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HomeMy WebLinkAboutbld-23-001123 PtA )O1) 1 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department 1146 Route 28, South Yarmouth,MA 02664-4492 'N, 508 398 2231 ext, 1261 Fax 508-398-0836 14 Massachusetts State Building Code,780 CMR "t Building Permit Application To Construct, Repair, Renovate Or Demolish :::. :;::' a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: ,6 LD-3-3'l�1123 Date Applied: i RECEIVED Building Official(Print Name) ature I DaAUG 3 0 2022 SECTION 1:SITE INFORMATION fi BUILDING DEPARTMENT' 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers I II - - an CvsA-x.w.0PF- Os , 25 30Cs 1.1 a Is this an accepted street?yes v" 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 l Provided Required Provided Required Provided t 1.6 Water Supply: (IvI.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private CI _Zone: Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: e,acb:I ec i rt 1C 63 WI ct Ci. c -Tyi9 5 cr NAA o►8?g Name(Print) City,State,ZIP C3 W, S:i_rki? (- 7sl-33?-8261 AuncybecbPc; ICt1scct f-euLi-' No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORT 2(check all that apply) New Construction Cl Existing Building V/ Owner-Occupied 0 I Repairs(s) 0 Alteration(s) Ig Addition ❑ Demolition 0 I Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work2: pl,,h Il\n 'ZAe F( ( ZP' CQ) C v MA�Wr v A��i.li ct w t g croT ,i3;v.•.n c�c�rb 4.�n , 1' 0 1 - .. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ (72.y t 1. Building Permit Fee:$`4,(20 Indicate how fee is determined: 2.Electrical $ IN Standard City/Town Application Fee ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ ,S r 2. Other Fees: $ ,,, 4.Mechanical (HVAC) $ `7 f IC List: 3 rj—,OD MC% a- g 1�( C\ 5.Mechanical (Fire II k"� Suppression) $ Total All Fees:$ \ i�., Check No. Check Amount: Cash E�unt: - 6.Total Project Cost: $ by k 0 Paid in Full $1 Outstanding Balance Die: 1G' s • 1D`13 � ' �r �" :ma's'" i ,':;,Ti:' SECTION5: COrISTuUCTIONS n ICES Y.. "Construction Supervisor License(CSL) ts- 03331 .. 1 tV/2 4 ' '- rice , t. L.* A O , „.,,,� License Number Expiration Date _ `" Lint CSL,Type(sae below) x _ m Iype Description U Unrestricted(Buildings op to 33,i) 3 eu.R) - -,.,,, 'i% , - i' 0 2 GO It Restricted lea Family Dwelling ilk. c fTdWit. t?t, tw! iLtaao f F - =, _ RC Roofing Covering , i r � , fi. iJS Window and Siding k i '' _', m a "` y� SFSolid Fuel Burning Appliances ` " = W ' ':°'q ;`t ; • gJzvV r a3 .C«-r+ .w.. I Insulation Triephotae Email address D Demolition SA Registered Horne Improvement Contractor(RIC) ,470,,,C.. 1` C tx 1''' o tHIC Registration Number Sxpt atian Datep_.,:,,,::, `- r HI'C Compiety Name or RIC Registrant Name : f-CT iSc',�c fi.31 'nh ;Na and St eel t " S.1 ti'A,itp A Q Z6A Email address "1 ' ._U iTOw �`<� Telephone I 1 ;:,.' i SECTION 6:WORKERS'COIVIPENSATION INSURANCE AFFIDAVIT(M.C.L.c. 152.§ 25C(6)) 13� - ' " ' Work=Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide , " Vt ' davit 'ul result is;Me denial of the Issuance of the building permit. : davit Attached? Yes It( ilo.., ,..,.,.0 f I $ z+ "SECTION 7a:OWNER AUTIIORVIATION TO BE COMPLETED WHEN t';; n? x OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PER.ti lT #Iy�s tTsestrbirctproperty,hereby authorize .-�' 8o ( ( c�Y1J cal(.tr)c) _ <its [ halE in all matters relative to work authorised by this building perms application. 1:' :dot Owner's Name(Electronic Sig tire) Date Y I SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION } i By eteering ray name below,I hereby attest under the pairs and penalties of perjury that all of the information, 0. 3' contained in this -- a is true and accurate to the best of nay knowledge and understanding. r -43.7 T' .