HomeMy WebLinkAboutBLD-22-005720 •
ONE & TWO FAMILY ONLY- BUILDING PERMIT
Town of Yarmouth Building Department to y •_.
1146 Route 28,South Yarmouth,MA 02664-4492
508-398-2231 ext. 1261 Fax 508-398-0836 ''
Massachusetts State Building Code,780 CMR
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
REG , ivED
This Section For Official Use Only
Building Permit Number: . (1)- —01) J Z ate Applie • APR 6 2O22
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Building Official(Print Name) � ignature DUibR�(Nt;D PARTMENT
SECTION 1:SITE INFORMATION '"" tom' 4 j ; ii-"
Li Property Addre -�'`..._ -
1.2 Assessors Map&Parcel um'ers
1.l a Is this an accepted street?yes no Map Number :arc= Num:' 12
12 1.3 Zoning Information: 1.4 Property Dimensions: i (JI' 1?'NC U�''=ART, _'1
Vli'/ +
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) --`„r_
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone?
— IVtunicipal❑ On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: OU
EV CIA .i i �a —cofla1\1Oi� in C �,� �� O4I6CI
VName(Print) City,State,ZIP
o° ut ' C � o
(r�1-.�� CIS VSO�1�mtu� ocv
.and Stre Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building❑ Owner-Occupied ❑ I Repairs(s) 0 Alteration(s) 0 I Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
.ef Descri+ ion of Proposed Work2:
0 1 I . I .' . /aIAr , W/.�'/_�
SECTION 4:ESTIMATED CONSTRUCTION COSTS. &FtLV1 0
Item Estimated Costs: Official Use Only
(Labor and Materials) .
1.Building $ 1. Building Permit Fee:$ WIS-Indicate how fee is determined: /
2.Electrical $ t Standard City/Town Application Fee j�jrp 3 CI�{��{`
0 Total Project Costa tem 6)x multiplier _x
3.Plumbing $ 2. Other Fees: $ —6n • 1. a
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ •
-
Suppression) Total All Fees:$ \
/ J/1.� Check No. Check Amount: Cash that: 1 (�
Y 6.Total Project Cost: $ IVV i< ❑Paid in Full Outstanding Balance Du : 10443
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SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)_
R Restricted lck2 Family Dwelling
City/Town,State,ZIP lvI lvlasonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name
HIC Registration Number Expiration Date
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT 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 0
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 plication is true and accurate to the best of my knowledge and understanding.
e/ f^ ()(O./2J1 2
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oce Information on the Construction Supervisor License can be found at www.mass.eov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) . Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open_
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
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Cape Cod, MA
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§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 51 Mill Pond Road, West Yarmouth, MA 02673
Work Address
Is to be disposed of oat the following location: ►`kiM \C�VIA Qec yci 11/►G1
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Ch. 111, §150A.
03-28-2022
Signature of Application Date
Permit No.
04 TOWN OF YAIZM[OUTH
BUILDING DEPARTMENT
K ;_ - •°' 1146 Route 28, South Yarmouth,MA 02664 508-398-2231 ext. 1261
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE: 03-28-2022
JOB LOCATION: 51 Mill Pond Road, West Yarmouth, MA 02673
NAME STREET ADDRESS SECTION OF TOWN
"HOMEOWNER" Erion Sollomoni 617-216-5185 617-216-5185
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADDRESS 30 Squanto Rd
Quincy, MA 02169
CITY OR TOWN STA IE ZIP CODE
The current exemption for `Homeowner' was extended to include owner—occupied dwellings of one or two units
and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such
homeowner shall act as supervisor, (State Building Code Section 110 R5.1.3.1)
Definition of Homeowner:
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to
be, a one or two family attached or detached structure assessory to such use and/or farm structures. A person who
constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall
submit to the building official,on a form acceptable to the building official,that he/she shall be responsible for all
such work performed under the building permit. (Section 110 R5.1.3.1)
The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other
applicable codes,by-laws, rules and regulations.
The undersigned 'homeowner' certifies that he/ she understands the Town of Yarmouth Building Department
minimum inspection procedures and requirements and that he / she will comply with said procedures and
requirements.
-n— -- --
HOMEOWNER"S SIGNATUR` --..-....
V APPROVAL OF BUILDING OFFICIAL
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL
Ch.142. Yes No
If you have checked ves,please indicate the type coverage by checking the appropriate box.
