HomeMy WebLinkAboutBLD-22-007223 ONE & TWO FAMILY ONLY-BUILDING PERMIT
Town of Yarmouth Building Department
........_
1146 Route 28,South Yarmouth,MA 02664-4492 y
508-398-2231 ext. 1261 Fax 508-398-0836
Massachusetts State Building '`"Code,780 CMR �',
Building Permit Application To Constrzrct, Repair, Renovate Or Demolish `
a One-or Two-Family Dwelling
This Section)~or Official Use Only RED = I V E D
Building Permit Number:13(Z-ZZ-(7
02 Date App]i
�►� 5 is
,� ! �� 2022
$r3-
Buiidin Official _----(Print Name) • Signature Q. PARTMENT
By -bate
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
-MCA- � YiQRAT �y3 SO.I�
1.1 a Is this an accepted street?yes +/ no Map Number IC,
Parcel Number /1
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use
Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards
Required Rear Yard
q Provided Required Provided
Required Provided
o IIIIIMMI 2 0 2 0
1.6 Water S ply: (M.G.L c.40,Q 54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public G•-- Private CIZone: Outside Flood Zon
Check if yes Municipal 0 On site disposal system
SECTION 2: PROPERTY OWNERSIi]p'
2.1 Owner'of Record:
A,r1A1,4 � __ ,
Name(Print)
City,State,ZIP ,U,U/} /OO(0
No.and Street , Ca,-7Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WO 2(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied r. Repairs(s) ❑ Alteration(s) ❑ Addition a
Demolition 0 Accessory Bldg. 0 Number of Units
Brief Description of Proposed Work2: Other ❑ Specify;
/5' 22' ✓�` yic� �.,1 ,QLcCft' GU�1.3i,?yc(JO o�� / L /t.
SECTION 4:ESTIMATED CONSTRUCTION COSTS.
Estimated Costs:
abor and Materials) Official Use Only
I.Building 11111111111111 1. Building Permit Fee:$ , .
MEMENIMIN I. Indicate how fee is determined:
$ vio O 0 Standard City/Town Application Fee
3.Plumbing ,� 0 Total Project Cost(Ite 6)�x/�multiplier ;t
�"�"'�'+` 11 2. Other Fees: �y 64k
•
5.Mechanical (Fire - List:
Su..ression) '
Total All Fees:$ � -
6.Total Project Cost: $ Check No. Check Amount: Cash ••
/
7 5�0 0 Paid in Full lit: l,,�M
Outstanding Balance Du.: ) r, l
❑t O
i3iaa
May 18, 2022
To Whom It May Concern:
I authorize Dan Speakman to act as my agent regarding building permit applications ect.
for my property at 8 Setucket Rd Yarmouthport, MA 02675.
Sincerely,
a41,a- /60)t,Q.)
Anna Pons
8 Setucket Rd
Yarmouthport, MA 02675
REScheck Software Version 4.7.2
Compliance Certificate
Project 8 Setucket Road '
Energy Code: 2020 Massachusetts Energy Conservation Code
Location: Yarmouth Port, Massachusetts
Construction Type: Single-family
Project Type: Addition
Climate Zone: 5 (6137 HDD)
Permit Date:
Permit Number:
Construction Site: Owner/Agent: Designer/Contractor:
8 Seatucket Rd Dan Speakman
Yarmouth Port, MA Speakman Construction
15 Speak Way
Harwich, MA 02645
508-432-5565
danaspeakman@hotmail.com
Compliance: Passes using UA trade-off
Compliance: 2.0%Better Than Code Maximum UA: 102 Your UA:- 100
The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules.
It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
NOTE: Slab-on-grade tradeoffs are no longer considered in the UA or performance compliance path in REScheck. Each slab-on-
grade assembly in the specified climate zone must meet the minimum energy code insulation R-value and depth requirements.
Envelope Assemblies
Gross Area
Cavity Cont. Prop. Req. Prop. Req.
