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Home My WebLink About23-E021 140 North Dennis Rd ApprovedARMO TM T i v ? 01- ER- '2r4R� n9; 9 1 RE C - TOWN OF YARMOUTH 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 ECEEIVTOL Telephone (508) 398-2231 Ext. 1292-Fax (598) 398-9836 MAR 14 20c� +r �IKING'S HIGHWAY HISTORIC DISTRICT COMMITTEE (AmlviUU i r , APPLICATION FOR KINGS HIGHWAY CERTIFICATE OF EXEMPTION Application is hereby 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. Type or Print leatbly: Address of proposed work: _ 7y Ay PA40 Map/Lot # Owners :z//.1� �`�l\%7l-fi/�+ S %—,A/�7�/`i Phone All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: Year built: Email: %)2iI-\j\j C' 1-3SA CO Al Preferred notification method: ✓ Phone L�-Email AgenMConlractor: Mailing Address: Email: Phone #: Preferred notification method: Phone Email Description of Proposed Work 1Additional gapes may be attached If necessary): 16 /x / Z / S-14, D 94F-IV,11V 0 1- vV Signed (Owner or agent .A.2��4— Date: -5/ Z -r ➢ Ownerlcontractorlagent is aware that a permit maybe required from the Building Department. (Check other departments, also.) ➢ 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: Amount i)0, to Cash/CK #: Rcvdby:. L-i Sr Date Signed: _1z Approved Approved with change PPnied Reason for denial: Signed: YARMOUTH APPLICATION #: 9 r09 i V5 2017 Sherman, Lisa From: Richard Ventrone <rav9463@gmail.com> Sent: Tuesday, March 21, 2023 8:56 AM YARM0EiT# CWN a To: Sherman, Lisa Subject: Re: 23-EO21 140 North Dennis Road Attachments: 23-E021 140 North Dennis Rd.pdf 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. APPROVED. Thank you. Richard A. Ventrone, Jr. Yarmouth Port, Massachusetts On Mar 14, 2023, at 2:06 PM, Sherman, Lisa <LSherman@yarmouth.ma.us> wrote: Hi Rick, Residents would like to build a shed at 1.40 North Dennis Road. Built off site then brought to the property. Please let me know if you need any additional information. APP nVED Thanks Rick, MAR 2 1 2023 Lisa YH mou Fh Lisa Sherman Town of Yarmouth Administrator, Old King's Highway Historic District and Yarmouth Historical Commission 508-398-2231, ext. 1292 lsherman@yarmouth.ma.us 1 a 3- t-01 n o TOWN OF Y A R M 0 U T H klt,�PPN 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451 Telephone (508) 398-2231 Ext.1292 Fax (508) 398-0836 OLD KING'S HIGHWAY HISTORIC DISTRICT COAMTTI WAIVER OF 45-DAY DETERMINATION ECEIVED MAR 1 4 M3 r AmiviUu i r, The applicant/applicant's agent understands and agrees that due to the current declared National and State public health emergencies the determination of our Application for a Certificate of A ppropriateness/Demo I it ion/Exempt ion may not be made within 45 days of the fling of such application. The applicant agrees to extend the time frame within which a determination is to be made as required by the Old King's Highway Regional Historic District Act. SECTION 9 -Meetings, Hearings, Time for Making Determinations "As soon as convenient after such public hearing; but in any event within forty-five (45) days after the filing of application, or within such firrther time as the applicant shall allow in writing, the Committee shall make a determination on the application. " Applicant understands that the review of this application will be scheduled as soon as the situation allows. Applicant/Agent Name (pI Applicant/Agent signature ('d M10. :!I,-, A/ a 7 L CI - ff.4- F —e-F rrco G, S I ieAfz,n 13C4%TL--/V Y,' 0 /,Q r7 /V4, Tu /ZAP ' AP id Y MAR 21 2023 'fARMOUTH Application #: 3�e U;? f srxo20 "V6i- _°. � 4 ra� ��' nnrrn r, crr� 4 4w..yait r � 9. FcmVED MAR 14 2023 r ArtlVlUU a rt APP OV MAR 21 2023 YARMOUTH EXPRESS SHED PERMIT APPLICATION TOWN O YARMOUT1-1 Yarmouth Building Department 1146 Route 28 Smith Yarmouth, MA 02664 (508)'198-2231 Ext. 1261 CONSTRUCTION ADDRESS: 1 *0 N . 11�/VnI1 � IQ/aS'. Y�fZMoU7�! OWNER: S?Z/AN # CYA4774/ . SNrA►ftn/ 1�0 N. DFvNI r RD. CONTRAC I'(y12: NAMI / idential 0 Commercial sssHome Improvement C:ontmetor Lie. # htAILItNU r11.1[)I(t .5S Workman umainpenstttion Insurance: (check tine) the horneottoer I ant the sole propri.:lor insmunce Company Name: Office Use Only Permit#-. Arnounl Permit expires 190 dnvs frotrt issue date 7/5 - -% t -S23a rl'L. 0 list. (.ocl of ('onstruction s dw-' Construction Supervisor Lie. # I have Worker's C'ompcnsatiun Insurnrtce ...__.