A liability insurance policy Other type of indemnity Bond
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner Agent
h:homeownrlicexernp
The Commonwealth of Massachusetts
!'"'— Department of Industrial Accidents
1 Congress Street, Suite 100
Vtgif—f Boston,MA 02114-2017
gm, www.mass.gov/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): Imelda & Erion Sollomoni
Address: 30 Squanto Rd
City/State/Zip: Quincy, MA 02169 Phone#: 617-216-5185
Are you an employer?Check the appropriate box:
Type of project(required):
I.Q I am a employer with employees(full and/or part-time).*
7. New construction
2.El I am a sole proprietor or partnership and have no employees working for me in •
an ca •act 8. Remodeling
y p ty.(!`io workers'comp,insurance required.]
3.XX 1 am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition
4.0 l am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ® Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.E 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 I . Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.a Other
152,§1(4),and we have no employees.(No workers'comp.insurance required.]
"Any applicant that checks box:l must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
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 forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under z pains and penalties of perjury that the information provided above is true and correct.
Sicnature: Date: 03-28-2022
Phone 4:
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#:
Sears, Tim
From: Sears, Tim
Sent: Tuesday, May 31, 2022 2:41 PM
To: 'erion sollomoni'
Subject: RE: 51 Mill Pond Rd
Erion,
I have reviewed the stamped site plan provided and the proposed deck is angled toward the lot line creating a more
non-conforming setback. This will require relief from the Zoning Board of Appeals in the form of a special permit.
Please call with any questions l�
I imothy Sears CBO
Deputy Building Commissioner
Town of Yarmouth
508-?,98-2231 Ext. 1259
mailto:tsearsPyarmouth.ma.us,
From: erion sollomoni<sollomoni@hotmail.com>
Sent:Thursday, May 19, 2022 3:03 PM
To: Sears,Tim <tsears@yarmouth.ma.us>
Subject: Fw: 51 Mill Pond Rd
Attention!:This email originates outside of the organization. Do not open attachments or click links unless you are
sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure.
Otherwise delete this email.
Hi Tim
Hope you are doing well
We drop last week the documents that you required and I was wondering if is there anything else that we
should provide .
Thank you for your help and looking forward to hear from you
Erion Sollomoni
From: isollomoni@gmail.com <isollomoni@gmail.com>
Sent:Thursday, April 21, 2022 4:50 PM
To: Erioni <sollomoniPhotmail.com>
Subject: Fwd: 51 Mill Pond
1
Take care,
Imelda
Begin forwarded message:
From: "Sears,Tim" <tsears@yarmouth.ma.us>
Date:April 21, 2022 at 9:08:27 AM EDT
To: isollomoni@gmail.com
Subject: 51 Mill Pond
Imelda,
I have reviewed your application for the addition/renovations and there are some items needed.
1. Health Department sign off(under review)
2. Plot plan stamped by a land surveyor showing setbacks to proposed addition
3. Smoke/co detectors marked on plan as required by sections R314, R315
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(avarmouth.ma.us
2
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( )\VN OF YAR:MOUTI i
�. o WATER DEPARTMENT
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0-1'-( ..3 99 Buck Wand Road •
74,7c `�g West Yarmouth, MA O2(i7;
�' rt'trphone: 15tt r ht 771-7921 • Fat: t508: 771--998
BUILDING PERMIT APPLICATION FOR
WATER DEPARTMENT SIGN OFF
TRANSMITTAL FORM
BUILDING SITE LOCATION: 51 Mill Pond Road,West Yarmouth, MA 02673
Renovation &addition to the single family residence located at
PROPOSED WORK: the address noted above
APPLICANT: Imelda& Erion Sollomoni
ADDRESS: 30 Squanto Rd, Quincy, MA 02169
TELPIIO lE: 617-216-5185
RESIDENTIAL AND 'OR COMMERCIAL BUILDING
Water-Department: Determines Compliance of Water Availahilitc and or existing location
Enuineering Department: Determines Compliance for Parking and Drainage
Conservation Commission: Determines Compliance to Wetlands Act: i.e. If lolls►border any type of
wetlands. streams, ponds,rivers,ocean. hogs. boys. marshland. ETC...
I lealth Department: Determines Compliance to State and Town Regulations, i.e.
requirements fir Septage Disposal and other Public I lealth Activites
Fire Department: Determines Compliance to State and Town Requirements for Personal
Safety, Property Protections, i.e. Smoke Detectors, Sprinkler Systems,etc
APPLICANT SIGNATURE DATE
OFFICE USE: COMMENTS ON PERMIT _APPROV:V. OR DI:NI U.
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