BLD-23-000359 on 1 ►`il ° (v I3 0'1 Z
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JUL 2120 ONE & TWO FAMILY ONLY- BUILDING PERMIT`
U0.0. Town of Yarmouth Building Department
ENT 1146 Route 28, South Yarmouth,MA 02664-4492 ` .
BByUILDING 508-398-2231 ext. 1261 Fax 508-398-0836 i .�;*«'
______.___;______ -,
Massachusetts State Building Code, 780 CMR
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: fj0)-a ---C)h 357 Date Applied:
Building Official(Print Name) Signature Date
1Pr ca SECTION 1:SITE INFORMATION •
130 Figgtlie ne Yai mouthport, MA 02675 1.2 Assessors Map&Parcel Numbers
115 27
1.1a Is this an accepted street?yes XX no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R-40 Single Family Residence 16,420 120
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required I Provided Requirec. Provided Required Provided
30 35.2 20 22.9 20 58.1
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public IOC Private 0 Zone: Outside Flood Zone?
_ Municipal 0 On site disposal system QIUC
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
Paul Saweyer Yarmouthport, MA 02675
Name(Print) City,State,ZIP
30 Heather Lane psawyer@fianic.com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction Pc Existing BuildinAal 1 Owner OccupieX)tl 1 Repairs(s) ❑ Alteration(s) 0 AdditionXX
Demolition 0 I Accessory Bldg. 0 Number of Units one Other 0 Specify:
Brief Description of Proposed Work2: Build a wood frame,single story, 14'x 16'-4"3 season room to rear
of exst.structure. _
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ 1. Building Permit Fee:S' V) Indicate how fee is determined:
2.Electrical $ liii
Standard City/Town Application Fee
❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $ (DO,U C`6 '
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire
$
Suppression) Total All Fees:$ C'
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 70 �D El Paid in Full Ell Outstanding Balance Due:-)6 \\ l
ei' Ah
ONE or TWO FAMILY— BULDING PERMIT
APPLICATION REGULATORY APPROVALS NOTICE
Address of Proposed Work: 30 Heather Lane
Scope of Proposed Work: to build a wood frame, one story, 14'x 16'4 season room to rear of existing single fami
home 30 Heather
Date: 06/14/22
Based on the scope of work described above, the applicant is required to obtain approval sign-
offs from the following departments as checked-of below:
Health Dept. —508-398-2231 ext. 1241
Conservation —508-398-2231 ext. 1288
Water Dept. —99 Buck Island Road, 508-771-7921
XX Old Kings HWY. Hist. Comm. —508-398-22631 ext. 1292
Engineering Dept. —508-398-2231 ext. 1250
Fire Dept. — Kevin Huck/Scott Smith, 96 Old Main Street, SY
Note: Please call Fire Department for an appointment. 508-398-2212
Other
Appropriate plans and/or application shall be provided to each departments checked-off above.
Each of these regulatory authorities has their own requirements outside the jurisdiction of the
Building Department. All applicable approvals shall be obtained prior to submitting a building
permit application to the Building Dept.
Thank you for your cooperation.
Receipt Acknowledgement:
Robert Snow 06/14/22
Applicant's Signature Date
Rev. Jan. 2019
•
—� The Commonwealth of Massachusetts
; G Department of Industrial Accidents
=��= 1 Congress Street, Suite 100
W. `— Boston, MA 02114-2017
IMP
\tir
www.mass.ao v/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH TEE PERMITTING AUTHORITY.
Applicant Information
Please Print Legibly
Name (Business/Organization/Individual): Robert Snow
Address: 29 Heather Lane Yarmouthport, MA
City/State/Zip: Yarmouthport, MA 02675 774.994-7155
_ Phone :
Are you an employer?Check the appropriate box:
Type of project (required):
l.0 I am a employer with employees(full and/or part-time).*
7. nNew construction
2.n,am a sole proprietor or partnership and have no employees working for me in
any capacity.[No workers'comp. insurance required.] 8. Remodeling •
3.[]I am a homeowner doing all work myself. [No workers'comp, insurance required.]r 9. r❑](Demolition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 J Building addition
ensure that all contractors either have workers'compensation insurance or are sole
11.E Electrical repairs or additions
proprietors with no employees.
5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet, 12 ❑Plumbing repairs or additions
These sub-contractors have employees and have workers'comp.insurance.t 13•LI Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per,MIGL c. I4.❑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.
tContractors 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.
N/A
Insurance Company Name:
Policy#or Self-ins.Lic.4:
Expiration Date:
Job Site Address: 30 Heather LaneCity/S tate/Zip: Yarmouthport, MA 02675
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 abov i rue and correct.
Signature:
Robert Snow(ES) 06(e29�/ 2
Phone#:
774-995-7155 Date:
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License r
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#:
•
•
•
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE:Individual
Registration Expiration
172220 08/08/2022
ROBERT M.SNOW
ROBERT SNOW �� .
29 HEATHER LN. �i/u"''i0� g
YARMOUTH PORT,MA 02675 Undersecretary
L. Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards •
COnst\i t tWilpp,rvisor
CS-106188 ! tyc�pires: 10/24/2023
ROBERT SNOW •.
29 HEATHER-NAPP,, * O
YARMOUTH 129R d 11�
a
0a1sS'a3�
Commissioner �ia t K. 'Fmcb
•
•
•
•
F
of.YAit n TOWN OF YARMOUTH
� - BUILDING DEPARTMENT
, 1146 Route 28, South Yarmouth,MA. 02664 508-398-2231 ext. 1261
k _6"
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE:
JOB LOCATION:
NAME STREET ADDRESS SECTION OF TOWN
"HOMEOWNER"
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADDRESS
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 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.
HOMEOWNER"S SIGNATURE
APPROVAL OF BUILDING OP4141CIAL
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:homeownrlicexemp
§TOWN OF YARMOUTH
1146 Route 28, South Yarmouth, MA 02664
508-398-2231 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 30 Heather Lane
Work Address
Is to be disposed of oat the following location: Shawmut LLC 295 Service Srd East Sandwich, MA 02537
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Ch. 111, §150A.
Robert Snow(ES) 06/29/22
Signature of Application Date
Permit No.
Sears, Tim
From: Sears, Tim
Sent: Tuesday, July 26, 2022 9:21 AM
To: 'Bob Snow'
Subject: 30 Heather Ln
Bob,
I have reviewed your application for the addition and there are some items needed.
Health Department sign off(under review)
N. The use of sonotubes for a foundation requires the plans be reviewed and stamped by a Registered Design
Professional
There is an open permit for a garage addition that was never closed out.This permit will need to be closed out
before any more permits are issued.
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@yarmouth.ma.us
1
PT . TOWN OF YARMOUTH
e
RECO' w..! 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone (508) 398-2231 Ext. 1292-Fax (508) 398-0836
Jul 0 9 20OLD,KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
OLDKINGHIGHWAY
APPLICATION FOR
'S
CERTIFICATE OF EXEMPTION
Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of
Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs
accompanying this application.
Type or print legibly:
Address of proposed work:
30 Heather Lane Yarmouthport, MA Map/Lot# 115/27
Paul & Marie Sawyer
Owner(s) Phone*
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 10 Pomeworth St Unit A Stoneham, MA 02180 Year built: 1969
psawyer@fianic.com XX
Email: Preferred notification method: Phone Email
Agent/Mar: Allen B. Osgood Phone tt- 508-364-5369
Mailing Address PO Box 735 Sandwich, MA 02563-0735
Email: yourplanstore@verizon.net Preferred notification method: Phone Email
Description of Proposed Work(Additional pages may be attached if necessary):
To demolish an exsiting 14' x 18' wood deck and construct a wood frame, single story, 14'
16' all season room on a concrete foundation, to rear of existing structure
Signed)(419(or agent): Allen B./ Osgood ES Date: 03/06/22
r Owner/contractor/agent is aware that a permit may be required from the Budding Department. (Check other departments.also)
This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later
For Committee use only:
Date 1411 /Approved Approved with charrAPPR • ortiE;Fi
Amount 20tW Reason for denial:
,ION I 0 ?NZ
Cash/CK# 4;264 I
ARMOUT
Rcvd by:
Date Signed: 0/1(173- Signed: .).ee t4i?“--e -&vyy?
APPLICATION#: 3-6Crn
V5?Cr,'
Sherman, Lisa
From: RICHARD GEGENWARTH <r.gegenwarth@comcast.net>
Sent: Friday, June 10, 2022 2:26 PM
To: Sherman, Lisa
Subject: RE: 22-E077 30 Heather Lane
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.
Thank you Lisa. Having seen it all, I can now give it my approval.
Richard
On 06/10/2022 8:41 AM Sherman, Lisa <Isherman@yarmouth.ma.us>wrote:
Hi Richard,
Sorry about that— I rescanned the COE, so should be OK now,
Thanks Richard, P
A
PR
VED
Lisa
JUN 0 2022
YARMOUTH
OLD KING'S HIGHWAY
From: RICHARD GEGENWARTH <r.gegenwarth@comcast.net>
Sent:Thursday,June 9, 2022 4:24 PM
To:Sherman, Lisa<LSherman@yarmouth.ma.us>
Subject: Re: 22-E077 30 Heather Lane
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.
Last several pages came through blank.
On 06/09/2022 11:06 AM Sherman, Lisa<Isherman@varmouth.ma.us>wrote:
Hi Richard,
Request to replace a deck with a four-season room in the back of 30
Heather Lane.
Please let me know if you need any additional information.
Thanks Richard,
Amp it rtj,
Lisa
JUN 1 0 2022
s(ARMOUTH
A.12514AP5
HGHW
Lisa Sherman
Office Administrator
Old Kings Highway Committee/Yarmouth Historical Commission
Town of Yarmouth
S08-398-2231, ext. 1292
Isherman@yarmouth.rna.us
2)-;e6r7
2
4q TOWN OF YARMOUTH
t 7 1146 ROUTE 28,SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
_ Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
WAIVER OF 45-DAY DETERMINATION
The applicant/applicant's agent understands and agrees that due to the current declared National
and State public health emergencies the determination of our Application for a Certificate of
Appropriatenes/Demolition;"Exemption may not be made within 45 days of the filing of such
application.
l'he applicant agrees to extend the time frame within which a determination is to be made as
required by the Old Kings l lighway Regional Historic District Act.
SECTION 9-Meetings, Hearings, Time fir Making Determinations
-As soon as convenient oiler srtch public. hearing: but in any, event within,fhr•ty-five f-45) days
after the_filing of application. or within such fiar'ther time as the applicant shall allow in writing,
the Committee shall make to determination on the application, "
Applicant understands that the review of this application will be scheduled as soon as the
situation allows.
Allen B. Osgood
X XXX!Agcnt Name (please print):
_ r_m
Allen B. Osgood 6 . :K.,... .... 03/06/22
Applicant/Agent signature: N,Am � Date;
D
2. 2 JUJN 1 0 2€22
tAF3E�fittUa R
OLD IN a'S tit3 it dr Y — YARMOUTH
OLD KIN 'S HHHtAY
Application #: '
Your Plan Store
Allen B. Osgood
PO Box 135 32 Jarves Street Phone: 506-364-530
Sandwich, MA 02563-0135 EMAIL yourplanstore@verizon net
PROJECT AGENT AUTHORIZATION
To whom it may concern:
Allen B. Osgood is authorized to represent us, as our Agent, before various
boards, only f he d n of our project at 30 Heather lane Yarmouthport,
02675.
Paul or Marie Sawyer Dated
ECJVED
JUN 0 9 2022
YAEIMQUih
LD KING'S HIGHWAY
APPROVED
JUN 1 0 2022
YARMOUTH
OLD KING'S HIGHWAY
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Front elevation; no changes
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Proposed rear elevation—new addition
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! 4144 rrigij V t JUN 0 9 2072 I
jUN 1 0 2022
YAHtitgl,JD I t ,
OLD KING'S HIGHV',JAY
YAFIIV/OUTF I
OLD KING'S HI HWAY
• NOTES wilinimig ',
1.DATUM IS BASED6 h
2.THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO cI
BE USED FOR LOT LINE STAKING OR ANY OTHER 9°°aaa PURPOSE.3.CO POSE.0R SHALL BE RESPONSIBLE FOR CAWNC *lilt
DICSAFE(1-888-344-7233)AND VERIFYING THELOCATION OF ALL UNDERGROUND k OVERHEAD UTILITIESPRIOR TO COMMENCEMENT OF WORK.4.EXISTING SEPTIC LOCATION PER TIE-CARD ON FILE
`` 4,i
' ti
ROWER
TOM. yV`
5.NO INCREASE IN NUER OF BEDROOMS PROPOSED.
• \_ it .
LOCUS MAP
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a (a ) l ,1 � 2--,.._
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0r r�..� __39 ;r
t ZONING SUMMARY
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p { r-�I ZONING DISTRICT: R-40 DISTRICT
1 11l i l k 1 N ? p i 1 \ \ REQUIRED: EXISTING: PROPOSED:
)J'`-."y n li i ('� io,,--.. _0 •ROPOSED , ) �,-, MIN. LOT SIZE 40,000 S.F. 16,420 S.F.± 16,420 S.F.±
__ ADDITION ( MIN. LOT FRONTAGE 150' 120' 120'
�- ,�,', \ ,,r - ON SONO-t4 8ES - MIN. FRONT SETBACK 30' 35.2' 35.2'
��, ( `9 / / / 1 .1 MIN.
MIN. SIDE SETBACK 20' 22.9' 22.9'
/ l` \, i 0 L- , �■ b 0=� \ f 1 \� MIN. REAR SETBACK 20' 58.1' 59.8'
111 MAX. BUILDING COVERAGE 25% 12.1% 12.2%
\` I EXISTING _ i � O I Np ` MAX. BUILDING HEIGHT 35'
1� )y' \ n DWELLING - DECK ` o
/-I rT Ja,"f1 \ �, ;TOFR 40.3" r '1 ✓p'' 1�A �'- \I (\ SITE IS LOCATED WITHIN THE AQUIFER PROTECTION OVERLAY DISTRICT
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`� OF
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�`—�' 111 r�, t�—j #30 HEATHER LANE
t C° --' YARMOUTHPORT, MA
PREPARED FOR
PAUL SAWYER
o' VI.
�q".+mow ' DANIELA ' DATE: MAY 23,2022
,d DANIEL OJALA
i OJIHA CIVIL g. N 508-362-4541
No.40960, 4465°2 W�' x A�J fax 508-362-9880
Fess` . ,44�. t I T eowncaP.cam o
l4AosA VE''• 'L E down cape engineering,/nc,
r r`^) civil engineers
Scaler"=20"=20' _ ' g_(,�j-2:1_ 1_ . ' h�J/ land surveyors
939 Main Street (Rte 6A)
DCE #22-066
0 ID 20 30 40 50 FEET DATE DANIEL A. OJALA,P.E., P.L.S. YARMOUTHPOPT MA 02675
CJF
3P0auHleaantdhe Mr aLraienie 7S2awyer
Map 115 Parcel
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• A-2
Your Plan Store
Allen B. Osgood
PO Box/35 32 Jarves Street Phone: 505-364-5369
Sandwich, MA 02563-0135 EMAIL: yourplanstore@verizon.net
PROJECT AGENT AUTHORIZATION
To whom it may concern:
Allen B. Osgood is authorized to represent us, as our Agent, before various
boards, only f he d n of our project at 30 Heather Lane Yarmouthport,
02575.
