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Home My WebLink AboutLFADMIN 8/30/2018 11:21:47 AM g. 4.4 Dr o TOWN OF YARMOUTH ittniG MTTACME ....c6,,'Ata.e..no+# 0,i Application for a Permit to Build No. 7°2-547,5 , UPON FINAL APPROVAL Qq •Q3 .93 MAP // V LOT C/9 FEE MUST ACCOMPANY THIS APPLICATION. DATE ' 9/9 ,3 1993 The undersigned hereby applies for a permit to build 93,93 according to the following specifications •_ I = s. ' NA. Name of property owner SEE w. v. cusNaQ J. t'P4 p.R.se4U Tel. 34 4-7I.z.s—" Address 3l TA t m a N a p¢ L(A¢.h. G o-r14- d 2 L7.1- 2.Name ofArchitect(ifany) _ _ Tel. 4 Name of builder o w u ea.. Address s A in. 4. License No. Tel. 5. Name of Mason Address 6. License No. Tel �� V /. Construction address 31 Ta s m aa,ft 'pia. get lam o o Wr FloodDistrict (1 TO 8. Date of subdivision Approval plain zone Zone fC 9. Private dwelling 0 Estimated CostAO NOT WRITE IN THIS SPACE 10. Multi family ❑ ;C 0 o o TyJpe of room No. 11. Commercial 0 �� -4 S' I# .: Kit he ' 12. Other 0 kA-S / vo Dining Rm. 13. No.of stories (bait Living Rm. Bed Rm. 14. Foundation — Full 0 Half 0 Crawl 0 Slab ❑ ' Bath 15. Materials — Wood 0 Cement 0 Other ❑ - Deck 16. Type of heat — Oil 0 Gas 0 Electric 0 Other 0 o. ' Closed porch Family Rm. 17. Garage — 1 0 2 0 ., 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.I.C.R. No. LOT RELEASED BYSignature /i� e a eit�i.,D,G/!Lo( PLANNING BOARD Address Date TOWN OF YAMOUTH • - BUILDING DEPARTMENT : '1I01EOWNER LICENSE EXEMPTION PLEASE PRINT: DATE 'Se-p 7 /A, /443 JOB LOCATION 3 T ( AV/VIA/01h 'D e. LetaZtNOdT 1"E' NUMBER STREET ADDRESS SECTION OF;TOWN "HOMEOWNER" Ler W,' PA , vs FA✓ .sq M-'Thz ---- ea,9 8 -2a'12 NAME NOME PHONE WORK PHONE PRESENT MAILING ADRESS3t i A vn cry 1 �` • . ' SIT'l.4• tA. d2 675 CITY OR TOWN,• 0 • • ' STATE ZIP CODE 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 WHO 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 T1IE BUILDING OFFICIAL, ON A POILM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT TIE/SIZE 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 UNDE•RSIGNE•D "HOMEOWNER" CE•RTII'IES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH BUILDING DEPARTMENT MINIMI❑ INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE WILL COMPLY WITH SAID PROCEDURES AND REQUI' aI NTS. HOMEOWNER'S SIGNATURE • 11 • APPROVAL OF BUILDING OFFICIAL NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED TO COMPLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION CONTROL. INSURANCE COVERAGE: I have a current liability insurance pclicy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ❑ No ❑ If you have checked vess, please indicate the type coverage by checking the appropriate box. A liabiEty Insurance policy ❑ Other type cf indemnity, 0 Bcnd ❑ OWNER'S INSURANCE WAIVER: I am aware- that the licensee does not have the insurance coverage required ny Chapter 142 of the Mass. General Laws, and that my signature cn this permit application waives this requirement. Check one: Owner 0 Agent 0 _i;na:ore c: Oster cr Oster s :.cent J Suggested Affidavit for Home Improvement Contractor Permit Application For orrice Use Only NAME OF CITY/TOWN • Permit Na `e Aero o'-TVr Date AFr1DAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c.1424 requires that the"reconstruction.alteration.renovation.repair,modernization,conversion.inprovement,removal.demolition. or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or budding"be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: QC_R ooe Est. Cost`, opo_ Address ofWorkr3t TAA rn4tot4 biz— Q4Zvi'ooT41- 6161C Owner Name: Lee' W. y. W wpt,) j PI4es-as4cJ Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): . _Work excluded by law _Job under SI,000 Building not owner-occupied ,Cdwner 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. I42A ' 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 Date ap Iv for a permit as the owner of the above property: Owner Name COMMONWEALTH OF MASSACHUSETTS • `W f DEPAR:MEIvT OF LNDUSTRIAL ACCIDEN • TS 600 WASHINGTON STREET • names Gamine!: BOSTON, MASSACHUSETTS 02111 • • Comnss,one WORKERS' COMPENSATION INSURANCE AFFIDAVIT • I, CSCE - G/- /—iffzE�sez14�/ (licensee/perminee) with a principal place of business/residence at: ✓3r 11-Srks3A,rA Pg- Y4,z atfrH /'a. A:14? 