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HomeMy WebLinkAboutBLDR-23-9974- -,r----iz v. %, _.-A, . gyt cONIVb ri.a RrtS>„ 0A \--\y'tc' I NE & TWO FAMILY ONLY- BUILDING PERMIT ©v Town of Yarmouth Building Department ... 1146 Route 28,South Yarmouth,MA 02664-4492 508-398-2231 ext, 1261 Fax 508-398-0836 i ; Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling nt„oeZ 9�i RECEIVED /� s Section For Official Use 0 Building Permit Number: �1.1)�Z -o ci Date Appli •• qk 10023 c-F_13 1 Building Official(Print Name) Si ature qq_D I N G D E PA RT M N T SECTION 1:SITE INFORMATION _By __—— 1.1 Property Address: 1.2 Assessors Map&Parcel Number in N 4 J Wyk-- 2.Pt....- t{ i 1.1 a Is this an accepted street?yes v no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: A-t . 2- 14,1 . 2-7 ' 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 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: � Outside Flood Zone? Municipal 0 On site disposal system F1 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Pit,1ns,-.c 1..i F- "Ale 1./A___ W. 44 t v'tL t ` a (7 3 Name(Print) City,State,ZIP l© !V 4 L'c-v`r- i2.. Ste, gat 1.3:,- 0141 t -SK- S, L44 0 ti 44)'' -- No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied C I Repairs(s) IR Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: - Brief Description of Proposed Work2: '� Wei ei i Kea^..'7- r? cL L.dn,c�i:Lie el-- 1Z`t �,n„c,rrttr' p;e.A-a p-x- % c-K., lJ-Z.-c oec 'r.,.(5 SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 2.t�o O 1. Building Permit Fee:$ ? ) Indicate how fee is determined: 2.Electrical $ A Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 3c,OD c agD 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash ' ..ount: 6.Total Project Cost: $ Z t 5-0-0 j 0 Paid in Full Iti Outstanding Balance i ue: Li 0 I sd9-, apdasen , s i I va- '� me_ , Corn , Cluj' ti t, • 1 - _ SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 18c2 Family Dwelling City/Town,State,ZIP Ivi Masonry RC Roofing Covering • WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D j Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name No.and Street Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(AA.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 0 No 0 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 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 containe ' r application is true and accurate to the best of my knowledge and understanding. r;L— )O— ZOZ? P ' er r Authorized Agent's Name(Electronic Signature) Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.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" 2 '\ The Commonwealth of Massachusetts I ,� Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 tir 1 : Y•�•� www.mass.gov/dia Workers Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. II Applicant Information Please Print Legibly Name (Business/Organization/Individual). ,,.., J IL, 9 t U C�_ Address: t p N' ace S-6T _ • City/State/Zip: L) . y .7r.0 C.)" Phone #: S'tz.8 al 5- 1' 3 0 Cs- Are you an employer?Check the appropriate box: Type of project(required): I.❑I am a employer with employees(full and/or part-time).* 2.❑I am a sole proprietor or partnership and have no employees working for me in 2. ❑Newm odeli construction any capacity.[No workers'comp. insurance required.] 8. ❑ Reg • 3.W I am a homeowner doing all work myself. [No workers'comp. insurance required.]t g ❑ Demolition 4.