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Home My WebLink AboutBLD-23-001124 ,-Of k;'i—e- rn ate` /� l/0 Office Use Only OV•Y� P11 10/ � Permit# 025--- C O H; Amount 90,tto _ MATTA M 1t ' Permit expires 180 days from issue date 6 t-D e3 -_&&IIZ EXPRESS BUILDING PERMIT APPLICATION TOWN OF YARMOUTH Yarmouth Building Department RECEIVED 1146 Route 28 South Yarmouth, MA 02664 , (508) 398-2231 Ext. 1261 1- AUG 3 0 2022 CONSTRUCTION ADDRESS: IT -PAO< 4-Va BUILDING DEPARTMENT ASSESSOR'S INFORMATION: f Map: t32 d Parcel:,___3.--?;OWNER: flit t C./'/lE—v''/ L / -7 . GZa e"- I- %�/YGG 4 SD 7?/ q4'0 7 NAME � / j PRESENT �ADDRESS /� ,/ TEL. # ,+ CONTRACTOR: k1 - )/f /p7 �'? i ed/h i k5, /)S'}'Z 5 Yiwi jam!J-( 1 4. NAME MAILING ADDRESS TEL.# 13 esidential ❑Commercial Est.Cost of Construction$ 2 dee Home Improvement Contractor Lic.# /35.--e4S 7 Construction Supervisor Lie.# ‘,81/347 Workman's Compensation Insurance: (check one) ❑ I am the homeowner ❑/Ham the sole proprietor ,I have Worker's Compensation Insurance ,,l ' Insurance Company Name: 4//)/ glioP/ Worker's Comp.Policy#.Q4"d "7 ;7 39f 2 WORK TO BE PERFORMED � �� Tent Duration (Fire Retardant Certificate attached?) Wood Stove I 1 Siding: #of Squares Replacement windows:# Replacement doors: # Roofing: #of Squares (❑)Remove existing* (max.2 layers) Insulation I I Old Kings Highway/Historic Dist. (1J)Replacing like for like Pool fencing *The debris will be disposed of at: xf.n/YYt.Q1J 4 ?i /1-1 • 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 y licen e an for prosecution under M.G.L.Ch.268,Section 1. 'K Applicant's Signature: Date: 1~3 6 —Z Z �`�� Owners Signature(or attachment) Date: `—'�_. Date: Approved By: Building Official(or desig e EMAIL ADDRESS: Zoning District: Historical District: ':: Yes No Flood Plain Zone: Yes I No Water Resource Protection District: Within 100 ft.of Wetlands: Yes .' No i I Yes No The Commonwealth of Massachusetts P s;9- L Department of Industrial accidents `1_ 1= �, � I 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 Please Print Legibly Name (Business/Organization/Individual): Alt a , ,/'tiii-toi& Address: c; q 9 V A fPLe j -Vit City/State/Zip: 8 X/±'ipt l /I14A. O26 i' Phone#: -77/ �' Are you an employer? Check the appropriate box: Type of project (required): i.iI am a employer with ,. employees(full and/or part-time).* 7. New construction 2.E I am a sole proprietor or partnership and have no employees working for me in 8. —Remodeling any capacity.[No workers'comp.insurance required.) 3.0 I am a homeowner doing all work myself,[No workers'comp.insurance required.]t 9. demolition 10 (I Building addition 4.0 I 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 11.n Electrical repairs or additions proprietors with no employees, 12.❑Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.Ell Roof repairs These sub-contractors have employees and have workers'comp. insurance.$ 60 We are a corporation and its officers have exercised their right of exemption per NIGL c. 14.Q 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_ tContractors 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. l Insurance Company Name: /4 71/ Rie li— / Policy#or Self-ins.Lic.#: /'4r/G, /44-2o3 4If70Z- 4 Expiration Date: 3'" IZ-'3 Job Site Address: I r 7)j , V, "hi City/State/Zip: X fy t,‘ � 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. 1 do hereby certify under the p . s and penalties of perjury that the information provided above is true and correct. Si ature: Ald`i /✓ Date: 0— a---z Phone#: zX-- -17 ''4'z.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#: Office of Consumer.Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston,Massachusetts 02118 Home Improvement Contractor Registration Type: LLC M J NAROONE CARPENTRY LLC. Registration: 135887 299 WHITES PATH Expiration: 0811412022 SOUTH YARMOUTH,MA D2854 Update Address and Return Card. OMc.of Consumer Admire A Realness Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date.If found return to: heyietration Foniration Once of Consumer Affairs and Business Regulation 135887 08/14/2022 lu 1000 Washington Street-Suite 710 J NAROONE CARPENTRY LLC. Boston,MA 02118• CHAEL J,NAROONE � f v 9 WHITES PATH j dorn •rna vot. KITH YARMOUTH,MA 02584 Undersecretary Not id without signature .5. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Const'tA% �isor CS-081139 OK,pires:09/16/202: MICHAEL J NARDONE 299 WHITES PATH C SOUTH YARMOUTH MA 02664 =C .7® S Commissioner (fie. K. Frnclt �� EV E RS=U RC E 247 Station Drive Westwood,Massachusetts 02090 ENERGY August 30, 2022 Sent to: ashley@mjnardone.com RE: 15 Park Avenue Hyannis MA To whom it may concern, At Eversource, we're committed to delivering great service. This letter serves as confirmation that the electric service at the address noted above has been removed. Based on this information, there is no electric power at this address and you may proceed with the demolition. If you have any questions, please contact me at (888) 633-3797. Sincerely, Phyllis MacPherson Electric Services Support Center TOWN OF YARMOUTH :ti; `� WATER DIVISION `1 �'�tp" , bi 99 Buck Island Road .E - f West Yarmouth,MA 02673 H r\rw,. M CHEESE �, �, E^ .; Telephone: 508-771-7921 Fax: 508-771-7998 August 17, 2022 MJ Nardone Dig-IT Construction RE: 15 Park Ave, West Yarmouth —Cut and Cap completed The Yarmouth Water Department performed a cut and cap of the water service at 15 Park Ave, West Yarmouth on 8/16/2022. This service has been paid in full. If you have any questions please don't hesitate to give us a call 508-771-7921 Sincerely, Yarmouth Water Department C:\Users\Mike Nardone\AppData\Loca1\Microsoft\Windows\INetCache\Content.Outlook\J5ULELXE\15 park ave-cut and cap.docx national grid gd August 16, 2022 Michael Lenzi 810 Merrimack Ave Dracut, MA 01826 TO WHOM IT MAY CONCERN: RE 15 Park Avenue, West Yarmouth, MA This email is to confirm that there is no live gas at this property. This letter DOES NOT preclude the excavator or homeowner from calling Dig Safe at 811 before commencing any work. State law requires anyone planning underground excavation work to notify local utilities by calling 811 to get your underground utilities identified for you prior to doing any digging. The call to 811 is the LAW and must be made in advance of starting work. This confirmation letter of a gas cut-off DOES NOT relieve the excavator of making the call to 811. It is a State Law requirement. I can be reached directly at 508-760-7439 should there be any further questions. Sincerely, W-0?-& Ellen Whelan Customer Connections, NE National Grid 127 Whites Path S. Yarmouth, MA 02664 (T) 508-760-7439 Y�R � TOWN OF YARMOUTH of . _Jyp BUILDING DEPARTMENT „ev „ATs eSE 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 261 BUILDING DEPARTMENT TOTAL DEMOLITION SIGN-OFF FORM State Building Code(780 CMR) Chapter 33, Section 3303.6-Service Connections "Before a building or structure is demolished or removed, the owner or agent shall notify all utilities having service connections within the structure, such as water, electric, gas sewer and other connections. A permit to demolish or remove a building or structure shall not be issued until a release is obtained from the utilities, stating that their respective service connections and appurtenant equipment, such as meter and regulators, have been removed or sealed and plugged in a safe manner." "All debris shall be disposed of in accordance with 780CMR 111.5." Building or Structure Location: Is" Map: Lot:---?‘" Owner's Name: Address:70-7% Phone: Contractor's Name: T-A41ii.-o, Address:*7 Phone: SD'j%- 7?/ Eversource: Date: 3Z) -2 By: `Fb�6'(r , /9t v"v. 1. �a Title: (5/4 c,(nti-u1 i!/t(� 6119/�+1 's National Grid: Date: e--r4- '9- By: er4,,, tt'/ '. Title: ,1-rr ac/wKi- a Water Dept.: Date: P-17-2?- By: /'i ► 4 i� _ fra ksi- Title: y!i1„rr,,,,Y- ' Board of Health: Date: By: Title: Condition: Fire Dept.: Date: -31-Z Z- By: z.+• g -e A-,vy VodLe,-.s.-0-- S.f ,es6'-e Title: L f,/1,Jf �' ��,rc pep Historic Commission: Date: By: Title: Conservation: Date: By: Comcast: Date: 3/15