Loading...
HomeMy WebLinkAboutBLD-21-006279 . - •,-oF-.Y.14 BUILDING PERMIT APPLICATION c ` APPUCATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE, OCCUPANCY OF, ,G . ° OR DEMOUafi ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING. —ur..,cr. - ,r; Town of-Yarmouth Building Department . � ,-•-....,,us•a Ca'- 1146 Route `�i3 • Yarmouth, MA D`266:E49` Tel: 508.39g-271i ext. 1261 Fa SOS-39 836 Office Use Only Planning Board Information Assessors Department Information: Perm No�-.ZI-W /bite Plan Type. Map for II I Permit Fee $�`�(.: Endorsement Date / /�- Recording Date New Deposit Rec'd. $ () Date Plzn No. 'SA Property DiiilelsiOrt5. Net Due6 A i 549 $\.cj C Other Let Area(sf) Frontage(It) Lot Coverage i nis Section for Office Use Only Building Permit Number. I Date Issued: Signature: • --/ - t i - . Cet titica to of Occupancy BuldIng O rt'°iaai Data r iz Is not requited Section 1 - Site Information I 1.1 Property Address: 1.2 Zoning Information_ r,ihnv i llrii.G i'L 'aT7` & VA Zoning District Proposed Use • 1.3 Building Setbacks(it) ' Front Yard l Side Yards 4 Rear Yard Required 1 Provided Required 1 Provided j Required 1 Provided 1.4 Water Supply MILL c.40.S 54) 15 Flood Zone Information: Comments. Public Private Zone_ BFE Section 2- Property Ownership/Authorized Agent I - 2.1 Owner off Record; 5--"1 k 5 1 1 .+411c,. A/4r l oa, .L.1 . "v /OZ . 'rosy' rg,./L%,r -; 2-v. y".7�aid,4- Nalne(print, Mailing Address: iii /, , J Signature Telephone Telephone / Email Address: 2_2 Authorized Agent I , j / I t/S& ^,-) '74/Ip! � J e} � �i� fl73�Sr i 1 7 Navas/*Intl Mailing Mailing Address: l '* Signature Telephone Fax d vi -o,-n-:a At, 4La/ e°n-,ail Address: 1 Section 3 - Construction ServIces 1 3.1 Licnss d Construction Supervisor Not Applicable 0 Lr { t,; ors O5Z37 i ' �,' - ,J 1 License Number 7 /r.ficrrif1. /'�is� �Lng, Alf... td r8a.y. Al* .£j7:537 / / Address J 73I •/:' J E iration Date 5Ci, 75=1 fj ilsiTGAY �l1 %Ina,/.Idrit Signature Telephone Email Address: 3.2 Registered Home Improvement Contracbr_ .- Company Hams I Not Applicable 0 Cr- � A 0 �"fa Registration Number Address/ �v (, /it_.---— •:-7b'S`- V6V- U i ✓ Expb tion ate signatufe Telephone 7' 7/ZZ Section 4-Workers'Compensation Insurance Affidavit(ki,G_L c. 152 S 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. I Signed Affidavit Attached Yes ..fi.1'.... No Section 5 - Professional Design and Conituction Services-for Buildings and Structures Subject i to Construction Control Pursuant to 780 CUR 116 (containing more than 35,ODD c.f. of enclosed space) Section Si Registered Architect 1 Name (R ogistr nt): Not Appr,^abie 0 Registrlion Number A-ddress Expiration Date Signa u a \�19C!1�R3 I Section e.2 Registered Processional Eneirteer(s)I1 I Flames ,,Area of Respo�3iiiiy Address ,Reestrat an Number Signature ieephona Expiration Data Ara or Re onsbirity AFsm® negisrrat on 1 UtTO9T ,ddr..ss Telephone Exi.iration Date Signature i I, l Araa of Responsibility Registration Number A.ddraGc Signature Telephone Expiration Date I 1 Area of Responsibility i,, Herne \Reistetion g Number Address Signature Telephone I Expiration Dale i S'att on S.3 Gececa1 Cartactav ,+ - Not Appticabfe --\ . ay.,el A, 6On- 5/ re trle moorr i//�, Ci Comps y!tame DAvr1 d �f v\ Person Re ip�nsible for Cho/structi n �o �` 7 civil!!ly /'11 ,- Aare., •5• . AL. C."l�S'I 1.....