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• ONE & TWO FAMILY ONLY- BUILDING PERMIT
Town of Yarmouth Building Department .......r'
1146 Route 28, South Yarmouth,MA 02664-44924.1.1PW
508-398-2231 ext. 1261 Fax 508-398-0836 + ',.$::,
Massachusetts State Building Code,780 CMR I;.
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: %L .p•'0_0() ,'SC7 Date Appli
Seen J VC-6'lCN
Building Official(Print Name) Signature', Date
SECTION 1:SITE INFORMATION
1.1 Pro erty A dress• 1.2 Assessors Map&Parcel Numibers3 , RECEiVED
1.la Is this an accepted street?yes / no Map Number Parcel Number; l g
1.3 Z,Qning Information: 1.4 Pro erDimensions: / l,}. SEP - 2019 1
77
Zoning District Proposed Use Lot Area sq ft) Frontage(ft) P C1�''�� R�-;%`"��LL�y,y
2-
1.5 Building Setbacks(ft) ` __` "�
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
-7r- .2--o 2v -mod _ .,. ifir
1.6 Water Supply: (M.G.L c.40,§54) 1.7 FIood Zone Information: 1.8 Sewage Disposal System:
Public Private 0 Zone: ^ Outside Flood Zone? Municipal 0 On site disposal systen> �
Check if yew
SECTION 2: PROPERTY /O/WNERSHIIP'
O 2.1 wl of Record: 1 — Js oivrh /) &6 '/
Name(Print) Slone)/,.�i ,,�.. . . City,State,ZIP
/3 m4 4 cd ,04'V 410,9444'r is=/4w
No.and Street Telephone Em Address
SECTION.3::DESCRIPTION OF PROPOSE D WOW(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied ❑ Repairs(s)jiir., Alteration(s) 0 Addition 0
Demolition ❑ Accessory Bldg.0 Number of Units Other 0 Specify:
Brief Description of Prq�p_sed Work2: T �•OPS AA, 7d A"iJfrI/i�J s
DL�/4u P/ o 92 i<� (J 4/!/k ,4
' ,v/ ' fi l "yArie
I'/NOBGn 1L/�-i/ A'A
.
SECTION:4:ESTIMATED CONSTRUCTION COSTS. . 1 ,1,
Estimated Costs:
Item , Official Use Only
(Labor and Materials) ..
1.Building $ 25' :1 Building Permit'Fee:$1.0. Indicate how fee;is determined:
2.Electrical $ ' *Standard City/Town Application Fee:
❑.Total Project Co einj)X multiplier _ x - • . .
3.Plumbing $ 'r— 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire
Suppression) $ Total All Fees.$
✓� CheckNo.,V Check Amount: .Cash Amo; t:� '
6.Total Project Cost: $ O Paid in Full +Outstanding Balance Due: 1► —
`; SECTION 5:.CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) �� 9-/-‘
_
4
C4_zsforvVlk Le Expiration Date
Name ofSL Holder
2 /,4� oe J,([Z. List CSL Type(see below) V
No,and Street j4 &Jijt't
%vt Type Description
V U Unrestricted(Buildings up to 35,000 cu,ft.)
/ v/ R Restricted I&2 Family Dwelling
City/Town,State,ZIP ( M Masonry
RC Roofing Covering
WS Window and Siding
f y� SF Solid Fuel Burning Appliances
ili- �� 'l y iti;4 4 p ,(/ •(pjl I Insulation
Telephone Email dress D Demolition
5.2 Registered Home Improvement Contractor(HIC)
P. U d /,3se g? /v a0
HIC Registration Number Expiration Date
HIC CCo� or HIc-deg ant Name
No�nd �
, �4o6 41177 flail address
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 No ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
• OWNER'S AGENT OR CONTRACTOR NAPPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize /ll k,V O,11,c
t on ehalf, all matters relative to work authorized by t is building permit application.
1 ��Print O( r'sNathre)(Electronic
(....„..._
• SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pins and penalties of perjury that all of the information
contained in this app ication is true and accurate to the best of my knowledge and understanding.
hi --#
Print Owner's r 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.eov/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
07, Department oflndustrialAccidents
.--: ,
— lltl• = 1 Congress Street, Suite 100
G 1,.c Boston, MA 02114-2017
ay" • www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information PIease Print Legibly
Name (Business/Organization/Individual): . /s/4 eDcYri r CA4t PeN 41-0 L 4
Address: o Q 4( Gifti j 2 g -P1' •1,1
City/State/Zip: s• rodemoutlnlrk. C324.64 Phone#: , Z:3%• '7771 •q4z?
