HomeMy WebLinkAboutBLD-93-801- , " '` O'r TOWN OF YARMOUTH BKF-ew /1R/93
p�-MATTACHEES • • • ,r r
•.Vott'••.w•m" Application for.a Permit to Build No. 8V
UPON FINAL APPROVAL 0; /D"ai4 MAP 1O4 -Egli LOT eq$
FEE MUST ACCOMPANY THIS APPLICATION. DATE !a//Z 19 9l
The undersigned hereby applies for a permit to build /61/4//!
according to the following specifications /0//93
1. Name of property owner Rt.(A c.1mnnac Tel(518)3 b8�/.
Address 3I Oces-Iweett Pv �?nehecf,44y 1.1 7' 1.2 3o4
2.Name of Architect(if any) Tel.
3. Name of builder 1aild P( Address
4. License No. ' Tel.
5. Name of Mason Address k
6. License No. . Tel.
7. Construction address (02 Wttrd Lc *cvicvt povl MA 0267
Flood District )p ,/a
8. Date of subdivision Approval plain zone Zone
9. Private dwelling 0 Estimated Cost ' (be: DO NOT WRITE IN THIS SPACE
jIC/�Q cd Jo'o e Type of room No.
10. Multi family 0 10 G � o � i%'/9� dE�11. Commercial ❑ f ' " �, F6K U� / gfi Kitchen
12. Other ❑ � 2-- Dining Rm.
8f---•--7 Living Rm.
13. No. of stories //o ,9i
14. Foundation — Full 0 Half 0 Crawl 0 Slab 0 fo.aopcP Bed Rm. a.
1/ O0A _ Bath /
15. Materials — Wood 0 Cement 0 Other 0 Deck
16. Type of heat — Oil 0 Gas 0 Electric 0 Other ❑ Closed porch
17. Garage — 1 ❑ 2 ❑ Family Rm.
Sun room
la Swimming pool - Size Garage
19. Storage shed — Size Shed
20. Stove — Wood 0 Coal 0 V. 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
2a 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.
adAA_ICLOT RELEASED BY Signatu /A«.
PLANNING BOARD 1136\44 Address Ion. iie • board l--ck
Date >6Cv mei/kJ-hp/1Mir 0.2,6'75..
Prmit Aldose 31 cves lneNec N5,,i,-
12''660 tynAg O
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: NiG{np(yIA , ll.AoMg4• BUILDING PERMIT If:
•
ADDRESS: 3IOtc i1r,Dd-hYIAte� / yli5OGTEL/E. NO. :(51i)"3.54-03(4, DATE FILED::
BLDG. SITE LOCATION:Infft2, ut1l4yetytt16Mf,�'RS4MA• MAP #: Oil -Pig LOT/f: p
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. TITE.BUII.DING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH
THE FOLLOWING DEPARTMENTS: .
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT: r- •, -• DETERMINES COMPLIANCE OF WATER AVAILABILITY.
ENGINEERING DEPARTMENT: DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE.
CONSERVATION COMMISSION: DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E.: IF LOT(S) BORDER ANY
TYPE OP WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH
LAND; ETC.
HEALTH DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E. : REQUIRE-
• A, _ .': 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:
1. WATER DEPARTMENT ," DATE: N/A:
2. ENGINEERING DEPARTMENT: , • DATE: N/A:
3. CONSERVATION: • ' . ' .• DATE: N/A:
4. HEALTH DEPARTMENT i ,e jrFophe . GCPo DATE: 49-4r111? N/A:
, INDUSTRIAL AND/OR COMMERCIAL PERMITS
5. WIRING,INSPECTOR:I ,' . DATE: N/A:
6. PLUMBING :INSPECTOR: DATE: N/A:
7. FIRE, DEPARTMENTI DATE: N/A:
, .
PLEASE NOTE
A
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: ,tI i' ....1.-A, P,, di -twee, 4- , . - ' Aar 4t i d,
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. 3 = COMMONWEALTH OF MASSACHUSETTS
E •
—_ ;!' ---• -1.DEPARTMENT OF LNDUSTRIAL ACCIDENTS . . ,
,.: 600 WASHINGTON STREET
James Campoei, BOSTON, MASSACHUSETTS 02111
Cpmmrsstoner • WORKERS! COMPENSATION INSURANCE AFFIDAVIT •
1, c�lAir�( "thaws
(hca principal place
. ( Cres& (r(J6'
• with a principal place of business/residence at: a�
SdAetitCfadi 1 MIJw %tfrk 1236,4
(City/Bute/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.
[/1 am a sole proprietor,general contractor o omeovener ( rde one) and have hired the contractors listed below
who have the following workers' compensatin ins: .. - .. :cies: - •• • - •-i-- . ••
eoL t ii.„..„ 0),,,, b," )
Name of Contractor • . Insurance Company/Policy Number.. .
Ootn 1i Po Z2 elf I . ��I cetr; C,sdl
Name of Contractor Insurance Company/Policy Number - . • -•
Name of Contractor Insurance Company/Policy Number -
yi I am a homeowner performing all the work myself. p k C c pfi- C I-c cfr, cal 4J P)uns'6 rn^e.