❑I am a homeowner and will be hiringcontractors10 Building ldin addition toditto conduct alln work on my ❑ �property. ensure that all contractors either have workers'compensation insurance or are sole ]will proprietors with no employees. 11.O Electrical repairs or additions 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.t 1 •❑Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per NIGL c. 14.II Other 152,§1(4),and we have no employees. [No workers'comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy 4 or Self-ins.Lic.4: Expiration Date: Job Site Address: City/State/Zip: i Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify or•r the pains and penalties of perjury that the information provided above is true and correct. Signature: • li Date: ,4-��'t L ( `Z- 3 1 Phone#: 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 : i i p1 TOWN OF YARMOUTH % BUILDING DEPARTMENT �pp 4ri:.t:,,c;..-?'<" 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext. 1261 ,O� •aK.nte: HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: DATE: JOB LOCATION: t..G /V& ›F`� e-C4—._ (Ji • y.4C' cz -' -, NAME STPF ETet— CB 8 ES S S SECTION 3 "HOMEOWNER" '� !v I� it-, S i� 1t ^ V � NAME HOME PHONE WORK PHONE PRESENT MAILING ADDRESS C 0 p A—u 12,6 / 'Yf.-1,Prn o v 7A— /ran 0 t OZ 6."7'3 CITY OR TOWN STATE ZIP CODE The current exemption for `Homeowner' was extended to include owner—occupied dwellings of one or two units and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such homeowner shall act as supervisor. (State Building Code Section 110 R5.1.3.1) Definition of Homeowner: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to be,a one or two family attached or detached structure assessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall submit to the building official,on a form acceptable to the building official,that he/she shall be responsible for all such work performed under the building permit.(Section 110 R5.1.3.1) The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes,by-laws, rules and regulations. The undersigned 'homeowner' certifies that he / she understands the Town of Yarmouth Building Department minimum inspection procedures and requiremen that he / she will comply with said procedures and requirements. HOMEOWNER"S SIGNATURE APPROVAL OF BUILDING OFFICIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch.142. Yes No If you have checked ves,please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity Bond OWNER'S INSU'.-1 1 CE , AIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 o he Mass. ' eneral Laws and that my signature on this permit application waives this requirement. I_ . Check one: Signatures • e-r. •wner's Agent Owner Agent h:homeownrlic,.emp §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 ext.-1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at t C lU 9( tp'' • �' u �L- Work Address Is to be disposed of oat the following location: L( mod`orn o b v Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Signature plica 'on Date Permit No. ONE or TWO FAMILY— BULDING PERMIT APPLICATION REGULATORY APPROVALS NOTICE Address of Proposed Work: t Scope of Proposed Work: 1 cc_ r -2- ( Cct +--e P -< ) PT Gi i r Az - ,�- le-tL3 Date: Based on the scope of work described above,the applicant is required to obtain approval sign- offs from the following departments as checked-of below: Health Dept.—508-398-2231 ext. 1241 Conservation—508-398-2231 ext. 1288 Water Dept.—99 Buck Island Road, 508-771-7921 Old Kings HWY. Hist. Comm. —508-398-22631 ext. 1292 Engineering Dept.