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I *` -. .% WO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department """y i L- 1146 Route 28,South Yarmouth,MA 02664-4492 JUL 01 2022 50$-398-2231 ext. 1261 Fax SQ$-39$-Q$36 �.� ,e , J Massachusetts State Building Code,780 CMR Bui Di ter zit Application To Construct, Repair, Renovate Or Demolish By 1k " -- a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 54,/)...03—‘)20/2, Date Applied: j�;^li P.�I'5 "� Building Official(Print Name) ignature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 379 L.9e;r lel. lafo 39, 1_ 1.l a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: aacn Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 30 ' 30' IS— - ' 8Y 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private 0 Zone: _ Outside Flood Zone? Check if yes❑ Municipal 0 On site disposal system CI SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: SifAre,tt14o ( i Arrrzr Yanmo SMC&Pen - Jvt AA- oa-(07S- Name Print City,State,ZIP 379 t�t..4`r e . 7711-3S3-6 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WQRK2(check all that apply) New Construction Existing Building❑ Owner-Occupied 0 f Repairs(s) 0 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: gv;ld a (��(r�, A 2 �(aK r do wa , , SECTION 4:ESTIMATED CONSTRUCTION COSTS. • Item Estimated Costs: (Labor and Materials) Official Use Only I.Building $ /,7 1. BuildingPermit Fee:$ - S� Indicate how fee is determined: 2.Electrical $ /Dceo ii Standard City/Town Application Fee ' ❑Total Project Costs(Ite 6)x multiplier x 3.Plumbing $ ���`,,, 2. Other Fees: S C f*3 4.Mechanical (HVAC) $ S—et2 List 53 �� 5.MechanicaI (Fire Suppression) $ 1/4 Total All Fees:$ • 6.Total Project Cost: $ z Check No. Check Amount: Cash Amount: V` /septr El Paid in Full ® V\ l Outstanding Balance Due: / SECTION 5: CONSTRUCTION SERVICES 5.1QC�onsttruction Supervisor License(CSL) 08 t0�0 4 �a D 0.�`(1(, ja,c,o\oS License Number E ira on Date Name of CSL Holder List CSL Type(see below) (� P.O. Qo x 3yY No.and Street Type Description /A rpm ?Oct � ��7S U Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP 1 R Restricted 1Jc2 Family Dwelling M Masonry RC I Roofing Covering • WS Window and Siding SF Solid Fuel Burning Appliances —3S3-690fD- ea-fSao06s78Pya.&a,. coves, I Insulation Telephone Email addfess D Demolition 5.2 Registered Home Improvement Contractor(HIC)co l� g s A'�Pock`_ . �a HIC Registration Number pir don Date HIC Company Name or HIC Registrant Name O. doe 7y4 No.and Set a� W�S 7�1" yGL�L 00. L Ow. o►il(it J Email addf s yarn+ 4a-fi yrI r c)-fobs" `77Y-Fs'7-0,Ss"; City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ❑ No .❑ 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 See. cke-aiC to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date • SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accura to the best of my knowledge and understanding. Print Owner's or Authorized Agent's Name(Electrons ignature) /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.aov/oca Information on the Construction Supervisor License can be found at www.mass.aov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) ( ? O s9. Yq. (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) 5/&7 sr. .; Habitable room count_ Number of fireplaces e./,i•,. Number of bedrooms Number of bathrooms `` / Number of half/baths Type of heating system /5 i44G Number of decks/porches w ,a- Type of cooling system hi/Ate Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts G Department of Industrial Accidents gIlxl 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia rr Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information PIease Print Legibly Name (Business/Organization/Individual): PQ,4-r Address: P.O, (' O K 3yg City/State/Zip: {-t 0,44 e 4 75-- Phone#: -2 7K- 35-7— Are you an employer?Check the appropriate box: Type of project(required): I.O 1 am a employer with employees(full and/or part-time).* 7., lew construction 8. Remodeling • I am a sole proprietor or partnership and have no employees working for me in `—' capacity.[No workers'comp,insurance required.] 