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HomeMy WebLinkAboutBLDR-23-12960 pm 0 -ci -z 3 R E _ E I 1 TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department , ' ..._"y I E �� �� 1146 Route 28,South Yarmouth,MA 02664 4492 508-398-2231 ext. 1261 Fax 508-398-0836 i rgx..1%,e, '. Massachusetts State Building Code,780 CMR gNT �: _ _ __ y .tszu�drng emit Application To Construct, Repair, Renovate Or Demolish �"`" """ a One-or Two-Family Dwelling Xhis Section For Official Use Only Building Permit Number: e)('1 PI"2- 'i 7 04- ,V0 Date Applied: 7 y 1 ��^ C) %�5 (I- -d.3 Building Official(Print Name) ign'S ature Date SECTION 1:SITE INFORMATION 1.1 PropertWdress: ( f� 1.2 Assessors Map&Parcel Numbers , , 1 % KCx. l �3 f'1 1.1 a Is this an accdpted street?yes)4 no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) -1.5 Building Setbacks(ft) P.:>° Front Yard Side Yards Rear Yard Required I 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 0 Private 0 Zone: Outside Flood Zone? — Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owne 'ofR r � � i �v►)1 o f v e7 ,s : f G,r'm 1 �, f C1�1 R Name(P int) 1 City,State,ZIP ')) I< mo hj) to ve. 3G) ,- i c -Jot', c- )vcl.. 4m ck Gcsr\ No.and Street I Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORD'(check all that apply) New Construction 0 1 Existing Building 0 ( Owner-Occupied ❑ 1 Repairs(s) 0 Alteration(s) 0 (Addition 0 Demolition ❑ I Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Work2: I/ SECTION 4:ESTIMATED CONSTRUCTION COSTS. Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ Cli 000 1. Building Permit Fee:$ M Q Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6 x multiplier x 3.Plumbing $ 2. Other Fees: $ &P(i t O V C. b 70 4_Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount 1,, i 6.Total Project Cost: $ 3 C�(�}(� 0 Paid in Full l]Outstanding Balance Due: 6 60 107 oR J g frilsti co / SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U 1 Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted l&2 Family Dwelling City/Town,State,ZIP M MSomy RC Roofing Covering • WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Company Name or HIC Registrant Name HIC Registration Number Expiration Date Na.and Street 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 ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WREN 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: OWNER'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. 4 );CT C \ ,0 / ,�)&& Print Owner's or Authorized Agent's Name(Electronic Signature) 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.sov/oca Information on the Construction Supervisor License can be found at www.mass.nov/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" The Commonwealth of Massachusetts a Department of.IndustrialAccidents aifir�'�� 1 Congress Street, Suite 100 `'#it Boston,MA 02114-2017 M — 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): � (, 1 y (..I CG\ �e l/ Address: -11 Vt»INd Ate, v City/State/Zip:, 7.. Xi-crylv b Zt Lk Phone#: t3{) 3 I -441 ) Are you an employer?Check the appropriate box: Type of project(required): 1.E I am a employer with employees(full and/or part-time).* 7. ❑New construction ?.Q 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. I am a homeowner doingall work myself. t 9. ❑Demolition ❑ y (No workers'comp.insurance required.] d.faracn a homeowner and will be hiring contractors to conduct all work on my property. I will 1 Q E Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑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 13.0 Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. I 4.❑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. 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. Insurance Company Name: Policy#or Self-ins.Lie.#: 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 ivIGL 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: �vQ'�.