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HomeMy WebLinkAboutBLD-23-002696 go s i elPc- ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department o� r --_ 1146 Route 28, South Yarmouth,MA 02664-4492 �� _ 508-398-2231 ext. 1261 Fax 508-398-0836 • '."�s'�A Massachusetts State Building Code,780 CAR • Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Secti9Official Use Only Building Permit Number . )(., - 2 Date Applied:. cly Building Official(Print Name) Sign •. • SECTION I;SITE INFORMATION' ECE1VED 1.1 Property Address:, 1.2 Assessors Map&Parcel Numbers ,C0 nLt 1ai ii, J-L. 'y ( 0 ,z1 '7 NOV 15 2022 1.1a Is this an accepted street?yes k/ no Map Number Parcel Number 1.3 ZoningInformation: 1.4 Property Dimensions: BUILDING DEPARTMENT `I .-98 1efi. I'l, I4(, la-I.. e, By' 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 381 I'>> I ao " IC,. 9 2,0 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood ne? Public 0 Private 0 ____ Municipal 0 On site disposal system Cl Check if ye SECTION 2 PROPERTY(WNERSHIP' ::',.'....,',::'i'''::1....:'.:'.....:.,.. ...:'•-I..: ;: -. . 2.1, Owners of Record: ILK C. CO t ell) 30J-6Oil, tip 04210 Name(Print) City,State,ZIP 300 J NA ey Jt.. # , 'l Ci,i- go1-a65G aLcliti,L .,c ig (ctoC ..coL) No.and Street Telephone Email Address SEC TION 3�DESCRIPTION OF PROPOSED ORIC:(check,all that apply) New Construction❑ Existing Building Owner-Occupied ❑ Repairs(s) 0 Alteration(s), Addition Demolition Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Wor : r fi' • rLsc L (1rf.am... c �r rQ a�° K yCd 1 x to 4 r lac r, b 411 a c, )ct ,r, t p O c c. (�i o G� �, r �91 v r ,'/fir, �1L (0 4 If,..0..(Art fl JCt t r t,1k o}-: i7o 6 c .t,G c � (Lp c. . f: SECTION 4�.ESTIMATED OONSTRI1CTIO,1 COSTg Estimated Costs: �"•T '• Item (Labor and Materials) Official Use Only 1.Building $ 1 Building Permiaee1$.- ;Indicate how fee is determined l ��` ,l•'Standard City/Town Aliphcatipn vec 2.Electrical $ x t 'i 0 On, ❑_::Total Project Costs(item 6)x multiplier: •x Plumbing :'7'`3.P1 $ ees'.2�=�Otlae''F. _ _...,:;;:., . gar 4,: List.. :.. ,:'- 4.Mechanical (HVAC) $ Ii e,O AA. -r T L �f� 5.Mechanical (Fire $ t ' f� { Suppression) Total A11 Fees - \✓ ' ') Cl eck l lb. .Check Amount- . Cash Amount 6.Total Co st ost: $ • 1 .i o O o i) ❑Paid in Full Ll:0utstaudmg$a ance Due 11.4 - , ' , S•\ Ala' \`) a SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) f o GC,()}l C ` a,v(J License Number Expi d n Date Name of CSiolder U List CSL Type(see below) Lag 0 k tt0AG‘, utyeet, No.and Street Type Description U O La IN, Flo.r o At 1. ItA e ry U Unrestricted Buildings up to 35,000 cu.ft.)) t�J 4 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry _ RC Roofing Covering WS Window and Siding p SF Solid Fuel Burning Appliances ,r)j0(" .)Jp L"(,4�a�C Vi��E�CI'Pnlr(�Peil,rdlt.C� ("0(1�k I Insulation Telephone E address D Demolition 5.2 Registered Home Improvement Contractor(BIC) Ii i(r `"a'v(`f' I(AL, HIC Registration Number Ex ira on Date C Co N e or C R,egistrarft Name ,3 N r v. a�1� (I--tart 0a (Ark Gor cdovic!(ItCECI}bj No, d Street J+ Qr'h4OECEIl I � Q,�..fo�1� �iQ3'' '3 Oic21�. ' Em ddress City/Town,State,7TP 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 (9 COM r, 36_1/1r,, . itiC. to act on my behalf,in all matters relative to work authorized by this building permit application. ice a,tta,ckidi 11 Ivy 1 � Print Owner's Name(Electronic Signature) to SECTION 7b: OWNER'OR AUT.aORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pairs 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. ()foil e Oa,v 1 Print Owner's dijkiithorizcd Agent's Name(Electronic Sigiature) Da e NO TES: 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.sovioca Information on the Construction Supervisor License can be found at www.mass.uov/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" ' ARM1 O T H T OWN CLERK :OTc .Y4it ' 3JPIN31r!410:54 RED' k•E' i'-`-;--MX?',0 TOWN OF YARMOUTH •i C BOARD OF APPEALS 0 DECISION 7;*7,4CME' BI-i 35.6 5 0 P.9323 s•7•_7}70 132--23 _-2O23 its 07 M: -.-' E, FILED WITH TOWN CLERK: January 31,2023 PETITION NO: 4997 RECEIVED HEARING DATE: January 12,2023 FEB 2 3 2023 PETITIONER: Anne E. Welch,Trustee BUILDING DEPARTMENT Anne E.Welch Revocable Trust BY 300 Summer Street No. 27 Boston,MA 02210 PROPERTY: 286 Old Main Street, South Yarmouth,MA Map 60, Parcel 217 Zoning District: RS-40 Title: Book 21082,Page 73 MEMBERS PRESENT AND VOTING: Jay Fraprie (Acting Chair), Dick Neitz, John Mantoni, Doug Campbell,Dick Martin Notice of the hearing was given by sending notice thereof to the Petitioner and all those owners of property as required by law, and to the public by posting notice of the hearing and publishing in The Cape Cod Times. The hearing opened and was held on the date stated above. The petitioner seeks either a Special Permit and/or a Variance to increase the height ofpre-existing, non-conforming structure by 12 inches. At the hearing, the petitioner's representative, George Davis did a fine job presenting the petition. Serving as the general contractor, Mr. Davis described the age of the property as "old". The property at 286 Old Main Street was built in 1800. The petitioner seeks relief to lift the single-story structure off the ground to install a foundation. The increase in height would be no more than 12 inches. The Board agreed that the petition meets the criteria for a Special Permit. The Board noted that the project represents significant historic preservation—both in saving the structure and improving the appearance of the structure. 