HomeMy WebLinkAboutBLD-23-001181 i
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�NF & TWO FAMILY ONLY- BUILDING PERMIT
R V E d' Town of Yarmouth Building Department I
� — 1146 Route 28, South Yarmouth,MA 02664-4492
508-398-2231 ext. 1261 Fax 508-398-0836 ,�' ' '
Ud 3 2�2 Massachusetts State Building Code, 780 CM.R . ,`
Buildi.g ernut Application To Construct, Repair, Renovate Or Demolish ....._:€4:'...
BUIL ING DE PA�'Tv!�'; a One-or Two-Family Dwelling
8. =
This Section For Official Use Only
Building Permit Number: f5CD-23 W-1 Date Applied:
Building Official(Print Name) ature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: f 1 1.2 Assessors Map&Parcel Numbers
50 Ceh.4cr Sf y„r•.�oatA floe I / 32- i1-"2--
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Q yo £e,Srdec4 t r I 6-5‘. DZ(P 67 ‘3C 8 Ph-
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard 1 Side Yards Rear Yard
Required Provided Required Provided Required Provided
go' ` 3675-' _26 ' a/. 3' moo ' '1.v '
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sedge Disposal System:
I Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Public 0 Private 0 i Check if yes❑ p y _
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
'(lc d ltvy 1rrusf a8/24/2o yrr&ou414%po1'r Ma oz , 3-5
Name(Print) /Nartc. 4 Kur-, Kerrey City,State,ZIP
50 Cer'v1rer55i-, yarrnout_4-illoof-i'
.S4g36, ase9-Z nnekeilay l Veriwar►• nG
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building 0 1 Owner-Occupied I Repairs(s) 0 ' Alteration(s) 0 1 Addition 0
Demolition 0 ' Accessory Bldg. 0 ( Number of Units Other 0 Specify:
Brief Description of Proposed Work2: /4e) J q/e.c A- Axvtiw y n
Noose nq,/e•- /`l54-4/!ec/ 4.41- lain cen,S4''G.Z/ '""
E Q
�i UCTION COSTS
SECTION 4:ESTIMATED CONSTRUCTION
Estimated Costs: [Till/35Item (Labor and Materials) Official Use Onl sUli_ 9pHEj
1. Building $ /2. . oOe) 1. Building Permit Fee:$ _Indicat — -
i 13.Standard City/Town Application Fee
Electrical $ 3
2. 0 Total Project Cost (Item x m e x
3.Plumbing $ 2. Other Fees: $ 0VI, "
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees:$
Check No. Check Amount: Cash Am O.-
6.Total Project Cost: $ l Z. 000 0 Paid in Full 131 Outstanding Balance Du : ( \:i�
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
i
License Number Expiration Date
Name of CSL Holder i
List CSL Type(see below)
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu. ft.)
City/Town,State,ZIP R ! Restricted 1&2 Family Dwelling
M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I I Insulation
Telephone Email address D ( Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name 1 HIC Registration Number Expiration Date
No.and Street
i Email address
City/Town, State,ZIP Telephone
SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6))
I
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. i
Signed Affidavit Attached? Yes 0 No ,.. .... d
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN I
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1.4.
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. i
Print Owner's Name(Electronic Signature)
Date•
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
{
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
/21y L iCr/l /Lasc,L e
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
V )
NOTES:
1. An Owner who obtains a building permit to do his/her own work,of 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.¢ov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos
2. When substantial work is planned,provide the information below:
1 Total floor area(sq.ft.) 3 b-516 69, A'A (including garage,finished basement/attics, decks or porch) i
Gross living area(sq.ft.) .2.1 ''0 ,Sy A& Habitable room count #
Number of fireplaces / ,c, S Number of bedrooms 2.
Number of bathrooms 2. Number of halfibaths /
Type of heating system (.rw r.-t et fit /G 6 Number of decks/porches / Crea 4 /p oreh
Type of cooling system Enclosed Open ✓'
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
I
...\ The Commonwealth of Massachusetts
Department of lndccstrialAcciderzts
-°' s 1 Congress Street, Suite 100
.t., i .
Boston, MA 02119-2017
www.tnass.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): ' /qr--L k— itle,//e e�
Address: c5`0 CehIer �h /
City/State/Zip: rae"10r'e4 por'd 'YQ 0.24 7-C. Phone 4: s-bb• .G Z • 517i2_
Are you an employer?Check the appropriate box:
Type of project (required):
I.E I am a employer with employees(full and/or par-time).'
7. C New construction
2 Q I am a sole proprietor or partnership and have no employees working for me;n
anca aciS. Q Remodeling
Y F ty. (No workers'comp. insurance required.]
