Loading...
HomeMy WebLinkAboutBLD-23-001833 PZ/ 10/Z�G r ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department ,. -., 1146 Route 28, South Yarmouth,MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 ,Iti ,': Massachusetts State Building Code, 780 CMR • Building Permit Application To Construct, Repair, Renovate Or Demolish ::_ti,;..•,r:. a One-or Two-Family Dwelling 1 This Section For Official Use Only Building Permit Number: E3 L -a -MI 3 3 Date Applied: Vr-• SO(' S . ---� 3- iECEIVIED Building Official(Print Name) Signature pae- ; —" SECTION 1:SITE INFORMATION (' 9n j 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 05 �u Z.. k--LAckir- U t^ V✓e-k �t.6-,.,`' t BUILDING CEPARTMENT 1.1a Is this an accepted street?yes 0( no Map Number Parcel Number , I y 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 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,I54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private ElZone: — Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP'. 2.1 Owner1 of Record: k‘,tLci L4ru f« k- T,d,.. 1=r,.1 -0,- i MA (r7 Q i Name(Print) City,State,ZIPS CJ S :51 (4.4-1..cra,.,_ tint CO." al.Cc A. No.and Street Telephone Emil Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building l 1 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition El Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: R co.o L , V,let c, I'(,4 c oN N y t— AG r, z \-rac wctik. of c.v1-frthi- Cln., r..3e5: (l t/'c- e-Kt5l-'n. 5u '1- rvt VukL 1 itts krtv.Ave_., 51,u✓Ir iracl,- oP\ c,cl-e✓tc - ,..1�1i SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only 1. Building $ 1. Building Permit Fee:$I c0 _Indicate how fee is determined: 2.Electrical $ 5 uv If Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier . x 3.Plumbing $ 2,WS, "' 2. Other Fees: $ 3 5^,W I,� 4.Mechanical (HVAC) $ wv List: � o) a 4 5.Mechanical (Fire Suppression) $ Total All Fees:$ - Check No. Check Amount: Cash unto 6.Total Project Cost: $ 2 / 1 , (,Z y 0 paid in Full Outstanding Balance Dud: 1'c b \.5I 111 . • 3 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Name of CSL Holder / License Number Expiration Date 2- CJ✓wlL crcL List CSL Type(see below) (A No.and Street Type Description Ay-c.,i kerAA- o),6 3( U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP1 R ` Restricted 1842 Family Dwelling • M I Masonry RC Roofing Covering WS Window and Siding 7 T d-5-6) -OL(2 , Ik)'^y QY c1wt•_@ C y f rc�SF Solid Fuel Burning Appliances I j Insulation Telephone Email address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) Ct-CC 6�,10(,�.-, itc, i Zvi 7-2s 4(�G( 3 HIC Company Name or HICLegistrant Name HIC Registration Number Expiration Date . (Z C7:at_ C,rtl L CFTC 1��� 2-c Ny� •and Stre t �w 1 r+1iO� ,,{Ai-,r5 4'tc,,s l'« r ►vl A- 02_0 ( r►7.(.