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Home My WebLink AboutBLD-23-002548 s . pa hoglaz ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,MA 02664-4492 �`' 508-398-2231 ext. 1261 Fax 508-398-0836 Sit r' ■ ` Massachusetts State Building Code,780 CMI. -' Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 1?),1).21j—Du X Date Appli - RECEIVED fir^ RA�.5 \,'(,\- NOV 082022 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION BUILDING DEPARTMENT . 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers By. 35-(iluioOtiQ&b ) L-i1 41 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 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: Public lii Private❑ Zone: Outside Flood Zone? — Municipal 0 On site disposal system CV Check if yea SECTION 2: PROPERTY OWNERSHIP' 2.1 �� or LA_ yI-Q(10v1 i PORT N lk (AbiS' Name(Print) City,State,ZIP 1 Csi tv cs-% [Z132-EN') �--1\) , C7$ 6(a . 9 of h i IL Sv savi •Toro,i1 . No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied ❑ 1 Repairs(s) 0 Alteration(s) 0 I Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: GohtJdk j / c (9iitit(.(= 10 l'l-M I& i Rlrrl'\ SECTION 4:ESTIMATED CONSTRUCTION COSTS. Estimated Costs: Item (Labor and Materials) Official Use Only 1.Building $ aid00 oft) 1. Building Permit Fee:$ 1 co Indicate how fee is determined: 2.Electrical $ ai Standard City/Town Application Fee MD.00 0 Total Project Cost3(Item 6 x multiplier x 3.Plumbing $ 2. Other Fees: $ ,.3 5•UU . 4.Mechanical (HVAC) $ List: d e 107.3 9 �'C 5.Mechanical (Fire . . .$ Suppression) Total All Fees:$ Check No. Check Amount: Cash • it•un/ 14 6.Total Project Cost: $ 3S,qv •Jp El Paid in Full ill Outstanding Balance D e: \>> L.,I ► 24 J22, SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) l N License Number Expiration ate Name of CSL Holder �it Ll S List CSL Type(see below) No.and Street / Type Description ^lOk/ til H p 0 )cU Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,``ZIP Restricted I&2 Family Dwelling ivI Masonry RC Roofing Covering WS Window and Siding ,7� 3'3 e �e rein O J(,wo SF Solid Fuel Burning Appliances Telephone 110 I InsuEation ele P P'`EmaiI address D Demolition 5.2 Registered Home Improvement Contractor(HIC) GG C 4-5 ir°UL IiIC Registration Number Expiration Daze HIC Company Name or HIC Registrant Name No.and Street Email address 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 No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as O% of the subject property,hereby authorize j E 1 r RE y W RA&b--- to act m behalf,in all rs lative to work authorized by this building permit application. vl Prin er's Name(Electron ignature) 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 applicati n's true and accurate to the best of my knowledge and understanding. - - d- Print Owner's or A iz is Name(Electronic Signature) Date NOTES: I. An 0% who a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered m 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.sov/oca 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 508-398-22311 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 }c v),NUlAvg k OM; Work Address Is to be disposed of oat the following location: 'lO i '1J1} ()(,, Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. c}a gnatur f ication Date Permit No. Commonwealth of Massachusetts Division of P Reg u ationsLand Standards �U" Board of 8uildin9 9 p i rvisor Cons Ji ` '* , t pires:0912012023 i Cs-075746 ; f LAGG V EILEENJEFFREY ST RA MA 02675 AR MOUTH�9 ,;: i Commissioner '4 ' THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration F \ .', Type: Individual -�Registration: 149773 JEFFREY WRAGG Lt't .,= 4$ Expiration: 02/21/2024 54 EILEEN STREET ..., Ns -»~, YARMOUTHPORT, MA 02675 , ,.= Cc Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE: Individual Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 149773 = 02/21/2024 Boston, MA 02118 JEFFREY WRAGG F JEFFREY L.WRAGG ' +. - t'i 54 EILEEN STREET ,,4- , f4.1 " YARMOUTHPORT,MA 02675 Undersecretary N t v ' without signature The Commonwealth of Massachusetts - Department of Industrial Accidents 1 Congress Street,Suite 100 oston, MA 02114-2017 � inass.gov/dia ,j� Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lejbly _ Name(Business/Organization/Individual): ., ez r 1 11,Eiit (;j pAtv Address:,...4'"1 SILL 7i �-I'1Lii(, City/Mate/Zip:1;)IL'r'U )i ftPcl) AV)--04-7r Phone#: -7 T`'A - s' - ! )..- Are you e@ employer?Check the appropriate boa: Type of project(required): 1.0I am a employer with employees(full and/or part-time).* 7. 0 New construction 2. I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] !3. Remodeling 3.D I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ®Demolition 4.01 am a homeowner and will be hiring contractors to conduct all work on m y pro 1 will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0I 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.in;urance.t 13. JRoof repairs 6.®We are a corporation and its officers have exercised their right of exemption per MGL c. 14.®Other 132,§1(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. 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: SS U I A/L )l.,1�I L/ ) L41uL 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 tt.e 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 r the pains and penalties of perjury that the information provided above is true and correct Signature: Date: I 1—,)-- a} Phone#: 1 LfJL&il use only.'Do not write in this area,to be completed by city or town officiaL ICity or Town: _Permit/License# issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing)Inspector I 6.Other Contact Person: Phone#: Sears, Tim From: Sears, Tim Sent: Friday, November 18, 2022 11:22 AM To: jeff@capehomeremodel.com Cc: Slack, Christine Subject: 35 Gingerbread Ln Jeff, have reviewed your application and you are going to need Health Department sign off. Thank you Timothy Sears CBO Deputy Building Commissioner Town of Yarmouth 508•-398 2231 Ext. 1259 mailto:tsears@varmouth.ma.us 1 Firefox about:blank • pf�Yqk TOWN OF YARMOUTH .1*s it.c HEALTH DEPARTMENT itz PERMIT APPLICATION SIGN OFF TRANSMITTAL.SHEET To be completed by Applicant: Building Site Location: 3. t 1 IA5la13 tdtP5 Proposed Improvement: L j ' i3L4eg1r F 1Lt, (�•.i,v� c-` eat,Z ¢ &etC /1"c<C4 Applicant: (TL�t iZE1/ Tel.No.: 74 3 -t }-)L Address: 611-ghi S j Date Filed: /f 91'—4. **If you would like e-mail notification of sign off please provide e-mail address: e pit CLtpe..hlfirtii'utk c s Owner Name:SU..MJ l+1l.L Owner Address: 3S (9tivLt'k}Y101 G Owner Tel.No.:. O -44)' —10r 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: P.7."7 (1.) Site Plan showing existing buildings,water line location, and septic system location; NOV 2 8 2022 (2.) Floor plan labeling ALL rooms within building (all existing and proposed)— H EAL. ' 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: W/A-2, P EASE NOTE COMMENTS/CONDITIONS: 3l� f c) ck 1/vl (. 1 of 1 11/23/2022.3:17 PM RECLWED Sunroom Deck NOV 26 2022 1 1 HEALTH DEPT. Step ! I L Hallway ININIINMI Dining Living Kitchen Closet Garage Bedroom 1 ?IZO Pos_ Room Front Porch `" 1 - Bath 1 i =1 i Bedroom 2 Bedroom 3 35 Gingerbread Lane REC.E, ED NOV 2 8 2022 Sunroom Deck HEALTH DEPT. Step 1 I 1 Hallway Dining Living Kitchen Closet Garage Bedroom 1 PRO Pos P pfttiNai Room Front Porch Bath 1 —_ Bedroom 2 Bedroom 3 35 Gingerbread Lane • 35 Gingerbread Lane 330 Sq. Ft. Cover concrete slab with 1 inch foil faced insulation, taped at seams. Build 2x8 floor system over that with R-30HD insulation and covered with 3/4 plywood. Frame in wall with 3 Anderson 28310 double hung windows with grids to replace the garage door using existing header, no structural work needed. Match existing trim & siding Closed cell foam insulation in perimeter walls to envelope Sheetrock walls & ceiling R-30 in ceiling Mini-split for heat/air REVIEWED K7 ".'^ ,O'P I-WE ERRORS D ,L ,i tc THE AF'LICANT FROM THE RESPONSIBILITY uf-'AS BUILT" COMPLIANCE, LATE: I r�. Cif BUILDINc OFFICIAL .:, I Y 'r- y. tUo Doof( 3 b( sou '100 £ERJ DOut3i. ttUNk- lu PL-X d r (7/h,E.own /3h/fi Yai1v.,2 l!; Firefox about:blank of•-): TOWN OF YARMOUTH 5 .'',c i0.3 NHEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: 35 ($11ki‘12-ty3). L-✓}pt- Proposed Improvement: L9 J 10 jLCe'i/ pApi lo ugl .e14..Z .f. & Ict- /Hcc< . Applicant: (31 :1I�ti 'WMb Tel.No.:-01-1 3 .4 --1,)- Address:Sil L; 1- I\1 S j if-edjfi Date Filed: j I'-)-j-??- **Ifyou would like e-mail notification of sign off please provide e-mail address: e 1 f V CLipe_hai ru k 1 c Ge m Owner Name:SW M) if/U_ Owner Address: 3r (phif ftVie.4') OIL Owner Tel.No.:SO -44)- -`ltur 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: REC ^' (1.) Site Plan showing existing buildings,water line location, and septic system location; NOV 2.6 ZOZZ (2.) Floor plan labeling ALL rooms within building (all existing and proposed)- HEAL:: : ;. .. 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: I j-�/ A2 P EASE NOTE COMMENTS/CONDITIONS: ti- r3 ( 2 JV-C r l� u � vv� �2- ( �l l of 1 11/23/2022.3:17 PM