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HomeMy WebLinkAboutBLD-93-792 oo.Ygk, fOV /6i/9.3 ` . c T ,, o TOWN OF YARMOUTH ©< ' /sfr • MATTACMC $ K e„,co,,,,•i'6d'.' Application for a Permit to Build No. g 2' UPON FINAL APPROVAL /IV 10 -0-----p \ MAP /e/a LOT / 28 FEE MUST ACCOMPANY THIS APPLICATION. \DATE 0-1;% 1993 The undersigned hereby applies for a permit to build /67172 according to the following specifications /6//593 \ 1. Name of property owner ,<.ri✓DA 2), 12E/q/4/6' Tel. 3.49,-447/14 \Address 3S- GaRnew LAA/E) YARAaYT✓/Ain; /Y s'S 2.Name of Architect(if any) � Tel. . \3. Name of builder A • AIL•�l�i •. t e J A dd�`reS ` der 4. License No. Tel. 5. Name of Mason Address 6. License No: Tel. \ 7. Construction address 3r ("Girt 2o..n /ar�..d✓)L rf Acs- ' Flood District 8. Date of subdivision Approval plain one C- Zone _ �' yd. 9. Private dwelling 0 Estimated Cost ��A DO NOT WRITE IN THIS SPACE /0 0 G emcee-ea Type of room No. 10. Multi family 0 73, coo ,00 5f , /o/.�✓c/3/c - �rAeBd . 11. Commercial 0 �0, Kitchen 4t$ l R a 16% Dining Rm, 12. Other ❑ i, p�, 13. No. of stories 1 9 X , Living Rm. f 0 --0-0Dl' Bed Rm. 14. Foundation — Full 0 Half 0 Crawl 0 Slab sol /tL 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 ❑ 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 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 BY \Signature- dyi. r> il r - PLANNING BOARD Address ?C rid, •�,,,in-,A,.,,71n Date ,t.� . X6/7/93 `&C UI n ERP FF " �. _ � .1�, �/ APPLICA‘NTi .` .4 5, pm � 1n BUILDING PERMIT : ADDRESS: 3� �y�,rom lo„C•. XV*t TELE. NO. : 3.6.2-3/1>J7 DATE FILED: BLDG. .SITE LOCATION: rcgme 4S Qiye. MAP if: IOC LOTlf: -dd • 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. :1 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: 601. WATER DEPARTMENT ? ,pyx ` I�„e,Q.�^, DATE: p - 4 - CI 3 N/A: 2. ENGINEERING DEPARTMENT: DATE: N/A: • 3. CONSERVATION: DATE: N/A: 4. HEALTH DEPARTMENT DATE: /0/ 0 _ N/A: NDUST IAL 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.utteR- — Ole- P -. r)e-T.4G•NS9 S-A (�C..DG 0 "X ti- ` /3Grfly • ,F=i visff l�c n r7� 1//arn- Cr'-vvd >na Ta C/ .F-J) � .c6rtdent/ a . .Crl 7' ,IC[ST$ hr 7/' &inc. #iitJCrSfS G . Rn-rflct fizay.� J. rosn- 73 re #->/t,.s . • r is I3L21/89 }° 47/9"3- • F-7 LOT N0. :, BA_ADDRESS35CUeQoiv4 1: "' OWNERS NAME: 4-t V 44 e Lc�S ` - ", • � ' " • SEWAGE PERMIT NO. . NEW: t-I6AIR: DATE .ISSUED:E hf/'AATE INSTALLED: 8./ • INSTALLERS NAME; DAA) 4) P Alfi'1A••..) • -p, e")1/4. .,,, - -1 x?A INSTALLATION OF:: AnC.TAvtt ',C Y7�/2 2 ,-. • WATER TABLE:•.,.JA FINAL INSPECTION,B. STALLATION ON REVERS DRAWING OF Ib E IDE:• • .,.i, f Y • a . �. r; fir., y u i, st r` ...v r 'v is . �55,�p» '�4.a �.� r ',.•11...:, f a r ` Y • A� r n Y " ?" '' '. M A. YI �' t' �' ht't1, rm rF h '. /�� IC '°'�{y G 'r f s ' r a• •''� r: ,..:.!•�'�T G O ppi S C :u,..hy.t,?,F':". :s•.F. i•,:7,':,1-1-*-:e'b '•-' ..:'',,..7::•:. '•;' : :i';9 23.5 •:. :.q ..., - - si-r: "Z. 7.