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HomeMy WebLinkAboutBLD-19-2412 t -•"ti., ' : 1 F:7,:-.3 11 IANSc' f I i?,-.u. '.Office Use Only t. .OT�YgR t t4a:rtlit .3..4 , 'r ',:.:E 1. y'�i` �C rir ' N i LC:r UNE P 01 Lic:iti. Pennit;l J• � ilP l'': ' I,r l c f T � 1 C?�' 81'1F" AND iAmotmt "ww""i.� ;Pennit expires ISO days from t" !issue date 13W—IG -DO Zq I Z EXPRESS SHED PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 �//� CONSTRUCTION ADDRESS: 7 dies fit C .Na- y ASSESSOR'S INFORMATION: / Map: //5 (J /'•eParcel: OWNER: ter -I•T 174pSSG I� if sy/A LIj isntIC - 5-019,3k oL/'1S NAME _/ PRESENT AD SS TEL. # CONTRACTOR: rt NL `1/404or. ;cp &oe dt sin tel 4L% Szr430 net NAME MAILING ADDRESS TEL.# le esidential 0 Commercialer2 Est Cost of Construction S u Kn n -1 ,Q I Rome Improvement Contractor Lie.# I 50135 Construction Supervisor Lie.#e-3c'if -61 sS(. j Workman's Compensation Insurance: (check one) 0 I am the homeowner// 0 I aam�the—sole proprietor l5_1 have Worker's Compensation insurance -�T ,Q Insurance Company Name: U(,uu kY.& �1bt.te(SWorker's Comp.Policy#P.C,C-(06D • q 4`31 -aolsA J SITEDINFORMATION r M New ✓ Size L /c/ x W /O x H // / Corner Lot: Yes `" No . Per Town of Yarmouth Zoning By-Law Sec 203.5 E: Side and rear setbacks far accessory buildings less than 150 square feet and single story, shall he 6 feet in all districts, but in no case built closer than 12 feet to any other building. Replace existing* _ Size LC�� no PE x H ,��p *The debris will be disposed of at DM no ccn A� 4 Q"0�I 6 KIN ' Location of Facility I declare under penalties of perjury/a he staler Date:ills herein contained are true and correct to the best of my knowledge and belief. I understandQthat any false a swets) will be just cause for denial or rev. 'I, • y hcase and for prosecution under M.O.L.Ch.263.Section I. q ( t Z I v iir Applicant's Signature:a Oak ...41111 - Owners Signa CIF attaclfirIF��''e Date: +� Approved Br fi. /f�//i. Date: __OZ•ft- Buil Duil ing Offi iale.7 - - r. EMAIL ADDRESS: •`-`.u,T Zoning District: Historical District: `1 Yes fI No Flood Plain Zone: r1 Yes G No Water Resource Protection District: • Within 100 ft.of Wetlands:•" U Yes C No ❑ Yes U No • ***Note:Conservation review required if within 100 ft.of Wetlands 9/13 07/13/2018 11:01AM FAX 13084301115+ PINE HARBOR 20001/0001 . ✓ , • The Commonwealth of Massachusetts I. _, Department of Industrial Accidents • c • =•" '==r Officeof Investigations —�4t ' 00 Washington Street 1:i- Boston,MA 02111 www,massgov/dia Workers' Compensation Insurane Affidavit Builders/Contractors/Electricians/Plumbers ppallclhnt Information l ^Meeasse print Letn'blr Name(BusinesR o.th ad[ndlvidu 4j ,i,f/�'m tact • in �.i1,p/(f 1C Address: a"! Queen hint tread q !�dinn City/State/Zip:Th�jeJ DIM, Phone#: 5O�3'� 0..aJQO Are you an employer?Check the appropriate bole LEI I an a employer with 4. 0 I am a general contractor and I Type of prof (required): employees MI at parttime).• have hired the Cti 0 New cotsetttction 2.0 I am a sole proprietor or partner- listed on the attached sheet 7. (]Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' [No workers'camp.insurance comp.Insurance.: 9. Building addition required.] S. 0 We are a corporation and its l0. Electrical repairs or additions 3.0 1 am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself.[No worker'comp. right of exemption pa MIL 12. Rork—pairs • insurance required.]t e.152,§1(4).and we have no employees.[No workers' 13. Other cam&insurance required.] !Any implicate Met daisbaaItmod also fill out the sectionhelms aborrbtgtheirwaken .. ttampownera who summa this affidavit bdesksthey ere doing all work and them biro outside convectors policyea • a mw dndavt indicating such. tome ersthatcheckthisboxmootattachedmadditionalahoctshowingthetomeorthe mid atm bethnc*Viocc entitles have mtployea. If the w,6cmmaotom have employees,they mot provide their waken'amp,pokey smmbat f ata en employer that bprovld rg women'conrpitcrallon lasatmret fornvp employees is dee policy aad jobsite >yor eelon. Insurance Company Name: 11 f(e gn tlkqerc (mare CF •` Policy II or Self-ins.Lie.#: Ell -jm-ki • '2OIRA Expiration lob Site Address: I City/State/Zip Attach a copy of the workers'compensation poky declaration page(showing the polity number and expiration date). Failure to secure coverage as required undo Secti 23A of MGL a. 152 can lead to the imposition of criminal penalties of a fine up to 51,300.00 and/or one-year imprisonment, well as civil penalties in the form of a STOP WORK ORDER and a tine 'flip to 5250.00 a day*gal - Be advi that a copy of this statement may be(awarded to the Office of Investigations of the D .. 'fication. I da hereby erre ft . . . _ T - • t.. , a of per/my that Me locomotion provided above Is;nne end correct %mat1e: Date• none#: SO• -11‘,5 . a _ Oficial use once Do not write he IkE,area,to completedby cls,ortown official City or Town: PermitR,ieense# Issuing Authority(circle one). • I.Board of Health 2.Building Department 3. ltyftowa Cleric 4.Electrical inspector 5.Plumbing Inspector 6.Other ' Contact Person: Phone 0: ' M ,g. 4 PLOT PLAN 0" 0 FOR LOT M Indicate Additions with dashed linn of es or accessory building a�� vl` S4),Sewerage ' disposal (cesspool) ® 5y � Ott/ I 1 ii‘ii — I (lot (0 ft. rear) ' Abutter's 0 'N — —' Name I 614' Abutter' Lot N I • Name I 'Xi,/ Lot M this a REAR YARD t lhhi 0(ont'teL :orner lot. 1 If this rite in name ••• 86•1°.•• corner If street. I write i name of I 0 other �e v8 street. q 4 05(6-7 • SIDE YARD V • in : HOUSE SIDE YARD • _ET •• U . �. 5te h�e * • I • V\ SET BACK •• I s 1 0 • (lot (6)-) ft. frontage) // SEiiptr 4,ijr, (NAME OF STREET) Information / \ Supplied by ,/ �Gf-ir gig- s G VI- PARK NORTH POINT { Information and Instructions hdmaaaiats Cate!Laws obapta 132 requires all employin to provide waken'compemadan Pot their employee. Pursuant to this stands,an aapieyn is defined.."—every pass is the service of another under au cad alike, egress or implied,oral or writhe" As splays It defined arms individual,partmabk,auactadoe,corpaados or aha ltpl sadly,or any two or me of the beeping sewed Is aka.anlnpda,and ked*the Irpl nprsmtadrw oft domed rmyby% a the receive or Meow etas bdMdoal,pamashtp,amodatlos at orbs hpt sdty,a engbyesa However the ensu of identifies bone having not me than that spsrtmaii Moths reside.there*as the anonym Mho dwelling base of asubr who employs persons to de matmmaoa,wslmetlon or meek wart on sock dwelling house or an the pale ce building appntrmmt than shill not bus dmch employment be deemed to be as mpbyse Mt ehsptu 137,$25C(6)she skies that"every state a heel Ilasrtagsnowy ski withheld is imam a newel de lease eie permit b waren a batser ate estreat Whim b the emsevraia lir any sppptast lobe bee net media/sweetens nichees dampibse with the Issas muses rgdnd,' Additional%MOL cbS"152,12sC(7)stun"Neither the conanameth sur any kis poWieai subdivision shad eater S say eaotrad he the pail morn ofpubgs want_- aeeptabk evidence of eampMmaa with the SUMP regokaoas of tele thsptes have tees penned b the wetwodeg Moray" Apparent • Pleas flit net the wahin'wmpmaetlos dads*eompiest%by checking the boss that apply to yea sena ice mad,if ss7,apply (s)ss(s),sddtese(e)and pines i mba(a)slug with tisk catlfims(s)of iresancs thedied filefailkyCaspeoles(LLC)or Lbdbd Lis6itty labaahips(LLD)with an employ.as other etas the members oeparbes,as not nuked to cry wain'ooap..atlos knaaeea if an LLC a LL?doss have employes.,a pansy le sugared. Be advised that this s davit my be submitted to the Nang of Ialarls& Accidents Ser askrma os of Mance cocottes. AS be nee te sign sad dale as afildae t The akdavk should be mesad se the city or tow this the sppliatioe be the parva a time b beky regaeted,net the Deportment of • Wahl hlAaeianat Shield yea hue any_ o roma.the law aay=asnuked teabed.amime' aompardoa pansy,phase call thus Dusan as the mbar U.S below &pined ampestes should ata their satins.Unse maims she appapiiL$pew C7q a Tiers OQlslsta Pitm be sus that S afdsvl is complete and sewed kgibh. Tea Menton ha provided i spew at the lamas of the amdbM the you to AB opt It the flea the Cake of lensdptkn ha to cared you regarding the Applicata Pim be me b all Is tis.mm10aane Mien which will be tad as a reforms nnmbea in additke.an applicant that met salsa Maple permanent appanage is say gina yew,nowt only submit mg sifidant ignitable meet policy lsamstion(if easy)and Mgr lob Site Adam"the appikaat Mond write"al imago la (city or tout)."Aguy ofdie slab*Teethesboas a lkialystamped armahadbytheapertownmaybepeovidedmthe appliceMaproof data valid atidbgbaamebribasepermits atkemaAnewa ikvkmstbeIDkiornsak year.Mum aMae men China IeobtainingaI4e..eorpamanotmksdlearybasica.orcaomachlvtasse (Loa dog lases or puck le bum lava ea.)said paean is NOT regdrd b combs this affidavit The Ofila of laresdptios would tib to thank you to advance Da yaw coopasam and should you have say gnostical. please denthesitate tie gin ustcall. The Depsend-a address,Siphon sad Be mob= The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Stmt • Boston,MA 02111 - Tel.M 611421-1900 ext 406 or 1-877-61ASSAFB Revised t 1.12x16 Fax M 617-727.7749 www.maa nor/die i - 1. TY" ROBN rig-n:444_ .:, '3 N"LCOX N ter,, a , tb. 31341 i a e(e,q ,k N_ WSSX O. inFa'* to W ',.,.a 26_ EGA ,� o A A w CI L11� Ct. 33.5' teN LOT 14 1l53 O10,065.8 .f S.F. 0. c. . \ O 917' ✓ ."7d *6 TO THE BEST OF MY INFORMATION, "PROPOSED" PLOT PLAN KNOWLEDGE, AND BELIEF THE YARMOUTH, MASS. STRUCTURES SHOWN ON THIS PLAN PLBK. 187 PG. 149, LOT 14 HAS BEEN LOCATED ON THE GROUND DATE 4/4/15 SCALE 1" = 20' AS INDICATED. / �/ _ JOB 7553-00 CLIENT HASSETT 4/4/15 �/v SWEETSER ENGINEERING 203 SETUCKET ROAD DATE PROFESSIONAL LAND SURVEYOR oFF. 5P0 SOUTH DENNIS, MA 026-365-6991 C: 1 S8 1 PROJ 1 7553-00 1 dwg 1 7553-PPP.DWG 0 2015 SWEETSER ENGINEERING _gv:1L� _ e . w .*Pta.C ,o TOWN OF YARMOUTH RECEIVED r ,,, 1146 ROUTE 28,SOUTH YARMOUTH, MA 02664-4451 Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 SEP 12 2018 OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE YARMOUTH OLD KING'S HIGHWAY APPLICATION FOR CERTIFICATE OF APPROPRIATENESS Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as amended,for proposed work as described below&on plans,drawings,photographs,&other supplemental info accompanying this application. PLEASE SUBMIT 4 copies OF SPEC SHEET(S),ELEVATIONS,PHOTOS,&SUPPLEMENTAL INFORMATION. Check All Categories That Apply: Indicate type of Building: . Commercial_Residential 1) Exterior Building Construction: New Building _Addition _Alterations _Reroof_Garage V Shed _Solar Panels _Other: RECEIVED 2)Exterior Painting: Siding _Shutters _Doors _Trim , __Other: OCT 1 O 2010 3)Signs/Billboards: _New Sign _Change to Existing Sign 4) Miscellaneous Structures: _Fence Wall Flagpole _Pool Other T�L