3. I am a homeowner doingall work myself. o workers'comp.insurance t 9. ❑Demolition ❑ Y [No prequired.] I am a homeowner and will be contractors to conduct all work on my10 Building addition 4. ❑ hiring property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑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.• 13.0 Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption pertMIGL c. 14.❑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. *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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 S1,500.00 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. 1 do hereby certify under pai and ties of perjury that the information provided above is truetr and correct. Signature: a Date: .c/.�/ >Q�.-, 7 Phone#: 7y' .55-7— 6 eel / Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 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 3 79 (AecY , Work Address Is to be disposed of oat the following location: R na. Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Signature of pplication D e Permit No. From: Steve Karras steve@kaleidoscopeimprints.com B Subject: Signed Permission Date: April 11,2022 at 10:08 AM To: Pat Jacobs patjacobs78@yahoo.com Hi Pat, Let me know if this is what you need.Happy to make any changes necessary. Looking forward to working with you. I'd like to meet up to discuss one small change to the plan. Thanks for all your help so far. Steve Steven and Cheryl Karras Trs.,Karras Realty Trust 379 Weir Road Yarmouth Port,MA 02675 April 8,2022 To Whom It May Concern. We,Steven and Cheryl Karras,give Pat Jacobs permission to act on our behalf to build,contract, apply for permits and meet with any town officials necessary towards the construction and completion of our garage on our 379 weir Road property.Please consider him a trusted representative of our affairs regarding this project. Sincerely, Steven).Karras Cheryl Karras Division of Occupational Licensure Board of Building Re ulations and Standards IT' Cons ton fteervisor CS-081040 Eof-caires:04/04/2024 so. PATRICK H*Cs 28 WHITTIEMIRIV 1181 DENNIS MA 3638 470/".I.vd.',13 Commissioner dada K. VEkniitt,L , THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affshas,81 Business Regulation HOME IMPROVE 1, CONTRACTOR TY • - 16,4 ,5 PATRICK JACOBS „ AND REMODELING D/B/A P.JACOBS CLL. PATRICK JACOBS - 28 WHITTER DR. DENNIS,MA 02638 1, , Undersecretary • Sears, Tim From: Sears, Tim Sent: Thursday, July 14, 2022 10:32 AM To: 'patjacobs78@yahoo.com' Cc: Hudson, Heidi Subject: 379 Weir Rd Pat, I have reviewed your application for construction of a 3 car garage/barn and there are some items needed. /Conservation transmittal 2. Engineering for beams marking of more t an a oning oa 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@varmouth.ma.us 1 Generatedliance by REScheckCertificate-Web Software 0 Comp Project 379 Weir Road Energy Code: 2018 IECC Location: Yarmouth Port, Massachusetts Construction Type: Single-family Project Type: New Construction Conditioned Floor Area: 1,940 ft2 Glazing Area 5% Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 379 Weir Road Yarmouth Port, MA 02675 Compliance: Passes using UA trade-off Compliance: 5.1%Better Than Code Maximum UA: 98 Your UA: 93 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. 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 R-Value R-Value U-Factor U-Factor UA UA Perimeter Ceiling: Flat Ceiling or Scissor Truss 450 49.0 0.0 0.026 0.026 12 12 Ceiling 1: Cathedral Ceiling 70 38.0 0.0 0.027 0.026 2 2 Wall: Wood Frame, 16"o.c. 788 20.0 0.0 0.059 0.060 41 42 Door: Solid Door(under 50%glazing) 24 0.200 0.300 5 7 Door 1: Solid Door(under 50%glazing) 24 0.240 0.300 6 7 Window:Vinyl Frame 38 0.260 0.300 10 11 Floor:All-Wood Joist/Truss 530 30.0 0.0 0.033 0.033 17 17 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 2018 IECC requirements in REScheck Version : REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: 379 Weir Road Report date: 06/29/22 Data filename: Page 1 of 1 A c. I i rlii , ti 1 „--t i f 4' in so oboe r I : 1 ,''':, , - otrrst -�� tOO . L L'1 I - Ilk i a y` r I P 1 rrr frr ":`\•„`\�_ s' IS -- r t' 1 .*1 1 I J •. a r ff F A1� ",.\ 11 1 1 1 _ 1 1 , 1 1t il .,N : : L.