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HomeMy WebLinkAboutBLD-22-001648 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 Massachusetts State Building Code,780 CMR -.., �...,t, Building Permit Application To Construct,Repair,Renovate Or Demolish � � V .� a One-or Two-Family Dwelling " - . :...:� -- This Section For Official Use Only SEP ti G 2Q2 Building/P�e'rmit Number: BLS_?— r Date Applied ] it.01 --- _.___ Building Official(Print Name) Si re p C I V E b SECTION 1:SITE INFORMATION R Gr---...-- -_..._..__.� 1.1 Proper Address: 1.2 Assessors,Map&Parcel Numbers 9 2022 V4 6 AUGA 1.1 a Is this an accepted street?y� G' no Map Numb Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: y�j BUILDING D PARTMf1�' Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) ��f 1.5 Building Setbacks(ft) too Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided .37,7 � y _2-7 1.6 Water Supply:(M.G.L c.40,¢54) 1.7 Poo Zone Inforr on( 1.8 Sewage Disposal System: Zone: Outside Flood Zo ? �/ Public i Private❑ IN Check if yes Municipal❑ On site disposal system SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: 4-D L rZ L 4 y gAlLV; 4.,.6,i A-41-- f/(r17 Name(Print) City,State,ZIP / No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0' 13xisting Building❑ Owner-Occupied 0 1 Repairs(s) 0 Alteration(s) 0 Addition I Demolition ❑ Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Work2: D /2•"x /S•.r vet/" /?/VA/ k✓� Are-// Z. Ali `- E,./ /)ar^e-t-/ SECTION 4:ESTIMATED CONSTRUCTION COSTS. • Item Estimated Costs: Official UseOnly (Labor and Materials) 1.Building $ j-e' „we 1. Building Permit Fee:S LOS Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ - ©"U 0 Total Project Co (Item 6)x multiplier x 3.Plumbing $ vol.) 2. Other Fees: $ "iSto 4.Mechanical (HVAC) $ l List lz�tf 5.Mechanical (Fire $ Total All Fees:$ Suppression) ‘.2( �- Check No. Check Amount: Cash Amoun• �3� 6.Total Project Cost: $ jc 06/j CI Paid in Full 0 Outstanding Balance Due: \,14112-)- SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) c3 — . Ze9 t 6 47 y License Number Expiration Date Name of CSL Holder / List CSL Type(see below).54; vJ� 7"/ Na.and Street Type Description ge%l`_ �, e)/e07 ( Unrestricted(Buildings up to 35,000 Cu.ft.) f7 / R Restricted I8c2 Family Dwelling City/Town,State,ZIP l Masonry RC Roofing Covering _ WS Window and Siding "e . /� 641 l'/""e SF Solid Fuel Burning Appliances '1/3 f7Y V f,, I Insulation Telephone Email address D Demolition . 5.2 Registered Home Improvement Contractor(HIC) 6 HIC Registra' Number % oncate BIC Company N or HIC Re istrant N N1 •d Stet' C� ,-f 2z1- f /e/st y ei rrh-r,,_e- - i v I ii e//T-37y y6/ Email address City/Town, State, IP Telephone 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 Iss e of the building permit. Signed Affidavit Attached? Yes 0 No 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETE])WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize 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. �y /c�' ,o-g 9/, 2/ Print Owner's or Authorized Age s Name(Electronic Signature) Date NOTES: I. 