The URL can be used to link to this page

Home My WebLink AboutBLD-23-001082 Cca k x 1/3i// Y .' 's. OfficeUse t7itlPermittl co.1.0'i ' ...It, --;,,,, 'D i " „, „. Amount 1),._,. Permit expires 180 days from issue date ai ECEIVED TOWN OF YARMOl1I I! Yarmouth Building Department 1 146 Route 28 AUG 12 2022 South Yarmouth, MA 02664 (508) - 2 i I Ext. 1 261 BUILDING DEPARTMENT CONSTRUCTION ADDRESS ..q.3 N, rl i9-►.n Si JO(.Gl,_4.._.Y621444_4 ✓he_¢ _ _ 1 5o8- 3(0,-5 L OWNER:_ n�a 1 P _ a, T z -ZW I-a�8 NAME PRESENT ADDRESS TEL if 1_ 4 25 OVeen t�ntne" h� YS CONTRACTOR;C)R. ! ._.. bow ktUo {�odccfs `� M oZb NAME ��AVISIed t MAILING ADDRESS 1 Fl..if )(Residential Cl Commercial Est.Cost of Construction-.. 04 Ot _ Dome Improvement Contractor Lie.it Construction Supervisor Lie.# Workman's Corn.en:ation Insurance: (check one) I am the hnmeawne I am the sole proprietor I have Worker's Compensation Insurance Jfa Insurance Company Name:,mA% .__ _.. ktA thole.._.. INKS Worker's Comp. Policy# SHED INFORMATION New / Size L I x Wa x HI !1 7/Z Corner Lot: Yes X No Per Toren of}'ar€iwiith Zoning By-Lute See 2O3.5 Notre Iy: tr o Se/u am!reor tC€F°t"f setbacks for 6t[' 't`',CCU'l Ir/Itfrl0ngc C_'r7ftfiilfitn%one Iltuoire'Cd'fi/lt t 1 st/ltrire f ei Or less Olaf 1'fft;rfi'81(.0:1% Vitrilf be sty(fa}fuel in of ft.sft'u'fs, but moo r'ioe cia,!! 4ritrl,#c cessrer flitildin,,,;, I'c l'wlf,`Jost'[`llhim 'mire tI 2i tees to tlfmt''10/ 01/tee but:fiIiiig as oil thi cfi:','€il ' I in ;1Ir1 s/iccfti i/F'(`t't't..J ,f&JP'i'i I'I f'Ifli.t act thirdt t '''!' Icct from etiiL:from lot line f f f I Replace existing* Size L x I x H (ora affrrict *"I'lae dehrrs will he disposed ctt'st( ling4.111901 .__. ....._ ...... Location of Facility I declare under penalties of penury that the statements herein contained are true and correct to the best army knowledge and belief I understand that any false answer(st wilt hems!cause for denial or revocation ot'my license a for prosecution under 'sI t,L.Ch.268,Section I i) Applicant's Signature: t a/4:"-Z--. _.__.. f7atc:._.0 `jZ .: Owners Signature(or:mac! [fate: }}7-2-00744— ,.,_. Approved By` Date /� �Y/' Building Official(or designee) EMAIL ADDRESS Zoning District.. m„__ _._.._ Historical District: Yes No Flood Plain Zone: Yes No Water Resource Protection District: Within 100 ft.of Wetlands:*** Yes No Yes No ***Note:Conservation review required il'within 100 ft. of Wetlands 3/22 • PLOT PLAN '•,,, , i FOR LOT AdditionIndicate icrerizion. citr garage txr accessory Bwildirxj s. with dashed lines ----- sew.. .. disposal (cesspool) (g30' Well 0_4 I I I I tO Abutter's 41 1 Aabmutteer's (i) 0 I Name 4/r______L___7 Lot it gat A Lot# I pf, 67---- REAR YARD If this is a if this is a 0.f- corner lot, corner lot, write in ..''''''''r—ft 3_ _ __ write in name of street. name of street. l•-• i cii •_ , $ .13 I • Itl 4 - . : SIDE YARD SIDS YARD i . HOUSE *• •4 ......_ 4 • • i r : i . --r . t I ( SST BACA . ( .A i i A 1 c 1 ( • oat..................ft. fr.tac ) W Mil:it3s-treej-- „, / / (NAME OF STREET) ---> (--- i \ Informaticr JiAn(Fi(teal-fen / \ axpplied by r a a „ ' ,, Office of Consumer Affairs and us ness Regulation • I I 0 Park Plaza- Suite 5170 Boston, Massa,- etts 02116 •Home Improvement et..,e,4 for Registration-. -� tc � Commonwealth of Massachusetts {{ _ U- I€ D+vision of OccuP�ttorSal Licensure T _VI Board of Budding ReAutattons and Standards MCGRATH POST& BEAM CO. (7,,,..81. t,� tz2 �,��r�,t> ea�� j ;r n JAIVIES MCGRATH _ e � CS> A-073E85 259 QUEEN ANNE RD. _= t, ' w %pires 03/14/2024 r )APAES R rYtLuRk t3 i ! -LARWlCH, MA 02645 C _T. L 20 c iu°�a BREWSTER �� ,_ C* A t,,..s 't e t. .t;,tierie_rrnrs+s �'tt,r.4 iil''' :a° s4;1'. Commissioner dr,L A'. 