- Owlik 'IN >" 1 1., \ I, I 14 ' Is. ' : ___ ill I I II r _ .,a , < 3e , E. g..4 r r E i ttt!!#j , j � i .,,. , „ � ilk 3 ‘ la \ 1 li 1 1• ,., „1.,„,,,,, s j r 4 r4 �y I I I r is t QIa j .. \ 9 i 1 a i 1 {` , x•. 1 TT N , i . i r r., i t ,,\.£}�'`X\. 1 J V 1 1 j may'\ \t 'I ` \\ \I \C r - r t ` I I II I I , k _; r10%1 ,' ?, vv ; ; ,,,,,,.� \ I t ' � t ` 1 t 1 • ` r X \ i'' % \ t \i it I 1 it 1 t I 1, I 4 t t 4 \ I I{ I1 \t 1 i ` r ,. r 1 /fN. C' \ li;CI\' ` I 1 it X ` t \. ( 4. ♦ �� \ \t \ t I .IV. - i X` X\�` 1`X XXX It 1 \ L ; r it \ I I t I t' X\ `\F•`\ \\\ \ \�` tip 4 I A y.. IIX\X XIX i( AVN'1 -1J1H S.ONI?1 QIC '� i `y\ Ij X\y X\ X\ 7r� 4 I I I I \ i % I ; ( .�t\\X\X\\\i�\X` \ `b ++ tZ t 3 oat s F , I\ ‘ ,s.�' Z?RZ ti Nli I . I, \, X ��` `- __\ a \ X \ r a 3A0liddV I I ..,,, \ '' tl : 1 : 1\'% \ 1 : 11 t`� �N 0 -( runs.c 0CRD , .81%,..Giq oi v WZ5 (I) b > Z 'p .0 m i i'1 fTlrll4if .7) 4 m 2 fll - > a3Ala 3 I ,,,A 8, ... sio, PI 9 a f '� . Conservation Office Town of Yarmouth kgrant anvarmouth.ma.us E4 MATT, E, .AT Conservation Commission .�; Building Permit Sign-off Application TO BE FILLED OUT BY BUILDING PERMIT APPLICANT: Building Site Location: 79 t4elr KII( . a rivto la ref- Map# Lot(s)# Property Owner: S4eVto- M(5 Date filed: 7 c [-c ,. -- *Applicant: Pct,-(--r\IL JQ CdDS Applicant Address: pc, !B 0)( 3`I ( - YZn''l OM P Email: P��Ua cOlo,S -76 C yaC Co_ co,-, Telephone: —7 711 -3.5"3 --(2 S Please Note:By submitting this application the applicant grants permission to the Conservation Office to enter the location to conduct a site visit(if needed). Proposed Project Description: B tJ,1(c9, a 3 ea- 4-04 k 4 9a.6-1L - Site Plan Title/Date: ;1'I v1(t >^ .4 (vvp-C k t 0 Z OZ a Usd i 01.4) 4 ZOZ Z TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR: Does the proposed project require a permit? `I e S Refer to: SE83- o DOA ermit Comments from Conservation Commissio Approved I Conditionally Approved Rejected Conservation Commission Sign-off Signature: 1� Date: 10 01 Z 2 *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. Pat Jacobs Dennis, MA BeamChek v2021 licensed to:Don Knox/Scituate Lumber Reg#3145-69111 Date: 8/02/22 Selection W 24x 62 50 ksi Wide Flange Steel Lateral Support: Lc=5.8 ft max. Conditions Actual Size is 7 x 23-3/4 in. Min Bearing Length R1= 1.4 in. R2= 1.4 in. (1.0)DL Defl= 0.23 in Recom Camber=0.34 in Data Beam Span 30.0 ft Reaction 1 LL 13575# Reaction 2 LL 13575# Beam Wt per ft 62.0# Reaction 1 TL 21930# Reaction 2 TL 21930# Bm Wt Included 1860# Maximum V 21930# Max Moment 164475'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/608 LL Max Defl L/360 LL Actual Defl L/983 Attributes Section(in') Shear(in2) TL Defl(in) LL Defl Actual 131.00 10.21 0.59 0.37 Critical 59.81 1.10 1.50 1.00 Status OK OK OK OK Ratio 46% 11% 39% 37% Fb(psi) Fv(psi) E(psi x mil) Values Ref.Value Fy 50000 50000 29.0 Adjusted Values 33000 20000 29.0 Adjustments YP Factor, Lc 0.66 0.40 Loads Uniform LL: 905 Uniform TL: 1400 =A Uniform Load A R1 =21930 R2=21930 SPAN=30 FT Uniform and partial uniform loads are lbs per lineal ft. 5 4 Massachusetts Department of Environmental Protection `1-,---- Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 A. General Information Important: When filling out From: forms on the Yarmouth computer,use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Steven&Cheryl Karras return key. Name Name I©I 379 Weir Road Mailing Address Mailing Address fa.XYarmouthport MA 02675 City/Town State Zip Code City/Town State Zip Code , 1. Title and Date(or Revised Date if applicable)of Final Plans and Other Documents: Site Plan of Land,379 Weir Road,Yarmouthport, MA 4/12/2022 Title Date Title Date Title Date 2. Date Request Filed: 3/23/2022 B. Determination Pursuant to the authority of M.G.L. c. 131, §40,the Conservation Commission considered your Request for Determination of Applicability,with its supporting documentation, and made the following Determination. Project Description (if applicable): Construction of a barn and extension of a driveway within the buffer zone to vegetated wetlands Project Location: 379 Weir Road Yarmouthport Street Address City/Town 126 41.1 Assessors Map/Plat