____„_—'' JAddress e� e,�_� 1'5ignatur> _ Telephone Section 6 - Description of Proposed Work(check all applicable)) • 'New Construction a I (tor multiple family only) No.of Bedrooms I (for multiple family only) No.of Bathrooms Existing Bldg. ❑ 1 Repair(s) L. f Alterations II 1 Addition Accessory Bldg. 0 Type !Demolition Other Specify: 1 I Brief Description of Proposed Work: i4-%e.4.4. doo,-144a.y' ar A.refi Oil ilk. . -"aic ray 4 gi, L're...Atx101. 4move_ e•''d,54114J ISlOo,- art ,Or'/ , r ei-41 rkz, /XJ')_ /00d`: F.dea"; /i'l"fie,u v" itis db .°'�'Ca a 6stndi/)c� C11 d rte. El c9� r� rrs /�li►S hi/ Vrte I 1 Section 7- Use Group and Construction-77671. LBuilding Use Group(Check as applicapable) I Construction Type A ASSEMBLY Q t;-, U A-2 3 A-3 0 ' 14, 0 A-: 0 A-s ❑ 15 0 B BUSINESS 2.4 Ci E EDUCATIONAL U 0 Z9 F FACTORY 0 r-1 U F-2 U 2C ral H HIGH HAZARD I U 3A e t this' tLtlT oNAL Q I-t 0 F-2 0 1-3 0 33 0 tit MERCHAN T ILE I U _f y 0 rP RESIDENTIAL I 0 a-i 0 R-2 U R-3 ran, SA iU S STORAGE 1 ❑ S-t Q S-z 0 on U u UTiU T Y I Q SPECIFY: fa MIXED USE I ,..-a S SPCCIAL USE I CI SPECIFY: Complete this section if existing building undergoing renovations;additions and/or change in use.l Existing Use Group: I Proposed Use Group: Existing Hazard Index 780 CMR 34 Proposed Hazard Index 7 B0 CIVI R+ 34 Section 8 Building Height and Area I - Building Area Existng(t appticabtet • r?roiposet, Number of floors or stones include basement levels Floor Area per Floor(sf) I !:, Total Area All Floors (sf) ' I Total Height(ft) Section 9 - STRUCTURAL PEER REVIEW (780CMR 110 11) I l Independent Structural Engineering Structural Peer Review Required Yes No ] SECTION 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, A i a`e .,‘ , as Owner of the subject property, hereby authorize /eav1 C �--..dr-.-, to act on my be If, in all matters relative to work authorized by this building permit application. owe /({leariz /;74/ I Signature of Owner Date 1 SECTION l Ob OWNER/AUTHORIZED AGENT DECLARATION I I, a v i dal r,1 a=Owner/Authorized Agent hereby declare that the statements and information on the forgoing application are true and acurate, to the best of my knowledge and belief_ Signed under the pains and penalties of perjury. y ;dJ rM ,,r—.�; Print Nam9 ` Signature of Owner/Agent Date (Section 11 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Collar)to be completed by permit applicant 1.Building 2_eectril 1 I 3.Plumbing/Gas 1 4.Mechanical(HVAC) S.Fire Protection E.Total_(1 4-2+34-44-5) 7.Total Square FL lure c r.z3 s a :5xe1 Check Below Q Conservation-Commission Filing (if applicable) 0 Old Kings Highway&Historical Commission approval (if applicable) §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 /oz 4,1541 �4/l r / J Work Address Is to be disposed of oat the following location: ovtrig. !r'4,+s 54 of Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 11 §150A. 41/0, Signature of Application Date Permit No. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-052327 Expires: 05/23/2021 MZO 7 7 AVID MORNING MIST LN BUZZARDS BAY MA 02532 .01101 . Commissioner .c_ + - �h lion mom/wad r ^747.;.0 rAriirl/' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 103483 07/07/2020 DAVID M ZORN DAVID M.ZORN 7 MORNING MIST LANE BUZZARDS BAY,MA 02532 Undersecretary • /V/ram' /fly , c h&c. el z. /3 eVerr,"� 4_ 5 a l� his ,.or SG.ti% MIL a n¢c✓ ca�. +• ��.f-. • a .e♦ +� .j , The Commonwealth of Massachusetts =- Department of Industrial Accidents Office of Investigations 600 Ti'ashington Street Boston,14 02111 fir srwn.mass.goE/dia Workers' Compensation Insurance Affidavit: Buildersr`ContractorsiElechicians?Plumbers Applicant Information [ / Please Print Legibly Name(BustaessOrganizaionIndividual): Awe.' Zorn � /lo/�!l�la. /en'le II el Address: 7 f'!Gc'&, t4is r Lane City StateiZip:It1ZZ4rcis dar, OZ5,2 Phone : SOb- 759- 8210 Are yo r employer? Check the appropriate box: Type of project(required): 1. I am a employer with 3 4. ❑ I am a general contractor and I New an-,tniction employees(full and'orpart-time).' have hired the sub contractors _.❑ listed cu the attached sheet. emodehng I am a sole proprietor or partner- ship and have no employees These sub-contractors have S. Demolition working for me in any capacity. employees and have v:orkers y ❑Building addition o:corkers-con insurance comp.insurance.- [No 10.0 Electrical repairs or additions required.]3. 5. ❑ We are a corporation and its ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.[No workers' comp. might of exemption per�IGL 1_ ❑Roof repairs insurance required.]- C. 152_ j 1(4).and we have no employees. [No workers- 1 .❑Other comp_insurance required_] Any applicant that check;box=1 mast 91E0 fall out the sec::on below showint:he:r workers compensation policy info:nn3 0n. Homeowners who subtt:t this affidavit indicating they are doing all work and then h re outside contractors m.iu sdarair a new 3ffdaytt i dicathhe s'ach- -Contrac:o:s that check d::s hoti must attached au addition:sheet shen':n;the name of the sub-contractors and stare whether o:not those en::t:es have employees. If the su -:oncacCo save employees.they must tJro ide their workers'comp.polio number. I ain air employer that is providing workers'compensation insurance for my employees. Below is the policy and job site infornration. , �,A n Insurance Company Name: /4./1 AA. /t'lJ�Na 11// T ISvcatice- C. /19any — Policy f or Self-ins.Lic.r: VWG-too-6 olio 9J-,ZD Expiration Date: /o/z8/2/ Job Site Address:/6 Z i9hid / 1/er /<ocd Cit t StateiZip: racivicug, AL. OZC 73 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 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 da against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations oft LA for insurance coverage verification. I do hereby cert. under the pains and penalties of pedury that the information provided bore is true and correct. Signature: Date: 77¢/Z1 Phone: 5O6 759-- SILO Official rise oiilt'. Do riot write in This area,to be completed by city or town official. City or Town: Permit+License it Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. CityrTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 ,: �: `a«to'..