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HomeMy WebLinkAboutBLD-23-005384 RECEIV = & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department ,:. 1., MAR 2 9 2023 1146 Route 28, South Yarmouth,MA 02664-4492 n't, 508-398-2231 ext. 1261 Fax 50$-398-0836 . -' 'Zi1 BUILD NG DEPARTMENT Massachusetts State Building Code,780 CMR ey. — H g Permit Application To Construct, Repair, Renovate Or Demolish i ;' a One-or Two-Family Dwelling "` Dwelling This Section For Official Use Only Building Permit Number: (, '-2')— to1015T I Date Applie . Building Official(Print Name) ignature Date SECTION 1:SITE INFORMATION 1.1 Property Addre - 1.2 Assessors M &Parcel Numbers _0' kiae- 0-v:-.,-;---- 1..-f , , 67 14-2 - .5"--- 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area s q O t$ ei 2- 3�. ( ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided Required reed Provided Re uired Provided 01 1.6 Water Supply: (M.G.L c.40,§54) L7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' R G 4....`i ''r ,) )•� o 444„..„1 tAik 02:_k tt Name(Print) City,State,ZIP f rt 3i'l-Ole L‘x7/ 1 1 e►7 139 ?c V/ g,7 le C u AAA c-t-i Q No.and Street Telephone Email Address gt (0-11 SEC N 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New ConstructionWi Existing Building 0 Owner-Occupied ❑ Repairs(s) Q II Alteration(s) 0 J Addition 0 Demolition 0 I Accessory Bldg. 0 Number of Units I Other 0 Specify: Brief Description o Proposed W k2: fr a .. , I• _ - E, .ram '/ SECTION 4:ESTIMATED CONSTRUCTIO COSTS. PjA 0.4 C1c,L Item Estimated Costs: (Labor and Materials) Official Use Only I.Building $ x, �a Penn it Building Pit Fee:$ t _k)q Indicate how - .0- lli y- 2.Electrical $ 1 Standard City/Town Application Fee 3.Plumbing $ Ycc" 0 Total Project Cost3(Item 6)x ultipIier x 2p23 Cj cf o %> 2. Other Fees: $_ 4.Mechanical (HVAC) $ 0.a c'V List: M �f 5.Mechanical (Fire ;. Suppression) $ Total All Fees:$ 6.Total Project Cost: $ B Check No. Check Amount; Cas Amo t:��t® .—v ❑Paid in Full �I Outstanding Balance ► e;--......... 1-1/P ib) �� 5 -r SECTION 5: CONSTRUCTION SERVICES 5.1 Conn cy io Supervisor L'cense r-1 L 4S ' 0I� 6 I 0(rr'[A 141A 1 License Number Expiration Date Name of CSL Holder p. ,. _ 41,-.. - c 4-i-t I)t-k-LA- List CSL Type(see below) No.and Street T' a Description 0 c;et "ur'..} A-cl Q! I A / U nrestncted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP E \ ��----�� Restricted l&2 Family Dwelling NI Masonry RC Roofing Covering _ WS Window and Siding i t �,k k k SF Solid Fuel Burning Appliances L g-/ 2./ 7 e.eo `. n 0451 A}-p", I Insulation Telephone Email address D Demolition 5.2 Registers Home Improvement Contractor(HIC) I ^4 Sn /0//0, `�k`'�` 'a HIC Registration / HIC Comp,,��nny Name r HIC egistrant N - `- g on Number Expiration Date No. Str et ,\, y f�;C.'`��t �} Emai!address �r'/ A / 1fl tit t?6a l City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be come eted and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance ,e building permit. Signed Affidavit Attached? Yes a No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETE])WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in al erg relative to wor this b ding permit application. Pr' a er's N ectronic Signature)sryf ) 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 containedd}in this9app is tion is true and accurate to the best f my knowledge and understanding. i--\ A 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 Itoi 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.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/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 '� `= 1 Department of ' �=�'ll�►, P Indrestrial.Acciderzfs �= 1 Congress Street,Suite 100 Boston,MA A 02I14-2017 .. 