Number Parcel/Lot Number wpatorm2 doc•Detem*,atian of Applicability•rev.5/1W2020 Page 1 of 5 4 111Massachusetts Department of Environmental Protection , Bureau of Resource Protection -Wetlands WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 B. Determination (cont.) The following Determination(s)is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)or Order of Resource Area Delineation(issued following submittal of Simplified Review ANRAD)has been received from the issuing authority(i.e.,Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s)is an area subject to protection under the Act. Removing,filling,dredging,or altering of the area requires the filing of a Notice of Intent. ❑ 2a.The boundary delineations of the following resource areas described on the referenced plan(s)are confirmed as accurate.Therefore,the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. ❑ 2b. The boundaries of resource areas listed below are confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3.The work described on referenced plan(s)and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4.The work described on referenced plan(s)and document(s)is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone). ❑ 5.The area and/or work described on referenced plan(s)and document(s)is subject to review and approval by: Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation wpaform2.doc•Determination of Applocabaty•rev.5/18/2020 Page 2 of 5 4 1MMassachusetts Department of Environmental Protection ),,--- Bureau of Resource Protection -Wetlands t WPA Form 2 — Determination of Applicability ` assachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 B. Determination (cont.) O 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s),which includes all or part of the work described in the Request,the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c.for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located,the subdivided parcels,any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability,work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department. Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove,fill, dredge,or alter that area. Therefore, said work does not require the filing of a Notice of Intent. ® 3.The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions(if any). No Bearing of vegetation beyond the work line limit. ❑ 4.The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone).Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpa/orm2.dx•Dotertninat on of ApphcawNt„•rev.5/18/2020 Page 3 of 5 4 Massachusetts Department of Environmental Protection L - Bureau of Resource Protection -Wetlands �� WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 B. Determination (cont.) ❑ 5.The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Yarmouth-Per 3. above Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Wetland Protection Bylaw Ch 143 Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on ® by certified mail, return receipt requested on 4/13/2022 Date Date This Determination is valid for three years from the date of issuance(except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state,or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office(see https://www.mass.Qov/service-details/massdep-regional-offices- by-community)and the property owner(if different from the applicant). wpaform2 doc•Determination of Applicabfity•rev 5/18/2020 Page 4 of 5 4 Massachusetts Department of Environmental Protection L-- Bureau of Resource Protection -Wetlands ` WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By-Law, Chapter 143 C. Authorization (cont.) Sign., r-s: , ..d.ilii11.