Assembly or
Perimeter R-Value R-Value U-Factor U-Factor UA UA
Ceiling 1: Cathedral Ceiling 450 49.0 0.0 0.022 0.026 10 12
Wall 1: Wood Frame, 16" o.c. 593 21.0 0.0 0.057 0.060 24 25
Window 1: Wood Frame:Double Pane with Low-E 132
0.300 0.300 40 40
Door 1: Glass 42 0.330 0.300 14 13
Floor 1: All-Wood joist/Truss:Over Outside Air 352 30.0 0.0 0.033 0.033 12 12
Additional Efficiency Package(s)
Not applicable
•
Project Title: 8 Setucket Road Report date: 05/19/22
Data filename: C:\Users\Cjohnson\Documents\REScheck\8 Setucket Road.rck Page 1 of 2
Sears, Tim
From: Sears,Tim
Sent: Friday,June 17, 2022 9:44 AM
To: 'danaspeakman@hotmail.com'
Subject: 8 SetuEket Rd
Dan,
I have reviewed your application for the addition and there are some items needed.
--- Health Department sign off(under review)
�2 The use of sonotubes for footings for the room addition requires plans be reviewed and stamped by an architect
or structural engineer(R403.1)
110mph checklist or stamped plans
Deck plans showing connection details for ledger, railings, beams,etc.
I have a question about the plot plan, please call when you get a chance.
Please submit the items above 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
[own of Yarmouth
508-398-2231 Ext. 1259
mailto:tsears@yarmouth.ma.us
1
The Commonwealth of Massachusetts Flint-Form
Department of Industrial Accidents
- 'Nam mo
Office of Investigations
`.1' ' 1 Congress Street,Suite 100
VIM=•!MEI4 Boston,MA 02114-2017
i wWw.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual):D)A ASPAER-teM4 A COA iTJGTio _
Address: /s s jE-,gam ec/4 y
City/State/Zip: '4 C.t C1-( Phone#: 77Y.- 11•, CtS
Are you an employer?Check the appropriate b / Type of project(required):
I.❑ I am a employer with 4. .am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction
listed on the attached sheet. 7. ❑ Remodeling
2.❑ I am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. El Demolition
working for me in any capacity. employees and have workers'
comp insurance.: 9. ❑iuilding addition
[No workers'comp. insurance P
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have exercised their 11.0 Plumbing repairs or additions
3.❑ I am a homeowner doing all work
myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
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: iii&,$p C,,,, erii0 040Yets /An. Ca,
Policy#or Self-ins.Lic.#6)0C-600--,BOO 95CSeeO/q Expiration Date: /fA0/ ea2._
Job Site Address:, 8 L.A.0 C- j20+ City/State/Zip:.l�4lz'.d7'
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do herebyt'lnlfjrrin r the pains d pe ties of perjury that the information provided above is true and correct
Signature:ivieDate ,
71 2-0 22 I
Phone#: '7 Y .834 • G,$5 9
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#:
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATION PAGE
Associated Employers Insurance Company
54 Third Avenue, Burlington, Massachusetts 01803-0970
(800)876-2765 NCCI NO 40959
POLICY NO. WCC-500-5009565-2021 A�
PRIOR NO. WCC-500-5009565-2020A
ITEM
1. The Insured: Dan Speakman
DBA: Dan A Seakman Construction
Mailing address: 15 Speak Way FEIN:**-***4938
Harwich,MA 02645-0000
Legal Entity Type: Individual
Other workplaces not shown above: See Location
2. The policy period is from 11/10/2021 to 11/10/2022 12:01 a.m.standard time at the insured's mailing address.
3. A. Workers Compensation Insurance:Part One of the policy applies to the Workers Compensation Law of the
states listed here: MA
B. Employers'Liability Insurance:Part Two of the policy applies to work in each state listed in item 3.A.
The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease $ 500,000 each employee
C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B
D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE
4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans.
All information required below is subject to verification and change by audit.
Classifications Premium Basis Rates
Code Estimated Per$100 Estimated O
No. Total Annual Annual
Remuneration Remuneration Premium
INTRA 000137314
INTER SEE CLASS CODE SCHEDU_E
Minimum Premium $550
GOV 1 GOV _
STATE CLASS
MA 5645
This policy,including all endorsements,is hereby countersigned by ter �—�'C--- 10/28/2021
Authorized Signature Date
Service Office: HUB International New England LLC
54 Third Avenue PO Box 696
Burlington MA 01803 Wilmington,MA 01887
WC000001A(7-11)
includes copyrighted material of the National Council on Compensation insurance,
used with Its permission.
Commonwealth of Massachusetts
VI Division of Occupational Licensure'
Board of Building R uiations and Standards
Constfi t$ visor
CS-037636 , f* Fires:04/22/2024
DAN A SPEAg M t.i .-
15 SPEAK WAY
HARWICH Mit 0
Commissioner
(6,,, ieVire ei7/,4' /..1/4-)vr744)/1/
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
TYPE:Individual
Registration Expiration
120040 10/08/2023
DAN A SPEAKMAN'
DAN A.SPEAKMAN
15 SPEAK WAY
NO HARWICH,MA 02645
Undersecretary
VA Al ft c)re-4IC Kai) v trro t ,► ,2,. �.-
'Y' R TOWN OF VAR lot q i l
3� WATER DEPARTMENT
99 Buck I;i<snd Rif 1r1
wt^f4[:riEESE
�, e4 }lrtmmouth, �Ai\ 0267
Ich•ithon ;r;i1;ir 7'1-7921 • t.
3�: t3U1Si - 98
BUILDING PERMIT APPLICATION FOR
WATER DEPARTMENT SIGN OFF
TRANSMITTAL FORM
BUILDING SITE LOCATION:
''7'LJCfC�! P4. sm n pi-
PROPOSED WORK: 16 X 22 400/77c,. / Xt 7' D
APPLICANT: OAS s'p ? y)
ADDRESS: l5- * Pe.. _ _-_------___
Gd'17' f (mac „,lc/
TELPHONE: ` 0.
RESIDENTIAL AND 'OR COMMERCIAL- BUILDING
Water Department: Determines Compliance of tt ater Availability and or existing. location
Engineering Department: Determines Compliance for Parking and
Conservation Commission: Determines Compliance to Wetlands Act: i e. If lots)border any type of
wetlands.streams. ponds, rivers. ocean, hots. boys. marshland. ETC...
I Iealth Department: Determines Compliance to State and Town Regul
ations, i.e.
requirements li>i-Septage Disposal and other Public health Activates
Fire Iepartment: Determines Compliance to State and town Requirements for Personal
Sal'cty, Property Protections, i.e. Smoke Detectors Sprinkler Systems.etc
I.tCANT SIGNATU s //'�'i
DATE
OFFICE USE: CO .I TENTS ON PERMIT APPROVAL OR DENIAL
REVIE 'ED BY WATER DIVISION(SIGNATURE) cS —2e°—20Z
DATE
i % r
"p*- -)
SERVICE NO ;".\
1689 12/30/02
8 SETUCKET RD
Mt;_" ANNA PONS
STREET E 5 � 1(,lC 7
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VILLAGE y/1 Rat 0 vil,
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° YAK' TOWN OF YARMOUTH
...�a» EC 1. 4 d 4Y 1 iF
r 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451
Telephone(508)398-2231 Ext. 1292—Fax(508)398-0836
MAY 19 '
Artmc}u LD K NG'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ow IN ` `HIGHWS2.'.._
APPLICATION FOR *` �"' D
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: SETOCk — 7 7 fly/ %tRIJT Map/Lot# /47 —/'C>
Owner's)* AA),t\A !� 4- � Phone#: 'i 7 2/0-(fit/$y
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: B SETucttreT /^OiO, "49.6 •. ? ,26- Year built: 19'249
Email:/ilatP P/O0() 6'AIA/4..(2,0fri Preferred notification method: Phone L. Email
Aaent/Contractor: D.)41k A-, �/°EAilr/f24 A) Phone#: 77 8,'• 59
Mailing Address: /6 SIAE 4 >e, ,e-0 ,4,y ,.
