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HomeMy WebLinkAboutBLD-23-003415 l PO 'l h/Z3 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 l '7t'S11 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 I DEC 2 0 2022 Building Permit Number: Nly - 3 Lk t< Date Applied: A < ULUINc DEPARTMENT ( Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&ParceI Numbers Er) Nrisi-4ousvRoad 1.1a 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 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 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Mail' OvanpS N2whury, N- h 03255 Name(Print) City,State,ZIP/ 3�ba aoLd IPs -oap 676128.Lt65o Ma-IFovanes etc I Dud.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 I Owner-Occupied ❑ 1 Repairs(s) 0 Alteration(s)Al Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units l Other 0 Specify: Brief Description of Proposed Work2: ike+mto I1.9bc th , r-epl act w l ndow ;I've ►sk n9 open i 119 l r-e plant ono gi SECTION 4:ESTIMATED CONSTRUCTION COSTS • Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 701000 1. Building Permit Fee:$ r.30 Indicate how fee is determined: 2.Electrical $ 7 �� 111 Standard City/Town Application Fee 1 0 Total Project Cost3t x multiplier x 3.Plumbing $ 12tG5 2. Other Fees: $3 • / 4.Mechanical (HVAC) $ List: a- 5 0 / 12_ 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash ount:� 6.Total Project Cost: $ 90, 1-T5 ❑Paid in Full = Outstanding Balance D e: i\ 5, a ail� SECTION 5: CONSTRUCTION SERVICES 3.1 Construction Supervisor License(CSL) CS UgIggS I123)2024 Div)ots W M i kin License Number Expiration Date Name of 4 SL Holder i3714k ovy }};I I Cr Rele List CSL Type(see below) IA No.and Street Type Description OS$-Q('1/illP 0a64-5 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP 1vI Masonry RC f Roofing Covering • WS Window and Siding II 11 ss SF Solid Fuel Burning Appliances `1/R64 1Jouuenlulkn�vi Il l' Gore I Insulation Telephone Email addre D I Demolition 5.2 Registered Home Improvement Contractor(HIC) Mullin ,vflam? 'Romo�lin9 1��3►`7 HI Com any Name o HIC egistrant Name HIC Registration Number pition Date "P0 Sgoc I2�4 T)au @MvU�bu► "nq.Co' No.andMCVSibns kills,Mfr tea- fR' 17'{yg-7 r Email address I 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 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. t `l (74/2 Print Owne •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.nov/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" Commonwealth of Massachusetts Division of Occupational Licensure Board of Building ReggulTations and Standards I`I �OTI V{ [Ivnvisor CS-081995 _ 154pires:01/23/2024 D87OUGLAS VWNULLEN . • HICKORY.IILL CIR -^ OSTERVILLE1IA 02655 i �'• 'J Commissioner Baba i'' et- rntlla IdP/Ao6•sseurutmm psi"Jo 00Zt-LZL(LI.9)IIeD asua3i1 situ lnoge uogeuuouut Jo3 •asuaoll situ Jo uopeoonaJ JoJ asne3 Si apo3 Sulplm8 a1euS suuasntoessew atl Jo uoippa tuaLino e ssassod of aJnpej -coeds pasoloua Jo (sJalaw oigno L66) laaj oigno 000'S£uequ ssal uieluoo totgM dnoj6 asn Sue jo s6uiplln8- PaIoulsaJun Josituadn5 uot3nJusuo3 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: LLC MULLEN BUILDING & REMODELING LLC Registration: 175317 P.O. BOX 1274 Expiration: 05/02/2023 MASTONS MILLS, MA 02648 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE: LLC before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 175317 05/02/2023 1000 Washington Street -Suite 710 MULLEN BUILDING & REMODELING LLC Boston, MA 02118 DOUGLAS MULLEN 87 HICKORY HILL CIR G6(&.'1'a.