- ma's or Au on ed Agent's Name(Electronic Signature) -. Date x " NC TES: I. a •sac sbtaintabvi}d b, r" in permit to do his/her own work„or an owner who hires an unregistered contract's - - ,, `;k ed inthe Horne improvement Contractor(HIC)Program),will anon have access to the arbitration 1 , , ,t , tlr�.Ma L c,I42A.Other important information on the IIIC Program can be found :,r, : , , F s=l a...03 ,,• .anon on" the Construction Supervisor License can be found at�ti ww, p�^ r ..m j ntasS.gQv/tlpg ta '. -i .. planned,provide the information below: w 4 �r= ui . (in+:luding garage,finished bosementlattics,decks,or porch) I•Iabilable room count � � • � �y �- . r � . Number of bedrooms Number of h;�lf/bttths 3 . 4 i' a ?„umber of decks/porches off ',„,d :ra e .s:', a a s liri` Mkt z` s� ,Ap,,,"PM-PA „ t)?` ,f, f n glt b< a .4'af S ,f§ Si�„�" .s, dam' ;'a - : ,:4 .<. .,'tom r" po )Q f) 11 Z2 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 o,�e Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only .- Building Permit Number: ,r3 1123 Date Applied: 7 E di I V E D t Building Official(Print Name) store i DAN 3 0 2022 SECTION 1:SITE INFORMATION BUILDING DEPARTMENT' 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers I t'Y I ' Se.,Y`,WO1~F �c - 25 3 0 c 1.1 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 1 Provided Required Provided Required Provided 1.6 Water Supply: (Ivi.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: e)4c b:1 ec , tt OSX 6 3 w 6.4 Put ce C; c "-TYvi9 s 6osc,) ("Ao f 8 7 g Name(Print) City,State,ZIP c3 W1 9. ce 73I-33 Z(1 ngn(ybecb.PC; Ct,ftca3rNA- No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) z New Construction 0 Existing Building 5d'/ Owner-Occupied 0 I Repairs(s) 0 Alteration(s) >V7 I Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: f j,,h 11\n 1.'' `- ( c-Pdc3:11 C v cr4 A*-`-7 U 4 ^l i w i q•Cti i'1?v...A igPcL lb v.,-M / cr 0 P14"� SECTION 4: ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ Q.C t 1. Building Permit Fee:$%',c90 Indicate how fee is determined: 1 Standard City/Town Application Fee 2.Electrical $ S K 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ s K 2. Other Fees: $ 4.Mechanical (HVAC) $ -V IC List: j —,uD MC% eZ g-gq \k"`C\ 5.Mechanical (Fire Suppression) $ Total All Fees:$ C 1 C�., "� Check No. Check Amount: Cash E�ount: -1.-- 6.Total Project Cost: $ by I- ❑Paid in Full al Outstanding Balance D e: ,G-S S 10\13)39L SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 339e �?3/j y/2 y CS- 03 ‘l.I' Onc )' (QJ-7 f O License Number Expiration Date N e of CSL Holder , 5 ‹ 15,3 i List CSL Type(see below) No,and Street Type Description S, i ikN'f )) , '" \M Q. e G c. U I Unrestricted(Buildings up to 35,000 cu.ft.) _ City/Town,State,ZPP R Restricted 1&2 Family Dwelling lv1 Masonry RC f Roofing Covering • WS Window and Siding 51 9 7 i332 SQ ker& RY 3J)() 4) -e�M SF InsSoluldation Fuel Burning Appliances `C7t Insulation Telephone Email address D Demolition 5.2_Registered Home Improvement�s Contractor(HIC) 7 2 i`�r1i a , 6 -3. `cx f'-\ `. HIC Registration Number Expiration Date HIC Company'Name or HIC Registrant Name No.and Street /� Email address S' e.t)' AMA 0Z-6Ca City/Town, StatZJP 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 e No .El 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 ' a • n is true and accurate to the best of my knowledge and understanding. ____ '/zgiZt Print Owner's or Authorized Agent'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.cov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) 1 ' < (including garage,finished basement/attics, decks•or porch) Gross living area(sq.ft.) i (p 3 Habitable room count -3 Number of fireplaces ' Number of bedrooms 3 Number of bathrooms Number of half/baths 1- Type of heating system C IANi' 1 Number of