�, .,\ <.�-.,1 ". ..4 .. •.. :!, - • Fallon,Rosa From: Dave Zorn <DaveZorn1 @hotmail.com> Sent: Thursday,April 29,2021 5:31 PM To: Fallon, Rosa Subject: 102 Ansel Hallet Road Attention! This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete this email. Hi Rosa, Sorry for the omission, the building cost for the landirg work and sheetrock is$6,000. Thanks, Dave Zorn Sent from Mail for Windows 10 1 F 91�Ul P!! g oDo o .5m , 2 ao y� a mm Wm is .31m m ' m � m o a m o m a m y o £o £ m 2 m � > m 0. y 3� N o 0 o'm 'm mm m H O y y m 0 0 £_ D a d R. a 3 3 0 �n n,0 5 H itlif qg _ ' 3m 0 m ' o m F.m a b "g .. »Di m m x N�N c L a m m m F — n o-n> a m' n y 3 fc N N N ll pf 41 1. ... m m a 88 p �Q R m a m 7 1 R 8.ICgE+ _. 111111111111 A u ,'1,1k11 84 ITO 'In flf N s '�` s3 h a< -D 1111111 11 ill 0 11111 VP. 'lig i 1111111111 gi ® l 0 IIIuIII - il r p ga -- _ c/�1 E ' l;11 of 1 g 7 1 $ 5 1 Z Z P. m -:, o -T, CO II % E� I I 9-' a P Z bs C7 If _� it r mo G -c13 n _ C3-17= `f 5 Gar 0 o GCD I I � � �1�111111 _' c . m- ma CQ I ® . . . .Qa I�_ )' , ._. i „ 1 —ry` i 11 t_-- -71 y r b a �" v a I "I"!i' II I MOO z ��IIINIIIIIII 0 ii� z —�L II- _____ © 4c HYANNIS ANIMAL HOSPITAL 0 11. � I I `E"I°°°'""�IIII 6 oo PROPOSED ALTERATIONS i 1 : 1 4 102 ANSEL BALLET RD AVADNHp n.�wozals RI sa WEST YARMOUTH,MA 02673 o-3a2aae2 V Secondary scope of Work 1. All other work noted including smoke detectors, new landing at top of stairs, new 5/8" fire-code sheetrock on three attic side walls. O - MECH./UNFlNIBHED ...__ PROVIDE b/8"TYPE"X"F.C.GYP,BOARD f TAPED&MUD JOINTS TYP.EACH ATTIC UNFINISHED WALL SURFACE EASING DOOR EXISTING METAL ROOF I TO RENNIN BELOW TO REMAIN ' - -- �. NEW 12'Wx6'H.x±6'LONG y �STEP TW IO WIDOW- o WOOD FRAME W/VAIN LVT °� EXISTING SPRINKLER © FLOORING AS TREAD HEAD TO REMAIN 2 Existinq Office \ r2 REMOVE EXISTING OA CASEMENT WINDOW- Note:remove&replace sheet PROVIDE NEW CXWT3 CASEMENT WINDOW carpet this room with 2'x2'carpet NEW SMOKE/CO DETECTOR FOR EGRESS(R.O.=3'-OW x 3'-0'W")INFILL tiles-commercial grade (^`y� CONNECTED TO EXISTING EXISTING OPENING AS REQUIRED&PROVIDE V FRE/tIARM SYSTEM 1 x PVC TRIM Existing Staff Breakroom Note: Clean, prepand re-paint Note:remove 8 replace sheet p carpet this room with 2'x2'carpet all walls at spaces within this tiles-commercial grade \-- work limit area. EX.M7H /1--- EXISTING KITCHENETTE 'f TO REMAIN Ib .__ -..`' NEW WALLS TO YIELD NEW \ _ In -, START LANDING AT TOP I I, j REMOVE/RELOCATE 5 i I 11 I I 1 li i - 9 /// EXISTING DOOR - - _ C DN Q Z__ir ' 7-10 I/C EXISTING DOOR } ...... -- - EXISTING STAIR _ EXISTTOREM4N G.W.B.WI LTVP.NEW5/B'TYPEIC B TO REMAIN MUD JOINTSEXNTWG ATHC PROPOSED SECOND FLOOR PLAN 1/4" = 1 r-0" Tf�1ra�LI _ y*7. �i o.. � ' 'TH I l ,�+�F. wI 3 • RrVir:M. .,E.P. : COMPLI- '' . . J-VE THE :" I. . HS BUILT" APPLICANT'S COPY ��5 MAXHE UJ`.J rJ; MA%.NEpQT.. -" 5 6N rff�,rI�rK.gy,GAMMA.M00.r _ o. _ 1 :q MINIX LW'Y nNe.ur»mu _ yL I ! ma 'D ! 