(4t°i' OSTERVILLE, MA 02655 Undersecretary Not valid �tho gnature "" • 10 , 1,1 M. ULLEN Pm pert' Yncfiiit Complete and le lsct on If CsittiLA Buildcr 01/4-kr6 - _ . Mullen Buiklina& Renkodclow. 11.(:• • - °. - knidtr • — • -• ifp-u C /z-0 y4-4 ,411 I Atidre-•••• ifth) frncry and aiamit arc Th,l)crwrits..inbihr, nn21.1),x.4., arc n(n.to cic 3.1_1(T rs art. nt Sigt‘turc .kpriticant Sienaturc of 0t Print Name Print Name f)air §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 Alms Buie Road, Yavmov 1)da-+, ML 0463-5 Work Address Is to be disposed of oat the following location.n oliAY 1 o U'ti+'uhS` t.�S"fickbN Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. /1-) 17170 ptaa Signat4e of Application Date Permit No. • The Commonwealh of Massachusetts 1—_ ,= Department of la dustrial.Acciclents _y�l= 1 Congress Street, Suite 100 f, Boston,MA 02114-2017 `I„ www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeoibIy Name (Business/organization/Individual): MI II.in (main" 41 P.AmMing Address: 8 .{-iCKOn.1 F4sj I CrR(► City/State/Zip: O3•}sv jj If/ o -.b Phone#: 774•Lg3- Are you an employer?Check the appropriate box: Type of project(required): l. am a employer with employees(full and/or pan-time).* 7. ❑New construction 2.D I am a sole proprietor or partnership and have no employees working for me in 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. Demolition 4.D I am a homeowner and will be hiring contractors to conduct all work on m Y ProPen7`• I 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 5.0 I 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.insurance.: 13. Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§I(4),and we have no employees.(No workers'comp.insurance required.] *Any applicant that checks box AEI 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. :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 ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ASSOCia+P Cl Fir p)Ojta S I J,vr ' d'1 CD. Policy or Self-ins.Lic.#: W( CooC'p 1. '2C)29-p ,4 Expiration Date: y/3atet2Q Job Site Address: 5f')4lmj' )-O P Rpa ) City/State/Zip: YAvrno h 4f` MA 0267 j 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 under the ains and penalties of perjury that the information provided above is true and correct. Sitrnature: Date: /7/1770 �7lri Phone#: •L 7- (o ff 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): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: A DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/15/2022 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 Joanne Sullivan,CSR NAME: The Hilb Group New England,LLC PHONE (800)640-1620 FAX (A/C,No,EM): (A/C,No): dba Dowling&O'Neil E-MAIL jsullivan hilb rou com ADDRESS: g p' 973 lyannough Road INSURER(S)AFFORDING COVERAGE NAIC# Hyannis MA 02601 INSURERA: Arbella Protection Insurance Co 41360 INSURED INSURERS: Associated Employers Insurance Co 11104 Mullen Building&Remodeling LLC INSURER C: PO Box 1274 INSURER D: INSURER E: Marstons Mills MA 02648 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2212516151 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PREMISESO(Ea occur ence) $ 100,000 MED EXP(Any one person) $ 5,000 A 952012183001 09/08/2022 09/08/2023 PERSONAL&AOVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY I' _f jERC7 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED 1020123341 11/12/2022 11/12/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X STATUTE EOTH AND