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EXPRESS SHED PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth,MA 02664
(508)398-2231 Ext. 1261
CONSTRUCTION ADDRESS: I a Puxitviii 6r39' 1 - -e_s* >/ 6(fl4 O
ASSESSOR'S INFORMATION:
l // Map: s� Parcel: J
OWNER: � G AV G�L !ry'J I -e t / O'- 0"/y u/Z f �/� f9 7'9 / #�O t— 7 7/-4 6S 2'
NAME PRESENT ADDRESS � / L �ek
CONTRACTOR: I V f/L( t./ 1 C�AN, L!S a2 Co��a r 41 I.y�-�e �c. �-4 rt,n 1 S 1/�d C3 .1-6 40
N l MAILING ADDRESS TEL# / )
R Residential U Commercial Est.Cost of Construction S 3'u/� C/
Home Improvement Contractor Lic.# 179394 Construction Supervisor Lie.N
Workman's Compensation Insurance: (check one)
❑ I am the homeowner ❑ I am the sole proprietor X I have Worker's Compensation Insurance *See Attached
Insurance Company Name: Worker's Comp.Policy#
SHED INFORMATION
New x Size L w x W /' x H 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 L x W z H
*The debris will be disposed of at: S & J Exco, Great Western Road, South Dennis, MA 02660
Location of Facility
I declare under penalties of perjury that the 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 denial or revocation of my license and for prosecution under M.G.L Ch.268,Section 1.
Applicant's Signature: Date:
Owners Signature(or attachment) 414-.1--. Date:
Approved By: Date: oc a < /
c' (or designee) E ADDRESS:
Zoning District:
Historical District: C Yes C No Flood Plain Zone: Yes C No
Water Resource Protection District: Within 100 R of Wetlands:***
L Yes 0 No C Yes ❑ No
***Note:Conservation review required if within 100 ft.of Wetlands
9/13
The Commonwealth of Massachusetts
_
lr—' t!l. Department of Industrial Accidents
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— 1 Congress Street,Suite 100
_ fij Boston,MA 02114-2017
www massgov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):Salt Spray Sheds
Address:235 Great Western Road
City/State/Zip:South Dennis, MA 02660 Phone#:508-398-1900
Are you an employer?Check the appropriate box: Type of project(required):
1.Q I am a employer with employees(full and/or part-time).* 7. 17,3 New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling
any capprity.[No workers'comp.insurance required.]
3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]1 9. El Demolition
10 Q Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance.:
14.17 Other shed construction
6.11 We are a corporation and its officers have exercised their right of exemption per MGL c.
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.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct
Signature: Date: 04/13/2019
Phone#:508-398-1900
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#:
/Ae Vommoymnecrid cien`ftfaut a Au e/
Office of Consumer Affairs&Business Regulation
HONE MPROVEYENT CONTRACTOR
TYPE Caraoration
188352 07/19/2019
SALT SPRAY SHEDS,INC.
ANDREW WARBURTON
235 GREAT WESTERN ROAD
SOUTH DENNIS,MA 02660 Undersecrellary
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Indicate location of garage or accessory building
Additions with dashed lines
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SIDE YARD SIDE YARD
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Information
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' Salt Spray Sheds Date Estimate#
235 Great Western Road •
South Dennis, MA 02660 4/13/2019 5416
508-398-1900 Office Building Date:
www.saltsprayhseds.com Estimate
Name I Address /Telephone Building Site
Alan Hibbert
West Yarmouth, MA
Description City Total
10x14 Even Pitch Shed 3,625.00
All sheds, garages, barns,cottages, and tiny houses are post and beam construction
built on site.Salt Spray Sheds does not prefabricate or panelize any of our buildings.
Additionally,we use full dimensional lumber and kiln dried boarding; our buildings do not
contain any form of particleboard, as it does not hold up to the changing temperatures
and conditions in New England.
*An Even Pitch Design can not accommodate a loft. If you are interested in loft space,
please consider one of our other shed styles.
The floor frame on all Salt Spray Sheds buildings is built using pressure treated lumber. 140 0.00
5/8"CDX Plywood, included in all buildings 4.375 0.00
Optional upgrades include 3/4"CDX or Pressure Treated Plywood
Standard 6'-5" interior post height(head room) 140 0.00
Standard 3' Board and batten Door 1 0.00
Please let us know where you would like the door placed on the shed.
