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Permit# �/i
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Amount ,00
�+ „ Permit expires 180 days from
E�
issue date
6 LAD -- c9-.. - —Oo 138O
EXPRESS SHED PERMIT APPLICATION_ E I V E D
M TOWN OF YAROUTH -----
Yarmouth Building Department U N 2 2 2022
1146 Route 28
South Yarmouth,MA 02664 — - ��-
(508)398-2231 Ext. 1261 Bl.i I IegDA El---
BY _
CONSTRUCTION ADDRESS: 82 Harbor Rd West Yarmouth
ASSESSOR'S INFORMATION:
Map: Parcel:
OWNER: Adriana Parianos 10 Turtleback Rd Essex MA 01929 978-833-1.373 r/'
NAME PRESENT ADDRESS TEL. #
CONTRACTOR: NAME Walpole Fence Falmouth MA MAILING ADDRESS TEL.#
lXtesidential 0 Commercial Est.Cost of Construction$ 8,000
Rome Improvement Contractor Lic.# Construction Supervisor Lic.#
Workman's Compensation Insurance: (check one)
X I am the homeowner C I am the sole proprietor C..'. I have Worker's Compensation Insurance
Insurance Company Name: Worker's Comp.Policy#
SHED INFORMATION
New Size L 14. x w 14 x H Corner Lot:Yes X No
Per Town of Yarmouth Zoning By-Law Sec 203.5 E:
Side and rear setbacks for accessory buildings less than 150 square feet and single story, shall be 6 feet in all districts, but
in no case built closer than 12 feet to any other building.
Replace existing* Size L x W x H
*The debris will be disposed of at:
Location of Facility
I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s)
will be just cause for denial or revocatio f my license and for prosecution under M.G.L.Ch.268,Section 1.
Applicant's Signature: Date: 1 1/24/22
Owners Signature(or attachment) v`G Date:_
Approved By: Date: --2.1 '2'
Building O al designee) EMA ADDRESS:
Zoning District:
Historical District: "i Yes No Flood Plain Zone: ".'. Yes No
Water Resource Protection District: Within 100 ft.of Wetlands:***
_= Yes Noy Yes I No
***Note:Conservation review required if within 100 ft.of Wetlands
9/13
p 0 r�
The Commonwealth of Massachusetts
Department of Industrial Accidents
-7400M. 1 Congress Street,Suite 100
—NM' Boston,MA 02114-2017
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/Individual): A d r%G( /1 A Pa/i Gt/7 U S
Address: /0 fC /�aL� ei X
City/State/Zip: /k/t/t b 19 21 Phone#: 78 e 3 i 3 73
Are you an employer?Check the appropriate box:
Type of project(required):
1.❑I am a employer with employees(full and/or part-time).*
7. ❑New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in
any capacity.[No workers'comp.insurance required.] 8. El Remodeling
3.4 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition
4.0 I am a homeowner and will be hiring contractors to conduct all work on my pro 10 0 Building addition
ensure that all contractors either have workers'compensation insurance or are sole I will 11. 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. 12.0 Plumbing repairs or additions
These sub-contractors have employees and have workers'comp.insurance.t 13.❑Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 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.
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#or Self-ins.Lie.#: 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$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 'its and penalties of perjury that the information provided above is true and correct.
Signature: 6/�� la
Date: /
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#:
• DoL:1 s 461 r 735 06--22-2022 10:17
BARNSTABLE LAND COURT REGISTRY
f Y
; '4 TOWN OF YARMOUTII
-fi= BOARD OF APPEALS
g16-'......__:.1;-.3--
t y DECISION
r 1
►, x
-..1
• FILED WITS TOWN CLERK: April 29,2022
PETITION NO: 4943
BEARING DATE: March 24,2022
PETITIONER: Adriana Parianes '-
PROPERTY: Map 21,Lot 10,
82 Harbor Rd.West Yarmouth,MA
Zoning District:R-25
Book 152 Page 68 ..- . -
Certificate 220819
Land Court Lot 43
MEMBERS PRESENT
AND VOTING:,Chairman Sean Igoe,Richard Martin,Jay Fraprie,and
Megan Seiner. thereof to the Petitioner and all those owners of
Notice of the hearing has been given by sending notice propertynotice of the hearing and publishing in The
as required by law,and to the public by posting
Cape Cod Ames,the hearing opened and held on the date stated above.
The Petitioner seeks a Variance pursuant to section 203.5 of the Bylaw and in the altematiye,a
to allow a 14 x 14 Shade Pergola to be built within thug Hof strict The Petitioner
line setback
and 16 Permit is located i n a R-25
and required feet off r the eived administrative
Theapproval
from the Yarmouth Conservation Commission
was and received admfnistm
due to it being within 100 feet of a wetland. d as well as the south
The prop'is abutted by conservation land along the rear property boim aty,
facing side bounty where the Pergola would be located so there would never be a detrimental
impact to any neighbor.
whether there was an alternative location for the Pergola that could be
Board further
discussed line however,after hearing testimony from the Petitioner it was
placed off the property
determined that the proposed location was the most feasible.
a motion was made by Mr.Martin,seconded by Mr.Fraprie,to grant the Variance.
TAccordingly,
e e mmemembbeers voted unanimously in favor of the motion.
Thr
�t
ifff
TFIlit. ISTTEsT:
f s. •'ts
IIfIM CMG` Tf.) N CLERK
�, 4.7rAcotiAY 2 3 2022
lie ,r -i
cs motion was made by Mr.Martin to allow the Petitioner to withdraw her request for a
gpecisi d Permit without prejudice.The motion was seconded by Mr.Frappe and the Board voted.
.• /-
unanimously in favor of the motion.
shall issue until 20 days from the filing of this decision with the Town Clerk. Appeals
' No permit
from this decision shall be made pursuant to MOL c40A section 17 and must be filed within 20
' days after filing of thisnotice/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,MOL c40A§9).
S go Chairman 7
411111
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#4943 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.
{
Mary A.Maslowski
MAY 2 3 2022
Y
T• U ATTEST:
•
•t•i tj. ..,'
,'...CMitlie I i. WN CLEFat
.4'ft ` �
/efts'
,
>' F!Y COMMONWEALTH OF MASSACHUSETTS
•*t:'rq TOWN OF YARMOUTH
ot.S�cti G 'r j,1:::t§
BOARD OF APPEALS
•
Appeal#4943 Date: May 20,2022
Certificate of Granting Variance
(General Laws Chapter 40A,section 11)
The Board of Appeals of the Town of Yatmouth Massachusetts hereby certifies that a Variance has been
granted to:
Adriana Parianos
10 Turtleback Road
Essex,MA 01929
Affecting the rights of the owner with respect to land or buildings at: 82 Harbor Road,West Yarmouth,MA
02673;Map&lot#:21.10;Zoning District:R-25;Book/Page:152/68;Certificate#220819;Land Court
Lot 43,and the said Board of Appeals further certifies that the decision attached hereto is a true and correct
copy of its decision granting said Variance,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 and/or Variance,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 - a a a g or registering shall be paid by the owner or applicant.
Sean Igo �'--
A' 1 13TEST
a
BARNSTABLE REGISTRY OF DEEDS Amu _ Gi i_ERK
:(
BARNSTABLE COUNTY .:.T""i.�;r� A
REGISTRY OF DEEDS John F. Meade, Register w y�T 2Q22
A TRUE DOPY,ATTEST �
-jh..::-.",
rACtt�
JOHN F.MEADE,REGISTER,
oV*----
)�t CONSERVATION
o � OFFICE
N � 4" kgrant(a�varmouth.ma.us
Yarmouth Conservation Commission
Administrative Review
Applicant Information:
Name: Michael &Adriana Parianos
Mailing Address: 10 Turtleback Rd Essex, MA 01929
Phone: 978-833-1373 Email: adrianaparianos@gmail.com
Signature: ��
Location of Work: 82 Harbor Road
Street Name and Number
Detailed Description and Reason for Proposed Work:
Place a 14x14 shade pergola
onto back corner of patio
See attached photo
Closest Distance to Resource Area: Abutter
Proposed Start Date: 5/1/22
Company to do Work:
Name: Walpole Outdoor
Address: 958 East Falmouth Highway Falmouth and 255 Patriot Place Foxboro
Phone: 781-622-9099 978-618-5293 Email: Russ.culligan@walpoleoutdoors.com
Administrative Approval:
/coey4.44tt-
This approval is valid for one year. This Approval does not grant any property rights or any exclusive privileges;it does not
authorize any injury to private property or invasion of property.
Yarmouth Conservation Commission • 1146 Route 28,South Yarmouth,MA 02664•(508)398-2231• Ext 1288
4
1R 1= The Commonwealth of Massachusetts
—Ali—
t Department of ofIndustrial Accidents
1 Congress Street,Suite 100
"if Boston, MA 02114-2017
ti:" 4 www.mass.gov/dia
IMP
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
A licant Information
Name(Business/Organization/Individual): ctr-i"a Please Print Le 'bl
�� Gti, A/toS
Address: 0 7 r C-, /.01_r✓k__ ed
ESseX
City/State/Zip: A b 19 2
Phone#: 9 28 g 3 '3 i3 7 3
Are you an employer?Check the appropriate box:
Type of project(required):
1.0 I am a employer with
employees(full and/or part-time).*
7.
