The URL can be used to link to this page

Home My WebLink AboutBLD-23-0000506 f a q//q/e • 04..-Y9,Q BUILDING PERMIT APPLICATION • .�c% APPLICATION TO CONSTRUCT, REPAIR, RENOVATE , CHANGE THE USE, OCCUPANCY OF, o c OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING. Town of Yirn >uth Building Department M�TT4CnCCSU� •'" 7-i 1 146 Route _';1 • Yarmouth, MA (12664-4492 Tel: J03.398-2231 ext. 1261 Fax 508-398-i :r, , r, A ED Office Use Only Planning Board Information Assessors Department Inform;tion Permit t (A. ate Plan Type_ maa AJL 2 9 2022 v Permit Fee $4,S C) Endorsement Date \Eli Recording Dt;te N— ILDING DEPARTMENT �`�1r Deposit Rec'd. Da e Plan No. 1.4 Property Dimensions: Net Due $ Other Lot Area(sf) Frontage(tt) Lot Coverage _...---'21..., " This Section for Office Use Onty Building Permit Number. Date Issued: Is Signature: �'N 5 - i c - Certificate of Occupancy Building`Of icia! Data is Is not required Section 1 - Site Information 1 1.1 Property Address: 1.2 Zoning Information: i• j k),.) !-L c). 1) I likt. Zoning District Proposed Use 1.3 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required I Provided Required I Provided Re 1 � Required I Provided 1.4 Water Supply(M.CL.L c.40.S 54) 1.5 Rood Zone information: Comments Public Private Zone: _ BFE. Section 2 - Property Ownership/Authorized Agent 2.1 Owner of Record: • • 661LASea4Aeio Na print Mailing Address: Sin — S °J d 6l ` 3?6 1) Telephone Telephone / Email Address: 2.2 Authorized Agent: C-� Ak-tt itaSc-t2 Nam (print) Mailing Address: 1 roA034173-.0 Signature Telephone P Fax En-,all Address: Section 3 - Construction Services �3.1 Licensed Construction Supervisor: Not Applicable I] _ ►� Y � � �� n , CCI / ( License Number Li 1 rC(' �� 0 S ��c m A Addrss J (� Qr - � � 3 �, ( � o 8 .J J y 9,3,� W •lit G, Expira-on Date Signature _ l / Telephonell l) Email A SS- • , Section 6 - Description of Proposed Work (check all applicable) New Construction (for multiple❑ Ifamily p only) No.of Bedrooms I (for multiple family only) No.of Bathrooms Existing Bldg. X I Repair(s) ❑ I Alterations ❑ I Addition ❑ I Accessory Bldg. ❑ Type Demolition Other Specify; Brief Description of Proposed Work: kop P Ye-ss Oc)ag 0,L() do f P I Section 7- Use Group and Construction Type , Building Use Group (Check as appficapable) Construction Type A ASSEMBLY ❑ A-1 ❑ A-2 ❑ A-3 ❑ IA ❑ A-4 ❑ A-5 ❑ 19 0 B BUSINESS I 1 2A ❑ E EDUCATIONAL I-❑ ❑ F FACTORY f (, r-t ❑ F-2 ❑ 2C ❑ H HIGH HAZARD I ❑ ❑ - 3A I INSTITUTIONAL I ❑ I-t ❑ 1-2 ❑ I.3 ❑ 39 Cl M MIERCHANTILE I ❑ 4 ❑ . 4__• R RESIDENTIAL I ❑ R-t ❑ R-2 ❑ R-3 (] 5A El S STORAGE 10 s t ❑ S 2 • U UTILITY 59 SPECIFY: . M MIXED USE SPECIFY: S SPECIAL USE I ❑ SPECIFY' - Complete this section if existing building undergoing renovations,additions and/or change in use.I Existing Use Group: fiProposed Use Group: .S'/{4'44....- [Existing Hazard Index 780 CMR 34 Proposed Hazard Index 780 CMR 34 Section 8 Building Height and Area I 4 Building Area Existing ;if applicable) Proposed Number of floors or stories include basement levels Floor Area per Floor(st) Total Area All Floors (sf) I Total Height (ft) Section 9 - STRUCTURAL PEER REVIEW (780CMR 110 11) Independent Structural Engineering Structural Peer Review Required Yes No SECTION 10a OWNER AUTHORIZATION -TO BE COMPLETED WHEN ' AGENT 0 ONTRACTOR APPLIES FOR BUILDING PERMIT f( I, , as Owner of the subject property, to act on hereby authorize �a�2 �l�S ER my behalf, in all matters relative to work authcrized by this building permit application. Signature of Owner Date SECTION 10b OWNER/AUTHORIZED AGENT DECLARATION • l C ; A Y ��la-S `\ ' , as Owner/Authorized Agent hereby declare that the statements and information on the forgoing application are true and acurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Gkg. -k34 • Print Name Wc/6-1 '7/-26 2.), Signature of Owner/ ent g Date Section 11 - ESTIMATED CONSTRUCTION CCSTS Item Estimated Cost(Dollars)to be completed by permit applicant 1.Building 5 oc a Electrical 3.Plumbing/Gas 4.Mechanical(1-NAC) 5.Fire Protection 6.Total=(1 +2+3+4+5) 7.Total Square Ft.(Ix new sML.tr:es s axibxc) Check Below ❑ Conservation-Commission Filing (if applicable) ❑ Old Kings Highway& Historical Commission approval (if applicable) • • • i . The Commonwealth of Massachusetts 1= ir Department of Industrial Accidents 1 Congress Street, Suite 100 i l Boston, MA 02114-2017 sv'''' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): c ' t f kip$ Address: e 3C L,' I ?-e ,c \r-c City/State/Zip: R;r4L,,/ % 111 Cl- — Phone #: ,-J '? Zf 9 3S^c Are you an employer? Check the appropriate box: Type of project (required): i.E I am a employer with employees(full and/or part-time).