EMPLOYERS'LIABILITY Y/N 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA WCC50050133082022A 04/30/2022 04/30/2023 E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1000000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations,and endorsements.Nothing contained in the Certificate of Insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 I � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Property Location:50 ALMS HOUSE RD MAP ID:148/1/// Bldg Name: State Use:1010 Vision ID:16745 Account#16745 Bldg#: 1 of 1 Sec#: 1 of 1 Card 1 of 1 Print Date:03/07/2017 18:18 CURRENT OWNER TOPO. UTILITIES . STRT✓ROAD LOCATION CURRENT ASSESSMENT PETERSON JOSEPH FRANCIS TR 1 Level 2 Public Water 3 Unpaved 2 Suburban Description Code Appraised Value Assessed Value PETERSON DOROTHY ANN TR 6 Septic RESIDNTL 1010 178,900 178,900 815 P O BOX 234 - - RES LAND 1010 444,200 444,200 YARMOUTH,MA WEST BOXFORD,MA 01885-0234 SUPPLEMENTAL DATA Additional Owners: Other ID: 125/J002/// VOTE N MISC 420 VOTE DATE05/13/2014 CHANGES PRIVATE R(ALMS HOUSE RD-YP BETTERMENT VISION PLAN NUMBEI667-667 ZIP CODE 2675 GISID: M_305065_830784 ASSOCPID# Total 623,100 623,100 RECORD OF OWNERSHIP BK-VOL/PAGE SALE DATE q/u v/i SALE PRICE V.C. PREVIOUS ASSESSMENTS(HISTORY) PETERSON JOSEPH FRANCIS TR 17749/288 10/03/2003 U I 100 1F Yr. Code Assessed Value Yr. Code Assessed Value Yr. Code' Assessed Value PETERSON JOSEPH F TR 17749/286 10/03/2003 U I 100 1F 2016 1010 178,900 2015 1010 164,400 2014 1010 164,400 . PETERSON JOSEPH FRANCIS I 0 2016 1010 444,200 2015 1010 444,200 2014 1010 400,300 Total: 623,100 Total: 608,600 Total: 564,700 EXEMPTIONS OTHER ASSESSMENTS This signature acknowledges a visit by a Data Collector or Assessor Year Type Description Amount Code Description Number Amount Comm.Int. APPRAISED VALUE SUMMARY Total: Appraised Bldg.Value(Card) 173,100 ASSESSING NEIGHBORHOOD Appraised XF(B)Value(Bldg) 5,800 NBHD/SUB NBHD Name Street Index Name Tracing Batch Appraised OB(L)Value(Bldg) 0 0077/A Appraised Land Value(Bldg) 444,200 NOTES Special Land Value 0 MAGNIFICENT VIEW/5 RMS 0420 IN MIDDLE OF TOY CONSERVATION LAND Total Appraised Parcel Value 623,100 GREAT OCEAN VIEW Valuation Method: C NATURAL IA Adjustment: 0 Net Total Appraised Parcel Value 623,100 BUILDING PERMIT RECORD VISIT/CHANGE HISTORY Permit ID Issue Date Type Description Amount Insp.Date %Comp. Date Comp. Comments Date Type IS ID Cd. Purpose/Result 12-860 01/09/2012 RP Repair 4,000 0 TWO REPLACEMENT 01/01/2014 01 1 BH CY CYCLICAL 2014 12/01/2005 JB 01 Measur+lVisit 01/01/1991 WE 00 Measur+Listed LAND LINE VALUATION SECTION B Use Use Unit I. Acre C. ST. Special Pricing SAdj # Code Description Zone D Front Depth Units Price Factor S.A. Disc Factor Idx Adj. Notes-Adj Spec Use Spec Calc Fact Adj. Unit Price Land Value -1 1010 SINGLE FAM MDL-01 13,503 SF 6.58 1.0000 7 1.0000 1.00 0077 2.00 LOC WF25 WF2d 2.50 32.90 444,200 Total Card Land Units: 0.31 AC Parcel Total Land Area:0.31 AC Total Land Value: 444,200 Property Location: 50 ALMS HOUSE RD MAP ID:148/1/// Bldg Name: State Use:1010 Vision ID:16745 __Accoun_t#16745 Bldg#: 1 of 1 Sec#: 1 of 1 Card 1 of 1 Print Date:03/07/2017 18:18 CONSTRUCTION DETAIL CONSTRUCTION DETAIL(CONTINUED) Element Cd. Ch. Description Element Cd. Ch. Description Style 04 Cape Cod Model 01 Residential Grade 05 Average+20 WDK 22 3 Stories 1.5 1 1/2 Stories 22 Occupancy l MIXED USE Exterior Wall 1 14 Wood Shingle Code Description Percentage 13 Exterior Wall 2 1010 SINGLE FAM MDL-01 100 WDK 