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.aov/oca Information on the Construction Supervisor License can be found at www.mass.aov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) 72-G (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count S Number of fireplaces Number of bedrooms 2- Number of bathrooms f Z- Number of half/baths /> . Type of heating system 1/jj¢e.— Number of decks/porches / Type of cooling system Enclosed Open / 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Y5; Ova r) -53 oc ma�� Z 3� z"a rn��cto ?co �2 ` 3aOrm -C ffx tcY bDo m' Cm • •41 • rn iii C. ,o RZQ o dV vo t. c. xpu m ti A, -4pa oz AIi m n m §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 ? /)m6 vr/ Work Address Is to be disposed of oat the following location: 5: yntri.14,,/-1, Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. tl/C72,/ Signature of Applica 'on Dat Permit No. The Commonwealth of Massachusetts Department of Industrial Accidents �s:,tltl= 1 Congress Street, Suite 100 'tor- Boston, MA 02114-2017 �,..�' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leoiibty Name (Business/Organization/Individual): � LAG l� o g �i'"c�1,7e.tif � Address: �/®` S '$ /fie Cit /State/Zi C7�la Y p: f, �4 44r fl A— Phone#: ef rl 3. / �---- Are you an employer?Check the appropriate box: Type of project (required): I.O l am a ployer with employees(full and/or part-time).* 7. -e construction �'I a 2 n a sole proprietor or partnership and have no employees working for me in 8. E 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 10 Li Building addition 4.7 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 sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box R1 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. iContractors 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: S/k- Policy#or Self-ins.Lic.#: /14P0#-P-'61'4 .Y7 Expiration Date: t ! 2— „ Job Site Address: D/" At V S'/r e t City/State/Zip: , 1. 6 yhor°' IG' iX /'4A- Attach a copy of the workers' compensation policy declaration page(showing the policy number a d expiration date). 612_4G cj 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under to pail and penalties of perjury that the information provided above is true and correct. Signature: Date: 9/572-, Phone#: 'Vf.:3 zjl,►/ Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: AccoRd CERTIFICATE OF LIABILITY INSURANCE OM tat= 1 C93:42021 fink CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER_THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE/IOU At/THORIEED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policyliesl must hays ADDITIONAL INSURED prowsione or be endorsed. N SUBROGATION IS INIAIVED,sublect to the twins and conditions of the policy,certain pokcies may require an endorsement. A statement on this certificate does not corder rights to The certifIr.atie holder in Nut of such endorsements, PROCRICISI WCOMT.W7 Fe4 go D.Ralson A!: Bet a Hudson Ilnidfaral POISXV PICINI .',I13:323 9fir 413;323 6132 tam Ma le$:, % '9 Ps Man Slress "Al. 112421ixraturlarrIbudson com ARDREEI: INIURE161311.411)=114G COVCNAGE 11AC 4 BothartEran MA C3CC? Ni,,,,,,A: Main Short Americo Assurance 29939 NUNN= 111511111:1111 EDWIN LEARY ED LEARY HOME 11.9pROVEME.N1 MINIM c 46 S LISE'RrY ST 11111ANIIIN CI NOUMEA t EIELCHERIOWN MA C1C,C7,9622 _,,,,,,,, COVERAGES CERTIFICATE NUMBER: 23'21 REVISION NUMBER Te,sS IS TO CERTIFY THAT THE POLIC*5 OF INSLRANCE LISTED