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 sums 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 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
fineiof 5100.00 a day against me. / 15a-- .a.
d this G day of , 19 -/
3
Irk'y�y •
. , •I asarta
icersee.'Permirr c LicensoriPermittor
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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
e I.•
MGL142A requirethat the"reconstruction.alter
c. sation,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 building"be done by registered contractors,with certain exceptions,along with other
requirements. ,fir' -• / - '
Type of Work: t itietth{m IMrpanlMA �b tile 6 h,�) Est. Cosi-44006 t
Address of Work IA 2'• 1 YP�t�64 VC( / ,/i{,l/Wli re 11- MA o2 C7
•
Owner Name: RI/,We( �. ethiniv1,7 �, T.ov tse
Date of Permit Application: /j
I hereby certify that:
Registration is not required for the following reason(s): •
_Work excluded by law
Job under 51,000
OBilding not owner-occupied
wner 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 notice, I hereby apply fr .a permit as the owner of the above property:
AilirAr41:41411/ 'SW
Date Owner 'duce_
facet2vo( " (40
!
. 1 •1 r. a " •t . . . ..,
•1 •
•
• TOWN OF YARMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE 1013/ 9J
y�
JOB LOCATION k n '.. eeII trevV4 (a , YG(VWI oU"I d rt"
NUMBER TREET ADDRESS SECTION OF TOWN
"HOMEOWNER" i4al-d ThenVtaY (CIS)3Sz.-o'4lo (Sig) 4-7 —6
NAME / � H'HOME PHONE W RK PHb NE
PRESENT MAILING ADDRESS 3 a
( psiulaoci Dv
{A-cv,eciAd la ecu Zosr (236 ,
CITY OR T,WN ST TE ZIP CODE
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER-
OCCUPIED DWELLINGS OF ONE OR TWO UNITS AND TO ALLOW SUCH HOMEOWNERS TO
ENGAGE AN INDIVIDUAL FOR HIRE WHO DOES NOT POSSESS A LICENSE, PROVIDED
THAT SUCH HOMEOWNER SHALL ACT AS SUPERVISOR. (STATE BUILDING CODE SEC-
109.1.1)
DEFINITION OF HOMEOWNER:
PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICH HE/SHE RESIDES OR INTENDS TO
RESIDE, ON WHICH THERE IS, OR IS INTENDED TO BE, A ONE OR TWO FAMILY
ATTACHED OR DETACHED STRUCTURES ASSESSORY 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 THE BUILDING OFFICIAL, ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL,
THAT HE/SHE 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 REGU-
LATIONS.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF
YARMOUTH BUILDING DEPARw MINIMUM INSPECTION PROCEDURES AND REQUIRE-
MENTS AND THAT HE/SHE C•y•LY WIT DCEDURES AND REQUIREMENTS.
HOMEOWNER'S SIGNATURE Ao," ' k��CC/
APPROVAL OF BUILDING 0 FICIAL
INSURANCE COVERAGE: •
I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes ❑ No ❑
If you have checked ys, please Indicate the type coverage by checking the appropriate box.
A liability Insurance policy 0 ' Other type of Indemnity 0 Bond 0
O h UM.INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by
•pt 14 of the Mass. ne Laws, and that my signature on this permit application waives this requirement.
000; Ch one:
Owner Agent❑
Signature of • er or • er s Agent
C1:ij.i:;(: AS;10CIS . _1_, r ,' 6Am.—p `of L: /i
N71E: Slcpil ceiling re:p ns TCIU'L TOTAL) lt= 30 94..
•' e3'c ad ridge Cr ale/ TOP SURFACE - U= 4./ WINDOWS: ,V ^-C.
• � � R=O.61 RH3JLRIDIOTAL R 30.0
9" FIBERGLASS 1 0.033
S i.c/t,A t-n 6e / INSULATION
/tedg-t/� R=30
t
v1111 liAlt LTulI nAn n n n!
t \=SHEETROCK DOORS : i En*west
C
R= 0.45 '? • Eve srr/+�J lI4,-
• r _7 \_BOflOM SURFACE r, Case
/ ,.t ` R= 0.61
1/2".PLYWOOD_ .17 INSIDE SURFACE ° WALL ASSEMBLY " • REAR ELEVATION
R=•0.62 1 R= 0.68 TOTAL R= G.W.A. /Sy v C
WOOD I" SHEETROCK II= /,5--
SHINGLES -. , I —R 0.4511:LIERED Tom' lb 12'5
R= 0.87 �jU= 0,08 WINDOWS: /
OUTSIDE pH/-3}" FIBERGLASS RECUIFED ugh, lb 20.0
INSULATION 2.1%3
SURFACE ELESHC I-MT U= 0.05
R= 0.17 / R=11
l
\NISR
RFACE RESISTANCE
11
/f C J FLOOR ASSEMBLY DOORS: nrstC
J I • FLOOR /CRAS TOTAL R=
0.91TWO BEADS FECUIEFDTOM R= 20.0
CAULKING " PLYWOOD C1= 0.05i� RIGHT SIDE ELEVAT
UNDER PLATE lSUI LOOR /
R •
'/ L 0.62 G.W.A. 5t, E.
