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HomeMy WebLinkAboutBld-20-003893 ear):,(..ee,k 1 Inizo 4I, TOWN OF YARMOUTH Idin Department µ glitilr'.. (508) 3 8-2 31 ext.1261 BUILDING Le r 4 ' 4 PERMIT NO BLD-20-003893 PERMIT ,r, ,� „or ISSUE DATE 01/17/2020 JOB WEATHER CARD APPLICANT PETER W WATTS • PERMIT TO Alteration AT(LOCATION) PUNSTER PATH,WEST YARMOUTH, MA 0267 1 ZONING DISTRICT R-40 Bldg.Type: Residential SUBDIVISION MAP BLOCK LOT 086.80 I BUILDING IS TO BE: CONST TYPE ;(V B-1 USE GROUP `R 3 r- _ w... CONTRACTOR 1 REMARKS Alterations per approved plan 780 CMR MSBC, 9th Edition-remodel existing [ r.__ 3 { bathroom(508-776-2470) .. _..,_ `� LICENSE CS-086599 11 � :Construction Supervisor , 1 € PETER W WATTS � �� . . .. � _ IPETER WATTS AREA(SQ FT) 436 427 640 EST COST($) 10000 00 ' PERMIT FEE($) 150.00 l 1 Box 97 .. .,..m_ f CHATHAM, MA 02633 OWNER - _a MARK DELANEY 9 __ . ._ ! BUILDING DEPT BY i ADDRESS ,50 ETHAN ALLEN DRIVE m..... ;ACTON AMA 01720 �_` HONE ,. .. . I � � �,°° 4 ,,_ __.r __. . , _._.a THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWAL OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON WHERE APPLICABLE CONSTRUCTION WORK: 1)FOUNDATIONS OR JOB AND THIS CARD KEPT POSTED UNTIL SEPARATE PERMITS ARE FOOTINGS.2)PRIOR TO COVERING STRUCTURAL FINAL INSPECTION HAS BEEN MADE. REQUIRED FOR ELECTRICAL MEMBERS(READY FOR LATH OR FINISH WHERE A CERTIFICATE OF OCCUPANCY IS PLUMBING/GAS AND COVERING)3)FINAL INSPECTION BEFORE REQUIRED,SUCH BUILDING SHALL NOT BE MECHANICAL INSTALLATIONS. OCCUPANCY 4)REFER TO DETAILED INSPECTION BEEN MAD UNTIL FINAL INSPECTION HAS BEEN MADE. SCHEDULE POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTIONS APPROVALS OTHER: I • WORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF INPSECTIONS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN CAN BE ARRANGED FOR BY TELEPHONE APPROVED THE VARIOUS SIX MONTHS OF DATE THE PERMIT IS ISSUED AS OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION NOTED ABOVE. ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department ...._y 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 -211 Massachusetts State Building Code, 780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number:13L j2Li �3 Date App ' t, r �eflcs r — o Cll 3q Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors M Parcel NuV 2 o� 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 i 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❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: /44 A'r U&'/A'V C-Y Ac j-bAl /n n / 7 2 Name(Print) City,State,ZIP / _5 o r7rq.✓ ALL it-' p": j'73' .3 9% o o S�5' y_S-c) (c�� No. and Street Telephone Email Address C,M SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building.Building fa Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units Other III Specify: .9, 7W- /; 6), e L Brief Description of Proposed Work2: R�/noL .qN0 Cc 13,41- n-r e3c�� lr/-A- T Y/z- A V 1 %�/ 7-(..42/Se./o wER C.vi f/PG.44 2 L/cL/7-5, ,-sgni� �C �ti y'z-/717S SECTION 4: ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee:$1 SO Indicate how fee is determined: r'/3su. U� - 2.Electrical $ RI Standard City/Town Application Fee 3.Plumbing Z' o C. `� 0 Total Project Cost3(Item 6)x multiplier x $ 3 6 S , a o 2. Other Fees: $ SS 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ /0, 6 r;C• o v 0 Paid in Full Outstanding Balance Due: S a/A- V CO • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS cs(z y�Z za p License Number