'Bi iii • Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation l Registration: 132935 MCGRATH POST&BEAM CO. Expiration: 10130C2022 DB/A PINE HARBOR WOOD PRODUCTS 259 QUEEN ANNE RD. HARWCH,MA 02345 Update Address and Return Card. 1 Office of Consumer Affairs 3 Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Coroaration before the expiration date. tt found return to: Office of Consumer Affairs end Business Regulation 132935 10t30/2022 1000 Washington Street-Suite 710 MCGRATH POST&BEAM CO. Boston,MA 02118 D/B/A PINE HARBOR WOOD PRODUCTS JAMES R.MCGRATH 11 -- 259(QUEEN ANNE RD. a./. k Hn.�� "" N•Z l '•!tt signature ARWICH,MA 02845 Undersecretary ``' The Commonwealth of Massachusetts S}t Department of Industrial Accidents '�t I"'."" 1 Congress Street, Suite 180 rpr'mat , Y Boston,MA 02114-2017 1 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITII THE PERMITTING AUTHORITY. Applicant_Information `_ pal Print Legibly. Name(Business/Organization/Individual): e Girth 1'+ i ?etfn C�bt'a ion Address: p City/State/Zip: r ..milouiLi 5 Phone ft 5043 '9 O cc 600 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. f1New construction 20 I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 9. 0 Demolition 301 am a homeowner doing all work myself.[No workers'camp,insurance required.]t 10 0 Building addition 4.01 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 MO Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5E1 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0Roof repairs These sub-contractors have employees and have workers'camp.insurance.: p�^^--�p 6.0we are a corporation and its officers have exercised their right of exemption per MGI,c. 14.t_ 1 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. teontractors 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. Tithe 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: Neto H( Ivi R1 if .,. Err) l tryof � __ Policy#or Self-ins.Lie.#: Ee" - ` � 'S 7 ' ` , _ Expiration Date:___ .JQ II j.....8..- }t-9 3 Job Site Address; 13 hi.• PlfN st - City/State/Zip:5,1144,41 ourc4n,a Attach a copy of the workers'compensation policy declaration page(showing the policy number and etpiration date). ate Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 0204. 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' r th p ' an penalties of perjury that the information provided above is true and correct Signature: Date: 1l°ZZ 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ... Nw.« t . ,. _ \ • The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 =rtry Boston, IV A 02114-2017 www.mass.gov/ilia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information PIease Print Legibly Name (Business/Organizatio ndividual .` n (R, L— •2,,q Address: 93 If f lg1r0 51, ''v ' City/State/Zip: S, `1�1 {�i1bl t�,`) /✓� 02694 C� '36� -SS" �} Phone#: 1z0- Zol-01-02 Are you an employer?Check the appropriate box: Type of project(required): 1.Q I am a employer with employees(full and/or part-time).* 7. S 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. Remodeling ' 3.0 I am a homeowner doing all work myself.[No workers'comp,insurance required.); 9. Demolition a.®I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑ Building addition ensure that all contractors either have workers'compensation insurance or are sol proprietors with no employees. 11.0 Electrical repairs or additions 5.0 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.; 13.❑Roof repairs 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#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 3Contractors 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 ant 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: 9314 1 i' '5+; • S.V�, c� Attach a copy of the workers' compensation policy declaration page(showingtthe 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: , ;� C'ect . Phone#: (J Date: i Z) 20 Z2_ 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): I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: