HomeMy WebLinkAboutBLD-23-005833 oF'YaR
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t',4 C "� / Permit (J4 &q37
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Permit expires 180 days from
issue date x {, ,j
EXPRESS SHED PERMIT APPLICATIO
TOWN OF YARMOUTH
Yarmouth Building Department R E E E
1146 Route 28
D
South Yarmouth, MA 02664
(508) 398-2231 Ext. 1261 APR 18 2023
CONSTRUCTION ADDRESS: e l kL.) I7ri YG BUILDING DEPARTMENT
J uy.
OWNER:/jriG (1IK 01 l.vtnli !1100 11)n've, 'earm0111h Tr:,ml4 T 7H• a i a• 17 u
NAME RESENT ADDRESS TEL. #
CONTRACTOR: Rlf Riff bet WWI'Pr l , 2KQ /1 r '1CRI% fjoueth telt, f IS S �)
NAME MAI ING ADDRESS TEL.#
esidential Commercial Est.Cost of Construction$
Ica 8OO. °°
Home Improvement Contractor Lic.# 13013c Construction Supervisor Lic.# 0735(.11
Workman's Compensation Insurance: (check one)
I am the homeowner I am the sole proprietor vol have Worker's Compensation Insurance
Insurance Company Name: id. &J) �(S Worker's Comp. Policy# ECG,• jOQ•400061 57. 24
Insurance. "H SHED INFORMATION
New � Size L 1 S 'x W 10• x H Ia. a Corner Lot: Yes No /
Per Town of Yarmouth ZoninR By-Law Sec 203.5 Note E:
Side and rear yard setbacks for accessory buildings containing one hundred fifty(150)square feet or less and single story,
shall be six(65)feet in all districts, but in no case shall said accessory buildings be built closer than twelve (12)feet to any
other building on an adjacent parcel. All sheds are required to be located thirty(30)feet from any front lot line
Replace existing* Size L x W x H
*The debris will be disposed of at:Qs �'rc0 o'1bd avert Vim'Rfutd, ;Dennis m ei /D'420
Location of Facility
I declare under penalties of pe ' ry that t statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answers)
will be just cause for denial vocation f my licen a and for prosecution under M.G.L.Ch.268,Section 1.
Applicant's Signature: Date: 11 Pi II 43,. anal
Owners Signature(or tt m Date:
Approved By: Date:
Building 0 al a gnee) EMA DDRESS:
Zoning District:
Historical District: Yes No Flood Plain Zone: Yes No
Water Resource Protection District: Within 100 It of Wetlands:***
Yes No Yes No
***Note:Conservation review required if within 100 ft.of Wetlands
3f22
The Commonwealth of Massachusetts
i.=w_ —!l Department of Industrial Accidents
'slTal_! 1 Congress Street,Suite 100
Boston,MA 02114-2017
;, -_ ,c www.mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY. •
Applicant Information �Pllease Print Legibly
Name(Business/Organization/Individual): Jule_ Gr4h 1.+ # fe4n'I Co I'piwa4 i or
Address: G541 awn Anne "knaci
City/State/Zip: l-tiraiiei,,mn '1 S Phone#: Stft3 '130 0800
Are you as employer?Check tie appropriate box:
Type of project(required):
1. I am a employer with employees(full and/or part-time).* 7. dNew construction
20I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling
any capacity.[No workers'comp.insurance required.]
3.�1 am a homeowner doingall workmyself[No workers' t 9. Demolition❑
comp.insurance required.]
10 0 Building addition
4.01 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 11.0 Electrical repairs or additions
proprietors with no employees.
12.1:Plumbing repairs or additions
50 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.: 13.0Roof repairs
6.1D We are a corporation and its officers have exercised their right of exemption per MGL c. 14.OOther
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. lithe 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: N Net ) Harepshl{G Ern Mar s 'milli/i l 'f. (1mpIti
Policy#or Self-ins.Lic.#: —t -t{( 5 7 'cpoga A Expiration Date: JO 19 8 tp9 3
Job Site Address: On Lb I I n V !(i e" City/State/Zip: 'Ll arut h Tt h/1t i9 tn.CI'n
Attach a copy of the workers'co pensation 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 r p ' an enalties of perjury that the information provided above is true and correct.