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/Indiviiddual): C J(, A(_- egg' AV t s/l/ Address: ,. (:)- Yj (-p. / At-6 6 LI City/State/Zip: C 0 - , 02 1 I Li--Phone #: C37 Are you an employer?Check the appropriate box: I. 1 am a employer with Type of proje (required): ❑ employees(full and/or part-time).* 72.0 ram a sole proprietor or partnership and have no employees working8. construction any capacity. for mei0 8. Remodeling [No workers'comp,insurance required.] • 3.0 I am a homeowner doing all work myself.(No workers'comp.insurance required.]t 9. 0 Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑ Building addition ensure that all contractors either have workers'compensation insurance or are sole 1 1•❑ Electrical repairs or additions proprietors with no employees. 5. 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.' 13. Roof repairs 6. We 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 till 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: q2:-:<---' C P i 1 k.-Tk. \ A.(.__-- Policy r or Self-ins.Lic.#: Expiration Date: Job Site Address: Lk. 'r 4)CQ.5 olio de Clty/State/Zip; E%,. � �'^� L___ Attach a copy of the workers' compensation policy claratton page(showing the policy number and ex i Failure to secure coverage as required - p�tton date). q under MGL c. 1 52,§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 e, `ice of Investigations of the DIA for insurance _coverage verification. I do hereby certify under the pains :penalties . . tat t i Ion provided above is true and correct Signature: Date: Phone T: I 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 CIerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-223!1 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 Work Address Is to be disposed of oat the followinglocation: c p Said disposal site shall be a licensed so .4 aste facility as defined by M.G.L. Ch. 111, §150A. S' ture of Application Date Permit No. ---°:r4fH' /W-Perfti (rcifitte. & " eptitigtrion HOME IMPROVEMENT CONTRACTOR TYPE: Individual Registration Expiration 18057 10/19/2023 WILLIAM A, HEARN „ 4, • A b' • •;:•" • WILLIAM H EPA r141 V,. \-2 - • 193 HUNNEWELL, STRT/ 4:7,7 •i zr„ NEED -JAM, MA 02494Undersecretary 5. Security National Insurance Company A Stock Insurance Company WORKERS COMPENSATION WC 99 00 01 B AND EMPLOYERS LIABILITY 1 of 5 INSURANCE POLICY INFORMATION PAGE Ncci Code:40533 1. Insured: Policy Number: SWC1411380 Curragh Dobbin,Inc PO Box 146644 Attn:Bill Hearn _Individual Partnership Boston,MA 02108 X Corporation or Other workplaces not shown above: See Extension of Information Page Federal Tax ID: 471981940 Producer: Risk Id: HUB International New England LLC Renewal of: SWC1360658 300 Ballardvale St. Wilmington,MA 01887 2. The policy period is from 11/6/2022 to 11/6/2023 12:01 a.m.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:Massachusetts B. Employers Liability Insurance:Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: State Bodily Injury by Accident Bodily Injury by Disease Bodily Injury by Disease $1,000,000 each accident $1,000,000 policy limit $1,000,000 each employee C. Other States Insurance:Part Three of the policy applies to the states,if any,listed here: All states except ND,OH,WA,WY and State(s)Designated in Item 3A. D. This policy includes these endorsements and schedules:See Extension of Information Page 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. See Extension of Information Page TOTAL ESTIMATED ANNUAL PREMIUM 695 STATE ASSESSMENT 18 TOTAL ESTIMATED COST 713 Minimum Premium 361 Deposit Premium 296 Issue Date:9/30/2022 Countersigned by: Authorized Representative 4/3/23,2:31 PM Mail-Sears,Tim-Outlook 103 River Sears, Tim <tsears@yarmouth.ma.us> Mon 4/3/2023 2:31 PM