Loading...
HomeMy WebLinkAboutBLD-19-001199 ' p • :1-4r7):1 ! CSS 1HAN I!:,'CC' FT SF4- U i Office Use Only r1l ' SI AP'`IRj• — r-.: :- :A taUPt16A!hal 1.Si: 'tC- �rij k^-�,W''!. 0 rh C.;4 THE r",(Ei r Lt::r I INE 'd.G - Permit# �@� Y,F .5i -.41Nf tE_m or 177-7 ET FRO,,1 51F..Ir:i lvtin 5S� . Amount t` ,Q'. Z5cT ;.:I,:,-; -..;*.....,00.,(4-'� ,Permit expires 130 days from 1issne date bLb- Ici -OD(l9 ct EXPRESS SHED PERMIT APPLICATION TOWN OF YARMOUTH RECEIVED Yarmouth Building Department • 1146 Route 28 AUG 28 2018 South Yarmouth, MA 02664 (508)398-2231 Ext. 1261 By: BUILgy? FnyTiAnT16CONSTRUCTION ADDRESS: � T �� S \O ASSESSOR'S INFORMATION: / Map: f 01 Parcel: I O p 7 ow n: f,�,tpt e Ott 4 -q,7 T a Set`05 t 3(1/ / NAM PRESENTADD S TEL # CONTRACTOR. i / Li. . , .i _ii <.;�!....af{_. - •I r , ..._ :moi. ' . • N• L- MAILINOADIRESS TEL it 'Elesidential 0 Commercial I 3a.q 3 S Est.Cost of Construction$ 7 Ob ). Home Improvement Contractor Lie. Construction Sapervisor Lic.AI b ` 39&25 Workman's Compensation Insurance: (check one) C I am the homeowner 0 loathe solelepg��ppprieto� I have Worker's Compensation insurance Etc_ b-(wogs 7— Insurance Company Name: :� ZT�F4-CC... Worker's Comp.Policy# SHED INFORMATION ZU hisiii- New Size L til x 4Y I b x H I bt RU Corner Lot: Yes No 1/ • . Per Town of Yarmouth Zoning 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 p Replace existing* Size L 7/ x P7q x If p *The debris will be disposed of at /S9 .a/opt g-tint,4 A19' Location dI Facility I declare wider penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answers) will be just cause for denial revocati f mylicenseand for prose cution unddeery�MA.L Ch.263.Section 1. ///... Applicant's Signature:/j 4t4 RS "i h✓� r t 1T/+ * Date:J,1u�t4A .21,.:2)fI II f f a 1 Owners Signature(or se ! ice, '�ii - Date: [fit fiksi�2. 2D 1pl Approved By:Stet .�i Date: a 7- o Building Official(or designee EMA[L ADDRESS: Zoning District Historical District Yes Il No Flood Plain Zone: '1 Yes G No Water Resource Protection District: Within 100 ft.of Wetlands:4" ❑ Yes C No 11 Yes 13 No • •**Note:Conservation review requird if within 100 ft.of Wetlands 9/13 * M Us r let. r- Sl..-,"g 05 s 4'-toetie r 1 •1. .- = fi Office of Consumer Affairs and Business Regulation • _sl- a 1. 10 Park Plaza- Suite 5170 =7,.,) � Boston, MassacIL,�tts 02116 , 5:,, ' • I • . Home Improvement ` tor Registration.. • A =*—=Et— C. Commonwealth of Massachusetts > l_ �kV� Division of Professional Licensure MCGRATH POST & BEAM CO. P Board of Building Regulations and Standards JAMES MCGRATH constructiOn„sii* tfi5mr� &2 Family . 259 QUEEN ANNE RD. , =e= = . • CSFA-073665 �� I HARWICH, MA 02645 -< i ,, �3fires:03/14/202 `� JAMES R MCGRATH y'� pc'.4041•11: 'r . /0'1 a` 1j F '� hN V • M _ yv . - 204 CRANVIEW RD ''i.6..11Wj7 t .� k' . BREWSTER MA.p2634'4' ',4, Jt tot t '.I' . t% au.uwiavitoa1s 1 f>Ic1/49dO� Commissioner a- • • ice. (69....„,,,,,N. ?c czcficaeG .€-;.„,,z4.0,iS"Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 41 Boston, Mashusetts 02116 Home Improveme_ tractor Registration . _�' ( Type: Corporation 9=-_-_== ,-6.(6 Registration: 132935 MCGRATH POST & BEAM CO. = A% Expiration: 10/30/20113 259 Queen Anne Rd. vi ` Harwich, MA 02645 • ,. wit g'1 - it \r 4- `zI4L Y`- Update Address and return card. Mark reason for change. SCA1 a 20M-0snt 0 Address 0 Renewal 0 Employment 0 Lost Card ó2u Wpo2n nonweala alctfaeaad wel4 :1 Office of Consumer Affairs EE Business Regulation -_:me HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only Ct before the expiration date. If round return to:. $'�p��" Type: I Office of Consumer Affairs and Business Regulation =1r . . °tfeoistreton )rxoiratlon 10 Park Plaza•Suite 5170 ! 43783$ 10/30/2018 Boston,MA 02116 McGRATHPOST$s` leatko. D/B/A Pine Harbotylboh, Products - • /meat---- James eat James MCGRATH. --'4-:h,:'. . • 259 Queen Anne Rd..i- •- Undersecretary Not valid without signature Harwich,MA 02645 .. . . 