Signature: Date: fl LI, 9Dai
Phone#: S O i e) fpespo
t
Off cial 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#:
PINE HARBOR •
WOOD PRODUCTS
259 Queen Anne Rood I Harwich MA,02645
(508)430-2800 I pineharbor.com I barns@pineharbor.com
Homeowner Authorization
C. (,' / Ar , as owner of the property
located at 67 Lon lfo,v i y%rgo�- posh- M)- have
�dz67S
requested that Pine Harbor Wood Products apply for this building
permit on my behalf. Pine Harbor will be serving only as my
contractor and representative for matters relating to this
application. I will be acting as the applicant and will assume all
responsibilities associated with this permit.
As owner of the subject property, I authorize Pine Harbor Wood Products to file this
permit application in my name.
e}t/
Signature: (� ' Date: Z/ 3
Pine Harbor Wood Products-259 Queen Anne Road, Harwich MA,02645
fit,>A,,/ . y
ti ,.,,
�, fir.� in;, � �,a i' 8
HIC Registration Complaints
Registration # 132935
Registrant McGRATH POST & BEAM CO.
DBA PINE HARBOR WOOD PRODUCTS
Name JAMES McGRATH
Address 259 QUEEN ANNE RD.
City, State Zip HARWICH, MA 02645
Expiration Date 10/30/2024
Complaints Details
No complaints found for this registrant.
You can also view arbitration and Guaranty Fund history_.
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ri'''..;,:. . TOWN OF YARMOUTH
• IJUT Till" , ,
1146 ROUTE 28,SOUTH YARMOUTH,MA 02664-4451
R C C E IV E I\_ Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836
I�.. arr
13APl.11A049:2 t_ Rif:
M A IPP21KI 'S HIGHWAY HISTORIC DISTRICT COMMITTEE
rHHlvlUu i t, APPLICATION FOR
OLU KING'S HIGHWAY 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 info accompanying this
application. PLEASE SUBMIT 4 Copies OF SPEC SHEET(S), ELEVATIONS,PHOTOS,&SUPPLEMENTAL INFORMATION.
Check All Catenaries That Apply: Indicate type of Building: Commercial V Residential
1) Exterior Building Construction: New Building Addition _Alterations Reroof Garage
I Shed _Solar Panels Other:
2) Exterior Painting: Siding Shutters Doors _Trim Other:
3) Signs/Billboards: New Sign Change to Existing Sign
4)Miscellaneous Structures: Fence Wall Flagpole Pool Other:
Please type or print legibly:
Address of proposed work: 197 LON'l 3 )AVOW )ridt. Map/Lot# 15 1 / Inn
Owner(s): Er iW„,.•Wt%lty Phone#: 7 7 I• ,Q la1. 4."1a 1
All applications must be submitted//►► by owner or accompanied by letter from owner approving submittal of application.
Mailing address: (91 LOnel 1 110U.3 3 f if VG Year built:
Email: Pf i ic.f resit/►•k v fats wit .CI.At t Preferred notification method: Phone ✓ Email
Agent/contractor: i int FIa/tbf ViderntlIY IS Phone#: 508•Akio. o7AOO
Mailing Address: 12,59 Quit n Anne:ROtt.ti , flointsitb , MA Oa U sa 5
Lrftter+)
Email: l WrA l9 pinebarbor to4A. Preferred notification method: ✓ Phone ✓ Email
Description of Proposed Work: �p Fon,�lruc,f . 10'v 1% ' Shed on solitI l'on rtfG bloc 1t s . The shed (.4)Cons�,rl of a 3'2rtRe���L`�`tl�oor anill&U' board ,bid III nc 4urn I double dote( and CZ) two NM• PV 4. U al Qoubtt.