—508-398-2231 ext. 1250 Fire Dept.—Kevin Huck/Scott Smith, 96 Old Main Street,SY Note: Please call Fire Department for an appointment. 508-398-2212 Other Appropriate plans and/or application shall be provided to each departments checked-off above. Each of these regulatory authorities has their own requirements outside the jurisdiction of the Building Department. All applicable approvals shall be obtained prior to submitting a building permit application to the Building Dept. Thank you for your cooperation. Receipt Acknowledgement: Applicant's Signature Date Rev.Jan. 2019 Proposed: 9'X6' front door landing and footings • rim 1111w minim- 1 9 .-cs' i Z'� y 30 ' p L eV �i (O O ........- , ........-,no -ave :bneo1-! ' - ''. —rw''''''"'""'""' -441—am",00,04•Niesemem..."...",*,,,,.....itommtereg•wwwwwwarowapsomoo.nre.15.00...... ,. . / it , t :w1r1P•ONales‘v- L" IIi : 1Li ., .1. i 7, 2 4 ; ttia.eesq:~ i 1 I taw.„ *....rp f , 0, lit ' ...4.1416,04.11,,VAMINergoti.r4V-41/44:1aswarrawbc,Malistiosa,AggroomometkPr womegOvigefflasemor""*.ftwax ' '„ New-2x8pt ledger board w/6" ledgerlocks 1 New-2x8pt joist followed with metal hangers } New-4x4pt post on metal post base i i New-12"sonotube with bigfoot 4' bellow grade New- 5/4 AZEC decking n 1) N,,, 11 C =-- 0 11,1 / 1 k m I i? }s:1 +r "as yF._{ 'F)7...i ; p ..). ' ,, . •Utarr, 4-44/1 Ewa-rlkss�vtxara�¢�a=, ...�a,;�.�.,�..�.:�,�,,,.• ,.,au; A yy C A Q k 5e? i ry t t • 4/18/23, 10:12 AM Mail-Sears,Tim-Outlook 10 Nauset Rd Sears, Tim <tsears@yarmouth.ma.us> Tue 4/18/2023 10:12 AM To:andersen.silva@me.com <andersen.silva@me.com> Anderson, I have reviewed your application and there are some items needed. 1. Health Department sign off � Water Department sign off 3. There is an open permit BLD-22-005280 to create one bedroom out of two bedrooms. What is the status of the work? There have/ been no inspections done to date. `r^ 1'SL {At., >'. ‘,„Or nc5 Ao'" Please submit items #1 & #2 for review, and let me know about item #3 Timothy Sears CB0 Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsearsPyarmouth.ma.us https://outlook.office.com/mail/sentitems/id/AAQkADE3MDQ5NWZmLTkOYzItNDIwNi1 iMDQxLWNkMGQyNmE4NzE5NAAQAG3hzvMdsBVMjDE3UU7... 1/1 T %'' % " 1 1 y•Y TOWN OF VARctOUTI I 1� o '4R PI e-19 o WATER DEPARTMENT 0 `iv\. ') 99 Bud: Island Road E"`'"' '�; � 11't<t 1�irrnouth, VIA t}?(17 3 Tt41)1:mu. 5-16 -7I.7c/2t . Fav: itrl?) 7—I.`:)98 BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: \ 'O t f-'J � ` 3 " — lx 9 . y AA,-, ,,,jr? PROPOSED WORK: A,O u: A AI'PI IC'A\T: A.,,,,...)---,70--e>,1„.--4-.) fi v g`---- _ . (1' ADDRESS: C c w) {g-t,.1 C}--' ,. +- , -4- F c c e. 1/4_ TELPIIONE: 5-43 t '. ro ..._ R1=SIDEN I'IAL AND OR COMMERCIAL BUILD1\Ci Wier Department: Determine,('omplianceol'11'attr:\Varlahiltt� and r e istint location — n ' l ngineering Department: Determines Compliance for Parking and Drainage Conservation Commission' Determines Compliance to Wetland; Act: i e 1f Iot(.)border any type of wetlands. streams. ponds, ricers.ocean, hogs. boys. marshland. ETC... I Ieahh Department: Determines(ompiiance to State and"kmn Regulations, i.c. requirements for Scptage Disposal and whet Public I lealth Actin ites Fire Department: Determines Compliance to State and Town Requirements for Personal Safety, Property Protections,i.e.Smoke Detwors,Sprinkler Systems.etc ___,,,3 , A — 8 -- 2 S .i a. • AN SIGNATURE: DATE OFFICE USE: COMMENTS ON PERMIT APPROVAL OR DENIM, fb-L (dt RE 'I 3 :I) BY NVAT}R DIVISION(SIGNATURE) Z DATE It %1 ‘\ q tl MAY 08 ZCZ3 Y TOWN OF Y.ARMOUTI l `�o WATER DEPARTMENT it). L I,., \IC y ev .F`'.