HomeMy WebLinkAboutBld-20-000709 6fr /a6'/9 8// _
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ONE & TWO FAMILY ONLY-BUILDING PERMIT !�
Town of Yarmouth Building Department 4:46,Ni1146 Route 28,South Yarmouth,MA 02664-4492
508-398-2231 ext. 1261 Fax 508-398-0836 ,Ii.,6:1
Massachusetts State Building Code,780 CMRw
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: f j(,4)— ij art)9 0 y:. •Date Applied:
i1' S€fs —0... : _ =a.3-I5
Building Official(Print Name) Si Date
SECTION 1:SITE INFORMATION.
. 1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers
14-14, Lot,rNw "'" 1
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
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
1.6 Water Supply:(M.G.L c.40,I54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public Di( Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system •
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP':
1 Owner'of Record:
1 ,art dec. Rea,l.4.,1 LLZ H. A n i`A_ NI IA- O a 6 o I
Name(Print) City,City,State,ZIP
16 s (.
ki not, vat �j3g•S 7-7a5T n d ;J, I , ,J. to..
No.and Street Telephone Em:I Address go
SECTION 3::DESCRIP ON OF PROPOSED WORK(check.all that apply)
New Construction 0 Existing Building Owner-Occupied ❑ Repairs(s) Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg.0 Number of Units Other 0 S ecify:
Brief Description of Proposed Wor .
31,07)
. SECTION:4:ESTIMATED CONSTRUCTION COSTS < .:,-;'v jt 4, /01 i
Estimated Costs: } . ' 6
Item .. O cial se L� , �i`Er�-Hrz E`;T
(Labor and Materials) • , •
1.Building $ :1. Building Permit Fee:.$:1 `0. Indicatb l ow •-.- ._.. s _!
g Jlr0 •
2.Electrical $ /��� :Standard Citya4wn Application I ee:`-• ,' . ', •';.
C7.Total Project Cost3•(It ,• • .x.multiplier. - x _
3.Plumbing $ J t-J D O 2. OtherFees: $ SS .. .
4.Mechanical (HVAC) $
5.Mechanical (Fire
$
Suppression) Total All Fees:$.
Check No.. Check Amount .A my t.
6.Total Project Cost: 1'
`���UQ �Paid m Full •._ 'l>0 Otitstandidi�gg�te�ce�u� �_
AUG 012019
.,./ L' Id PART MEN
r.Y.
N. SECTION 5:.CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) OQ3�iL�.S 2 f zC1 za
bt:V1I115 K Ck License Number Expiration Date
Name of CSL Holder
`6 (f ' S Li List CSL Type(see below) V
- heiool
No.and Stree Type • Description
u44E s M it o960 f U Unrestricted(Buildings up to 35,000 cu ft.)!' rj P. Restricted I&2 Family Dwelling
City own,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
$g-577_7 ? & d pr�a y SF Solid Fuel Burning Appliances
Telephone or]a 9 'r'�,r" I Insulation
P mail address D Demolition
5.2 Registered
�,Home
{I�mivement Contractor, (HIC) , I..1.1q, Z'Z) /Z0
be it' irk"' �� "`j ker. t"1 tL C- IIIC Registration Number Expiration Date
C Company Name or HICistrant ame
)4 l€.tilcs c..
N .and Stre t ( c�,0 Jf'1 r�� �,q �,i, �,v.
t,
!trsr►is oin 026 0/ 97w -s-77-•7aSa' Emai address
Ci /Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6))
Workers Compensation Insurance affidavit must be mpleted and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuan of the building permit.
Signed Affidavit Attached? Yes No 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLE LED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES
'FOR
I BUILDING PERMIT
I,as Owner of the subject property,hereby authorize v 047)
to act on my behalf,in all matters relative orize ' building permit application.
))'(.44/V16.- IttaLl'4‹, _ ---.__, -- 7 h 0 if /
Print Owner's Name(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 this application is true and acc ate to the best of my knowledge and understanding.