un h wrnd6W m
S• #on} wait will twat clapboard SSetarete qraA1 are414 f444ainin9 i.aaIls na4wnti bcilrd•
Wien 41dl1•?Fe roof Will h6.e w lorrZ•• path sorlyl Arch( kclured To.0 erwood roof ShingirS , 'die
-trim cunt kx whi k P A• Fill i, and Spec$ -b ma in s eakaiil house .Wear are r,tr►•lwny etisl rni shal •
Signed(Owner or agent): ilk A..A Date:A4 rt'h 9. SW 1
D Owner/contractor/agent is ewer-0 at a permit' •• =d from the Building Department.(Check other departments,also.)
If application is approved,appr' 1 is - - « to a 10-day appeal period required by the Act.
➢ This certificate is good for one year om approval date or upon date of expiration of Building Permit,whichever date shall be later.
Y All new construction will be subject to�inspection by OKH.OKH-approved plans MUST be available on-site for framing&final inspections.
For Committee use only: c. Approved Approved with Modifications Denied
Rcvd Date1 311 3I25 Reason for Denial:
Amount a S.1,0
Cash/CK#: .317 . /_, , ISigned: lid._4e�'
Rcvd by: I",S, -����r��il
45 Days: MOW,
i ' \,[$ I O ?O?!
/AHiVIUUIH
Date Signed: 9LD KING'S H1GNWAY
1 APPLICATION#: R3--A. 01
•
TOWN OF YARMOUTH
off- 4. OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
Telephone(508)398-2231 Ext.1292 Fax(508)398-0836
STATEMENT OF UNDERSTANDING
CHANGES TO AN OLD KING'S HIGHWAY APPROVED PLAN
As property owner/contractor/agent for construction at &I l . U v.i 0fl..t . ,
Map/Lot 5 I/100 C/A# - V°I Approval Date: e ( ( le)1q0,23)
I certify that I understand the following requirements regarding any changes that may
be required for this project:
In accordance with paragraph 2(a) of section 1.03(General Procedures) of the OKH 972
CMR Rules and Regulations: Only minor changes may be approved by the Committee
without the filing of a new application and a new hearing. Minor changes include
alterations that can be done without a detrimental impact on the overall appearance of
the project such as altering a single window or door change or a minor change of
colors. All minor changes by amendment will require the local Committee's or its
designee's approval.
All changes to previously OKH approved plans require notification to and approval
from the local OKH Committee. Change requests must be submitted to the Committee
in writing on the appropriate request form,which may be obtained from the OKH office.
All change approvals must be obtained before incorporating the change into the
project.
If the change has been implemented prior to receipt of OKH approval, a Minor Change
approval or Certificate of Appropriateness application for the revised plans is still
required and will result in a doubled filing fee for the appropriate category of work.
Failure to comply with the above statements will result in the Building Department
issuing a stop work order or delaying issuance of an Occupancy Permit or final
• inspection approval.
I have read and understand the above statements.
Date(j'f �f") (�1� Signed: Adak
(0 ner/C', - •!t•r/Agent
• �� .Its
Signed: ► '
(Chairman, Old King's Highway Commi
APPROVED
0 fl2'
H:\OKH COMMITTEE\Application Forms\Statement of Understanding 2015.docx
MtilViUU?F1
Updated 1212015
;J4)K1NG'S,tiiCNG'UAY_;
GENERAL SPECIFICATION SHEET
Project Address:
FOUNDATION: Material: Upllll 1'l(Jt k Siodi Exposure(Not to exceed 18"): LI 0'i
CHIMNEY: Material/Color: 14-A GUTTERS: Material/Color: 1•1-14
ROOF: Material:Arthiltflural 1I Pitch (7/12 min) 10/1I Height to Ridge: la' 8" Color:Titdie enr,cyl
SIDING: Material/Style: Front: rr.V•c. all bnarA Sides/Rear: Board + ?fin COLOR CHIPS
Color: Front: .%jici4i Grain Sides/Rear: Na-aura
TRIM: All windows&doors to be trimmed with: 1x 4 0 (Circle one.)
