Loading...
HomeMy WebLinkAboutBld-23-004418 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department r 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 4f4rit Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling y� s/Section For Official Use Only, Building Permit Number: 13Lb43'cw L7a Date Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro erty Address; 1.2 Assessors Map&Parcel Numbers 15 bilk cI-tZpoi_ t cw 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40, 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Public 6Y Private❑ Check if yes0 Municipal 0 On site disposal system ,rY SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: �oQh s e b.e) Va_rovAigt. itiL6L CZ 66, `rG Name(Print) City,State,ZIP 25 D( 5-4 -to BS-3 D7 L), i se.A b'e rr OcoA ca_5}-, Ad- No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 I Repairs(s) 0 Alteration(s) 0 I Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Other Iipecify: eu ytC'y./ 14-44 . Brief Description of Proposed Work2: " 1-1.`) a G, i L .L Lt -kG�� tv-tC�t L e �11Mi€ -� Lek_ aS I t✓''i1 114 �rLiJ t,vk,i o _ 64411 Ce iew L,L5 L-1 w`r t Z. k SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I.Building $ j)CC) _ 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ Standard City/Town Application Fee Zt trz� ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ Z` La)-j) 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ Z`t` DL.) — 0 Paid in Full 151 Outstanding Balance Due: C,, SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 'r _%/ 62Z / 9- 17- Z3 B ni r 5 V k XA ci___ License Number Expiration Date Name of CSL Holder 5 l , •J D t_ Ie List CSL Type(see below) (� No.and Street I�- Type Description to e 11 V � Z1 g U I Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,Mate,ZIP 1 R Restricted 1&2 Family Dwelling NI Masonry p.u)ac j Qrn e fi OciLA itaL �-�^� „ RC I Roofing Covering S Window and Siding i_��I_ .333 z SF Solid Fuel Burning Appliances D I Insulation Telephone Email address D 1 Demolition 5.2 Registered Home Improvement Contractor(HIC) Au1'eJ l cask_ + ""61(4-4`7'"-4'4) 1 4,(4._' HIC Registration Number Expiration Dalte BIC Compagy Name or HIC gistrant Name L No.an4 Streetl r — l ,A„ 1 ` C. f �SJI _ l D 3 3 Email address City/Towni 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 „Afr----` No 0 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 elf i( ..,�V `' 11.�46,41.eS r lyt.L to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date • 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 containe ' this applicatio r is true d accurate to the best of my knowledge and understanding. [ 1 1 -4 -- 1 ' OLeiabt/12-- —46W-'?_S----./ et C 2- 21z_ Owner's or 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.eovloca Information on the Construction Supervisor License can be found at www.mass.zov/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" §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 exit. 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 La_► Work Address Is to be disposed of oat the following location: A__)0,1 A.0.1/4 Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. ignature of Application Date Permit No. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center V 2Avenue de Lafayette, Boston, MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): American Mobile Homes, Inc Address: 51 Moore Rd City/State/Zip:Weymouth, Ma 02189 Phone #:781-331-0333 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ I am a employer with 12 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. El New construction listed on the attached sheet. 7. [' Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no tempmobile home employees. [No workers' 13.❑■ Other comp. insurance required.] *Any applicant that checks box#1 must also fill 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 for my employees. Below is the policy and job site information. Insurance Company Name: A.I.M. Ins. Co. Policy#or Self-ins. Lic. #:We 500-5022645-2022 Expiration Date:8/12/23 Job Site Address: 129 driftwood lane City/State/Zip:Yarmouth 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 $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. Be advised that 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 ndpenalties of perjury that the information provided above is true and correct. Signature: — � Date: Z L3 Phone#: 7 1-331-0333 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 11:1Board of Health 20 Building Department 3.00ity/Town Clerk 4.0 Electrical Inspector 5.Ilumbing Inspector 6.