decks/porches i Type of cooling system cot tea ,Pr r Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" • . —� The Commonwealth of Massachusetts 1 Department of Inclustrial Accidents 1 Congress Street, Suite 100 kg` I} Boston, MA 02114-2017 ,�•' www.mass.go v/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY, Applicant Information %� Please Print Legibly ) Name (Business/Organization/Individual): ki \do A Cr Address: 1) G'x /j 32 1 City/State/Zip: ,p. p26G Phone #: .S`�'$ -9r-f 33 7 Are you an employer?Check the appropriate box: Type of project (required): l.211 am a employer with 3 employees(full and/or part-time).* 7. ❑New construction 2.0 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.O I am a homeowner doing all work myself.[No workers'comp. insurance required.]t I. ❑ Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12. 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.t 13. Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we have no employees. [No workers'comp.insurance required.] *Any applicant that checks box#1 must also till 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. 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: "Q W \\� Q r I C21 , Policy#or Self-ins.Lic.#: V CC TaC5.5 V V13 ft 13 2 of a A (� Expiration Date: S�S- � Ze 2 3 Job Site Address: S"(i•••, `A \AI'p 1 V City/State/Zip: S crNit (W\`D 2b� 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 and penal of perjury that the information provided above is true and correct. Signature: _ Date: /2-4! Z Phone#: Sk)lc c� � ' 33 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 CIerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone I/: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-223!A 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 I 0 S0 J' " S 0 Work Address Is to be disposed of oat the following location: 3 ft .1) ek Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. b/ 2ct(2 ignature o pplication Date Permit No. Sears, Tim From: Sears, Tim Sent: Friday, September 9, 2022 9:39 AM To: Raymond Caterino Subject: 10 Southwest Attachments: work in flood zone packet.PDF Raymond, I have reviewed your application and there are some items needed. }( VI This property is in a flood zone, I have attached a packet for you to review. Please return the completed cost worksheet, contractor&owner affidavits. Save the final affidavit for the completion of work. t. smoke/co detectors marked on plan as required. 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.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:tsears@varmouth.ma.us 1 DDWLIN L GROUP G D NEI " May 6, 2022 RJC Building & Maintenance, LLC P.O. Box 1532 South Dennis, MA 02660 Re: Associated Employers Ins Co, Workers Compensation, Policy# WCC50050173132022A, 05/05/2022 - 05/05/2023. Enclosed is your Workers' Compensation policy with Associated Employers Ins Co which is effective 5/5/2022, along with a "Notice to Employees" which is required to be posted in a visible area in your workplace. Your premium is based on an estimate of your payroll during the upcoming policy year. Your actual premium will be calculated at the end of the policy term and any adjustment to your premium will be made at that time. At the time of your audit, you will be required to provide your payroll records as well as Certificates of Insurance for General Liability and Worker's Compensation coverage for any subcontractors that you have paid during the policy year. If these subcontractors are either individuals or partnerships, the Certificate of Insurance must indicate that the individual or partners are covered by the Worker's Compensation policy. Failure to show proof that an individual or partnership has "opted" into the Worker's Compensation coverage could result in their payroll