HomeMy WebLinkAboutBLD-23-002915 1:1
e eate-14-- ///2 q/Z2
., -7.• RECEiVE
NOV 28 20271
Office Use Oats ,
40.',C.-Y44,N
Permail _ e-002107 7 3
(f -04 'C°r34 BUILDING DEPARTMENT
BY
'''',;17t'z- Permit expires 180 days from
isacs date
41-31-0- 3 -.0014 IS—
EXPRESS BUILDING PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth,MA 02664
(508)398-2231 Ext. 1261
CONSTRUCTION ADDRESS: `374- iA-61c-
ASSESSOR'S INFORMATION:
I .
Map: I Parcel: '
i .
OWNER: kitaC-fialsreA al.t) ftcs— oc4--s, *g 4,,...bo-rix4 c44,110 Lt 0.441
NAME 'MKT ADDRESS
TEL #‘11, OFA1144t1/4L4421t,i, Sr-
CONTRACTOR: '5C-44`i2k.';Cla "A-Cr ..-%.7.,(,,,. CA426"(•-•&t`Zoiro,-1,•-Ctbil. wocier,84-14,.....pm, aas-)
NAME MAILING ADDRESS TEL.a
0 Residential iCommercial Est.Cost of Construction$ OW CV()
A..._),
Home Improvement Contractor Lie.at teN t. Construction Supervisor Lie.
Wort Compensation Insurance: (check one) Mb,
El I am the homeowner 0 lam the sole proprietor Al have Worker's Compensation Insurance
Insurance Company Name: 4re-42 P,INitalla-isf-AC's Worker's Comp, 4C ?-4-)Es(:, .3 git-'t I AzZ-
tt4 49 ›C-, ,)ep 64-22-zs
WORK TO BE PERFORMED D6.• '..7-4—'
.0....,0'"'
Tent I:1 Duration (Fire Retardant Certificate attached?) Wood Stove a
Siding: #of Squares Replacement windows:# Replacement doors: #
Roofing: #of Squares (E)Remove existing*(max.2 layers) Insulation TI
Fl ._Old Kings Highway/Historic Dist. 4 Replacing like for like Pool fencing_Fl
'Me dehrts will be disposed of c, C 40," Location of of Facility
1 declare ander penalties ape:pry Ma t autp„.e.....aff a . .. ,are oar and,CMCCt tt.t the best of my knowledge and belief. I understand that any false answerls)
will being cause ft .•,r sat 'of n;oopr". for prow ion tinder lt.,t.,1.,Ch.263,Section I
Apph-,t s ;mature. _, 'QC ,lee *Wt. S''',- Ce•4? Date Lb\__12Lii
Owner ignature(or att ,mend). . `, ' alb iVeatitt-4.04,414,.„ C124me:612tfesQ110_,. rryo"
2--2—
Approv t . .____
Building e* i'mt e EMAIL ADDRESS:
Zoning District:
historical I Disti let: - Yes No Flood Plain Zone: Yes No
Water Resource Protection District: Within 100 ft.of Wetlands:
i Yes No Yes No
i,.
reneoviPg e g 4 t7 ' 1
jr-,,,I,o A iiti rn tt-ferf ,-1-
1--6 aide am de
r0 4'I.
- --_
-r
Jele)pd afil
rep la ce. iv ilx_ ru.i2 r 0 1 Axi
emo schiappa
From: ;elf Phillips<jphill'ps@theriverviewresort.corn>
Sent: Tuesday,October 18,2022 5:53 PM
To: emo schiappa f
Subject: Riverview Resort Roof Replacement
Skip,
We all know that time is of the essence,as the window for any roofing work in 2022 continues to close on us. I would
like to have you start the process of filing for a permit with the Town of Yarmouth for the roof work we've
discussed. Please keep me posted on your progress along the way.