4 - The Commonwealth of Massachusetts Department of Industrial Accidents =rxrOat= , Office of Investigations ' =ie/I_ 600 Washington Street Boston,MA 02111 • •�,•'`` www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information } �,w,,s�t Please Print� Legibly Name(Business/Organization/Individual): Me Grath Past 4. L.e.Nte 1 �ra ii Address: ati Qv r '`oditi City/State/Zip:_HarWltha rnW O U9'15 Phone/I: .508.1130.ZOO Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 0 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in anycapacity. employees and have workers' P h• t 9. 0 Building addition [No workers'comp.insurance comp.insurance. 10.0 Electrical repairs or additions required.] 5. 0 We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs . insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] d •Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. P Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have :mployees. if the sub-contractors have employees,they must provide their workers'comp.policy number. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Information. Insurance Company Name: , ■1.1/l 1 ' 11 II'._ Policy#or Self-ins.Lic.#: ECC (0Cn a 41007151- aoJBA Expiration Date:NJ— (j-I lob Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine yf up to$250.00 a day against • .•. • = Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DI• 'v insurance cover.?.e verification. • f do hereby certify u der the r a'f a . r al es of perjury,that the information provided above is true and correct jignature: Date: _ it Phone#: 5 _ V _ Oficial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: , a—, • • .. .............9,0 MCGRPOS-01 KDOYLE A O�� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) 08/06/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder Is an ADDITIONAL INSURED,the polley(ies)must have ADDITIONAL INSURED provisions orbs endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CORACT Rogers&Gray Insurance Agency,Inc .PHONE434 �y c,No):(877)816-2156 South ena ss,mail ro ers re com South Dennis,MA 02660 _��� � 9 g Y• NSURER(S)AFFORDING COVERAGE NAIC a INSURER A,Travelers Indemnity Company of America 25666 INSURED INSURERS:Travelers indemnity Company 25658 McGrath Posta Beam Corp INSURER c:New Hampshire Employers Insurance Compan 13083 dba Pine Harbor Wood Products 259 Queen Anne Rd INSURER o: Harwich,MA 02645 INSURER E_ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR TYPE OF INSURANCE AOOLISUBR POLICY NUMBER POLICY EFF POLICY EXP LNC ITR INSD WVD NMIDDNYYY) MILVDDATYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _-_F 1,000,000 CLAIMS-MADE X OCCUR I.660-03688196-TIA-18 01/31/2018 01/3112019 TEtts TORENTED 100,000 _PBEMISES1Ea�D�D�RI "" 5 MED EXP(ASI nreor , $ 5,000 or , PERSONAL a ADV INJURY 5 1,00%000 GENL AGGREGATE LIMIT PLIES PER GENERAL AGGREGATES 2,000,000 AP X l POLICY za I-1 LOC PRODUCTS•COMP/OP AGO A 2,000,000 OTHER. $ B AUTOMOBILE LIABILITY COMBINEDOUINGLE LIMIT $ 1,000,000 ANY AUTO _ BA-4487B686-18-SEL 01/3112018 01/31/2019 BODILY INJURY(Per Wenn/ $ _- OWN ONLY X NANUUpTNO.pSSWyOLNN1NEEEDp BODILY INJURY(Per accident) 5__ _ X NI ONLY X AUTOSONLY PPROPE� IOAMAGE -3-" 1 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADEAGGREGATE _E__ _ DED RETENTION$ $ C WORKERS COMPENSATION X PER RFI I OEC_ AND EMPLOYERS'LIABILITY ECC-600.4000957.2018A 07/08/2018 07/08/2019 100,000 ANYFad:PROPRIETOR/PARTNER/EXECUTIVE N YIN NIA E L.EACH ACCIDENT i (MpeiniCNH)EXCLUDED? — 1Myn XNNN E L.DISEASE•EA EMPLOYEES 100,000 I DESCRIPTION OF OPERATIONS below E L.DISEASE•POLICY LIMIT $ 500'000 DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES(ACORD 101,Addltlanel Remarks Schedule,may be attached N more sped le requIred) CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE Town of Yarmouth ACCORDANCE WITH?E POLICY POVISION$CE WILL BE DELIVERED IN Building Dept 1146 Main SR Route 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ./,/// ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r y.-w r r/ r' ; PLOT PLAN • FOR LOT M /O// V/ Indicate location of garage or accessory building Additions with dashed lines Sewerage disposal (cesspool) ED Well 22 1 — — -- — I (lot �� ft. rear) I Abuttor's 'fl' — -- — - Name I Abuttor' Lot I Name I Lot f! :f this is a REAR YARD xarner lot, / If this alto in name •�' •••ft• corner if street I write it — name of b0 1 other e street. 