HomeMy WebLinkAboutBLD-22-002341 Lin Z
LESS -{AN SC_ ( Office Use Only
• /� y
,j }) �� A.�v OF �?u Permit# VI--����
O `I ll�Ai'.t4 OF r _ET FROM SIDESf ! �i t Amount
"C* MATTH M S •l,tom,.. if',y�-�
' Permit expires 180 days from
issue date
&c-b-02J — 6da3-f/
EXPRESS SHED PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department RECEIVED
1146 Route 28 �---
South Yarmouth, MA 02664 SEP 17 2021
(508) 398-2231 Ext. 1261
CONSTRUCTION ADDRESS: C BUILDING DEPARTMENT/1 ray _ ___.
ASSESSOR'S INFORMATION:
Map: Parcel:
OWNER: Stezrell (iLAafrefint-y C al`Pe I r►o(Gnr weed c'e 02.07-YR.C of
NAME PRESENT fARESS TEL. #
CONTRACTOR:
NAME MAILING ADDRESS TEL.#
OG
(Residential ❑Commercial Est.Cost of Construction$ 200o
Home Improvement Contractor Lic.# Construction Supervisor Lic.#
Workman's Compensation Insurance: (check one)
X I am the homeowner :1 I am the sole proprietor I have Worker's Compensation Insurance
Insurance Company Name: Worker's Comp.Policy#
SHED INFORMATION �/
New Size L Z x W I O x H « Corner Lot:Yes No X
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. ? ( ��4 f,
Replace existing* Size L x W x H / / Z?
*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 revocation of my license and for prosecution under M.G.L.Ch.268,Section 1.
Applicant's Signature: ff (/ Date:
Owners Signature(or attachment)/�t --" 72,i�.i Date:
Approved By:
� Date: /7 45'2 2_
Building Official(or design EMAIL ADDRESS:
Zoning District:
Historical District: f Yes No Flood Plain Zone: 7 Yes No
Water Resource Protection District: Within 100 ft.of Wetlands:***
Yes No I Yes No
***Note:Conservation review required if within 100 ft.of Wetlands
9/13
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The Commonwealth of Massachusetts
Department oflndustrialAccidents
1 Congress Street, Suite 100
l W, 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): ff frp./ c..41,-,,l(
/Address: IRO_ ee/ lh 0/0,4 l7r]V
City/State/Zip: Varr por+ , AAA Phone #: `77q LIP-7— -'1/9
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. E New construction
2. I am a sole proprietor or partnership and have no employees working for me in 8. Ell Remodeling
an capacity.[No workers'comp.insurance required.]
3. I am a homeowner doing all work myself.[No workers'comp. insurance required.]t 9. ❑ Demolition
4.E I am a homeowner and will be hiring contractors to conduct all work on m YP roe
PrtY I will 10 Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.E Electrical repairs or additions
proprietors with no employees.
12.E Plumbing repairs or additions
5.11 I am a general.contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
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 41 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 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 hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
V Sinnature: ` 2/ ,,,,/ 6L i2 Date: 9 /-2*�/
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#:
•
•
PLOT PLAN
FOR LOT #
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) ED
Well 07
I I
I_ (lot ft. rear)
I
Abuttor's fl' — — -
Name4 £o-fiee rI
Name
Lot # Abettor'
�- ,I b I Lot #
�e 6+ -���4 REAR YARD
f this is a ��
turner lot, this
vrite in name 1 ft.
3 corner
f street. Id write i
a --1! I
,� name of
vS .p. other
,o street.
. 4
.
: SIDE YARD
SIDE YARD :
•
HOUSE
_ _ET_,_ () a_ _ _ '
•
•
SET BACK
.
.
ft.
I
I
1
(lot ft. frontage)
(NAME OF STREET)
information
Supplied by
PARK NORTH POINT
1
, ..
TOWN OF YARMOUTH
7-.--_,---,-...--- ,,,,--‘ .„ t .j,4 1146 ROUTE 28,SOUTH YARMOUTH,MA 02664-4451
1„,;(--,rvt:, - `-• Telephone(508)398-2231 Ext. 1292-Fx(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
I ',A R , APPLICATION FOR
CERTIFICATE OF APPROPRIATENESS
Application is hereby made for issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts of 1973 as
amended,for proposed work as described below&on plans,drawings,photographs, &other supplemental info accompanying this
application, PLEASE SUBMIT 4 copies OF SPEC SHEET(S),ELEVATIONS PHOTOS,&SUPPLEMENTAL INFORMATION.
Check All Categories That APplv: Indicate type of Building: Commercial — IVED F.