To:bill@curraghdobbin.com <bill@curraghdobbin.com> Bill, The new Stretch Energy Code went into effect on Jan 1st. Existing buildings are now a part of the new code. It appears that the scope of work falls under the new requirements. A HERS Certificate will be needed 225 CMR 22: Massachusetts Residential Stretch Energy Code R503.1.5 Level 3 Alterations or Change of Use.Alterations that meet the IEBC definition for Level 3 Alteration or the IRC definition for Extensive Alteration, exceeding 1,000 sq ft or exceeding 100%of the existing conditioned floor area, shall require the dwelling unit to comply with the maximum HERS ratings for alterations, additions or change of use shown in Table R406.5 IRC 2015 Appendix J AJ501.3 Extensive alterations. Where the total area of all of the work areas included in the alteration exceeds 50 percent of the area of the dwelling unit, the work shall be considered to be a reconstruction and shall comply with the requirements of these provisions for reconstruction work. 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 fora 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 https://outlook.office.com/mail/sentitems/id/AAQkADE3MDQ5NWZmLTkOYzItNDIwNi1 iMDQxLWNkMGQyNmE4NzE5NAAQABoEOdtAKbFKsu9k0,2... 1/1 RECEIVED LAW OFFICES OF PAUL R. TARDIF, ESQ., P.C. MAR 29 2023 490 MAIN STREET BUILDING DEPARTMENT YARMOUTH PORT,MA 02675 ay. --- (508)362-7799 (508)362-7199 fax Paul R Tardif,Esq. Stacey A. Curley,Esq. ptardif(jtardiflaw.com www.tardiflaw.com scurley@tardiflaw.com REFER TO FILE NO. March 24,2023 Dolores Fallon Yarmouth Zoning Board of Appeals 1146 Route 28 South Yarmouth, MA 02664 RE: Zoning Appeal— 103 River Street, South Yarmouth William A. Hearn, Trustee of the River Street Nominee Trust - Petition 4992 Dear Ms. Fallon: Enclosed please find a copy of the Board of Appeals Decision, which was registered, for the above referenced matter on March 24, 2023 in the Land Court Division of the Barnstable County Registry of Deeds as Document 1478156. Please note that the Declaration of Covenants for a Family Related Accessory Apartment and the Affidavit have also been recorded in Document 1478157. A copy of the recorded Decision has been forwarded to the Building Gip).artment for their records. I thank you for your assistance in this matter. T ly Yours, aul R. dif cc: William A. Hearn Mark Grylls Doc: 1 , 478 , 156 03-24-2023 10 : 10 -- 7, . ;P�' TOWN OF YARMOUTH 4 y J z_ BOARD OF APPEALS ji i DECISION FILED WITH TOWN CLERK: March 2,2023 PETITION NO: 4992 HEARING DATE: January 26, 2023 PETITIONER: William A. Hearn,Trustee of the River Street Nominee Trust PROPERTY: 103 River Street, South Yarmouth, MA Map 43,Parcel 5 Zoning District: RS-40 Title: Document 1,465,001 on Certificate of Title No. 230745 (Lots 2 and 7 on Land Court Plan 15857) MEMBERS PRESENT AND VOTING: Chairman Sean Igoe, Dick Neitz, Jay Fraprie and Tim Kelley Notice of the hearing has been given by sending notice thereof to the Petitioner and all those owners of property as required by law, and to the public by posting notice of the hearing and publishing in The Cape Cod Times, the hearing opened and held on the date stated above. The Applicant seeks a Special Permit per §407.2 and/or per §202.5 A-1 and A-10 to create a family-related accessory apartment and a Special Permit per §104.3.2(2) to encroach in side setback on a pre-existing, nonconforming structure. The Property is located in the RS40 Zoning District and is improved with a two-story single- family structure having 4 bedrooms and 2 baths, and constructed in approximately 1785, on a lot containing 14,461 square feet of area. The Applicant also owns a lot across River Street, along the Bass River, which is currently undeveloped, consisting