❑Other Contact Person: Phone#: 11 AMERICAN MOBILE HOMES INC. A 51 Moore Road 1! Weymouth,MA 02189 (781)331-0 333 1-800-232-9991 PROPOSAL Fax(781)335-0707 Date 2 J//23 Name ,,A 15P'— v\ Est. deliery date (((((( Address I Zit �ft-�-{'1-4or1 _ILK _ /CL(V1'//VSK .t� American Mobile Homes,Inc.hereby propose to furnish the terials and perform the labor necessary for the completion of installing l/N,41__. 12_XH. L-/ Z 3 leased mobile home containing: Refrigerator,stove,dining set,living room set,curtains,be ' lstltt!.1-,2nd / ay,3rd!_'— ,washer and dryer,air conditioning. v O 'temporary Plumbing installation to mobile home p Applying for building permit for mobile home Temporary Electric installation to mobile home t,❑ Remove necessary trees,tree limbs or shrubbery ❑ Remove any necessary fencing ❑ Other: Any resulting damage to said property as a result of the installation,removal and existence,of mobile home and its its utility connections shall not be the responsibility of American Mobile Homes,Inc.,specifically driveway,fence, stonewall,septic system,trees,lawn or any other type of landscape items and/or: American Mobile Homes,Inc.,is not responsible for the re-installation of any of these items. Costs: The monthly rental of the mobile home ( — mos. The delivery and pick up charge of 3 4-21-6 Air conditioning Pet fees 5?-2) - other There will be additional charges for utility connections,permits,fees,site preparation. There will be a profit and overhead charge of 10& 10 for all sub contractors and fees paid out. Any applicable sales tax. A 5%carrying cost will be billed and payable on all invoices not paid within 45days of billing. A$1,000.00 security deposit is due on delivery of mobile home. I/we agree to sign a lease for the mobile home rental at delivery. Projected job cost:o?`{t OTC: 1\,ALLu- , 1ly S.?S ,(� Payment Method : Billed directly to insurance company with a signed assignment of payment. ❑ Other: Any alteration or deviation from above specifications involving extra costs, will become an extra charge over and above the estimate. All agreements Respectfully submitted _ contingent upon strikes,accidents or delays beyond our control ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are a thorized to do the work as specified. Payment will be made as outlined above. If insurance company is not willing to honor assignment of payment,I/we understand I/we will be responsible for full payment of all services. NOTICE OF RIGHTS TO CANCELLATION You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller,which may be his main office or branch thereof,provided you notify the Seller in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing agreement. See attached notice of cancellation form for an explanation of this right. Signature l Date Signature Clarke, Kristin From: Clarke, Kristin Sent: Friday, February 3, 2023 8:47 AM To: fward@americanmobilehomes.com Cc: Fallon, Rosa Subject: RE: 129 Driftwood Lane temp mobile home after afire Attachments: Electrical-Permits.pdf; Plumbing-Permit-Application.pdf Hi Frank, This is the correct building permit application; this permit is not able to be done online. The building permit fee for the mobile home is$120.00,the permit will not be processed until payment has been received. Per Tim Sears,the Deputy Building Commissioner a Health Department sign off is required. You can reach the Health Department directly at 508- 398-2231 x 1240 or 1241. Also, a Plumbing and Electrical permits will need to be obtained. I have attached the applications, which can be mailed in or dropped off to The Town Hall, Building Department, 1146 Route 28,South Yarmouth, MA 02664. Thank you, Kristin Clarke Office Assistant Building Department 508-398-2231 x1261 o9 \( \l° From: Frank Ward <fward@americanmobilehomes.com> Sent:Thursday, February 2, 2023 4:38 PM To: Grylls, Mark<mgrylls( varmouth.ma.us> Subject: 129 Driftwood Lane temp mobile home after afire 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 Mark I have enclosed a permit application for a temporary mobile home after a fire. I tried doing it on your on line portal but was not having any success finalizing it If you can let me know what the fee would be and if you need any additional information. Thank you, Frank Ward American Mobile Homes, Inc 781-331-0333 1 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department "\\ 1 146 Route 28, South Yarmouth,MA 02664-4492 7r 508-398-2231 ext. 1261 Fax 508-398-0836 Massachusetts State Building Code,780 CiVf.R. • - Building Permit Applwation To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling RECEIVED This Section For Official Use Only Building Perrnit Number: Date Applied: FFR 0,3 2023 BUILT)INP, DEPARTMENT Building Officia:(Print Name) Signature By SECTION 1: SITE INFORMATION 1.1 Property Address' 1.2 Assessors Map& Parcel Numbers be,C1-14)(201._ 