�..01, G Y2t?r L a ctf /-t'/)<'2 `,natu. Printed Name • r. I A ALA I Ardi411 RR'ck 6/3hO S'1 Printed Name J� .i/, '' , / L. .i ,c ?1l`1EIS E/ ''� ' re Printed Name�7 �� Y S nc - --, /` a-, inT/Tv°r,'1 C 7 Printed Name c Past t ( f&; i rLs Signature Printed Name /✓ Signature Printed Name Signature Printed Name Signature Printed Name D. Appeals The applicant, owner,any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located,are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office(see https://www.mass.gov/service-details/massdep-regional-offices-bv- community)to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form)as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. wPdam2.doc•Determination of Applicability.rev 5/18l2020 Page 5 of 5 • Massachusetts Department of Environmental Protection Bureau of Resource Protection DEP File Number: Request for Departmental- Wetlands Action Fee Transmittal Form Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information 1. Location of Project a.Street Address b.City/Town,Zip c.Check number d.Fee amount Important: 2. Person or makingrequest(if appropriate, name the citizen group's representative): When filling q 9 P out forms on the computer, Name use only the tab key to Mailing Address move your cursor-do City/Town State Zip Code not use the return key. Phone Number Fax Number(if applicable) 0111 3. Applicant(as shown on Determination of Applicability(Form 2), Order of Resource Area Delineation (Form 4B), Order of Conditions(Form 5), Restoration Order of Conditions(Form 5A), or Notice of Non-Significance(Form 6)): i me Ar,‘ Name Mailing Address City/Town State Zip Code Phone Number Fax Number(if applicable) 4. DEP File Number: B. Instructions 1. When the Departmental action request is for(check one): ❑ Superseding Order of Conditions—Fee: $120.00(single family house projects)or$245(all other projects) ❑ Superseding Determination of Applicability—Fee:$120 ❑ Superseding Order of Resource Area Delineation—Fee:$120 Send this form and check or money order,payable to the Commonwealth of Massachusetts, to: Department of Environmental Protection Box 4062 Boston, MA 02211 wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev 5/18/2020 Page 1 of 2 Massachusetts Department of Environmental Protection ?� Bureau DEP File Number Requestof forResource DepartmenProtectiontal-Wetlands Action Fee Transmittal Form Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed. To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office(see https://www.mass.gov/service-details/massdep-regional-offices-bv-community). 4. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. wpaform2 doc•Request for Departmental Action Fee Transmittal Form•rev 5/18/2020 Page 2 of 2 ... • RECEIVED 041, ..,,, :...,; '* TOWN OF YARMOUTH — , - 1146 ROUTE 28. SOUTH YARMOUTH,MA 02664-4451 APPROVED MAY 2 4 2022 - Telephone(508)398-2231 Ext. 1292-Fax(508)398-0836 YAHiviODILD KING'S HIGHWAY HISTORIC DISTRICT CO MItitt 2022 OLD KING'S HIGHWAY I APPLICATION FOR YARMOUTH OLD KINGS 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,&SUPPLEME AL INFORMATION. Check All Categories That Apply: Indicate type of Building: Commercial Residential 1)Exterior Buildin Construction: New Building ri Addition Iterations FIZoof ri Garage 4, op 121Shed Solar Panels ri _Other: 2)Exterior Painting: Siding Shutters r--- /coors grim EjOther: Vix 3)Signs/Billboards: ,1-1 New Sip Change to Existing Sign 4)Miscellaneous Structures: IjFence Wall 0 Flagpole n Pool DOther: Please type or print legibly: Address of proposed work. 37 9 (442:yr- .Gt. Yarm.04 fort Map/Lot# *it I 1,226/1*L__" Owner(s) si-e..4e_ 4 out•-vf Kartac Phone#: Ste-3111-sac:Q. All applications must be subthifted by owner or accompanied by letter from owner approving submittal of application. Mailing address. 3 7/ titith- 1(4.• Yartvtot, eori-i OA(A• OW0 ic Year built Email: s/pee 4..e..w4AorOcel a cow as+-.0 et- Preferred notification method Phone IZ Email • Agent/contractor- eix L,k_ Ta• 'dos Phone#: -7 7(1-35-3—4,6 Sa Mailing Address' (:)-0- gerA 34c-I /acwto UllA Por't" i 0/04 Daa 7 r Email. alt:k ct.c..0(ps '70 0 vaiActo . Preferred, 1----v""notification method e L___ Email '__ aPtion Description bt Proposed Work. Stockx-n e f er- pt aft c 6,ct ese..k,d ,Brauct cirVe.tAlk/ ,. 7.4,--____-- ---- ,If Signed(Owner or agent)- 0" -"'"''' .767 Date.____75- /5-- a0 - Owner/contractor/agent is aware that a pe it is required from the Building Department (Check other departments.also.) If application is approved approval is subject to a 10-day appeal period required by the Act. ',- This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. ii- Alt new construction will be subject to*nspection by OKH OKH-approved plans MUST be available on-site for framing&final inspections For Committee use only: Approved Approved with Modifications Denied Rcvd Date: Cii22 Reason for Dental Amount 1-40 tiA) Cash/CK#: 3 ,4t .,- Signed Revd by 1,,.. 