L
Paul or Marie Sawyer Dated
�� �, T(�)\V\ C)F Y=� y )t 1 t
tA
'o WATER DEPARTMENT
o-t.`( c ? c►<f Fit,r1. I ion;i R ,.ad
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I.-G )Mi 't.-q I Iox: t',08, . 'I `1°)Fz
BUILDING PERMIT APPLICATION FOR
WATER DEPARTMENT SIGN OFF
TRANSMITTAL FORM
BUILDING SITE LOCATION: 3 ' V._
Wy-121/,—.7 _.-._
APPI.ICAN:"\v"--
ADDRESS"1L6-1 c, ` 1 )
TEATIKUNE ._`)t _ ..__ ....._.-__.
RESIDENTIAL AND OR COMMERCIAL BUILDING
Water Department:
Determines Compliance of Water A%ailabilit and or existing location
Engineering Department: Determines Compliance for Parking and Drainage
Conservation Commission: Determines Compliance to Wetlands Act. I e.If lot(s.mbr de any pe of
wetlands.streams.ponds,rivers
I lcaith I)epartment: Determines Compliance to State and'I Town Regulations, i.e.
rctltnr intents for Septage Disposal and other Public Iieahh Activites
Fire I)epartment: Determines Compliance to State and'town Requirements for Personal
Safety.Property Protections. i.e.Smoke Detectors,Sprinkler Systems,etc
APPLICANT SIGNATURE
OFFIC'F: LSE: COMNIEN FS ON PFRMI'l APPROVAL OR DENIAL.
.4. ii,44
REVD:A\E Y WATER DIVISION(SIGNATURE)
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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 30 Heather Lane
Work Address
Is to be disposed of oat the following location:
Shawmut LLC 295 Service Srd East Sandwich, MA 02537
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Ch. 111, §150A.
Robert Snow(ES) 06/29/22
Signature of Application Date
Permit No.
01.'BAR\ TOWN OF YARMOUTH
o " BUILDING DEPARTMENT
4 << Sfy$. 1146 Route 28, South Yarmouth,MA 02664 S08-398-2231 ext. 1261
ate"
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE:
JOB LOCATION:
NAME STREET ADDRESS SECTION OF TOWN
"HOMEOWNER"
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADDRESS
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 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.
HOMEOWNER"S SIGNATURE
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:homeownrlicexemp
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CS1061V8 10/24/23
Robert M. Snow
License Number Expiration Date
Name of CSL Holder
29 Heather Lane List CSL Type(see below)
No.and Street Type Description
Yarmouthport, MA 02675 U , Unrestricted(Buildings up to 35,000 cu.ft.)
R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
•
WS Window and Siding
774-994-7155 SF Solid Fuel Burning Appliances
rsnow47@yahoo.com i Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 172220 08/08122
Robert M. Snow HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
29 Heather Lane rsnow47@yahoo.com
No.and Street 02675 Email address
Yarmouthport, MA 774-994-7155
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 ❑ NoC
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 Robert Snow
to act on my behalf,in all matters relative to work authorized by this building permit application.
Paul Sawyer(ES) 6/29/22
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 peijury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
Robert Snow(ES) 6/29/22
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.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/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 oils 14'x1 G'4"
Type of heating system Number of decks/porches
Type of cooling system Enclosed one Open none
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
Mark R.McManus A TR C kil if 7 JP C T
1461 Halls Path (802)770-0650(mobile)
Harwich,MA 02645 mcmanusarchitect@gmaiI.com
Tim Sears November 4,2022
Deputy Building Commissioner
Town of Yarmouth,Ma.
Re:Sawyer Addition/Beam hangers
Please note the following options to reinforce the metal beam hangers connecting the 6 x 10 floor beams to
the existing house box beam:
1.Use a 1/4"thick x 6"long,2"x 3 1/2"steel angle.Drill for and install(3)5/16"x 4"lags screw each leg.
Short leg to be attached tight to the box beam,long leg to outside face of 6 x 10.
2.Use a Simpson connector#AE116(1 1/2"x 4 9/16"11ga.)with(4)SDHR 27400 lag screws each face.
Same installation orientation as#1 option.
Submitted by,
or i
1HOFM-.
Mark McManus,Architect
cc.Bob Snow
end.
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Misc. Connectors for Engineered Wood
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