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HomeMy WebLinkAboutBLDE-23-000336 f. 0. cuILLec 1I1,74 -. 0101' YRrtr� Office Use Only t/(fr ( . o 0.2.41.0Z�C Permit# 'IA, � -0.,C���:E d' Amount 3 ia Permit expires 180 days from issue date etD - 023 - O003 EXPRESS SHED PERMIT APPLICATION TOWN OF YARMOUTH RECEIVED Yarmouth Building Department - ----- 1146 Route 28 JUL 18 2022 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 BUILDING DEPARTMENT % CONSTRUCTION ADDRESS: 14142 C,rcu'b rr e G—(.�11 t- ��11 1Nktt-r I' . ILi G6-c., VOWNER:aci5f)A -e-. .c-t o r- 1(1. 1 Cry.-terry Lc4 e. 5 39'$. /a ym NAME PRESENT ADDRESS TEL. # CONTRACTOR: .Q.i NAME MAILING ADDRESS TEL.# ,eResidential o Commercial Est.Cost of Construction$ Home Improvement Contractor Lic.# Construction Supervisor Lic.# Workma}'s Compensation Insurance: (check one) I I am the homeownerX I am the sole proprietor I have Worker's Compensation Insurance Insurance Company Name: Worker's Comp. Policy# SHED INFORMATION fJ,/G b/ejlaP j/i9 ANew Size L /0 x W ) ©., x H C' Corner Lot: Yes No x`� 1//SW'? Per Town of Yarmouth Zoning By-Law Sec 203.5 Note E: Side and rear yard setbacks for accessory buildings containing one hundred fifty (150) square feet or less and single story, shall be six (6)feet in all districts, but in no case shall said accessory buildings be built closer than twelve (12)feet to any other building on an adjacent parcel. All sheds are required to be located thirty(30)feet from any front lot line Replace existing* Size L x W x H VP- The debris will be disposed of at: \I(JLC tnO(.C41z 1.--- t�r rrs-Fe,r 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: Date: g Owners Signature(or attachment) thja4&41.....6Date: / a- Approved By: Date: ^ -1 Building Official(or desi. EMAIL ADDRES Zoning District: 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 if within 100 ft.of Wetlands 3122 _, .'� The Commonwealth of Massachusetts Sinlid►= Department of Industrial Accidents v�Al= I Congress Street, Suite 100 _a �= Boston, MA 02114-2017 •, IMP 5.,.�'' www.mass.gov/dia Yorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information / ) Please Print Legibly Name (Business/Organization/Individual): I\(A.{le__ (—I 6 b ' -/ I Y)(iS-�) Yl L ('(.SCi /1 /Address: 1 it(� (, ! i'yl 6.e.c rq '� City/State/Zip: ,a) u4-}-h (ifr�1b c�`F��1 ln`� Phone #: .( -36 • 13-q° Are you an employer?Check the appropr ate box: Type of project (required): 1.E I am a employer with employees(full and/or part-time).* 7. New construction 2.E 1 am a sole proprietor or partnership and have no employees working for me in 8. E Remodeling a capacity. [No workers'comp. insurance required.] — 9. _ Demolition 3. I am a homeowner doing all work myself. [No workers'comp. insurance required.]t 7 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 11.E 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.C Roof repairs These sub-contractors have employees and have workers'comp. insurance.1 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.E 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. (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. ij' Si —G nature: t 2 L .6 � Date: • l g J z 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 locattcn of garage or Additions w accessory building nes Sewerage disposal (cesspool) Well aff I I I (tat rear) }-Abutter's i , Name Abutter's Lot* I Name Lot# If this is a REAR YARD /� corner lot, V" If this is a write in corner lot, name of street. ft. write in ` name of street. .0. • ,o � I � SIDE YARD HOMESIDE YARD • • • • • • SET BACK • ' ft • (/ot ft. frrntsge) • e_`tn be LP \ / (NAME OF STREET) \ Informatirn Supplied by TOWN OF YARMOUTH 1E8120V: D • $ - .. 7, :::, . . .. ". 1146 ROUTE 28, SOUTH YARMOUTH MA 02664-4451 . , It 7 appoy . R E: JUL 1 4 2022 1 AHMOU I r- OLD KING'S HIGHWAY Telephone(508)398-2231 Ext. 1292-Fax(508) 398-0836 0' D KING'S HIGHWAY HISTORIC DISTRICT COMMITT APPLICATION FOR CERTIFICATE OF EXEMPTION EvILDING DEP—ARTMENT Application #$ hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of Acts of 1973 as amended, for the proposed work as described below and on plans, drawings, or photographs accompanying this application. Type or print legibly: Address o proposed work' /v6 „ e_e_,A)4,2,gieley ,94.46 MapiLot# //q, i.:;)y 7 Owneq$) ("Ina. ,4.