that as a condition of Building Permit
Number O c p /`/3 all debris resulting from the construction activity governed by this
Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL
c 111, S 150A. ' •
I certify that I will notify the Building Official by 04/ or Led-o rt- 0c4 i /9 9 .?
(Two months maximum) of the location of the solid waste disposal facility where the debris resulting from
the said construction activity shall be disposed of, and I shall submit the appropriate form for attachment
to the Building Permit.
2.
7/
Date Signature of Permit Applicant
(Print or type the following information) •
cJAIrlfS N do I/,, 1
Name of Permit Applicant
@o /I/J1 6314-C1 a sin C
Firm Name, if any
S5 &l lam v4ap
F,-;// /t/t'- /l7/9Ss• Address
Oa7a4
•
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