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 for me. - - [ l I am a sole proprietor, general contractor ot6omeo~"y (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 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 to the Department of Industrial Accidents' Office of Insurance 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 day of /�// , 19 Licensee:Pumrec. Licensor/Permittor -. . Application to / 'NE4t�} lP ' '"• v; Old Kings Highway Regional Historic District Committee I � ' . in the Town of Yarmouth fora • I J CERTIFICATION OF EXEMPTION Application is hereby made, in triplicate, for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, l Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo- j graphs accompanying this application; II TYPE OR PRINT LEGIBLY DATE Seepr J4, 144-5 ADDRESS OF PROPOSED WORK '3 TA.S'}NAf, MA `OP— QA'PSith rt{•- ASSESSORS MAP NO. )I Lk OWNER Le- +- eiEt' $Q`1 Prat ut ASSESSORS LOT NOE- f c~• I It HOME ADDRESS St4&I '--- TEL. NO. 4-2.19c-1 -7 t,z sr AGENT OR CONTRACTOR Cg Catr .. ADDRESS vA N1 h" TEL. NO. '3gL '7132r This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. ❑ (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) . PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot, and, if an addition is involved, show- ing location of existingbuilding.-- 2 - en01= �S.Xitrft House §•AeATG� A StF� 1).3 in( 4' &e l� Wet-LiMC' UJ icWeQ,eA wore BC-CP. AS9"Cr • ,01 2 4ti o ay . ill APPROVED�"/ YARMOUTH COMMITTEE OKHRD • SIGNED -, d' -6 � zif-e--az.„-/ .,Space below line for Committee use. Owner-Contractor-Agent Received by H.D.C. The Certificate is herebyer/'�'�. .�— r '"'� • - Date ?hid q 3 c�, 9,'%/ / ini - / `G�// } ` /� d ted # Time " �• - /.... V // t. 'r^,',.{r', • \Approved The categories of work entitled to exemption are listed on Disapproved , the back of this form. I • EXTERIOR ARCHITECTURAL FEATURES SUITABLE FOR CERTIFICATES OF EXEMPTION FOR RESIDENTIAL USE ONLY • s FENCES: 1. Post and rail, split, half round or round; natural finish 2. Square rail;white or natural finish 3. Stockade; natural or gray stain finish; not forward of face of main building 4. Picket;white only (Maximum height of all fences, 4 feet) • HEDGES: natural, not to exceed four feet in height • DECKS: constructed of wood, on single family dwellings, built after 1900, at fitst floor,level, at the rear only, railings not to exceed 26 inches in height, not over 50% to be visible from a way; natural finish or color I r compatible with building involved - • BREEZEWAYS: enclosure of existing breezeways, consistent with style, material and color of house, excluding sliding ' glass doors facing street,way or public place FLAGPOLES: on residential property, not over 24 feet high, not less than 20 feet from way, constructed of wood, with • - natural finish or painted white, or of aluminum, or of fiberglas or metal painted white • . - • ARBORS AND TRELLISES: of lightweight,wooden construction, not over nine feet high ROOFS: natural cedar shingles,or asphalt shingles per approved color samples; not over five inches exposure to weather SIDING: natural cedar shingles, or wooden clapboards - natural or approved color; not over five inches exposure to weather ' STORM SASH, STORM DOORS, WINDOW SCREENS, SCREEN DOORS, GUTTERS AND LEADERS: permissible if consistent with style, material and color of building LIGHT POST: permissible if consistent with style, material and color of building . AIR CONDITIONERS: portable, window units at side or rear of building STONE WALLS: construction of field or split stone, not exceeding 30 inches in height _ . • • NOTE 1. All prior bulletins hereoy superseded. 1 2. Conditions contained in certificates of appropriateness shall be binding regardless of any exemptions contained herein. 1