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Home My WebLink AboutBLD-23-002006 po ii / _ REC EI . TWO FAMILY ONLY- B BUILDING PERMIT Town of Yarmouth Building Department ..... ...... OCT 4 2022 i 146 Route 28,South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836ti`, Lg ILDING DEPARTMENT Massachusetts State Building Code, 780 C "!� iY liding PPYmitApplication To Construct, Repair, Renovate Or Demolish II�..��,,,,�� a One-or Two-Family Dwelling -'`✓ This Section For Official Use Only Building Permit Number: i Lb-2 -D 6 Z,(xjb Date Applied: ,diip Building Officialt mtName) `"�"�S� '� 40 AirSignature Date SECT ON 1:SITE INFORMATION 1.1 Pr ert�Add ss: 5 A r, 1.2 Assessors Map&Parcel Numbers I.l 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 (sqArea 1.5 Building Setbacks(ft) ft) Frontage(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: Public 0 Zone: 1.8 Sewage Disposal System: Private❑ _ Outside Flood Zone? Check if yes❑ Municipal 0 On site disposal system CI SECTION 2: PROPERTY OWNERSHIP' 2.1,Own f Weir Name(Print) 02 , ec c ity,State,ZIP No.and Street Q(j Z( yea Telephone Email A res SECTION 3:DESCRIPTION OF PROPOSED ORK (check -II that apply) New Construction 0 Existing Building 0 Owner-Occupied 4 Repairs(s) TA Alteration(s) 'Al Addition 0 Demolition ❑ Accessory Bldg. 0 Number of Units Brief Desc ip ion of• •posed Work': t ��, p Other 0 Specify; MMM- r rzl/ r0 t1 , Y. SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: (Labor and Materials) Official Use Only 1.BuiIding $ 2Z/I©o I. Building Permit Fee:S :::Indicate how fee is determined: 0Standard City/Town Application Fee 2.Electrical $ if Ze,p 3.Plumbing $ 0 Total Project Cost'(Item 6)x multiplier x �\ b l�/ o 0 02. Other Fees: $ 3S-— �^' I 4.Mechanical (HVAC) $ List `�lC `s v 5.Mechanical (Fire 3 p\ Suppression) $ Total All Fees:$ 6.Total Project Cost: $ O , -T:. Check No. Check Amount Cash • ,•ount: // �/ Od 0 Paid in Full 0 Outstanding Balance Du- 21/ §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 135 Coad Work Address Is to be disposed of oat the following location: VartV10 tith. )0XIV tJ Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. /0-- 1q-70z2- Signature of pp ication Date • Permit No. SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C� - /4 5� Cad_ t�3%-z_oz3 Name of C Holder License Number Expiration a ee r A-l. List CSL Type(see below) No.and Sheet 15 I3ect. 3.''.,�, Description W Unrestricted(Buildin: u.to 35,000 cu.ft. City/To State,ZIP Restricted t&2 Famil Dwellin. MUM Mast) J6 73 RC Roofing Coverin MILMIN Window and Sidin � �� l 9, CfpCO{f( �� 4� MN am= Solid Fuel Burning Appliances Tele. one Email ad.'es �� e.► — D Insulation 5.2 Registered Home Improvement Contractor(HIC) Demolition HIC pang Nape or HIC gistrant N e HIC Registration Number "' `o T�� ,,j Expiration Date Ci /Town State,ZIP XZ • Email address Tele.hone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(iVI,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 Issuan of the building permit. Signed Affidavit Attached? Yes r No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize IPIRA 4 to act on my ,D�ve to work authorized a If,in a 1 ma er elati ~ / IR �' by this build g permit application. Print Owner's Name(Electronic Signature) j /u Date 7 _ • Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury contained in this application is . -I , acc . - to the best of ray knowledge and uunderstanding. information / Print Owner's or Authorize. 41...- lectronic Signature) �f�-zoz 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/tot 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.gov/oca Information on the Construction Supervisor License can be found at www,mass.00v/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including Gross living area(sq.ft.) garage,finished basement/attics,decks or porch) Number of fireplaces Habitable room count Number of bathrooms Number of bedrooms Type of heating system Number ofhalf/baths Type of cooling system Number of decks/porches Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" • --= The Commonwealth of Massachusetts 4 ►..,MMI Department of Industrial.Accidents ' 1' c. 1 Congress Street,Suite 100 Yi{' Boston,MA 02114-2017 '`t . � www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. A. •licant Information Name (Business/Organizatio ndividual): rellUirill 0Please Print Le7'b- Address: ri- / y' 15 07 City/State/Zip: /f/17 fit / riP07‘73 Phone#: 5-07—2 -- Are you a mployer?Check the appropriate box: �� 1.0 I , a employer with Type of project(required): —yemployees(full and/or part-time).* ? am a sole proprietor or partnership and have no employees working forma in 7. 0 New construction any capacity.[No workers'comp, insurance required.] 8. ❑Remodeling 3.0 I am a homeowner doing all work myself.(No workers'comp.insurance required.]t 9. 0 Demolition 10 ❑ d.❑I 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 Building addition proprietors with no employees. I 1•❑Electrical repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 12.El Plumbing repairs or additions These sub-contractors have employees and have workers'comp.insurance.? 13.El Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per,MIGL c. ❑ 152,§I(4),and we have no employees.[No workers'comp.insurance required.] 14' Other *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 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: . C. a Policy#or Self-ins.Lie.#: � � � S _ � Expiration Date: /` �� -�� Job Site Address: _3 Attach a copy of the workers' compensation policy declaration page(showing thetpo icy number and xpiration 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. 1 do hereby certify to er the pain and nalties of perjury Mat the information provided above is true and correct Signature: Date: /t, '--`g - 2.eaz Phone#: .s---0 r Wfl -9 f y Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License r Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone;;`: THE COMMONWEALTH OF MASSACHUSETTS Offlmo of Consumer Affairs&8uslnas*Rapuiallon HOME IMPROVEMCNCONTRACTOR TYPE: ndv dual 186088 09/27/2024 BARRY HALL D/B/A CREATIVE CARPENTRY BARRY HALL 3 BETTY'S PATH a e 4 •4 W. YARMOUTH, MA 02673 Undersecretary T Commonwealth of Massachusetts Division of Occupational Licensure 3141- Board of Building Re ulations and Standards I Tic Cons t;ly on isor CS-105506 Epires 12/3112023 BARRY R H/ ,L Ar1 . v 3 BETTY'S PATH WEST YAR14JJTi Commissioner ' , American Window Film, Inc. Authorized Window Film Dealer Prestige Dealer Network 71 Elm , Unit 10, Foxboro, MA 02035 '4_4 C4I t, RECEIVED( 08 549.0300 . f 508.543.4777 r\ The Skin Caner Foundation — ww.americanwindowfilm.com C� recommends many 3M Window Film 800.274.T I NT products as effective UV Protectants. \_ JAN 09 202; t I,: Creative Carpentry auli��aG lei. id y, December 2, 2022 By Barry Hall Phone: 508-241-9964 3 Betty's Path Alt. Phone: k �A West Yarmouth, MA 02673 Fax: Email: creativecarpenter@comcast.net WE PROPOSE to furnish and install 3M Window Film as follows: 3MT'" S800 Safety and Security Window Film Installation of Film to(2) Lites -Bath Skylights Installation of Film to (1) Lite-Bath Double Hung For the Amount of $400.00 *Lifetime 3M Warranty Labor and Materials \b-0 CatAk Job Site: - Thatcher Shore Rd. Yarmouth, KA 92644 Ot° 7 1(CC i%\/: For the sum of: Four Hundred Dollars Payment to be made as follows: 50%Deposit, Balance Due Upon Completion 3M warrants against glass failure due to thermal shock fracture or seal failure(maximum value of$500 per window)caused only as a direct result of the application of Scotchtlntrm and Scotchshield TM'films provided the film is applied to recommended types of glass and the glass failure is reported to the Seller within a specified number of years from the start of the installation.Any glass failure covered by this warranty must be reviewed by Seller prior to repair,and only covers film and glass replacement.See sample of specific warranty pertaining to your type of installation. Note:This proposal may be withdrawn by us if not accepted within 32 days. Authorized Signature. Bart M. Rubin ACCEPTANCE OF PROPOSAL These prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date /g—pC c9C� in the event that payment is not made on r before the due date hereof,the parties agree that carrying charges at the rate of 1 1/2%per month shall be added to the unpaid principal. The buyer further agrees that in the event of default of payment on the due date,the buyer will pay all costs,and expenses of collection including reasonable attorney's fees if the balance is referred to an attorney for collection. Please Note: I understand that 3M Scotchtint"Fade Reducing Films will not prevent fabrics from absolute fading. I have read and I understand the 3M warranty for material and labor for this particular project. (Please initial.)