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Home My WebLink AboutBld-20-001337 CO � Ait TOWN OF YARMOUTH Building Department BUILDING . ,,, (508) 398-2231 ext.1261 0 PERMIT + PERMIT NO BLD-20-001337 " � �"t d.s JOB WEATHER CARD '' ISSUE DATE 09/12/2019 .r._, APPLICANT Cotuit Solar LLC PERMIT TO Repair IAT(LOCATION) 1170 PLEASANT ST SOUTH YARMOUTH MA 026 ` ZONING DISTRICT Bldg.Type 'Residential SUBDIVISION MAP BLOCK LOT i051.92 I BUILDING IS TO BE: 1CONST TYPE <1 USE GROUP I CONTRACTOR REMARKS Roof mounted PV solar system. System consists of fifteen 320 watt modules .._��_.,.,.��_ ._.. connected with microinverters. Total system size is 4.8 kW DC. I LICENSE ;; r A- { f 1 z.......... . ..........-a. zA- .... ,.» ......tea . >.....:.,.,,.:.-.m...,.A... ,....,.A. .„. AREA(SQ FT) i 2 466 715 68; EST COST($) 18304 00 PERMIT FEE($) -150 00 OWNER 'SPENCER ABBOTT K JR TRS I i _, .�. . BUILDING DEPT BY ADDRESS IC/O ACHESON ELEANOR D 425 8TH ST NW IWASHINGTON ;DC 20004 PHONE ' THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIC4NALK 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. OCCUPIED UNTIL FINAL INSPECTION HAS OCCUPANCY 4)REFER TO DETAILED INSPECTION BEEN MADE. SCHEDULE POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTIONS APPROVALS OTHER: 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. : J 01''Z'gR Office Use Only ' 4. .! ��r D Perm O . ,` 1 . y r Amount S ve MAT7A M E'�SE 4. � �r oa. co �d Permit expires 180 days from '", �� t'issue date �20-/ 240 EXPRESS BUILDING PERMIT APPLICAT TOWN OF YARMOUTH E EV `. *, Yarmouth Building Department `a, ""s 1146 Route 28 South Yarmouth, MA 02664 ��P �� (508) 398-2231 Ext. 1261 oui 'r r, A St By _ i CONSTRUCTION ADDRESS: /5 \JCgn/Y , 471 ASSESSOR'S INFORMATION: Map: 66 F Parcel: irdO�''j oZ OWNER: 0,6Nrf7 4/tie, /_ J�ii ( ;q , ,5 Cl / f 7y6P, PRESENT ADDRESS TEL. # CONTRACTOR:A,,,,,,,,,), 51,1,,./3 rd .4 :,,,, z(5 /, I' TEL'#7q °" NAME-Residential ❑Commercial Est.Cost of Construction$ , dOO Home Improvement Contractor Lie.# /9f/ 8O Construction Supervisor Lic.# (.5 /4,? Y''*- Workman's Compensation Insurance: (check one) ❑ I am the homeowner 4-1 am the sole proprietor ik-Ifiiave Worker's Compensation Insurance Insurance Company Name: 14'6, rrvders Worker's Comp.Policy# 477 5'6 ( WORK TO BE PERFORMED Tent Duration (Fire Retardant Certificate attached?) Wood Stove Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares ! �Q (-Remove existing* (max.2 layers) Insulation Old Kings Highway/Historic Dist. ( )Replacing like for like Pool fencing *The debris will be disposed of at: e704,QeeLwdfj, 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 revoca. n of my license and for prosecution under M.G.L.Ch.268,Section I. Applicant's Signa re: _ U" Date: 9-G'—/ ' ti Owners Signature or attachment) ° A l, r Date: _79 Approved By: Date: .,— '7'," Bui ' g cial(or designee) L ADDRESS: Zoning District: Historical District: ❑ Yes ❑ No Flood Plain Zone: ❑ Yes 0 No Water Resource Protection District: Within 100 ft.of Wetlands: 0 Yes 0 No 0 Yes 0 No .74 The Commonwealth of Massachusetts =W Department oflndustrialAccidents 4Arj- 1 Congress Street, Suite 100 j' Boston, MA 02114-2017 `'M' www.mass.go v/dia 5Y Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information PIease Print Legibly Name (Business/Organization/Individual): iG k,74, i%A Address: P'4 / 715 City/State/Zip: J vre 44- 4f j' Phone #: 77 7 j 2/ 07 Are you an employer?Check the appropriate box: Type of project(required): 1..gal am a employer with O employees(full and/or part-time).* — 7. _New construction 2Iam a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8• Remodeling 3.0 I am a homeowner doing all work myself[No workers'comp. insurance required.]; 9 El Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on myproperty. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sol 11.El Electrical repairs or additions proprietors with no employees. 5.[:I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.❑Plumbing repairs or additions These sub-contractors have employees and have workers'comp. insurance.$ 1 oof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.El 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. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a 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: 1- ,e riemZe ors Policy#or Self-ins.Lic. #: s�6K Expiration Date: /.,6),40a6, Job Site Address: /5 jp.r K� City/State/Zip1`_ 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: `/ _/l f,fe 67 r r 1�`�ur �, /Jis/Date: , �/ Phone#: ! 1 7 5" 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#: