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HomeMy WebLinkAboutBLD-22-007480 ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department ............. of 1146 Route 28, South Yarmouth,MA 02664-4492 •' 508-398-2231 ext. 1261 Fax 508-398-0836 Massachusetts State Building Code, 780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family m ly Dwelling This Section For Official Use Only RECEIVED Building Permit Number: BCD 22-DC11 180 Date Applied: - "�-----� JUN 2 7 2022 Building Official(Print Name) Signature . Date ___._. SECTION 1:SITE INFORMATION BUILDING ePARTMrvT 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers It did I1 74ni.0 /d tj o.O 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 2- 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,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: — Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Sa-ndap J JUL z'Jhrekusbu , mA- (Print) City,State,ZIP Ili Ji 4k3-a_410 y No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building ❑ Owner-Occupied 0 Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': new d bed roe,77 yeziztiti e, SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6 multiplier x 3.Plumbing $ 2. Other Fees: $ ram 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ gooloe2 Paid in Full 0 Outstanding Balance Due: .. 1 'I ~ SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) AA j �vOrJer /rl' d 57 aIt 57/c/Z 3 it Gij�/A�e /L`9 License Number Expiration Date Name of CSL Holder Y K t line,, )27,'WS d List CSL Type(see below) No.and Street Type Description 'NM /77/4-- ae-3G�1 U Unrestricted(Buildings up to 35,000 cu.ft.) City/TAn,State,ZIP C/ R Restricted 1&2 Family Dwelling NI Masonry RC Roofing Covering WS Window and Siding �a ,.� 9� L �.�� i 9S SF Solid Fuel Burning Appliances I Insulation Telephone Email address V(E.2••••4.N. ne--N0 I Demolition 5.2 Registered Home Improvement Contractor(HIC) N1 tGhgc j �nho�Lin�C,-r I I a t i t v 12_1 HIC Cpmpany Name or HIC Registrant Name HIC Registration Number Expiration Date !> 1'/i*ii rn/I/S ,Xd � b �S 9ScQu -, , No. d Street �"l 1 �> Pl yi-ext4 7 �4 0�3GD Email 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 0 No 0 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 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 By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. Print Owner's or Authorized Agent's Name(Electronic i e Date NOTES: 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.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2 When substantial work is planned,provide the information below: Total floor area(sq. ft.) Gross living area(sq. ft.) (including garage,finished basement/attics,decks or porch) Number of fireplaces Habitable room count Number of bathrooms Number of bedrooms Type of heating system Number of half/baths Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts 4i�► s Department of Industrial Accidents y ���l� 0 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 Please Print Legibly Name (Business/Organization/Individual): Nt '— e. -3 T\"v-1 elk.„,- f-.---,N. L. L Address: Li R ,- S , t ( . A-. City/State/Zip: c c- 3 L U Phone #: _S '6 —•`(' . . — 1 Are you an employer?Check the appropriate box: Type of project(required): I.E I am a employer with employees(full and/or part-time).* 7. 7 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. E Remodeling • 3.E 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 11.7 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp. insurance.t 1 Roof repairs :�,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. I.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 i 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. Signature: G�_/0,_ Date: v / 277 I R:\ 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#: i ' THE C Howe , 10. e,,. � s ,` t; ONTRAC.ro_OR w MICHAELti o P Goo, r 1 W. MICHAELt. P.C, '.'� � P S' 4 RU Opp. . ►'LYA pUTH MILLS 2 60 ,Y`Y I ; 1 [-4 /' �/ l Z`rl **Undersecretary0: it Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructio "14 p 1 & 2 Family CSFA-057128 r MICHAEL Ppires:O5/15/2023 4 RUSSELL r RD ,' ' PLYMOUTH 102 i' p ;i� ,fie... ,,so jy. ,.. Commissioner daeG K Sten i r June 23, 2022 Mr. Tim Sears Deputy Building Commissioner Yarmouth Town Hall 1146 Route 28 South Yarmouth, MA 02664 REFERENCE: 78 Old Hyannis Rd Building Permit Kind Attention: Mr. Tim Sears, Sir, as indicated to you over the phone I am the owner of the property at 78 Old Hyannis Rd. BUILDING PERMT TRANSFER I have terminated the current contractor and have hired Mike & Tony Elbow Pond LLC to complete the project. Mr. Michael P Goodman of 4 Russell Mills Rd, Plymouth is one of the owners of Mike & Tony Elbow Pond LLC. As discussed over the phone, thru this letter I request you to transfer the building permit in the name of the new contractor. STAMPED PLANS Mr. Michael Goodman will carry a set of plans with him. As discussed kindly get these plans stamped so that we have a set of stamped plans to start work. I will be traveling and out of the country and can be reached via WhatsApp on my cell phone at 508-963-2969. Thank You for all your help. Regards, (14/ 1U-el) Sandeep Sadhu 16 Sinclair Rd Shrewsbury, MA 01545 Cell 508-963-2969 WhatsApp : 508-963-2969 •y04 '�` TOWN OF YARMOUTH Building Department BUILDING �a (508) 398-2231 ext.1261 154-".. , ' y PERMIT NO BLD-22-001232 PERMIT V'c4""* ; { ► ISSUE DATE 11/19/2021 JOB WEATHER CARD APPLICANT @JohnM Schneider _ N PERMIT TO New Building AT(LOCATION) 178 MOLD HYANNIS RD, YARMOUTH, MA02675 -IRONING DISTRICT ! _ µ"Bldg. Type. Residential SUBDIVISION MAP BLOCK LOT ,94.13.42 BUILDING IS TO BE:ICONST TYPE " B FUSE GROUP 1R 3 m __ CONTRACTOR i REMARKS New Construction per approved plan 780 CMR MSBC, 9th Edition,TOY -1 i .__,..._. Bylaws- New 4 bedroom single family dwelling with 3 car garage I LICENSE CS-078819 (781-706-5980)A CERTIFIED AS-BUILT IS REQUIRED BEFORE FINAL t Construction Supervisor INSPECTION I.-_ _____. _,.._.__ "JOHN M SCHNEIDER John Schneider .. Plymouth MA 02360 AREA(SQ FT) EST COST($)[480000.00 PERMIT FEE($)I ,328 __.._..�.00 Lu__,___ _,_ , OWNER PAMPOSH USA INC BUILDING DEPT,BY ADDRESS 116 SINCLAIR RD ISHREWSBURY MA !di-545 .''°� -. PHONE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SI EWALK OR ANY PART THEREOF, EITHER TEMPORARILY OF PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEE FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM MINIMUM INSPECTIONS REQUIRED FOR ALL APPROVED PLANS MUST BE RETAINED ON JOB WHERE APPLICABLE SEPARATE CONSTRUCTION WORK: 1) FOUNDATIONS OR AND THIS CARD KEPT POSTED UNTIL FINAL PERMITS ARE REQUIRED FOR FOOTINGS. 2) PRIOR TO COVERING STRUCTURAL INSPECTION HAS BEEN MADE.WHERE A ELECTRICAL PLUMBING/GAS ANC MEMBERS (READY FOR LATH OR FINISH COVERING) CERTIFICATE OF OCCUPANCY IS REQUIRED, MECHANICAL INSTALLATIONS. 3) FINAL INSPECTION BEFORE OCCUPANCY 4) SUCH BUILDING SHALL NOT BE OCCUPIED REFER TO DETAILED INSPECTION SCHEDULE UNTIL FINAL INSPECTION HAS BEEN MADE. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTIONS APPROVALS /fre---01/ 1/4-1 I-- f(G)) (31641- (4 Re41141\ II 11-4Zt r 2��C.-- �/ ,'..._ --; hl Iei4l( ' 110/' c- ', 1- id— y OTHER: I iNORK SHALL NOT PROCEED PERMIT WILL BECOME NULL AND VOID IF NPSECTIONS INDICATED ON THIS CARD UNTIL THE INSPECTOR HAS CONSTRUCTION WORK IS NOT STARTED WITHIN SIX CAN BE ARRANGED FOR BY TELEPHONE APPROVED THE VARIOUS MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED OR WRITTEN NOTIFICATION. STAGES OF CONSTRUCTION ABOVE.