4 .i.J 4 • 1;3UE•COP\ A'tr ST: 14r, At4iit;6444 C CMViC/TOWNCOLERK 2023 The petitioner received comments in favor of the project from abutters: Maureen Carser and Suzane Bazner, 285 Old Main Street,who sent a letter of support; and Barbara Adams, 289 Old Main Street, who voiced her support in-person at the hearing. A motion was made by Mr.Neitz and seconded by Mr. Mantoni to approve the Special Permit as requested, without conditions. On a roll call vote(5-0), the Special Permit as requested, without conditions, was approved as follows: Mr. Neitz-Aye; Mr. Mantoni-Aye; Mr. Campbell-Aye; Mr. Martin-Aye; Mr. Fraprie-Aye. The petitioner requested to withdraw the Variance portion of the petition, without prejudice. A motion was made by Mr. Neitz and seconded by Mr. Mantoni to allow for the withdrawal of the Variance, without prejudice. On a roll call vote (5-0), the request for the withdrawal of the Variance,without prejudice,was approved as follows: Mr. Neitz-Aye; Mr. Mantoni-Aye; Mr. Campbell-Aye; Mr. Martin-Aye; Mr. Fraprie-Aye. No permit shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals from this decision shall be made pursuant to MGL c40A section 17 and must be filed within 20 days after filing of this notice/decision with the Town Clerk. Unless otherwise provided herein, the Special Permit shall lapse if a substantial use thereof has not begun within 24 months. (See bylaw §103.2.5, MGL c40A §9) r Jay Fr 'e, cting Chain CERTIFICATION OF TOWN CLERK I, Mary A. Maslowski, Town Clerk, Town of Yarmouth, do hereby certify that 20 days have elapsed since the filing with me of the above Board of Appeals Decision #4997 that no notice of appeal of said decision has been filed with me, or, if such appeal has been filed it has been dismissed or denied. All appeals have been exhausted. ,4Tioti,a).A4461-x,,a4 . 6 Mary A. Maslowski FEB 2 3 2023 t r l f:A .NIA 1 ,,. 4 Ui=C 4 EST ,h4/4:tett\ 44,/ gym"�C i�civic i ERK � .1TAc . :42, 1211A+� 63 Q, ',it 1 ,ay•Y`` COMMONWEALTH OF MASSACHUSETTS TOWN OF YARMOUTH S' �' a aBOARD OF APPEALS ` gF Petition #: 4997 Date: February 21,2023 Certificate of Granting of a Special Permit (General Laws Chapter 40A, Section 11) The Board of Appeals of the Town of Yarmouth Massachusetts hereby certifies that a Special Permit has been granted to: Anne E. Welch,Trustee Anne E.Welch Revocable Trust 300 Summer Street No.27 Boston,MA 02210 Affecting the rights of the owner with respect to land or buildings at: 286 Old Main Street, South Yarmouth, MA; Map 60,Parcel 217; Zoning District: RS-40; Title: Book 21082,Page 73 and the said Board of Appeals further certifies that the decision attached hereto is a true and correct copy of its decision granting said Special Permit, and copies of said decision, and of all plans referred to in the decision,have been filed. The Board of Appeals also calls to the attention of the owner or applicant that General Laws, Chapter 40A, Section 11 (last paragraph) and Section 13,provides that no Special Permit, or any extension,modification or renewal thereof, shall take effect until a copy of the decision bearing the certification of the Town Clerk that twenty(20) days have elapsed after the decision has been filed in the office of the Town Clerk and no appeal has been filed or that, if such appeal has been filed, that it has been dismissed or denied, is recorded in the Registry of Deeds for the county and district in which the land is located and indexed in the grantor index under the name of the owner of record or is recorded and noted on the owner's certificate of title. The fee for such recording or registering shall be paid by the owner or applicant. Jay F line, i ng Chai I1iE C0 Y Ifd T: . BARNSTABLE REGISTRY OF DEEDS G, CA /CMC t 1VONA."LERK John F. Meade, Register �; 4PEW rt ZQ23 EV E RS=U RC E 247 Station Drive Westwood,Massachusetts 02090 ENERGY December 28, 2022 Sent to: CATHY@GEORGEDAVISINC.COM RE: 286 OLD-MAIN ST S YARMOUTH 02664 To whom it may concern, At Eversource, we're committed to delivering great service. This letter serves as confirmation that the electric service at the address noted above has been removed. Based on this information, there is no electric power at this address and you may proceed with the demolition. If you have any questions, please contact me at (888) 633-3797. Sincerely, Phyllis MacPherson Electric Services Support Center national ri gd December 6, 2022 George Davis, Inc. Attn: Cathy Whiteside 33 Old Main St. South Yarmouth, MA 02664 TO WHOM IT MAY CONCERN: RE 286 Old Main St., S. Yarmouth, MA This email is to confirm that there is no live gas at this property. This letter DOES NOT preclude the excavator or homeowner from calling Dig Safe at 811 before commencing any work. State law requires anyone planning underground excavation work to notify local utilities by calling 811 to get your underground utilities identified for you prior to doing any digging. The call to 811 is the LAW and must be made in advance of starting work. This confirmation letter of a gas cut-off DOES NOT relieve the excavator of making the call to 811. It is a State Law requirement. I can be reached directly at 508-760-7439 should there be any further questions. Sincerely, Ellen Whelan Residential Gas Connections National grid 127 Whites Path S. Yarmouth, MA 02664 (508) 760-7439 Ellen.Whelan@nationalgrid.com 11/23/22, 10:07 AM Mail-Sears,Tim-Outlook 286 Old Main St Sears, Tim <tsears@yarmouth.ma.us> Wed 11/23/2022 3:07 PM To:George Davis <gdavis@georgedavisinc.com> George, I am following up our phone conversation about lifting part of this structure for a new foundation. The house is currently nonconforming and if the height of the ridge will be raised it will require relief from the Zoning Board in the form of a special permit. Please advise Timothy Sears CB0 Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsearsPyarmouth.ma.us • https://outlook.office.com/mail/sentitems/id/AAQkADE3MDQ5NWZmLTkOYzItNDIwNi1 iMDQxLWNkMGQyNmE4NzE5NAAQAFsiXDJcmZZLsiTbfAjWU... 