EApiration Date Name of CSL Holder List CSL Type(see below) Li /(--) v'r.x 9 7 No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Ct-t77--77/147V-i m 4 (-9 2"E 3 ' R Restricted I&2 Family Dwelling City/Town,State,ZIP IvI Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) /y2 y -a- 7/z3/Z0 /0c2 L� Y HIC Registration Number E,piration Date HIC Company Name or HIC Registrant Name 7� SiT%S[,w /'r')L £- rC` ��� 77JCO�Cu I/- It No. and Street Email address C t�-13Tff-dT n. in A— O L( }?j City/Town, State,ZIP 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. 71219 Ai 677 (SEC— n / —/C%-- c.: Print Owner's Name(Electronic Signature) Date • SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my na low,I hereby attest under the pains and penalties of perjury that all of the information contained in t ' a ication is true and accurate to the best of my knowledge and understanding. /-2_ -- Z U c 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.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) 4/3 (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" _�a _ '� The Commonwealth of Massachusetts A 1, Department of Industrial Accidents NII,- 1 Congress Street, Suite 100 "41-_ ,�_ 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 Please Print Legibly Name (Business/Organization/Individual): /E f` 1-c.., // Address: p 0 Box. o, 7 City/State/Zip: c - ,,,, u z E 3 3 Phone #: S-t, is---7-7 b - 2'7 7 c, Are you an employer?Check the appropriate box: Type of project (required): I.04Cam a employer with _7 employees(full and/or part-time).* 7. El New construction 2.E 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.E I am a homeowner doing all work myself [No workers'comp. insurance required.]t 9. Demolition 4.]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.E Electrical repairs or additions proprietors with no employees. 12.E Plumbine repairs or additions 5.0 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. insurances 13• Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 1 ❑Other 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. I.Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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: L., /,Vc r-c:,,e__r Policy#or Self-ins.Lic.#: 1UC.5 ? S 36 7 >%Oo 2 ! Expiration Date: hie f/2 a Z c Job Site Address: a 1j,../.v.s -erg ,p City/State/Zip: z2�?ivtil_5 ,yj 4 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 n r the pains and penalties of perjury that the information provided above is true and correct. Signature: L„t-P,_ C�-� Date: j- >o- 2 c Z_6/ Phone#: Ste ' 726 -2776 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#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 2 P - Work Address Is to be disposed of oat the following location: S Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. -/ ZuL u S gnature of Application Date Permit No. Homeowners Authorization To whom it may concern, 1, MAU FA.DEu4 r EY owner of the property located at 2 Dunster Path, Yarmouth, MA hereby authorize my contractor, Peter Watts, Construction Supervisor license CS-086599 to act on my behalf in all matters relating to permitting and construction bathroom remodeling job at the above referenced • ProPerty, Sincerely, 4 1 ( Zolo • Signature Date Pot av# 44Ie i 2 DOhs kAr we4i yaf/►'Mouth Sec Barrnlntle Detd5 600k.320114 pc9e 5-e dokd 5 -20)5 6D F 1!UM Dr. AGkon Mg 0020 ) Off Cape address c/o Pin-, De/4nel cl Pp, ew,of col- ® A neiej. ton, Or 91 e' Yt ti- g4 Oi051 DEL Q .,ei Atm,c y 60 ® q ►._ . Email. Phone t heekbY aClaw% tilAA 1, tde, ;nk4o/ fo Occupy .z ,�vnSkn P004, fie' i yti/ma, , $19 ao A reg.;iftibeL on or 6e-bre_ 1- 9- Zogo• do (h 4c. I, is I 11.141 dale 1-9-2-0 - _ Q5CCa eoparr saki otataaaftek ael4 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:individual Registration ;:,._ Expiration 142462 07/23/2020 PETER WATTS D/B/A PETER WATTS ROME IMPROVEMENT PETER W.WATTS /`""-"- 75 STETSON COVE LN CHATHAM,MA 02633 Undersecretary Commonwealth of Massachusetts IfDivision of Professional Licensure Board of Building Regulations and Standards ConstRiet l igiipervisor CS-086599 Spires:04/02/2021 • PETER W WATTS - PO BOX 9T 4. . „ CHATHAM MA 02633 Commissioner ©® CERTIFICATE OF LIABILITY INSURANCE °"TE(MM`NNYY") THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(Iss)must be endorsed. If 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 confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Craig Vokey CRAIG S VOKEY DBA MARK T VOKEY INSURANCE ,xtp (s08 945 353s T FAk MAIL IAIC LoL P O BOX 1247 ItDDREss:- cra►ggivokeylnsurance.com w WEST CHATHAM MSURER3stAFFORDetGCOVERAGE _ ` NAIoe , HATH __ MA 02669-1247 INSURERA: LM INS CORP j 33600 INSURED PETER WATTS INC INSURER e;_ INSURER C DBA PETER WATTS HOME IMP ROVEMENT IN,_SLR„€,R D PO BOX 97 INSURER E CHATHAM MA 02633 INSURER F: i COVERAGES CERTIFICATE NUMBER: 448432 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Lre I TYPE OF INSURANCE wyDd f I POLICY EFF Pd ICY FJIP �< POLICY tMMmDrvyrllrsrM/oDryryYl uMfTS c COMMERCIAL GENERAL LUteIUTY I rEACH OCCURRENCE $ CLAIMS-MADE J OCCUR y i I 11 t i MED EXP(Arty as person) ($Li N/A PERSONAL✓4 ADV INJURY t$ GENL AGGREGATE LIMIT APPLIES PER: III I 1 1 GENERAL AGGREGATE i$ PRO- U i `POLICY JECT L� ' IPRODUors-COMP/OP AGO z i ,OTHER: $ ._.... j AUTOMOBILE UABIUTY ' glibNGLE t3M,T !ANY AUTO I ?ALL OWNED BODILY INJURY(Per person) $ SCHEDULED I-....-{AUTOS I..__I AUTOS _ N/A BODILY INJURY(Per aeddam)F i I HIRED AUTOS NU ED F PROPERTY DAMAGE I r I ..1EIEIDt)—..___ . lµ UMBRELLA W1B i OCCUR j 4 I ^-_ I EACH cx OCCURRENCE 1$ l EXCESS UAB a ID Ms MA N/A I r 1 I 3AGGREGATE < D � I RETENTION;< e€0 � 3 }} $ i ANDCYERS'UAB ITY 1 1 PEA t Tf�- Xµra s TUTE : __ � =ANYPROPRlETOR/PARTNERlFJ(ECUTiVE Y/N EL EACH ACCIDENT $ 100,000 _ A p(OFFICER/MEMBERM In EXCLUDED'? NIA;WA I NIA WC531S387440029 106/25/2019;06/25/2020-- - fV_�yee describe tender E.L..DISEASE•FA EMPLOYE $ 100,000 I DESCRIPTION OF_OPERATIONB below ! I 1•EL DISEASE-POLICY LIMIT S 600,000 3 ! N/A 1 t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached IT more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization Is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of Insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www,rraSs,gov/Iwd/workers-compensationlinvestigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Chatham Building Ins 261 George Ryder Rd AUTHORIZED REPRESENTATIVE Chatham MA 02633 'E1 L ,Q I Daniel M.Cr. eey,CPCU,Vice President—Residual Market—WCRIBMA 01988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD k, 7tSte ......._) • 414 B /t0,d 1 A /NT5Iioi , AQcf rn f irFt No Exr4terO / 41- 44 gdrrtorwit 41Y -?9" rt, eenfA roe S alom4 /v / //-►//Vt /72 0121 ,i c.97 - S /vo /-/SL-14:_,.e1 no A-) TOWN OF Yff:Lr MOUI E H I;EVIEWED For'WILDING AND ZONI 3 CODE COMPLI- / NCE, ERRORS OR 0 o,',ISSIOi'S DO NOT RELIEVE THE AI i-ICANT FROM THE RESPONSIBILITY OF"AS BUILT" COMPLIANCE. DATE: 1- 1)'a0 ,....)--z1„---, BUILDING OFFICIAL