- _ ,A�,. 99 Buck Island Road ''"°T'''�"E.T.•id. West Yarmouth, MA 02673 �1.,'_. C:• Telephone: i50£3) ,f 1-'921 ;tom: Fax: 15081 ?-1-7998 BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SITE LOCATION: \ IC , N %--- --- _-GIL._ t LA-9 , LPG A"'\--rh PROPOSED WORK: , .0 4b ` - 1J-e'LLI 9 )( 1 c0/•-/ g' p C'j -k APPLICANT: 4,l`--l�'o t�IU Sic V'y' ed — • ADDRESS: C o 1U]4v Q-� 62._--Gt ---. ..-W. rf1-, rry-to ce I'ELPHONE: b 8 I S 9 _(0 3 RESIDENTIAL AND -OR COMMERCIAL BUILDING e i ) - flmDe� 8-ni, 5iIve . @(� ME,- water Iepartment: Determines Compliance of Water Availability and or existing location v``� 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'... I lealth Department: Determines Compliance to State and Town Regulations, i.e. requirements for Septage Disposal and other Public I lealth Activites Fire Department: Determines Compliance to State and Town Requirements for-Personal Safety, Property Protections, i.e. Smoke Detectors, Sprinkler Systems,etc ---3 ✓17\ ^ s 23 A :1N SIGNATURE DATE OFFICE: USE: COMMENTS ON PERMIT APPROVAL OR DENIAL ta„,...N. r-J A .$ �3 RE: 'I N :D BY WATER DIVISION(SIGNATURE) DATE - ... r -:,,-;-7.7----,-.:.-- i. ,,.. -, -, ,-- i•,i ;; if V 1 Z IIbt `...,..,.{ I Lill • NOTE: EXISTING DWELLING LIES WITHIN FLOOD ZONE AE - BASE FLOOD N EL. I I .O Ln J Ln W U p` w CV `b• LOT 73 $ PORTION < a_ Off LOT 73A o 1- 12699.3 S.F. sZ Q / 0 4 0 `9,9, Co OZ Oil \�a zz 0 AIM a_ w cn EXISTING SEPTIC 10 - SYSTEM LOCATION - PER AS-BUILT CARD �, 2� .. ..... OQ ,,,,,, .0 ik,,___, . as t\. R • `Z INSTALL DRYWELL rO CONTAIN O ROOF RUNOFF rL I O V 0\ \Pv WORK MUST CONFORM TO ALL TO BY AW & REGUL TI NI Z YA UTH WATER DEPT. E BUILDING LOCATION PLAN FOR I 0 NAUSET RD., WE5T YARMOUTH, MA cPj-OF MA b*V44‘ 6519 PREPARED FOR / ANDE__ RSON SILVA �y�o�/ STEVEN W, Th r RUMBA `" I " = 30' 07-23-2020 TMW No. 35791 oe nymeez _ K')1.<, '' •oisrER�o �o- I I I 6 202 ( CPP I /c)44gLL AMU SJ WELLER $ ASSOCIATES ---.„ P.O. BOX 4 17 CENTERVILLE, MA \ TEL: (508) 328-4G92 Z 1 Z EMAIL: trlsweller@gmall.com REGISTERED LAND SURVEYORS * ENVIRONMENTAL CONSULTANT' t' il ,+ V L t kz tl. il 4 , 4 • LLL 4; i JJA-OT Msi0=i1/!O3 T2UM ?i5OW e aocitr ►JU03fi A 2.WA_lY OWOT x .,° 3T .x ! (' 'sin 5.13TA, , fi-r iiMr9AY 3 44 • rwd.,"">.::W-brv .6M-'vifrroiy?,.sa!1..;..h Rai6 �.. i+. ,.- .. - _., �.•.•Sy.,z ..z. - e/CO NAME STREET / /14 CI s e T. !1 Qq d lid 1 ,..:J - 73'9 I� , VILLAGE W QS % )4I Yi O u T b SERVICE NO. / Zr- v'/�I R- 6Ys dl 44739��.55ff 5jg i Q./-9Y :C METER NO. )r-\ 7z ; _ _ c ip if g-fr. 40 0s qV / ._ / Is / . i / ' ' it Poio • - 'b 3i,4 „ ci 6-t)/- --- ;. p` a /At 4/Ai v .pf ti'AR M .,,,r ,:�a TOWN OF YAROUTH i't. � ,:*,:'� o HEALTH DEPARTMENT :, , a r'^ "`4� , PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: Building Site Location: ' ' Aj 4 v , ---1"1—" 12„_6 W T t rt_o o\ - Proposed Improvement: TO ( u c 1- b Ai e k.ki ( )Cc cam_ Applicant: A )"' \ t i� \f4`-_ '� 5 5 :��� � � -L Tel. No.: S � � � � 1 �i!?