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Home My WebLink AboutBLD-23-005720 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 i+ Massachusetts State Building Code,780 CIvR ■ Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling BLbR -023•- '?75 This Section For Official Use Only I V E D Building Permit Number: , () — 2 D Date Applied: ,, ors �4J d 3 APR 12023 Building Official(Print Name) • S ature SECTION 1:SITE INFORMATION BUILDING DEPARTMENT 1.1 Pro er ddress: 1.2 Assessors Map&Parcel Number � �taei^ 6 tD f4 • .56 3 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zonin Information: n 1..jrope Dimensions: 3 Zoning is let Proposed Use Lot Afea(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided Required Provided Required Provided 30 3.4.. 6 v. '7 c2O , ad,y 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Publi¢ Private 0 Zone: _X Outside Flood Zone? Check if yesD Municipal El On site disposal system,! SECTION 2: PROPERTY O WNERSFDP" 2.1 Oyvr ier'pf Record:, PPs Name(Print)ek ` ,/ /�b21�I• !�1A— 62623 City,State,ZIP `t ic.. r g-77> '' `? flf '� A hP6Ae-CAi No.and Street Telephone Em Address SECTION 3:DESCRIPTION OF PROPOSED WORD"(check all that apply) New Construction 0 Existing Building 0 I Owner-Occupied I Repairs(s) El Alteration(s) It. 1 Addition El Demolition Z. Accessory Bldg.0 Number of Units Other El Specify; Brief Description of Proposed Work2• / DL/rr b^ r '' ' ,6 G / 7/ We-. 0 SECTION 4:ESTIMATED CONSTRUCTION COSTS. • Item Estimated Costs: Official Use Only (Labor and Materials) I.Building $ 3.515d 1. Building Permit Fee:$3(C:f •Indicate how fee is determined; 2.ElectricaI $ / 1S Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: iLo Q, OD Oa—74k 5.Mechanical (Fire Suppression) $ Total All Fees:$ • ` , / .r , Check No. Check Amount: Cash Amount: V ,(�]� 6.Total Project Cost: $ � "1j97 El Paid in Full ilk Outstanding Balance Due:—3 0F5 v \�\\\ "` ce Town of Yarmouth, MA $318.20 Paid via Credit Card ending in 4139 Thanks for using the Online Service Center Mike Nardone Building Permit- Residential#BLDR-23-9975 May 23, 2023 decks/porches $308.00 Processing Fee $10.20 Total Paid $318.20 Powered by the ViewPoint Cloud platform Receipt number#676 • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Dg1/3 9— 23 r L.)41 an1/4e License Number Expiration Date Name of CSL Holder / �, q J 7_ V j List CSL Type(see below) I/ _sj No,and Street f? �i �'7�7 it Type Description V/,4 . �� ' ,6C I Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP lvi Masonry RC I Roofing Covering WS Window and Siding (,-7-� SF Solid Fuel Burning Appliances ti 3/4 '7 �� A/I,z ,L v I Insulation Telephone Vail address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Corn_panyl\ramgor Registrant Name Nosapd%ton. /116- Em address City/Town,State,ZIP 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 .0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDINGT / PERMIT I,as Owner of the subject property,hereby authorize Will/ z'/ 1497_/ 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 containede in this application is true and accurate to the best of my knowledge and understanding. �/ 7 /c/44P11)741- 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.sov/oca Information on the Construction Supervisor License can be found at www.mass.sov/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" • The Commonwealth of Massachusetts _* Department of Industrial Accidents 1 Congress Street, Suite 100 e= ZT Boston, MA 0211,4-2017 www.mass.gov/dia \Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): M • = /l rLJD ' i, &la Address: 42q L' 1i i '9i City/State/Zip: Artni M 4- 62 a / Phone#: S.Sb g' 7 7/ • 9'2 w7 Are you an employer?Check the appropriate box: Type of project(required):j I.ZI am a employer with .. employees(full and/or part-time).* 7. ❑New construction 2.01 am a sole proprietor or partnership and have no employees working for me in 8. gLemodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Q Building addition 4.0I 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.❑Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.0I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.0We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§I(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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• , tiro A-L Policy#or Self-ins.Lic.