3.I am a homeowner doing all work myself [No workers'comp. insurance required.]r g ❑ Demolition
4 piI am a homeowner and will be hiring contractors to conduct ail work on my property. I will 10 C Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.E Electrical repairs or additions
proprietors with no emoloyees
12.0 Plumbing repairs or additions
5 I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
These sub-contractors have employees and have workers'comp. insurance.: 13.0 Roof repairs /
6 El Weare a corporation and its officers have exercised their right of exemption per UIGL c. 14 Other QeG.e_ 6'yY/i)
152,§1(4),and we have no employees [No workers'comp. insurance required.]
-Any applicant that checks box 41 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 slibmit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and stat!*hether 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:
Policy#or Self-ins. Lic. r: 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 the pains and penalties of perjury that the information provided above is true and correct.
Signature: A/p`Q e Date: �/1U/2 O Z Z-
Phone#: a"oet cfi Z .t„TZ
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#:
R _ TOWN OF YARMOUTH
o BUILDING DEPARTMENT
� nFTT%C�CASl•tid a 1146 Route 28, South Yarmouth, -MA 02664 �08-398 2..31 ext. 1251
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE: 8/3a`2o z 2,
JOB LOCATION: e€514r-L r61a`77 cep o✓ S �gr�oU � pc i-LL
NAML STREET ADDRESS SECTION OF TOWN
"HOMEOWNER" '141'4 �e/!ej`' V8 575372_ .67,8 347 6-e16 3
NAME / HOME PHONE WORK PHONE
PRESENT MAILING ADDRESS
ale-/rr u 6r44 /.2 / 0 2 v 7-6—
CITY OR TOWN STATE 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/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.
HOMEOWNER"S SIGNATURE Alek,e
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
4111,
If you have checked vas, p ease 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.
Afeze £ � Check one:
Signature of Owner oirOwners Agent (Ow , Agent
h:homeownrlicexemp
)NN
46 Route 28, South Ya rtmour,th
508-398-2231 ext. 1261 Fax 508-39483 ,
ffee of the Building, Cnnunissioni:7-
BUILDING DEPARTMENT
DEMOLITION DEBRIS DISPOSAL AFFIDAVIT
Pursuant to M.G. L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111/5
if*
I hereby certify that the debris resulting from the proposed work/demolition to be
conducted at 60 CeizLyV (""1-449 leCr•
Work Address
Is to be disposed of at the following location: yaw:moo/4 ZIP'4-4 64r- 7.4/01-1
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Chapter 111, Section 150A.
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c9/50/-2.8 z
Signature of Apprrcant Date
Permit No.
6 026 Sf.
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DRIVE 920 It.
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EXISTING ma's.
FOUNDATION
TOF = 27.5
35.5' 1,
SONOTUBES
Co-
S84'48'42"E
268.61
AS-BUILT PLOT PLAN DCE #20-296
LOCATION : #50 CENTER STREET YARMOUTHPORT, MA
SCALE : 1 " = 60' DATE : FEBRUARY 23, 2022 PREPARED FOR:
REFERENCE : MAP 132 PARCEL 122 BAYSIDE BUILDING INC.
I HEREBY CERTIFY THAT THE STRUCTURE
SHOWN ON THIS PLAN IS LOCATED ON THE
GROUND AS SHOWN HEREON.
off.508-362-4541
tof 508-362-9860
downcope.com .
owl cope esgineelieg one.
civil engineers
land surveyors
939 Main Street ( Rte 6A)
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YARMOUTHPORT MA 02675 DATE REG. LAND SURVEYOR
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68 Flint Street, Marstons Mills, MA 02648
r G TEL: 508-428-4772 FAX: 508-428-4707
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COMMONWEALTH OF MASSACHUSETTS N/V-ee5r ,L-
Board aJHealflt, Yra orurdh,Am ---'----1-;-ma -"
rz-4r
•CERTIFICATE OF COMPLIANCE t iY
Description of Work: [D'CompleteSystem 10Individual Components
The undersigned hereby certify that the Sewage Disposal System;Constructed( ;paired O Upgraded O Abandoned()
by: Nfrlu .4tax2,J fiLG (a4-6E. 16 --
at: 6-0 C.,•n•rerr 66,,e7 Yar,.n Prr
has been installed in accordance with the p vi ton 310 CMR 15.00(Title 5)and I eapproved design plans/as-built plans relating to
application No. 2.1'r0 L(2,dated -7 1 2 t. Approved Design Flow (god).
Installer: red it
Designer:' ' . VRN14! 493744.4 Inspector: j>OC.0 W P (-H y Date: __ _
The issuance of this permit shall not he construed as a guarantee that the system will function as designed.
NoV;Dia'_Zk FEE ,C)
COMMONWEALTH OF MASSACHUSETTS
Board of Heuith, Yarmouth.MA
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is herebye granted to; Construct(' Repair() L- grade() Abandon() an individual sewage disposal system at
'co Grrt�r r- 5712-t•t 7- `(,a Care rr as described in the application for
Disposal System Construction PermitNo. Z.I— 2 ,dated �( ��i
Provide Conr traction shall be complete pith. ..c years th •of this permit.All local conditions must be met.
Date `t IC 7- Board of Health
-
666 v
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e re, tl� � ,k , ham rv�Pel �2c/z
C!o/ g i vz,5 5 API'
r"" TOWN OF YARMOUTH
i 1 146 ROUTF 28,SOUTH YARMOUTH,MA 02664-4451
c...s Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
APPLICATION FOR
CERTIFICATE OF APPROPRIATENESS
Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as
amended for proposed work as described below&on plans,drawings.photographs,&other supplemental injp accompanying this
application. PLEASE SUBMIT 4 copies OF SPEC SHEET(S),ELEVATIONS,PHOTOS,&SUPPLEMENTAL INFORMATION.
Check All Categories That Appl : id
Indicate type of Building: _Commercial Residential
1) Exterior Buildin Construction: V lNew Building —I Addition Iterations Reroof 1 'Garage
IShed Solar Panels IOther:
2)Exterior Painting: I Siding l Shutters I VI Doors V Trim Other:
3)Signs/Billboards: New Sign Change to Existing Sign
4)Miscellaneous Structures: LIFence IWall Flagpole I IPool Other:
Please type or print legibly: /
Address of proppyedwc)1Jt: y,r , t X2 f t"�_ r`i ,c_ .Map/Lot#
//
Owner(s;. ! ; ll Phone#:
All app c must e submitted by owner or accompanied by letter from owner approving submitito____
tal of application.
Mailing address: 1 t)l'/' rt Z 1(,t!1f`1 )-d Year built: r
Email A VAM,L �, vi f
[ , _ l Q,L-�. Ct:Yr\ Preferred notification method. � Phone Email
Agent/conKraclor. Wst�- i t. ( Phone#: 4-)Z f E Lf
Maihng Address: ?C 6 GX 5 1 Cerr{et-v'l tic. C:G Z-C:2'6 2-
t / l
Email: i1(_0 C)p t j I/I( (1 a I ft/, ((4 \ Preferred notification method: Phone [] Email
Description of Pro ed Work: , ))
/ t.` C vn r1-cr/ ( rot‘,.) 1 j..lY 61 h
IhAte\k4 L....)I Col a. i-/-0.-4_1•-1_a/ 7- (a' l'"'-v-S (-
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Signed(Owner or agent) __ • i !' 2,,,/J2�
_ Date: — —
Ownericontractor/agent is a that a permit is required from the Builcing Department.(Check other departments,also 1
It appkcation.s approved,appr vat is subject lb a 10 day appeal period required by the Act.
This certificate is good for one year from app(oval dale or upon date of expiration of Building Permit,whichever date shall be later.
All new construction will be subject to inspection by OKH.OKH-approved plans MUST be available on-site for training&final inspections.
For Committee use only: _ Approved _ Approved with Modifications
Denied
Rcvd Date Reason for Denial: 21-A029 50 Center Street Hearing: 2/22/2021
Amount 6 --.'i;` 3 S 1 a Approved Remotely by:
Cas-lCK#. , Lj� / , — Richard Gegenwarth Rosemary Nicholls -
Rcvd by. Signed: — Robert Wilkins
45 Days:- — -- 21-A029 50 Center Street Hearing 2/22/2021
Applicant shall seek OKH approval for any
changes to these plans pnor to the change
Date Signed: _ _ — being incorporated into the project
1
APPLICATION#. ACV 9
4'
GENERAL SPECIFICATION SHEET
Project Address:
//,-
FOUNDATION: Material: Potr4 t c t Exposure(Not to exceed 18"): Ij
CHIMNEY: Material/Color: A6.fh‘l, u twit tJAERS: Matesial/Color: A;,;MtnU j,Jti;
ROOF: Material: Ay/No.1'1- Pitch(7/12 min) V Height to Ridge: 2./I/ Color.(P 4rWtV49`
SIDING:Material/Style: Front: dap 44 1 Sides/Rear: ,411 �a j COLOR CHIPS
Color: Front: ��1 Sides/Rear: 0A.. -
TRIM: All windows&doors to be
Material: ` Orit }(1S!'f!itrrimmed with: 1x 4 co (Circle one.)
�- Color: U k t+E.
r
DOORS: Qty: "2) Material: 1-t beel1O 5 _ Color: I-(a: K J Cei
Style/Size(if not listed/shown on elevations): 45t . elefiguiteiy.,
STORM DOORS: Qty: t Material: AktOIVIU1U11n. Color: WtI�
GARAGE DOORS: Qty: t Mat'l: f,{, %(j,1 y l Style: olor: ( h t lje
WINDOWS:City/side::Front: I�. Left: Right: .) Rear: I I Color: �)(l i-.