165/16; dd 7/7 d /1 '
Print Owner's or Authorized Agent's N (Electronic Signature) Date
• 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.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (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
Arz. Department of Industrial Accidents
►r= l l Office of Investigations
• c; ,, ^„ 600 Washington Street
Boston, MA 02111
—7�'' www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Bayridge Realty LLC/Dennis Kerkado
Address: 16 Kings Way
City/State/Zip:Hyannis, MA 02601 Phone #: 508-577-7258
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 3 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs
insurance required.] t employees. [No workers'
comp. insurance required.] 13.❑ Other
*My 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 their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: American Zurich Insurance Company
Policy# or Self-ins.Lic. #: 6ZZUB-9F53709-9-19 Expiration Date: 03/09/2020
Job Site Address: 14-16 Courtland Way City/State/Zip:
West Yarmouth
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under t an pena ties erjury that the information provided above is true and correct
Signature: ,%' Date:
07/30/2019
Phone#: 5 - -7258
Official use only. Do not write in this area,to be completed by city or town officiaL
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
'.-d.i.Y`44;?,, TOWN OF YARMOUTH
. „ c B UILD ING D EPARTMENT
*
,x 1146 Route 28,South Yarmouth,MA 02664
`*.—� s 508-398-2231 ext. 1261 Fax 508-398-0836
BUILDING DEPARTMENT
•
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G.L Chapter 40,Section 54 and 780 CMR, Chapter I, Section 111$,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at i ii "' /6 Com wy j inAc../
Work Address
Is to be disposed of at the following location: \j(t✓te inkf-`-
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section I50A.
Si -1 /7 r-' ii 9
ppficahon Date
Permit No,
{ Commonwealth of Massachusetts
Division of Professional Lrcensure
Board of Building Regulations and Standards
:onstrl,9Ct4bf SU per visor
CS 093445 F.Aprres 02/26r2020
ii
DENNIS KERKADO
16 KINGS ROAD •.•6 ..
HYANNIS MA 02601
Commissioner
Construction Supervisor
Unrestricted-Buildings of any use group
i contain
less than 36,000 cubic feet(991 cubicmeters of enclosed
space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For information about this license
Cali(617)727-3200 or visit wvwy.mass.govtdps
Otfios of ConsumerAMalrs A 9uainam Rowoflon
HOME IMPROVEMENT CONTRACTOR
:LLC
177910 02/23/2020
BAYRIDGE REALTY LLC.
DENNIS KERRAOO
16 KINGS WAY
HYANNIS,MA 02801
Undersecretary
•
Ite.straitOn send far ifIlitVitatiatuse
Ottft 1 , be to:
Win,t A omit
•
NOTICE twokk. NOTICE
TO —__- ►� TO
EMPLOYEES '' = — EMPLOYEES
7 ev
M = S•I6
The Commonwealth of Massachusetts
DEPARTMENT OF INDUSTRIAL ACCIDENTS
1 Congress Street, Suite 100, Boston, Massachusetts 02114 — 2017
617-727-4900 — http://www.state.ma.us/dia
As required by Massachusetts General Law, Chapter 152, Sections 21,22&30, this will give you notice that
I (we) have provided for payment to our injured employees under the above mentioned chapter by
insuring with:
ZURICH-AMERICAN INSURANCE GROUP
NAME OF INSURANCE COMPANY
P.O. BOX 1450
MIDDLEBORO. MA 02344-1450
ADDRESS OF INSURANCE COMPANY
(6ZZU8-9F53709-9-19) 03-09-19 TO 03-09-20
POLICY NUMBER EFFECTIVE DATES
ROGERS & GRAY INS 434 ROUTE 134
SOUTH DENNIS MA 02660
NAME OF INSURANCE AGENT ADDRESS PHONE#
jggg BAYRIDGE REALTY LLC 16 KINGS WAY
0=
_ HYANNIS
°� MA 02601
EMPLOYER ADDRESS
MEN
EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE
MEDICAL TREATMENT
The above named insurer is required in cases of personal injuries arising out of and in the course of
employment to furnish adequate and reasonable hospital and medical services in accordance with the
provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the
injured employee. The employee may select his or her own physician. The reasonable cost of the services
<-=,--7 provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably
connected to the work related injury. In cases requiring hospital attention, employees are hereby notified
that the insurer has arranged for such attention at the
NAME OF HOSPITAL ADDRESS
TO BE POSTED BY EMPLOYER
012858 W20P1G15
Sears, Tim
From: Sears, Tim
Sent: Wednesday, August 14, 2019 3:03 PM
To: 'bayridgerealty@gmail.com'
Subject: 14-16 Courtland Way
Attachments: work in flood zone packet.PDF
v7-
Dennis,
pplication for 14-16 Courtland way and this property is located in a FEMA designated flood zone. I
a packet for you to review, and return filled out with the notarized affidavits.