BELOAI HAVE BEEN IS5A,E0 70 THE INSURED NAMED oaaiE FOR THE POLICY PERIOD 14D1CATEC3 NOPA37kSTANDING ANY REOUIREMEN7'TERM OR CCF4D,T,Ces OF 11,1.0(COICRACT OR OTHER DOCUMENT Wit*RESPECT 70 esHICH CERTIF,CATE IMV BE tSSUED OR MAY PERTAIN THE INSURANCE AFFORDED EY THE POL,CES DESCRBED kEREIN IS SSAliEC7 TO ALL THE TERMS EACLUSsOlsa AND CONDMOKS OF SUCH POLCIES LIMITS SHOUT MAY HAVE BEEN REDUCED BY PM)CLAIMS tif Accummu 140LICY AamugyertAl „ y44;-, LIINTS trite et allmuatot 1410 WVO 111.141111/1 2.4L X.CONNORCLIU.ammtAi.Laraurr 1, .CcC.CC0 ust.'n accumma T Z CCC CLARE-MA2t :X0-fit 4 rat.144 I.s;La.r...e-sre• %S i YU,C$1%%Am-4,xontrl% ;S ---' .C CC( A — VF0611639 11 1 I.t232C 11,1P232 I , 2 ',CCC,CCO !GIN.SCA':Mt:At t L/Al API...ILS rtlt 2'CCC CC° — ri I,StthEILAL AC:LW/LAU 4'1 $$CI.PCY Ei.7,,P; ... I r$ICCIJ:'S crstaroPw.g.:, i s 2,CCCCC° PRSVS Ss CCC ,3111111 AUT01111:11114 Lawry CCIVIIIME2:MUSS l AV? % %1 4 s szsIert% — VI+A±±±-11f) 1$7,1:$1S I•4%Orr%r or Z.',/,'k, ,$ —D4W —1 3.71,t2LIEZ If 1$4.1.1$$$,%Vol 1,-4.V 1 _Amin cfcr 1 AJ ros i 'liED %MAI-MP= PIXIIJCII%DASSIoa i %I AUf o iii &ITO!,0.4..Y t,na,aalaaah_ . I s H — $=.111111141111.La LJAS ;DCG1.111 ±t.47,1 C.ICCUAK.INCL f i'MONIS LIM 1.7...APPIA1A34 4 Ai:wit:Art ',s , OID 1 I%ILI t$1110$1 I 1 I , I % NICIMENS CONPENBANC41 D.121 1 NNO 41/41PLOYO414 LIAOLRY Y I N Ate,r1zgruttmv•ANTM4R,r_stcorra 1-7 A.,A L.1.L*Cli 04:034.1, 1 2 CPIr.2141/a411LA C.V.L.Lr.L.00 4111mlawir.win 1.---I ,EL 3,SEASI SA L411..CYLL ft tat asautaa.pdat CZ ICRIFTiON Of=TAM KIM NH= i 1-L 3tMASE.r.:31.1'.:Y LIICT I f f ' ± i ± % I s INISCIIPTION OF OMANI WW1 LOCATICIA4.YtNICLIN IACONO 141.AikalearaillaPraria Ictiabila.map be allathod If ewe Num a ration441 Halle Inproveenern Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DnestiaEo POUCIES BE CANCELLED BEFORE THE EXPI/LefrON DATE THEREOF.NOTICE WILL BE DELIVERED St ACCORDANCE MTH THE POLICY PROVISION& Tat C,YitTrOLLUI Rutting Depairtned 1146 Race 2s AUTIMINIZO PNINIVIENTATIVT Scull Viwiroulti MA C2664 I li ISS114015 ACORD CORPORATION. Al rights reserved. ACORD IS 420151131 The ACORD name and logo ars mensisrad mares of ACORD • Sears, Tim From: Sears,Tim Sent: Friday, October 1, 2021 3:56 PM To: 'eleary@charter.net' Cc: Slack, Christine; Grant, Kelly;Water Department Subject: 8 Danbury Attachments: 9th Edition flood FAQ.PDF;work in flood zone packet.PDF Ed, I have reviewed your application for the addition, and there are some items needed; /Health Department sign off v2. Water Department sign off 3. Conservation sign off �4. Updated plot plan showing setbacks to proposed addition 5. 110mph checklist or stamped plans 6. This property is located in a flood zone, I have attached an FAQ for additions to review.The minimum NIrequirement is that the floor be elevated to match the existing floor. 7. Attached is a flood packet to review, we need the worksheet filled out, along with the owners affidavit. 