� Date: 1 I 1 ) D`J3 Phone T: 1 - -3 ) 9 �- L10i l Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License r Issuing Authority(circle one): I.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone I/: o1. R4 TOWN OF YARMOUTH � - BUILDING DEPARTMENT rt`pp ^T,,,+: =, �'4, 1146 Route 28, South Yarmouth,MA 02664 508-398-2231 ext. 1261 HOMEOWNER LICENSE EXEMPTION PLEASE PRINT: DAZE: JOB LOCATION: 1 ,, LSr4 � 1 c NAME I STREET ADDRESS SECTION OF TOWN "HOMEOWNER" Li t j CIA)V 3G 1 " 3 I 'I —A A? tr NAME, HOME PHO WORK PHONE PRESENT MAILNG ADDRESS 7 ) Kc,,:i rnm f'vc A-tif L------ CITY OR TOWN STATE ZIP ODE The current exemption for `Homeowner' was extended to include owner—occupied dwellinCIs of one or two units and to allow such homeowners to engage an individual for hire who does not possess a license,provided that such homeowner shall act as supervisor. (State Building Code Section 110 R5.1.3.1) Definition of Homeowner: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is or is intended to be, a one or two family attached or detached structure assessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner;such"homeowner"shall submit to the building official, on a form acceptable to the building official,that he/she shall be responsible for all such work performed under the building permit. (Section 110 R5.1.3.1) The undersigned `homeowner' assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned 'homeowner' certifies that he/ she understands the Town of Yarmouth Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements. HOMEOWNER"S SIGNATURECS" Li C �� K/ APPROVAL OF BUILDING OFHCIAL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch.142. Yes No If you have checked yes,please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent h:homeownrlicexemp §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 ext.-1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at —71 ' '`c.Y 1\ , Work Address Is to be disposed of oat the following location: Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. n ) D-2 Si&ature of Application Date Permit No. '71' AYMOND AV 00690X15 Page '001 Nbhd: 290.00 L095 M100 B095 f Date 1/01/91 1010: Single Family 7/1/vi Appr D800 DN CAMA 105400 • Value 105400 a ///'r/91 By CAMA BUILDING DATA r No Bldg Feature Description +- + 01 Building Use Ra Bch rY! i� I. ! 02 Model SF ! ,4Tr I, ! 03 Exterior Wall-1 WOOD SHINGLE ! 14---+ ! 04 r ! t_ ! 05 Roof Structure GAB E OR HIP ! ! +Y 52+---24 + ! 06 Roof Cover ASP ALT 124FGR(336) ! ! ! 07 Interior Fin 1 DRY ALL ! ! 18 ! UBM(336) 1 ! 08 ! ! ! FBM(963) ) 26 ! • -09 Flooring - 1 HAR WOOD ! ! ! +---24 + 10 ! +-14---+-+ 12 ! 11 Heating Fuel OIL ! 3 ! 1 12 HEATING HOT WATER ! + 46 + ! 13 Air Condition NON ! ! 14 Duality AVE AGE ` ! 15 Actual Year Bit 196 ! ! 16 Eff. Year Built 197 ! ! 17 Normal Depr Tbl 1/./ lEAR ! - ! 18 Economic Obs. 000'00 ! ! 19 Functional. Obs. 000400 ! ! 20 ! /' 1 21 ! ! 22 Res. Bedrm/Bath 03 :DRM-1.0 BTH ! ! 23 +--- + 24 Number Stories 1.0 STORY BAS 1304 25 FGR 336 26 FBM 968 27 UBM 336 28 ti 30 SALES DATA PERMIT DATA BUILDING SUMMARY --- No Date DC DC S AC Adj Sale Price No Date Permit Amt Base Area 1941 01 3/92 OC 0 I 106500 724 9/92 1400 Bldg Rate 41.15 Repl Cast 79880 Depr Pct 17 RCNLD 66300 MISCELLANEOUS DATA No Use Description Grade Misc Units Adj Price Yr DT Dpr Value 01 FPL1 Fireplace/1 Sty Chim 100 1.00 2200.00 74 01 017 1800 02 FPO Extra Fplce Opening 100 1.00 800.00 74 01 017 700 b 3 f,s MISCELLANEOUS VALUE 2500 LAND DATA ---- No Use Description Zoning Land Units Adjustments Adj Price Value 01 1010 Single Family R s 10018.80C SI 3.66 36600 MARKET LAND VALUE 36600 Mr , li • ,-, rl 0 N O M - .r O j09 N N N .-? za g am v , I I it, cof I / k * w m *m °r co t> A ? ' ' N N 11 i! 