of 8,404 square feet, and which is not the subject of any relief sought tonight. The lot is technically a corner lot, and as such, has 2 front yard setbacks and 2 side yard setbacks. The existing structure encroaches slightly into both front yard setbacks, and into one side setback by 14 feet. Lot coverage is 17.9%. The house is historic and is listed on the National Register of Historic Places. The Applicant has been to the Yarmouth Historical Commission for permission to demolish sections of the house, leaving the most historic front section on River Street. At their meeting in September of 2022, the Commission unanimously approved that request. The proposal was also presented to the Conservation Commission in December of 2022, which issued an Order of Conditions for the work. A TRUE COPY ATTEST: .1 -714/t1.1 "114 (I l: i�; Ivi`.iMAR L 3 vl IC.` IrNG202Li=i3.K Doc : 1 , 478 , 156 03-24-2023 10 : 10 Page 2 of 3 The Petitioner proposes to demolish the existing structure, other than the historic front section referenced above, and to construct a 2 story, 3-bedroom single family dwelling, along with a one bedroom family related accessory apartment, located in the rear portion of the first and second floor. The structure will comply with all existing setback and other bulk requirements, with the exception of a landing and 2 stairs leading from the intended accessory apartment. That landing will encroach by 1.9 feet into that side setback on the north side of the property. This is the only relief that the applicant is seeking regarding the new structure, and it is hardly detrimental to the neighborhood, nor will it be an undue nuisance, or cause hazard or congestion. The Board then considered the request for a Special Permit to allow the creation of the family- related accessory apartment. Petitioner submitted an architect stamped square footage calculation showing that the apartment would contain 791 square feet, a calculation which was confirmed by the Yarmouth Building Commissioner. Petitioner also demonstrated that he complied with the other requirements for relief, as outlined in Zoning Bylaw Section 407.2. The Board agreed that the requirements of Section 407.2 of the Bylaw have been met, and that the issuance of the Special Permit for the creation of a family related accessory apartment will not result in undue nuisance, hazard or congestion and that there will be no substantial harm to the established or future character of the neighborhood or town. Accordingly, a motion was made by Mr. Fraprie, seconded by Mr. Neitz, to grant the request for the Special Permit, as requested, without conditions. The members voted unanimously in favor of the motion. No permit shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals from this decision shall be made pursuant to MGL c40A section 17 and must he filed within 20 days after filing of this notice/decision with the Town Clerk. Unless otherwise provided herein, the Special Permit shall lapse if a substantial use thereof has not begun within 24 months. (See bylaw §103.2.5, MGL c40A §9) Sean Igoe, Chairman CERTIFICATION OF TOWN CLERK I, Mary A. Maslowski, Town Clerk, Town of Yarmouth, do hereby certify that 20 days have elapsed since the filing with me of the above Board of Appeals Decision #4992 that no notice of appeal of said decision has been filed with me, or, if such appeal has been filed it has been dismissed or denied. All appeals have been exhausted. kkoe Aitda,v4tL,t, Mary A. Maslowski A TRUE COPY .ATTEST. MAR Z 3 2023 . I 1 3 2021 Doc : 1 , 478 , 156 03-24-2023 10 : 10 Page 3 of 3 vim, COMMONWEALTH OF MASSACHUSETTS ' TOWN OF YARMOUTH 1^ $ . "" BOARD OF APPEALS Petition #: 4992 Date: March 23, 2023 Certificate of Granting