0 V 53 r,m.G.[L.,r00.M,Oro.r..r, — _ T.D.PLATE J I r -.. - I I f yl_ 11 - -__ ¢ Z I Base work scope; .. i 1.Provide new egress window/finish and new step up at I I ._. -f I i ! p) - 0 C�V "Existing Bedroom __ I _ - - - I —___ _ t Ci 2.Provide new carpet flooring(I'm calling this out as 2x2 I - I -- _ , j J carpet tiles so that replacement of damaged tiles will be easier -1 I 1 -•-I - .t 'i -. mri .I`_ I I L. -I __"nF ac 1� , than sheet carpet-please provide one box of extra stock in — -- - - --- --- -- --- r °'' -~-i _moil a price) 3.Clean,prep and re-paint all walls&ceiling in work limit area 4 PROPOSED PARTIAL SOUTH ELEVATION 3;EXISTING PARTIAL SOUTH-ELEVATION _ 2 0 0 1/4"=1'-0" - 1/4"=1'-0" N ry N (NI Secondary scope of Work Z O 0 , 1.All other work noted including smoke detectors.new landing Z 0 ^r�n.-i at top of stairs,new 5/8"fire-code sheetrock on three attic side } E 5 walls. _ !B: - - _gn 8 . -- ,„,„._ ..„,„. _. m_fecnems. wcx.r w..wo 000. l IRE ., PROPOSED =';;;;;;;,„""`" ' • r=== SECOND FLOOR PLAN OMNI NC R.ivsr#M Mruvx. '. - fl .fir _..1. °61m.uc.u....'»m. .� I.RC TM .6111.0I0016..w�Lu.MOMb.a. IPF.uM�r:,IM rGr. 1/4.=t,_0., ~Note'Clean,prep and re-paint _.. .- ' oMe - owlsno i all walls at spaces within IC:- REASONS - --- �> _ -------------- uyeve REASO I work limit area. Iu_I b-I- a,ve rO rf1Y.. taut ul M •.l yr`:.:._ raw MLLurOr60P ^'t ' tlG Id Rranr[ 5' 1 5 5 . J _ 1-(5_ )� .0; - a r 1 1. os a in ,r t M---- OMwn Maar f.B 1 r"rLM,rr - w""..nc _ Marv.. w.wr.w,orn: B uc..,w.nrm WANING NO.: F 1EXISTING SECOND FLOORPLAN. 4I 2 PROPOSED SECOND FLOOR PLAN -'1/4"=1'-0" SK-24 IE. 1 1/4"=1r-0„ :i : Secondary scope of Work 1. All other work noted including smoke detectors, new landing at top of stairs, new 5/8" fire-code sheetrock on three attic side walls. O MECH,/UNFINISHED PROVIDE 5/8"TYPE"X"F.C.GYP.BOARD TAPED&MUD JOINTS TYP.EACH ATTIC UNFINISHED WALL SURFACE EXISTING DOOR EXISTING METAL ROOF I TO REMAIN BELOW TO REMAIN I - R\ ,1NEW 12"W.x6"H.x-_6'LONG �9 _ STEP UP TO WINDOW- g WOOD FRAME W/VINYL LVT °� EXISTING SPRINKLER OP Ark FLOORING AS TREAD HEAD TO REMAIN 2 11227 Existing Office \ 8 REMOVE EXISTING C23 CASEMENT WINDOW- — Note:remove&replace Sheet • PROVIDE NEW CXW13 CASEMENT WINDOW carpet this room with 2'x2'carpet NEW SMOKE/CO DETECTOR FOR EGRESS IRO.=3'-OW"x 3'-0'W)INFILL tiles-commercial grade ,^`y/ CONNECTED TO EXISTING OPENING AS REQUIRED&PROVIDE V FIRE ALARM SYSTEM 1 x WC TRIM Existing Staff Breakroom • Note:remove&replace sheet Note: Clean, prep and re-paint + T carpet this room with 2'x2'carpet all walls at spaces within this tiles-commercial grade work limit area. PC BATH EXISTING KITCHENETTE 3, rIl TO REMAIN • NEW WALLS TO YIELD NEW A. • -- -, STAIR LANDING AT TOP CO _ I I_�� /REMOVE I RELOCATE �� I EXSTING DOOR < II' ®� 1 III I EXISTING STAIR EXISTING DOOR __TYP._TYp NEW 5/8"NPE"1C" G.W.B.W/MUD JOINTS---- p TO REMAIN TO REMAIN p --EXISTING ATTIC 2 PROPOSED SECOND FLOOR PLAN 1/4" = 1-0"