Email: DIA itc P S iriggA 74 f L,C$ Preferred notification method: Phone Email
Description of Proposed Work(Additional pages may be attached if necessary): RE,47 O(J..AC, cfreenco OCrC•
a
is •X/+2,2 ' /U 4/T/cA.) 7"d 7�r'E- ,'E'i1/R OF rt,ci . 6",,--,A.,t.4
Th' %42'4Cry,
•
Signed(Owner or agent): , ,J...),.... //
Date: S //V hi.-
> Owner/contractorlagent is aware that a permit may be required from the Building Department.(Check other departments,also.)
> This certificate is good for one year from approval date or upon date or expiration of Building Permit,whichever date shall be later.
For Committee use only:
Date: 5N1,2a Approved Approved with Chang sAppRoveD
Amount 20.04 Reason for denial:
Cash/CK#: ,7r .°
Rcvd by: LA 5 YAfis�li()I i }l
_ t LU i€It_g tit(3t t rA'{
Date Signed' A l7,-- Signed: vit Q,imd -6612 I
APPLICATION#: 4 'eEO172-
VS 2011
`o, ., TOWN OF YARMOUTH
;, ,• °7- 1
HEALTH DEPARTMENT
it••,. , :.Z_
•
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To he completed by Applicant: ,
Building Site Location: & Se-71)etCe7 R'/OI j V4/�O,)ryi- Zoe.,f'
- Proposed Improvement: ga-neD2/E EX/S!/10a. IX.0 —Cc S7irUC'r jEcu ,S;,(e,
000iTfoA) ar /6 i,x, /7' Decie-
Applicant: 7 ' 4 A 4 ,c al Tel. No.: 7751-:63%,,-G 55'
Address: /5 SPE /r y J�'('92'W 4./A-1-
� �� Date Filed: (�.;
**If would like e-mail notification of sign off please provide e-mail address: PA M A Se64e/WA i,brA1g,—.cony
Owner Name: A Gti nl 4 Po4\12
Owner Address: 9,6-7ticr re , ....0...) ,IVEv4-7Q07027 Owner Tel. No.: 6/7 7/0 - y
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;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) -
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: ,r------ DATE: C j7/ - '2--
2- `
4....\--7
COMMENTS/CONDITIONS: PLEASE NOTE
w
o` �" TOWN OF YARMOUTH
1- '" " �.
ar, . •
`` 1146 ROUTE 28,SOUTH YARMOUTH, MA 02664-4451
. Telephone(508)398-2231 Ext, 1292—Fax(508)398-0836
MAY . f
yAkimouP K NG'S HIGHWAY HISTORIC DISTRICT COMMITTEE
OLD KING'S HIGHWAY t (�P,
APPLICATION FOR
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.
Tyne or print iealbly:
Address of proposed work: s S>l)Of<7 ''OI O) > 1 RP 7 MapiLot# /'/ —/�0
Owner(s): Ak ,f\* PCPAS Phone#: C%1 7 710-(j473 '
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 8 S ern f OCk , "14/6 ` e)&G 2 Year built: /'28
Email:Matil f/t ) aik2A/4-,j--;0,1 Preferred notification method. Phone /
tX'" Email
AoentlContractor: Z) /0 11 . �" ' Air efrti4.00 Phone#: 77 8 •
Mailing Address: 15 $PE >rF w 'e.6.5
Email:DetAl if P 1 Cr/ e--c "/ Preferred notification method' /
Phone Imo' Emait
Description of Proposed Work(Additional pages may be attached if necessary):
/5 'x 22 ' .66/7/64u TO 7 e. � pfi a -our ,-,c
Try q// i./ ,
.
Signed(Owner or agent): ..- '`-7 /
oc'; Crate: ,j" 3/G 1,--
S* Ownerfcontractortagent is aware that a permit may be required from the Building Department.(Check other departments,also.)
la This certificate Is good for one year from approval dale or upon date of expiration of Building Permit,whichever date shall be later.
For Committee use only:
Date. , Approved Approved with chang: * • * a r
Amount .,r' .i'tt7 Reason for denial.
CashICK#: 7rd"' x` i(
Rcvdby: LA.- YARMOUTH
Date Signed' ‘I 20- Signed. . . '141 ,4J W 2' 1
APPLICATION# rE
Ctelr
V5 7017
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RECEIVED APPROVED
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