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HomeMy WebLinkAboutBld-20-001104 Office Use Only SHEDS LESS THAN 150 SO. FT. SHALL O t „fit# /J 69//eV �� t ! C RE PLACED A MINIMUM OF 30 FEET Amount f * FROM THE FRONT LOT LINE AND A �' ~.44 =L ,.. Permit expires 180 days from �� MINIMUM OF 6 FEET FROM SIDES AND kEAR LOT LINES. . issue date j EXPRESS SHED PERMIT APPLIcAWF. E D TOWN OF YARMOUTH 1 Yarmouth Building Department 1146 Route 28 AUG 201 South Yarmouth, MA 02664 8l' DIN DEPARTMENT i (508) 398-2231 Ext. 1261 { E_3, _ _ _ y_, _y.�_ a "f �,CONSTRUCTION ADDRESS: � c ( 3 6 U a . L A-1140 f A / ASSESSOR'S INFORMATION: Map: Parcel: OWNER: d)o c� " 0,,S R/. � , 5©O — Q i a-k-1 IlliVf-- a.ot.cool NAME PRESENT ADDRESS TEL. # Email Address: CONTRACTOR11NQ / d P UC1oc4-s .,,,n(i (7e-n Ac\r19- Rck 130'2&U NAME MAILING ADDRESS TEL.# `—__- — -- Email Address: Residential Commercial) Est.Cost of Construction$C•-�3(-�c) • �' • Home Improvement Contractor Lic.# 1 X�c !3 Construction Supervisor Lic.#C 0-1 e. ') Workman's Compensation Insurance: (check one) I am the homeowner I am the sole proprietor I have Worker's Compensation Insurance A Insurance Company Name:la..kJ lr1.1i\f�2&''1 Omit( .act Worker's Comp.Policy#ECC-600 e QJ7-z oil SHED INFORMATION New A Size LVc x W ( q l x H J/) t 11 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* 'zeJ ;Size�L x W (fix H D *The debris will be disposed of at }C ► Ge-e-X t 1�� .AA � w( t `-h' 1 Location of Facility I declare under penalties of---Jury tha e statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s) will be just cause for dent 1 o %vocatio 1 of my license and for prosecution under M.G.L.Ch.268,Section 1. Applicant's Signature: l Date: V 1 l L.12 l l 9 Owners Signature(or at,chment) A,�e� Date: fQ� b Approved By: Date: C/ 7/9' Building Off i ) Zoning District: Historical District: Yes No Flood Plain Zone: Yes No Water Resource Protection District: Within 100 ft.of Wetlands:*** Yes No Yes No ***Note:Conservation review required if within 100 ft.of Wetlands 9/13 ....._.... r • PLOT PLAN FOR LOT it Indicate location of garage or accessory building Additions with dashed lines --------- Sewerage disposal. (cesspool) 400 1 I _ _ _ i `'°� - � I Abutter's 1 Abutter's © Name Name S,DUItlee Lot# Lot# If this is a REAR YARD If this is a corner lot, corner lot, write in •....••. ....ft. write in name of street. name of street. ) 004 •crpv.i1) 4 +t: SIDE YARD HOUSE SIDE YARD • • • • • • • 1 • •• • • • SET BACK • • • • 4 I v • (lot ft. s tage) • Cr." 3 • \\ (NAME OF STREET) D6()er.„...Supplied by wirtea ��...14) MCGRPOS-01 THORNE i4 �R�y CERTIFICATE OF LIABILITY INSURANCE °"7 `.... 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 TIE COVERAGE AFFORDED BY THE POLICES BELOW. TIES CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISBURNG INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policypes)must have ADDITIONAL INSURED provisions or be endorsed. I SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not corder rights to the certificate holder In lieu of such ems). ppPRO UCes ! 43�Fite S4�IraRRnlrRce Agency,Inc. no (800)553-1801 (re,nol:(877')816-2156 South Dennis,MA 02860 Uffiss,mail@rogersgray.com INSURE RISI AFFORDING COVERAGE NAC I INSURER w:Travelers Indemnity Company 25658 INSURED INSURER e:NeW Hampshire Employers Insurance Compare ,13083 McGrath Poste Cori . Y INSURER C: dba Pine H�Wood P � ,f 'y I SURBI D: b-_" INSURER E: COVERAGES °'� i`�ICUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES 4 —SU . BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVMTHSTANDING ANY w t., ENT, s CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Y TH RESPECT TO YM*CH THIS CERTIFICATE MAY BE ISSUED OR , AIN. THE U AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF Sic LICIES.LIMA SH Y HAVE BEEN REDUCED BY PAID CLAIMS.Ly 11613 LTR TYPE OF INSURANCE ''''INSD (IBIpDMYYYf ar DRrYY11 �WS POLCII"RII 1,000,000 A X COMMERCIAL eEN®ML LMBaJi v EACH OCCURRENCE S CLASIS. ADE X OCCUR ` I-660-' B-IND- ;_' 1/3IR019 