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HomeMy WebLinkAboutBLD-23-001935 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department of 1146 Route 28,Sough Yarmouth,MA 02664-4492 41-Lfil 508-398-2231 ext. 1261 Fax 508-398-0836 .,..,! Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling - E C E I V E D This Section For Official Use Only Building Permit Number: r3 Ci)—23� �C� Date Appli ' oc'rii 2022 r �} (n QA‘ !, /1 /(�ii BUILDING DEPARTMENT Official(Print Name) Signature O OV- SECTION 1:SITE INFORMATION 1.1 Proper Address; 1.2 Assessors Map&Parcel Numbers S thy se J /4 14) Yar,► N 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 ZoningInformation: 1.4 Property Dimensions: /2 - � Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) CC Front Yard Side Yards Rear ±'aid►DD E C E 1 V E D Required i Provided Required I Provided Required Provided DEC 14 2022 i 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal Spstem: Zone: _ Outside Flood Zone? Public D I y G lPA' N T Private❑ Check if yesO Municipal El site disO l�Ysiem I� ti' SECTION 2: PROPERTY OWNERSHIP' 2. Owner'of co d: au(u ,oe,. .viu e S k)e s3 ye .rou#-h 144- a -6 7 7 Name(Print) City,State,ZIP Nu SG be No.and Street u Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK.'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 1 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other $Specify: er.k �`� Brief Description of Pro osed W/ork2: / — � � alb/ n�v G, � P a e}.1 baG - SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.BuiIding $ '5 o oo ' f I. Building Permit Fee:$ I W6 Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ a -- Cl Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 3 SI VB 4.Mechanical (HVAC) $ List: (1; ..331p62 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amo t- 6.Total Project Cost: $ !S OCXj Gd ! 0 Paid in Full 0 Outstanding Balance Due: k;&iL I • • • • C t s T t. J . • k • • 41 } • a . a 1 . SECTION(CSL)S: CONSTRUCTION SERVICES 5.1 Construction Supervisor License j, 11 �e (li Ke/�e.ri e r' Licensee Number �g�<j�Expirat� r`� Date Name of CSL Holder / List CSL Type(see below) k an No.and Street �� � Type Description it; �( 114 D a / - U Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP [s - R I Restricted 1&2 Family Dwelling lV1 Masonry C 5�� 0 9 0V-6 S- RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances SO? 776 a 3 30 IA eG4i tps;_ I Insulation Telephone Email addr.ss D Demolition 5.2 Registered Home Improvement Contractor(HIC) l<3 I, y0 " y y� HIC Registration Number Expiration Date HIC C pant' ame or C Registrant Name No.and Streetatar/-e-e io i- toQ U�• re)N 1 /e'9 caf/d ftQ00 /3 f, S 6 g >76 ,, Email address City/Town,State,ZIP r � hi4 aat3 r 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 iel No . 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 t-dia e/ y,qy��.�rP to act on my behalf,in all matters relative to work authorized by this building permit application. te3iPrint Owner's Name(Electronic Signature) ate 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 this application is true and accurate to the best of my lmo;vledge and understanding. -5,... ._,Z, j/?//,9o,72- Print Owner's r Auth i ed Agent's Name(Electronic Si aturey� 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.aov/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 t Department ofIndustrialAccidents t=� 1 congress Street, Suite 100 f 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 (Busincss/Organization/Individual): � p Address: /4 S1reiez/1,00 d Df City/State/Zip:C a s NA- f ?S Phone A: 7 2 G V 3 36 Are you an employer?Check the appropriate box: —1Type of project(required): I lam a employer with / employees(full and/or part-time).* 7. [1]New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in anyc aci 8. Remodeling • ap ty.(i`io workers'comp,insurance required.] 3.0 I am a homeowner doing all work myself.(No workers'comp.insurance required.]1 g• ❑Demolition 4.71 I am a homeowner and will be hiring contractors to conduct all work on my property. 3 will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 1 I.❑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. These sub-contractors have employees and have workers'comp.insurance.t 13.0 r—�Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL C. 14.C Other der A 152, 1(41,and we have§ o employees.[No workers'w�cl:2rs'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: A- r ea,lee / r'm A.,S s Policy t or Self-ins.Lic.#: :c c_rco SD//Oy , o }...,A Expiration Date: t'S/1 r/`a.o 9 7 Job Site Address: /314a4Se/�c( City/State/Zip: e.s4-� O,267 Attach a copy attic 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 grit !al penalties of perjury that the information provided above is true and correct. Signature: Date: Q Phone#: c(j 7d 0736 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): I.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 508-398-22311 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 / N"s / ,e,1 e_; Y ',viz dui-1 Work Address Is to be disposed of oat the following location: Ya r mo u"14 Ld 1C7) Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. 3/3 Z Signature of Application D to Permit No. Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Individual MICHAEL AUPPERLEE Registration: 153440 169 SANDALWOOD DR Expiration: 12/10/2022 COTUIT, MA 02635 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 153440 12/10/2022 1000 Washington Street -Suite 710 MICHAEL AUPPERLEE Boston,MA 02118 cm N MICHAEL J.AUPPERLEE 169 SANDALWOOD DR �f,. � (,,4 ` ' '; L'�- -iC- �—� U1 aIi 112 COTUIT,MA 02635 Not valid wi t signature Undersecretary S' v. N .., Luc ,8 111 l' f)h p4 ,_i -u " 9 n m ,C i ..1 re . „. 0, W 0 10 A. c_ c9 0 01 aa822 .1~ 5(S E 0m < f_ E .�w 2 ->QQ t_ U > O Y O W 2 2 U 2,.., O d .0 — .. H E U m ,i U C.) AC.T.31?II CERTIFICATE OF LIABILITY INSURANCE 0A1t,11.11,4 ".,rt. 08103(2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER 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 TILE ISSUING 1NSURERISI,AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT. if the certificate holder is an ADDITIONAL INSURED,the policyfiest must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on i this certificate does not confer rights to the certificate holder 1n lieu of such endorsementis. r#tMUr_GA M <cr Christy Schneider McShea Insurance Agency,Inc 1 rnaNe ,c Nsi;50B>42,j 9)1U i506i420.901I ?A% 1645 Falmouth Road,Rt 28 BLDG D !EDMDA1rcss c9rnstyeincshealnsurance.cam Centerville. MA 02632 _.__. tNwRtR�Sly- CrmxAc:L YA11_• NSURGPA National Grange Mutual Ins Co. 29939 Nsu#eC Nsuece a NATIONAL GRANGE MUTUAL 14788 Michael Aupperlee =u#eNc AIM Mutual DBA: Michael Aupperlee Renovations Inc i169 Sandalwood Dr N'uRenc 1 Cotuit,MA 02635-2315 NSuett.L NsuitR r COVERAGES CERTIFICATE NUMBER: 00000$91.0 REVISION NUMBER: 1 THIS TS TO C.RTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NS)JRED NAMED ABOVE '-I=POLICY PER OD Ir CATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT IVTH h t:_I TO WHICH THIS CERTIFICATE MAY RE ISRURD OR MAY PERTAIN.TIE INSURANCE AFFORDED EY THE POLICIES DESCRIBED HEREIN IS SLIBJEC 7 TO ALL THE T E PIA': EXCLUSIONS MO CONDIt ONS OF SUCH POLICIES i>a'TS Suit'.%MAY HA+/E.SEEN RECUCED BY PAtC CLAIMS j RIM iYPC Cr INSI:A.AP AD *NVSUB C0LKr MAMCA ,wnro'Yr"Y' 1YMDI1'0.3LK's err POLICY tv, L.ItOIS ii# NSo W.4 A X COMIStRCUU.CY htStAi.LIA811.11Y MPJ26304 02fOS,2022 02N9+2022 :_.::,,,fcc ititeNct . 300.000 µ t furtEsti._ 500.000 -.. 10,000 300.000 r,;.�::rr. .L.,+.r.I Ar,•_1Ls 1t1t 600.000 X r,::1:' +ll.. 600.000 B A1,147A081LL LMBLIr- till T4893T 09+9012021 09+302022 ANY M19v - 250.000 Nittatear X 500.000 A1JYai4NI.0 X 250,000 tsleRe.LALMa ._..I, . tXCt88 UM +: ,,<<e »:.-..;.,,:. C teORRe118CtiYrGNSATION WCC5005011097-2022A U6+19,2022 0Y+134021 X '.`•" , _ _ AMI h�t.D rePar LWIUiY ANr Ml7r#kTGI6VARTNG1rY)fe':UYhe Y1R , + 500.000 rrrtttR.nn neR r1P'«¢rt C1:3 �J N'A 1re.er nyHA MR 500,000 f+..4.IiOit ci t8 s.ta. ..�. :.�': x�1= , 500.000 OBSCINP1WN Or OPIRATIO#S t LOCAIIONB r Vt1RCLLE(AMMO 1N AdiRNnrt Ra11.rN.Somme nay N..ttadied►war.spas I.n,oltt.d) • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUC ES BE CANCELLED BEFORE TIE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. Building Department AUTI4DNLae Ne?At SENT A net n iyr --1 --. ICNIBI S 1988-2015 ACORD CORPORATION. Ail rights reserved. AC ORD 25 12016+J Y The ACORD name and logo are registered marks of ACORD Prrrlod br CMS on 3f it 2C22 at 03.49PM From Sandra 3ndra@mcsheainsurance.corn Subject FW: COI - Date Aug 11, 2022 at 4:29:13 PM To theaup@aol.com Sandra Johnson From: christy@mcsheainsurance.com Sent: Friday, August 5, 2022 10:01:28 AM To: theaup@aol.com Subject: FW: COI - r <Ygl4 1 )r .elt`., ) ' E o WATER DEPARTMENT `ex a ti 0—�# i i y 99 B 6,, t ..piK:Jad E 3i t- 'ris- RECEIVED BUILDING PERMIT APPLICATION FOR DEC 0 7 2022 WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING DEPARTMENT By: _____--- BUILDING SITE LOCATION: __45 . 4 4_e ' '4.1 b"`sfYe- tf ___ PROPOSED WORK: a d e( n cki c ee k` O r) ......__hock of h1364- ' APPLICANT: ._. i'1 i c�24 e-i to peer ��t- K ADDRESS: / Sanv / vot,1/41 Or, Ca4-1•451 Oc9.67 S TELPHONE: Sc, Is 7 7 ' 3 ` d._ leDINT , AND OR COMMERCIAL BUILDING water Dept-twin: Determines Compliance of Water AYailabiltt) and or existing location Engineering I)epatttnent: Determines Compliance fr)r Parking and I)ramage Conserurtion Commission- I)ctennines Compliance to Wetlands Act. i e IfIot(s) border any type of wetlands. streams,ponds. rrtct_s,ocean. bogs, boys, marshland. E IC .. I Icalth Department: Determines Compliance to State and Town Regulations, i.e. requirements fry Septage Disposal and other Public IIealth :Activiies lire Department: Determines Compliance to State and 'I'own Requirements m i Personal Safety, Property Protections. i.c. Smoke Detectors, Sprinkler System .etc 4.-,,�j, �.,.-Z /;/I .d- �} APPLICANT SI(:NA-Y . RF: I)AT OFF USE: (MAIN'EN I S ON PERMIT APPROVAL OR DENIAL. Nod" 45$rRv&r ( ,V'1712-4/VC 'TO rfGasS yir4 rt?r 74-1*-!.-- -- /4,- ao -o.ozz REVIEW - BY WATER I)I\ ISION (SIGNATURE) DATE M Town of Yarmouth Subsurface Sewage Disposal System AsAiullt information Street Acidress- 15 _AI 5c.--c.,.teb Map 44 9_Parcel: 5" Owner Name, &AbetYA4s_ta.te. ?sObirkt_CQUE—r-°‘ Permit# ZOt+tiC, -2.0 -02.10 Date Installed 1 i it \ Z.0 New: Repa(r: 4.0"..: installer Name _etAp-e,A--- __....,_._ co,. Installer Phone:508 -411- 96 7 7 Installation of(list all components,both newly Installed and existing to remain In use) t'l EL) o1500 d..1. PLSTIC_ lid f t Ltic461-1-7,a.... -r 4.J ie ill 6 Do5; - — (5) i-i-7(2_ Lc. - (4„ clifwv,136-e_s _ leach Capacity(gpd): 330 Ground Water Depth(inches): ..Wit Health Inspection by: ,,,,C, _6,16-)frieffEit.j6- As-built Diagram NI (Print Clearly in Black/Blue ink and Use Straight Edge-label Risers and Zabel Filter) 44 al rkr_r_f_r_Trii . 3 , :.-:,......-._ — : ...a.... 1 i _DJ c/,,,,,,,,"--1 1 X 1 //QcP 9 120'',,._ .. .. . 0 A IS EA1'f}f DP:: 4*44te , v i\I ivAse-t- a b ---1 ,.. , 2 10.3 I IT.6 5 'Ill 37.2 ......._ __ E / • 381 --A-4-TiTI ,. .....„.... e Pa,..11.1f. NA1,4. ' 7741.°31E42110/7 STREET , •. ,. . . . 7 7714,7c' VILLAGE: SERVICE NO. A. . .„ /:: r" -'. 1,, '----- .1 METER NCc--;2441-944474-- • atleirin•#4047** 3-17-71 4, 1 egC: , 4*-7. 9:,,), V/ '577 /-- --,i-z --(3? _. , \ . , . 1 i . , !, 1 „ 1 . s't . \ \ , ,.„ :,-....., . , ,, • .,...„ ,•! 474>'' 3 '' 36' •-'' • \ , / ii ,...; \ ! e'4.. rt '',•,; i i 1 \\\ I ;‘ 4' /' , .41, . .,61 ' I , 7 ir cer _..... ' Ye Y """"%x--r` i 4 Massachusetts Department of Environmental Protection Ali - .--- Bureau of Resource Protection - Wetlands WPA Form 2 - Determination of Applicability 0 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 A. General Information Important: RECEIVED When filling out From: forms on the Yarmouth E3EC 07 2022 computer, use Conservation Commission only the tab ---- ___----MENT key to move To: Applicant Property Owner(if di '-reloltifrtitftl�ai�api your cursor ey do not use the Troy Thomas return key. Name Name PO Box 177 ' I Mailing Address Mailing Address Centerville MA 02632 FifICity/Town State Zip Code City/Town State Zip Code 1. Title and Date(or Revised Date if applicable)of Final Plans and Other Documents: Proposal for Back Deck at 15 Nauset Road W Yarmouth 10/19/2022 Title Date Title Date Title Date 2. Date Request Filed: 10/19/2022 B. Determination Pursuant to the authority of M.G.L. c. 131, §40,the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): Proposed 31' by 12'deck on sonotubes with two stairwells in Land Subject to Coastal Storm Flowage. Project Location: 15 Nauset Rd West Yarmouth Street Address City/Town 49 5 Assessors Map/Plat Number Parcel/Lot Number wpaform2.doc•Determination of Applicability•rev.5/18/2020 Page 1 of 5 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c.'131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 B. Determination (cont.) The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) or Order of Resource Area Delineation(issued following submittal of Simplified Review ANRAD)has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s)is an area subject to protection under the Act. Removing,filling, dredging, or altering of the area requires the filing of a Notice of Intent. ❑ 2a.The boundary delineations of the following resource areas described on the referenced plan(s)are confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone). ❑ 5. The area and/or work described on referenced plan(s)and document(s) is subject to review and approval by: Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation Page 2 of 5 wpaform2.doc•Determination of Applicability•rev 5/t 872020 4 ciMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 B. Determination (cont.) ❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels. any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department. Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. Z 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of Intent. ❑ 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions (if any). ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaform2.doc•Determination of Appficabitity•rev 5/18/2020 Page 3 of 5 4 LIMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on Z by certified mail, return receipt requested on _ _...._..__............._. 11/4/2022 Date Date-____.__.__ �__...._ _..._........._......___._.._..__._..__—_....._.............._ This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office(see https.//www.mass.gov/service-details/massdep-regional-offices- by-community) and the property owner(if different from the applicant). Page 4 of 5 wpaform2.0oc•Determination of Applicability•rev 5f 1 B12Q20 4 [11 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 C. Authorization (cont.) Signatures:. c 400r Signat._-° Printed Name , Doty'U�.:1..--L LLA.j 1-{tdl Si.4:47 Printed Name Signa ure eft • Printed Name Signature Printed Name Qa - I\A,,‘ w Signature P}rinted Name ‘,6;4:,,,,o'gel:5.7 'VR.11,)k r\ Signature Printed Name Signature Printed Name .__._.._........