Material: TV. C. . Color: \Mite,
DOORS: Qty: Material: r;ropel ?n[ + l�n� ncl N
hlorllir�! Color: -Ich f►sir r ttivfai
Style/Size(if not listed/shown on elevations): a.. 'Panel I* t U' EOartl r B4-14en Dubk Doors
STORM DOORS: Qty: Material: Color:
GARAGE DOORS: Qty: Mat'I: Style: Color:
WINDOWS: Qtv/side:: Front: 1 Left: Right: Rear: 1 Color. What.
Manufacturer/Series: Will cStipply Material: Igllirbint).AA r PU.L. R . _._
Grilles(Required): Pattern(6/6,2/1,etc.) U/L9 Grille Tyr*: True Divided Lite:
I� � ��El
Snap-In: Between Glass: Permanently Applied: Exterior / Interior ?� tak i , %'(Il
STORM WINDOWS: Qty: Material: Color: OLU KING NIGHWAI
SHUTTERS: Mat'l: Style: Paneled Louvered Color:
SKYLIGHTS: Qty: Fixed Vented . Size Color:
DECK: Size: Decking Matt Color:
Railing Mat'I: Style: Color:
WALLS/FENCES* (Max 6'height): Height: 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: Screening: I APPROVED
LIGHTS: Qty: Style: Color: LI >k 1 0 202"
Location(s): YANMOu1 r,
LIGHT POSTS: Qty: Material: Color: OLD KINGS HIGHWAY
Location(s):
Additional information:
2-General APPLICATION#: 2 �
! -tea pi
•
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: ge W el IV
Property Address/Location: (01 l_erw-re I I nu) )iqr Vunkacth ,rnt-
Hearing Date: 1-1/J(0,-5
Notices must be sent to the applicant and abutters (including owners of land on any
public or private street or way) whose property directly abuts or is across the street from
the applicant. 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.yarmouth.ma.us
Map Number Lot Number
Applicant Information: 151 1 oo
Lien
Abutter Information: 51 IQ
151[ ? EIVE0 \ 1 51 ( 13
t�1a4=, 1 r 51 11 1 110 iv('
i HHIv1vU i t' 1 51 1 1 2 6
OL()KING'S HIGHWAY OVEDak'R t 0 2o2
Application #: a 3 c7
3
8.2018
°IY14411a TOWN OF YARMOUTH
1146 ROUTE 28,SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
•
151/ 119/ / /
MCCARTHY MARY WYSE Please use this signature to certify this list of properties
18 CONWAY DR
YARMOUTH PORT,MA 02675 directly abutting and across the street from the parcel located at:
67 Longfellow Dr., Yarmouth Port, MA 02675
Assessors Map 151, Lot 100
1MC51/ 1 ELAINE M
C/O MCDEVITT ELAINE M TR Andy fachado, Director of Assessing
29 OLD CASTLE RD
YARMOUTH PORT,MA 02675 March 27, 2023
151/ 100/ / /
WELLER ERIK C
67 LONGFELLOW DR,
WEST YARMOUTH ,MA 02673
RECEIVED
151/ 101/ / /
MORRISON RICHARD B P I a ' ) `j 'QZ i
C/O BURNS PATRICK C
73 LONGFELLOW DRIVE r AHIVIUU l h
YARMOUTH PORT,MA 02675 KiNG'S HIGHWAY
151/ 71/ / /
TESSIER MATTHEW F
TESSIER LAURIE B
43 BRENNAN WAY
HOLDEN,MA 01520 APROVED
151/ 99/ / / °;F'P I 0 XI??
PROVENCHER RICHARD R
PROVENCHER SUSAN L (ARMUU i ri
P 0 BOX 154 IL OLD KING'S HIGHWAY r)q\7
YARMOUTH PORT,MA 02675-0154 ��
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