1/31f3020 S ell 100,t100 MED EXP tMv one person) .; 5,000 PERSONAL&ADV INJURY 1,000,000 GEM.AGGREc�TE L rt*._. GENERAL AGGREGATE $ 2,000,000 X POLICY! LOD { PRODUCTS-COMP/OP AGG ; 2,000,000 OTHER ' y $ A } r, s r (Ea accident) $ AU7UE s %. s4 s3x SINGLE LAArr s ANY AUTO t ' 'n` r t BA-4467B68B-1� �019 'f�0 eODtl.Yw.N1RvtParpewanl $ OARED SCHEDU ED 1 AUTOS ONLY; y,, S 0 1 , z'' t, BODILY INJURY(Per oxidant), $ XAt%ONLY xe U'er a�) $ UMBRELUI EXCESS LIAaLJAB ClA '' , E $ DED RETENTIONS A�>fC `T° B COMPENSATION --, k ' ,�, nn 1`. i I e bt ,. PERoTH- $ MD EMPLOYERS'LIABILITY � s {� • , ? STATUTE' BR MD EM Pa YER EXCLUDED? Y1I N/A ' ''iCC'.h( 005-2118A 7/8I2019.4` . ' 2020 E L; H ACCIr { $ 500,000 E.L DISEASE LSO $ ,000 r yyeess,�deernbe wider 500,000 DESCRIPTION OF OPERATIONS below n n` ' 4i r r:<' i r EL DISEAS -.UCY ut `E , r y:` I I. Y , l MDeal fDN OF OPeATIoNs/IACANS/YENICLES(ACORD let,AdBlaa Ranetssa1 #S I Aonapaoara � 9; CERTFICATE HOLDER CANCELLATION SHOULD ANY OF TIE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL Town of Yarmouth ACCORDANCE WITH THE POUCY PROVISIONS. BE DELIVERED IN Building Dept 1148 Main St,Rode 28 South Yarmouth,MA 02064 AUTHORIZED REPRESENTATIVE . J--AsAPTI 7/€1‘444#— ------ ACORD 25(2018/ 3) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD u7i1.01isuia 18:40PH FAX 13084301111+ PINE HARBOR laf1D0i/A041 • The aim (1/4.,. ' iwippet_!►nassziewiffirn4 D2lJ44017 Address: - Me�Maa +.Cheek de UMW PIlOOt;#, �kaad ep e4torp i�ttandAr . 1 -pc tPI eet( . mow wpm*pal milbigealwit �r•.di�rerArrdae� „, ""'r0� I.;�r' r 3. 0 Remodeling I an a ioaawavra� is at Wier pa maw }t 9.. on 11431Rectricel maim or addhiaos aaieethea. nothe to anew i■.weer TIff 'g' t'"� �o�J a�idiotoa ��tone �e�op�andi■ae imatathai'�e4odl.et, 3 Q Or addition' 152.t1[siart� siaaeaamiad� � Q law ,IN* aeparpil�a, I!~ imam 1e4e *Jew mediumgirt death bes 1 see .11 oat de melon } e.to+r Liblislwage Ms**mit Ibis Ade*iambs ati sIV daft SI veered Sae Wm age*esmusioname Meat vewdenwitimmiteg um Beam Heradomommta Eaasaa< iwe mot _chic vaulter mom +rdodaierar hmemace Company Nam • ferivemmtneac Da1ra.kest pelD„raiseaoiee Policy dOrSd s Lo.d Isar �: Zp� Failure to mare comm. endlor one-year as r NM a 152.USA is a Brim Attach a copy ef the woritere'conspeasation porky deelaradea page(showing Mc polity atea iid lsp�ra dly Ogling the violator. py�onment.OP VA*4 civil in the o(a ORDER�ble :has a fine c b:S 0iD.00 ion. thi*element dsd m the Office of ise 10 a . `iir i'* / � � lrraa�iet�ae arneet Qilleltdanaaot Do attar*k lis Ann r,e 47 sr tows galkdot fir orTewa; iceaek it Itaigi Angkor*4 L Beard KBeaiti L SailloiDapammast3. 4.OarCirylTo+rae Clerk 4.E1eet & cement Perna: Mae* .� i w ts-i-r/rro ?G(.6fea.f.,61E'?, OA- �' Office of Consumer Affairs and Busines Reg�tonZGG 10 Park PIaia-- Suite 5170 Boston, Massac efts 02116 Home Improvement R''`f.• tor Rezistratioa.. •- =74 ': ' rrenweefih or Stessedniestts 71 •=_ _^L A__ OMiSi n of Professional L1ClAlIM! McGRATH POST& BEAM.Co. °f =—. bird sad Shisdirds JAIES McGRATH 1 -_ii� I , , ; RI , f ,1 2 Family 259 QUEEN ANNE RD. --_' ` cSFA-a738 S * - `r HARWICH,MA 02fi4�S- '� —_= ` = ' :A21441 i it _ r f� t • +`' JADES R O - =,�v `' 294 «- '' -Wins a TEt 4' 19 A40 •_ Commissioner CAL A 012/,i e y i€/ife e 1 1 1 4 ,/tAaieiar,/,43e14,. Office of Consumer Affairs and Business Regulation 1000 W: - ,j Street-Suite 710 Boston, r,, setts 02118 Home In! rov a • r,. Registration �rf +, ____ � Typel Corporation MCGRATH POST&SEAM CO. _ 132935 DIB/A PINE HARBOR WOOD PRODUCTS d Inc 1= 10V3Qr102p 250 QUEEN ANNE RD. V HARW ICH,MA 02645 *1 y r +. t O aorFasn� BodgesAddnas and Return Cud, SA osseaseardisaI�.Aauoaesa Manor CoaswsaARMrs a er sbous R esioNsa HOME MII • - ENT CONTRACTOR Registration valid for Mdhriduai use only Office of AI2 Consumer Affairs 6usirase ffrpifioe } 10l20E Washington Street-Solve 710 MCGRATH •• ;� s Boston,MA 02118 DIB/A PINE + ,O : :. • A--._ r r_-_-...... 250 QUEEN APSE _• "- ifllftMlK:li,PM 026/5undersecretary Not valid without signature •