-- Signature Printed Name D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office (see https lrwww.mass,gov/service-detailsimassdep-regional-offices-by- community) to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and Fee Transmittal Form (see • Request for Departmental Action Fee Transmittal Form)as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. wpaform2 doc•Determination of Applicdb trty•rev 5/18/2020 Page 5 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: Request for Departmental Action Fee Transmittal Form Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information 1. Location of Project a.Street Address b.City/Town,Zip c.Check number d. Fee amount Important: When filling 2. Person or party making request(if appropriate, name the citizen group's representative): out forms on the computer, Name use only the tab key to Mailing Address move your cursor do City/Town y State _ Zip Code not use the returnkey. _..._..---__ _. _._......._...-_._. ___—................._—�. Phone Number Fax Number(if applicable) 111 3. Applicant(as shown on Determination of Applicability (Form 2), Order of Resource Area Delineation (Form 4B), Order of Conditions(Form 5), Restoration Order of Conditions(Form 5A), or Notice of Non-Significance(Form 6)): rain Name Mailing Address CitytTown State Zip Code Phone Number Fax Number(if applicable) 4. DEP File Number: B. Instructions 1. When the Departmental action request is for(check one): ❑ Superseding Order of Conditions— Fee: $120.00(single family house projects)or$245(all other projects) ❑ Superseding Determination of Applicability— Fee: $120 ❑ Superseding Order of Resource Area Delineation—Fee: $120 Send this form and check or money order, payable to the Commonwealth of Massachusetts, to: Department of Environmental Protection Box 4062 Boston, MA 02211 wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev,5118/2020 Page 1 of 2 LI.111 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number Provided by DEP Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed. To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office(see https,Ilwww_mass.govtservice-detailslmassdep-regional-offices-by-communitv)_ 4. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. wpaform2 doc•Regue>t for Departmental Action Fee Transnrittal Form•rev 5/18;2020 Page 2 of 2 Sears, Tim From: Sears, Tim Sent: Monday, October 17, 2022 3:40 PM To: 'theaup@aol.com' Cc: Slack, Christine; Water Department; DiRienzo, Brittany Subject: 15 Nauset Rd Michael, I have r iewed your application for the deck addition and there are some items needed. H alth Department sign off ater Department sign off . Conservation sign off S-c;\1 rc c Please submit these items for review. This email is considered a written denial of your permit application per Section 105.3.1 of the Massachusetts State Building Code. Section 105.3.2 states in part that "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith" You may appeal this denial to the Building Code Appeals Board in accordance with M.G.L. c. 143 §100, within 45 days of this notice. Timothy Sears CB0 Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsears( yarmouth.ma.us i k+, fl Town r.f Var ��� co 04 u.ly �.., s — bdirien� � _V E D \MATTA H 5,Sc Conservation LViliiili5SiOii :- - ,-„:� . DEC 0 8 2022 `�:� Buildina Permit Sian-off Application TO BE FILLED OUT BY BUILDING PERMIT APPLICANT: BUILDING DEPARTMENT By ouiioing 6iie Location: / A J.t /ftY-A (/V Wt-0A-1-1 �/''-1/ 177.JMap# -j ,;?Vj LOt(S)1 j �� s Property Owner: 91,45,.. ekeivic,,ut,;, Date tiled: /*C7 "o7S `A = *Applicant: 1 griviAj le,,r►.i ,t,,L,-rv�a4r C«. Applicant Address: A d & /n t,\,/L( P/vf &6.-2.2 Email !✓'eve% %C, s-. .C,,tv„-".-✓4 c C;,vcnc/.''"Telephone: Vv /t.)u /C)). T Please note:by submitting this application,th applicant grants permission to the Conservation Office to enter the Inca ion to conduct a site visit(if needed). Proposed Project Description: p , NefoSx lo ‘,-, Li ii x).1 Dee-1- V e,./. .../i , 16,^-47' ' 4,,,,(„4,,..., 4 r''^ act( 4„r li-f 6, . --�S"4 1.