Are you an employer?Check the appropriate box:
Type of project(required):
I g1 am a employer with employees(full and/or part-time).* 7. El New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. [ZRemodeling
any capacity.[No workers'comp.insurance required.]
3.0 I am a homeowner doing all work myself [No workers'comp. insurance required.]t 9. [1] Demolition
4.0 I am a homeowner and will be hiring contractors to conduct all work on mYP property.ro I will 10 Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.0 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.t 13.0 Roof repairs
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 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 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: 41/yl AlUftAN-L /NS' ea
Policy#or Self ins.Lic.#: Awetgoo3q17a.20? A Expiration Date: 3- 12• ZO
Job Site Address: 9 /mil/1-C'lel&2 1 L? City/State/Zip: . Y'1€ - j21( Q926,6((
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: AAA- Date: 7�'-15
Phone#: Sa '771 . 942-7
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
o c BUILDING DEPARTMENT
?. • x 114-6 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 1 l 1.5,
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at /3 Afre/ -/,:tc.
Work Address
Is to be disposed of at the following location: )'ii w/l
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
Si_is :tune of Application
Date
Permit No.
omrrcrwean iassacasuseir ,
Division o`?.'dfesstor,a _C• si
Board of Building Regulations and Standards
Co^lstructior`! Supe'rv'so;"
CS-081139 Expires: 09/16/2019
14,
MICHAEL J NARDONE
299 WHITES PATH $
SOUTH YARMOUTH MA 02664
a�n
Commissioner CL
("Re omi),-m,ea4l/C ^`41.ii dfe;(16
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE:LLC
Registration Expiration
135887 08/14/2020
M J NARDONE CARPENTRY LLC.
MICHAEL J.NARDONE
299 WHITES PATH
SOUTH YARMOUTH,MA 02664 Undersecretary
Registration valid for individual use only
before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
1000 Washington Street-Suite 710
Boston,MA 02118
•
qirlet /'".%"`
of valid without signature
o`e Y44' TOWN OF YARMOUTH
4• 16o HEALTH DEPARTMENT
• e`- PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant: t!�
Building Site Location: g �" j
Proposed Improvement: LYVrr' i/4_ 17 :-e- 62,4,e5
5v W R.ao van •
Applicant: /K /0172I1 Tel. No.: 'Z • 77( 9fZ7
Address: 0 1 `'GCL'c 7�`L- C- Date Filed: 7' 'GI
"If you would like e-mail notification of sign off please provide e-mail address:
Owner Name: e,4,5,
Owner Address: /2 4-4ei iZ1 Owner Tel. No.: 544" 22/9 ?
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: _____nr------- DATE: 7 ------ O -I c'C'`
PLEASE NOTE
COMMENTS/CONDITIONS:
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13 MACKENZIE ROAD,YARMOUTH,MA i ingenuity ING19069 July 17,2019
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REVISIONS
)02.6 MM/DD/YY REMARKS /...1
%. 1 07/17/zoi9 FOR CONSTRUCTION
Porch Front Elevation 2
3
13 MACKENZIE ROAD,YARMOUTH,MA -Colina Remodel- 4
5
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REVISIONS
MM/DD/YY REMARKS CV
07/47/2m9 FOR CONSTRUCTION
Right Porch Elevation :::;:11.,s, 2
3
13 MACKENZIE ROAD,YARMOUTH,MA -Colina Remodel- 4
5
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REVISIONS
MM/DD/YY REMARKS Cr)t4 ,,...� 1 07/17/2019 FOR CONSTRUCTION
LEFT PORCH ELEVATION `° °",
2
3
13 MACKENZIE ROAD,YARMOUTH,MA -Colina Remodel- 4
.11
5
tSHOFM-
EXISTING OVERFRAMED 4 g �
�
RAFTERS TO REMAIN 2,
0LAR$JEN$EN
DORMER WALL MUST ALIGN WITH BEARING VERIFY EXISTING OR o STRUCTURALA
EXISTING DORMER WALL AT 1ST STORY(GC TO V.I.F.) FRAME NEW BEARING '� -+
TO REMAIN WALL W/MIN.2x4 STUDS No 50602
q
!1'' AT16"O.C.TOSUPPORT �O cisr�' k.