Thank you,
Jeff Phillips
General Manager
Riverview Resort
37 Neptune Lane•South Yarmouth,MA•02664
Email:jphillips@theriverviewresort.corn
Phone:508-394-9801 Ext.302
Fax:508-394-6012
www.theriverviewreso rt.corn
trt
Ac,
;(-)NlY
CERTIFICATE OF LIABILITY INSURANCE
:PIN':CERTIFICATE IS ISSUED AS A MATTER OP INFORMA RON ONLY AND CONFERS NO MOATS UPON u Yi
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND THE CERTIFICATE or ERE PO TIES
BELOW. RIS CERTIFICATE OF iftSiMANOF DOES NOT CONSTITUTE'UTE A,-;onUR At.TER E DIE
NG IN UR IS TAU IIDRIZED REPRESENTATIVE 939E PRO.OME1R,AN THE ERT€Ft ATE 110LDE'R TTdAC.'BETWEEN T#fE ISSUING€NSJRER•,� A97 .O9YXED
IMPORTANT,if the ."442.42 ca#e 10300.Aa 1 ADI'.ITIONAL INSURED.INA Aohoyikoi moo* ADDITIONAL ENSURED
Kf SUSRC3OAT7DN 36 WAIVEDIRONS*to the 00*o*od wndC3oTm of Y Rol p.NA NA Roncfn oroo ons 3Y4 404 Sao:3s owl:MEEAN 1NOs ttoo can3arn'(y"'(ts to 4& *4350 o 1ofoor in INN of INN endcolfa Rontfoi. °ca:f8 2e±Prnia.'S,+.xnn.nt. A STbltx:ngni so,
dk. ^sUfa(tCe 1.4» ta..Y T a _
3(.',Ors.*53 S3 tnC' >(1$}i Y xry k fi i i
1..&11?-116, ,ASOBsissamsEAB BYE _ ..
t
T "$ 'P MA':t:G`2 „.... ih¢sz'CBRFF'4Ra40 COVEP,A„ ar.Ee,.....
I.
xau+na astxen FEST Nc. T .. ...._.
n..F.nm.A d AM QI:AN INEttRONEFI f..0 ...._
' S4(.T'.MAN L3N t*4 m 'R,
—
ERTIECATE NU.9ENIR )
REVISION NUMBER;
THIS 1 `D CE FIFE TWIT TAP ACC BE OFMtRBNCP ETE IF t 3uY ISSUEDIYNM14144 R& OTT Y :NDNAT_t N IVA "^Nar P ifi'IR T +I4MfR r AYi14}F PET '3]wC H DINES D).UMST`rip 2F TTO R SIE?FF;fILS[ Y 3 1'4 4 r SPAT PERTAIN, NE*3 3FUh/ i ?Of PS i rI E S Q JHF cNI; )RJ "Tt:£L-ri,ETEk OB ApD°FiFtN33>.3 AltiC,ES LINSOON1+ar ynlCPES.N REDESISSI By PAID 244444
EIBIS
OP
I ill' ..... PE.dH4.-'R44 # ``'f%K;
`h _ RC[Ai acuaaA Ninny ._.---a. -A POT _ ;A... _.
A
1 C AR':a:DO:N.25SO o,IIIO£L Ott.2P-2T:1$ rvl i & i D D
.Ch:,c.Ax2£DeAP
C :. P .(. L 1.tAN1 OE
of - ✓, DNA
E ( 2'8'## +ADTf �— .•... zN`3 1 2
Q11l7 Uib
' _.._.. iud 4
?8 AWE a T '�"A" tP ew 3 ..
- .. 1 .Cf<.t , f ,,,,,,S
•
EXrF LR9 _. a _..._.
xNtli£Rg far,k1.l a£8C(n-SKW QFtgY'A'+S'#lKY f/fi 4EH0.K4£R'qF-.nl.Affi¢tra;m M¢py-f ^ o:.'N4AL P SRED IS::..S Ei 9 T:2I
Nne% Mr ........^^.E'pIYF t ., i't T�9psf 4,,.cL 51
•
I
CEE7IFiCATF.F{fJLDER
__.Y CANCELLATION
'tLn.9`l ANC THE A3GYf,DESCRIBED POLICIES PE fA...�� _.._Ei
S N' P..4TION LATE "IERF.F, kf 1-0'v'E'U£A3EF.F2'.E
t{4 LI[a;.ate".,x Cite-tpl,ry.�1R(mu Y C:..,_ AEG- 'A4Tit THE 3>s,1t4Y 1T+:i bVxi. DE 61ELlt'tnpEC' k4 I
RDAWF.
...P'Rfll'F5KMTe.
I9 .'1.9,g4$Stipp; " a k3 Ewa A c
AG:IN}7 85 44534 431 The ACORN name , S ,N I 2rI PSACCRD CORPORATION.Ai,rights Ata[ate 1 i rost roarAa of A:'ORD 9 0*54 +l,
Yh Common a'a1if a''I?i a r Isumzto
rs _ 'Teptztt€xas„rr7 Of'rnzitieb0014ceidertib
lk- y €art,.7'firs Nimbi,t:a to 100
cx
a idw masa€,oYdia
Wooldirtt Ownpato-of/4a InStrragth Agilthoeig,£ i se,Y
TO BR FP7I i` h K '3 LO.I"aefo'p b t-cl:Feians.T::xmGers.