of a Special Permit (General Laws Chapter 40A, Section 11) The Board of Appeals of the Town of Yarmouth Massachusetts hereby certifies that a Special Permit has been granted to: William A. Hearn, Trustee of the River Street Nominee Trust Affecting the rights of the owner with respect to land or buildings at: 103 River Street, South Yarmouth, MA; Map 43, Parcel 5; Zoning District: RS-40; Title: Document 1,465,001 on Certificate of Title No.230745 (Lots 2 and 7 on Land Court Plan 15857) and the said Board of Appeals further certifies that the decision attached hereto is a true and correct copy of its decision granting said Special Permit, and copies of said decision, and of all plans referred to in the decision, have been filed. The Board of Appeals also calls to the attention of the owner or applicant that General Laws, Chapter 40A, Section 11 (last paragraph) and Section 13, provides that no Special Permit, or any extension, modification or renewal thereof, shall take effect until a copy of the decision bearing the certification of the Town Clerk that twenty (20) days have elapsed after the decision has been filed in the office of the Town Clerk and no appeal has been filed or that, if such appeal has been filed, that it has been dismissed or denied, is recorded in the Registry of Deeds for the county and district in which the land is located and indexed in the grantor index under the name of the owner of record or is recorded and noted on the owner's certificate of title. The fee for such recording or registering shall be paid by the owner or applicant. Sean Igoe, Chair A�rTRUE // CO PY�JATT�ATTEST: (. ��77 i s t``1' ' l l:I:C,ITr`'1v'v N CLERK MAR 2 3 2023 • JOHN F. MEADE, ASSISTANT RECORDER BARNSTABLE REGISTRY LAND COURT DISTRIC Dcrcrin,n a ocnnoncn cr_crmontir rnr.ry Doc: 1 , 478 , 157 03-24-2023 10 : 56 ;. C. .j DECLARATION OF COVENANTS • , FAMILY RELATED ACCESSORY APARTMENT cf ,S.• r '-x L�r� William A. Hearn, Trustee of the u` Whereas;^River Street Nominee Trust is the owner of the property at, 1 03 River St. , South Yarmouth , more particularly described in a r deed dated and recorded with the Barnstable County Registry of Deeds in Ctf. 2 30745 �� ''' Book: Page: which real estate is shown on Yarmouth Assessor's .. Map#.4 3 Parcel: 9 ; I �, William A. Hearn, Trustee of the Whereas ver St_ Nominee- Trust has been granted a Special Permit to create 1- ;-- L. a Family Related Accessory Apartment in Appeal# 4 9 9 2 Dated ii',:,rdi y:, ; •3 . 2 C Whereas,said Special Permit and Section 407 of Town of Yarmouth Zoning Bylaw require that the accessory apartment be limited to the term of ownership and occupancy. of the premises by the.Petitioner; it Ili am A. Hearn, Trustee of the Now therefore Rimer St. Nominee Trustigrees that on sale of premises or transfer 5. of beneficial interest, or when;he/she no longer occupies the premises,as his/her principal r ,r, residence,whichever comes first, that the rights granted to him/her in Appeal #4 992 .. u (soDated: lla f .1 V ;DIshall lapse and the Special Permit shall.be void. No accessory •-) r- u. r apartment shall be held in separate ownership from the principal structure/dwelling unit. � Signed under the pains and penalties of pepjmy,this - day of l- ONE t y 20�- ; , ;�; ; -14- (\.{ - 'I ! ,c: - -...�",; ^'''-e's�'. _ —- -- A.SigriattFfe)Y L. COMMONWEALTH OF MASSACHUSETTS v Barnstable, County,ss. NiOn this , day of •te '� ,,ii ,20 ' ,before me,the undersigned notary public,personally appeared t-f; I TTA WI 4 �?..A`u, ri. (Owner) proved to me through satisfactory evidence of identification, which was [a current 'l' driver's license] [a current U.S.passport] [my per.Fnal knowledge],to be the person whose name is signed on the preceding instrument nd ac knoweedgcd to me that he/she signed it voluntarily for its stated purpose. f % / \ j WITNESS my hand and official seal. ' '. / . j dAirAl jf i/.1//1,/,/,/y )/ 'LAV' //M " Ja11bi, , Notary Public ,/ ; 44�..o�S,�o 2o��s s My commission expires: , ,_ , I- ,: 0 %�'��,� '*9M;zALTH OF�1/4;; ''',,,,n u I i,,,,, ` Doc: 1 , 478 , 157 03-24-2023 10 : 56 Page 2 of 2 r: ci.: .