being included in your audit. You will be contacted either by the insurance company or an auditor and requested to have this information available at the appointed time. If there is no certificate of Workers' Compensation insurance for subcontractors, an auditor will include payments to these subcontractors as payroll in each subcontractor classification. The impact on your final premium could be significant. If you need any assistance with the audit or have questions, please give me a call. If there is a significant difference in reported payrolls, from one policy term to the next, the renewal policy will be endorsed to reflect the appropriate differences. If you require a Certificate of Insurance you may access our website at www.doins.com and click on "Certificates". Many clients have found this to be a very efficient way to order and track Certificates. If you work in states other than Massachusetts, please notify us immediately prior to work commencing. I appreciate this opportunity to be of assistance to you. Sincerely, • ,, 12 Tina Reeves Phone:(508)957-4258 Email: treeves@doins.com The Hilb Group of New England LLC dba Dowling&O'Neil Insurance Agency 1973 lyannough Roadl P.O.Box 1990 I Hyannis,MA 102601 800.640.1620 I www.doins.com Commonwealth of Massachusetts • s® Division of Professional Licensure Board of Building Regulations and Standards Cons1,Ntut4htlA 1pprvisor r CS-083390 �.' 6cpires:08114/2022 RAYMOND J CATE- . t ' I . PO BOX 1532' I� SOUTH DENNII MA .;...,,I..w 1' v ?� ' 1 , /1 °ems"4 t()/S;!1:0Z, Commissioner dial, K. Devn(i.,... ii� n„z�yz,,ii�an2rue o ��arid oruJP�g,Office of Consumer Affairs&Business Re HOME IMPROVEMENT 9uiation TYPE:IndividualCONTRACTOR Re istratio Ex�i_ 'ration i 187136 03/05/2021 i RAYMOND J.CATERINO D B/A RJC-BUILDING MAINTENANCE f f RAYMOND CATERINO 1 ' • 56 CAMP ST AR—Cc Q�„ W.YARMOUTH,MA 02673 J Undersecretarj Mass.gov p ,i, -, 1 1 Affa ' ; s .'-'.. .//,e , ,,,,,, Vie,;,.. 4, EUOfl4 A C ^3 HIC Registration Complaints Registration 187136 Registrant RAYMOND J. CATERINO DBA RJC BUILDING & MAINTENANCE Name RAYMOND CATERINO Address 56 CAMP ST City, State W. YARMOUTH, MA 02673 Zip Expiration 03/05/2023 Date Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Licensee Details Demographic Information Full Name: RAYMOND J CATERINO Owner Name: License Address Information City: South Dennis State: MA Zipcode: 02660 Country: United States License Information License No: CS-083390 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 8/17/2022 Issue Date: 8/14/2010 Expiration Date: 8/14/2024 License Status: Active Today's Date: 8/29/2022 Secondary License Type: Doing Business As: Status Change Reason: License Renewal Prerequisite Information No Prerequisite Information No Available Documents cijc/51--c _ /Q2. vn /,,t/G" - ( 0 Y1-4-c-Cle-• 14Z RECEIVEa SEP 0 6 2022 BUILDING DEPARTMENT RECEIVED 11) Flooring a. Vinyl Plank Flooring Allowance for materials-$4,320.00 SEP 0- 9 2022 b. All 2nd floor flooring to be vinyl plank BUILDING DEPARTMENT By 12) Mirrors a. Customer to provide all mirrors and builder will install b. Customer to supply all toilet paper holders, towel bars, robe hooks, etc. and builder will install in desired locations. Total contract price: $80,500.00 3.3 Payments. The contract price will be paid as follows: Deposit: Owner to provide$15,000.00 before any construction will begin upon signing of contract. Additional deposit will go towards purchasing of windows. Deposit will be credited against cost of house. First Draw: 25%when rough framing is done. $16,375.00 Second Draw: 30%when plumbing, electrical rough. $19,650.00 Third Draw: 30%when sheetrock is installed and primed. $19,650.00 Fourth Draw: 10%when interior doors,flooring and trim installed. $6,550.00 Fifth & Final: 5%on final