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HomeMy WebLinkAboutBLD-19-001075 e /4 = t FOSN S it IA 'F? .:",,H..!0 FTJ 'Office Use Only '$• �O F,C'.:' ;HE : a;!Jr I_t:r Li?JC: '4Mf,' .Permit# W o ,yr 'itr•.IF R!'�". IX/ r FIT Er.o ;,;i`lr.:i AND ;Amoant csn i..a c�- :Permit expires ISO days from jssue date D BL -I9_00io7& EXPRESS SHED PERMIT APPLICATICI5JE C E I V E D TOWN OF YARMOUTH Yarmouth Building Department • AUG 22 2018 i , 1146 Route 28 South Yarmouth, MA 02664 suu.Dle Rte t,� c c� Pompano (55088)t398"--22231�Exft.�12Q661 �I- l TICl� 0 CONSTRUCTION ADDRESS: a5 Pom oTA /QC-fey0(l+�rr ?O t AlNa.- O& ' ASSESSOR'S INFORMATION: 1 Map: Parcel: owNER.3tufe+earD( er 167 fanebenv Jin L41t}7 PA 17.43 717-10142 1 1 NAME �^QPRESENTAD Arm-v._ n� TEL ii �t,v` CONTRACTOR:ttc A,n( Sal(Doter) ANe _Qd 5c5430 .28C 0 �,J� NAME MAILING ADDRESS TEL.# /Igl,itesidential 0 Commercialci - Est.Cost of Construction$ nLilco• Vp, q (/ Rome Improvement Contractor Lie.# I .3-x 1I5 Construction Supervisor Lie.kv PA "O1 S C��R...) Workman's Compensation Insurance: (check one) 0 I am the homeowner ` - ❑ I am the sole proprietor � 41 have Worker's Compensation Insurance ^���p /t t/ 1'nsurance Company Name: bt+Jt 'Cr FYt t4 of S`"Worker's Comp.Policy#lCC '&b•uOC.dk57—2018„ SHED INFORMATION tt ''ll` t( t/ New 1_ Size L (9 s W 0 x Hie...) Corner Lot: Yes_ No . Per Town of Yarmouth Zonin?By-Law Sec 203.5 E: Side and rear setbacks for accessory buildings less than 150 square feet and single story, shall be 6 feet in all districts, but in no case built closer than 12 feet to any other building. Replace existing* _ Size L x W a If tom,/� tit (� /��� ,I C� *The debris will be disposed ofat A fit[}- `- c , t t 1 C't _045 Location of Facility I declare under penalti • r' ry that t statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false mrswer(s) will be just cause for / t ion o my license and For prosecution under M.G.L.Ch.265.Section 1. I�' Applicant's Signature. ,� t Date: Ika / Owners Signature(o A Tr c • •� - ' a it _ Date: p l ✓✓✓ Approved Br / •,L. �1, Dale: 6 -6.a,- ix Building Official(or designee) EMAIL ADDRESS: • .....�...... • Zoning District: '""'_�_� Historical District Yes fl No Flood Plain Zone: n Yes r; No Water Resource Protection District: Within 100 ft.of Wetlands:•" 17 Yes C No FI Yes 0 No • ***Note:Conservation review required if within 100 fl.of Wetlands 9/13 -"' ""' .. PINS HARBOR c 0001/0001 .... • V . • The Commonwealths of Massachusetts Department of Industrial Accidents • kr Officeof Investigations • • ' 600 Washington Street Boston,MA 02111 Workers Compensation Insurance Affidavit. Builders/Contractors/El ._ e ell ant Info ie al on lans/Pinmbc Please i t . Name(Bus; ; ;naso: Li , t i MIMI • t1 to,10 I7 a.1 Address: , ' Q • a istaterzip: l trn h'P 1. tvMo Q?t9si 7 Phone itSS 4130 Are you n employer?Check the appropriate box. 1.0 /am a employer with 4. 0 lam a general contractor and I Type of proieet(regrlred); employees(Sill and/or part-time).* have hired the sub-contractors 6 0 New construction• 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-eantraetora have working for me in any capacity. employees and have workers' 8 a Demolition [No worker,'comp.insurance comp insurance,: 9. a Building addition 3.0 required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.