Buildin Per,•f ,sr "
1)Exterior Construction: New Building El Addition Iterations . tp..,:a
21,17.. . -
Shed LiSolar Panels I Other: NOV 15 2022
2) Exterior Painting: FISiding Shutters 1-1 Doors Drrim 'pother
:.ILDING DEPART
3)Signs/Billboards: ri We " n Change to ' ting Sign By MENT
------____
4)Miscellaneous Structures: Fence Wall Flagpole Pool Other:
Please type or print legibly: ii, ?/
Address of proposed work: 2 C.,0/1;45.1.A.,0061 Or. Map/Lot# / 7 -,)/ 7/
Owner(s): nk, y (i„rre,i I 5"7-,e(,,,' e,-) Ri c/11,a f a Phone#. ,20s7-y3.2 -64146(
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 44 .2, Colitry tvood Or. Year built: / ? 7 C's
Email: gteo e n a r ictia t ce (V /)-1 4,4 cc' ?-1,,-)Preferred notification method: a Phone ELEmail
Agent/contractor: 0 La A t 1,5 ,/ Phone#: „AO 2 - '..i 3,2- ‘1,'`. ..'V
Mailing Address: A C,4117,-) 4„,0061:1 6"
Email: 5:-ter v2 e, r l'etic,rt-41,6„- „4,,,,e,;`f, (2-0 /1"--1 Preferred notification method: El Phone ELEmail
Description of Proposed Wdrk:
Giled 10\x 14/
P;r14, Har or 014.,/\aiqc-rure- Clq-“,`6.- P-,e6e3 !model Ou; yen-Cc P'-c
aild Aocis Ti,o ill 4 fi-ii
Signed(Owner or agent): 1„.77„.." ,..." A„1„,,,z,4,4, Date: k7-ii,3-,ZGA 2
> Owner/contractor/agent is aware that a permit is required from t e Building Department(Check other departments,also.)
> If application is approved,approval is subject to a 10-day appeal period required by the Act.
> This certificate is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later.
> All new construction will be subject to inspection by OKH.OKH-approved plans MUST be available on-site for framing&final inspections.
For Committee use only: VI Approved Approved with Modifications ii a, --•••- ;,, , t,g
* -: ' x
-oeiit.if 'IC
Rcvd Date: 1 q 71)22 Reason for Denial;
Amount
Signed:
„,•-•
' ilA'rt
46 Days: ,,f r,4,,,,,,
) e°'
*1'6—
Date 1.-
Signed: i i I 14/2 0
/
1
APPLICATION#:
-4„ TOWN OF YARMOUTH
z ci
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
1146 ROUTE 28. SOUTH YARMOUTH,MASSACHUSEITS 02664-4451
Telephone(508)398-2231 Ext.1292 Fax(508)398-)836
STATEMENT OF UNDERSTANDING
CHANGES TO AN OLD KING'S HIGHWAY APPROVED PLAN
As property owner/contractor/agent for construction at 2,
62, ( toe5 191,„
)Map/Lot -20 C/A # •-A Approval Date: II//4)-)
I certify that I understand the following requirements regarding any changes that may
be required for this project:
In accordance with paragraph 2(a) of section 1.03(General Procedures) of the OKH 972
CMR Rules and Regulations: Only minor changes may be approved by the Committee
without the filing of a new application and a new hearing. Minor changes include
alterations that can be done without a detrimental impact on the overall appearance of
the project such as altering a single window or door change or a minor change of
colors. All minor changes by amendment will require the local Committee's or its
designee's approval.
All changes to previously OKH approved plans require notification to and approval
from the local OKH Committee. Change requests must be submitted to the Committee
in writing on the appropriate request form, which may be obtained from the OKH office.
All change approvals must be obtained before incorporating the change into the
project.
If the change has been implemented prior to receipt of OKH approval, a Minor Change
approval or Certificate of Appropriateness application for the revised plans is still
required and will result in a doubled filing fee for the appropriate category of work.
Failure to comply with the above statements will result in the Building Department
issuing a stop-work order or delaying issuance of an Occupancy Permit or final
inspection approval.
I have read and understand the above statements.
/.;
Date: if " Signed:
(Owner/Contractor/Agent)
Signed:
(Chairman, Old King's Highway Committee)
H\OKH COMMITTEE Appheatem Feels Statement of Understanding 2015 doe,
Updated 12 2015
.,„y-Y44 TOWN OF YARMOUTH
,,,,,,. ,,,c),,,c,
1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451
4k1Vga',110-T Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
WAIVER OF 45-DAY DETERMINATION
The applicant/applicant's agent understands and agrees that due to the current declared
National and State public health emergencies the determination of our Application for a
Certificate of Appropriateness/Demolition/Exemption may not be made within 45 days of the
filing of such application.
The applicant agrees to extend the time frame within which a determination is to be made as
required by the Old Kings Highway Regional Historic District Act,
SECTION 9-Meetings,Hearings, Time for Making Determinations
"As soon as convenient after such public hearing,. but in any event within larty-five (45) days
after the filing of application, or within such further time as the applicant shall allow in
writing, the committee shall make a determination on the application. "
Applicant understands that the review of this application will be scheduled as soon as the
situation allows.
Applicant/Agent Name (please print):fill,r/ Co r',till Skye..A Rsi:CAard
,
/4
Applicant/Agent signature: 1941 Z„ii,-1,-"ce. Date: (7--,x0-,2.2„.