1/1 s�F'YAR TOWN OF YARMOUTH C BUILDING DEPARTMENT o . H 1146 Route 28,South Yarmouth, MA 02664 �;:.: s 508-398-2231 ext. 1261 Fax 508-398-0836 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 2cG act_ cft. cf/ Work Address Is to be disposed of at the following location: J4 .XC, Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. Signature of Application Date Permit No. September 26,2022 Town of Yarmouth Building Department 1146 Route 28 South Yarmouth, MA 02064 Re; permit LeJthortzatino fpr. 216 OW Niatn Street South Yarmouth, MA 02664 I. Arms Welch.SS°Wrier of-the tutioa perry. hereby authorm (iroege Drell', Inc-10 rxt on my bthtig..ln marten'elan vc ti,work at.ehotited by this Willing permi! application formiat the above referetKed pre,perry. './ kigraturt De 4\ Wi IV PrIm Num Commonwealth of Massachusetts Construction Supervisor Ve Division of Professional Licensure Unrestricted -Buildings of any use group which contain Board of Building Regulations and Standards less than 35,000 cubic feet(991 cubic meters) of enclosed Constrt78-CUltr pprvisor space. CS-056130 ''-.�' Ecpires:•03/01/2023 GEORGE F OpVIS •,; f - 33 N MAIN Sr _,� " SOUTH YARMOUTH MA 02664 C �M�IS;t3a� Failure to possess a current edition of the Massachusetts ,�` State Building Code is cause For revocation of this license. Commissioner d K �1 Fr 7 Orn, For information about this license U Call (617)727-3200 or visit www.mass.gov/dp1 C c lf%2minaItuiecr t opfL 4 arituoe1tJ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 160164: - = 07/01/2022 1000 Washington Street -Suite 710 GEORGE DAVIS,INC. . ,- Boston,MA 02118 • GEORGE F.DAVIS:' 33 NORTH MAIN STREET,. Low"'a.� Not VBII without signature__�— SOUTH YARMOUTH,MA 02664 Undersecretary The Commonwealth of Massachusetts 1 =`1 h Department of Industrial Accidents O►- 1 Congress Street, Suite 100 0 �� < Boston,MA 02114-2017 ,,�' www.mass.gov/dia I. Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): G 60 r e 3a,v(..f, TGt,C. Address: 31 N t0 rU kq i k, AJ J/C e. City/State/Zip:S Yam O(A--E1x.) IL A, Qd (lI(j Phone#: -3 - (,d)c_J/, Are you an employer?Check the appropriate box: Type of project(required): 1'30 am a employer with I I 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 $.AaRemodeling 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 [] Building addition 4.❑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.Q 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. 13.n Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 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#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. :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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: A (rs o C(r E di, ehr i l cbl Ar t r(,to c/' /jdL,tf ct-rGt.il C' 6 Policy#or Self-ins.Lic.#: �)( �' 6®j'Q I t ti 9 Q,;Z Q ;Z � Expiration Date: L3'N''/,3 Job Site Address: 1,16 Q 1A It I du rf t vt t°t City/State/Zip: J, yn y 11,,Q(A.t 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 pains and penalties of perjury that the information provided above is true and correct. Signature: �h h�1 Date: ii li\Jrii __ Phone#: 3 0 f- !'lQv - 14 00 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#: ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/4/2022 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 AHT Insurance, A Baldwin Risk Partner PHONE Tom Messier FAX 458 South Ave (NC.No.Eat):800-648-4807 INC.No):781-447-7230 _ Whitman MA 02382 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# License#:CA#0658748 INSURER A:Western World Insurance 13196 INSURED GEORDAV-01 INSURER B:NGM Insurance Company 14788 George Davis, Inc.33 North Main St. INSURER c:Associated Industries Insuranc 23140 South Yarmouth MA 02664-3437 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:600930477 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY NPP1577750 1/12/2022 1/12/2023 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY M9M28491 10/26/2021 10/26/2022 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS _ - -- X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION WCC50050143902022A 3/5/2022 3/5/2023 X PER TH- AND EMPLOYERS'LIABILITY STATUTE ER Y N ANYPROPRIETOR/PARTNER/EXECUTIVE N E.L.EACH ACCIDENT $500,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of Insurance AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • REScheck Software Version 4..6.5 Compliance Certificate Project Addition/Renovation Energy Code: 780 CMR 51.00: Massachusetts Residential Code, 9th Edition, Energy Efficiency Location: South