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.I. c. 143 §100,within 45 days of this notice. iirnothy Sears CB() Deputy Building Commissioner !own of Yarmouth 508-398-2231 Ext. 1259 mailto:tsears@varmouth.ma.us 1 Substantial Improvement Worksheet for Floodplain Construction (for reconstruction,rehabilitation,addition,or other improvements,and repair of damage from any cause) Property Owner: EQ. Gt z Zi�iP Address: 4/6• Soli( 4,b.e / - Qe/c.h ' -a /'i l 0/007 Permit No.: Location: 0, 1%4 vey SA—eel-- Description of improvements: 1412Q/-j e/V Present Market Value of structure.ONLY Olarket appraisal or adjusted o', ' ' _S • assessed van e,BEFORE improvement,or if damaged before Ilia damage ocx urr iotiriciudi>ag(and rralue }. Q $ ?AO, ODa Cast of Improvement Actual Oat ibftYie coiistr ctian see items to r eludel Jude $ 'Ysi • °`include volunteer3aboranddonated supplies i Rio= Cost of Improvement(or Cost to Repair �0 y# �-O °,0 Market V e if ratio is 50 percent or greater(Substantial Improvement),entire structure including the existing building must be elevated to the base flood elevation(BFE)and all other aspects brought into compliance. Important Notes: 1. Review cost estimates to ensure that all appropriate costs are included or excluded. 2. If a residential pre-FIRM building is determined to be substantially improved,it must be elevated to or above the BFE. If a non-residential pre-FIRM building is substantially improved,it must be elevated or dry floodproofed to the BFE. 3. Proposals to repair damage from any cause must be analyzed using the formula shown above. 4. Any proposed improvements or repairs to a post-FIRM building must be evaluated to ensure that the improvements or repairs comply with floodplain management regulations and to ensure that the improvements or repairs do not atter any aspect of the building that would make it non-compliant 5. Alterations to and repairs of designated historic structures may be granted a variance or be exempt under the substantial improvenient definition)provided the work will not preclude continued designation as a"historic structure." 6. Any costs associated with directly correcting health,sanitary,and safety code violations may be excluded from the cost of improvement. The violation must have been officially cited prior to submission of the permit application. Determination completed by: 6�/ ( CAR Date: `/S'/Z / 4 i+ �F'Y TOWN OF YARMOUTH ° BUILDING DEPARTMENT fir..:-- � 1c of. -r.�t k l ,. .,-1]..+SbE/ pRt 1146 Route 28, South Yarmouth,MA 02664 Telephone 508-398-2231 ext. 1261 Fax 508-398-0836 Owner's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address: A474"Xo fr- 4 71_ 1 Parcel ID Number: / of / Owner's Name: G ) 6'y Z-6-A4C y Owner's Address/Phone: (qij ) 37V— qo/3-- Contractor: e > e i/ Contractor's License Number: "V-7 9 3-i- Date of contractor's Estimate: /O//S/ Z/ I hereby attest that the description included in the permit application for work on the existing building all improvements, rehabilitation, remodeling, repairs, additions, and other forms of improvement. I further attest that I requested the above-identified contractor to prepare a cost estimate for all of the work, including the contractor's overhead and profit. I acknowledge that if, during the course of construction, I decided to add more work or to modify the work described, that the Town of Yarmouth will re-evaluate its comparison of the cost of work to the market value of the building to determine if the work is substantial improvement. Such re- evaluation may require revision of the permit and may subject the property to additional requirements. I also understand that I am subject to enforcement action and/or fines if inspection of the property reveals that I have or authorized repairs or improvements that were not included in the description of work, and the cost estimate for that work that were basis for issuance of a permit. Owner's Signature: .;7(1,12-00-.7 Date: /d4S/Z/ - - ,_ CHRISTOPHER JENNETTE tar Notarized: 0 ) c 7 'MONNo LTHOFnuic bl CHusFTrs �Y����G� ��� My Gomm on Expires On Cd `' Lee 'j 3i jry K d'? 4 May 03,2024 I 1WV, FA' TOWN OF YARMOUTH li°V WATER DEPARTMENT ,e,: 0,,..ILA,IU: _ *3 l. 99 Buck Island Road W ., est Yarmok,ith M A, 0267 V7 3 Telephone: l508) 771-7921 • Fax: (.508) 771-7998 BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: Air c-ke-41--- PROPOSED WORK: t4dch 117 IA/- . APPLICANT: n z6.4-- , ADDRESS: 1‘ Sboe.4 4 . ge/c_Xer.4'1A-r--) TELPHONE: (1//3) 37Y— g4'7.01-- RESIDENTIAL AND /OR COMMERCIAL BUILDING Water Department: Determines Compliance of Water Availability and or existing location Engineering Department: Determines Compliance for Parking and Drainage Conservation Commission: Determines Compliance to Wetlands Act: i.e. If lot(s)border any type of wetlands, streams, ponds, rivers, ocean, bogs, boys, marshland, ETC... Health Department: Determines Compliance to State and Town Regulations, i.e. requirements for Septage Disposal and other Public Health Activites Fire Department: Determines Compliance to State and Town Requirements for Personal Safety, Property Protections, i.e. Smoke Detectors, Sprinkler Systems,etc 110// APPLICANT SIGNATURE I ATE OFFICE USE: COMMENTS ON PERMIT APPROVAL OR DENIAL REVIEW"WATER DIVIS'--ION (SIGNATURE) DATE 0 ... SERVICE NO. 4.2 0 / NAME STREET S 2AN,3 ugY sr VILLAGE SY METER NO. 77 6 '451-10 crawl Y; • rilD 7o lP/. 0 t PiT"' t P ( 4 - - 5), e, ' ' Iei ,b nN 8 u fey 577" 100.00' LOTS 109 & 110 9,500± S.F. CV 39.4' b CONCRETE o fr7 FOUNDATION °' TF = 11.6 0 tri rn 30.1 ' 100.00' DANBURY STREET DCE #09-293 FOUNDATION PLOT PLAN PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE LOCATION 8 DANBURY STREET PREPARED FOR: (SOUTH) YARMOUTH,MASS. EDWIN LEARY SCALE : 1" = 20' DATE : FEBRUARY 11, 2010 REFERENCE : ASSESS. MAP 34 PCL 168 I HEREBY CERTIFY THAT THE STRUCTURE ," SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. I` ! 1 S foxoff SOB-338282-4541 �, r 508 down cape engineering, inc. �€FI i; o } , • CIVIL ENGINEERS f 1 v LAND SURVEYORS DATE REG. LAND SURVEYOR 939 Main Street — YARMOUTHPORT, MASS. 100.00' LOTS 109 & 110 9,500± S.F. o am 39.4' CONCRETE o FOUNDATION tri rn TF = 11.6 Lri am 30.1 WORK MUST C INFORM TO ALL loom' TO A BY A REGULA ION$f YA ;tOUTH WAT ER D E PT BURY STREET DCE #09-293 FOUNDATION PLOT PLAN PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE 8 DANBURY STREET PREPARED FOR: LOCATION (SOUTH)YARMOUTH,MASS. EDWIN LEARY SCALE : 1" = 20' DATE : FEBRUARY 11, 2010 REFERENCE : ASSESS. MAP 34 PCL 168 �< 4 I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. "y off 508-362—I541 fox 508 362-9880 down cape engineering, Inc. ceh., 2®1 f C/VIL ENGINEERS r t LAND SURVEYORS DATE REG. LAND SURVEYOR 939 Mo/n Street — YARMOUTHPORT, MASS. , - . ,TOWN OF YARM, - , ..4S71K. ' ' °'• c I ;44., 4 , - -7-:--.,Y, ,-.*•.4.1tlf,,, 4i7, WATER DE ' A ...