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Home My WebLink AboutBLD-22-005717 A - g31y h4L!u 16A i RE ; EIVE ® 1\i_ O * TWO FAMILY ONLY- BUILDING PERMIT 0 4 2Q � Town of Yarmouth Building Department or r tk f 1146 Route 28,South Yarmouth,MA 02664-4492 Al � ENT 508-398-2231 ext. 1261 Fax 508-398-0836 .�..` E AA e u 1 Massachusetts State Building Code,780 CMR III Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Onl Building Permit Number: G �-f►rii Date Appli rIr�. <Rsai G-1�. 1,). 'Building Official(Print Name) • *nature Date SECTION 1:SITE INFORMATION . 1.1��erty A�tdress: 1.2 Assessors Map&Parcel Numbers i t0k tyre 1.1 a Is this an accepted street?yes ✓ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(It) 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: / Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Public C� Private 0 — Check • if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Ilikwneri of Record: I O ,q oonel IA a- o.) l-}- Name(Print) City,State,ZIP ' N i 1 cf. PRvc- (1 -doske No.and Street elephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building Owner-Occupied 0 i Repairs(s) 0 Alter Demolition ❑ Accessory Bldg.Cl Number of Units Other 0 Specify: - ..: _ .., Brief Description of Proposed orle: Pttso lNC X15A-'t(-,3 con �NGUEPARTMENT BUILD SECTION 4:ESTEVIATED CONSTRUCTION COSTS. By------- Estimated Costs: Official Use Only Item (Labor and Materials) I.Building $ 3 3 55C0 1. Building Permit Fee:S 1 56 Indicate how fee is determined: • ®Standard City/Town Application-Fee / 2.Electrical $ -00 0 0 Total Projectro Cost3(Item 1 jplier x C[1�1 3.Plumbing $ / 2. Other Fees: S �5-L 77 r 4.Mechanical (HVAC) S List: 5.Mechanical (Fire • $ Total All Fees.$ Suppression) Check No. Check Amount Cash t: 6.Total Project Cost: $ 3 56V " 0 Paid in Full lie Outstanding Balance D e: 1 i Lot l SECTION 5: CONSTRUCTION SERVICES 5.1 i Construction Supervisor License(CSL) C,S '�' r tit D eu rr 1Pc.6 License Number Expiration ate Name of CSL Holder St ]o o _ rl elf List CSL Type(see below) Uf r -fr C- No.and Street Type Description UUes 1 c RiNno\Tiln IvIrf 0303 U Unrestricted(Buildings up to 35,000 cu.R) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Amy RC Roofing Covering • WS Window and Siding 50d1`l /l�i_ SF Solid Fuel Burning Appliances ��L Tya_1)/ , 1`1_ I Insulation Telephone Email address D Demolition , 5.2 Registered Home Improvement Contractor(HIC) `il r r sZ / James 0 r it-124.1 c.`/ HIC Registration Number i 'on Date HIC Com y Name or HIC Registrant Name 1- Le� 0� MA ,Self.9 4 Email dress 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 2( No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMITI,as Owner of the subject property,hereby authorize J A 1 e..3 l Z A-a m e c-t--c to act on my behalf,in all matters relative to work authorized by this building permit application. JI Z - A Print Owner's Name ec c 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 /accurate to the best of my knowledge and understanding. j� Jn-Prn EL CIRC ( LiLA.v-ihnf�l.ged no en-i) Li- 7 ' .,. Print Owner's or Authorized Agent's Name(Electroolltts'c 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.eov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) i 9 .o (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) I 14(a Li Habitable room count Number of fireplaces Number of bedrooms (71 Number of bathrooms Number of half/baths FType of heating system i41t1 Number of decks/porches / Type of cooling system r n Enclosed Qj Open ( p (toe 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts Department oflndustrialAccidents = 1 Congress Street, Suite 100 "Slf Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/EIectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): J Art) j e2 at---le C i Address: 8 j 1-(Pr-4-1 r) t City/State/Zip: (A) . LicfMc`vrh r')ft ejzl--'p Phone#: „ea- 0-3-v- 1 r'i Are you an employer'Check the appropriate box: Type of project(required): I.Q I am a employer with employees(full and/or part-time).* 7. Q New construction 2.3t amain a sole proprietor or partnership and have no employees working for me in • any capacity.(No workers'comp.insurance required.] 