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Home My WebLink AboutBLD-23-005725 R C ! : �'•. TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department of r .. 1146 Route 28, South Yarmouth,MA 02664-4492 APR 12 202 508-398-2231 ext. 1261 Fax 508-398-0836 ' 3 Massachusetts State Building Code,780 CMR �� BUILDING DEPAFPli f 'ernzitApplication To Construct, Repair, Renovate Or Demolish ________ a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: /1 -r33= 51 Date Applied: �Y"` Sl?As S _ .?1•1" 4.3 Building Official(Print Name) A igna re Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 45 Rainbow Road 22 I83 1.1 a Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) __ Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,I54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private❑ Zone: _ Outside FIbQd Zone? Municipal 0 On site disposal system 0 Check if yeiall SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Joanna Murray West Yarmouth, MA 02673 Name(Print) City,State,ZIP 45 Rainbow Road (617) 851-2197 rnurray.joanna96@gmail.com No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK' (check all that apply) New Construction 0 Existing Building IN Owner-Occupied El [Repairs(s) 0 Alteration(s) tffi Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: Alteration of existing stairs to second floor loft. Install pocket door in 1st floor hall bath. T -___� SECTION 4: ESTIMATED CONSTRUCTION COSTS. • Estimated Costs: Item Official Use Only (Labor and Materials) 1. Building $ 23,000.00 1. Building Permit Fee: $ CS 0 Indicate how fee is - .- .r-d% I 0 9 Standard City/Town Application Fee e C ` 2.Electrical $ R 0 Total Project Cost3(Item 6)x multiplier " 25 20 • 2. 3.Plumbing $ _ Other Fees: $ �l 4. Mechanical (HVAC) $ List: �� `� AR-tpI ii' i 5.Mechanical (Fire -- ' \_._- 14G O- Suppression) $ Total All Fees:$T • ,/ � Check No. Check Amount: Cash A.m .i. • : _ n 6.Total Project Cost: $ 23,000.00 0 Paid in Full `�Outstanding Balance Due: \\'-� �J r • : - . ES4S s. g9 E { • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Su• pervisor License(CSL) CS-083184 04-28-2024 Charles Whitcomb License Number Expiration Date Name of CSL Holder 273 Service Road List CSL Type(see below) No.and Street Type Description East Sandwich, MA 02537 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted l8 2 Family Dwelling City/Town,State,ZIP M Masonry RC j Roofinig Covering • WS Window and Siding SF Solid Fuel Burning Appliances (774)722-7382 nancy.whitcombbuilding@gmail.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC 194325 01-24-2025 Whitcomb Building and Remodeling LLC HIC Registration Number Expiration Date I-UC Company Name or HIC Registrant Name P.O. Box 254 nancy.whitcombbuilding@gmail.com No.and Street Email address East Sandwich, MA 02537 (774)722-7382 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 Whitcomb Building and Remodeling LLC to act on my behalf,in all matters relative to work authorized by this building permit application. \\4)4"rct?,ticn.'e 1/44,rl i ,, f 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 applicati is true and accurate to the best of my knowledge and understanding. itioto Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.nov/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 Department of Industrial Accidents 1 Congress Street, Suite 100 _4._ Boston, MA 02114-2017 -� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant information Please Print Legibly Name (Business/Organization/Individual): Whitcomb Building and Remodeling LLC Address: P.O. Box 254 City/State/Zip: East Sandwich, MA 02537 Phone #: (774) 722-7382 Are you an employer?Check the appropriate box: Type of project(required): I.®lam a employer with 31 employees(full and/or part-time).* 7. ❑New construction 2.1=1 I am a sole proprietor or partnership and have no employees working for me in 8. IN Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t I0 ❑ Building addition 3.n I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.1=1 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 1 3.1:Roof repairs These sub-contractors have employees and have workers'comp.insurance 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. 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. :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 police'and job site information. Insurance Company Name: AIM Mutual Insurance Company Policy#or Self-ins. Lic.#: WMZ-800-8008121-2022A Expiration Date: 10-28-2023 Job Site Address: 45 Rainbow Road City/State/Zip:West Yarmouth, MA 02673 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 3/ 0/(3 Phone#: (774) 722-7382 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231,1 ext..1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 45 Rainbow Road Work Address Is to be disposed of oat the following location: Harwich Transfer Station Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. 3/v�s Signature of Application Date Permit No. 1 1 1 , Commonwealth of Massachusetts {�: Division of Occupational Licensure Board of Building Regulations and Standards L-it I Cons ion S rvisor l N.- ,P CS-083184 IA 6cpires: 0412812024 i CHARLES A 11HITCOMR,JR 88 GREENWOOD AVE ) , HYANNIS ML t2601 I .# `�_ -_..' Commissioner a h. p E;,Uc,Lt.k., THE COMMONWEAL EH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Wastr.ngton$Frei-Suite 710 Boston,Massachusetts 02118 Home Improvement Contractor Registration I Type TLC 11 Rrnlatrat.on 198325 WHITCOMB BUILDING&RE?JODFLING L t C. :epiration 01242025 ti 0 BOX 254 t-5 A FAST SANDWICH,MA 02537 - .. Update Addrerys and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Afiaus at Business ReguL,1 o^ Rcgmfration valid for:ndrvidual use only Wont 1M rIOME IMPROVEMENT CONTRACTOR expiration date.11 found retufn to, TYPE:LLC Office of Consumer Aflai s and BYarrllaa ReguWBon Reff13IMIM08 E;p.rJfiQ 1 1000 Washington Street-Suit 710 '94325 .01/242025 Boston.MA 02118 MJTCOYB BUILDING d REMOOELING.L_C HAKES A Yh11TCOM18 BI /' „/ .74 .AUNT SOPHIES ROAD r-t VA C7ti31 i..._.__'._.... u..•-._r:.x...I•r.....•�i..�..•...� , -.