-,i ^ . .; '.a, 4.4C-'''ca �"='at%Y::;^' ,.,�. c:, .a ..e•. . .4� y non ..:.? qp .,.,4 ,�:, e.,, ,A -' r',• ^:t. 'a.._ _ ,:•lt,t•; v '^'''''-'7•:•!^:;'''''; '•”1:- ..‘," ta.:''.r� :k4t. .. � � �t'. y\' i1 l'.l�n i+ Yi , � ':`�zi�' "�'k4,.,• ;�:-,fa .» ,j'};i: ,;?y.,`"' •' 4t,: '16 r,,`;',4';.:0... , 't,,.;Y',y (( tt om.." '" • ' r..+'�•'•� ,:t':,•4,••',D,'D T," 'Y�f.v t.- i1.1,• ' i1.;:• "''t't.-..V;. 3`L/,.-Y#.,'4Jl Y'l ri:.,j et i< 'C4rc..c rvrlt,;.7.•..51",;•.:a + 2' v, 'r* it f5i1 ,&- k �43t L r s.,�e,4f! '1.«C'9 ri, s5,,i, }ait2 °v` ±.r�tir? a.' ;` '`s ,. �i .w PLOT PLAN r • • FOR LOT IT 7724> Indicate location of garage or accessory building Additions with dashed lines Sewerage disposal (cesspool) ED • . Well fa lid/ I a� (lot /08 ft. rear) ar I _ Abuttor's I . -1\ '1$ 4 A u' Name I ' �` ( �/� Nam Lot n I • ( Lot n r f 22ff JJJ \ 10 'I ; 1 .. If this is a • REAR�YAR s / • ,` %%' If t corner lot, c 1�. . • corn write in name iari of street. _ I a -• name G oth-- v stre ro d SIDE YARD SIDE YARD i • HOUSE L • 0 ozota FT. 0 . • 0 _a 9__ FT{\ Q • • 1 • • SET BACK . . . .3.6. .ft. o o I I • (lot OF ft. frontage) . \ / ./ 35-0,60ak Z 0 i \ / (NAME OF STREET) / \ Supplied by a 2. .• Application to ,+� -r ,. � �',, '4, Old King's Highway Regional Historic District Committee . V .-.1 in the Town of,Yarmouth for a 1 U--''V ; CERTIFICATE OF APPROPR• IATENESS 3 q" 9. • Application is hereby made in triplicate,fcr the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings or photographs accompanying this application for. • CHECK CATEGORIES THAT APPLY: - 1. Exterior Building Construction: ❑New Building 0 Addition C Alteration - .. .sr Indicate type of building:0 House • O Garage 0 Commercial 0 Othor . . Z- 2. Exterior Painting: ❑ C3 r u , 3. Signs or Billboards:❑ New sign 0 Existing sign ❑ Repainting existing sign r+, (n IT( 4. Structure: ❑Fence O Walt ❑ Flagpole t Other GAZEBO i-`r, t C1 (Please read other side for explanation and requirements). P'i. e ',:--`• TYPE OR PRINT LEGIBLY DATE TC/1 R/93 • ?'c b m ADDRESS OF PROPOSED WORK 35 Gordon Lane, YarmouthPort-Ma. ASSESSORSP)AP NO-` /o'a W� OWNER Linda D. Fleming ASSESSORS LOT NO. / aKP HOMEADDRESS 35 Gordon Lane,YarmouthPort,Ma, 02675 let_ NL). 362-4714 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Induce name of adjacent property owners across any public street or way.(Attach additional sheet if necessary). Leslje..D,.-SWitzer,41, •Gordon Lane,YarmouthPort - Carl/Marion Morgan,28 Arthur Lane,YarmouthPort Chrystal Hal1 ,24 Arthur Lane,YarmouthPort - George/Ruth Wunner,29 Gordon Lane,YarmouthPort, James/Cheryl Cooke, 36 Gordon Lane, YarnouthPort AGENT OR CONTRACTOR David S. Fleming III TEL. NO. (617)246-1887 ADDRESS 49 Cordis St. , Wakefield; Ma. 01880 (617)245-7471 • 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). Ft. Wide Octagonal Gazebo to be made of #'t eat,ed- lumtw th s•:-•---- ' , • ittezir. cedar roof & cement footings. Color to -be . - ' -_-------- so-ite: �'be placed at back right corner of house/land (lookingsf - streei M' caner-Con raMof-•gent State 0.10w lint ICI Comm,ree use. - • . . . Received by H.D.C. • ll • • Date 4I k/113-The Certificate is hereby Date 1. / • Time - � l - .