Timothy Sears CBO
Building Inspector
Town of Yarmouth
508-398-2231 Ext. 1259
mailto:tsears@varmouth.ma.us
1
iI)7n }
f 1SF1 f i
• i
Substantial Improvement Worksheet for Floodplain Coa °,3 8._I
(for reconstruction,rehabilitation,addition,or other improvements,and repair of damage from any cause)
Property Owner: V)A.4(169 t. ( LLL
Address: Io kiA5t WC,LA 1. ,r•nrtS
Permit No.:
Location: ( ( A la v A (dGC,. (A. 46.r w+UJ t-t s
Description of improvements: Vt,jH jy eA ([,t, ' k,t,.,
Market Value of straf e 910:4tiriet0 raisal gar added
assessed ixa e,BEFO � pr ment,orff i ,�
be pe amage ned) not g r- L �' b i' $ 31, pc)OF
�.�,..
xx, W
� al'cost d �� ,�,�,�,to ��,}� ]'C .3 d i Ii F .r W 0''
,+a{fit �..�.`r`R�'�J s ;.i.; iT r r ��0 i,
44,
.... ..
.F._ ....., :<x _..,..:•. •
If ratio is 50 percent or greater(Substantial Improvement),entire structure including the existing
building must be elevated to the base flood elevation(BFE)and all other aspects brought into compliance.
Important Notes:
1. Review cost estimates to ensure that all appropriate costs are included or excluded.
2. If a residential pre-FIRM building is determined to be substantially improved,it must be elevated to or above the BFE. If a
non-residential pre-FIRM building is substantially improved,it must be elevated or dry floodproofed to the BFE.
3. Proposals to repair damage from any cause must be analyzed using the formula shown above.
4. Any proposed improvements or repairs to a post-FIRM building must be evaluated to ensure that the improvements or
repairs comply with floodplain management regulations and to ensure that the improvements or repairs do not alter any
aspect of the building that would make it non-compliant.
5. Alterations to and repairs of designated historic structures may be granted a variance or be exempt under the substantial
improvement definition)provided the work will not preclude continued designation as a"historic structure.'
6. Any costs associated with directly correcting health,sanitary,and safety code violations may be excluded from the cost of
improvement. The violation must have been officially cited prior to submission of the permit application.
Determination completed by: —D?.i/r iM,$ LYY....,0i/30
Date: S l2 I 1 I
y
L,� TOWN OF YARMOUTH
y BUILDING DEPARTMENT
;4. 1146 Route 28, South Yarmouth, MA 02664
Telephone 508-398-2231 ext. 1261 Fax 508-398-0836
Contractor's Affidavit: Substantial Improvement or Repair of Substantial Damage
r'lProperty Address: '(a 1-.1 641 � • YCV-1/000 '�'k
Parcel ID Number: 32 I I Z I 1
Owner's Name: NrIArie, V(4 111 t, 'C'
Contractor: Yr() LZA,'t 4
Contractor's License Number: OCI 3 4 45
Date of Contractor's Estimate: .'1 Z 1 ! ri
I hereby attest that I have personally inspected the building located at the above-referenced address by the
nature and extent of the work requested by the owner, including all improvements, rehabilitation,
remodeling, repairs,additions, and any other form of improvement.
At the request of the owner, I have prepared a cost estimate for all of the improvement work requested by
the owner and the cost estimate includes, at a minimum, the cost elements identified by the Town of
Yarmouth that are appropriate for the nature of the work. If the work is repair of damage, I have prepared a
cost estimate to repair the building to its pre-damage condition. I acknowledge that if, during the course of
construction, the owner requests more work or modification of the work described in the application,that a
revised cost estimate must be provided to the Town of Yarmouth, which will re-evaluate its comparison of the
cost of work to the market value of the building to determine if the work is substantial improvement. Such re-
evaluation may require revision of the permit and may require revision of the permit and may subject the
property to additional requirements.
I also understand that I am subject to enforcement action and/or fines if inspection of the property reveals
that I have made or authorized repairs or improvements that if inspection of the property reveals that I have
made or authorized repairs or improvements that were not included in the description of work and the cost
estimate for that work that were basis for issuance of a permit.
Contractor's Signature
Date: dZi Ii c]
Notarized: 1
:6 BRIDGET A GRAHAM
n.,,=':f7 ruble
C, a c -?—a:.,,userts
My Cc m w ss;on E es Oct.26,2G23
0v3 TOWN OF YARMOUTH
o•
},y BUILDING DEPARTMENT
t 4ri"t a I 1146 Route 28, South Yarmouth,MA 02664
Telephone 508-398-2231 ext. 1261 Fax 508-398-0836
Owner's Affidavit: Substantial Improvement or Repair of Substantial Damage
Property Address: ( e) & 1 • \kW le u. rl,,
Parcel ID Number: 3 Iii U
Owner's Name: f►ay., czecuwiL LC,
Owner's Address/Phone: 1 65 PvvivrtryiiS
-
Contractor: I�iVl►'t5
Contractor's License Number: og31445
Date of contractor's Estimate: $(2) 1 i. 1
I hereby attest that the description included in the permit application for work on the existing building all
improvements, rehabilitation, remodeling, repairs, additions, and other forms of improvement. I further
attest that I requested the above-identified contractor to prepare a cost estimate for all of the work, including
the contractor's overhead and profit. I acknowledge that if, during the course of construction, I decided to add
more work or to modify the work described, that the Town of Yarmouth will re-evaluate its comparison of the
cost of work to the market value of the building to determine if the work is substantial improvement. Such re-
evaluation may require revision of the permit and may subject the property to additional requirements.