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CO all _ m > ' m - ( k\\ 0 cc> 1 \/\ 33 § i'M - . / \x Fr, MI' 1,02 )§(2 - \w _ { \ } \\\ 8 RI ( mew Ledger Board to be flashed and bolted%,«bolts with washers or equivalent_ry+on center (See ledger detail in de COI k�construction m emm@+n pressure w wmmMmAe.am+a_# e nailed. 114111(1%(404, Beams to be sh uretreated southern IRC code. (See rail detail in deck construction guide) Stairs to be maw 7-3/4"min rise«m run,2 per IRC oade. (Se stair detail in deck construction guid e) Decking e ~ ®o Pressure manufacturers' ° N 0 rn g mzrmb° 0 0 ° y ><mcz v� moS Fr., o a 0 S m.. A WC ➢ o o I, ZO mp=DU C- Z C 3 C D < I m n m z °m° m oDmZz Z Z y D D ° mfbi1F v10 1 0 i9g z Z 1 oD 1 A m N Z O y 3 7 a � z X y O C m V D D jC rz - m ° -1 g3 m 0 33 m `o C m O 2 !7 H D 1 O 1 I D 1 C 1 y • D Z O - co m o o a 0 z O I T - - -1_ 0 i n 1 F L a m 1 --,I Z rn Z II ° O FF. " D r z 37 m CD m z F D r i t t t b O D N ?O 8N° -'o cU'i ° p D O m�D3 m 9 Z D D a Z_ n D� O 3 D m y 03$ °rrtn D D9 ,_33 D O 10 ,2 Z D T I7 D y C m <m OOmF D Z° D C O mmm DrI D N y O F m D Z® my am DymO Opm ~ DOSC N m y>O 'DK•O m n BaiaOO o O m mES E D Z co,30 9 ° U m F Nns3 m < m K D rg • 2x10 Ledger Board to be flashed and bolted(2)1/2"bolts with washers or equivalent every 16"on center. (See ledger detail in LCKS.CV rn dock constructionpressure guide) Joists to bee 2x10 treated southern yellow pine installed 16"on center. Beams to be 2-2x10 pressure treated southern yellow pine nailed. / Guard Rails to be 36"high with less than 4"openings per IRC code. (See rail detail in deck construction guide) Stairs to be built max rise 7-3/4"min rise 4"in run 10"per IRC code. (See stair detail in deck construction guide) Decking to be 5/4x6 Pressure Treated Pine. (Follow manufacturers'installation instructions) All hardware to be corrosion resistant and installed per manufacturers'instructions. 4,', MIN00 A y DCmps m my m3 oa�� A 0 W3�C T HoD a OCD IO z onm z� yo°N� Z a x n z N am N N P m Z o zamNo m o ruia p DO 0 m mmo z I °z�� Nocm x D ac m o ? L 9N a) 0 m O C a - O Voi. .A IMIIIIIIMMINWL O ■=■': a ■_■,. ■ c. ■_■' D W ■�■! Co c '■■ 1■', ■ m 60 te g■I 0 ■ r ■�.' z :�■, H o ■ = ■ .,. ■1 m ■_■' n ..1111. ■�.' z Ri ■�■ m ■ ■L z m 1■... ■ O ■�■ z aI■�■' z ■�■; 0 ii '■_■, cm o m ■ter, O m Imo- ■.■,. 5 Z rcor: x ■-■' r ■�■1 n ■-■ O ■�■ O ■�■ m F 8 0 1■— ■I z ■�■ 0 m ■ter O O N o c �_. L�1 D 'K 0 _ U o n �S 2P g O m m Z n n D 3 O g<2 S D a m c c y < OaM Do So O°°_ ▪ tonmm n 9 a N myyy a D C N NO Z F e°y9m DOm➢ DO NaaNmO D S ,o N ON yT S �y 3 N DZ O l D®yO m mm O 1aZ nm 2x10 Ledger Board to be flashed and bolted(2)1/2"bolts with washers or equivalent every 16"on center. (See ledger detail in decks.com deck construction guide)pressure to be 2x10 treated southern yellow pine installed 16"on center. Beams to be 2-2x10 pressure treated southern yellow pine nailed. �� Guard Rails to be 36"high with less than 4"openings per IRC code. (See rail detail in deck construction guide) Stairs to be built max rise 7-3/4"min rise 4"in run 10"per IRC code. (See stair detail in deck construction guide) Decking to be 5/4x6 Pressure Treated Pine. (Follow manufacturers'installation instructions) All hardware to be corrosion resistant and installed per manufacturers'instructions. 0 n CD 3 n a r l' m Izt A II I 0 !I0 co m z mom -13 D 0�0 SJ o 1 3 o 3' o - m 3 ° O z z _X V oimo1ynaT 0 _ gg_NoBm cq a 0 3 -c& Oa m Z 0 O D O D n , D Z N 1 a D ccn m FA I : ' o 0 0 t mD Cl) Cl)( D D z_N mxD I Dm ON Nz m < 1E z zEA 1' 33 m D (m o —I n N 0 0 0 r 0 C C O F - CD CD CD m m D uiut ODiri , O O�3 ti Z Z N w m 0 n n8l N 0 N N Z HP',", D D O g D Z a y OOm D O Z m y 0 SO -_Ci 0 ONm2 < m 2,Oy6 D D O=J D T M O rtXl O D< D D r m O O m m iti OT 8 N y S OT O M N O D m D D O N 2z N O NO5 N D_O n3 Footings to be installed to 48"depth as is required by your local building ordinance. e/" CS.COtfl Frost footing sizes based on 55 lbs per square foot tributary loads applied to 1500 psi soil compression capacity(assumed clay See footing detail in deck construction guide.