,..-
r-----—iN,c I E 1 , t • . 0
V e vm
\ 4 NZ2,
NOVHO 1 4 ZOK 11
vAliM• OUIri
L OLD Ki.NIG5 FOG i'MA,_
Application#: .2?
3/2020
TOWN OF YARMOUTH
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
ABUTTERS' LIST
Applicant's (Owner) Name: (46 y rt 0, I/ Cie uevi qr 41)1
Property Address/Location: 260tc, tv 4,a tit
Hearing Date: iiii112;
Notices must be sent to the Applicant and abutters (including owners of land on any
public or private street or way) who's property directly abuts or is across the street from
the Applicant. Please provide the Assessor's Tax Map and Lot numbers only. The
OKH Office will send out notices using the addresses as they appear on the most recent
applicable tax list.
Note: Instructions for obtaining the abutters Map and Lot numbers can be found on the Old King's
Highway Department page on the Town website: www.yarmouth.ma.us
Map Number Lot Number
Applicant Information: / y3 71
Abutter Information. Y 3 '76
Pt 372
p
tif 3 et'
ti 3 FC, 7 I,
v 3 ?
) (e
Application#: 22
8.2018
143/ 70/ / / Please use this signature to certifythis list of properties
CLARKSON CECELIA T P p
72 COLLINGWOOD DR directly abutting and across the street from the parcel located at:
YARMOUTH PORT, MA 02675 62 Collingwood Dr., Yarmouth Port, MA 02675
Assessors Map 143, Lot 71
143/ 71! / /
RICHARD STEVEN A Andy NlaIhado, Director of Assessing
CARROLL MARY T
62 COLLINGWOOD DR, October 28, 2022
YARMOUTH PORT,MA 02675
143/ 72/ I /
TARANTINO GAIL A TRS
TARANTINO ROBERT J TRS
52 COLLINGWOOD DR
YARMOUTH PORT, MA 02675
143! 68/ / /
DEHIMER ROGER N
61 COLLINGWOOD DR
YARMOUTH PORT,MA 02675
Ecovr
9 s
3 t
143/ 67l /
LEIDEL CHRISTOPHER
CALLANEN SUZANNE
377 SUMMER ST APT 64
SOMERVILLE ,MA 02114
143/ 86.7/ 1 /
MCMAHON JOHN J
MCMAHON ROSEMARY A
31 WALDEN WAY
YARMOUTH PORT,MA 02675leity/
t
143/ 86.6/ / /
HIBBARD GEORGE K
HIBBARD CAROL ANN BISSON
37 WALDEN WAY
YARMOUTH PORT, MA 02675
=rAl'( }t.J!='
OLi) li•ice s h`=CJ::&
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10/24/22, 1101 AM about blank
62 Collingswood Drive
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OLD KINGS HIGHVVA'L_
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GENERAL SPECIFICATION SHEET
Project Address:
FOUNDATION: Material: 13/6(..4 Exposure(Not to exceed 18"): 2
CHIMNEY: Material/Color: GUTTERS: Material/Color: )129/4
ROOF: Material: -:- /4-isz 42Tecrci,rd Pitch (7/12 min) /Oa Height to Ridge: Color /),9Q1uCi ftt
sit,,qct.te
SIDING: Material/Style: Front: C fol) boftr 6( Sides/Rear: liga 00 I/ COLOR CHIPS
Color: Front: Mez-vc)„ ii,J c Sides/Rear: 424/cf
TRIM: All windows& doors to be trimmed with: lx 4 1x5 (Circle one.)
Material: PVC. Color: tokit--e
DOORS: Qty: 14.. Material: 41-0,16.(1 Color: toll,' 4
r
Style/Size(if not listed/shown on elevations):
STORM DOORS: Qty: Material: Color:
GARAGE DOORS: Qty: Marl: Style: Color:
WINDOWS: My/side::Front: 0\,,, Left: Right: Rear: Color: tult.v‘ic<
Manufacturer/Series: Material: (if t!'/7 y
Grilles(Required• Pattern(6/6,2/1,etc.) Grille Type: True Divided Lite: EL
Snap-In: Between Glass: Jj Permanently Applied: DExterior ElInterior
STORM WINDOWS: Qty: WM- Material: Color:
mylat
SHUTTERS: Matt -7' Style: Paneled Louvered X Color: 1--n.*rc4' ,/,‘„,
SKYLIGHTS: Qty:, th) 14. Fixed Vented Size Color: .
PP, • VE,if
DECK: Size: )"1)(4.- Decking Mar I: Color:
Railing Mat'l: Style: Color: 4 20'i
WALLS/FENCES*(Max 6 height): Height /14 Mar I:
Style: Color'
(Show running footage &location on plot plan.) *Finished side of fence must face out from fenced in area,
UTILITY METERS/HVAC UNITS: Location: /217/9 Screening:
LIGHTS: Qty:_4a_Style: Color:
Location(s):
LIGHT POSTS: Qty: 14,9/24- Material: Color:
Location(s):
Additional information:
2-General
APPLICATION#:
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