Loading...
HomeMy WebLinkAboutbld-20-001556 ,. ...fi—h44t.te,-- qh&hi ,_,.. ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 '. ;Y'I� Massachusetts State Building Code,780 CMR . Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling g This Section For Official Use Only 7 Building Permit Number. , Date Applie - _ _ N `S y C -1,1-15 i Building Official(Print Name) S ature Date SECTION 1:SITE INFORMATION 1.1 Pro erty Addr�ss: ��J e . �+'t5 k Tii h 1.2 Assessors jP�&Parcel Numbers �Jr M.�SSu v{j '3 fiVt �(04-Ke.r /1 aj g3. i 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,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' x 2.1 Owne ' ff Record:^ 4 i l i ih M a 0 e (?� �L(^�� Name(Print) n City,State,p ZIP ,try ��J' i0Z'1 (1Ith e 1, L 40- - (�7" 9( -540 et ir�5`,-/- ac v , /l �p � No.and Street 1 Telephone Email Address Pci`A'(SECTION 3:.DESCRIPTION OF PROPOSED WORK2(check all that apply) all New Construction 0 Existing Building Owner-Occupied J' Repairs(s) Arl Alteration(s) tr Addition 0 W Demolition 0 Accessory Bldg. 0 .�p Number of Units Other 0 Specify: 4 1�IN" Brief Descriptigji of Prqposed Work2: Rg i , t if-4, . r�+ c ©C I 3 I'Co Lei 4�+�=S, 64-)0 �c t;r\5 o<(3\ L to:,r cb 42-4— SECTION4:ESTIMATED CONSTRUCTION COSTS , Item Estimated Costs: Official Use Only 1. Building $ /3 49 d 7 1. Building Permit Fee:$ ,Slndicate how fee is determined: 2.Electrical $ %Standard City/Town Application Fee it 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $cc 4.Mechanical (HVAC) $ List 5.Mechanical (Fire Suppression) $ Total All Fees $ - Check No. Check Amount: Cash Amount: ��' 6.Total Project Cost: $ 1 C 1 CIw Paid in Full El Outstanding Balance Due: GO ' " SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) S�-1D 1 !6 r —to Z tj e+_ P k b. . l ( , 0 License Number Expirationat Date Na f CSL Ptolder . 3 List CSL Type(see below) Li l-Ft{Sti frk-C No.and Street Type Description +1 �Qr� Park k s Oz 1 3 /b U Unrestricted(Buildings up to 35,000 cu.ft.) `( R Restricted l&2 Family Dwelling City/T wn,State,ZIP M Masonry RC Roofing Covering WS Window and Siding -q SF Solid Fuel Burning Appliances Co� 5 12,/7�73 pc0 .SI i 6 r 0 n I Insulation one Email dress D Demolition . �3 gistered Home provement Contractor(HIC) l_,/�S 1-Nsl.p l c"� m 31 9 . w /off a t/ HI C mp Name or HIC Re istrant Name HIC Registration,Number Expiration Date A �(( 5 �resc. �Te rrc� eja T4an S eet Email address RxrL m(4- o213(� City , State,ZLl' Telephone 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 0 No 0 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 all matters relative to work authorized by this building permit application. 