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HomeMy WebLinkAboutBLD-19-001936 o1P•vq TOWN OF YARMOUTH Building Department BUILDING 2 r . SO (508) 398-2231 ext.1261 O"-- ' y PERMIT NO BLD-19-001936 PERMIT se�;*;moils° 4. ISSUE DATE 10/2412018 JOB WEATHER CARD APPLICANT ;MICHAEL J BARNETT PERMIT TO : Alteration AT(LOCATION) 110 CYGNET RD.WEST YARMOUTH,MA 02673 I ZONING DISTRICT I I Bldg.Type: 'Residential I SUBDIVISION MAP BLOCK LOT 048.54.1 BUILDING IS TO BE: CONST TYPE V B USE GROUP R-3 REMARKS Alteration-per approved dated plans 780cmr MSBC TOY Bylaws porch& CONTRACTOR house siding, 16 replacement windows,construct front&rear landings LICENSE CS-080523 (857-222-3383)(engineered letter on deck) c. Construction Supervisor MICHAEL J BARNETT MICHAEL BARNETT AREA(SQ FT) -• 284,621,040. EST COST($) 21000.00 PERMIT FEE($) 750.00 Abington,MA 02351 OWNER MORIN ROBERT J BUILDING DEPT BY ADDRESS MORIN DOREEN M,58 DILLA ST ;MILFORD MA 01757 PHONE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE SEPARATE CONSTRUCTION WORK:1)FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL PERMITS ARE REQUIRED FOR FOOTINGS.2)PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE.WHERE ELECTRICAL PLUMBING/GAS MEMBERS(READY FOR LATH OR FINISH COVERING) A CERTIFICATE OF OCCUPANCY IS AND MECHANICAL 3)FINAL INSPECTION BEFORE OCCUPANCY 4) REQUIRED,SUCH BUILDING SHALL NOT BE INSTALLATIONS. REFER TO DETAILED INSPECTION SCHEDULE OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. , POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTIONS APPROVALS Frame Inspector Date WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INPSECTIONS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE APPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION ARC\/F r .aoz Mot, r 6,4 .0,.z Prs'a$ - 660 - I% !d. 7Pec t�sr� . .t-da .. _.. It7 LQi( tr -pt2 & cat\ c .v10 . I sto > FMT ✓ ' Swanson Structural, Inc. Paul W. Swanson, P.E. 92 Acre Hill Road ` p Barnstable, MA 02630 - "C 508-446-1042 /D , -yr-- / R October 19, 2018 Brad Inkley, Building Inspector Yarmouth Town Hall 1146 Route 28 Yarmouth, MA 02664 Subject: Front and Rear Deck Structural Inspection, 10 Cygnet Road, West Yarmouth, MA Dear Mr. Inkley, I was retained Bob Morin to provide perform a structural inspection of the new decks at the subject project. On Wednesday, October 17, 2018 I met with Mr. Morin on site. He had opened up a hole with a post hole digger so I could verify that the new sona tubes were 48"deep. The decks are small,4' x 5' for the front and 8' square for the rear. They are neatly framed with PT 2x8's spaced 16" on center. In addition to the sona tubes,the front deck bears on an older concrete block front step. The rear deck joists run parallel to the rear wall of the house. The joist adjacent to the house is fastened to the house with modern high strength lags. The 4x4 newell posts were notched at the deck level for a flush installation of the rim joists. Due to the redundancy of the railings attached to the nailed 2x2 balusters, the newell posts are not acting alone and the notches are acceptable. I have attached an as-built sketch of the decks. It is my professional opinion that the decks were built neatly and that they can resist the structural loads as required by the Massachusetts state building code, 9th edition. If you have any questions,please feel free to contact me. gyps +n , Sincerely,�,{J ty:tok OF Mgrs . --I oo PAULO �C • SSS'ANSON v'% STRUCTURAL a Paul W. Swanson, P.E. q 9No.35334o Swanson Structural, Inc. \ c%s?E - tt �p/t 9�Z p t g Ref. 5957 "S�,SSioNALEN id- . • N..1 41 To Pi teil f, I I tT I t 1 coz, 'tea • _., ;4 c'd 14•1 -7. •-`i t ; •. a ..c. .1 4. v.. ,.. _... == ,?, ‘4; 2 I caj,k11 .._'11C •k t 14 .....t4 A z teiltt..„ .... 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This Section For Official Use Only Building PermitNumber:WO—/9 OOgt :: Date Applied: 0 . Z r IS . uilding Official(Print N e) - - iga: e / t�(` SECTION 1:SITE INFORMATION R V E 1.1 Pro erty Addre �I 1.2 Assessors Map&Parcel Numbers to el�tratik- 41 hi VAX/tta i-a' OCT 2 2018 1.1a Is this an accepted street?yes 1( no Map Number Parcel Number I ui�yiNt,.TDE � 3 oni I ormation: 1.4 Pro er Dimensions: a�r; _��ri ENT k5�c�sa �a` S"kas�a�� G�tkAf� E s�s�� �o• `1`!' _ Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided it if- 2.0 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flo2 Zone Information: 1.8 Sewage Disposal System: Public Private ElZone: t Outside Flood Zone? Municipal Cl On site disposal system g Check if yeskir 2„1SECTION 2: PROPERTY OWNERSHIP'OWNERSHIP' ' kiti� AddOwner'of e40)-(e.J Moi-13 /11:14.4iMMA 01 q-- Name(Print) City,State,ZII? 56 swirs4-. 98-sto - 1gI1 Q,ie443QJtx;2 t & No.and Street Telephone Email Address SECTION 3:.DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building( Owner-Occupied'it Repairs(s)S Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units I Other ID Specify: Brief Descriptio of ProposedWork2: 'tR ( r1-51::44C-6--J; `a. p peat/dab && ' Ib gt tvplite.t. 404' IPM'ie, LAct ryr5 rr'ik14' btA1t5 • fit-A111 1-v- SECTION 4i ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: • Official Use Only (Labor and Materials) 1.Building $ t 6 Sib,it, 1 Building Permit Fee:$Indicate how fee is determined: t ❑Standard City/Ibwn Application Fee 2.Electrical $ OQ)• GD It ❑Total Project Costa 6)'x multiplier x 3.Plumbing $ 3OQr 0� 2. Other.Fees: $ — 4.Mechanical (HVAC) $ -.--' List: 5.Mechanical (Fire Suppression) $ `� TotalAll Pies.$ CheckN6. • Check Amount: Cash Amount • ' 6.Total Project Cost $ ilia, •op ❑Paid inFull 1:3Outstanding Balance Due: I. • J SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 08O j 23 l't^Icl.1RtL _1 , AR&rrr License Number Expiration ate Name of CSL Holder V 1 17 Noark A u E . List CSL Type(see below) No.ffd Street Type . .• Description W 6/NGTan/ /eh/ U Unrestricted(Buildings up to 35,000 cu.R) City/Town,State,ZIP R Restricted I&2 Family Dwelling NI Masonry Oz 3S) . RC Roofing Covering WS Window and Siding /S7/Cifelea 4j4RA1E7'r SF Solid FuelBumingAppliances 8-6-7. . 2LZ 33.573 226 eyA/tcc_Coin I Insulation Telephone Email address D Demolition ' 5.2 Registered Home Improvement Contr ,or“I I / IMtckr4EL erlitivcrr D6A /4Rs r'o �6 lu a/ ora nDate Mtge HIC Registration Number Expiration Date HICII'7 Weide ' Jgistran tmVE 2 ,,//`r' 6LlIGl1i9�L�f1R��7Y" 2 Z6. %NGTod/ /r ^ 0 �7^Z22^383Email address . City/Town,State,ZIP p � 23 '/ Telephone Yp4049 ^ Can, SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes k No...........❑ • SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT .. I,as Owner of the subject property,hereby authorize -to act on my behalf,in a`lllers relative to work authorized by this building permit application. j5CaJL Ilty Pner' (Electronic Signature) Date • • 'SECTION 7b:OWNER'.OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in is true and accurate to the best of my knowledge and understanding. '/ Print Owner's or Authorized Agent's Name(Electronic Signature) to • NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.Rov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.R.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms • Number of bathrooms • Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts • Frio / Department oflndustrialAccidents a __EIIII= 1 Congress Street,Suite 100 II=if Boston, MA 02114-2017 .�,. • www.mass.gov/dia 'Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information .1 Please Print Legibly Name(Business/Organization/Individual): T3/M A/e rr C o NSTR tic ric nJ C Address: 1 1 7 AloRr tc 4 ve- i' L City/State/Zip:A/km/472 / i rf. 02 347 Phone#: $67— Z Z Z "33 3 • Are you an employer?Check the appropriate box: Type of project(required): 1.91 am ployer with © employees(full and/or pan-time).• 7. ❑New construction 2 am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8. Remodeling 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on m property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.9 Plumbing repairs or additions 5.91 am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance.; 13.0 Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑OtheI 152,§1(4),and we have no employees. [No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: f94 2_ 4 ZDir Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# • Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Y, 44°F'"-rts TOWN OF YARMOUTH 3 vg e BUILDING DEPARTMENT • • °. •—t 1146 Route 28,South Yarmouth,MA 02664 �,A--.. st.V 508-398-2231 ext. 1261 Fax 508-398-0836 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L Chapter 40,Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at ID (?9 &4c4- 44i/ t,5}-' �//,�tlatv4- Work Address Is to be disposed of at the following location: Altai Bed L ) 411- Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Si�re� l d9, zS , i b gn of Application Date Permit No. Information and Instructions • • Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the • dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial • Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. . Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. • The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia r • ACC:MOW CERTIFICATE OF LIABILITY INSURANCE • ATEV WDDIT 'r" 04/10/2018 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: N the certificate holder is an ADDITIONAL INSURED,the poilcy(ies)must have ADDITIONAL INSURED provisions or be endorsed. IfSUBROGATION IS WANED,subject to the terms 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 lieu of such endorsement(s). PRODUCER Darlene Vaughn Vaughn Insurance Group PuHOc,NN.Eaak (617)322-1455 I FAX Nn). (617)224-9055 424 Adams Street Ass: Suite#102 - - NSDRERIS)AFFORDING COVERAGE NAICI Milton MA 02186• 'Hamm Green Mountain Insurance Company 20680 INSURED • INSURERS: Mirdaei Barnet INSURER C: 117 North Ave s2 NSURERD: INSURER E: • Abinngton MA 02351-1713 y,SppEp W: COVERAGES CERTIFICATE NUMBER: 011841002270 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 DOCUMENTVNTH RESPECT TO WHICH MIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. • LEP LIR TYPE OF INSURANCE 50 VMS POLICY NOMMER isvoor PUUCY YY Pt1UCY YD w.AIOVYYT'() w.lJrmm LIMITS X COMMERCIAL GENERAL LU1BLPY EACH OCCURRENCE S 1.000.000 DDAMN.*IURani to CLAIMS-MADE x OCCUR PREMISES(Ea occurrence) S �•0� MED EXP(Any one person) S 5.000 A _ 20017511 • 0212212018 0222/2019 psnsaPolLS Any$$$$$y $ INCLUDED CENIAGGREGATE UNIT APPLIES PER GENERAL AGGREGATE S 2.000.000 IPOLICY El % [J LOC- PRODUCTS-COMP2P AGG S 2.000.000 OTHER: $ AUTOMOBILE UABS)TY91NED10SINGLE UNIT $ (Ea accide ANY AUTO BODILY INJURY(Par person) S — AUTOS ONLY BODILY INJURY('er accident) $ HIRED NON-0VR€O PROPERTY DAMAGE AUTOS ONLY — AUTOS ONLY • (Perms) f UMBRELLA ISIS OCCUR EACH OCCURRENCE _ $ EXCESS UAB CLNIA9.11af>F AGGREGATE _ S DED I RETENTION t t WORNERS CON'ENSATNN I PERTUTE I I ERTM AND EMPLOYERS'LIABILITY YIN ANY PROPRIETO RPMTNER,DZCUTNE EL EACH ' OFFICER/MEMBER EXCLUDED? NIA ACCIDEOFFICER/MEMBERS In ) EL DISEASE-EA EMPLOYEE S N describeYes,dese under • DESCRIPTION CF OPERATIONS bdow EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 101,AddYi.W Mamas Sdade*may be MWdad S mon SWIM M,spud) for the property located at 8 CYGNET ROAD,WEST YARMOUTH,MA a CERTIFICATE HOLDER ' CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE •- THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BOB MORIN ACCORDANCE WITH THE POLICY PROVISIONS. 