HomeMy WebLinkAboutBld-20-004260 ED
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BUILDING DEPARTMENT Permit expires 180days from
By3 issue date
EXPRESS SHED PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth, MA 02664
(508) 398-2231 Ext. 1261
CONSTRUCTION ADDRESS: k% i' C V �S 9- l N) G 1 tc R—v`A_o "•-. k
ASSESSOR'S INFORMATION:
Map: Parcel: e-‘f\.•-%.k.,- S„ �.--._s. .C ,
OWNER: C\A it 0-N.-E--S fJ c 11.4.1 W/-(;.)oo:t '- `-A-rN C 2 it - t t 6 '$
NAME PRESENT ADDRESS TEL. #
Email Address:
CONTRACTOR: C, V-\ SQ.'214*-y 5µE-.. 0)3s S c Rcli.
NAME MAILING ADDRESS TEL.#
Erna' Address:
esidential Commercial Est.Cost of Construction$ ,2 "
...)
Home Improvement Contractor Lie.# / FE 3 SZ Construction Supervisor Lic.#
Workman's Compensation Insurance: (check one)
I am the homeowner I am the sole proprietor I have Worker's Compensation Insurance
Insurance Company Name: Worker's Comp.Policy#
SHED INFORMATION
New Size L x W ` x H
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 an 2 feet to any other building.
Replace existing* Size L x W x H
*The debris will be disposed of at:
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 myieense auu or fr08ecution under M.G.L.Ch.268,Section 1.
Applicant's Signature: �- t1S ` A`` \ J .r1_ Date: c J '3 2-C3 0- 0
Owners Signature(or attachment) Date: �
Approved By: 1.....--""—e.T l.t Date: CI - — 0`0
Building Official(or designee)
Zoning District:
Historical District: Yes No Flood Plain Zone: Yes No
Water Resource Protection District: Within 100 ft.of Wetlands: ***
Yes No Yes No
***Note:Conservation review required if within 100 ft.of Wetlands
9/13
The Commonwealth of Massachusetts
tip= /, Department of Industrial Accidents
1 Congress Street,Suite 100
_lf= 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):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.❑I am a employer with employees(full and/or part-time).* 7. ❑✓ New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. Ej Remodeling
any capacity.[No workers'comp.insurance required.]
3.0I am a homeowner doing all work myself[No workers'comp.insurance required.]t
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.❑Plumbing repairs or additions
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
6.2We are a corporation and its officers have exercised their right of exemption per MGL c.
14.❑✓ Other shed construction
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.
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:
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: 02/03/2020
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#:
• 7-?P*iorxnzancaea/f ^itia icAuQe/!!:t
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE:Corporation
Reoistratioq Expiration
188352 07/19/2021
SALT SPRAY SHEDS,INC.
ANDREW WARBURTON
235 GREAT WESTERN ROAD
SOUTH DENNIS,MA 02660 Undersecretary
•
PLOT PLAN
FOR LOT #
Indicate Incalion of garage or
AdditS�ons withdashed accessory b
�� disp�i (cesspool) 469
0
1
I GICk ft— rear)
Abutter's `r b �ti I
Name � Abutter's
Lot# I Name
Lot#
If this is a REAR YARD If this is a
corner lot,
write in �� ft. corner lot,
name of street. • name of street.
I • a
4
: SIDE YARD
HOUSE SIDB YARD •
. •
.
.
•
. I
I .
•
•
SET BALE :•
s •
•
(lot ft. )
/
• / (NAME OF STREET)
—4 <—
/ Inbormation C. ..`` `( C- ..-
Supplied by
f3vt3 3
•
Y
.0 TOWN OF YARMOUTH RECEIVED
,, 1146 ROUTE 28,SOUTH YARMOUTH,MA 02664-4451
Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 JAN 2020
RECEIVED OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITT YARMOUTH
e ' KING' HI
" GHWAY
JAN j 8 /1I?O APPLICATION FOR
TOWN CLERK CERTIFICATE OF EXEMPTION
SOUTH l Q i 1I hMbby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of
Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs
accompanying this application.
Tvoe or print lealbly:
S N \. C t'1 v h.,p. ,Q '2 , ,) r. 'b
Address of proposed work: ��_ Map/Lot#
Owner(s): C t- <-VA" 6 A-..\ \ K a .)-,c• ...> Phone#: 9 0 4 b SS ')-`)- t 1
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
C +--� v .P..