--,-,etie 1 cxe./ 0,6_ A.,/zz,s,,,() Phone 4-64-3-45- /..3.if° All applications must be submitted by owner or accompanied by letterividm owner approving submittal of application. Marling address ./2,,:--ie ..7 4.11 ts,Yer.,_mckm ip, Year built /962_ I - Email 0.,C4 3+14-0,....11-e-r 0,0/4 CC"in Preferred notification method Phone Email AgentiContraCtor Phone# Mailing Address Email preffilrred notification method Phone Email Description of Proposed Work(Additional pages may be attached if necessary): 4_9 * rt ',6 g , e/ 4 ....._ Signed(Owner or agent) 1 0 Date. 7 4Z g2.-- .. ',... Ownericontractorlagent is aware that a permit may be required from the Building Department (Check other departments,also) > This certificate is good for one year from approval date or upon date of expiration of Building Permit whichever date shall be later For Committee use only: Dale _71o/iv__ /Approved Approve ''';''.-R:- . VILDenied i Amount ;De 11) Reason for denial -414 1 8 2022 Cash/Ck O. Ce4 h YAANIOU l'h OLD KING'$HIGI-.1W,AY_I Rcvd by: 1.-15. - Date Signed -711,42 ., ,,„_ Signed. „(Z aiteetN24 eito?1 ) APPLICATION#' ,45 20,7 Sherman, Lisa From: RICHARD GEGENWARTH <r.gegenwarth@comcastnet> Sent: Thursday,July 14,2022 2:32 PM To: Sherman, Lisa Subject: Re:22-E095 146 Cranberry Lane $ Attention!:This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe.Call the sender to verify if unsure. Otherwise delete this email. If the shed has white trim and roof shingles matching the house I would approve Richard On 07/14/2022 11:33 AM Sherman, Lisa<Isherman@yarmouth.ma.us>wrote: I ' 4„__ „(11 11:1 Hi Richard, Residents would like to build a shed at 146 Cranberry Lane. Please let me know if you need any additional information. Thanks Richard, Lisa Lisa Sherman Office Administrator Old Kings Highway Committee/Yarmouth Historical Commission Town of Yarmouth 508-398-2231,ext. 1292 gd, C--047S— TOWN OF YARMOUTH ( 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451 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 w ithin 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; hut in ally event within finiy-live (45) dovs (Vier the filing ofappiiralion, or within such further time as the applicant shall allow in writin , the C'ommittee shall make a determination on the application. " Applicant understands that the review of this application will be schedtded as soon as the situation allows. Applicant/Agent Name(please print): /47( Applicant/Agent sianawre:__ 2-2— /-71 ...., _ , iii' i 4 28P __ • = Ilw ims-P*6 E ill s OLD (-0-i HW A i i KIN 'S HIG \( UM 1 8 022 YARMOO 1H OLD K(NG'$ 1-119HWAY ' •'e''V fr 3/2020 Application #: T.4 - - ,.. 02 . .. ,,,, . • .., . - ,A't , .i' ..•,, ,, r . •-• .:,F, :,,, ,.. .,. `-. , .. . .•:...„, „... 40' f i i . . ..itit.. 1 4 2022 ' f , r rirtiviOu if; () -LC)KINGS HIGHWAY C Jzt co 4.;. _1 as >, ,..., s.... (I) ..C1 C ; 'A : • ,, I V E . CO 0 .-4 In Ln s..... a I i2022 1 1 YARMLiti lil Of.f.)KINGS HI HWAY i ..-1 .r.4 .”..1 v.8 Cr; e..1 a; ki..» ,.. .le 2 4/4 '4.'..,kt.0,1r• , ''''`Wri,g,'•.*°,', ,,,. 7 c a. "-). v,,'''''W.,3,••• ," '''... 5. o ii to .,..., JUL I 4 2.02.? [ 1 JUL, . 18 2022 i - YARMOU1 rt 1 OLD KING'S HIGHWAY ji MAMU 1 ., 1 •, OLD O KING'S.HIGHWAY j , C4,.... (i.. ... \--.. , --‘b *.'"',..,,,- 7-.•. A. ,.... 41 _/....„0 .....,,* 3 .......; .....„. 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Jul 12,2022 7:41 pm Attachments: '''''',.:4-4.,:''."'.....`,"5?--,;,-..:,::,,..!:... ..'",..4,-A$1141,12t'--.• ,-:°.,-4:..4. --•'-' ", - ' '':4:-.'. :......:„...,4*30P,-.- ; - ,- --;:,,,-7 --7.--•:7,.... ;ii, ,;,.., • .:.,•...::?,;!., .. . ‘. 4'*• '' ''!t.'... ill ... .... , g. .. .,..., „._,..„ ''' •'''''-or F 1 1--: .'-k.'• . ... . 1 4 2022 1 ,I,JL ,,,Av j l't G' HIGH" ' OLD KIN ' iiiL 1 2022 yAiimou;,, ; OLD Ki S 1-11 iivii,y_ , 03- p--'.