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HomeMy WebLinkAboutBLD-19-1574 F.) ^� g•Y I r-: ..t I F::x:$ i1 IAN t!hC C;(11 F T ::H-.li ;Office Use 7Only C../ f, O �L •- 1--..•••:,.:; AtUfrlif:fet , •Y ' : c'_ct 1Pe 6D —//o/iS 0� y "ilf.lt ti f i. )F. rc CT F{:•-s,1 ;iinr:i lvirf F Amount �J I E'' ,.ef i l.; l.:!,:1::3. A\^+•%`•`' !Permit expires ISO days from • :issue date • • EXPRESS SHED PERMIT APPLICATION E C E I V E D TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 St j 4�2018 South Yarmouth, MA 02664 BUILDING DEPAN 29 I'\ (508)- 398-2231 Ext. 1261 D 6y' . , CONSTRUCTION ADDRESS: 1.DI IVrv% S. '4AQA ouri4 U O� V� ASSESSOR'S INFORMATION: Map: Parcel: y OWNER: .6-1-1 -2Rlr 1).CA1-6aori • 5A nit. 1p8.3tot. (ot3O NAME^ PRESENT ADDRESS ?"EL, B t, CONTRACTOR: "r I T‘.7E 't,{••�f Pt Q130R_, NAME MAI LIND ADDRESS TEL.ft ❑Residential 0 Commercial(� Est.Cost of Constructiontil- PC /1 00 Rome Improvement Contractor tic.# 15x935 Construction Supervisor Lic.0C..,>i' 1'i -61 5PLo3 • Workman's Compensation Insurance: (check one) C I am the homeowner 0 I am the sole proprietors )(I have Worker's Compensation Insurance �1� n EA p / 14 Insurance Company Name:N.- Qf ptia Ec\5l.{u S Worker's Comp.Policy# cc G /kw Limo q 51 '2O ✓ �/ l� SHED INFORMATION / New X Size L I& x W I C)r x H lit l el Corner Lot: Yes No ✓ . 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. Replace existing* _ Size LQ x iv x (ll *The debris will be disposed ofatd5 1 Queen ?c\ckd• 44-0-wJ cc 1 t .. ` t C4 \..J000 45 Location of Facility F declare under penalties p ju that tl •statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answers) will be jut cause for di ini 1 j�t,/,'on f my license and for prosecution under M.G.L.Ch.263.Section 1. Q Applicant's Sign /�/{I atu •• ' Date: `I ca t („Q ) (c Owners Signature(or T* aa lir ,� i tl r Date: q/a. 42-0/63 Apprnvcd By: ,.." ..C.. Date: 9 'ILb"lg Building Official(or dent_ cc) EMAIL ADDRESS: Zoning District: ^—~�.~...._�•- ---._... ._ Historical District: 1 Yes fi No Flood Plain Zone: " Yes C1 No Water Resource Protection District: Within 100 ft.of Wetlands:*** U Yes C No Il Yes V No fridr• ***Note:Conservation review required if within 100 ft.of Wetlands 9/13 --' • •� runs HARBOR a0001/0001 I .......4 . J •• The Commonwealth of Massachusetts I.'- =. Department oflndusbial.leetdexa ` i, =r QQ'uxoflnvatigations __n_ 600 Washington Street Boston,MA 02111 • Workers' Compensation Insurance Affidavit: dere/Contractors/Electiriciana/Plnmbers Applicant Information Please Print I.em'bJy Name(B '^ Q /)�:MC &On %,j. e iti l�tdjl',o ttiol 5 ! Address: a tauten flint RQQd City/State/Zip: ��•�L Oa& I Phone#: $08.488-scgap An you an employer?Check the appropriate box: 1.0 I am a employer with 4. 0 I am a general contractor mid I Type of project(rMalred): employees Mall and/or part-lime), hived the 6. 0 New construction 2.0 1 am a sok proprietor or partnere listed on the attached sheet. 7. 0 Remodeling ship and have no employees 'These subcontractors have g• 0 Demolition working for me in any capacity. employees and have workers' [No works,'comp.insurance comp Insurance.: 9. 0 Building addition 3.0 required.] S. 0 We area corpvmtlon and its 10.0 Electrical repairs or addrions 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.[No worker•comp, right of exemption per MGL ❑ insurance required.]t 0.152,41(4),and we have no IZ. Roofrepairs employees.[No worker' 13.0 Other comp.insurance required.] : 'Any gTlicad the ire s box SI mot also fill ac the action below showing their workers'con on policy ISmmmiee. 'HomeowamwhoabedthisafihwkIndkattostheywedoingsolworkandthenhoeoohieconna=nestsubm/.newatrA k indicadrg rah tartnicters that check this ben mon attached an additiorad vheet diowing the mme ortho subcontractors ana no whet* cit have muployees. If the lave employed,they most provide their wake,'comp,policy number. I ant an employes the,is providing warken'coarpacwe,lon itusrmrce forurp employees delorr hese policy and fob Insurance Company Name: 1 �t •1,,tut 11r, I El 1I/„ I 1 o a • ult. /. Policy#or Self-ins.Lie.#:j(f- -klar ••ae184 Expiration Date: , : - I lob Site Address: City/State/Zip: Attach a copy of the workers'compensation polity declaration page(showbiz the polity number and expiration da,. Failure to scan coverage as required under Section 25A of MGL a 152 a en lead to the imposition of criminal penalties • a fine up to 51,500.00 and/or one yaw 6nprisonment,as well ea civil penalties in the than of a STOP WORK ORDER and a tine if up to 5250.00 a day mai . -. Be advised that a copy ofthis statement may be investigations of the D • insurance coy .e verification. Y forwarded to the Office of I do hereby eatify a.da the• T , r •y- a, a of per/ray thanks Afore:am provided above b sae end correct .."-: w Official use onot Do not write la Ms area,to becoaplaedby ay or town official Chy or Tows: Permit/[.kease# 'ssith•g Anthortty(crrele out): I.Board of Health 2.Building Department 3.Cltyrfowa Clerk 4.Electrical inspector 5,Plumbing Inspector 6.Other Contact Person: Phase#: • . /'n MCGRPOS411 ZHELLWIG A�oRo CERTIFICATE OF LIABILITY INSURANCE ordataiDA 8 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: If the certificate holder Is an ADDmONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the tenni 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 Neu of such �ryery}TnAAd�Corsement(s). WIZPRODUCERtray .RAME:. ._. .. ._ I3dRts trey Iguana Agency,Inc. PNDN[ -SAN 8162156.__ 4S3o�utthtsDennis,MA 02880 I MOD&PIPIIrgersgray.Iwm .IAw. F{� .._LuenEEI _A?A —1--.KW II -wane a:Trav&ers Indemnity Company of Amerka 25666 PeWm ,.81a0Pet0;TrayelerslndemnNyCOlnpany . . . 25858 McGrath Post&Beam Corp _wytree e:New Hampshire Employers Insurance Cxnpan ,13083 dba Peds Harbor Wood Products 269 Queen Anne Rd ;Ne0RBr 0: . . .. .. . . _......... . Harwich,MA 02845 ,Paint a: 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 WHCEI THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UMR_S_SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. eBB- LNTRR Den OF INSURANCE -IDE wVDD;POLICY I/MOM (ainADAW/ MN/D.. urns A X COMMERCIAL wan&Lwurr EACNOCCIIRRENCE ;i 1,000,000 n•P W•,Ana ' X OCCUR 1-660-07688188-TIM16 0113112018 01/312019 P?EEM D,v,n) ,4 100,000 IRE EXP(MYcos parson) ,s 5'no PERSONAL a ADV INJURY $ 1,Oob,000 _CEIM1AGGREGCATE LW APpLES PER: MINERAL AGGREGATE _.i 200000 X.- " 'aP 7 L Loc mown :s z 000 000 'OTHER: CCOoLLeeaa s B Auroroesauae I .VEINED SINGLE UST . .i 1,000,000 _ ANY AUTO ,r a�Ep�L� I ,BA.448TB688-18-SEL 01/312018 01212019 spots antr runnel,/ s •AUT eat X Aura ` 11005.1 INJURY(Per Acdlan0 s .X:gn sax .XIIS s ._- . s welauALw OCCUR I ,EACH OGC.URRENCE $ EXCESSL1Ae ' CW9• MMAD! I . I ,AOGRL:GATE_ .5 DED.; :RETBRICNS ' • $ CAND women EMPLOYER,rrePUA L ALT, I ' X Aum �.ER -.1_ AN,PRovRnTOR+� YIN•: ECC400400095T-2618A O7/0W2018 0T18201g'aEA�,� $ 100,000 QFnCERA1EMBER EXCLUDED? N NIAMIT i ,�A,yi.n,OEeNry In mU I i I .EI DISEASE.EA E1mLOYIK1 •OFECRIfi fOFOPERAT101e tatty I EL DISEASE-PCUCYLWR j 500,000 DESCRIPTION CF OPERATIONS I LOCATIONS,VEHICLES(ACORD In.A/ASRAN amide Smea4.sqt Mitts/sews spin Is awing CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF TIE ABOVE DESCRIBED POLICIES BE CAECELLED BETOPM Town otYarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE OLSJYBIED W Building Dept ACCORDANCE ERMINE POLICY PROVISIONS. 1146 Main St,Route 28 South Yarmouth,MA 02884 AUTHORIZED Re WITATNE ACORD 25(2018/03) 01988-2015 ACORD CORPORATION. All rights reserved. . The ACORD name and logo ars registered marks of/CORD • a Office of Consumer Affairs and usiness Regulation 'r;' 10 Park Plaia - Suite 5170 • =.��• Boston, Massace .setts 02116 d Home Improvement litsg tor Registration-. PO ii i`: 111.1.1 �. t' Corm�onweafh o Massachusetts McGRATH POST& BEAM CO. 4` V�r Division of Professional Licensure ' Board of Building Regulations and Standards JAMES McGRATH = , a ' Constructio�l„ga�ei4isbr,1 &2 Family 259 QUEEN ANNE RD. HARWICH, NIA 02645• , # �� CSFA-073885 FEPires 05.3/14/2021 \ t.- la\ `r `+a i Sc.' is ' +'`k " . 14 vim yew• JAMES R MCGRATH .r • ,�• '' 9r"i a s I 204CRANVIEWFtD 11« act. . .: wa...n.r. - BREWSTER Mk:62631 t` it f 147, .:{_t it (S1140.•40: t r: -. Commissioner az•• • • sore= `?x,'114.' Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Mahusetts 02116 Home Improvemgq ' tractor Registration 1T�aa— --- 177: Type: ion McGRATH POST& BEAM CO. ':, 4 "7----/—z..-i' piratiorr. ,14'3Oi 259 Queen Anne Rd. hri"r 4',•I E�tratiorr 1w3orzole Harwich, MA 02645 t � .J i �I' ;fie ...,. _.,..ate , sCA r o 2014-05111 " l:.• Update Address and return card. Mark reason to mange. 0 Address 0 Renewal 0 Employment 0 Lost Card — .,lam ri * �iammo.w�ev4Gf ofp iarac/•us.. ` Office of Consumer Wain a Business RegulatIo +, ,_ HOME IMPROVEMENT CONTRACTOR n Registration valid for individual use only dvS.': > Type: Common, ':ilg: i'Ii,491A trdka Off ceeof Consumer the Affairs date, If found return to 170 • ? :1 895 10/30/2018 10 P Plaza.Suite SRS and Business Regulation McGRAn•i poet..asoma. tet' .MA oz1,6 Q Products eHartw► ^ 400°P. e Yr James MCGRATMcGRATH �• "I 259 Queen Anne Rd: H:uvrictt MA 02s45 Undersecretary Not valid without signature • p4 -- TOWN OF YARMOUTH • ta-�� x 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 RECEIVED Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 SEP 1 1 2018 OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE YARMOUTH OLD KING'S HIGHWAY • APPLICATION FOR CERTIFICATE OF EXEMPTION Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs accompanying this application. Type or print legibly: ©© Q Address of proposed work: '/-_> LO KJ C' R pfi Map/Lot#- Owne s): €(4tQiz(kkT. Cs-woo Phone#: so8.3(az (0130 All applicati,ryp►1g,must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address:_r QQ 1O, 142 Year`built ZOO I Email: —505 ' 3(02' lc (30 Preferred notification method: >C, Phone Email�il4' Agent/Contractor. i Yoee& WAR e. ' 1 r�PPhhonne#615141,3L5 rt;)ta ) Mailing Address: �`1 1(-Axe n cnf Rd 'T'1 110l . \ \ \ rao4t Email�f �,H 2�Ytt Il , Can Preferred notification method: Phone OC Email Description of Proposed Work(Additional pages may be attached If necessary): l,iift(L loV-tZ Qoivat c- Al2.d RECEIVED SEP 14.2018 TOWN)CLERK MA ,, _,-, l SOUTHYARtM/OUTH Signed(Owner or agent): ///�� �CCPLAWN _ Date: Cl/740/e > Owner/contractor/agent is aware that a permit may be required from the Building Department.(Check other departments,also.) > This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. For Committee use only: / Date: 9-11-,S. Approved _Approved with changes _Denied Amount ao l C Reason for denial: rIPROVED Cas K#CPIS RRv SEP 1 � 2018 cvdby: YARMOUTH OLD KING S HIGHWAY ( / Date Signed: VI3/mos Signed: (0 - •� 7� - E U 9 9 APPLICATION#: V5 2017 r. . d • PLOT PLAN rEiveb7 _ . FOR LOT ((indicate location of 1 1 2018 garage or accessory building Additions with dashed linesSewerage disposal (cesspool) ED S HIGHWAY Well I . I if (lot ft. rear) I Abutbar's 0 I — — Name Abettor Lot I I .Name f this is a REAR YARD zrner lot, ft. SQG If this write in name corner a if street. I write i name of o a other v ,o street. 4 SIDE YARD SIDE YARD HOUSEI • AP PROVED • • • .E1S132018 • • SET BACK YARMOUTH OL II KI1' G'S HIGHWAY • 4 ft. I - 1 1 Td 13D (lot Et. frontage) RECEIVED // 2S � ST, SEP 1 c20R8 rl�- ' SO TOY R (NAMEMOVTH, OF STREET) UTH information Supplied by !ARK NORTH POINT O ' 18 - E0. 99; � �d � J . SEP 11� 2018 � { ARMOUTH NI OLS KdNG'SHIGHWAY /^//�^��\ j�d� (PINE I-IARBOR OFront Elevation ` / Left Elevation ' \ WOOD PRODUCTS\LLL... i (/�� �PNSNMIROR COM SCALE:I/4'=I'-0' SCALE:I/b'=I'-0' 'Oi/ �g� Ia0o-5aas11ED SEPSEP -�'® 59 Queen Anna Road N.rvicb.MA 02545 Y 6.1506)430.2400 1 E:1506100.1111 pY/1h,, 18 Mn.sepineh.r69r.mi 1 5 1 1 1 ; 10411' INffR'S STAMP Architectural$h2s11 11I11 - . 1 , 1FVC Tnm Board and Batten IWhlce cedar SI-�ines _ P- ROJECT::12' Quivett 7 I 1 12-0' I 1,---10.-0" � - I CLIENT: TL 'fL Sherrie Cahoon ADDRESS: 'A 28 Winter Street Yarmouthport.MA 02675 © Rear Elevation © Right Elevation soCe RJNA C�' PHONE: 508-362-6130 SCALE I/w=I'-0' SCALE I/L'= I'-O' Ty� - E-MAIL: 1 1 1 1 1 i 1 1 ' 1 ' j � ���� 1 rnbsandtabpcomcast net Il 1t I1111111111 Ti i C(‘ 4 1 1 Architectural Singles I_i Q `/p ADDRESS OF PROPOSED WORK: 11111 111 I 1 111 ' ( 1 �� 1 1 1 I 1 I 1 1 1 1 I I 1 r ( fe' 28 Winter Street E Yarmoumport.MA 02675 � i � . 1s 'L -Y REVISION DATE: Er✓ Beard and Batten I 9/7/18 OD DRAWN BY GB 1 Bxrd and Batten U rti _ Scale:I/d'=I'-0' ijilli O - Unless otherwise noted vo Page A.I