`) ' ; 1 t7 is r• TOWN OF YARMOUTH ' La _ __ FAMILY RELATED APARTMENT AFFIDAVIT . .i ! , `. J 1--- AFFIDAVITOF;William A. Hearn, Trustee of the River Street Nominee Trust (Name of Petitioner) J ��� —` ..-1 I/We hereby certify that I/we are the owners in principal residence,and will occupy the main portion of the residence,at 103 River Street, South Yarmouth (Address) `� =� I/WE further certify that the FAMILY RELATED ACCESSORY APARTMENT at said address will be v , occupied by Ciara Hearn `' r- (Name) . T as his/her principal residence who is my/our Daughter (Relationship to petitioners) r (� Signed under the pains and penalties of perjury,this 3rd day of February 20 23 :3 4 Owner/O*iers of property `: y (i) 'If C..) kfl COMMONWEALTH OF MASSACHUSETTS Barnstable,ss.fC .•` , '` On this the 3 day of 1jc' 3 before me, +%tN; 1 t '! Month 1 Year i Name of Notary:Public / --rr The undersigned Notary.Public,personally appeared_ ;N t WI 'J i i ('' '• )l . Name of Signer(s) Proved to me through satisfactory evidence of identity,which was/were f"'%T' /L .c.— "M , to be the person(s) whose name(s) was/were signed on the preceding or attached document in my presthice7 and wlio soGbr`,k o7s affirmed to me that the contents of this document is truthful and accurate to the best of his!her/their know pie t4ig: .,,ow11ullullllrr J`/1' 1.1 / ,.•k 1. 7'4Rrr'4 Silgnature of Votary Public `•QP �pM15SlO/y��%j f t', 1 'l i; n s Printed Name of Notary r 6 _ I I- ''' -1�' Place Notary Seal" ndx�,St. i •ve '. My Commission Expires [ ; t . 5PG%., :•,Hof MA5C�� H;\My FileslDocumentst'Acpotio,.. fiidavitFam ilyRelated.doc(1/2015) luisJOHN F. MEADE, ASSISTANT RECORDER BARNSTABLE REGISTRY LAND COURT DISTRIC ocrwTiln.n [ ocrnoncn cT crmon11Tr11T Tv Home Energy Rating Certificate Rating Date: Projected Report Registry ID: Based on Plans Ekotrope ID:LZg6885d HERS® Index Score: Annual Savings Home: Your home's HERS score is a relative 841 103 River St 5 performance Tower Yarmouth,MA 02664 theperfor morea energyscore.The efficient the home.thenumb Toer, Builder: learn more,visit www.hersindex.com *Relative to an average U.S.home Currag Dobbin Inc Your Home's Estimated Energy Use: This home meets or exceeds the Use tnitetul Annual Cost criteria of the following: Heating 68.3 $1,191 2021 International Energy Conservation Code Cooling 0.8 $47 2018 International Energy Conservation Code Hot Water 10.0 $166 2015 International Energy Conservation Code Lights/Appliances 27.7 $1,573 2012 International Energy Conservation Code Service Charges $0 2009 International Energy Conservation Code Generation(e.g.Solar) 0.0 $0 2006 International Energy Conservation Code Total: 106.7 $2,977 HERS Index Home Feature Summary: Rating Completed by: w-,-... Home Type: Single family detached Energy Rater.Andrew Popielarski sii Model: N/A F.x„0„.0 uu Community: N/A RESNETID;5363711 Room *'o Conditioned Floor Area: 4,306 ft' Rating Company:Home Energy Raters `a Number of Bedrooms: 3 180 State Rd;Suite 2U Sagamore Beach MA 02562 Raw.. sra Primary Heating System: Furnace•Natural Gas•95 AFUE. 508-833-3100 Hump 100 Primary Cooling System: Air Conditioner•Electric•16 SEER Rating Provider:Energy Raters of Massachusetts 8° Primary Water Heating: Residential Water Heater•Natural Gas•0,94 Energy 2 Woodlawn Street Amesbury,MA 01913 FactorIM 978-270.3911 ,.M,..,, in€a House Tightness: 3 ACH50 ,: ��" y Ventilation: 100 CFM•37 Watts•ERV } '° TM"... Duct Leakage to Outside: 10 CFM W 25Pa(0,23/100 ft') 3° Above Grade Walls: R-21 ''h. ;,.a.. ra Ceiling: Vaulted Roof,R 49 sa zero rnargy p Window Type: U•Value:0.3,SHGC:0.3 .........