[No workers'camp. right of exemption per MGL • insurance required.)t e.152,BON and we have no 12.0 Hoof repairs employees.[No workers' 13.0 Other con .insurance s P whohocheck aim r mat h Meath! below showind theithen hit ca tide mpeneadatcoareetas mustImlays+teemmaw •; Contractors matNeckthisboxmootembedanadditionals ng anwork andneeoft esti-cwnaaktars and state aa+mita reruns Mattingaffidavit su h ma Ioyees. Ifthesub•omp haveenaloyces they meatprovid�eeg the woe r workeenecomp.poicynumber.contactors aedanaswhede,•mnattroreoaddeshave ram • an employer that b providing workers'eonlpptratfort insurance/or,ry employees. Below bhe pony and Insurance Company Name: 1. ,y k ■Is u1/,,, a t t 1 4. . fi ,j Policy//orSelf-Ms.Lic.4: Etc-�•gae�BAExpirationa a • I ul�! ti ExpirationDate: _ , . lob Site Address • Attach a copy of the worker'mom City/State/Zip: failure toa secure coverage as compensation policy declaration page(showiag the policy number and expirstioa da fine up to secc 0 eraanda requited tattler Section 25A of MGL c.152 can lead to the imposition Of aimiaal penalties of of up to o Sl,00.a day alai one-year impriaoranent,as well as civil penalties in the form of a STOP WORK ORDER and a 1 . Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D .a, . , „ ,.. .. ,,:,..verification. tar hereby cat II,a T • PT- t do 1„ill r 1 IP�haJ shag rlYetgfarmatlowearldafabort truueand covert ,•r-41•11.I l•. SCS•• . • • _`�� Official use oalj: Do not wrae In Ws arca,to be eompteredby earl,or town official C!!y or Tows: Subs Arithe _ Penntt/lleease# I.Board of Health(2.Building Department 3.Cltytrawn Clerk 4.Electrical inspector pecten 3 Plumbing Inspector Contact Person: Phase M: ' P. - 1s '—. •••. • PLOT PLAN .•,• • FOR LOT N Indicate location of garage or accessory building Additions with dashed lines Sewerage disposal (cesspool) ED Well a II _ — I (lot ft. rear) I Abutmr's — 0 — -- - Name Abuteor' Lot N Name Lot N 1 this a REAR YARD :orner lot, c this trite in name I ft. corner )f street. l Iwrite1.1 ' �, name of a other b 8 street. . v DE YARD SID HOUSE E YARD 0 i . V. • I • SET BA (/� 11..�1 ff I. • A 1 ft. 4.2 vis (lot ft. frontage) / \ i / 3 (NAME OF STREET) Information Supplied by PARK NORTH POINT • .ate.. a. • ripfoodiso tossaut PtriT 11 Mall 6tWLu-L19 N sod 931BBt79-LL8-1 ao!ohletsOCRSKU119,'pa !mom same nmS aolllalgsoW 1$09 amwAlfillsamg p PRIM 4aalPai impar Jo W$WISS0 tlInturamin to IA DJ eta ' r nz pr aagdosl'awe a taoa.a a1113 PIM syll «u Yoopmb Lm sesq nal nom pot_gssdooa+aac al soars a!ask mewl a p! �sem ULL loom sPilnem es palms 1014stend pre('sPseam ntpCOLS nosmogsaps. i) amsmapepWaill03>D ppm Lsa co poop moa pad is amyl a fal4stgo s9=PP a Baro nig•DMA lea TSnPapppsgmaram aasr seam mad agq►yOalDeaeal sawsPromaP> t mpg mail a9Lam_raleAPPPLgPIP=fe Pans Lgeplpomin oft Pqtraw gip miff Yslain ao Lrar'—sl amapaq 11s.PPP Naar Penna&P41.aa4'PY Pm(ls agsM)oklem gm!t.rd rano eg mmpsWooelaPsLpopma'ssLesalllamnoporideamaggodswdppmruPaPsaPP 'remade s'. . -sal 'agmen Wawspe