Yarmouth, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 286 Old Main St George Davis Inc S Yarmouth, MA 02664 33 North Main St S Yarmouth, MA 02664 Compliance: Passes using UA trade-off Compliance: 4.4%Better Than Code Maximum UA: 340 Your UA: 325 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Assembly or R-Value R-Value U-Factor UA Perimeter Ceiling 1: Cathedral Ceiling 1,925 38.0 0.0 0.027 52 Wall 1:Wood Frame, 16"o.c. 2,320 21.0 0.0 0.057 109 Window 1:Vinyl/Fiberglass Frame:Double Pane with Low-E 290 0.270 78 Door 1: Solid 80 0.270 22 Door 2: Glass 40 0.290 12 Floor 1: All-Wood joist/Truss:Over Unconditioned Space 1,580 30.0 0.0 0.033 52 Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 780 CMR 51.00: Massachusetts Residential Code,9th Edition, Energy Efficiency requirements i EScheck Version 4.6.5 and to comply with the ma9.0atory requ,i.r.pments listed in the REScheck Inspection Checklist. Co r' c javLsr R1,Z o4.2, Name-Tit a Signa Date Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 1 ofl0 • REScheck Software VersionChecklist 4.6.5 Energy Code: 780 CMR 51.00: Massachusetts Residential Code, 9th Edition, Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified Field Verified Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Req.ID 103.1, Construction drawings and EComplies 103.2 documentation demonstrate ❑Does Not [PR1]1 energy code compliance for the building envelope.Thermal ❑Not Observable envelope represented on ❑Not Applicable construction documents. 103.1, Construction drawings and ElComplies 103.2, documentation demonstrate ❑Does Not 403.7 energy code compliance for [PR3]1 lighting and mechanical systems. ['Not Observable Systems serving multiple ❑Not Applicable dwelling units must demonstrate compliance with the IECC Commercial Provisions. 302.1, Heating and cooling equipment is Heating: Heating: EComplies 403.7 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not [PR2]2 on loads calculated per ACCA Cooling: Cooling: ❑Not Observable Manual J or other methods Btu/hr Btu/hr approved by the code official. ❑Not Applicable 103.1 Solar-Ready Roof: New detached EComplies [PR4]1 one-and two-family dwellings, ❑Does Not and multiple single-family dwellings (townhouses) with >= ❑Not Observable 600 ft2 (55.74 m2) of roof area ❑Not Applicable oriented between 110 degrees and 270 degrees of true north comply with sections AU103.2 through AU103.8 (RB103.2 through RB103.8). Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 2 of10 Section # Foundation Inspection Complies? Comments/Assumptions & Req.ID 303.2.1 A protective covering is installed to EComplies [FO11]2 protect exposed exterior insulation ❑Does Not and extends a minimum of 6 in. below grade. ❑Not Observable ❑Not Applicable 403.9 Snow-and ice-melting system controls ❑Complies [FO12]2 installed. DDoes Not Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 3 of10 Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 303.1.3 U-factors of fenestration products EComplies [FR4]1 are determined in accordance ❑Does Not with the NFRC test procedure or ENot Observable taken from the default table. ENot Applicable 402.1.1, Glazing U-factor(area-weighted U- U- ❑Complies See the Envelope Assemblies 402.3.1, average). ElDoes Not table for values, 402.3.3, 402.5 [Not Observable [FR2]1 ENot Applicable 402.1.1, Glazing SHGC value (area- SHGC: SHGC: EComplies See the Envelope Assemblies 402.3.2, weighted average). ElDoes Not table for values. 402.3.3, 402.5 ❑Not Observable [FR3]i ENot Applicable 402.1.1, Door U-factor. U- U- EComplies See the Envelope Assemblies 402.3.4 ❑Does Not table for values. [FRU' ENot Observable 4 ENot Applicable 402.4.1.1 Air barrier and thermal barrier ❑Complies [FR23]1 installed per manufacturer's ElDoes Not instructions. ENot Observable ENot Applicable 402.4.3 Fenestration that is not site built ❑Complies [FR20]1 is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440 or has infiltration rates per NFRC ❑Not Observable 400 that do not exceed code ❑Not Applicable limits. 402.4.5 IC-rated recessed lighting fixtures ❑Complies [FR16]2 sealed at housing/interior finish ElDoes Not and labeled to indicate 5.2.0 cfm leakage at 75 Pa. ENot Observable ENot Applicable 403.3.1 Supply and return ducts in attics ❑Complies [FR12]1 insulated >= R-8 where duct is ElDoes Not >= 3 inches in diameter and >= R-6 where < 3 inches. Supply and ❑Not Observable return ducts in other portions of ENot Applicable the building insulated >= R-6 for diameter>= 3 inches and R-4.2 for< 3 inches in diameter. 403.3.5 Building cavities are not used as EComplies [FR15]3 ducts or plenums. ElDoes Not V ENot Observable ENot Applicable 403.4 HVAC piping conveying fluids R- R- EComplies [FR17]2 above 105°F or chilled fluids ❑Does Not below 55°F are insulated to >R- 44 3 ❑Not Observable ❑Not Applicable 403.4.1 Protection of insulation on HVAC ❑Complies [FR24]1 piping. ❑Does Not V' [Not Observable ENot Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 4 of10 Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 403.5.3 Hot water pipes are insulated to R- R- ❑Complies [FR18]2 >_R-3. ❑Does Not ❑Not Observable ❑Not Applicable 403.6 Each dwelling unit of a residential EComplies [FR19]z building provided with ❑Does Not continuously operating exhaust, supply or balanced mechanical ❑Not Observable ventilation that has been site ❑Not Applicable verified to meet a minimum airflow per Section N1103.6. Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 5 of10 Section Plans Verified Field Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & Req.ID 303.1 All installed insulation is labeled ❑Complies [IN1312 or the installed R-values ❑Does Not ' provided. [Not Observable ❑Not Applicable 303.2 Wall insulation is installed per EComplies [IN4]1 manufacturer's instructions. ❑Does Not [Not Observable ❑Not Applicable 303.2, Floor insulation installed per EComplies 402.2.7 manufacturer's instructions and ❑Does Not [IN2]1 in substantial contact with the d, underside of the subfloor, or floor [Not Observable framing cavity insulation is in ❑Not Applicable contact with the top side of sheathing, or continuous insulation is installed on the underside of floor framing and extends from the bottom to the top of all perimeter floor framing members. 402.1.1, Wall insulation R-value. If this is a R- R- EComplies See the Envelope Assemblies 402.2.5, mass wall with at least lh of the ❑ Wood ❑ Wood ❑Does Not table for values. 402.2.6 wall insulation on the wall ❑ Mass ❑ Mass [Not Observable [IN3]1 exterior,the exterior insulation requirement applies(FR10). ❑ Steel ❑ Steel ❑Not Applicable 402.1.1, Floor insulation R-value. R- R- EComplies See the Envelope Assemblies 402.2.6 ❑ Wood ❑ Wood ❑Does Not table for values. [IN1]1 ❑ Steel ❑ Steel ENot Observable V ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 6 of10 , Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 303.1.1.1, Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions. ❑Does Not [F12]1 Blown insulation marked every 300 ft2. ❑Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies [F118]3 mechanical and water heating ❑Does Not systems have been provided. [Not Observable ❑Not Applicable 401.3 Compliance certificate posted. ❑Complies [FI7]2 ❑Does Not ❑Not Observable ❑Not Applicable 402.1.1, Ceiling insulation R-value. R- R- ❑Complies See the Envelope Assemblies 402.2.1, ❑ Wood ❑ Wood ❑Does Not table for values. 402.2.2, ❑ Steel ❑ Steel ['Not Observable 402.2.6 [Fill' ❑Not Applicable 402.2.3 Vented attics with air permeable ❑Complies [F122]2 insulation include baffle adjacent ❑Does Not to soffit and eave vents that extends over insulation. ❑Not Observable ❑Not Applicable 402.2.4 Attic access hatch and door R- R- ❑Complies [FI3]' insulation __R-value of the ❑Does Not adjacent assembly. ['Not Observable ❑Not Applicable 402.4.1.2 Blower door test @ 50 Pa. <=5 ACH 50 = ACH 50 = ❑Complies [F117]1 ach in Climate Zones 1-2, and ❑Does Not <=3 ach in Climate Zones 3-8. ❑Not Observable ❑Not Applicable 403.1.1 Programmable thermostats EComplies [F19]2 installed for control of primary ❑Does Not heating and cooling systems and initially set by manufacturer to ❑Nat Observable code specifications. ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [FI10]2 on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable 403.2 Hot water boilers supplying heat ❑Complies [F126]2 through one-or two-pipe heating ❑Does Not systems have outdoor setback control to lower boiler water ❑Not Observable temperature based on outdoor ❑Not Applicable temperature. 403.3.2.1 Air handler leakage designated ❑Complies [F124]1 by manufacturer at<=2%of ❑Does Not design air flow. ❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 7 of10 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 403.3.3 Ducts are pressure tested to cfm/100 cfm/100 ❑Complies [F127]1 determine air leakage with ft2 ft2 ❑Does Not either: Rough-in test:Total leakage measured with a ❑Not Observable pressure differential of 0.1 inch ❑Not Applicable w.g. across the system including the manufacturer's air handler enclosure if installed at time of test. Postconstruction test:Total leakage measured with a pressure differential of 0.1 inch w.g. across the entire system including the manufacturer's air handler enclosure. Post- construction or rough-in testing and verification done by a HERS Rater, HERS Rating Field Inspector, or an applicable BPI Certified Professional. 403.3.4 Duct tightness test result of<=4 cfm/100 cfm/100 Complies [F14]1 cfm/100 ft2 across the system or ft2 ft2 ❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa. For rough-in [Not Observable tests,verification may need to ❑Not Applicable occur during Framing Inspection. 403.5.1 Circulating service hot water ❑Complies [FI11]2 systems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ❑Not Applicable 403.5.1.1 Heated water circulation systems ❑Complies [FI28]2 have a circulation pump.The ❑Does Not system return pipe is a dedicated return pipe or a cold water supply ❑Not Observable pipe. Gravity and thermos- ENot Applicable syphon circulation systems are not present. Controls for circulating hot water system pumps start the pump with signal for hot water demand within the occupancy. Controls automatically turn off the pump when water is in circulation loop is at set-point temperature and no demand for hot water exists. 403.5.1.2 Electric heat trace systems ,❑Complies [F129]2 comply with IEEE 515.1 or UL ❑Does Not 515.Controls automatically adjust the energy input to the [Not Observable heat tracing to maintain the ❑Not Applicable desired water temperature in the piping. 403.5.2 Water distribution systems that ❑Complies [F130]2 have recirculation pumps that ❑Does Not pump water from a heated water supply pipe back to the heated ❑Not Observable water source through a cold ❑Not Applicable water supply pipe have a demand recirculation water system. Pumps have controls that manage operation of the pump and limit the temperature of the water entering the cold water piping to 104°F. 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 8 of10 • Section Plans Verified Field Verified Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 403.5.4 Drain water heat recovery units EComplies [F13112 tested in accordance with CSA ❑Does Not B55.1. Potable water-side pressure loss of drain water heat ['Not Observable recovery units < 3 psi for ENot Applicable individual units connected to one or two showers. Potable water- side pressure loss of drain water heat recovery units < 2 psi for individual units connected to three or more showers. 403.6.1 All mechanical ventilation system EComplies [FI25]z fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy and air flow limits. ❑Not Observable ❑Not Applicable 403.6.2 Installed performance of the EComplies [FI32]3 mechanical ventilation system ❑Does Not tested and verified by a HERS Rater, HERS Rating Field ['Not Observable Inspector, or an applicable BPI ❑Not Applicable Certified Professional, and measured using a flow hood,flow grid, or other airflow measuring device in accordance with either RESNET Standard Chapter 8 or ACCA Standard 5. 403,6.3 Ventilation devices and EComplies [F133]3 equipment are tested and ❑Does Not certified by Air Movement and Control Association ("AMCA") or ❑Not Observable Home Ventilating Institute ❑Not Applicable ("HVI") and the certification label is afixed to product.Where multiple duct sizes and/or exterior hoods are standard options,the minimum size shall not be used. 403.6.4 Sound ratings for fans used for EComplies [F134]3 whole building ventilation are ❑Does Not rated at a maximum of one sone. [Not Observable ❑Not Applicable 403.6.5 Owner and the occupant of the EComplies [F135]3 dwelling unit provided with ❑Does Not information on the ventilation design and systems installed, ❑Not Observable including instructions on the ❑Not Applicable proper operation and maintenance of the ventilation systems.Ventilation controls shall be labeled with regard to their function. 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 9 of10 Section Plans Verified Field Verified Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 403.6.6 All ventilation air inlets are EComplies [F136]3 unobstructed and located a ❑Does Not minimum of 10 feet from other vent openings that constitute ['Not Observable known contamination sources. ❑Not Applicable Outdoor forced air inlets are covered with rodent screens.. A whole house mechanical ventilation system does not extract air from an unconditioned basement unless approved by a registered design professional. Where wall inlet or exhaust vents are < 7 feet above finished grade in the area of the venting an identification plate is permanently mounted to the exterior of the building at a >= 8 feet above grade directly in line with the vent terminal. 404.1 75%of lamps in permanent ❑Complies [Fl6]1 fixtures or 75%of permanent ElDoes Not fixtures have high efficacy lamps. Does not apply to low-voltage ['Not Observable lighting. ENot Applicable 404.1.1 Fuel gas lighting systems have ❑Complies [FI23]3 no continuous pilot light. ❑Does Not [Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Addition/Renovation Report date: 09/20/22 Data filename: Untitled.rck Page 10 of10 780 C M R 51 .00 : Massachusetts Residential Code, 9th Edition, Energy Efficiency Energy Efficiency Certificate Insulation Rating R-Value Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): _ Glass&Door Rating U-Factor SHGC Window 0.27 Door 0.27 Heating&Cooling Equipment Efficiency Heating System: Cooling System: Water Heater: Name: Date: Comments k°f` c TOWN OF YARMOUTH 0, 44. 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451 Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836 HISTORICAL COMMITTEE MEMORANDUM TO: Mark Grylls,Building Commissioner FROM: Lisa Sherman,Office Administrator of the Yarmouth Historical Commission DATE: March 3, 2022 SUBJECT: 286 Old Main Street—Demolition Request The Yarmouth Historical Commission reviewed a request to demolish. The intended purpose of the partial demolition was to make alterations and additions to the dwelling. There was an initial public meeting held by the Yarmouth Historical Commission on October 14, 2021 to review the demolition and alteration request, where the Commission voted unanimously that the building maintain historical significance. The structure at 286 Old Main Street, South Yarmouth is over 75 years old and is located within the confines of the Bass River Historic District. The dwelling is listed as a contributing building on the district data sheet as the "Laban Baker House" as it is one of Bass River's oldest houses, dating from about 1800. On February 10, 2022 the Yarmouth Historical Commission voted unanimously to approve the partial demolition in accordance to the submitted revised plans which preserve the character-defining features of the building, referencing plans dated 2/9/22 presented to the YHC, pages 1-8, with original page 9 replaced with new page 10 (page 9 is not approved; rather, it is replaced with page 10), with the understanding the eastern ell will remain the same, the