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HomeMy WebLinkAboutBLD-93-785 0F'Y`�it; , G�G��i� yl90 .z ; ,- TOWN OF YARMOUTH s '? MATTACMCCS �r-'� t°--i Application for a Permit to Build No. 2 2. 5.— UPON FINAL APPROAV L i 10-'5'� MAP X49 LOT W Z ' w 3 --,,,` FEE MUST ACCOMPANY THIS APPLICATION. DATE ��/�/� 19 9S The undersigned hereby applies for a permit to build �` ' according to the following specifications /p/�sv/G 1. Name of property owner Zee, 0' entsnnn A- Se7hV -r Tel. 34Z`44vt Address 2 0 lib-see-7z L,1-A/(r >/4lzn u Lin/190a r• � 2.Name of Architect(if any) Tel. 3. Name of builder ,w�-40 W- k'ooU.4 Address Sac ads 84iisne-sCEr" 4. License No. his SSi Tel. 3‘3 - 444.1-7' 5. Name of Mason Address 6. License No. . Tel. . 7. Construction address Zs Pet L4vcr y, iro(.n2Pmar Flood District r 8. Date of subdivision Approval plain zone C Zone /Z. "z� 9. Private dwelling ® Estjmated Cost / DO NOT WRITE IN THIS SPACE 10. Multi family 0 /.5-�0 ✓ Type of room No. / 11. Commercial ❑ p��_ 4-n�/ (fid Kitchen 12. Other Cvti` > L O $435-:W Dining Rm. 13. No. of stories . C%(--P� Living Rm. Bed Rm. - 14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 Bath 15. Materials — Wood 0 Cement 0 Other 0 Deck 16.Type of heat — Oil 0 Gas 0 Electric 0 Other 0 Closed porch 17. Garage — 1 0 2 0 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 7-70 •00 No. of feet rear 2-/0•,t No. of feet deep 9/ 22. Size of building. No. of feet front Z4' No. of feet side 50/ 1 No. of feet rear 38, L ' 23. Distance from nearest building: Front Ft. side Ft. side Rear 24. Distance back from line or street ' 3 LI From rear lot line /S• G ' Side line Z-/ 25. H.I.C.R. No. /&66�� / LOT RELEASED BY Signature " ` ki PLANNING BOARD AddressCe-e-404,c fia, 0^"— Date /%/93 -z YEA Tho-- � �e. , (b • 1,x!4 �''�-..rat<:::'r , Old King's Highway Regional Historic District Committee • 1_ _, • ti in the Town of yarmouth for a . �,qrq . G--��� ��y ' • CERTIFICATE OF APPROPRIATENESS • Application is hereby made in triplicate.for the issuance of a Certificate of Appropriateness under Section 6 of Chapter470, Acts and Resolves of Massachusetts.1973,for proposed work as described below and on plans,dragr{ngs or photographs' accompanying this application for. , 2c • • 7y CHECK CATEGORIES THAT APPLY: a r� _ m .• 1. Exterior Building Construction: ❑New Building 0 Addition ®Alteration • ' ' . --z—S;?, -D . C) " Indicate type of building:0 House 0 Garage 0 Commercial 0 Other n', N) m . -a , 2. Exterior Painting: E3 m_r ti 3.Signs or Billboards:0 New sign ❑Existing sign 0 Repainting existing sign n2 w ITI 4.Structure: 0 Fence ❑Wall 0 Flagpole 0 Other r a lea (Please read other side for explanation and requirements). _' 3 TYPE OR PRINT LEGIBLY DATE 3C�'T 2 �9l • ADDRESS OF PROPOSED WORK Ze 176-5. e A'JLI- XVVY0ci 71/0,e/ASSESSORS MAP NO. /09 OWNER 9' 'g•eB4R4 4. BewAt&-77- • ASSESSORS LOT NO.WL I W3 HOME ADDRESS 22 Vis/e7a tearer y teditor1T/ TEL TEL.NO. Sea— C64t FULL NAMESAND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way, (Attach additional sheet if nneece • esssaa y)). //�� /��, -7.. . • • • • AGENT OR CONTRACTOR 67J•14,R2a cr- !a262". TEL.NO, 34.2*"5U7j ADDRESS 16;->) 37 a.#479A-M)PLA/D 414 - 4)2-‘37 . ; DETAILED DESCRIPTION OF PROPOSED WORK:Give all particulars of work to be done(see No.8,other side),including . materials to be used,if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). • . Signed c tfltd f: PC.