• i...a..... 99 Buck Island Road cr__yvest Yarmouth, MA 0.2673 . . ..,.."- .. . , ..." , 0 P.T. 4x4 2' SUPPORT —(2) 2x10 , o' , , I _ . - / \ / \ — . ‘ I ... III li. -.......... ks, i ....II..., I I I I (3) 2xlO BEAM (P.T.) 0 I I = 0 wAN5Cimp5014OR BEAM p556T06 CONC. I I 1 0 I I x vi I I I I I:I GF4£3°" - --- --- - 0DTEET.F2mOIN.14/(Ty1011.1 TU. 013FE4) - : Ir ---- - _ . I. . 1 1, . co i _. - . . I SMART VENT 1 , I I ' ...., I ' , ,* I 12X32 ACCESS VENT BY SPACE DOOR I, , I sysTErS, INC. OR I i . , , APPROVED EQUAL- ' ' ' I 1 . 1 I kls : 1 i i 0 0 0 1 i 2" CONC. : t 8" OVER POLY. , I 1 1 0 4 / 7( I " I I ; I I 11 I .• I 1 F_X -;-'''''T'Mr.."' Pi,'N1.1A"'",ON .t. • ., •- ' I I li I I I 1 1 I i I I I I 1 i _artL.. 1 1 1 , VII, i L... ____ _ ---- --- -r- 1 1 0gYA c` Town of Yarmouth Conservation Office y kgrant(a�yarmouth.ma.us '„ r Conservation Commission cur MATTA M 3€ Building Permit Sign-off Application TO BE FILLED OUT BY BUILDING PERMIT APPLICANT: Building Site Location: dc / a7,-/_ (.--ry l Map# Lot(s)# Property Owner: e--- Z--6 r Date filed: 4,72..7 *Applicant: E 7 V Applicant Address: Z-/ v sa U A/ L, e,e ge.jC X Email: (e, `y� G6'�-�-�c�= A-e� Telephone: y/3 3-7L/ ((6 /�— D/ao 7 Proposed Project Description: 4 1,� I`i °/4 f kr 16. w 'w /it ) S'!'iCT Site Plan Title/Date: ' )A 4 l U2 r TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR: Does the proposed project require a permit? v, 1,sr c 9ci4 i" 17 c)el�'( Refer to: SE83- or DOA permit Comments from Conservation Commissi. . Approved Conditionally Approved Rejected 6 S'r b' J U- Z ST per-49.1 Conservation Commission Sign-off Signature: /w Date: `� Z,' ZZ *TO APPLICANT: All work-related debris shall be taken offsite or disposed in a legal upland location. At the end of each day, the area shall be clean and no debris shall be in the Resource Area. If work is permitted under an Order of Conditions, please arrange a pre-construction site visit with the Conservation Administrator. At the time of site visit, the MassDEP File Number sign must be installed, along with the erosion control/work-limit line. A copy of the Order of Conditions must remain on-site during construction. Please refer to the Order of Conditions for further details. ot4.,46„ Y tk TOWN OF YARMOUTH HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: .^b(fir 5/ S <''T-, �v //'-''i .•,�t ,� Proposed Improvgment: /-�/ 11' O/v` /2 x ,'s- ' 57,"e—r 0"4 pereji /Atiti 5 t"G ve.--J ,3or-c,-,' ,/ , /.e...c,/.- rt...K-.fie,.-,s-/,, Applicant: x /l 2 f .4y Tel. No.: %"/.:? 7 7`/ '/ /.2-- Address: '7‘ .. 0. ei.4 y s . e/c A 4f sv; /`7all r ivc'Aate Filed: "' , **If you would like e-mail notification of sign off ple se provide e-mail address: €/e/ S/e:DeA,#-r°/r, /&-e-f i Owner Name: e L.e Owner Address: 4f r - /1 S A6j0v Owner Tel. No.: ,;det -•G- 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: . .., ".n'CIU'7 (1.) Site Plan showing existing buildings, water line location, •:. JUL 2 12022 and septic system location; (2.) Floor plan labeling ALL rooms within building HEALTH DEFT. (all existing and proposed) — 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: g to '1", ., PLEASE NOTE COMMENTS/CONDITIONS:i 1 , r-i-cA,) IL) i--c Irv\ct 1 ,--‘ "),. 3e Wc.) ‹./u„. r pf Cy ut Sr' 7 tc r crc'J‹ 8( 3 j .L LC�CCL71 CAr cs