I also understand that I am subject to enforcement action and/or fines if inspection of the property reveals
that I have or authorized repairs or improvements that were not included in the description of work, and the
cost estimate for that work that were basis for issuance of a permit.
Owner's Signature:
Date: -/zi //c,
Notarized:
• , BRIDGET A GRAHAM
-1 Notary Public
Comrran*vaith of Massachusetts
,. My Commission Expires Oct.26,2023
Property Location:14&16 COURTLAND WAY MAP ID:32/124/// Bldg Name: State Use:1040
Vision ID:2467 _Account#2467 Bldg#: 1 of 1 Sec#: 1 of 1 Card 1 of 1 Print Date:03/06/2017 16:57
CURRENT OWNER TOPO. UTILITIES STRT./ROAD LOCATION CURREN ASSESSIWENT
MARTIN BARRY E l Level p Public Water 1 Paved 2 Suburban Description Code Appraised Value Assessed Value
C/O S W MARTIN 0Septic RESIDNTL 1040 81,000 81,000 815
GORWIN DR I RES LAND 1040 140,000 140,000 YARMOUTH,MA
SSHARON,MA 02067-2704 SUPPLEMENTAL DATA
Additional Owners: Other ID: 20/E009/// VOTE
MISC 120 VOTE DATE
CHANGES PRIVATE R( VISION
BETTERMENT
PLAN NUMBE1139-A-B
ZIP CODE 2673
GIS ID: M_306187_822789 ASSOC PID# Total 221,000 221,000
RECORD OF OWNERSHIP B%VOL/PAGE SALE DATE flu 4 SALE PRICE V.0 PREVIOUS ASSESSMENTS(HISTORY)
ARTIN BARRY E 2435/338 12/03/1976 I ' Yr. Code Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value
ARTIN BARRY E I 0 2016 1040 81,0002015 1040 93,4002014 1040 93,400
2016 1040 140,000 2015 1040 140,000 2014 1040 126,300
Total: 221,000 Total: 233,400 Total: 219,700
EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor
Year Type Description Amount Code Description Number Amount Comm.Int
APPRAISED VALUE SUMMARY
ARY
Total: Appraised Bldg.Value(Card) 81,000
ASSESSING NEIGHBORHOOD Appraised XF(B)Value(Bldg) ---e?
NBHD/SUB NBHD Name Street Index Name Tracing Batch Appraised OB(L)Value(Bldg) 01
0060/A
Appraised Land Value(Bldg) 140,000!
1COM LOC NOTES Special Land Value 0I
BROWN IA i Total Appraised Parcel Value 221,000
i0120 ,Valuation Method: C
;Adjustment: 0
STet Total Appraised Parcel Value 221,000
BUILDING PERMIT RECORD VISIT/CHANGE HISTORY
Permit ID Issue Date Type Description Amount Insp.Date %Comp. - Date Comp. iC'omments Date Type IS ID Cd. Purpose/Result
998201 04/12/1993 800 100 REROOF {01/01/2014 01 1 BH CY CYCLICAL 2014
08/20/2004 JB 00 Measur+Listed
09/24/2003 ! JB 02 Measur+2Visit-Info Carr
09/03/2003 ! JB 01 Measur+lVisit
07/18/1995 DH 00 Measur+Listed
I !
! i
LAND LINE VALUATION SECTION
B Use ' Use I Unit I. ! Acre ' C. ST. Special Pricing S Adj
# Code Description Zone D Front Depth Units I Price Factor
PS.A.SA, Disc Factor Mx Adj. Notes-Adj Spec Use Spec Calc Fact fgd1, Unit Price Land Value
1 1040! WO FAMILY 10,019 SFi 8 73 1.0000 6 1.0000 1.000060 1.60 1.00 13.97 140,000!
j ! j1 1
! !
1 1
i I !
1 1
!
1 1 I
Total Card Land Units:i 0.23 AC! Parcel Total Land Area:0.23 AC v Total Land Value: 140,000