4 . SIDE YARD HOUSE SIDE YARD N.I ? 1 b p; ' S ? �• SET BACK it., • • 41 #2' °/ ft. •. 4 I . I a (lot . ct.0' ft. frontage) // OPE (NAME OF STREET) Information ` Supplied by ©/l/n !ARK NORTH POINT • SDUIzCz Dego (F--r AJr-ELS) Bsok'11QS(fa9, /ASP Ohr i a Emberett-t) 31/8 . ,CS J 6Wat • A Information and Instructions 1 ..• hainulaams that Laws chase 132 requites ad employ*,to provide pan'compassion for their mimes. ' Pursuant is this statute,as anis ee is defined n"...nary pass ha tit suvics of aaotha under sap eastad attire, sant a implied,oral a written.° Aa asgJgw is&And sea mdhitM4 pstoaship usoriatbq crapont as a other hail Pity,or sap two an • oohs toping npld Is*jolt carpets;and hang the bp1 tspramtadres ole inial d smplaysa a the ran or Mabee ahs ha kidall,putosuldp,said=a ads bpi eatiin employing suglopse. Ibi nt the own ohtoiling bran having sotmoados thin spins end vibe midis thus*athe n-copal altbe dwelling tote of amidst who employs persons b do mdatmsoce,eaaatttcdoa anpait wank as sock dwelling bane a as tit panda a building appurtenant shale sheik not leaps ossa!muloymrat be don b be a employer." • MOL Mir 152.423C(6)alae rites stat'wary dale or Mal Se s army sus/wMkkstd Ile bolas a rsssws ds Ikon se permit M sprats a holes[sr te cawed beadle.la the asawwaltk hr asy apt a l tele kis sstpndead asaptaMe svMssu et amine wait the inn sem[operate kindly.MOL chaps 152,425C(7)as Webb"the easanoawsakh nor any at le paint a lvitrWons sbai eats is any coon flat the puns=alphas wait and awparbi nine of camel ase with the loan requirements alibis Sp*bars bus pend b the contract*atehriga' Apnhiie '- 1 • Phase Ell out the none conisetbs affidavit complsilyt by chukkas tit bass that apply b your Pada soil,if osessasy.sappy )nets),alba(s)and phos astbe(a)along with tisk csd&ae(s)of *' iamama Limited Whigs Conales(LLC)or LIDS L dskty losassalips(LLP)with as eaplops otos the the mambos uputon as not misted b cony waken'coopsudon nom its LLC or UP does Mn emptoyesr.a peaty is wttgtrked. By adrked that fav affidavit may to sabadt*-1 is the Dawson of Indomist Actidnb 6s casdmatios athas-our coverage. Ake u am to rip sad daft the amigo .The ailklarit should be resmd is be city a lows that the spplirattse Ertho permit a ices is befog ngtraed,ass the Dewing et • rods sUAceidana► 3114uM you hare any pods anadWg the law or Wes as nun is abate a wales' cwoVessodos polka piste call tie Depmorst s the awohr kind below. Seit(nsered axone sherd ease their salmons lissom was oaths r4eaeeioas lea City sr Taws Oaldahi Mose he sae this the.Pintas is complus ad p.Laa kiddy. The Depertmst ha provided asps st dr b1a s r- oftie amdsvit ler yes to Ell oat is the event the 0tlfiw of laratipdoss hs in contact yaw reptttlag tit apr'cet. Please he ass to Ell in the pamiMinem awoke wlak will h ad s a Space asabaa (e additbti no applkaat that at utak=Mph pannirlioniss apptleadooe la my elves yes,oval oedy steads ace imdovIe tdfatlagcumest pulley hwdomtion(vas y)and ashy lob Ste Miner the applicant deriW write"an locations lo Iowa): bps lhiebamtWlyrasnyedor habd kadbytoityoaaybepravided or m appneoelspipe/that avalid amdnkhoe Mskrthese p im orScant Anew affidavit most he filled oat cora yeas Thais has owner acies*hr gladiolas a lines spank aotaMed bmyban acamoac(d v.aess (La s deg Icon or pundit is bum kava at)acid pans b NOT mired to aught ids affidavit Th Oma oft vesdpdas woes like whoa yrs fat advance Sr your eoopusrias and Amid yes tars my question; pleas denot hesitate a siva us a aiL Re Degausses adles,telepkoms ad ha nabs , ;The Comtaaaweaitb of Massachusetts Depntmeot of industrial Accidents 011!.atfinstlpdans 600 Washington Street Boston.MA 02111 Td.F 617-127-1900 ext 406 oe 1-877-MASSAFB Raised I 1-11.114 Fax N 617-777-7749 wwvenuagov/din � ) a - 'rel\• ' \ « , , \ �� ® \\ \ \ , ' o� v w \ `. — - J \ � � �� I / 2 a3/ 3" / �� QS�d� -g� / $ .Gg • / . — — 1 \ vs tr., :^` Ifrt b ... < CD in CN1 . a os? z & y - / » '