• Owner-Contractor • Space below line ler Committee use. • - Received by H.D.C. / ' • Date •' ' '7 TheCertificate is ereby!'-i-- . / Date / ' ' 7 ` w • Time 263°' // i // / 21>'- /�xle. 1.9=->�``ice By eA:- _ 1•',..Vt d;, '- "rit: tart:-% 1f1•11�APPROVEDi1c---:- J YARMOUTH COMM LE Ar:•=wc 'a IMPORTANT: If Certificate is approved,approval is subject to the 10 day app6013Pricd proviced in the Act. =•.fac rovee ❑ Please return to: Yarmouth Histanc District Commutes 3G czCO 29-�„y /<'r_wn HaII, 1146 Ht.28, South Yarmouth, Mass.02664 ;:ilq 4 ..ABUTTERS 109 W1 Joan Strauss. 11 Bay Water Dr. Darien, CT. 06820 0 109 W6 Mr `" Edward E. Kelley o hn Lid Barbara A. Bennett Box 51 w � \a„ f11 Cummaquid, MA. 02637 n G C Cc7z. `. .Z. 109 x15 Ivar Lindsey Johnson 376 Commercial St. Boston, MA. 02109 109 W10 Martin Devaney Catherine Devaney 206 Prospect St. Norwood, MA. 02062 100 H5 Barnstable County Mutual Fire Ins. , Co . Hallet Street Yarmouthport, MA. 02675 108 Z6A Nancy M. Hopkins John B. Hopkins 21 Vesper Lane Yarmouthport, MA. 02675 Ak? 100 J2 i CP APPROVED�- Rosalie B. Swansey YARMOUTH COMMITTEE 116 Hallet Street OKHRD Yarmouthport, MA. 02675 1 . /, `7.; e, It vi . s� Zo c� tai / • Wil_ VJ /��. • ` . . �f • cern "":-.4z . • < f, ee• lr o • fT3 . 4 �r 1 .,,� o• C ' 3� • •• I � '� �.-co v o QII4APPROVED fJ"-• e MOUTH COMMITTEE c p . '-- . OKHRD : . .vim 4-'1..,, ,!- � • f, A' 4' '4 , C/` c, Pairs 6 . • 2 o42 s`j•C - Al • /9 .�c>au . .451,"6•45•E; �•o1 E ,../ o . y�Q � F- Or � N ,v • p'� �4 ` • . •- .4 14 E.WA• r \. e ., i� K EY .• 3 • 9Ky : ., i , Felite �// / 11 / _ z4JgA- • I4. • • CERTIFIED. . PLOT . PLAN \`� LDCA yFYRHouTf/lbRT(frASS. . , . • • SCALE •. •<:'-30•• ,, . DATE /1/0✓. /e /Fe, • '� • • PLAN REFER . Oa/ 'c Lor a � y `4� �,• � ` , • • i9.,!r?: 4?" l.. . /,4,w,y °Ai. -.•9 , `�- � C • / • 1 CERTIFY THAT THE biisrrAi¢., un_ci.v.G...., • • SHOWN ON THIS PLAN IS LOCATED THE GROUND • • AS SHOWN HEREON. • • ¢ ED 'B ,e Ae424 .9:' B&WA/#-i • Le -r- 28 VE3pee !-ATi�-`'. , • DATE /ov./'/ye/ ��±+ PETITIONER: y11"ieho /Pow; Moss' oZC7,f' ' l�sU,RED N REGISTERED LAND SUR OR TOWN OF YAP.SCUT:I • OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT COMMITTEE A SPECIFICATION SHEET N'‘ APPLICANT'S NAME Leo le BALSA to A. S6iWWETT FOR: iC'cb� /-vor?ivt/ 29 Vnyoe.e FIs', yanAro ipon-T • I—J COLgR G ,3 . SIDPIG: ; > COS: g rn 1 1\ ih- 7,G N m ' ' .16 � cHrEx: • COL • me sorn L7,1001' MATERIAL: AspNrxr SLbtNGS PITCH: 0 2, COISIA Illvean"..54.-ye - Coto'C' s ( /:7zosr Coev2t> aztsr,MG WINDOWS: VSE &R/Sr,A/G WINDOW SIZE: ,3G"k' 3e • A-.'I Lc7Ldvc ?. TRIM COLOR: V#4/7-6 DOORS: COLOR: SHUTTERS: COLOR: (JuiLLRS: COLOR:• • • DECK: ' SIZE: COLOR: . GA AGE DOORS:. SIZE: COLOR: • • STORM WINDOWS & DOORS: , COLOR: ti SKYLIGHTS (FLAT ONLY) SIZE: COLOR: ADDITIONAL INFORMATION: • • I en Ty APPROVED YARMOUTH COMMITTEE CVHRD • 4 9/68:c1 • • • COMMONWEALTH OF MASSACHUSETTS o b, DEPART/AIN'T OF INDUSTRIAL ACCIDENTS 600 WASHINGTON STREET James Camooeu BOSTON, MASSACHUSETTS 02111 comm ss ones WORKERS' COMPENSATION INSURANCE AFFIDAVIT • I An -r✓O Ge) t J c ' . 