I: I EXISTING OVERFRAME& S �t`--
_ bG R _l - 1. NEW ROOF RAFTERS '`- .i
' 2x1dLEIIA*R' EXISTING LOWER ROOF _F / /201/
f j 1�is FRAMING TO REMAIN
IA
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NEW(3)-2x6 x CONTINUOUS
(SPICE NO MORE THAN ONE OF 3 PLIES
ATOP POST SUPPORT,TYP.)
3f% 3f"
29'-1"
NEW LOWER ROOF FRAMING PLAN
KEY NOTES:
ROOF FRAMING NOTES:
1. ALL ROOF SHEATHING(UNBLOCKED DIAPHRAGM W/PANEL LONG AXIS PERPENDICULAR TO RAFTERS,STAGGER LJ SIMPSON"LRU28Z"SLOPABLE FACE MOUNT HANGER,NAIL W/(6)-10d AT FACE,AND(5)-10d AT RAFTER,TYP.ALL
JOINTS)SHALL BE NEW%"THK.APA RATED SHEATHING,NAILED W/8d ANNULAR RING NAILS(DIA.=0.131"x 2.5" COMMON WIRE NAILS(0.148"DIA.x 3"LONG),TYP.
LONG)#4"O.C.AT BOTH PANEL EDGES AND IN HELD. b (2)-2x6 JACK STUDS BTWN WINDOW UNITS,TYP.
2. ROOF DIAPHRAGM EDGE NAILING SHALL BE 8d ANNULAR RING NAILS(NAIL DIA.=0.131"DIA.x 2.5"LONG)#4"O.0, CONNECT LEDGER VIA.(3)-ROWS OF 5"LONG LEDGERLOK SCREWS(BY FASTENMASTER)@ 16"O.C.INTO CENTERS
TYP.(INTO CENTER OF RAKE JOIST). OF EXISTING 2ND STORY 2x WALL STUDS,TYP.,PROVIDE 2"EDGE DISTANCE AT TOP AND BOTTOM OF LEDGER,TYP.
3. CONNECT ALL FRAMING RAFTER ENDS AT TOP PLATE AND HEADER SUPPORTS(AT ALL EXTERIOR WALLS)W/SIMPSON
"H2.SA"HURRICANE TIES,TYP.
4. REFER TO TYPICAL DETAILS&FRAMING SECTIONS. GENERAL SHEAR WALL&ANCHOR BOLT NOTES:
LEGEND: ALL NEW EXTERIOR FRAME WALLS SHALL BE CONSTRUCTED AS SHEAR WALLS MEETING THE FOLLOWING REQUIREMENTS
(2x STUDS @ 16"O.C.,TYP.):
102 D sc 2x BUILT-UP/ENG.WOOD COLUMNS BELOW — T.WALL BELOW SHEAR WALL TYPE"A":SHEATH WALL WITH 1 =THK.APA RATED PLYWOOD SHEATHING,NAIL W/8d ANNULAR COMMON
2x BUILT-UP/ENG.WOOD COLUMNS ABOVE WALL ABOVE RING NAILS(NAIL DIA:0.131")@ 4"O.C.AT ALL PANEL EDGES,AND 8"O.C.IN FIELD,PROVIDE BLOCKING AT ALL PANEL
EDGES,OR USE FULL HEIGHT SHEATHING PANELS.
(NOTE:MIN.NUMBER OF BUILT-UP WOOD POST PLIES SHALL BE CONSTRUCTED AS SHOWN ON PLAN.)
FULL DEPTH SOLID BLOCKING,USE 2x,TOE NAIL EACH END OF BLOCK,TYP. ANCHOR BOLTS:CONNECT NEW P.T.2x6 BASE PLATE VIA54"DIA.SIMPSON"TITEN HD"W/MIN.4"EMBEDMENT DEPTH @
FRAMING HANGER,SEE KEYNOTE FOR DETAILS 36"O.C.TO EXISTING CONCRETE FOUNDATION SLAB,OR USE DRILL AND EPDXY ANCHORS OF SAME SIZE&SPACING,TYP.
�e REVISIONS
°� MM/OD/YY REMARKS V
�4 •tt••a" 1 07/17/2°19 FOR CONSTRUCTION
NEW LOWER ROOF FRAMING PLAN ": 2
3
13 MACKENZIE ROAD,YARMOUTH,MA -Colina Remodel- 4 QI
5