� Address: ( 0 ,fl, (4t1/43` , ( p . r Agi t t( 7 ate Filed: **If you would like e-mail notification of sign off please provide e-mail address: ,4 V t)P 11SeN * S ('I V4 di me, Cli Owner Name: 4N-Sive(Z` - M Sc Y k 401. _ Owner Address: (p fr 4 u 1-,C-7 r--. S) Owner Tel. No.:6)°? B , 5- '1 3 0 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. w; w Please submit three (3) copies of plans, to include: r:,w�U�IG) (1.) Site Plan showing existing buildings, water line location, Y Q; Q3and septic system location; (2.) Floor plan labeling ALL rooms within building ALTH DEPT. j (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: ev '/6 'I)) } PLEASE NOTE COMMENTS/CONDITIONS: NOTE: EXISTING DWELLING LIES WIThIN (� FLOOD ZONE AE - BASE FLOODLn V EL. I I .0 U Ln __I w U w Q vb LOT 73 $ PORTION CI_ c0 IL OF LOT 73A o 1- 12G99.3 S.F. / 0 Y 0 n z 0 cn OM \cO 11,( l Adm a_ w cn O Q EXISTING SEPTIC # — SYSTEM LOCATION PER AS-BUILT CARD 2A Q G A z �� INSTALL DRYWELLCONTA 2\ O TO CONTAIN P ROOF RUNOFF 2�‘ O O\ n v J RECEIRV D MAY 0 8 2023 HEALTH DEPT. BUILDING LOCATION PLAN FOR I 0 NAUSET RD., WEST YARMOUTH, MA ar ., of Mess, PREPARED FOR °� STEVENW, P ANDERSON SILVA rn o RUMBA -I URwR" No. 35791 ti I " = 30' 07-23-2020 TMW of���,eE� , IP.rt) -sIEET �'oT 4F o 0 I I - I G-202 1 CPI"- I F ��sTea`` ' — SS>ONALLANOS WELLER $ ASSOCIATES P.O. BOX 417 CENTERVILLE, MA TEL: (508) 328-4G92 EMAIL: trlsweller@gmaII.com REGISTERED LAND SURVEYORS I ENVIRONMENTAL CONSULTANT: Proposed: 9'X6'front door landing and footings miamominek LI ® w.r_ is NUM 1111"1"1111.11."21LAIIIIIIIidavismodevswasimi as al imi 1 IMIIII61111111101111 OIL 410111111116 A q i i, i ..,............. ,, 3° ' , 'c' _ �=Lcv Ai' (0 0 RECEIVED MAY 08 2023 HEALTH DEPT. Proposed: 9'X6' front door landing and footings • ....ter 1111111111111111Umun - IMAM OIL alai .1"..w1113111 trblulh.."hi lel _� 9 Lrei„ x I2- 16 3 \N.; (2 c c L_ LeV l (O 0 \cZ_Ah/L..; '''' -0c AT \("N ?) la --\\1�,‘ti(-' I NE & TWO FAMILY ONLY- BUILDING PERMIT 3 Town of Yarmouth Building Departmentcsi ort r 1146 Route 28,South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 '. .' Massachusetts State Building Code,780 CMR �t � Building Permit Application To Construct,Repair, Renovate Or Demolish _ a One-or Two-Family Dwelling LDRz" RF (: EIVED s Section For Official Use 0 Building Permit Number: Z.D-2 _)C'1C17 lc Date Appli • (-F-13 ____..iti 6/ �/ �10 2023 Its Building Official Si attire iLDING DEPART NT SECTION 1:SITE INFORMATION By - 1.1 Property Address: 1.2 Assessors Map&Parcel Number ii ItJc4 c 2.. . - �iq 1.1 a Is this an accepted street?yes v no Map Number Parcel Number 1.3}Z-oning Information: 1.4 Property Dimensions: 4-t . a tz.%1 . 2-7' 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 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public I?] Private❑ Zone: Outside Flood Zone? Municipal 0 On site disposal system FJ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP[ 2.1 Owner'of Record: AtN P,2.s-.z� - �11. ,reN__ tu. 'try- At,ILV — .t Q <)^�.673 Name(Print) City,State,ZIP �- 1 4�.,s- �- ,tom_ Ste, t 3 i Pnt, z-S<�_ 3('Nr'G� � No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 I Existing Building❑ Owner-Occupied ffl I Repairs(s) fit Alteration(s) 0 Addition Cl Demolition 0 ! Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: 'f* G_. p vie, G/e.c . ri ( .io ,L 1 1Z.4 c,he,1" f pt ,-.?•-2 i p - ty&-C-KI .4-2`-e t9LCe---c'c-,ej SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 2 t c5"0 O 1. Building Permit Fee:$ 7 r Indicate how fee is determined: 2.Electrical $ 01 Standard City/Town Application Fee . ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ • 4.Mechanical (HVAC) $ List gc.OD OM 8-c0 5.Mechanical (Fire Suppression) $ Total All Fees:$ . Check No. Check Amount: Cash oust: 6.Total Project Cost: $ C t'5 ' ElPaid in Full L Outstanding Balance tie: T 0 I d 9s' InCICrse1 . 5i IV•I me , C6m - . �ll/) /464 • • _ • • • • • Y• - • •