en pen s4 ms Tows spur sesagplottsd sot ap op a swag surd nit mgt Swan sot ew-a a n4 sucdjia►alp mens se Plea se 01 Po lm a aac+gl RafW-mels saoer.q We P Wade!Mailing emwadsa sR211113111 Pole Pas assrdmoa wl WIMP PPI op ase sq mild • WPM matt as iso 'sag MaPdaeide mp so spam naseg seaseeips MCI ups Mange Wadi s Pam enure '%ap9Ps' eawmaa eP P Padasta mgt pet sold'ARO_oparadoaa papas lens temermtba.auqaa(PPa4C wnPlaaYPlasapal • p leateaoodoa art ew'laea6 oIkons1 smog JD rued ngtsg age ,,tide se Peoralb Lila sop spa ps nq Pratt 1P119/1 VAMP set NPP Pus alp a mat sq sill i/waoa soli aol momma s4 anPP'aY rtu- a17a P asiodaa a4i a n'PaRa ng Lea WARP RIP PRI?PPP a6 'reeks q aged m tastaldaa asp mop(TI so on a flax mepmsdueoo,newer Zr em peaks sea me'seeated s s-'r-- me asp aspo ai'gdoe ma Ira(rn)udrgsaana dieRW I Won so( fl eoPSP03ARPF11 Main--$1 so! la(W}leep uEs pp!pa Poop(W)egasm sop Pm maw,loco(r)seaa ow-o w Lrddm'Lasnoea A' a sepals moa a Lld&W Pe Pep mot Swop Lg°polo dans paw sopwdmoa,moon►se Po Ng amid sPsagddY :4--.-°lap-stsmemse apane-"d sang sem s earn'PPla putsupba' asmaaa!°e spry soag8mwlo sot W_ggetds=root poo sggadlo aaaWgsd asp up puma its seai arra rltgs"'PPIMP Pffird PIP+ta sea egnraammoa se s9wsl't.SS C031111 t s 2 ''Jon'4Pmsp}PPV ;pains dumas uasanl top pp sserriasp uspps sopranos Pssmpad las sT asp fade Lasaq>ppsou ssossol4dgPp ,,papas gss°nape•mak gpond assnugsppumas a mesa-n MVP'RRsissdsgsltas ll Pal a as mat,,Pe near apo(Pbtd to mar ion :sea*,ss sip apmsmp sgemmiordsspap msaa+4rte pqr soy enoaadds falppq a Pad setas oto smog fmlp sip Tams so pew sodas so upposaos Wangalsm op q rimed°Corkin err spans sen fagprP mega!_do=se so swap apps wpm!poomauds saws sae nam era loop moo agog op naso se-atop wLgdu.Weld=*PO PIN'OP s._.,,-peas*law fl' 't slaa)omonosalma sot so%LOP pwsap slo aap'rlesmadu Ido mgt folptgotq put'set" r pile s1 pedes faaUq ae t° nom s bp La s'Lspas phi:pm so_apnodsoa'w,, core d}q.aid'p.galp.l_s„n psnpep sl alights hts sY „spin so pus appri q so pomata Pomp pesos Luo am satsooelo sown sip s9 mod Leas'-„a poopap sl rs(glns se hotness pp a num vastanno pap sg soprsadmos,wtpar appud a.splordas Rs nesfia LC!p&p ern roasts elpra•gal larl •' suofl3nx}sai put uoueutao;UI AC RO' MC3RPOS-07 ZHELLWIG 1901../".' CERTIFICATE OF LIABILITY INSURANCE I uATEfI.MnrYrr, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIF ATE HOLDER.1THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORD D By THE POLICES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSU REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. RC P,AUTHORIZED IMPORTANT: If the certificate holder Is an ADDmONAL INSURED,the polirypes)must have AODRIONAL INSURED If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies mayor beteme t on this certificate does not confer rights to the certificate holder M lieu of such endorsement(s). an and A statementstatementon RPpRO�DUE�CER 43CRq 1E4G�assurance Agency,Inc. latiT--- . . _ - _ South Dennis,MA 02880 "O�-BOT_ FAX 816-21'..8 Witsht maB6ro5ersgmy.con, — T �. N/eURERJ{J_APPDgO(tIO COVERADE _1...