8 [ etnodeling 3. I am a homeowner doingall work myself t 9. ❑Demolition ❑ y [No workers'comp,insurance required.] 4. I am a homeowner and will be hiring contractors to conduct all work on ;will 10 Building addition ❑ my property. ensure that all contractors either have workers'compensation insurance or are sole MD Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 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 t 13.0 Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per?vIGL c. 14.0 Other 152,§I(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box gl 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 nay 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$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 hereb certify tder the pains al penalties of perju hat the information provided above is true and correct. Signatur . Date: Phone#: 54015. / -7 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 508-398-22311 ext.-1261 Fox 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 // Li i d.o/e. Ave_ Work Address Is to be disposed of oat the following location:000 Q Q M A (or'SfrJ p trbrt tl3Tc. PrVo,NeMew i Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch , A. 1-/- 11 Signature of Application Date Permit No. cliz°e F. 6/./ga,sac.XG1P s Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only :Individual before the expiration date. If found return to: Re i n Exaltation OM, • onsumer Affairs and Business Regulation 12/16/2023 I Wash gton Street -Suite 710 =oston,MA 02118 JAMES CZAf JAMES CZAR` 8 HASTINGS ,�/°" Not valid without signature WEST YARMOUTHAkkV2673 Undersecretary Commonwealth of Massachusetts Division of Occupational Licensure Board of Building R ulations and Standards Consstt r visor CS-089214 aw * Illttpires: 12/17/2023 JAMES B CZAR r 8 HASTING ,AVEE WEST YARNLJ 3 hsri �O y`TOLI,Vcia.33 Commissioner day f. K. YFmii.fa., • • Sears, Tim From: Sears, Tim Sent: Wednesday,April 20, 2022 10:42 AM To: 'theczars@Iive.com' Subject: 18 Nicole James, I have reviewed your application for finishing the basement and there are some items needed. \1. Health Department sign off(under review) \\2. Ceiling height needs to be shown on the plan 3. Please provide natural ventilation calculations per section R303, if needed provide specs on air exchanger 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. i...i m othy Sears C:BO Deputy Building Commissioner i own of Yarmouth 508-398-2231 Ext. 1259 mailto:tsears@Varmouth.ma.us 1 TOWN OF YARMOUTH y Y, . HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To he completed by Applicant: Building Site Location: /9 N 1 L)I e. Ave_ L& L L m't � }oposed Improvement: 1 1s esYI C_rI r i N C Ji; 1 1 ita r -a i d On .7 elj. a c i�a rrt z cam, , cP fiy 1* r'-I<e- rWM r G Applicant: \-1 flr ei Tel. No. "O 42?-Y Date Filed: 4"4-i - � **If you would like e-mail notification of sign off,please provide e-mail address: e.L /r 1 iv • (....Den Owner Name: et) O�` Owner Address: I 49t t (-Ole ) Q L• 41t(.WIO01 r) Owner Tel. No.(4 7 () 6 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: 2U22 (1.) Site Plan showing existing buildings, water line location, APR and septic system location; HEALTH DEPT. (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: PLEASE NOTE COMMEN CONDITIONS• EctvG &� M� T' - cam--. ©FF1Ce TO k-PA- c `tst 6 c`/ 1-44A42 Tr., isAA. a ,01 I�e�vv s — E5 s v-N I j ccc rv‘ia- c---)« vv&-\\- ct( r \it• k ciII1e_EiI__IIII Specifications Technical Data Model Amps Watts Airflow Capacity (A) (W) (CFM) (Sq.Ft.) DVS-CS 0.26 31 180 1800 VS 0.26 1 :7 ,,=,48Q. v.. 540 0.26 31 180 1511 - 0.3t 2411 DVS-BH 0.30 34 230 2100 All Units require a 115 VAC electrical outlet Dimensions Model Height* (In.) Width(In.) Depth(In.) DVS-CS 30.5" 11" 7.5" 80. DVS . 5"-95" ; 1:1' , ; 30.5" 11 7.5„ DVS-BH 86.5"-95" 11" 7.5" *A 24 Inch extension section is available if extra height is required 16 OD N, Z s, .„ �i 5 r, c� 2 0 4. r-i t AMA( , (-7,,, -Din inl Gym' .., --) p O z m �.✓- rn - P �, i�� 1t • • 4 le • tr), .......................„.„-- • I ,p,"V V '' Th —1 gl c `r' , �- c ft � _ � .....\\ 'N41". Obv m `` i� \"*".. "0 r� ti.! 461 O (5�) O rU C1 13 N nn -t ry C) . •� mg• ' ® • 2 0 ..- q .. , .-R-:: ,... . •iV - .. 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