5. . 7 46 Days: 116T410";e3;or I Date Signed: 4/2412°2?... 1 11.0 ' dr 1 410 APPLICATION#: °£ TOWN OF YARMOUTH OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE 1 146 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 3-7£ We l Map/Lot (/ q/. C/A# 77-- j 6$' Approval Date: 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: 2e zz Signed: PPRVED (Owner/Contractor/ ent) AN ) 7 2022 Signed: .t i Chairman Id King's Hi ghway Al 1,v1L.L, { g H ghway Committee) OLD KIN 'S HIGHWAY H:1OKH COMMTTEE4Application Forms'Statement of Understanding 2015.docx Updated 12/2015 GENERAL SPECIFICATION SHEET Project Address: FOUNDATION: Material: Cexvt424\t" Exposure(Not to exceed 18*): leS /CHIMNEY: Material/Color: ili .11 GUTTERS:Material/Color: 4,-,h,"1-e-/4/6/0.k7 iiet L.44/1 ROOF: Material:. rtle6-k Pitch(7/12 min) 07„, Height to Ridge: /16/2., Color:_ C-rrey - r SIDING: Material/Style: Front: et.re_. 1 gtarel46tetem, Sides/Rear: 014;17e, COLOR CHIPS Color:Front: idLik;+e, Sides/Rear: TRIM: All All windows&doors to be trimmed with: IV 1x5 (Circle one.) Material: eVe_ Color: CAA-N..4C, DOORS: Qty: dir Material: 'A berjas5 Color cAki+e- 1 RCEIVFn I Style/Size(if not listed/shown on elevations): ;VtAY 2 4 a ecitur---- . . AHmou f, : GARAGE DOORS:Qty: 3 Matl: Num.;t1 Lhiti Style: St40-tkr Color (A)VN8e. ! OW KING'S HIGHV •' ' WINDOWS:Oty/side:-Front %.1 Left 4 Right 5 Rear_ 4:: Color: g leka, Manufacturer/Series 4flailMe‘ LiCO Seri eg Material ‘ Ay( -106ock Grilles(Required Pattern(6/6,2/1,etc.) 4 6-4 I Grille Type'True Divided Lite: Et Snap-In: Between Glass: Permanently Applied: =Exterior F1)nterior ORMWNEKAWQty: Material: Color: APPROVED --SHUTTraR Style: Paneled Louvered Color: JUN 2 7 2022 -SKY-LIGHTS*: Oty: Fixed Vented Size Color: YAIRfv1OUTH OLD KING'S HIGHWAY ---06414:-Size: Decking Mail: Color: Railing Mail: Style: Color: --WALLSIFENGES*(Max 6 height): Height Mar I: Style: Color (Show running footage&location on plot plan.) *Finished side of fence must face out from fenced in area. LITILITY-METERS/HVAC—LINITS: Location: Screening: LIGHTS:Oty: Li Style: late%4e-cV\ Color: el A.CAr-- Location(s): Pft tors' aivi Fork rk5.3.,_ -LIGHTPOSTSi-Qty: Material: Color: Location(s): Additional information: 2-General APPLICATION# " Abit2 Er TOWN OF YARMOUTH OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE ABUTTERS' LIST Applicant's (Owner) Name: 546te_ 4 Ckecy( k.orrc&S Property Address/Location: 7g Loatr- ect. Vt rM4 O ?Olt Hearing Date: (oh 3/ Notices must be sent to the Applicant and abutters (including owners of land on any public or private street or way) who's property directly abuts or is across the street from the Applicant. Please provide the Assessor's Tax Map and Lot numbers only. The OKH Office wilt 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: Abutter Information: RECTIVED MA`'` 2 4 lIi/i . a fisrtlw�lu a f OLU KING'S HIGHWAY { -APPROVED JUG` 2 / Zan YARiv1OU TH OLD KING'S HIGHWAY Application#: Ab 8.2018 3 AWN OF YARMOUTH 1146 ROM 2S,SOUTH YARMOUTH,MASSACHUSETIS 016644 451 Telephone(508)398=22.31 Ext,1292 Fax(588)398 36 OLD KING'S HIGHWAY HISTORIC DISTRICT COMlVIIT!EE 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 Appropriateness/Demolition/Exemption may not be made within 45 days of the filing of such application. The applicant agrees to extend the time frame within which a determination is to be made as required by the Old Kitts's Highway Regional Historic District Act. SECTION 9-Meetings,Hearings, Time for Making Determinations "As soon as convenient after such public hearing; but in any event within forty five (45) days after the filing of application; or within such further time as the applicant shall allow in writing, the Committee shall make a determination on the application." Applicant understands that the review of this application will be scheduled as soon as the situation allows. Applicant/Agent Name(please print): WM, ,Cc7S Applicant/Agent signature: .e! -,: -' Date: 5"//r,x' oaa, f RE, FIV D f 2 4 zo?2. APPROVED YARMOUTH OLD KING'S HIGHWAY • Application#: 1t3 3l2020 126/ 8/ / ! MOOSA MOOSA E TRS Please use this signature to certify this list of properties PATEL BILKISH TRS 45 HEATH ST directly abutting and across the street from the parcel located at: BROOKLINE,MA 02445 379 Weir Rd., Yarmouth Port, MA 02675 Assessors Map 126, Lot 41.1 126/ 41.1! 