Optional upgrades included beadboard or transom glass doors
6'Board&Batten Double Door(additional door) 1 191.00
Please let us know where you would like the door placed on the shed.
Optional upgrades included beadboard or transom glass doors.
Standard stationary window, includes window box and shutters 1 0.00
Please let us know where you would like the window placed on the shed
Optional upgrades include an additional stationary window, single,or double hung
window.
•
Signature Total
Salt Spray Sheds Date Estimate#
235 Great Western Road
South Dennis, MA 02660 4/13/2019 5416
508-398-1900 Office Building Date:
Estimate
www.saltsprayhseds.com
Name /Address/Telephone I Building Site
Alan Hibbert
West Yarmouth, MA
Description Qty Total
This building is priced with board and batten siding. 4 0.00
Optional upgrades include cedar shingles, primed red cedar clapboard,or fiber cement
board.
This building is priced with rough sawn trim. It can be stained to match your existing 140 0.00
property.
Optional upgrades including smooth, pre-primed pine trim or Azek trim.
Customer must provide Architect Roof Shingle Color prior to building date. If we do not 8 0.00
receive your selection two days prior to building,we will install a charcoal black architect
roof shingle.
To help you identify the exact color, please visit our website, www.saltspraysheds.com,
choose optional features in the left hand column, and then scroll down to find roof
shingles, and you will see available color choices.
*The following colors: Silver Birch, Cobblestone Gray, Heather Blend and Driftwood
include a small surcharge
If after viewing you are not sure about the exact color, please send a clear picture of the
roof via e-mail, saltsprayshedsinc@comcast.net, text 774-327-7067 with your name,or
mail and we will help pick out the color that matches your existing roof.
Installation: 1 0.00
We arrive to build your new accessory building with a truck full of lumber.The truck must
be emptied and the building materials and tools must be carried to the build site. If that
location is more than 25', a carry charge will apply. The charge is dependent on the
distance above 25'.
Signature Total
Salt Spray Sheds Date Estimate#
235 Great Western Road
South Dennis, MA 02660 4/13/2019 5416
508-398-1900 Office Building Date:
Estimate
www.saltsprayhseds.com
Name /Address /Telephone Building Site
Alan Hibbert
West Yarmouth, MA
Description Qty Total
Site Work: 1 0.00
If you are concerned that the area where you would like us to build is unleveled, please
call or email us to discuss setting up an appointment to have a representative look at
your site to tell you on what may need to be done to make the site buildable.
If we arrive on the scheduled day to build and site work is needed, including shoveling,
there is a$75 an hour charge with an hour minimum. Additionally, if the building site
requires higher than normal blocks to level the floor frame, it will require a long door
ramp; a small charge will apply.
Permits: 3 0.00
Customer takes responsibility for and will secure any zoning, historic,conservation,or
building permits, if necessary for an accessory building
Payment Policy:
All buildings, including repairs and door purchases, require a 50%deposit before
scheduling.The final payment is due upon completion of your building. Bill pay checks
should be arranged prior to building completion to account for 7 days mailing period. **If
you are not available on the building date,we will provide electronic photos via cell
phone or e-mail.
Weather:
We will do our best to accommodate scheduling changes due to inclement weather,
which includes rain, snow,extreme heat or cold, and high winds. Salt Spray reserves
the right to reschedule due to weather or unforeseen events.
All our policies can be viewed at our website,saltspraysheds.com.
Signature Total
•
Salt Spray Sheds Date Estimate#
235 Great Western Road
South Dennis, MA 02660 4/13/2019 5416
508-398-1900 Office Building Date:
www.saltsprayhseds.com Estimate
Name /Address/Telephone Building Site
Alan Hibbert
West Yarmouth, MA
Description Qty Total
Prices include all building on site costs and taxes. 0.00
If you would like to order this building please e-mail,saltsprayshedsinc@comcast.net or
call Salt Spray Sheds at 508-398-1900 to schedule an installation date and to confirm
any specific details that are important to your particular location or request.
Thank You
Andy Warburton
Owner Salt Spray Sheds
508-398-1900 Office
774-327-7067 Cell; Call anytime
Signature Total $3,816.00