�_ 3 _()Liu mail address 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 - No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize $.3 P.e.i C.v.11vc,�k- c"`C to act on my behalf, in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER1 OR AUTHORIZED AGENT DECLARATION i 1 By entering my name belo‘• ,I hereby attest under the pains and penalties of perjury that all of the information containe ' this appli ion is true and accurate the best of ray knowledge and understanding. Pr' wner's or Authorized Agent's Name(Electronic Sib ature) Date NOTES: 1 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.zov/oca Information on the Construction Supervisor License can be found at www.mass.v.ov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) , Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" v \ The Commonwealth of Massachusetts r Department of Industrial Accidents 1 Congress Street, Suite 100 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 PIease Print Legibly Name (Business/Organization/Individual). C 14 C IS,,,,'1 g eft_c_,,,c,LA‘viT Address: I,), Gv«IL rc L City/State/Zip: Eft,-JSV-� i M. 4- 03-6 31 Phone #: '7`� — S `UK�� Are you an employer?Check the appropriate box: 1. I am a employer with Type of project(required): ❑ employees(full and/or part-time).* 2.©I am a sole proprietor or partnership and have no employees working for me in 7. El New CO str lipg tiOn any capacity.[No workers'comp. insurance required.] 8. ,Remodeling 3.0 I am a homeowner doing all work myself.[No workers'comp. insurance required.]t 9. ❑ Demolition 4. 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 sole proprietors with no employees. 11.� Electrical repairs or additions 5.❑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.! 1 Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§I(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. 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: i Attach a copy of the workers' compensation policy declaration page(showing theate/Zip:policy number and expiration date). I ) 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 and pains and aides o peryur t t !formation provided above is true and correct. Sienature: Date: 4'5---2 7-- Phone#: 79 Li - S` 3 —U 41Ze 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#: C TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G. L. Chapter 40, Section 54 and 780 CMR, Chapter 1, Section 111/5 I hereby certify that the debris resulting from the proposed work/demolition to be conducted at �w l,�„� W�s ✓ ,�� Work Address Is to be disposed of at the following location: Yo„c,, . ,,,, ... Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. / Signature of Applicant Date Permit No. ONE or TWO FAMILY- BULDING PERMIT APPLICATION REGULATORY APPROVALS NOTICE Address of Proposed Work: > r ILKw✓t . r ,,. 4 Scope of Proposed Work: rt 1� Gx,cl-,.c_ (4,1.cL� . ,,�5 �r""/` 1,"V u�t"w✓G-1 C J Date: (o—s" Based on the scope of work described above, the applicant is required to obtain approval sign- offs from the following departments as checked-of below: Health Dept. —508-398-2231 ext. 1241 Conservation —508-398-2231 ext. 1238 Water Dept. —99 Buck Island Road, 508-771-7921 Old Kings HWY. Hist. Comm. — 508-398-22631 ext. 1292 Engineering Dept. — 508-398-2231 exl:. 1250 Fire Dept. — Kevin Huck/Matt Bearse, 96 Old Main Street, SY Note: Please call Fire Department for an appointment. 