—Workcr's('ornp. Policg:k_ SHED 1N1.ORMA`I'ION New -�—e— Size 1, 44 x w 10 x H 16 Corder Lot: Yes Np-1— 37f11] lS wNSfiwe.7il dt er71F .Mv* ballvere 70 Nn �srwvC-rta..r Per Towtr�errtttouth Lottirm, BY -Lapp See, 203,5 'Vetter E: wIR.�. 7+dKt� soLs4C4 a#w rrf� 1*4/zvk�• SO(! and re°ur tirtrcl.selhaclss %rtr acce.,;'V l y bililflitrlra containing one hurtclred fifty° tl Jt)) sclucrre feet or less anal silig je arctr t. .shut( be six (6)fi el in call dbiric•is, furl in no case :shall said accessory halloo i'gs be Mull chaser than livelve I12}.feel to rnty other hidhling on an irtljucerri lour eel. A11,y erls are rve uji ed to be locextc+d thirty /jo feel 1i otit ern rcrrtt 1vt Ii>xc� Replace existingWO Size L x If x 11 °'fbe debris will bx disposed Ofid' Location of Facility — I declare undo penalties of periury Ittat tf staWments liert:in cimtuinetl are trite and corrm to the hc5t ormi knoi%ivdpand bchef. T understand that any fiche ani%yer(s) t1'ill he jtasl muse fir thole wnertut 1 y lie° fur praeculiaal under 1t1 (i L. (;la 24,8Section 1. 1pplic tnt's Slenaturc T_ Date Oil 'y_e�l — Owners Signalitre fur:rtlarhnarnt)//4 ZO Z 3y —4 —�— Apprrn ed By Building Official tear desisnce) f.-."MAIL ADDRFSS� Date. Toning Distritt: I listorical District: Yes No flood Ptaio Lone: Yes No. Waler Resource Protection District: Within IIHI ft. oCWcihutds: **" Yes No Yes No ***Natc: Conservation review requifed il'within IltO Cc of Wetlands ;2� -�-(E� b-,.)- I The Commonwealth of Massachusetts 1 FCFivtb = Department of Industrial Accidents I Congress Street, Suite 100 MAR 1 4 2023 Boston, MA 02114-2017 rHrtivll��,r, www.niass.gov/dia LOL'D KiNG'S HIGHWAy Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricianslPlurnbers- TO BE FILED WITH THE PERMUTING AUTHORITY. Apolicant Information Please Print Legibly Name (Business/Organizatiordlndividuai): ORL4 -1 d-CY147WIa MAn/`n^J Address: I1Vo N . OEWN r S (Z4 . City/State/Zip: S. 11 �AAMoV7t,F )Ar 02�ph Are you an empiayer? Check the appropriate box: #; l)3-3ol-e�3o I .❑ I am a employer with employees (full and/or part-time).' 2.[] 1 am a sole proprietor or partnership and have no employees working For me in any capacity. (No workers' comp. insurance required.) 3.[] 1 am a homeowner doing all work myself, [No workers' comp. insurance required, I t d. aI 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 proprietors with no employees. 5.n I am a general contractor and I have hired he sub -contractors listed on the attached sheet. These sub-contractgrs have employees and have workers' coma, insurance.l 6.0 we are a corporation and its officers have exercised their right of exemption per MGL C. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.) Type of project (required): 7. ,New construction 8. ❑ Remodeling 9. ❑ Demolition 10 Building addition I LE] Electrical repairs or additions 12. 0 Plumbing repairs or additions ] 3. [J— Roof repairs 14. ❑ Other `Any applicant that checks box 41 must also till out the section below showing their workers' compensation policy information. 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 far n=y employees. Below is the p information. W1,111J o --- ran Insurance Company J Policy # or Self -ins. Lie, il: Expiration Date: non 4 1 LUL Job Site Address: mmviw fh City/Statelzip: OLD K1NC'S HIGE- 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 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 Investic, ions of the DIA for insurance coverage verification. I do hereby certify under > ai d penalties of perjury fhtrt the information provided above is true` and correct. nature: Date - Sig 2yZ Phone #: 711 lo 11 To 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): —7 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector b. Other Contact Person: Phone #: R3- vq PLOT PLAN FOR LOT ! Addit�nQ � ux � b� x sexier dis,� iaessponl) _ �___� WeII f Vd0t-\Jv0p4 ' ,�ttt ty l } Abutter's T� Name Lot # It this is a corner lot, pa REAR YARD write in name of street. • • • - - • -...tic. to �o s•"b f' 5a yl.) N>Ec.FN A,PPAK., teC - 'C3" vo r► r r ' =E YAM - N 1'! HOME SDE YARD VI C-aaRR�c +� M�tcSrq � ssfi Baca � ---------------- 9 r N. oemvlS RD (NAME OF STREET) FREMvED"R 14 2023 wr•,iv,uu1rAir- c uir., ,..... Abutter's Name Lot # It this is a corner lot, write in name Of street. *f3 Nbc,rratanF FAXM A^qN,, Y A0v0j?0k /4M4 Apo, R.VED MAR 21 2023 r.AHIVIvu-rh kffmmadm St3?PUEd by %31ZIA.11/ .SrAArMN (OW Nt�J