-NMN/ tm BrMXTm .,.af*,Travelers Indemnity Company of . .dal 25688 McGrath Pod a Beam Corp +uXEXa Travelers IndemnKy.ccn,p ny 58 abs Pine Harbor Wood Products .:RSV RER c:New Hampshire Employers Insurance •capon ,13083 259 Queen Anne Rd ;INSURER I): HUMOR.MA 02645 . . .. _.._.._. .. "NUM F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER TMS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE F•-THE POLICY PER CO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RE ' CT TO WHCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRSED HEREIN IS SUBJ TO ALL THETE9MS. EXCLUSIONS AND CONDITIONS OF 5t1C11 POLICIES_LIMrTS SHOWN MAY HAVE BEEN REDUCED BY FAO CLAIMS. LTR TYPEOFRISIMAIILTf AOOL MIelSIR Peat%BP Palk*EW- A NSD eNa. POLICY mama fNWVO/rrrrl IMMA]D/rfYYI X CDNMERCPE OF INSUAL RANCE LRV EVNEIE:CURCUM-MADE X OCam 1.860-07888198-TIA.18 01/3112018 01(31/2019 RE :$ t,0o0,aoo no) EEG DP (AMINO IRMO ,E S.000 .OPEL AGOREQATE pUpLpM.APPLIES PER: PERSCNAI,{ADV INJURY $ 1,OOB4ODO i X.POLICY ;JE& L LOC C+ENENK AGGREGATE 2,000.000 B ,DipEd • I FR9051n-cciarAt)4 r s 2,000A00 TI' I i f _ AXYAuro J I BA44878886-+s.SEL sa . .A mornmstlir /.800.x. .rig ''Y - ,X 01A1Q018 01131!2018 eooiv eLMRT retiree) .A •X' ONLY .X JE came-... a A aMORELLA LMB 1 OCCUR S -� • •EECE{{LW : CWMSMADE I .EACH OCCURRENCE S . DED : 'RETENTIONS , I .ACGRECATE $ CAHD RsDYDDMPms*ERS eiry . _ s . Q PPR PROPRIETOR/PARTNER/EXECUTIVE rix.: ECC-600-0g0085T,2016A 07108/2018 07ro82019' X• INA EER- .. _ _ �Lyrw, '.BER E%CWDEDT N• N/A El EACNACCIDENT $ 199,090 oE3CRI PTION OOOFOrPERATIONS below i I ;El DI3EA5E_Ea EMPLOYEE 1�. ELL DISEASE•POIICYLBAIT • 590,900 DESCRIPTION OPOPERATIONS I WCATONS/VEm0.Ee fACDRD In.Addles.Romeo Nre/P,a,nHP albeML■NNUNSNOB Y OBROBN4 • •N E ,•, Town of Yarmouth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE = =.BEFORE Building THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED M ACCORDANCE WTHE POLICY PROVISIONS. 1140 Main St, DH Route 28 South Yarmouth,MA 02864 Mf4ORD!ID R®RElENTATNE AIF . Oe *CORD 25(2018/03) - C 1988.2015 ACORD CORPORATION. All Shp marred. The ACORD name end logo are registered marks of ACORD rr e s % ,/h �t / n ' Office of Consumer Affairs and Business regulation , ' /, /a } 10 Park Plaia - Suite 5170 Boston, Massae. Jetts 02116 , Home Improvement r, ; tar Registration.. r r 1 Conanonweakh .1 Massachusetts IUICGRATH POST& BEAM CO. �rw; •I� it Division of Prole sional Menu/re JAMES H POST& • Board of Building Reg tenons and Standards 259 QUEEN ANNE RD. _ Constructlo su tti. ibr l&2 Family HARWICH, MA 02645• '!Ilk t' CSFA-073665 r, ` sat Mk/ t �''"A-,,t flr 420: — ^�a JAMES R MCGRATH {'k. i ' 204 CRABIyIEW RD �`z#:, ��, • .s wa.unir.•nn,s BREWSTER MA 4211314w 4^• 7-i 4lit t:Slit1� a et Commissioner Cei- • u=� �>�ie /�Tjy7/, cvmmioneveida 144 / 4 •,4 •cl'13;10-r, / ' r Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Ma$chusetts 02116 Home Improvemet •pantractor Registration 'n _ i p Type McGRATH POST& BEAM CO. `'= i'.., _... ' (4 � orr. 132935ion 259 Queen Anne Rd. sr =-- . l.t F�iration 10/30/201e Harwich, MA 02645 f.' - '-i •.-.:--- tate.