1 I 7 j1. 4 KARRAS STEVEN J TRS KARRAS CHERYL A TRS Andy Krechado, Director of Assessing 379 WEIR RD May 27, 2022 YARMOUTH PORT,MA 02675 y 126/ 39.1/. 1_. / POWERS EILEEN F 385 WEIR RD YARMOUTH PORT,MA 02675 126/ 42.3.2/ / I GREW THOMAS A JR GREW LINDA A 353 WEIR RD RECEIVED YARMOUTH PORT MA 02675 A' ! 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DATE REVISIONS _ MaStreQt.t, ' R 10 t ELEVATIONS PROPOSED °' Pat Jacobs uim raove.rcawwc KARRAS Custom Design,uc .m en slain&doorto 27,4111r. $ a GARAGE $6 Willow Street Custom Carpentry& m CR375 WEIR ROAD b Yarmouth Port MA.02675 Remodeling 4 YARMOUTH PORT.MA. w.r.3 Derma.MA �� v t..ceam[x.,p,mm J gg ...1 FF Y m> `m !z a u I m.y t i I 1 ii { It ` t I# v jj ;1 i r: ,,,i ,,,,.„,,,i-----,:a.:7_, 4.14,7--: .,r ,---- - 1 i I :,„ ' ri,' --gil-444.1444:44-__ - , 1 . '8 I—i �_i__ .--- Icy 1 � L7s fN 1 i , m' xt f ei T ri a ---> ';Lii?-1' i ''''' n-Q' $da i 4. 1 r 1 1 1 i(j;fa 24- gigi ;IP. _-t it Itl I E 4110 ;i - * � r is < z , ; e , f y t , - �,- > 5,3 i> ID 7*t e ° �.� um1- eAti k !I ar z) I , � �3� r p _ °n ri , , ,:i ,k, 1 i $y ✓ 1 Z13 Ii. ..... _. .,..,,,”, ....1 _Rim tP, . ,.__�. F- 7, I 7 , .„ „....„ ,....,. I 1 [ ,,,,‘ _ii__ __1 441 a OF O x I lit °� J1 ,ilig, iii1 ;ii . 1,,..g., i,;„?...„, ' s-,-."4,, 1 , ,,-. I, �' . Im tz 1 ., c YJ -__ .o r_` i _.___. j o_s 1 ' 3 R ,w. 4 sr i �# 1:4O RpO i <fi r 2m y ' �' $ .� *---�—f .t t. I..y t— j I L i .; it !J 'ji1tI'fi !.JJ Rig - -R % c ia } g it I 1 31a"z#I P.' $ c' - o$ �, rn * — �m 6 2 'l9 ; .` 3?C 0} v U e hin,, > _ ; SHEET PROJECT 1 e Designed-- (+ \ BUILDER. if DATE REVISIONS § PROPOSED Bin,SfT@E?t L Ut grade stroon mltD '`' Pat Jacobs .,n� mov int . R FIRST FLOOR PLAN KARRAS Custom Design uc and mxteens a aim z,m nr. B 4 SECOND FLOOR PLAN GARAGE %Willow Street Custom Carpentry& °I 1 Yarmouth Port MA.1t2675 Remodeling \ 4f FOUNDATION PLAN r aARr�ouTM PORT MA. Dennis,°1N l 4=. ....1. - --7<,_.) II II , 1 pa,' :-- ii2 t., ,e:IZ ' - 'T%-, -4 ' --- ;10 % 7.1). 7 .:0 ., -, '.- , , -'8'r ,?, . ii. ,4---l', ;1> ., ril fr: ,„-------7 IC° 174/ - -0 -7 di 11=71 10> ---,- I I- I* - . 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I ,M "--• , ., „.., 1 __ ..J 10 1---`' J. 0 II I .....; m 1 6 =• C , . ,; • ---_,-- 1. •j, M . i--1 z ! iiiiiMii..111111rr ii 4 I›; I Z . . _ II 0 ,71 0 o44 -.-44, 444 4-.1- 4,-4 f-,1-1-44-4.,-..F..-1-i-1,-1,-1-1,.i to, Z ' : 2 omz :--, - i'...4 iz _______ 1 -f r--- ..„ : ..1 0 .------. el Ifi .. , .. ., ,,..„, I CA c ' 11 x• C7 'F. r'" ”.•'" --.: 4,--Th El DeNgsNd by: V \ I DATE REVISIONS > _ t SMEET PROJECT Win Str—e-eirj- 8' 10125/21 grade lievatiorm/C0 § E: i....) ' rn PROPOSED Pat Jacobs 441/1922 int 'Nc. jJ BUILDING DETAILS KARRAS Custom Design,!Lc Add ext Nan&door to 21v1 Ar. r 21 ; 86 Willow Strom Custom Carpentry&II.. GARAGE Yarmouth Port MA.0267S Remodeling IV, 4 378 WEJR ROAD YARMOUTH PORT,MA ,........., NNW,MA V 4, N,,, .74.74.70,77 ,'k„ / O V n a 1.—I f ' ". 1-- t- --'t - -, tr- ir- 1 I i P - m iQ E la g t173 4 3 4 a ¢ {Z 7. 6 6i' .R Z t3 3 a ; A Im - g ! a a Z IS L � � n n � ;C' v 1� ' c i 4 ' P'- i ,mil eI— r -1 1 Al E pR9 g s 'nA $$ I3 r :—: F 9 c; ,,,, " j. r r A 9 1 f Tx 1.11 .o 1. 111 a , * m or " gg %I 451s i agg g gn m 1t-m111is & ?f ? 13 gl m A.a i � l 4" tt fs11g 1 Ce1D f^ "I — m • gfis pap HQQpu • Y; �gF 5833 A' FSS 8$ $ ( H 8 8 • H 84 8S YtY? igg -vv. if . ��` ffi8f§ 88& S$ 38` hQ q s YY k 4 qq .q Y '�, g 11 R g i iiii =;A ER A io o A s is Fs sg g rtit g" as o 1 C O QQ 4 \'',-- IP0 , -0 i, z 3' g11y cq xc � ,,F C.D ■rr V` ..L. .V u'i N G _- �? D ; SHEET. PROJECT {Designed% MADER } DOTE REVISIONS 81It cSi t1 tarzszi wedew c0 ' �' PROPOSED " Pat Jacobs MM'isu winclowstroofing G m BUILDING DETAILS KARRAS r stom Design,uc aaeoueuasaaoe roaa9. GARAGE 86WilowStreet custom Catybmya 4 • 379 WEIR ROAD mouth Port MA ovo Remodeling - Dennis.MA � YARMOUTH PORT.MA ..,.raeav oA m € ug g g tom' a 1 m"j ova aR .._ a I 1 n 3qA W -41 ,In ^ ^i "s E � - - I �I t � �� mi i : ; >� r j 5 .. Knp v i ; i II' ti iD fi �S`� z9 , �' ��E tit # '� b t a - Fo m 1 S I �` ;_ I �A r i v'-a 1„I jR §TI3,;lisl } ' § 's:' � tH vv IZ 135, R u o III A 14 a R !I 1 HI ; , p j I tE E.3 tYH t • /'' j -j 5 ?n tk . M �� I 5,— ' '-'5-3-ii o 4 1� ! F.R 3� £ >� SS .a, -� i ` �t- —.1}:' p D' i ---A ,i_i•ro 1210.?_5.'....C.Y 35 :$ �=..i „Lain R -i<,m $ a � S' s j ,I li fx>• 11 $ a " Eg i ` V t -i ri.w-wsTErss v.acJ—_ �I -- to c ,F, ® J D Pm A t c \ w 3 co _ ; SHEET: PROJECT. (....Designed \ • DATE REVISIONS ain Street a. a tit*rads 4/14/22'' m » PROPOSED Pat Jacobs 5f22 '. km ii X BUILDING SECTIONS KARRAS custom D gn�'x'.,. o00e^'�nB�O'�" e- s a FLOOR&ROOF GARAGE t 86 Willow Custom Caryelttry& m CA FRAMING PLANS 18WEIR Yann uhPMMA.OSWS Remodeling YARMOUTH PORT,MA. Dennis,MA ,.,-k7Tr. t.-•, TOWN OF YARMOUTH WATER DEPARTMENT 0.--1,2_,.lit .-1. 99 Buck Island Road \Vest Yarmouth, MA 02673 Felephone: i5w3i 771-7921 • lax: 15138) 771-7998 ..... BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF' TRANSMITTAL FORM BUILDING SITE LOCATION: ,_$---7 Lie ri- e Gef• PROPOSED WORK: _an.f—v-N APPLICANT: ADDRESS: 02:0 - R o lc ?i,i q Y ari".caL 1-43-4-i-T TELPHONE: --77z( RESIDENTIAL AND 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!ohs) border any type of xvetlands. streams, ponds, rivers, ocean, bogs, boys. marshland. ETC... I lealth Department: Determines Compliance to State and Town Regulations, i.c. requirements for Septage Disposal and other Public Health Activites Fire I kpartment: Determines Compliance to State and Town Requirements for Personal Safety, Property Protections, i.e. Smoke Detectors, Sprinkler Systems,etc APPLICANT SIGNATU E OFFICE USE:USE: COMMENTS ON PERMIT APPROVAL OR DENIAL REVIEWED BY WATER DIVISION(SIGNATURE) DATE tOMk ov-4, , , TOWN OF YARMOUTH ° HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: ?7q (*ki r-- 1U, to QSt ?Or±' Proposed Improvement: e s,,a , ? ,a c- k \..0 G'ct c a t� t_..)a iL st` ( w1 a tao' ' cc r o c .." tic v...)S,e.L.L.)e✓ �tL Q Sc71)1t c -Ct>4 rc.t Applicant: pcx.'t-;,1, j‘-'e,coto_c Tel. No.: s ? �BS`l Address: _P, O. e>i X 3 Date Filed: 7/(0/ c 3 I f **Ifyou would like e-mail notification of sign off please provide e-mail address: Owner Name: < 4 . rr Gtf Owner Address: ? -79 (Y 12d . y-- ea Owner Tel. No.: cve.. 3 w _s 01• 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: DATE: 7- - •.: ., PLEASE NOTE COMMENTS/CONDITIONS: U(s e / s t- J v o S - a ti arc' r/c.c.) ,- ° j r•.)e `4-, 5 ct..v-7..e. 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MSC Home(/portal/) Learn more about 5teps you ran take(httos//www.fema gov/what-mitigationito reduce flood risk damage. MSC Search by Address (/portal/search) MSC Search All Products Search Results—Products for Show ALL Products»(hops-J/i (/portal/advanceSearch) YARMOUTH, TOWN OF MSC Products and Tools (/portal/resources/productsandtools) The flood map for the selected area is number25001C0579J,effective on 07/16/2014 0 Hazus (/portal/resources/hazus) DYNAMIC MAP MAP IMAGE Changes to this FIRM 0 LOMC Batch Files Revisions(3) rat (/portal/resources/lomc) Amendments(3) Product AvailabilityDOWNn^LOAD FIRM Revalidations(0) (/portal/productAvailability) PRIM 7 FIRMette (https://m sc.fema.gov/ports I/download Product. MSC Frequently Asked productTypelD=FINAI_PRODUCT&productSubTypelD=FIRM_PANEL&product!D=25001 Questions(FAQs) (/portal/resou rces/fa q) MSC Email Subscriptions You can choose a new flood map or move the location pin by selecting a different location on the locator Go To NFHL Viewer v(https'. (/portal/subscriptionHome) map below or by entering a new location in the search field above.It may take a minute or more during Contact MSC Help peak hours to generate a dynamic FIRMette.If you are a person with a disability,are blind,or have tow (/portal/resources/contact) vision,and need assistance,please contact a map specialist (https://msc.fema.gov/portal/resources/contact). 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