c!5 Please type or print legibly: / Address of proposed work: 9 510?p/,r IAAY Map/Lot# /1-51S3 Owner(s): gter f A495567�7— Phone#: 6)12372/Ar All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: 756/3/4Lr `194:)c yArtnovl Potf/ ,4M Year built: /97 7 Email: Fetrrjhaccer-f-@Omar/r eon Preferred notification method: Phone ✓ Email Agent/contractor: Rec. (4h rktnr" Phone it: PO 3LP 7755 Mailing Address: 306 fItyrypt,k ii ki �!pm 6 y mg ()IGO/ Email: /714/74115 A pin 1100 kr—. Coon. Preferred notification method: ✓ Phone Email Description of Proposed Work: / C ort s tlru or 4 Ao x it Sforo” She-4 a v ev e rr c PkitIV__ multi l w/ 9.4(1 boa r5 5r'rai Autr. `�J-- OCT — 9' 2018 G '�� 92�s�/s Signed(Owner or agent): ` �i ��i/ YARMOI TH Date: OLD KING'S 1 1611 NAY > Owner/contractor/agent is a re that a permit is required from the BjiWIi,y Department.(Ctiela IA lel departments,also.) > If application is approved,approval is subject to a 10-day appeal period required by the Act > This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. > All new construction will be subject to Inspection by OKH.OKH-approved plans MUST be available on-site for framing&final inspections.ct For Committee use only: V Approved _Approved with Modifications _Denied Rcvd Date: %/07--// g Reason for Denial: Amount c2' / i Cash/ #: ll/�'/ it/4 ./. t �'ll. / Signed: Rcvd by: !��✓ ,�fy e, r r 1' 45 Days: It7 ojC//i , .Z1fr. i ---• s..A Date Signed: /0 f 9 t n/Y �/ t 03/2018 1 APPLICATION f�� O _ A l O O : RECEfl/ED itt.�, SEP 1 2 2018 T aye ROB:NI y. a YARMOUTH <4 W! !L^.'. =T�.�, } OLD KING'S HIGH AY 3 V." CU t N 1s,;. < „ No.31341 0 er' q ' f•t`a/,T S:1413 N NN C ` yA L L..;� k 2 "" 0 Y 91 N W N'` Z6 Gfir / o o ,21g i /I. / 41 . ilr 1/ / yrA i , APPROV `- o OCT -9' 2018 th- cc �` 33'& YARMOUTH OLD KING'S HIGHW•Agg LOT 14 1100 O10,0658 ± S.F. til REC • ED g 1)0 OCT 10 2018 IpE N 0 ‘. 3..-9-.27' TOWN CLER SOUTH YARMOUT ti TO THE BEST OF MY INFORMATION, "PROPOSED" PLOT PLAN KNOWLEDGE, AND BELIEF THE YARMOUTH, MASS. STRUCTURES SHOWN ON THIS PLAN PLBK. 187 PG. 149, LOT 14 HAS BEEN LOCATED ON THE GROUND DATE 4/4/15 SCALE 1" = 20' AS INDICATED. / / ' JOB 7553LIHSTT 4/4/15 Z/�v SWEETSER-00 ENGINEERINGCENTASE 203 SETUCKET ROAD DATE PROFESSIONAL LAND SURVEYORPO BOX 713 SOUTH DENNIS, I 02 OFF. 508-385-6900 FAX 508-36660 5-6997 18 - 7 00 C: 1 S8 1 PROJ 1 7553-00 I dwg 17553-PPP.DWG C 2015 SWEETSER ENGINEERING ,RECEIVED r SEP 12 2018 { O Front Elevation Left Elevation YARMOUTH PINED,HAi ok SCALE: 1/4'=I'-0' \`J SCALE:v4• = 1-0• OLD KING'S HIGHWAY YINEHARIOR.COM E-000366.SHEQ ]59 Quenn Anne Road Harwich,MA 03645 1 1 1 1 ' ' 1 1 1 ' I 1 Lill , IO/12 pitch I is Snell430-iiu 3-tab Shingles I I I L i , l ' l 1 1 1 i bunteymehaAfi6cem rMire Black.--- I 1 I I I 11 I 1 I I I 1 1 1 1 1 ) I ��� I I ill�� ENGINEER'S STAMP 1 I I IIIIIIIIIIIII IN len ,- 111111 PK Trim�— eTop Board and BattenINNIIMIN MINION MINIMI■MNIININWhhe Cedar Shingles IOMNIINI��_ — PROJECT: an I0' x I4' Quivett Cape } 14'-0' t 8 0 /pi �Q-Q' CLIENT: 5 m Peter Hassett C 0 O ADDRESS: >0 N / 8 Skipper Lane 0 \m Yarmouthport.MA 02675 © Rear Elevation ?A co Right Elevation PHONE SCALE: 1/4' = I'-0' D SCALE:I/4' = l'-0' 508-237-2175 E-MAIL: imm-------------� peterjhassettpp Rmail corn mriniminiumiaininimpitm 3-tab Shingles ___ % it ADDRESS OF PROPOSED WORK: Mart Back^� ��� ���������, 8 Stripper Lane ini—_— =�aaa�a���, Varmou[hport.AAA 02675 II �� � j MO rREVISION DATf:Z D n 7(�I8/1E:Board and Batte•I I'I /�A - I °'�5.ard BattenEIyA� ' �j 5/18 111 1 DRAWN BY: 111111111111111111111 - _� co 0 GB _= o < CO ® Unless aotherwise noted Page A.1 18 - A ) no