#:fitd/ 6O7O j 7) 1,2 022 4- Expiration Date: _3—/Z—a / Job Site Address: sy City/State/Zip: /101;7• . /j-fit�� 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 certifyy under the pains and penalties of perjury that the information provided above is true and correct. Signature: 14i141/-4 Date: 7 �1/✓'23 Phone#: SO S 610.27 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): I.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: • §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 ext.-1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 37/ 341.f4„.A.4 O L'✓ Work Address Is to be disposed of oat the following location: y�i?/mdlr A 04 SL Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. S' ture of Application Date Permit No. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affa rs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT>CONTRACTOR expiration date. If found return to: =L-YPE tLG Office of Consumer Affairs and Business Regulation Registration -Expiration 1000 Washington Street -Suite 710 113588Z. 08/14/2024 Boston,MA 02118 A J NARDONE CARPENTRY f;LC i I' AICHAEL J.NARDONE T,,, '.."-,' 04/( /t/4/LryZk.....,‘,___ '.99 WHITES PATH SOUTH YARMOUTH,MA 0Z664 "�D �� L - Undersecretary of valid without signature Commonwealth of Massachusetts IFDivision of Professional Licensure Board of Building Regulations and Standards If LL Const t irSt ttsorvisor CS-081139 ,' ires:09/16/2023 MICHAEL J I�I31R �� 299 WHITES PATH tC I SOUTH YARM9UTH ` 64 17 si11/61C il.i�}�� Commissioner ca f;. rckta., April 10, 2023 To Whom it May Concern: I hereby authorize Michael Nardone of M J Nardone Building and Remodeling to act on my behalf as an agent to request and receive any and all permits for construction work planned at our property located at 54 barnboard Ln West Yarmouth. Sincerely Rick Sands TOWN OF YARMOUTH K_Vd HEALTH DEPARTMENT uu"9 r4 s ` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: °j jJ r w',21/1/,3`4)}77 c-1/ 4<(/ Proposed Improvement: i}l('P? '6' r A D, c 'C Applicant: N �7��-�. Tel. No.: -3/ Z.S-Yy `j Address: � � � � �. Zi�'I/ j �:�- 5� /1,14.4f Date Filed: �� **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: ... %Gr4 J '1 V 1) 5 Owner Address: 5-r .� /1-71 ,47Z� Liy r Owner Tel. No.: .�G� 7 7/ j�1-2 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: (1.) Site Plan showing existing buildings, water line location, and septic system location; RECeV � (2.) Floor plan labeling ALL rooms within building APR (all existing and proposed)- 2az Note:Floor plans not requiredfor q decks,sheds, windows, roofing; HEALTH®Epp (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: �� .� DATE: Lj -/S - ot) PLEASE NOTE COMMENTS/CONDITIONS: • "pF'Z' N TO\NN OFY\\iot-TtI 1, 'O� WATER DEPARTMENT '.; " ' xx.7-1 Wust Yarmouth, A)-\ 026 I Fay: _>tlfi - 9 D E i V E D APR 18 2023 BUILDING PERMIT APPLICATION FOR BUILDING DEPARTMENT ll' 1"I'ER DEPARTMENT SIGN OFF .By. TRANSMITTAL FORM BUILDING SITE LOCATION: 2n/ 4- .) 2/14 PROPOSED WORK: ,42/z/ape .5,-----A//4, .:.'---e-e---X APPLICANT: A-ez...4 A./X- I-57- L, Chi wit • ADDRESS: C / /"\ 4"• 1 :J' 4-eiii IELPI-IONE: RESIDENTIAL AND 'OR COMMERCIAL BUILDING mi/Atilithirepaie _Ca•2,1„ Water Ucruhnent: h'lIKz- I Determines Compliance of Water :\\ailabiIit.\ and or existing location Ingineering Department: Determines Compliance for Parking and Drainage Conserxation Commission: Determines Compliance to Wetlands Act: i e. If lot(s) border any type of wetlands. streams, ponds, ricers. ocean. bogs, bobs, marshland. ETC... I lealth Department: Determine:Compliance to State and"Town Regulations, i.e. requirements for Septage Disposal and other Public Ilealth Activites Fire Department: Determines Compliance to State and Town Requirements for Personal Safety, Property Protections, i.e. Smoke Detectors, Sprinkler Systems.etc ij, /..... ....„ , APPLICANT SIGNATURE TF DATE OFFICE USA; CpNIMFNTS ON PERMIT .APPROVAL OR DENIAL • REVIFWF.D Y WA ER DIVISION(SIGNATURE /Z A T 3 -'el—Mk SERVICE NO. P (� • NAME 13440 6/11/99 / James F Freeman '`k j Patricia J Freeman VILLAGE , METER NO. C_ mr- i/Wa4ae_,Z. kl-- 4)(1 • • • • • Pe