1 a_ei 1.1 a Is this an accepted street?yes no Map Number Parcei Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Sc Yards Rear Yard , Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40, 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public Cr Private 133 Check if yes Municipal 0 On site disposal system t: SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: —ZIA" L VarmakCid- U.4 oZ Name Name(Print) City,State,ZIP I 29 D(Lid-,)obi- LaYi e_ 5--a5 -5707 tb.er COI's< No and Street Telepnonc rAnta:1 Addrco3 SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner Occupied 0 Repairs(s) 0 Alteration(s) Ei Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other krIpecify: i. Brig:Description of Proposed Work2: J...-•171-itia._ cu.- 12.4..rtir- Di 5 Lauafr d twL- SECTION 4:ESTIMATED CONSTRUCTION COSTS. Estimated Casts: Item Official Use Only (Labor and Materials) 1.Building S I) 1. Building Permit Fee:S Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical s tral) - • 0 Total Project Cost3(Item 6)x multiplier 3.Plumbing S Z alrb 2. Other Fees: $ 4 Mechanical (HVAC) S List: 5.Mechanical (Fire Suppression) Total All Fees: Check No. Check Amount: Cash Amount: 6.Total Project Cost: S 2.y, cy,„0 — 0 paid in Full 0 Outstanding Balance Due: 1 1 F ! ' i"ryt.. — iii ■ Id -- - `fIIiIIiILl*t Ie. // W, `F (A- --1----; . -- -; 3 _ h_; Na/ -- ,2 �--._. �.. � � '; -�m..i...., i ._ � ,l�, �/ -_,; Yam.. { 4 li I 1 Y I1 1I ._ 1 , --T 7/ i I N 11 , I 1 i 1 I i , , _,,T____Iiiii-, ______. _______ 1 / n ft LO 1, 8 ci 1 c I t-. to S ,' N NN I- , 1 ? 53 - II c t i 1 VI 1 ,....., . 1 -, .,.:, _ s_tA 11, 6-. Ti..._ �) s ! I tt op _It c 1 i 1 I Nile � } -1fdIDIj; ameaman /101 _ i yin- �� ��i SOS L 1 -.r I- , �iIIIiiI /N//�q//j� , I 25,23,2:42 PM image0.jpeg !! i 24/23.5177(lel CPS. C''C-s C1•411* 1:?-.00k \/CrteACt,t+VN AAA , , , ,,,,8„,, , F,4;5.{-iryts loci*"r"OCrrr\ ("` T‘crvc•fIrtic.y--., . EN-e—ry 4:Nr.;ct 05 GA-,4y i rli: k n sc,nr.e..... \0 c_4,k--;,..c.N. 0,.• s)r-,0,,,,v--, . - '','''''Cl-w:,4*--'::' A 1 ek) own i nc... L.-3i ncicxo i fl S‘r'Cl"."14?---1---- tA.?4\r• , <..!'-ifi:if4-,c ii4 ,--L, 1-,..irry,i)„.A---4.4:k 94e.....s .0, - , r4,.4,..-1.---;:f,,, . „I..),. . ..; ......, .- --,, . 4 i. '...., N . ' , , •• ,, , L A 40_ • I 4,...., .,. . , :,, ,...,,,:i4.',.•.,`:ikk.i,:f- , . AietA) (4 i mlow -I`ervtio i Zi(ie Is," ilt-,7,`e4 '''' •,,,`-'''t'', ,Tie,xlitn mail a(Yiinbox?projector=1 10 tps://mail.google.comi mail/u/0/#sent/FMkgz0 rcFpMhZgcZaltLbOlwXXwxyZ?compose=GTvV i eSIIMAFLPFKV DRdXcGpFIXI'fSH1VmCKCWfdmdzZQHxZqsZQfvXQWrfxDxqPwRZHXfJpwwN ft&projectov--1 TRANSITION ENGINEERING INCORPORATED December 29. 2022 Mr. Jeremy Nickerson P4tr►or M'4S4, East Coast Professionals Building & Remodeling �� iz.29. 250 Cap'n Lijah's Rd. o? ERcC J. u+ Centerville. MA 02632 CEerRfloLM i 0 STRUCTURAL k No. 38962 RE: 65 Circuit Rd. —Yarmouth, MA—Stair Landing . • Dear Mr. Nickerson. Ifia. _: Transition Engineering, Inc. has reviewed the photos and video you provided (see example below) of the recently constructed stair larding at 65 Circuit Rd. in Yarmouth, MA relative to the suitability of reusing the existing 8" concrete pad as the foundation for the new landing. liq ,,, i t ff, ray, w ' , , ` > ' li Per the 2015 IRC, Section R403.1.4.1 "Frost Protection", Exception No. 3, "Decks not supported by a dwelling need not be provided with footings that extend below the frost line." Based on this code provision, and given that the stair landing has been reconstructed to its original footprint on a concrete pad that shows no signs of cracking or settlement, Transition Engineering, Inc. finds that it is acceptable to reuse the existing concrete pad to support the new stair landing. Should you have any questions regarding these findings, please do not hesitate to contact me. Sincerely, E.:.....e Eric J. Cederholm. PE Transition Engineering, Inc. PO Box 576 Cotuit, MA (508) 404-0358 eicpe@verizon.net Page 1 of 1 Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards ConstruCtibAUpervisor CS-057291 F_icplres:09/17,2023 FRANCIS V WARD, III 51 MOORE ROAD EAST WEYMOUTH MA 02189 itV Commissioner ;';"a t' tJtncf�a THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8 Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Re jj tration x fr tign 106386 07/22/2024 AMFRICAN MORI'E HOMES INC FRANCIS V.WARD III 51 MOORE RD E.WEYMOUTH, MA 02189 `'�"" ZeN"ot Undersecretary w 44 dilifr x P q e„, ,. 4 . A . #1* 4- 1 i it y rir r { al 'a. , k f1 4:4 4. 4 1 ' r" y, ,, ,. : ; m poi i+t, s '''''' S r 4. i s NI . , ei' 4 4 akilf 7 , , - , ''.$ ' - ''',-., 10'0- 4 *, , ,it f y�� yam, •_ Y Fl T y r i.. ;( q0 T _ . „.. .,.„„till: -- "" t .Sev.{� 1 1 ii Dr, P4-t�Obi CQne ) yQrww 11°4-.