508-398-2212 Other Appropriate plans and/or application shall be provided to each departments checked-off above. Each of these regulatory authorities has the r own requirements outside the jurisdiction of the Building Department. All applicable approvals shall be obtained prior to submitting a building permit application to the Building Dept. Thank you for your cooperation. Receipt Ack owledgernent: Applicant's Signature Date Rev. March 2022 t Commonwealth of Massachusetts Division of Occupational Licensure Board of Building RAgula_tions and Standards Conatl iOW Blibeirvisor CS-096829 r % , fikplres 04/26/2024 JOHN M CLESS g et s CAROLE BREWSTER tik , s jb ,1,4 5` VUlJ,v,ta J J Commissioner claA K. '„ office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. if found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 201725 04/26/2023 1000 Washington Street -Suite 710 CHC BUILDING&'REMODLING INC Boston,MA 02118 JOHN M.CLOHESSY ; 12 ORIOLE CIRCLE f�^,/„�,„„i(G.//, ' BREWSTER,MA 02631 Undersecretary Not Valid without signature . . . - • 7,, , • • ACT V,TY nESCRPTIQN OTY AT;..E. A� r,61JUI led lights. Installation of two customer provided flush mount light fixtures. Price is subject to adjustment due to market fluctuation on material prices. plumbing Installation of 1 customer 1 2,345.00 2,345.00 supplied sink and faucet.This may involve cutting open existing wall and moving waste to allow for dishwasher install. Installation of customer supplied dishwasher. Installation of water line to icemaker for fridge.This line item is based on the assumption that all existing plumbing is legal and up to code. Backsplash Installation of customer supplied 1 1,050.00 1,050.00 installation tile backsplash. Backsplash is scheduled at this time to be subway tile laid in a herring bone pattern. Client is responsible for supplying tile and grout. interior trim Installation of new 5 1/2"primed 1 650.00 650.00 finger jointed baseboard throughout new flooring areas. HVAC Move existing kitchen heat/air 1 300.00 300.00 conditioning boot to new location that is more aesthetically pleasing and effective with new kitchen design. material Bruce manchester 2 1/4" 1 4,796.28 4,796.28 prefinished oak flooring. Auqabar floor vapor retardant. Primed finger jointed 5 1/2" speedbase. Sheet rock.All fasteners, adhesives and sealants. All estimates are good for 30 days.Any and all work to be limited to TOTAL $23,191 .28 what is included in this estimate. Upon acceptance of this estimate via written or electronic means(i.e.text or email),client has a 3 day right of refusal.Material prices are subject to adjustment due to market fluctuation.This estimate is based on visible conditions,prices may vary due to unseen circumstances.Deposit and payment schedule to determined upon acceptance of this estimate.There is no allowance in this estimate for paint. Accepted B?<Katharine Grover and Accepted Date 8/3/22 Timothy Bryan CsI096829 HIC 195393 -„....,-..„„,...,,,,..........„, -...„...:.... „.. ..,,_ ...,... .. ... __ ..„ __...., _. „..,_ ,..., ..,......_.. ,... . . _ ____-. .. . .. . ........ : ... ....„,, i-•.,Y.i.,i'': - ,.,::• • .... .. _. . _. ..... .. ._ .. . .. ,•;•-.; -.,_,-. • ,,_:.„ ...... ,. . .. ....-,,, - ••-..;:. .-.. , - --,-„,, • : ., '-.;,-,!•-?•ii:. . . . . ...-.::-.......-...„ _ „...:. .-.:„..-.„„,„,...-.-....„....,.. - ... - - ,r,:ir.„ • . . . ,_,. - . -,.-,..- ':..-.. '..-•!-. ..• .-. - •-•.:.,.---:-L::::.-.,,.-.---.-..- .-.-„::r-,:r.'•-•:!:-.--.n.-..-:.---.--:•••:,-,-.•.--r-:•-.-..----.-!--:-..,--..-.:::,:-...-.,[--:•-'-.1,-:.. -.1-,..: '- ---• ..,••'- ----1.---....1.- - - - .-- „ . ....-_, - - --- •• •-.•:i'iir:-.,-?#,..,.4:,,,,,i*.tek.--Y.,-;:tf..:'...4t-4.,Y--.1.;--!:!---,..;'-"*.T.'•;f"----r,-,'"..,...*:•'''---x77-•-v--,-.-----•-•---,---------•- •----- ---- - . . .r• -.--. ''•- ,--, r•',.. --...-:-.4:•.:-- •-;,:..::•,,,,-.:::,•;-.::-- -. -•,_ -----",;. .,•:..4,- ••-•.::.r. ••:,:••:: .• .• ,•-•,:w, tt.A?"•, -,••;.i.•• i:•',':A.,..g.-,,.::,-:•ii,-;---,•f.,..-...F..',,.,•,.,:;:-...-...:..:.,----.• • -"•-. • - v.i,'.......:: 7.,•:;-:::•:, ..-•-:Aat .,,,_....,...... ..., . „, . --4- .r.-'.-•-•:, --'-,-1-[ •-,4•44,-:- ..,,,,,,,,,•.•: ,.f,',-.-.-. • ."-: •:'•.'.',','„•-•:1-,!.,.•-:' .,-`..'.,--•'.--.'.-t;',':•.' ,.. -•----;...n.--,f,,,i4v,.•-•_,...7.:•-•L•J,:--..,i- . .,. __ _ . . „„. „...,..... 41/k7.--;-'''•---: '1 '-•:';' •'''.:-:'''' • - • - ,...i,,,,i':,' . ... ' '..] i -Z . - . -.-4 .,.:-•,.-,-..-. - -...-.-- „.. , II li--;i7i 11 e-) :',•-•::,_, . - .- - , :„_.„.. _.,. „,.. .... -5.. .P -•-:-',.,',. ,,..,,. . ...... , ...-,. . ...„. .---. • ' ''''--9 '--,,-:-.-,--:-,.. •4 .C- ii .c2.u' n 0 .4.E.,g F.5. < \ '< '1 s',.'-' (r-, • \-) • 8 s° „.„-.,..g. a 8. a' 6' • - -•;•••?, a o •-i• 0 -..,- .-..„. -- . - - -• - -. -- ••' -_,-,--iii•-•:•Pf.,:lags • 55';i555575`- '' ' . ,. ,;.255,L55'5:2-55-5•'57l- V,;::5,5,'-1-0-t55,55;Ji55.-'55N.45r.i.5**.q';''' '5°f# --;;;41-ms.*:;1;i544i55;'54- 5-;;;",:5;!.'''''''''''Y''''..'.H55555.',I...7 At-' --;,.....;..,,,',.2.-.'.....-..'..,-,.,,,•.' 'L:i.r •'...',V...i0W,A:',1.4k"''''','. '-.--., ..„..,,....,..4.4'•.*1.4,;I:...,:177'.7..,,,..,_,..„., .,,.,,,',. ' •4..;;;:• ., „::.. -.:,.,:,...,.',..::.-.,-,,,,":::•,••:•I"..-:,,..,, •::,•,.., .:.•....i.,,••:-',.:.•,';,,.„•-,-.,,. •:. -, •- ... , . ••.'ill`r...'---7•'.i'•..':....*:' ...,.. .,,,..-...:: 'ci '' 41;6'', . , -'"*.'.-,...,•••%•••'!'••<.:13444444,,,';'•• il...I. r) tri '..X. _•,•,,,.. 0 5 a opo ;.,•'.;- jr.-. ILI ' ,5;:45'.5•555_55 Co 005 tr Cn CI, g• t...)55-5. 0-,. IQ N, n.)0 IQ h) .... i 1 • :: L,_t-,,,-ri.r.1- 7.,, ,__:: :,,::::,,,,..::.•,,,., ...,. .„. ., ,,,,,,, , ,:.,,,,_,,,,, _ ,::,,,,,,,:.„,:.,,:_.,r.,..: f„„, .,.._.„-.,.:':,_,..,-,--.' . .. .. : . _,,, .. . , , ...... .,_ , . ...,„..,.. : ,,_: ., _„,., _ _ . .=(,(„:11,...:,,,,,t.,.,,,,,,,,,..,:,,,.., ,„, _ „„,... . .,,, .;,, ,__., „.„. ,. _ __,,,,,_„...,...__„:„. .„, ,,,, _,....,_,_. . . „ , . .. . %t §. ni -.1 n UW1 0 - O.p,�:'G. ofot ro U O f a 0 a g ,x0 cm R .„_. i a hr, n ro s _ a d g Go W oW xt N o N '^' N r I 4? ,...„, „It.,„.., ilm!I "_.,., .,. ,, .,,,,,,,,....0,„ . ,, ,,,,:„.1r ,i, =xi . , . ,.:. ,, ,,„:,,,,.,.,i,.,,...„,, . „..,,,., , ,_...,_ ..._,,,.----,,,-.4.- --!:--.-.1•::-.7,,-.-; - -:-.ff.. - '- , N. 1 .::::a likm!p. , tztori ASS 1�,: 4 4- { t 'F _ rat - - , d } �' - 4 f as 'te .' ,, a E. „ — :° row A . p� � C 0- , 5 .f i "', ma , ' ,. 7c' Ro - ,'' . - ,. f "�„, fi � - ',i'� a x A . � m C n r I1f 5. a,a. w 6, 7g2N '' N N N s q