front will remain the same, the western ell will remain in the same footprint and retain the same character-defining features as present (except for the chimney), and all changes discussed in the previous informal reviews are approved as contained in the final plans dated 2/17/22. Thank you. Cc: Yarmouth Historical Commission Homeowners: Anne E Welch Revocable Trust Joe Bergstrom,Agent TOWN OF YARMOUTI I b% WATER DEPARTMENT 99 Buck Island Road V\e.ncnccsc/ West Yarmouth,MA 02673 Telephone: 1508) 771-7921 • Fax: IS081 771-7998 • BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: 286 Old Main Street, S. Yarmouth Shut water service at street; remove/disconnect water meter- PROPOSED WORK: Home being lifted/renovated. APPLICANT: George Davis, Inc. -Cathy Whiteside, Production Assistant ADDRESS: 33 N. Main Street, S. Yarmouth, MA 02664 TELPI TONE: 508-394-0832 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... I Icalth Department: Determines Compliance to State and Town Regulations,i.c. 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 APPLICA�1= rI(;NATURE DATE O ICE USE: COMMENTS ON PERMIT APPROVAL OR DENIAL eA/r C',,° eY/,s risvi wvi4-7€< 1r,-viez i -S 2c, d vt A-U uk 4-o /) wi7/ -A, Uri. l")*4-TGC r I//( /leej°v�STTy1-fJ. // 4 22 REVIEW BY WATER DIVISION(SIGNATURE) DATE O.f y, TOWN OF YARMOUTH 40 WATER DEPARTMENT 99 Buck Island Road West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Bldg. Site Location QIG OacC, �("" ,,J-L_ ;/'y Map #: (p Q Lot #: Proposed Improvement: Lift kou..fe J'CpLcut fo & o&i fof[?rC itaL Applicant: G0orj t cb cu/C,p ThC Address(33 ,oj'& /ta� ,'t Tel. #: 501-�3 ci µ-0112 Date Filed: J'0(a Yaritoc&tk) 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 Acts; i,e. If Lot(s) Border any Type of Wetlands, Streams, Ponds, Rivers, Ocean, Bogs, Bays, Marshland, Etc... Health Department: Determines Compliance to State and Town Regulations, i.e., Requirements for Septage Disposal and other Public Health Activities Fire Department: Determines Compliance to State and Town Requirements for Personal, Safety, Property Protection;, i.e. Smoke Detectors, Sprinkler Systems, Etc... Signature of applicant Date PLEASE NOTE: COMMENTS: Reviewed by: Water Division Date portLck. Ptpa,L r froi aAr h ceded,. RU,ze, rtpto e botk 6a e C coL. Kci,r. l e p i,ac e £L O O r.r, £L LL w bt_ko.011 f OWN OF YARMOUTH {,� ' ( ` �►*3 99 Buck Island Road n ,a. .. West Yarmouth, MA 02673 ��' ` ` Telephone: (508) 771-7921 • Fax: (508) 771-7998 BUILDING PERMIT APPLICATION DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET Bldg. Site Location 2, c, OLGL._ {,i. .t. J'>` Map#: Le) Lot#: 2 I ti Proposed Improvement: L A., 4p LCic t. fcu d Applicant: Geo 6 tb QV Cp, -TA0. i rg Address v.S 0}4.. ileiit (` TeL #: 501-3 q 4-O A 2. Date Filed: tfou-tk.. Yar .00-tlu 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 Acts; i.e.If Lot(s) Border any Type of Wetlands, Streams,Ponds, Rivers,Ocean,Bogs, Bays, Marshland, Etc.. Health Department: Determines Compliance to State and Town Regulations, i.e.,Requirements for Septage Disposal and other Public Health Activities Fire Department: Determines Compliance to State and Town Requirements for Personal, Safety,Property Protection;, i.e.Smoke Detectors, Sprinkler Systems, Etc... ,-...--al Signature of applicant Date PLEASE NOTE: COMMENTS: I Reviewed by: Water Division Date pertio-. lepa.Lr f rO iit9 Qs ALedecL. Razt of rcpCaxe both jiti Lack GOLe1/41,,P ltptcue. . rLOorf cal wt./ r l f cji L , liff 9 r0o f ci, trLl .. ECZk. SERVICE NO. (7 NAME • STREET (") si; VILLAGE METER NO. C j •, IL ce,m. c ca 141, 0 Tle) )11N1 tv„ /6/ //fiat / /, I/ 1 ...- SYSTEM PROFILE .41.!EARN.COMPONEN MARKED MTN MENEM I (11rt'0 SCA.) COMPARABLE Male II) MST RON COVERS TO FIN.MEM CONCRETE OR CAST MON C 2'PEASTME CA ME.EFILL FENBEDIVP - 16.9' 1---- TETER{AMC DAN STONE I I.' MUNE 6,-zo 17."'"'" 11111 On k I.. 00,00 OYER PRCCAST 1 -• lai IIII MATERTEST D'EfOX FOR LEVELNESS TAN.2- 'TESS, pvc .......:MOPE MUM°OVER BLOCKS OR PRECAST RT 1? ' - ^*iMMTI PM LEVEL 1ST 2' 1_,_.. .1 I 615144A 1 DIOS"14.6' — r w Iwo DAL 11-20 14. - TEE sepnc Tem TEE ,.0.5. r 16,,,,sthe , . .. . . ........z.:1;11,,.....3=.. E W.tbst,it5ttE,tat 5putifi: 11/7 fr , I t_ 9. 0 .--1-1/r DOORLE WASHED STONE A TAN. t'-'*°W°C''''' tfACH7Z Cur, I r CRUSHED STONE OR RECTMRCAL OVERALL MANSIONS 10 MEMO(OE STONE 0.00"T 12113' .. — CONPACTION 0 s22,Do (2 8 X SLOPt) LLB SLOPE) I-LA slOPE) H-20 FOuNOATIoN— 16 --SEPTIC TANK 8' — 0' sox 12' _____LEACHING FACIUTy "NOTE: INTERIOR PLUMBING TO BE RE-ROUTED TO EXIT THE OWELUNG IN LOCATION SHOWN ON • PLAN VIEW. PLUMBER TO CONFIRM FEASIDIUTY , PRIOR TO INSTALLING ANY PORTION OF THE SEPTIC SYSTEM ._ —...1 ..` LEGEND m.o...., • . ----- ., BOUND OH - '406.6'NAV088 1 , MAP 60 PCL 217 PAW .7.1464 S.F. X 4))so F um.SPOT EI/V. P. :)04 .;•‘' -fool— PROPOSED CONTDDR •-•.,/ __.... tH,1 001(4.1.41 TH1 I• ... .140., ,.., c-:-...;\/-" • .,' .„./..:,,".• L.-L..% or- ow 1* `..,,... ',/,..\ •,...,-••"- • 2 4 ...., 0 2% SLOPE Or GROUND , .432 , ,'<Q,Adt4t' ''' 03-1-( # • `0.., unirr ME ,..,`-''., ‘ 2:'4„,....") .... 1, , •, , FIRE thl'Aettti ''' .,, .".." .. -- 1 i, karD Rot ILL IMMO II&)44.014 It MONO I): \ _4 '1- // / /„.-^ (,) ,d.:, \ ----, i , / /11,4";: 1.4•:' ' # ..... ' TEST HOLE LOGS i / 10w; f olde, 0 ENG[NEER:CRAIG J. FERRARI. SE 113871 (\ 1 I /4117 laS° \- -,1/ 1 am° WITNESS; CAROL EASTMAN,.