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 •' application i e and orate to the best of my knowledge and understanding. Print Owner's or Authorized Agent's Name(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.2ov/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 _reht m Department of Industrial Accidents selfll= 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information P4-..t Please Print Legibly Name (Business/Organization/Individual): / ie.,5 C; Address: 4' 1r 5— e- 4—s c t7 s ry A City/State/Zip: {A)' �(y-e-to,,z4t, a(.-1-5 Phone #: 1 -1(.6 ` c(o c Are you an employer?Check the appropriate box: Type of project(required): LEI I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling . any capacity.[No workers'comp.insurance required.] 3. I am a homeowner doingall work myself. t 9. ❑ Demolition ❑ y [No workers'comp. insurance required.] 4. my I am a homeowner and will be hiring contractors to conduct all work on property. I will 10 [1] Building addition nsure that all contractors either have workers'compensation insurance or are sole 11.(l Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I 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.= 1 •❑Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§I(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. 1 do hereby cert. ender the pains d penp ' of perjury that the information provided above is true and correct. Signature: Date: � �Z f' 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#: dT, Y� TOWN OF YARMOUTH • < o y.r:srg y B U LD ING DEPARTMENT �.`` _� ,x 1146 Route 28, South Yarmouth,MA 02664 5-� 508-398-2231 ext. 1261 Fax 508-398-0836 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.GL Chapter 40,Section 54 and 780 CMR, Chapter I, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 46- I444sS41 AC45e14-5 Rat L.)—�� p,,_c)— tt- Work Address Is to be disposed of at the following location: \°-i"\ l D'A (iJ Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Sectio 50A. f_ , Z-- /� ignature o pplication Date Permit No, • ,,,,..'. -,c-':,:,4.--y,",..,*,;,..,,,,4,1"...r.*--...;•41P4. .1--..',-.".-'4,A7,.., ' —",. fit +� s. r { ��g� xi,s-t .7fi e & T,vb a*' ' . .... '---.5;-.-.".17.4,4z*.,74-...,*.1-,11,f.,,,,,,,.A...i.,,,,.-A.04--L-1,i, „c..,,,,,,,,,,,,:#4, € mxrr b „ t } Y is .:- -:-.7",,-;:1,,,'4,% ,,,..,, i-,. „,:?, 1.— ',',.....,,..- . ',.' , ' ' ,v,2"1.t- -,- :: ''. .'?:-2:,'',';',„';‘.1.'3.i:!,-'t!, ',;'-- ',,‘ r - - :, . .. 1 sg: � a :,-..4..; :.. ..,...„..„, ...,..,. ...,,.. .... : .., ....,. . ,, ,„,,:„., v b , p `� {t y 4 f 4' ttt.r''7 rtx .k 1.. S ...a:ak * . `y fi' ''''',:c:-:''''.i4;ftel.:4,11`tt*.W.F!:.r.4.4.k11. 1 :1, . ? ..` ^.,,, ',..i . 7�`.� of k w. 1 { a YL,y :, ...:;.::';'5,.:'411.tki::„'::::.ifT...!:'•:,.,:'.'''',i,...,:v i,,,...,,,.„,,,,,,..,..i.i,.., ...„...,;„.::::::.,A. ,;,...,.,,,:ii,,,i, ,,i,.,... „.....:.:...,: ..,.::.... .......„..„:,. „. ,,.„,..„;.....,. ..:j:::.„,,,, .„ „„ .„ „ . .,-,,,,A.4.i....,4z.„.„.v,,,..„,zi., „.,„:., ..,..4.:,:;...i,:;„„,......;,..,,;;... ....,,,,..„_;.;:<4.,....:.:.,._..,,:::,.,„, . ....:::„.„. . •.....,,,),::,,. ,. :,. A.1 W ++ Jy'y M a� �PYCP ' �...� f 1 r4 '4,,cli 411t : 2 r .a :3 4 ; t*.', Y r` t 6 fi a yr- .: Z .4^ L S J `k5'at=• !� S + '7"r,,,,3 y''r ✓sxy.,- F ».tom $#1. �.:•, 4 m ,a$a„ \- h RECEIVED • ' ov:Y/IitA TOWN OF YARMOUTH SEP 12 2019 O HEALTH DEPARTMENT o ,_ • HEALTH DEPT. PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: 11 Building Site Location: L1$ MoS5acl7(45et Ave- 1/0-Yawn o Al( Proposed Improvement: P-N.q r`+ CU r �j c a Nt W o Lt:s t C D v A eo t c rD, I r/rep l l cz ‹: 01, Applicant: ELI /1 uJG%'L Tel. No.: 6l7-964'5 b0 Address: WI /j?eke / 4 4, //`n 111A 6e tat Date Filed: Y/2-1 **/f you would like e-mail notification of sign off please provide e-mail address: Owner Name: Pa 1 �„� c c IZ� Owner Address: S -e- Owner Tel. No.: fe".'" 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.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note:Floor plans not required for decks,sheds, windows,roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: DATE: 1/(/ // PLEASE NOTE COMMENTS/CONDITIONS: V . '. •PjAi' i Cr ' 'tillr 1 I /r . - /-- No. Ce ? 4/011l i Application fora Permit to Build pre 0 �� LOT RELEASED BY Fee must accompany this applicatio 0 � 3 PLANNING BOARD 7,', Yarmouth Yarmouth 19� DATE( .. / /q0 / , l/ gr TO THE BOARD O SELE�( / "/90Z The undersigned hereby applies for a permit to build, according to the following specifications: 1. Name of Owner POl..1SE440, Ar/1eitGC Address (.0 0 ecosm WW rA,P. iOO1t4 2. Name of Architect (if any) µ Am p N A L P(A,jy 6e RV l G E 3. Name of Builder ib Lby e.0 fsc lT a 4. Precinct No. r- Lot No. 1 10 Plan: Name or No. To* f I 11 it or 1 g 5. Name of Street) A.S . 4 V . I O - S/ff .or.,29 6. Purpose of Building 17*/2L(..iNy agwz. - 5104LC R. ,• 7. Material GO M Gf211TI1 -POO µ ow I s ' N � Wetoo GIZK rrita, 8. Estimated cost of building f /at0 9. Dwelling yg, SSG, -i,z4 -a fas.,,,,.4 S7/ 10. Cottage — *4• i s r' 4titi 1,,,, ¢ 3 - $,IL, S&costae P/vim 4ov # ! — 1C ^ /o•-- 11. Heat i e5 /500 4 / - lc(6-4 12. Basement 1E5 lc,t o / 1/ 13. Garage I,j O * n Aro --• 14. Store U o —DiP l — D. 15. Shop NO Sew' ZS 16. No. of stories 2. 7. 3 17. Is there to be a Store in the lower storey 1V 0 i 18. Size of Lot. No. of feet front ct 0 No. of feet rear a No. of feet deep ...1.0.0 i 1 19. Size of building. No. of feet front 7 No. of feet side ...,v" No. of feet rear 7.%i 20. Distance from nearest building: Front VI 'F ft.; side. la ft.; side ' ' ft.; rear...5.0 30 17 i ' 21. Distance back from line or street �t'� , from rear lot line side line ( 1 Show by diagram the location of propsed building with relation to-d(stnces a from adjoin' is on reverse side. ) Name met, / .. 4� , ' Address 0 06 9c7 .1___NS*1lrl l 14 Gu =NI 1 : 3"Ii • . yi parr 1 •199bk _ 4lno.H .y,), • . . 0289-999 /9V-7:41e7/ ) 3(11 ._.994 ki,.•• :061 ,1 1 f: _ .avoy -?iY1:iiii-ir- I W Nl- 1 . d._IQ1 J .. o11tl el h n of 1# -- Iv f/ o - . j 1 : -gN1 :do PAY7 OlYli1 '2 3Hl • �. . � f:A; , ,�, . of W2IOd Mo7' Q/ii•y._Ta31Y1larfl �I ' , • t� -,��,04�'‘ . -- :Ft/ oil�►x,•7 ci fio/LiV rraY 4it 313' - blY/1slx1 sta.1P/1L 1,d11a37 I •11rl4' 11�380b /1. Z►�� �� . � ,• W - • 1-.7*-''. --.r,4. - -• - . . 