Manufacturer/Series: An d e►45 ovt .Se i Q'D Material: Y lye 1
Grilles(Required. _ attern(6/6,2/1,etc.) 'G Grille Type:True Divided Lite:
Snap-In: Between G ass: Permanently Applied: nExterior terior
STORM WINDOWS:\rQty: Material: Color: `
SHUTTERS: Mat'l: \t i r%t I Style:Paneled Louvered Color: p,k 1V
SKYLIGHTS: Qty: r Fill Vented Size Color:
DECK: Size: Decking Mat'l: A7 Color:-� '� C
Railing Mat'l: Style: /��l Color: I,...41 i
�WALLS/FENCES*(Max 6'height): Height: V/T _Mat'l:
Style: Color:
(Show running footage&location on plot plan.) 'Finished side of fence must face out from fenced in area.
UTILITY METERS/HVAC UNITS: Location: h O ICAScreening: PC Ci A+tl S
LIGHTS:Qty: 5 Style: Can jCA Color: /; ,4LC .
Location(s): 1-0,1'T" / 2, izaziT- _ - I j't
LIGHT POSTS:Qty: ' Material: ' w"l. Color: W k 1 te.,
Location(s): L/1V etApel
Additional information:
2-General
APPLICATION#:
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01///' SYSTEM PROFILE
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MS.tin•11141 LLM.,Miff REFERENCES
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- '''• (A----. -- \i TITLE 5 SITE PLAN
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#50 CENTER STREET
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Y ARMOUTH PORT, MA
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TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST •
Applicant's (Owner) Name: IINC0-AL L1Q..i
Property Address/Location: Ceft{e( °L., -E
Hearing Date:9-/72/1 /
Notices must be sent to the Applicant and abutters (including owners of land on any
public or private street or way) who's property directly abuts or is across the street from
the Applicant. Please provide th?Assessor's Tax Map and Lot numbers only. The
OKH Office will send out notices using the addresses as they appear on the most recent
applicable tax list.
Note: Instructions for obtaining the abutters Map and Lot numbers can be found on the Old King's
Highway Department page on the Town website:www.varmouth.ma.us
Map Number Lot Number
Applicant Information: --T'1:3
Abutter Information:
.
gzC _ , 131 123
v
47 Ct ' /1)' /$/ _ __ j
y 1 C-evt'er _ ,3 2 /3 z . 1
51CeAfr ,)Z- iVI. 1
2 `3-s- x l 3 4/
47 ad cat - -- 11 L i '1 _
6q ad 61 -- - 1'�2 I I q - ---
( ' OId ,, 14)11146 --- .
Application#: Q frA02 9
3
8.2018
132/ 130/ / / 132/ 132.1/ / /
HANNON JOHN T TRS PARKE JOHN S
HANNON BARBARA L TRS WARREN NANCY BRETT
41 CENTER ST 51 CENTER ST
YARMOUTH PORT,MA 02675 YARMOUTH PORT,MA 02675
132/ 122/ I /
KELLEY EUZABETH A
LYNN13 PINEM 01904 AVE Please use this signature to certifythis list of properties
,MA 01904 g p p
directly abutting and across the street from the parcel located at:
50 Center St., Yarmouth Port, MA 02675
132/ 131/ / / Assessors Map 132, Lot 122
LEONARD CHRISTOPHER
BIVOL LIUBA
47 CENTER ST AndyM�(chado, Director of Assessing
YARMOUTH PORT,MA 02675
132/ 123/ I /
FAGAN STEVEN F
FAGAN JOANNE M
42 CENTER ST
YARMOUTH PORT,MA 02675
132/ 121/ /
HALL BRADFORD L
HALL HERSILIA C
47 OLD CHURCH ST
YARMOUTH PORT,MA 02675-1337
132/ 118/ ' / /
VANEK RICHARD F JR
VANEK JUDITH A
68 OLD CHURCH ST 0`
YARMOUTH PORT,MA 02675
132/ 119! / I
FORSYTHE KENTON G
CHIACU-FORSYTHE CHRISTINE G
89 POUND HILL RD
NORTH SMITHFIELD,RI 02896-7028
_
133/ 3/ / /
RADCLIFF DONALD P
RADCLIFF JADE
800 SEVENTH ST
NEW BRIGHTON,PA 15066
133/ 4/ / /
HASSLER LISA M
LOCONTE DONNA J
7 STOCKTON ST
BOYLSTON,MA 01505
132/ 134.1/ / I
MAULDIN WILLIAM D JR
MAULDIN BETH ANNE M
59 CENTER ST
YARMOUTH PORT,MA 02675