(BARNSTABLE COUNTY) DATE......,12/20/21 PERC, RATE ,. < 2 MIN/INCH • '..r ', I.' ''•. L.> c• LP-....-CLASS,___!___. ..SOILS \ ' ) C,, / (/ ELEV. ELEV. ‘ % 14: EV1 17.5' s: W 175' i t PROPOSED AREA DRA (SEE DETAIL) A A , LS LS 10YR 4/2 10YR 4/2 • \ 14" \ le ....., 4. ... LS LS 30 10YR15.0' 5/610YR 5/6 " 36. 1 4.5' ....'\ 'f,. d\) ( 7g C C CO...., ROC E MS MS 10YR 7/4 10YR 7/4 14,7;:,..,-„,,,,,;,,, ,.',.• '•C''..I;”,';--1 132. 6.5' 126" 7.0' 1- NO GROUNDWATER GROUNDWATER ENCOUNTERED DATE DAMEL A. OJALA, P.E., P.L.S. DCE #19-305 NOTES not. I.DATUM IS NA511.88 �4 ,(4i,/ I,. N 3'GRADE 2.MUNICIPAL WATER IS P1050NG AT (/ �\�__.. 4, 3.MiWMUM PIPE PITCH TO BE tJe'PER FOOT. io,q cd`' l +c,hv 1 4,DESIGN LOADING FOR ALL PROPOSED PRECAST i{'" '..`„t-' " UNITS TO BE AASHO H-22 1 Y,, ,.�-"' .... 1 ezpi___ 5.PIPE JOINTS TO BF MALE WATERTIGHT. , '14.5 6.CONSTRIJ lIO+DET 0.5 TO BE IN ACCORDANCE ( • • I P4TH 310 CDR 15.000(TITLE 5.) • Ro"1� \. \ 7.TIT PLAN 15 FOR PROPOSED WORK ONLY AND I F-- NOT TO BE USED FOR NOT UNE STAKING OR ANY 10 . i 4).ZI 1,4,.-1 OTHER PURPOSE. G' I PRECAST GR •.. 6.PIPE FOR SEPTIC SYSTEM TO SON.4D-e PVC. �\ ; ~~` 9.COMPONENTS NOT TO BE BACKFILLED OR I 4 CONCEALED WITHOUT INSPECTION BY BOARD HEALTH AND PERMISSION OBTANNED FROM BOARD OF HEALTH. -''" TOM TN-, 10.CONTRACTOR SMALL BE RESPONSIBLE FOR T A R AD CALLING DIGSAFE(1-B86-344-72 3)AND LOCUS MAP VERIFYING THE LOCATION OF ALL UNDERGROUND k OVERHEAD OPUSES PRIOR TO COMMENCEMENT OF Kt . SCALE 1"n2000't IL ANY UNSUITABLE MATERIAL.ENCOUNTERED SHM,L ASSESSORS MAP 60 PARCEL 217 BE REMOVED BENEATH AND 5'AROUND THE PROPOSED tfAONNG FACBJTY. LOCUS IS WITHIN FEMA FLOOD ZONE X I).Ex+STRw LEACHING FACILITY SHALL BE PUMPED (AREA OF MINIMAL FLOOD HAZARD) AS AND REMOVED OR PUMPED ANC'Ru"D W.TH CLEAN SH0WT4 ON COMMUNITY PANEL p25001CO591J SAND DATED 7/16/2014 13.GUTTERS AND 0011WSPOUTS TO BE DIRECTED TO ORYWEU.S. ZONING SUMMARY SYSTEM DESIGN: i ZONING DISTRICT: RS-40 DISTRICTRED EXIST. PROP. GARBAGE DISPOSER IS NOT ALLOWED .MEN. LOT SIZE 40,000 S.F.17,146 S.F. 17,146 S.F. EXISTING 4 BR DWELLING MIN. LOT FRONTAGE 150' 121,52' 121.52' PROPOSED 5 BR DWEWNG MIN. FRONT SETBACK 30' 17.1' 17.1' T OU .PLUMBRNG MIN, SIDE SETBACK 20' 16.9' 16.9' DESIGN FLOW: 5 BEDROOMS P 110 GPO s 550 GPO ....14.4 MIN. REAR SETBACK 20' 0,0' 0.0' USE A 550 GPO DESIGN FLOW MAX. BUILDING COVERAGE 25% 15.6% 19.15% OPOSED ADOTION MAX. BUILDING HEIGHT 35" <35' t. 35' SEPTIC TANK: 550 GPO (2) = ti0t1 USE A 1500 GAL. SEPTIC TANK '`'." LEACHING: ', SIDES:2 (42.0 + 12.8) 2 (.74) 162.2 SPD \\ \ BOTTOM 42.0 x 12.8 (.74) m 397.8 GPO t \� TOTAL: 757 S.F. 560 GPO \ USE (4) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) \ MTh 4.0' STONE ALL AROUND MA e',,,to Two APPROVED DATE BOARD OF HEAL TH !' — .- it ( +nrs+rc wm¢fn-,4 wxs , t ALL TeuruNa!s s,'"°). :: irsorR"4 \• LF..: oe• MOW ma rat 14:i Am)e.AAP Lein � '°E .7 "I'' = TITLE 5 SITE PLAN � N-I° c.,, w x, vat : wooer ce c _:%'.ii ` smear!ItN N` ,:::*'.+�'r s.axY a coma w'';: stl.•ice c>) =ti`:I __...., ._r.:: a `= #286 OLD MAIN STREET \\9D ._I t_, J/ SOUTH YARMOUTH, MA ,.., Y MN..T03 R PtT e° UMDpf°" PREPARED FOR AREA DRAIN SECTION „C,10 SCALE ANNE WELCH x, DATE' JULY 11. 2022 r( off 588-362-45A1 r� to.50B-362-9880 y.„...,::: aoencppe.eom p own cope enjinee�inj,Inc. civil engineers Scale•:1'=-20' land surveyors -- - ------- 939 Mote Street (Rte 6A) r, .„ 2; s2 rto_ 5O sic! YARMOU7NPORT MA 02675 19--305 WE{.CH.DWG Ij TOWN OF VAR k.10t iII l ••A. , f or, WATER DEPARTMENT 19 Buck Island Roan. . e West Yarmouth.MA 0267S "a 4 telephone; ion) 771-7123 * r,ix (UM) 771;79)98 BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: 286 Old Main Street, S. Yarmouth Shut water service at street; remove/disconnect water meter- PRC)POSED WORK: Home being lifted/renovated. APPLICANT: George Davis, Inc. - Cathy Whiteside, Production Assistant ADDRESS: 33 N. Main Street, S. Yarmouth, MA 02664 •I F 1.,PI ION E: 508-394-0832 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 arty type of wetlands,streams,ponds,rivers.ocean.bogs,boys.marshland,ETC... I Icalth Department: Determines Compliance to State and Town Regulations,i.e. requirements liar 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 APPL.ICA14 'NATURE; DALE O IC'E USE: COMMENTS S ON PERMIT APPROVAL OR DENIAL dtir I64-70 e 4 riivj ,r47 et( -fit",'"t/ic:.e.. f •l" L4. - 4 ,(0.• tf"t i14•^ pD t/.,er 0 ` ,�'.;'r'a t..c.fif7/ 4v' iJ!L IBC " --T C/C y'Yf ff '1 f{T i7 i/__,,,.. //2/A 22_ REVIEW )BY WATER DIVISION SIG( NATURE) DATE Mir ti4 1,17:k TOWN OF YARMOUTH - ` ;=° HEALTH DEPARTMENT ''4 CNO PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: A1CU 0 Cd, Proposed Improvement:Lift{L004 ., !'ei1( at o okLpioL portlok. ? pc r/P'G idLih victr eit. ,7,e.yr1Li e i)otk_ tout ;�. r, lr ce. 2 t t rJ', , (.)c'.h.d.4L1) fi(c roof t ri.�L. {' - gyp Applicant: U P.o 11 11l , II�_C,. Tel.No.: _C�1 'v 9 " Address: 3 j\'()d k d�v �1 t, J0 LL,-,[f,., Yo)-j(ti 0 Gut,A..) Date Filed:jja4111___ **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: A out W LLcly -. Owner Address: 30 (.l,itL tI' t,. 1!) jj)c r �, ��R O2.110 Owner Tel.No.: G j -q 1- Li(d ) 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: R (1.) Site Plan showing existing buildings, water line location, ,,r )2 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: DA I'E: - 01, 2_ PLEASE NOTE COMMENTS/CO ITIONS: /1a-tt,t1- ,-C; e - �p rig c