-_ ............. ......__ .............__........ Andrew Popielarski,Certified Energy Rater u0. ' • muwrs Foundation Walls: NIA Date:4/12/23 at 7:33 AM Framed Floor: R-30 illbktatrcr Ekotrope RATER-Versron'3243138 The Energy Rating pisclosurefor this home is available from the Approved Rating Provider This report d ,t constitute any warranty or guarantee. Building Specification Summary Property Organization Inspection Status 103 River St Home Energy Raters Results are projected Yarmouth,MA 02664 Andrew Popielarski 508-833-3100 River St 103-L2g6B85d River St 103 Pre Builder Currag Dobbin Inc Building Information Rating Conditioned Area iftl 4,306.00 HERS Index 52 Conditioned Volume vel 41,380.00 HERS Index w/o PV 52 Thermal Boundary Area[ftl 10,329.60 Number Of Bedrooms 3 Housing Type Single family detached Building Shell Ceiling w/Attic I None Windows(largest)I U-Value:0.3,SHGC:0.3 Vaulted Ceiling I R49,HDF,7.5",8x16,G1,0,U-0.029 Window/Wall Ratio I 0.16 Above Grade Walls I R21,FG,6x16,G1;U-0.057 Infiltration I 3 ACH50 Found.Walls I None Duct Lkg to Outside110 CFM @ 25Pa(0.23/100 fta) Framed Floors I R30,FG,10x16,G1;R-30 Total Duct Leakage I 140 CFM©25Pa(Post-Construction) Slabs[None Mechanical Systems Heating Furnace Natural Gas•95 AFUE Cooling Air Conditioner•Electric•16 SEER Water Heating Residential Water Heater•Natural Gas•0.94 Energy Factor Programmable Thermostat Yes Ventilation System 100 CFM•37 Watts•ERV Whole House Fan N/A Lights and Appliances Percent Interior LED 100% Clothes Dryer Fuel Electric Percent Exterior LED 100% Clothes Dryer CEF 3.4 Refrigerator(kWh/yr) 691.0 Clothes Washer LER(kWhlyr) 284.0 Dishwasher Efficiency 270 kWh Clothes Washer Capacity 4,2 Ceiling Fan None Range/Oven Fuel Natural Gas Ekotrope RATER-Version 3.2.4.3138 All results are based on data entered by Ekotrope users Ekotrope dweratins all habritty for the tnforrnatron shown on this report :.� T • N F YA R M U H 0�, `i '4., 1146 ROUTE 28 SOUTH YARMOUTFI MASSACHUSI ClS 02664-4451 ►7ATTA N s °*Mwa�.► bra,'' Telephone(508) 398.2231,Ext.1250—Fax(508)760-4830 Engineering and Surveying Division Building Permit Review Residential and/or Commercial Buildings 1-011)1 A-% Name of Applicant: /t 41g4 5ej'4 i ,. Aht blaV •---1-4✓ Telephone or Email Address: ?1.7 3ci G 4 R , Cu R 4R-6-14 pa)qf3 i Proposed Building Location: ) 03, R t /eG,-' Qi lr {041 Date Submitted: 2 i p i . Requirements for review: Please submit one(1)copy of plans,to include: 1. For Residential: Site Plan showing proposed and or existing buildings, proposed contours with bench mark,water service location,and septic system location. For Commercial: Site Plan showing details required by the Zoning By-law and revisions required by Site Plan review, if any, Note: Site plans must be signed and stamped by a Licensed Professional Land Surveyor and Engineer or Sanitarian. 2. House or Building-Floor Plan(s) and Elevation Plan(s) 3, One(1)copy of application. Amanda wr. - m.mw.o=Enym.mna prl.on,ou=Y.rmoNDTY. Lima 4/7/2023 Reviewed By: __...... Date: .. .... PLEASE NOTE Comments/Conditions: Retain stormwater on site during and post construction. PrNad on AecyJad Pape; c all-ccd .4 0 i --M, MA►. 123[-11 TOWN OF YARMOUTH Og=-'9R• ...J 'c%;. o WATER DEPARTMENT By �? ; . .5„, , e' � • 99 Buck Island Road vi.„.411West Yarmouth, MA 02673 Telephone: (508) 771-7921 • Fax: (508) 771-7998 BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: /17 r( t tAl q4 • I PROPOSED WORK: +7 I+ Idl ive Q t I ,e Cr" I,,, 2 ofne E„.)A L APPLICANT: GOti /tlt-�y / A4 A.) '0t)v 6-- ADDRESS: f . 