SURFACE ✓ U U �/7
1� � 1_,
V� v iJUL�iJG�G�(l��
. R= 0.17 ,— WINDOWS: 22.fSSfr
.. •
—6I" FIBERGLASS 1
(. . INSULATION FOUNDATION
CONCRETE • ° ( 19 WALL ASSEMBLY DOORS: JG�,.
FOUNDATION I I SURFACE • SISTANCE (may be used instead /
WALL I ! of floor insulation)
R= 1.32 = 8" . I R= 01.61
1.48 = 10" r ( ! TOTAL R=
U= • LEFT SIDE ELEVATI
/
r, + r;- J RHiIIIFdD TQTAI R 12.5 G.W.A. // 4 Sy .f
INSIDE SURFACE rfit 11= 0.08 '
—R= 0.68 I _ �� rr �
` '1/8"'SHEETROCK f �u/S i WINDOWS:• SGTrx
1' • R= 0.32 ,
• ,,...--1." STYROFOAM
' lb 7.1 % DOORS: N ort.
. $ . . ••.. t / . • / 1 : I .. /. , . .'
NOTES:
PERNANENTT.Y INSTALLED STORM:// c, • G Gi lr� )
WINDOWS TO BE USED Eyck?// J 1
GROSS WALL AREA= 5 7 3 `/ 6 -' ,y
WINDCW AREA= S 3,7 .S ff %��d`1os 4--,
DCCR AREA= /y c7 [4./7 I `
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SsoN/N oN T/•I's PL qN IS 40C#97-4•0 ON THE 6 EVERF.Jl N 4-, ,
0eot✓Na ns a'.o ev...,/ NECCGt/..'nNa THfnr iT HINCIct i,
400 elS CONFO GM To reap. Zos/ c,C "t No. l7 7 %
ar L.q/vs oa THE 70N'A/ Or V,gQMA ,ta 1 : c ��.,
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LOW E IA/al LG, aa /A/C.. ;
YA.eMOUT-1 MASS. 7/ /_? .._
; - 0-7i -
. Application to
i
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y0 SAN NAPS GP .. .
0 OS C`SN�P tNN ..
,N °•frs � Old Kings Highway Regional Historic District Committee
1
clew-
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in the Town of Yarmouth for a •
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,
''Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo-
graphs accompanying this application.
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TYPE OR PRINT LEGIBLY r I ,�/ DATE 'L A
ADDRESS OF PROPOSED WORK (02 —yl2.t v-ita •
� y4VIMUt.46art ASSESSORS MAP NO. 104 -•mfg
OWNER { �l(iC1'lr4 � 4 5l ley e 1 r �• _ eq
/� ��....(( 11 /ll V / ^ J1 1�f1V1n'1G(���jjjS ASSESSORS LOT NO. /
HOME ADDRESS. 1c-keSiwddCy b ., ifieNPcttzeOi N/" I�o6 TEL. NO.(9&) 3�d b
AGENT OR CONTRACTOR 69e'f/ /
ADDRESS TEL. NO.
I
CCCT---��his application is for exemption of proposed exterior construction on the ground that: ,'
(1) It will not be visible from any way or public place. • ,•,r
(2) It is within a category declared entitled to exemption by Old King's Highway Regional HistorDistrict Commission.'•
(Check applicable box) xo W i
e-s fXIPROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot, and, if an pdrtion ibnvolvrn show-
ing location of existing building. (ft -f II SKI ti kh IN F•oerf — I/'ect•c 2 I c Va776y1 413 C)
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•wner-Contractor-Acent
Space below lire for Committee use. ., . -I A
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Received by H.D.C. The Certificate is herby• " /• `" ""
/� �� r rr1
Date / D/ !� r/�+ c� (� ��'l
Time 4 G1`'i /1
By (P Date / (-7/ /�
Approved 1tg The categories of work entitled to exemption are listen on
Disapproved 0 the back of this form.
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.:,.EXTERIOR ARCHITECTURAL FEATURES •
SUITABLE FOR CERTIFICATES OF EXEMPTION •
FOR RESIDENTIAL USE ONLY • • -
FENCES: 1. Post and rail, split, half round or round; natural finish
_ 2. Square rail;white or natural finish
Y ,
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, bilk afte.1900;at first floor,level, at the rear only,
railings not to exceed 36 inches in height, not over(50% to be visible from a way; natural finish or color,
• compatible with building involved s'
,
BREEZEWAYS: enclosure of existing breezeways, consistent wi h'siyle,material and color•of house, excluding sliding
glass doors facing street,way or public place •\
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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;no: over five incnes exposure
to weather ! !Ii fir'
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
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STONE WALLS: construction of field or split stone, not exceeding 30 inchesin height
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NOTE
.4-1
b. 1. All prior bulletins hereby superseded.
2. Conditions contained in certificates of appropriateness shall be binding regardless of any exemp::ons contaLnen herein.
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