--- ,:-/ apr O 20403/11 .' •r-r'<:c .,11 .. ••' plate Address and return card. Mark reason for ch — ange g4 Ens O Address ❑Renewal 0 Employment ❑Lost Card f Consume,nr Q�yss Re fa 5 Office IMPROVEMENTE airs Business taeWauon e _ CONTRACTOR Registration valid for Individual use only _,'17 ,F . Type: Carporatlor, +J,.a s before the expiration date. K found return to: .",4:' F.2SRILffi74.0 Office of Consumer Affairs end Business Regulation .. 10/30/2018 10P Reza-Suite 5170 MoGRATHPOST& ; QBEAi�t''CQ• Bos n MA 02718 /� D/B/A Pine HarbortWorle Products JameaMcGRATW •-`•' . /AOC 259 Queen Anne Rd: Undersecretary /" Harwich,MA 02645 Not valid without signature in taxi } .Y TOWN OF YARMOUTH ° 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 '9, Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 OLD KING'S HIGHWAY HISTORIC DISTRICT COMM i EIVED • APPLICATION FOR AUG 20 2018 CERTIFICATE OF EXEMPTION YARMOUT Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 a delL6fICNEf$ry �WfAY Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photogra accompanying this application. Type or print legibly. nn Address of proposed work: ti Porn QY_ nr Map/Lot# OS): (j,)CP 4- C :A 12)I r r-ser Phone#: 717-70I- 71 All applications must be submitted by owner or accompanied Iby letter from owner Jerr approving submittal of application. Mailing address: 167 / Lane_ L� IT2 Pk\ (J`f Year built: Email: Cb(trqJ -3 @ r ,rnroj—hnek Preferred notification method: Phone Email Agent/Contractor: - Phone#: Mailing Address: Email: Preferred notification method: Phone Email Description of Proposed Work(Additional pages may be attached if necessary): _ In d �'Azi �t nc �tor Shed APPR ED AUG 2 0 2018 PYARMOUTH ceQ:oost1 cafe roveaFor ax13. Ge'Eo i), SLe was :^s tle�+ OLD KING'S HIGHWAY Signed(Owner or agent): ( 41 v'ard Date: 8 20 '/ a > Owner/°ontractodagent is aware that a permit may be required from the Building Department(Check other departments,also.) > This certificate is good for one year from approval date or upon date of expiration of Building Permit whichever date shall be later. For Committee use only: Date: gid b Approved _Approved with changes _Denied Amount az) Reason for denial: RECEIVED Cash/CK#: (0357 TO 2 12013 Rcvd by. SV TOWV: CIL-itK SOUTH YARMOUTH, MA 82040/8' p [ O Q4 Date Signed: Signed: ".i6 ` __ APPLICATION#1 8 - L 0 V5.2017 F • i O Front Elevation © Left Elevation PINE HARBOR ROOD PaouovS SCALE V4'=r-0' SCALE I/4'=r-cr PrEHAR9oR coM 1900-369-SHED 1S9 pima Ann.Rood HIIWICL MA O}HS _ _____ 10/12 p Es061410-1.00 ___ i EMISO9^.1.-111` • =��meaelnisammimmniaimn �� �M��1 •� lechteaval Slinks 6.• .p ..ter. om ENGINEER'S STAMP _ IIPing DVC Um 2. 4 co = u■ _ _ ■■■ _ c II UN --mil I hRRRK y Composite SMq Bawd aId Batten C5 M N) J 1 w PROTECT: s'-0- i -o• I = C 1EFRI4' 4uivett Carle aci 0 Bruce Burger ADDRESS: 85 Pompano Road ORear Elevation O Right Elevation Yarmo Rhpat MA02575 SCALE I/4'=I'-0' SCALE I/4'= 1'-0- — --�'� PHONE: I 717-940-7947 �, E-MAIL: Singles i_ luirazg Z CaI bburg53@comcast net Orchtectural wo� /\ G T.� ADDRESS OF PROPOSED WORK: 4 f ] C 0A 1 85 Pompano Road C7—I ^ Yarrtwnthpvt.MA 02({75 S1 _) al� ..� ? w r '1 A REVISION DATE: 0 --•Bo'd and ears Board 6..5 eaten { DRAWN 8/16/18 m _ ('I �i GB o Zi a /77 Scale I/4'= r-o G). 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