A tt go !""F;.TMf 1c4£Ii.Tht•'A1r.'flf7fi t'v.
Name
L«Ng„r "'Yp1JhU.3G a€7 qq 40
seldr _.s. 5.-
ma e, .Type r3 project rertuirni' i
xs s acq' d s! ni, 9
I :r,, et ^arrrc vc,- ,h ! 1 )€f Mikity s £d G..
ropoiro-fir -t::ti I
'cay.v., ana4 r: ^L q+J Pletth JSS� 4
Tfl?Y
CLI•
;toot-moot
...
r .' .cp L h t,Yr r 4 D ( .r c�a§? st. t m yH vn " trand z rs G g -2':agog I-y.I this.
£x srr+ i„¢sg ¢,A n 461.7,raraatrn>,uuc,rrx „r thy e> /°te.€, Bob,,Is Eke policy itodfob she
:Warn;}„I:cku r£xy i°da!;.;e: f t<
.te._{ode` _._..._.
-
....— _
PolF'. g or$P Fin"i.3 {V ''�.`u
€ , ,t. P�. `` , VCaAftacr a eapy P h nn, r '•n e t£v pality d ',sa rag sha v n the polity panther sad ospiaalon
data).
Pailitro to option; v..y
go at art € nr�a '' o c is MOL 4
Fun-I �' x ai c xna€ sit c is P WORK 3.het€ g a: itp u
lnY a 'a i t r B._a v ofv c :' st r f' of In . >i c.t a: t
s m arn,a L 5 n. 7 be::tv. ,y i.., ,< 45 f
Office � N;F&10 f .
d.f0 hereby C1""1}yyit�' 'Y Jlama-min
( d£G' eribede'a6 -fi Mai n Y
_ f 1 .GIKY: 'Cr .df tlRrk?c'.� F _ ..
{�'-� }
.: "E$x,,^4a� '"w4,-^ tom-. a�.
I 97 i r3,. SC x r4 y; 3a no,atria,in th t new;iu r .-...�_..:::�-_;,..._.......__
be.,aa�r.G+sr¢,y_1.,,tv,< 0,61r1 z:. 11
CdmT''x
I saturig A.t lur E'(tittle one)...
..—._...Penal miae
oa
fi B,; alth 2 73aildia;tiop.rtsnerez 3£.nyrtmarn 4,Clark P.,t:az£ l ins.rxunr_.Plar
er
_ —. - `nbt F¢rea I
Utars I'tera�;
ll
§TOWN OF YARMOU'Ffi
1146 Route 28,South Yarmouth.MA 026454
0119
508-398-223,1 ext.I261 Fax 508-398-0836
Office of die Building Commissioner
BUILDING DEI)Al2TMENT
DEiV1()LITION DEBRIS ISPOSAL AFFIDAVI1
Pursuant to VLGL,C/a.40,§54 and 780 CNIR-Section 105,3.1.k4,
I hereby certify that the debris resulting from tiv proposed work/demolition to be
conducted as <-,c.,11,..) (424^itezr
Address
is to be dispo.sed of oat the following location:
ci. ttkk‘) Ckra
Said disposal site shall he a licensed i•oiid waste facilitle as defined by
Cti.111,§1S0A.
SignattiknfApplitlatior Date
Pefltdt N .
I
COMMOrMeaith Ot Massachusetts
'1:, :4F 4 Division of Occupational Licensure
Board of Building Relulations and Standards
Construct'," '': r Specialty
CSSL-101061 ,,----s - spires: 10/15/2023
EMO R SCHI4PPA
111 HATHA ,, Y STREET
. ,
WAREHANI At4 02571 :,,,-f ,,,,..,--!,..., ,,,,*4.:::::?., •
• ,, ,,,
. ,
''''/-'t -,1-•''' :'„,,,•.:'''0,,t f?1':', i'-1,-',.
11.1:‘''et.-1:1- ,,, ,7.:2.-,..44',:i.li!e1,11;;:.$!`.::,,,,f4,111,I•‘,,,,,
::'''4?'t,::''''4•;'1,'' ''''',,VO'i::ii.:::iqf't
Commissioner :Kel,,,iy,„‘ f),
..,
..,..,
„._
Commonwealth of Massachusetts
Division of Occupational Licensure
,,,,, [I r t,
H ' "'iii-j--E11641per
HE-086392 -- ' '-' pires: 10/15/2023
EMO R SCHIAPPA
111 HATHAWAY STREET
WAREHArkil '-',-. 0257'1
-, .,.. --,:•.,,-„,
4,,
(-11
',-
Commissioner
,)
I
I
........_..................____ .-.._ __ .._„.......___.— —— ---