2.❑1 am a sole proprietor or partnership and have no employees working for me in ❑New construction
any capacity.[No workers'comp.insurance required.] 8. Remodeling
3. 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 1 ❑Budding addition
ensure that all contractors either have workers'compensation insurance or are sole
11.0 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. 12.0 Plumbing repairs or additions
These sub-contractors have employees and have workers'comp.insurance.t
13.0 Roof repairs
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c.
152,§1(4),and we have no employees. 14.0 Other
P oyees.[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 or
information. f my employees. Below is the policy and job site
Insurance Company Name:
Policy#or Self-ins.Lic.#:
Expiration Date:
Job Site Address:
Attach a copy of thw e orkers' 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$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the 'ns and penalties of perjury that the information provided above Is true and correct.
iS Si nature:
Phone#:
Date: 6)- a
Official use only. Do not write in this area,to be completed by city or town official
City or Town:
Issuing Authority(circle one): Permit/License#
I.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing g Inspector
Contact Person:
Phone#:
us i Office Use Only�}t
° " 'r ''Pertnit#E ei t& J5 f
i' 2 , 7"'` k ._ i x ,,Di ..,�<��i'_ %Amount, JC ,V
Y hw �, s + 'Permit expires 180 days from
'+«.a,U' issue date <
EXPRESS SHED PERMIT APPLICAT *�' C E I V E D
TOWN OF YARMOUTH — �-
Yarmouth Building Department �UN 2 2 2022
1146 Route 28
South Yarmouth,MA 02664 B u i � T .E T
(50$) 398-2231 Ext. 1261
CONSTRUCTION ADDRESS: 82 Harbor Rd West Yarmouth
ASSESSOR'S INFORMATION:
Map: I Parcel:
OWNER: Adriana Parianos 10 Turtleback Rd Essex MA 01929 978-833-1.375
NAME PRESENT ADDRESS TEL. #
CONTRACTOR: Walpolel Fence Falmouth MA ESSTEL.#
NAME
[Xtesidential 0 Commercial Est.Cost of Construction$ 8,000
Rome Improvement Contractor Lie.# Construction Supervisor Lie.#
Workman's Compensation Insurance: (check one)
X I am the homeowner E I am the sole proprietor ❑ I have Worker's Compensation Insurance
Insurance Company Name:
Worker's Comp.Policy#
SHED INFORMATION
New Size L 14. x W 14 x H Corner Lot:Yes X No
Per Town of Yarmouth Zoning By-Law Sec 203.5 E:
Side and rear setbacks for accessory buildings less than 150 square feet and single story, shall be b feet in all districts, but
in no case built closer than 12 feet to any other building.
Replace existing* Size L x W x H
*The debris will be disposed of at: Location of Facility
I declare under penalties of perjury that the statements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s)
will be just cause for denial or revocatio f my license and for prosecution under M.G.L.Ch.2b8,Section 1. 1 1�24�22
Date:
Applicant's Signature:
Date:____.__...
Owners Signature(or attachment) / 21 -22-2_.
Date:
Approved By: -
Building Oi al • designee) EMA ADDRESS:
Zoning District:
Historical District: `:1 Yes No Flood Plain Zone: Yes No
Water Resource Protection District: Within 100 ft.of Wetlands:***
Yes No Yes No
***Note:Conservation review required if within 100 ft.of Wetlands 9J13
p 0 .
Z*--D
p� CONSERVATION
OFFICE
��re, T kerantCa�yarmouth.ma.us
Yarmouth Conservation Commission
Administrative Review
Applicant Information:
Name: Michael &Adriana Parianos
Mailing Address: 10 Turtleback Rd Essex, MA 01929
Phone: 978-833-1373 Email: adrianaparianos@gmail.com
Signature: ( I/v �y
Location of Work: 82 Harbor Road
Street Name and Number
Detailed Description and Reason for Proposed Work:
Place a 14x14 shade pergola
onto back corner of patio
See attached photo
Closest Distance to Resource Area: Abutter
Proposed Start Date: 5/1/22
Company to do Work:
Name: Walpole Outdoor
Address: 958 East Falmouth Highway Falmouth and 255 Patriot Place Foxboro
Phone: 781-622-9099 978-618-5293 Email: Russ.culligan@walpoleoutdoors.com
Administrative Approval:
/cQy1.a4rt-
This approval is valid for one year. This Approval does not grant any property rights or any exclusive privileges;it does not
authorize any injury to private property or invasion of property.
Yarmouth Conservation Commission • 1146 Route 28,South Yarmouth,MA 02664•(508)398-2231• Ext 1288