58 DILLA STREET AUTHORED REPRESENTATIVE MILFORD MA 01757 •' ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo am registered marks of ACORD • • • {` Comnariwealth of Massachusetts F . � r Division of Professional Licensure• -a Board of Building Regulations and Standards Construct t n Su;rervisor CS-080523 ' E;Pires: 10/28/2019 .- MICHAEL J BARNETT •, • - t 'j 117 NORTH AVENUE �r1h' APT 2 % _ ;.• .. .a,-b ABINGTON MA 02351 Commissioner L/" ' ( Z,1fT A/NO/Iumry/N of i^%l.Rtwdtv.'r/R Office of Consumer Affairs&Business Regulation i - - HOME IMPROVEMENT CONTRACTOR { • - TYPE:Individual Registration £xoiratloq - 165489 01/04/2020 MICHAEL BARNETT _ •s ` D/B/A BARNETT CONSTRUCTION • MICHAEL BARNET'r �— 117 NORTH AVE.*2 C —`- • ABINGTON,MA 02351 . UnderSecreti y • • • • • 1.Y44 TOWN OF YARMOUTH • rg WATER DEPARTMENT • 99 Buck Island Road • • %Nest Yarmouth, MA 02673 Telephone: (508) 771.7921 • Fax: (508) 771-7998 • • BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET • Bldg. Site Location ID el cmcuf Kt - > esw 'f-___ Proposed Improvement: 1�¢� //}Id Rog- �a�S W•}t� • Applicant: c•cqr (;�CthJ AddresstdrJD_ _t, 64i Tel. #: 50u'660Rl -Date Filed: Dela , S di e'Ve4-MI RESIDENTIAL AND / OR COMMERCIAL BUILDING Water Department: Determines Compliance of Water Availability and or Existing Location Engineering Department: Determines Compliance for Parking and Drainage Conservation Commissior: Determ,nes Compliance to Wetlands Acts: i.e. If Lot(s)Boder any Type or Wetlands, Streams, Ponds, Rivers,Ocean, Bogs, Bays, Marshland, Etc... • Health Department: Determines Compliance to State and Town Regulations,i.e., Requirements 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. n. Signature of applicant Date PLEASE NOTE: ' COMMENTS: • 404 y: �� � RevieWan DSte * • ,otgk,� TOWN OF YARMOUTH ° HEALTH DEPARTMENT 2. ��'' %� PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: (6 a(aka) ec44/ I�Z s4— IA L4lcu.i"k ,+i b 4 }'[J, Proposed Improvem nt: ' 4011t}42&) WCcc! 5d;mo 144 Loch 'cnc! 'LI 161 r rAII IL, 0 A02 A ' WS. IS 'vim e.� ESA— ��-1 ink, 1 . l s � — -A�5 • -011 sib�o . ' 6 p Applicant: ISoW IUCI . Tel.No.: Secy OGr 191 1— Address: SE b;ILF ST- bill• 1 (iCt Date Filed: oT.Zl t /S **Ifyou would like e-mail notification of sign off please provide e-mail address: e Owner Name: l Abel'1' frd &Lkk44 (if to r.. Owner Address: Sz-- rM A Owner Tel.No.: RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: (1.) 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Jr ■ 5■■ , „ ■ • I .1„,.2. , 4 • c. ti ,, "ALti 04 194)1 7 10' 1 L'< 1✓ f I '+ -A is �� a 4 �/f. 4�-t ZSR rt el' +I it ii Qv 1 rIN- v • CI olr' tri b's c"0-( � cr' 1 -idol �l C---, 9�c,h —4' , • SS 1/4 ON / 6 ‘ 7R 0 C X00 6��0' ' V It ryel- If • 56 LAbcC' S- rye Off. ..,A\ 2iN 6�9 J tiry 16h /brithSS•S 37 411 A0, /lnF C.G' �� ,✓�,�H OF 14-ss , J KO' t,SN Of MASS o� • � :OBIN cycN` 79 ci ,�a ROBIN 'St.,' , ,( i ^ 5S 0 �O f WILLIAM I" lS WILC�M mfD T� 4� • 0, "6 WILCOX m ,. 01 No. 3134 /Ji� S., No. 31341 01 \\"Fila/stE.9.J�„. �'9y .%e/G�sTc-3,�`�', NtivAL LAN�� 0(/J. •�GaALLAN„S t TO THE BEST OF MY INFORMATION, "AS-BUILT” PLOT PLAN KNOWLEDGE, AND BELIEF THE WEST YARMOUTH, MASS. FOUNDATION SHOWN ON THIS PLAN PL."BK. 556 PG. 42 HAS BEEN LOCATED ON THE GROUND DATE OCT. 3, 2018 SCALE 1" = 20' AS INDICATED. .ti: 4587-00 CLIENT MORIN 10/3/2018 �+! , - SWEETSER ENGINEERING 235 GREAT WESTERN ROAD DATE ROFESSIONAL LAND SURVEYORPO BOX 713 SOUTH DENNIS. MA 00 off. 508-398-3922 fax. 508-266398-3063 C:\S8‘PRO✓ 4587-OO\dwg\4587-CPP.DWG 0 2018 SWEETSER ENGINEERING