inspection for Yarmo ath Building Dept. $3,275.00 Any unused allowances will be credited back to homeowner cpto4 Mark Barbieri Raymond Caterino, President Date: 08/05/2022 Date: 08/05/2022 **Payment must be made within 5 business days, or late fees will be applied. If payment is not made within 30 days of project completion, RJC Building will refer your account for debt collection.An interest rate of 1.5%a month,or 18%annually will be charged to all past due Y�►k TOWN OF YARMOUTH rc HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: to Yo.r VI t�S �C M-0u \ Proposed Improvement: ✓11-S AZ �dc 1�1 ��Q\�` IV" b P�` Q AA Applicant: \-c'`,! ra 'A-0 Tel. No.: Y'9r) 3�7 Address: ' " r-) t x S. Oen1' T t04\ O 2 L 6 b Date Filed: Sl I "If you would like e-mail notification of sign off,please provide e-mail address: S. [PS )Z •f`9,, �..:� � I v C1��r Owner Name: I y `� ) Owner Address: to SISV �4 Owner Tel. No.:7 Y/'3 7F - &) 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. RECEIVED Please submit three (3) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, AUG 2 P 2022 and septic system location; (2.) Floor plan labeling ALL rooms within building HEALTH DEPT. (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: PLEASE NOTE COMMENTS/CONDITIONS: /Z (40 e_ , ( t ( 10 SOUTH WEST DR Location 10 SOUTH WEST DR Mblu 25/ 306/ / / Acct# 958 Owner BARBIERI MARK D TRS Assessment $600,200 PID 958 Building Count 1 Current Value Assessment Valuation Year Improvements Land Total 2023 $279,600 ` $320,600 $600,200 Owner of Record Owner BARBIERI MARK D TRS Sale Price $100 BARBIERI NANCY M TRS Certificate Care Of Book & Page C217136/0 Address 63 WIDEMERE CIR Sale Date 08/28/2018 TYNGSBORO, MA 01879 Instrument 1 F Qualified U Substantial Improvement Worksheet for Floodplain Construction (for reconstruction, rehabilitation,addition,or other improvements, and repair of damage from any cause) Property Owner: Address: .)•). \-s ,.i Q-51 vk_ Permit No.: Location: Description of improvements: Present Market Value of structure ONLY(market appraisal or adjusted assessed value BEFORE improvement,or:if<daaiaged, before the damage occurred);,not ncluding land value $ 'L7 Cost of no Imp v roement Actual cost of the coiistruction"k(see'items to include/exclude) $ 0 )t ''Include uolrnteertabor and'donated supplies'* Ratio= Cost of Improvement(ar Cost to Repair) % ,Maret Value:: 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 alter 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 improvement 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: Ray to ^ Date: lb)) S, 'LZ eo^R TOWN OF YARMOUTH * BU ILDING DEPARTMENT ^ri =SE= G 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: •.l 0 d S'4-AAA IftrOii Dc . Parcel ID Number: '2- 5 /1 o L Owner's Name: 11144c y C3c c b,e Owner's Address/Phone: t 0 STvv yJ'e rt 7 8 ) - r]Zy (04j ZS CA 0 Contractor: R')C B l\ .61vc .T1,,c_ Contractor's License Number: C.3 O 'R 3 3�� Date of contractor's Estimate: '/ z/ z 2 `< 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. \\\��„ u�,,,,�/// 6-01_ Owner's Signature: tN\C1 IQ�a.«` o 41. ° ��; Date: 1 IV/ 3/c,)a. = °� '�i2���S�cWEALttS.•'•. �� J` '•‘,2 ., Notarized: R R I4 yCornmi.sciO11 1145 (�b J°i/doa`3 • S ' • " TOWN OF YARMOUTH rtr. BUILDING DEPARTMENT r, nATT _ , .1:146 Route 28, South Yarmouth MA 02664 Telephone 508-398-2231 ext. 1261. Fax 508-398-0836 Contractor's Affidavit: Substantial Improvement or Repair of Substantial Damage Property Address: 0 Sv,A\'' v 'c Parcel ID Number: 2 5/ .3 o (c Owner's Name: No,ACy 130,c 6 i e,CI Contractor: � )C (3 )i` j i\ciL A c Contractor's License Number: C ,S'" 0 ? 