10 WDK 10 Roof Structure 03 Gable/Hip WDK 10 WDK 10 44 Roof Cover 03 Asph/F Gls/Cmp BAS FHS 11 4 2 Interior Wall 1 05 Drywall/Sheet BAS Interior Wall 2 COST/MARKET VALUATION 14 Interior Fir 1 12 Hardwood Adj.Base Rate: 130.92 29 , Interior FIr 2 197,946 Heat Fuel 04 Electric Net Other Adj: 5,747.50 Heat Type 07 Electr Basebrd Replace Cost 203,693 18 19 AYB 1987 , AC Type 01 None 26 Total Bedrooms 02 2 Bedrooms Dep Code G Total Bthrms 2 Remodel Rating 6 Total Half Baths 0 Year Remodeled 10 Total Xtra Fixtrs Dep% 15 Total Rooms Functional Obslnc D Bath Style 02 Average External Obslnc 0 I Kitchen Style 02 Modern Cost Trend Factor 34 Condition %Complete Overall%Cond 85 Apprais Val 173,100 Dep%Ovr D ' ' t Dep Ow Comment liv4' Misc Imp Ovr D '►jr- !� yy, Misc Imp Ovr Comment c' • Cost to Cure Ovr 0 _Y % �' Cost to Cure Ovr Comment ' ° • OB-OUTBUILDING& YARD ITEMS(L)/XF-BUILDING EXTRA FEATURES(B) '�c r` Code Description Sub Sub Descript L/B Units Unit Price Yr Gde Dp Rt Cnd °%Cnd Apr Value . FPL2 1.5 STORY CH B 1 -\2,500.00 2000 1 100 2,100 —--"' FPO EXTRA FPL 0 B 1 800.00 2000 1 100 700 , r w. t r...,... WHL WHIRLPOOL B 1 3,500.00 2000 1 100 3,000 ` • BUILDING SUB AREA SUMMARY SECTION g r ` Li J , .„' t�1�►`}+ Code Description Living Area Gross Area Eff Area Unit Cost Undeprec. Value ' rt lf r'".t " .. BAS First Floor 992 992 992 130.92 129,869 l', ;Hi `, t � y nlnlnit FHS Half Story,Finished 442 884 442 65.46 57,865 • �(• WDK Deck,Wood 0 776 78 13.16 10,211 ; e jam. q„ TEL Gross Liv/Lease Area: 1.434 2,652 1,512 203,693 i. .."•- • .,. °fY TOWN OF YARMOUTH II E EI I r'' �' �' 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 ' Telephone (508)398-2231 Ext. 1292—Fax (508)398-0836 ! RECEIVED �= , 21 2022 OH, KING'S HIGHWAY HISTORIC DISTRICT COMMIT EDEC 21 2022 YAHMOW t; OLD KING S NIGH4AY APPLICATION FOR �-- BUILDING DEPARTMENT CERTIFICATE OF EXEMPTION By Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs accompanying this application. Type or print legibly:Address of proposed work: 50 Alms House Road Map/Lot# 148/I1 Owner(s): Matt Ovanes Phone#:978-828-4650 All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: 368 Bowles Road, Newbury, NH 03255 Year built: 1987 Email: Mattovanes@icloud.com Preferred notification method: Phone Email Agent/contractor: Doug Mullen (Mullen Building & Remodeling) Phone#: 508-737-2349 Mailing Address: PO Box 1274 Marstons Mills, MA 02648 (� Email: Doug@mullenbuilding.Com Preferred notification method: C Phone l= Email Description of Proposed Work(Additional pages may be attached if necessary): Remove one window on rear of house and replace with Transome so we can fit a shower. ki.11 Signed(Owner or agent): Date: 12/20/2022 Owner/contractor/agent is aware that a permit may be required from the Building Department.(Check other departments,also.) This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. For Committee use only: Date: i l))l?3- Y Approved Approved with changes Denied Amount ? .l.^0 Reason for denial: Cash/CK#. T f Rcvd by: 1 .'�•�' OW KIN S HlGHwAY Date Signed: r9171(73- Signed: e A,L'L a all?I 1 APPLICATION#: V5.2017 --1 1., . - LI . .. (Hi- . , • ,...,UILT" _ . ...- ,....- / ',/ , • `, r .:, A ' I )( ...... .. r.... . f,.........,„ i'''''2, .,.".5. .......«,-.: 1.,......":.,,,,,,... .,...... , , .. . t.....) -. r-c- .,----‘ , NN>1 ....c t' 1 • 1: L., rn . . // ti 1 /-• , , . • 'm, ,... I `:t 1 ',/ 1 ...ro.r..p•mo...*.w...*.r.•N*"........."'e....eIeMIMIMMIIIIIIj • :^ i l¢ I!'3g3 ) • •`i .