-/c V �.wy43•ft vIt ' . at , (`i 4,f ,, 4/AL 4 714 19vi gyp. Site Plan Title/Date: illyPy 50 Pa 1 bacto D.f (,1( 04 (S Ala () l D[15 [ 22 TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR: Does the proposed project require a permit? e i Refer to: SE83- DOA permit Comments from Conservation Commissioncpproved ) Conditionally Approved Rejected Conservation Commission Sign-off Signature: p7,vp Date: 12 J Z2 7 I z 0 APPLICANT: Aii work-Ielated UeLms Shdii iJe taken Ut Slte or thspu,CU ill d iuydi upia IU location. At the end U each 1 day, the area shall be clean and no debris shall be in the Resource Area. If work is permitted under an Order of Conditions please arranne a pre-constn ction cite 'iisit with the Conservation Administrator. At the time of site visa, the MassDEP File Number sign must be installed, along will i the erosion n co III UII VVIJrn-iiI i Ili iii Ie. A copy of the Order of Conditions i i IU L remain i main on-site during construction. Please refer to the Order of Conditions for further details. i DN-Y1 TOWN OF YARMOUTH ;:*1 A ; HEALTH DEPARTMENT R �• ' PERMIT APPLICATION SIGN OFF TRANSMITTAL SH E a . 1 i/ To he completed by Applicant: a OCT 14 ?022 I ,�/ J l ayU`tNv 6,FPq,7t i Building Site Location: /S A/ 5e 7 eel . - o.s'.n Qk M NT Proposed Improvement: Zu . /o( h e cc. ! 2 X ?4 CI c c C il \ AC' 1:( i0 ( `j_0a r Applicant: hie-lu,� // /f/p, / e Tel. No.: CO8 7? SY?6 Address: ,' 1 Ho/t3 . O oc( i)t l o u- 1 kA 03d?5- Date Filed: !b/// D O 0-7 **/fyou would like e-mail notification of sign off,please provide e-mail address: Owner Name: Pi4 Oi e Il cctQ,%c:qu9 S Owner Address: /5 Austo c/ to "CAI .Vices J 4 Owner Tel. No.: 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, RECEWED and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — HEALTH DEPT. 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: /C2/fi1/.-1" PLEASE NOTE COMMENTS/COND TIONS: , / ,- SGfr y F' S arCJ /6 o h�Gc:4, Oct.�I1G/a 1, G .1 O,-4 c,i a?,i•G �C / ' ` S 1( ,i tvG.7 f/ G 4'17 ✓. I - ......... .. P 4t Town of Yarmouth Subsurface Sewage Disposal System As-Built Information Street Address: 15 Ni A SG r- I1.). Map: 49 Parcel: 5" Owner Name: P44/J6 VY1 2. RoDE-2lque5 Permit#; O(+DC„ "Zo -0210 Date Installed: 9 I it 1 2.4_, New: Repair: I/ Installer Name: ``O13 ,,c .6, OtA CO. Installer Phone:50$ 'IV-- 8877 Installation of(list all components, both newly Installed and existing to remain in use): E140 . (5O0 a6-1. PLASTIC '11 l Fit-TR. -Tn2 Tllki-.4 1L. } hL,O bo 5 (5) H-m LE - cP r_ fAp,i3es iI leach Capacity y(god): 330 Ground Water Depth(inches): elHealth Inspection by: 3C &-,-J -' ,, .- As-built Diagram (Print Clearly in Black/Blue Ink and Use Straight Edge-Label Risers and Zabel Filter) .? , 5 MIN Inn f� n5t ill111_NMI_ so K ,aK 3 t-jj _ _ ''-44_:....7--1 i 7.. i 4'- 1SEP 2 3 20211 ria > a • ♦IEALTH DEPT k' - A IS- - __,,,ro iq A-AS�-t- ab A B C D 1 32 22. E F 2 10.3 15.6 3 34. 3 Z9•1 --- 4 So 31 5 91.9 37.2 7 - 6 3(e AS - -- 1 38.7 9-2. /r Town of Yarmouth Subsurface Sewage Disposal System As-Built Information �^ Street Address: 15 !1 4(.15iG{— (et Q Map: i Parcel: �./ Owner Name: P1(A.(a I Mik 9-LC. rs. dty tque-5 Permit#:7:0 +t C - --OZI O Date Installed: 9 1 iZ ! 7AD New: Repair: r✓ Installer Name: Cp Installer Phone:508 -IV- 8877 Installation of(list all components, both newly installed and existing to remain in use): . (500 ri• PL A-STI C T I J F i L rrr --o 2 T etki-.! le_ , /1i0 bt (5) w o LC - CF Cal-Ar+nZ3 LS �r leach Capacity(gpd):, 330 Ground Water Depth(inches): el Health Inspection by: �C Ea fr-lr.)Asrz./,.kr As-built Diagram (Print Clearly in Black/Blue Ink and Use Straight Edge-Label Risers and Zabel Filter) 4.7 35 " m5f�{ Sbn4 P e ti, brJ 2. k (-.-..), --1 1 Xi D �•S . 2 3 20c? 9/.., • o` ia 1 " A -$1EALTH DEFT f1P.tAsE-r E.b ,,,ro A B C D E F G 1 32 2 2 2 10.3 15,5 3 34. 3 Z9.1 4 So 3 . 5 11.9 37.2. 6 3(ea -45" — _,_ - _ '7 381 : 419.1. I r • 34 - 1-77 -Cv ,7'a Fpc1N -- so 'd cs'S `/ . ,i/x c -moo L 07 7$ , ` pis- '^.,, , "'- , '<7 O . (434 ZS't -q - /' r I6'f . I Az 3 9.2 7 0C. J \o •r\ `� 12"25. 00 1 �76P - , CM•witY • rI h r- ., �_-0, &cdocio .i) Ex/67'NG � . 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