* 7. 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.) 8. Remodeling 3.0 I am a homeowner doing all work myself. [No workers'comp.insurance required.]t 9. E. Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on m property.Y I will 10 [] Building addition ensure that all contractors either have workers'compensation insurance or are sole 1 1.❑ Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.1=1 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. I3•El Roof repairs 14•El Other • 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 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. 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 nzy employees. Below is the policy and job site information. Insurance Company Name: Policy# or Self-ins. Lic.#: Expiration Date: Job Site Address: 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 fcrwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify 'der the pains and penalties of perjury that the information provided above is true and correct. Siznature: i 14,1A Date: 7/ a- 2- Phone#: 7)8 g11 "9 tr_s- 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: §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 / 20 d Rout—e_ J Work Address Is to be disposed of oat the following location: (3e,-L J , E e o v Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. i4J1 /0'? Signature of Application ate Permit No. Sears, Tim From: Sears, Tim Sent: Thursday, August 4, 2022 4:10 PM To: 'kjkaser@comcast.net' Subject: 1200 Route 28 Attachments: Xerox Scan 08042022154558.PDF Gary, I have reviewed your application to add a new egress door and it will need to be an accessible entrance per 521 CMR Section 3.3. Please update your plan and submit 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. 1259 mailto:tsearsPyarmouth.ma.us 1 l .T� nmrran�uPea VI/r Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 189692 11/14/f1 GARY KASER GARY KASER 65 WALKER ROAD BREW STER,MA 02631 Undersecretary Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Co nstrutt*A6Orvisor CS-103494 spires:09/05/2023 GARY J KASER,JR 65 WALKER ROAD BREWSTER MA 02631 #1 Home Improvement Retailer 4,0 ilk mow 0 h. Search Q 8 „ �; You're shopping Delivering to Hyannis v 02601 0 OPEN until 9 pm Home / Doors &Windows / Exterior Doors / Front Doors / Steel Doors / Steel Doors With Glass V 22 Steves & Sons (Brand Rating: 4.3/5) = 36 in. x 80 in. Premium Clear 4 Lite Plank Panel White Primed Steel Prehung Front Door (7) I i 2 ?7r Y ;_ F------ .2 vY I ,...., 1 + ,..,„ . ,, ,,....__ __ _ _ . ...,_ _ _ .........„ $803 01 • $134.00 /mo* suggested payments with 6 months* financing Apply Now 0 https://www.homedepot.com/p/Stever-Sons-36-in-x-80-in-Pre...rimed-Steel-Prehung-Front-Door-S22H-4LP-36-6R0/205591853 7/16/22, 8:18 PM Page 1 of 14 Common Door Size (WxH) in.: 36 x 80 32 x 80 34 x 80 36 x 80 Door Handing: Right-Hand/Outswing Left Hand/Outswing Left-Hand/Inswing Right-Hand/Inswing Right-Hand/Outswing How to Get It Delivering to: 08054 I Change Ship to Store Ship to Home Scheduled Delivery Pickup Get it by Not available for this Aug 4-Aug 9 Mon,Aug 15 item FREE Standard Delivery We'll send up to 25 to Mt Laurel for free pickup Change Store + � Add toCart —or— Buy now with payPal Product Details https://www.homedepot.com/p/Stever-Sons-36-in-x-80-in-Pre...rimed-Steel-Prehung-Front-Door-S22H-4LP-36-6R0/205591853 7/16/22, 8:18 PM Page 2 of 14 Panel Type 1 Panel Product Weight (lb_) 95 Returnable 90-Day Suggested Back,Basement Application Entry,Front,Side Warranty / Certifications Energy Star Qualified North- Central,Northern,South- Central,Southern Fire rating None Manufacturer 10 Year Limited Warranty Warranty Questions & Answers 12 Questions https://www.homedepot.com/p/Steves-Sons-36-in-x-80-in-Pre...rimed-Steel-Prehung-Front-Door-S22H-4LP-36-6R0/205591853 7/16/2z, 8:18 PM Page 5 of 14 1 r 0 el be k3 .381 lo P n is a o R , c, ..‹ U - . oo , ..„ -,---, XI -71 o'w cn �� -r ci l-I M . \0 p , 1 K; m y n Z) jD 71 a -� 1 -� A CO I �' Cy C i SO 75 n tp g7 4., r i ,..( c C. r . ' r 6 PeocCPA Dou6it 412114 1-ter.„14 0 u 5 cv i r 06%6 1 .1.0r* I PrtvOthic.- -7 tk One S.-1-.211 11 14 7 /a00 Lased iche My Public Portal More Q TownOfBrewsterCloud > ... > / Z0 Q O O Q 4 $ View plain text Ky https://portal.laserfiche.com/Portal/DocView.aspx?id=77709&repo=r-153f9d98 7/26/22, 10:51 AM Page 1 of 2 t I *i? ki'4 t T .r! i I F j 77 l'< C-0 (to `� .N/ N E o - - z- N S - - ''t e- a s ' C trl o c� x. 4, 1 6\cp cP 3 3 -),-, . c9 0) 0‘. “' 7 �` gip` N o k2 -r c c g 4 a