0 A c',-� I bb A c 51-c J •'44• 1tL - TELPHONE: '^ 1 .37, 7 2bi-t-ri RESIDENTIAL AND /OR COMMERCIAL BUILDING Water Department: Determines Compliance of Water Availability and or existing location Engineering Department: Determines Compliance for Parking and Drainage Conservation Commission: Determines Compliance to Wetlands Act; i.e. If lot(s)border any type of wetlands, streams, ponds,rivers, ocean, bogs, boys, marshland, ETC... Health Department: Determines Compliance to State and Town Regulations, i.e. requirements for Septage Disposal and other Public Health Activites Fire Department: Determines Compliance to State and Town Requirements for Personal Safety, Property Prot ions, i.e. Smoke Detectors, Sprinkler Systems,et AiPP'1PLICANT SIGNATURE DATE OFFICE USE: COMMENTS ON PERMIT APPROVAL OR DENIAL 1) Ot-if S Coke eAd t.r itA.y, 1i►' -cie._ (z414 z. ► Arta tEcwi own U70. 0 i e Peirfe tr rvt.e ed 41 2.._112-2— W 0 a.i-t- h -cl -C-0r Ire card - r1.4_,e .. 5l ��� REVIE ED BY WATER DIVISION(SIGNATURE) ATE Mk 1.:, O Conservation Office y Town of Yarmouth bdirienzo(a�yarmouth.ma.us °ufit ,,, y Conservation Commission Building Permit Sign-off Application TO BE FILLED OUT BY BUILDING PERMIT APPLICANT: Building Site Location: Map# Lot(s)# Property Owner: g +kic` ,?-k�i A)04 11 q i : -��'zv 5D "PIe fled g 1___. *Applicant: t ILA r-A 1-1' AA Applicant Address: P- 0 & K-7r i & I s-i 'V r i ( U ",z 1 / - Email: C2,1') 2 CV R446-H'- i2 C44# Ai, t' Telephone: b IV17 7 2 6 Please note:by submitting this application,the applicant grants permission to the Conservation Office to enter the ocation to conduct a site visit(if need Proposed Project Description: ---GC - 62 it? 1 IL.6) r t AL C-0-5-5- 6 0-4L.- i L)n----1--- ,--7 --6.---41 Site Plan Title/Date: g �� f?I_At) (6,, „-----.),act,...--, i � �J%> i CJ'Z , gc i-�...-d TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR: Does the proposed project require a permit? '(es Refer to: SE83- 73(-Q 4 or DOA permit Comments from Conservation Commission: Approved onditionally Approved) Rejected Conservation Commission Sign-off Signature: ? ] . Date: 3/z 'J Zp Z3 *TO APPLICANT: All work-related debris shall be taken offsite or disposed in a legal upland location. At the end of each day, the area shall be clean and no debris shall be in the Resource Area. If work is permitted under an Order of Conditions, please arrange a pre-construction site visit with the Conservation Administrator. At the time of site visit, the MassDEP File Number sign must be installed, along with the erosion control/work-limit line. A copy of the Order of Conditions must remain on-site during construction. Please refer to the Order of Conditions for further details. of YAR TOWN OF YARMOUTH 1 HEALTH DEPARTMENT o PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: l Q Building Site Location: i Proposed I provem nt: t /�c"�''1' -e 1, / q1 I h ,y_..I j Pa o 1 Ace-e4tr-P A 1,9 t Li--(A^'1 Applicant: A x ✓GK. c'''�4 /'i9M%,N% '1/ J el. No.: b ?'7 26LV7 Address: (). Q ,j 2,,k / t zi t-1-14- go r s o / / t-I— Date Filed: **Ifyou would like e-mail notification of sign off please provide e-mail address: x 1 1 e C O M A-C-44 Qc003/A).-fat Owner Name: , 91 i c GT N .11 h' .e12 -1-7 i Owner Address: q 3 /4✓4oet..at',/ j lv �C� Owner Tel. No.: b 17 3 c7 ;?z riot C4 L- Crif 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: GL� �dC-D (1.) Site Plan showing existing buildings, water line location, and septic system location; MAR 2 9 2023 (2.) Floor plan labeling ALL rooms within building HEALTH DEPT. (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: C�,a.tb , DATE: L/ /d2-- 49,3 PLEASE NOTE COMMENTS/CONDITIONS: