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HomeMy WebLinkAboutBLD-23-001735 ' iqA 7///t%z ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,MA 02664-4492 rl , 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 This Section For Official Use Only Building Permit Number: 13( )--23-(1)/ 3.— Date Applied: v R L Ci E t E D \;,r-, A i 5 "-")-V\'-- I _SEP 3 0 2022 Building Official(Print Name) • Signature 1 Date SECTION 1:SITE INFORMATION ` BUILDING DEPAR I MEANT 1. P�r perry Address: ( �� / 1.2 Assessors Map&Parcel Numbers ' r — --- q CSS�c /T 1.1 a Is this an accepted street?yes V no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: .4.)/4 Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) A)(I Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided i 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood ne? Public Private❑ Check if yesV Municipal 0 On site disposal system V SECTION 2: PROPERTY OWNERSHIP' 2 O)ner'of f Record: !�(%�i gar-oval-Aix C Name Print) City,State,ZIP Q ssex way 506-6r2-6 5- annel/at 9 2ha- . No.and Street Telephone EmairAddress SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 I Existing Building 0 1 Owner-Occupied 0 1 Repairs(s) ❑ Alteration(s) LI Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units J Other 0 Specify: Brief Description of Proposed Work2: P Lc tC#.//y T•'2.,5 I b.s'e.p)e—'-"/ zE-e / rccn L SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 1. Building Permit Fee:$ 1 CO _Indicate how fee is determined: ®Standard City/Town Application Fee 2.Electrical $ s 0 Total Project Cost (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 35.00 4.Mechanical (HVAC) $ List: 0 9-C1 S 7 5.Mechanical (Fire $ Suppression) Total All Fees:$ „f '`n , J,D c.,--0Check No. Check Amount: Cash Amount: Ui 9 t 6.Total Project Cost: $�'4 2 it 0 Paid in Full C11 Outstanding Balance Due: \\c ./c V 4, SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 0S_ v 74Pe r O'&V' 2 4!/Z��at 2_/ License Number Expiration Date Name of CSL Holder i ,tn-e'sor List CSL Type(see below) (� No.and Street Type Description c) k)l ett_ Mk) 0P6 6 1 U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP J R Restricted l&2 Family Dwelling !VI Masonry RC f Roofing Covering • WS Window and Siding SF Solid Fuel Burning Appliances 7 L 298--3586 creexkd dream/.orne`mpcvearu ll.insulation Telephone Email address D Demolition 5Ai/eif 7 Registered Home Improvement Contractor CHIC) �1/2<l/23 .Cebecie v f7 '777 HIC Comp y Marne or F,i C).egistrant Name HIC Registration Number Expiration Date Zv, 662r �( Gx p dream homer m prtcveme4 41,Lang and Street Email address iv/Clt ,09P,ad56b i-? -3m9 City/Town,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 Ii 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: ut(C 0 a`'(4 tk TI 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 contained in this application is true and accurate to the best of my knowledge and understanding. 'fife sce k becfe✓ _ Q(3o f Zz Print 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.eov/oca Information on the Construction Supervisor License can be found at www.mass.eov/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 ' Department of Industrial Accidents 1 Congress Street, Suite 100 -:i?�= Boston, MA 02114-2017 ,;,:Y•'�( www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information �®��j�,��� _ Pleased Print Legibly Name (Business/Organization/Individual): cr2Gcut r{,attt Jmj7r ilemkcA.," .� Address: 4(i/ �£� / City/State/Zip: 5W CIW/ c l.f1?i ,0256 Phone #: 77h-006--3689 Are you an employer?Check the appropriate box: Type of project (required): am a employer with 2 employees(full and/or part-time).* 7. New construction 21:1 I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling • any capacity.[No workers'comp. insurance required.] 3.0 I am a homeowner doing all work myself.(No workers'comp. insurance required,]t 9. ❑ Demolition 4.1:I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 5.11I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.0Plumbing repairs or additions These sub-contractors have employees and have workers'comp. insurance.' 13. Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c, 14.Q Other 152,§I(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. 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. J.1E Insurance Company Name:Policy#or Self-ins.Lic.#: Wee 50060156 V-92022 f' Expiration Date: 3/fs r/ ?- Job Site Address: 9 e.S'Se X W Yar/ThaakrVr4 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 a er the pains ai enalties of perjury that the information provided above is true and correct. Signature: Date: 7 / °— Phone#: 77tf-ea - 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 CIerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 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 Q ESSe-x waif 1 Wax- o p-41 MP Work Address Is to be disposed of oat the following location: YarolotA44- -from 5 A- Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. i& 6?/tC/2a, \ Date Signs re of Application Permit No. A!^�® DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 3/11/2022 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 THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED. the policy(ies)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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Eastern Insurance Group LLC PHONE FAX 233 West Central St IA/c.No.Estl•800-333-7234 (A/C,No):781-586-8244 Natick MA 01760 E-MAIL CSR24CL@easterninsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Arbella Protection Insurance Co 41360 INSURED DREAHOM-01 INSURER B:Associated Employers Insurance Company 11104 Dream Home Improvements LLC 7 Windsor Road INSURER C: Sandwich MA 02563 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1418929464 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE W ADDL SUBR POLICY EFF POLICY EXP UNITS LTR INSD VD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY 9520053178 3/8/2022 3/8/2023 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY 7007 LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA UAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WCC50050156792022A 3/8/2022 3/8/2023 X AND EMPLOYERS'LIABILITY STATUTE OTH- ER _ _ ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Display Purposes Only AUTHORIZED REPRESENTATIVE -'7 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Sears, Tim From: Sears, Tim Sent: Tuesday, October 4, 2022 1:30 PM To: alex@dreamhomeimprovement.com Cc: Slack, Christine Subject: 9 Essex Way Alexey, I have reviewed your application and there are some items needed. Vl. Health Department sign off �2. Floor plan of entire dwelling with smoke/co detectors marked as required by code(adding a bedroom requires the entire dwelling meet current code) 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 CBO Deputy Building Commissioner Town of Yarmouth 508-398-2231. Ext. :1.259 mailto:tsears@varmouth.ma.us 1 Dream Home Improvement LLC. 7 Winsor Rd. Sandwich Ma 02563, Home Email: john.dreamhillc@mail.com Improvement LLC. 508-332-8119 John Collinson Project Manager 774-208-3589 Alexey LebedevOwner/Contractor www.dreamhomeimprovement.com HIC#: 176777 CS#: CS-108208 Contract DATE: 4/2/22 PHONE: 508-612-6457 NAME: Anne & Jim Lang EMAIL: annetlang@yahoo.com MAIL ADDRESS: 9 Essex Way Yarmouthport, Ma. JOB ADDRESS: 9 Essex Way Yarmouthport, Ma. Dream Home Improvement hereby proposes to perform the following services in a neat, professional like manner in accordance with the manufacturer's specifications and local building code. Basement Remodel: 12x36 area Frame for bedroom and office: Framing will consist of a vapor barrier on the concrete. 2x4 wall studs 16" on center Build closet for Bedroom Door openings will be 2'8"by 6'8" quantity 3 Install drop ceiling with 2x2 square recessed tiles All labor,materials,disposal and permit fees are included in a price.All additional extra work will be charged 70$/h plus materials • Electrical: Install recessed lighting throughout bedroom and office. 2 in bedroom, 2 in office, and 1 in hallway Electrical outlets and switches according to current building code Insulate outside walls with R-21 faced insulation Moisture resistant wall board will be installed with tape and mud finish Doors will be solid core Masonite pro hung 6 panel. All trim on doors will be 2 % colonial with 5 % speed base Paint to be done by customer Laminate floor Install egress window in bedroom at end facing back yard Remove section of wall at top of stairs to meet opening to basement Add flooring in bedroom at bottom of stairs in basement. Additional 2,240.00 Total cost for project. $64,240.00 Due upon signing of contract $17,333.00 Due upon start of job $22,073.00 Due upon completion $24,834.00 Signing of this contract must be completed within 30 days of contract date to hold pricing All labor,materials,disposal and permit fees are included in a price.All additional extra work will be charged 70$/h plus materials Make All Checks payable to "Alexey Lebedev" Compliance with Laws: Contractor agrees that it is properly licensed and insured under Massachusetts General Laws Chapter 142A and that it will perform the services contracted for herein in compliance with applicable building codes, laws, statutes and ordinances. Parties' Understanding of This Agreement: by signing this agreement,the undersigned Parties acknowledge they have had the opportunity to ask any questions concerning its terms; have read, understand and agree that its terms are fair and reasonable; and agree to be bound by the terms in their entirety. This agreement is effective as of the date it is executed by all the undersigned. Contractor es Customer 44 La f' Date signed 6/20/2022 All labor,materials,disposal and permit fees are included in a price.All additional extra work will be charged 70$/h plus materials i..:omrnprsaartl+o A♦abaachuortto Q.rKxst ProlMaronal ucenst to Board of QunMng Repurarrcitrs anti Standards ,o-r.-15r. Soper cs-10e2Oa artptrea 11;27,2022 AL.t%EY LESED V 7 WVI OSOR RO AN0VACf1 MA 0NS$ Yes Gommlauoner e'r i r+llitll'/i��'/ 'P��!/ I' /.//l 40e/(;/(/3///f) Office of Consurner Affairs and Business RegttlatioI: 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvernernt Contractor Registrattort Type Ra,fl;•tratil;il- '1077 fR1J0.4 1OWE ItAPROVFMENT LLB-. Fxpitation. 7 WIND S R R-) sANa'dktCH, MA 1-0,63 r — t)ltdatc Address sod Rtalurn Card. A :CPO f/.. 4'0e4lMtll Ilw 111116i 11 1t.gliisir++aihoi+oRIo, ItDME IMPROVEMENT CONTRACTOR Raglatratton volt!tot Irtdlv.tluat use only TYPE I IC before the ea:piratlon date. II forintt taturn to. r4kgttrtwtIon £acalts1100, Office o4 Consumer Affairs and Busntass Repulutiun •7677? 1ON Wo.hingrton Sent -Solta 710 11!4PROVE-M N" ;Li: ftrr8tt•.n MA 021t$ '' "�`PD '+ Not valid without t;igntlture t,;; f.U; t72$6� urviar„ecrrier: • r 0t•1-4 .4, TOWN OF YARMOUTH it ; HEALTH DEPARTMENT '�• `` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant. Building Site Location: y �jJ<'-X (-c)2t j � P f 3ij J Proposed Improvement: 0_7 ici 1l/ --lit'-f, % 7E-t;.�) Jet v-h(cot., f210,...1 3, ,rocv Applicant: -/{"F X CC X- IXCv Tel. No.: 774- 2C6"-3 / Address: :> 1�aiuf/SG K ,,��, �`Jact /w/cX— 7?7,1,7,0256 3 Date Filed: //'//? a **If you would like e-mail notification of sign off,please provide e-mail address.a16X C`� 0reamhrinc- rv,t6w6-MeLt7` ,(-0,; i Owner Name: '' i , , a(- C / ` 4 '1 Owner Tel. No.:-5c6 6 _ '' _77 Owner Address: , '��, , Gc i 1� s % r -L � i �' /� 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: • RECEIVED (1.) Site Plan showing existing buildings, wate and septic system location; ---- (2.) Floor plan labeling ALL rooms within bu IdingoCT 26 2022 HEALTH DEPT. (all existing and proposed) — Note: Floor plans not required for decks, sheds, w '1�i�s ik&o RTwEwr Y _ _ (3.) If necessary, Title 5 application signed by icense in with fee. REVIEWED BY: cON/N-7/0DATE: / / 2-c - PLEASE NOTE COMMENTS/CONDITIONS: 140 V f L a c :... IL- r ON `� 3 y /%_e V'G awl S'' d 1 .ed v-0 +1 Imo` r c"1- F/cx-it : .. Pe w f ✓' ti 1. a%- A' ——) ---) ..-." -• 77 t'f' C.. ) r ev, (-- C cts , F --Z.) , F 0 , 0 .e• eV Li 0, L-- ( . /)..,. -• , '"Z1 ..1. C.) .-. . f.. 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I ,,-- i ......, t i in 4 ci 1 ,..., 2 ri i rn -0 171 H 0 i interior Exterior Side Side Permanent Ladder or Steps required when depth of window well is greater than 44 inches Emergency Escape ar N . ....., and Rescue Opening with sill height Window below grade Well > 44" Minimum 9 SO, FT. w 44" Maximum Sill Height above Finished Floor 38" Minimum Clear 1—x I—•CO * .1;M X 20 I 41 CD 0-•M =0 X 73 ,...0 NJ 0 0 0 ..i 3 .. -- ---Z ,_VS . V) 1 1. - . 1\., limormisimir ... ,1)x , • s 1 -... x r- ..IT,9 X . .L 8 r- , • L4 1 140021H.I.V9 NJ 1 1 ' . '-"--v. ----' ....%.% IV I- I 0< 11 t.;._. :.2 ui x C./ ,._. 701 x m ..18 1....0 .1...0 ..1 - .4 .Z •- ji .-"_ 1 1--•70 1,, .... Ti-H 1 GI t3 ri v, > 3, .• -4 l.4.— — _ ..:... 74 1 - 11 .... . L.1.) X n . .-•mi ko _. 9 . / .- i... \._./ T rn ... x .. 6 • rn . 111•1111111111110 a r....., rn ill -o 74 r-wilf 11.i, .1, K xt 2. o SD m r+ W 0. .t —ts 73 0 =ft VD ___---AMIMIIIIIMMIll l' in' *5,i SQ. FT. •Minimum - ' Openable Area 24" • • Minimum x Clear Single/Double Hung Window 44" Maximum Sill Height above Finished Floor Finished Floor 4 HEALTH DEPT 20" Minimum Clear i i ♦ *5.7 SQ. F N Minimum Openable Area Casement Window 44" Maximum Sill Height above Finished Floor Finished Floor CO?.K Cr`td"C:o..G /\ 0 1.-Q... Sri.=,t.,pvtD'4''r,..42,,,.4-. 17. ' d WATER DEPARTMENT 1ENT BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: � �� $' °r c ,-, PROPOSED WORK: APPLICANT: - f,ei/e �'. •t Lj t , ( ADDRESS: 9 'r .c/ /2Y/ t� TEL•PIIONE; , 1 ✓b RESIDENIIAI. ANI):OR ('OMM`IERCIAI. BUILDING DING • U'ater Department_ Determines Compliance of Water ,\rarlability and or existing location Engineering Depzoi tent: I)cternnoes Compliance tirr Parking and Drainage Conservation Commission. Determines Compliance to Wetlands Act; i c tI'lot(s)bonder any type of wetlands,streams,ponds, risers,ocean.bogs. boys.marshland, I'I l'(°-.. f leafth I)epartmemo Determines Compliance to State and hown Regulations. i-c requirements for Scptasse I Tisposal and other Public Ilealth Acti‘ites I'ire I)epartmeat: Determines(.ornpliance to State and [own Requirements tut Personal rfcty. Property Protections, i.e. Smoke Detectors. Sprinkler Systenrs.etc :APPI:1C ANT SIGNATURE DATE OFFICE USE: COMMENTS ON PERMIT APPROVAL OR DEaNIAl. esi•.riiz y pd I NI 1" o4- Wiorm(L Sc a-wl cc s-pkiaL . -.►b r 1 F D n5Tlev Lrell m'i Ave Y tow s-rev on o W ,eve D -h4i< i pu t.•l v-A e Act Cs 5 1-c2 t' -6 W rE t rM TE , • "dm 10/3/z_o REVI VED BY WATER DIVISION(SIGNATURE) DATE 4 $ if $ 4.' # . .vit $ ,..„ , - 1 , 1 /, 1- - 01114?#,... 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FT. 44" Maximum Sill Height above Finished Floor 36" Minimum Clear