Mailing address: \-� `�`'i � S) 'C� t J S- Year built: \ R �
t a ` , ii�
Email: C � \ �� � ` CPrefeferred notification method: Phone Email
Agent/Contractor. �'l �k S c G 1 S. L- Phone#: S Q S % V C" ��
Mailing Address: L'E is c '- c_'� t,-) c- '11 c t.,. 0— Co ,�
Email: Preferred notification method: Phone Email
Description of Proposed Work(Additional panes may be attached if necessary):
Elrt ck • v... cc. ` d X .% G' c.:.ccke_
stir\� d-- Q\� .../ v ‘^ ' c J ,r.,,'C •
C ` . /` , -_..__ A Vt� )- tJ
Signed(Owner or agent): A. Date:
> Owner/contractor/agent is aware that a permit may be required from the Building Department.(Check other departments,also.)
a This certificate is good for one year from approval date or upon date of expiration of Building Permit.whichever date shall be later.
For Committee use only: /
Date: I,a'{./9 Approved Approved with changes •:nied
Amount (C Reason for denial: A P>!..ROILED
CasN _'CK#: /
140 JAN 2 7 2020
Rcvd bv: U 1/ Y�RMOUTH
OLD KI (:s HICi WAY-
Date Signed: //2 7/ °2'6 Signed: Y ` i
APPLICATION#: ;it GCJ-
vs.2017
•
PLOT PLAN ,_.
•
FOR LOT 4 -
41v 2 4 2020
Indicate location of garage or accessory building yAh(w":
Additions with dashed lines `ALL,; , u,,-i
Sewerage disposal (cesspool) ® G S Hie,
Sewerage
Well j$
I I
I ' (lot ft. near) I
— _. �� .t,. /APP. OVEb Abutbor'
Abuttor s
Ncot 1# ✓Iame ' �� j JAN 2 7 2020 totName*
I
YARMOUTH
f this is a t REAR YARD • C)lU KING'S HIGHWAY
corner lot. _ i ft. corner :
vrite in name I write i!
of street. 40 -k 1 name of
St: • 1 is other
b47. b street.
40 — 0 _, 4
SIDE YARD P�`a �.HOUSESIDE YARD
L v K'C
I
I
1 -- S
SET BACK
� 1 ft A
1
1
clot ft. frontage) JAN 18 ?u?;)
\ // SoUTy Wid CLERK
a!<MQUTH, MA
/ (NAME OF STREET)
Information C 'V � t
-- s — .\/ Supplied y l
!ARK NORTH POINT
•
Dawn
Ok this looks fine. 'Ne will move ahead with this. Do I need anything
else from you to make an application for permit
Nigel
11
:)n Jan � , 2020, at 3:39 PM, �=saltsprayshecisinc<"comC 3st,rlet,
saitsprayshedsinc@comcast-net>wrote:
Hello.
it was a pleasure speaking with you this afternoon. Attached is an � ���®
estimate for an 8'x 10' Even pitch. It includes the standard features
'N and the addition of cedar shingles on the front .,ail. J:� 4 2020
If you have- any questions on your estimate, want to make changes, or 1 vdot lid
OLD KING SchI•
like to set up a building date please feel free to contact us at the wAY
office
(508)398-1900. Also, I will send over the forms for the historic
committee and the building department, if you need them
We look forward to working with you. APPROVED
1
Bost Regards, JAN 2 7 2020
Dawn
Dawn Warburton OLD
yARMpD��-;�
Salt Spray Sheds KING'S HIGHWAY
50f1-398.1600
A°,: iitspraysheds corn<Est 6184 from Salt Spray Shed., 26468 pdf,•
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LEFT SIDE ELEVATION FRONT ELEVATION
8' x 10' SHED DESIGN FOR:
Salt..Spray Shells
THOMPSON
PROPOSED SHED ELEVATIONS Al - 2
i RECEIVED
I JAN 2 4 2020
IYAHMOUTH
OLD KING'S HIGHWAY
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041
RIGHT SIDE ELEVATION REAR ELEVATION
8' x 10' SHED DESIGN FOR:
Salt SpIWY Sheds
THOMPSON
PROPOSED SHED ELEVATIONS A2 - 2
RECEIVED
JAN '8 ?UM
TOWN CLERK
SOUTH YARMOUTH, MA
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