• l I'dq t—r-f a. __,..-- , ., ......... ,s i _i_s _. • / lopRovE • r ARMOUIN GO tt i IEE c-c%re ' ❑ !MPO-GTANT: If Cer:ilicate is approved, approval is subject to the 10 day appeal p4Y:C ' crevices! in the Act. : u_Ctcvec 0 Please return to: Yarmculh Histl.nc District Commuted Tc•nn Hat 1143 Ht. 26. Scum Yarmouth, Mass. 02684 Suggested Affidavit for Home Improvement Contractor Permit Application For Office Use Only NAME OF CITY/TOWN Permit No. Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application • MGL c.142A requires that the"reconstruction,alteration,renovation.repair,modernization.conversion.inprovement,removal,demolition. or construction of an addition to any pre-existing owneroccupied hwlding containing at least one but not more than four dwelling units....or to structures which are adiacent to such residence or building"be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Est. Cost t bDo. Address of Work Owner Name: /h 4 c Date of Permit Application: 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. 142A. 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 reby ap v for a e as the owner of the above property: Dat { Owner mc • • • COMMONWEALTH OF MASSACHUSETTS • DEPARTMENT MEirT OF INDUSTRIAL ACCIDENT • S ,LI' • . 600 WASHINGTON STREET • games Camooe; BOSTON, MASSACHUSETTS 02111 • • comm ssonet WORKERS' COMPENSATION INSURANCE AFFIDAVIT • . // / /Genu l t (licensee/permittee) - - - • with a principal place off4rs/residence at: �j/ aSs G v`ofdh Lin a mind(//)-/r)7 / /A , 0Jg2c (City/Sure/Zip) do hereby certify, under the pains and penalties of perjury, that: - [) 1 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. [ J 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 mote 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 homeowoer 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 MGI.. 152 can lead to the impoiition 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 S100.00 a day against me. • `/ Signed this 7 In day of ( chi%r , 19 93 Licensee;Pe:^ittec. LicensoriPermiror TOWN OF YA4f0UT11 BUILDING DEPARTMENT 110ISLOWNER LICENSE EXEMPTION PLEASE PRINT: q .` q• DATE act, 7 �/ s Q )) ��` /� �J1— JOB LOCATION �S C9droCan -�.erl[� Xr_m_d / /�era NUMBER STREET ADDRESS SECTION OF3TOWN "HOMEOWNER" HfAciq /ein/ 3602-/f7ifr< 39&c c?Joo NAME HOME PHONE // WORK PHONE PRESENT MAILING ADRESS ,3s ��a-� 4,-Le ,LfXL�f a 0471-4' ?S"" CITY OR TOWN STATE ZIP CODE TIIE 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 WH0 DOES NOT POSSESS A LICENSE, PROVIDED THAT TILE OWNER ACTS AS SUPERVISOR. (STATE BUILDING CODE SECTION 109.1.1) • DEFINITION OF HOMEOWNER: PERSON(S) WH0 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 111E BUILDING OFFICIAL, ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT HE/SUE SHALL BE RESPONSIBLE FOR ALL SUCH WORK PERFORMED UNDER THE BUILDING PERMIT. (SECTION 109.1.1) THE UNDE'RSIGNE'D "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH TUE STATE BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGULATIONS. - THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT FIE/SHE UNDERSTANDS THE TOWN OF YARMOUTH BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE WILL COMPLY WITH SAID PROCEDURES ANDUI' aILTS. HOMEOWNER'S SIGNATURE ✓' "" _` 0 ! ` APPROVAL OF BUILDING OFFICIAL r 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 policy or its substantial equivalent which meets the requirements of MOL Ch. 142. Yes 0 No ❑ If you have checked ves. please indicate the type coverage by checking the appropriate box. A liability Insurance policy 0 Cther type cf indemnity 0 Bond 0 OWNES'S INSURANCE.WAIVER: I am aware- that the licensee does not have the insurance coverage required by Chapter 142 cf the Mass. General Laws, and that my signature cn this permit application waives this requirement. Check one: Owner 0 Agent _yaa:C:e c: Outer cr Owner s AC_.^.t _. . AUG 23 'y3 .U1 : 28Pl1 VIXEN HILL 21`5 286-EUS4 P. 3 h.r•Gt' ` 'C1Li.).) VA..)esa�... Key • • 9A 12A 15B 21C 24C 27C 30C 11A 14B 18B H + ++ " '�" 261?+' 290.6!;x' 143W 156'/2" 186%s" A:Height,Overall 153ye 162W 190!,a' 258 ix• 272,. B:HB nt,Grade to Peak 125W 134W 162 Vs" 220"'/.v' 23a'/a" 243',0" 252i6/i5' 125W 140W' 186'/x" 7 9" 79" 790 C:Height, Entrance Max, 79" 79" 79" 98' 98" 98" 98" 30' 30" 30" D:Height.Railing 30" 301' 30" ' 42" 42" 42" 42" F:Height.Trellis,Piling 13'/:" 13W 131E 254's" 25'2 25?2z'' 25i':" 13W 13W 13'2 " Trellis.Slab 81/4" 8'/ 8W 0?/i' 103%4' 10=/4' 10'/a" G:Height. 6a/.^ " 83/4.1 . H:Height,latMIPiling 41" 41" 41" 41" 41" 41" 41" a 41" 41" 41" .1:Width,Entrance Min. 32'/ix' 448,-se 33'`,it' 33W 5114" 636,4" 75'3'I( 33?4a" 6loiia" 78�/+a " 82 t3/tix" 1123/e 146W " 112`/." 146W 203W 241 2771 306W K:Width,Interior Min. ^ 8?t1i,a M:Width,PointTo Point 107W' 143W 1803/16' 249=-+4" 2975 328" 360'V,e M:Width,Short 98'S/,i' 132'Sha' 166'/,x" N:Width.Flat To Flat 98':'1&' 13211/48" 1663+0" +230°,'!6' 273'.4x" 303''/+e' 333'nc" N:Width,Long 126W 26015/ie" 217''/7 41" 55" 68n/it" 95';/x" 113"/ie" 125'!!x" 138%' 0:Side.Short 41" 55" 68'W O:Length,Side P:Radius.Center ToPiling 4T.4&' 623'<" 84" 1123/x" 1373!!4" 132 it 168 4C" P:Side, Long 6815%,x" 82" 120'/," 0:Spread,Piling To Piling 36" 48" 62" 86" 105" 117" 129" 0:Center S read 28" 28" 51" R:Diameter.Pili Max. 10" 10" 10" 10" 10'' 10" 10" 10" 10" 10" I1 '•l Y •' G s. " ` ' : t l J f; 'r,1, `, 1, Vir n Hi*11 Sty e 1.. 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