3 3 Date of Contractor's Estimate: J2) 24ti 7'- I hereby attest that I have personally inspected the building located at the above-referenced address by the nature and extent of the work requested by the owner, including all improvements, rehabilitation, remodeling, repairs, additions, and any other form of improvement. At the request of the owner, I have prepared a cost estimate for all of the improvement work requested by the owner and the cost estimate includes, at a minimum, the cost elements identified by the Town of Yarmouth that are appropriate for the nature of the work. If the work is repair of damage, I have prepared a cost estimate to repair the building to its pre-damage condition. I acknowledge that if, during the course of construction, the owner requests more work or modification of the work described in the application, that a revised cost estimate must be provided to the Town of Yarmouth, which 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 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 made or authorized repairs or improvements that if inspection of the property reveals that I have made 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. Contractor's Signature \ ELU C/q AA-- O<</i�o 6-01 2 Date: l D/ +.• j�3/ a ? • p sp;o • Notarized: �i O SS�K'EALSH � �� J,9••9SMUSEtjs••• �� /YlS �'om�ru�6�Oh Mile': 06/ .0d3 �'ii/ Y PUBOCI,\\``�`• NI REVIE\"'..-.. , �'+NL1_ P" ' THE L ,: BUILT" CO'1 . 36'-0"REF.PAVANA �.E' —1 ��PAVANOPTx PRICED" PROVIDEOIEION MICE TO MAKE DOLMA WINDOW MAKE DOME WINDOW WINDOW WINDOW WINDOW ADUSTING orn. '•� I. I I, .I BUILDii OFFICIAL IE " I Ir-u1/Z BATH 5' Ir-0" — tiII iEll III ■ MIN ",--Y-1"- .y 12.d�" ITT. L 1-31�9" VERIFY VERIFY n•°I fT I 9 �2 ` +: In on Loll :s GAME ROOM 4'."RO' HALLWAY / ❑1 / BEDROO " :3 VERIFY 1E1.1 /MI III ti oz r/, °..-1, CO 0 So _ ©EI - 6nN0 m.tip n. T z 1,1W. �/1�t1-- r--- M lOf TED I E— a . vw. WINDOWS -,^.:;. 2 W ERIST.NVAO /i IIII I DUCTS I CLO. '❑1 EuTURE WILT Or I LEFT SIDE ELEV.SIMILAR / • STORAGE"�� 000 ASI—` I MEI L._-- / RIGHT SIDE ELEVATION LOCATION A SIZE TRD �J LOCATION.SSTORAGE sin Teo :Eim' 1 • STORAGE MOM STORAGE 1 1 1 1 1 L LJ A RECEIVED (tom r I SECOND FLOOR PLAN "'1 N — •. y"n-' 1✓ SCALE ve"•r U 'L Lv li U(.i 2 9 2022 I HEALTH DEPT. ❑ DOOR SCHEDULE U QTY NOM.SIZE NOTES III III 1 3 2'8"x 6'8" R.H. III IIII 2 2 1'6"x 6'8" LH. III III 3 FI« n.-Owe O IatRevision Nome III ■IB 4 FOR RJC BUILDING Combination Design _ Nr...ENN ,o•Kw. '"-""°-`""""' - SECOND FLOOR FINISH 10 SOUTHWEST DRIVE SECTION A-A ^ v._. SOU H VARMO 1TH.IM oz66/ SCALE:vr.r ❑ataww °Con.APN.I21071622-01 7 ❑Proposal°Approval :IL nnrml wpm. ❑AA IUIR °Installation°e'—�, :ILz .............. TOWN OF YARMOUTH 1146 Route 28,'South, Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax. 508-398-0836 Office of the Buildin; Commissione R E C E I V E D R APR 2 7 2023 Q\\ 11 BUILDING DEPARTMENT By. — ——_ FINAL COST AFFIDVIT FOR WORK IN FEMA FLOOD ZONE To the Building Commissioner, In accordance with 780 CMR Section 109 of the Massachusetts State Building Code, the total estimated cost of construction, including all related costs* of the building at (() % J I f Q: . and constructed, reconstructed, altered, repaired, or extended under building permit no. V\ Z 3 amounts to S a $ i, R aye-, �e► *� a ,being referred to as the owner/agent identified below,do solemnly swear that the statements made herein are strictly true, correct and made in good faith *Related construction costs include all work done with or concurrently with the work contemplated by the building permit including construction, reconstruction, repairs, demolition, HVAC work, etc. Furnishings and portable equipment are not part of the total construction costs. gnature of owner/agent AD✓ Le , 02 C o2 Notary Publi Signature My Commission Expires STEPHANY E. HUTCHINSON Notary Seal: Notary Public 1 Massachusetts ; My Commission Expires Nov 6, 2026 y ' w .t� �. •?� x�•Il,rx f; �x r