4 771-41°-24, 2. • - ins oHti �� S`6 #- � .. • - --•01 .1'1 -- . • �9TOSroNd' • MOW . s • . •.. -. •H S318HH� r .• .• . ' I� 7L ? - . 41 _ 31d0 1d30 t13 _ M W1flOWHt11� �... - aI• � $ twin J : SMV1l�a N!v\O1 . )QcY • 1IVO! -. S. OOisnvj ucim . z, • s- %_ • • 6 % / kj I I\% it T . .11 , • 4 obi _-_f :.- - - --' -. u . I IA to t - -b$t 1�0.1 . • 9LI O S113SI1H3VSSVW'3SO1:113W - sia• • WAS • • s31VIOOSSV a131 3 'a - .. �4 �d 11b.=b 061 S .L.-1si w •' I I ' g \ 53 C't-t. .1ea IA Qa.�o'1d�N 1� i YARMOUTH WATER DIVISION 99 BUCK ISLAND ROAD WEST YARMOUTH, MA 02673 PH.: 508.771.7921 FAX: 508-771-7998 BUILDING PERMIT APPLICATION DEPARTMENTAL� SIGN OFF TRANSMITTAL SHEET Bldg. Site Location `/-11#14tcs'llus{!/- /`r�j✓e Map #: Lot #: GA,tn e 40r Ct/,r-.(hs>5 t�o✓ �. Pi flee_ t.(] i Z Proposed Improvement: 1 rKV n�; Applicant: Au / Ee,(5-c-; { Address -^-1.-C- Tel. #: 6/7-t6'3&'a Date Filed: 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 Commission: Determines Compliance to Wetlands Acts; i.e. If Lot(s) Border any Type of 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... d -/ - Sir.ture of applicant Date PLEASE NOTE: COMMENTS: 4 Reviewed by: Water Division ate SEP i 2 LU19 HEALTH DEPT • CN Pv ' _ '� F , 3d �'ifr by Er 1c r rnz wr: ' L- X is'1+.14 b/u 5t 11'A 5' SEP 161019 HEALTH DEPT f `�R TOWN OF );, <Ch'7t, UTtH REVIEWED FO"911"CINS ANC 2ONI;,3 CODE COMPLI- ANCE. ERROk;; ...,ISSIONS DO NOT RELIEVE THE APPLICANT FROM THE RESPONSIBILI1 Y OF"AS BUILT' COMPLIANCE. _ DATE: C/ del '1' 9UILEINl FILIAL 2 4? r 7L ' ._, . .... .. ...... .. . . . ..ied- 1..,.,,,,,,rr?.:.. .-.4,41--,...,-- . .• .. ... I*.-°-;=..._,,,,..-...., ..,.i......,.st:-..,..... ......-.•:-57,:i ..:-.:;.::.:_n-:..,:,,.;..,„.:. .,......,. : .. .... . :!,-,,,-..,,:.-i,.-4,,,.' 4,71„:,-„-.:..: ...,,..,....::::,:::::.v:f...„.::,. .::_ _., -- a: :0, : - - - -- . 1, - t-7-7--- 1;.'''' ''.-- ' • ' r . ,. l', I Ii --,r"7"-----'''''''''".-if77.'-- : -•'- t t, , , 00 ter. f s. �� • :� ' c� �' 4?�- 7 r # S+w�� C ,_:r s.; -ate ��' +� � Cs 4'.�5 : a PallcH ~x1b"� , Cone�i n� Pub ! 112:'x,z" 4 kr Zjt tb" gb 64 R•ks IIs— °1 / Pvi v+�90 � C 7 \l Z� y Q t2 r*d . ve.f_rn der. y g42 7p isa.,.� 0o1.4.,_.v,q u3-4:_4p l 9 ,,G ,.2r 4 I/1sui '5 sad sus ailp 5 „yf u/ J dj 17 L 1 $xS f t tIor yr £ /I'Sl�"( _ �'4 yam. *.j S# a. ." - y A'4.z ',i jxat Yefl.-wFva' ,' ,"`t "�r!' `#. - - -ai'�h.'S 1 xp • ,� Oro y �k 40° f 1 N , Framing Cross Section 5" Ledger Lock Screws 1/2" Plywood and Architectural Shingles 2"x10"Roof Rafter l Metal Wind Strap Metal Wind Strap Double 2"x10" Beam � • Existing House Joist Hanger 4x4 PT Post 8'-0" Existing Deck/Platform / . r Post Strong Tie • Galvinized ► • With 2"Anchor Screws ' .4_________ 12"x 4' deep cylindrical cement footing Existing Grade \ f ,, S?".E1l � �„ 0o11•1\t, • (.