7€a (licenseelperminee) • with a principal place of business/residence at 17o. 13o, - 2G 3 /'a/rrr1tlov'tl- 026-io (City/SntedZip) do hereby ceniry, 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<1_, 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 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(CL 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 1 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 undcr Section 25A'of MGL 152 can lead to the impoiition of criminal penalties consisting of a fine of up to S1500.00 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 : $ n- day of d C To i3 Cfl. 19 3 LicensouPermirzor • Suggested Affidavit for Home Improvement Contractor Permit Application . • • For Office use only NAME OF CITY/TOWN • Permit No. )4t oc7nit Date AFFIDAVIT Home Improvement Contractor Law . Supplement to Permit Application MGLe.142A requires that the"reconstruction.alteration.renovation.repair.modernization.conversion.inprovement,removal,demolition. or construction of an addition toanvpre-cdsting owner-occupied building containing at least one but not more than four dwelling units....or ' to structures which are adjacent to such residence or building"be done by registered contractors,with cenain exceptions,along with other requirements. Type of Work: /2,2"f= AmetT', de , Est. Costls, Address of Work a S7 UG'Sp?-c lit/..sevupy,-/o,-2 Owner Name: (eo -f /f/dr/t-9-varve i3e.ne-nre TT Date of Permit Application: /o- S -73 I hereby certify that: Registration is not required for the following reason(s): • • _Work excluded by law _Job under 51,000 _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. 1d2A. Signed under penalties of perjury: I hereby apply for a permit the agent of the owner: -7 3 7 4) (2,d4}4 /occ/s` Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name TOWN OF YARMOUTH • BUILDING DEPARTMENT • , - CONSTRUCTION SUPERVISOR FORM PLEASE PRINT: : " - JOB LOCATION: Z8 : Ve3p03 Gee yA z,90Li p°2T NUMBER ' . . STREET VILLAGE ', OWNER OF PROPERTY: ' Z&V •V Bs97Z5, de - .66W/16., , i CONSTRUCTION SUPERVISOR: / / 19,41 G✓ 63ay.z ie ©!s '' � Y 3G 2 - Se‘ 5`y NAME LICENSE NO: PHONE NO. ' ADDRESS P. goy-• 3 1244 '1- f%sf�i3Ca j l•1, - '02630 LICENSED DESIGNEE: ;., . .". : , • (IF OTHER THAN SUPERVISOR) NAME LICENSE N0. • 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 • - 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 2.1'5.3 OR ANY ' 1 OTHER SECTION OF THESE RULES AND REGULATIONS AND ANY PROCEDURES, AS AMENDED, SHALL 3E SUBJECT • I TO REVOCATION OR SUSPENSION OF LICENSE BY THE BOARD. - ' ; ;t. • 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 DEMOLITION 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 L`MEDIATELY CEASE UNTIL A SUCCESSOR LICENSE HOLDER IS'_UBSTITUTED . ' 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 INSURANCE COVERAGE: ' ' : 1-.. "" • - I have a current liability insurance pclicy or its substantial equivalent which meets the requirements of MGL1Ch.152" x: •I' _. ,."..- :1*- r.:: If you have ecked ves, please indicate the tJpe coverage by checking the ap'rcpriate bax. `: =;: . c • A liability Insurance pc:icy Other type of ;.idemnity 0 ---� - Bond ❑ '•- - =-i"'•----- ..:.��- :,, • • • • OWNER'S INSURANCE WAIVER:I am aware that the ucensee date rot have the insurance coverage re'quire?_y Chapter 152 of the Mass. General Laws, ana that my signature on Ins permit :cplication waives this requirerrer.: • Check one: • • _ Owner° Agent 0 Signature of Ownereror Owners Agent ' SIGNATURE�?�—� C-2 Cm,„)-.02 BUILDING OFFICIAL APPROVAL: