The URL can be used to link to this page

Home My WebLink AboutBLD-23-002741 ®1'4.-4 Office Use Only�� lyp Kj ® Permit# ClI 3 oL( ve .,AT ! fo d Amount S,[l� Permit expires 180 days from issue date a-a3 —0do q 1 EXPRESS SHED PERMIT APPLICAT TOWN OF YARMOUTH RECEIVED Yarmouth Building Department 1146 Route 28 NOV 16 2022 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 BUILDING DEPARTMENT By: CONSTRUCTION ADDRESS: c2/ gu ne.5 0 oe. 1 cae s e / 7oh O 6 f OWNER: _Pgvi' / 8eve(// A4f/len 3 I- 70 / Libg2._ NAME / �I/�� /[ PRESENT ADDRESS 1QQ,� ` Q� TEL. # �(� CONTRACTOR CDI IM.X3 P I d �bee t Ann/ d 14 "� '08cO NAME MAILING ADDRESS TEL.# )(Residential O Commercial Est.Cost of Construction$ 1 3aD i Home Improvement Contractor Lic.# I. a 93 5 Construction Supervisor Lic.#C_S-C-A - 67 381,05 Workman's Compensation Insurance: (check one) I am the homeowner I am the sole proprietor k 1 have Worker's Compensation Insurance a Insurance Company Nam .e al\tt" Li( ..-.__—Worker's Comp.Policy#eC C '� O b t57.2Z) SHED INFORMATION New X Size L ' x W I� x H I I 7 /Z Corner Lot: Yes No Per Town of Yarmouth Zoning By-Law Sec 203.5 Note E: Side and rear yard setbacks for accessory buildings containing one hundred fifth (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 he located thirty(30)fret from any front lot line Replace existing* Size L x W x H ' *The debris will be disposed of at: c � �` , ` ' ' ' ' I (, `A v' 4 Location of Facility I declare under penalties of : ry that t tatements herein contained are true and correct to the best of my knowledge and belief. I understand that any false answers) will be just cause for deni or 'v._a'on o ,iy license and for prosecution under M.GI.Ch.268,Section 1. Applicant's Signature: r Date: + ;� �+/I �__ Date: ///I7/ZOZZ Owners Signature(or a � / ��L% Approved By: Date: / Building Offic,/r j:mgnee) EMAIL ADDRESS: - Zoning District: Historical District: Yes No Flood Plain Zone: Yes No ( o O r� Water Resource Protection District: Within 100 ft.of Wetlands:*** n Yes No Yes No `I ***Note:Conservation review required if within 100 ft.of Wetlands CO 3/22 PLOT PLAN FOR LOT Indicate locatica of garage or accessory building Sewerage dismal (cesspool) 69 Well xi (1• I (.ltt................it. rear) I I Abutter's 4 --._. . Name Lot* i Abutter's • Name If this is a Lot# corner lot, REAR YARD write in /0//Z `i _' If this is a name of street. ........)....ft. She/ ` writer lot, write in name of street. I .0. 4 • J3O r . MD$ YARD 0- • HOUSE 51U$ YARD • • • • • • SET BAcx •_ft. . 1• ,v. • pat..................ft. fi altage) • / siDae., eia (NAME OF STREET) 7 / \ Znformatiran The Commonwealth of Massachusetts � l= Department of Industrial Accidents �:5 MEN Ill • 1 Congress Street, Suite 100 %Nur Vir W T./ / Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation insurance Affidavit: Builders/Contractors/Eieciricians/Plumbers. TO BE FILED WITH THE'ERMITTING AUTHORITY. Applicant Information f� ' Please Print Legibly Name (Business/OrganizationAndividual): MC GtaJh f 5L 4 dam �,'Ph at-1 r Address: ?$9 own Anne. 'oad City/State/Zip: )'j1rA..jCJfl1fl 0,9074-1 S Phone #: 5 '930 c 80O Are yoe an employer?Check the appropriate box: Type of project(required): l.0 i am a employer with employees(full and/or part-time).* am a sole proprietor or partnership and have no employees working for me in 7. [+ New delin construction g• Remo delin any capacity.[No workers'comp.insurance required.] g 3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]' 9 Demolition 4.D I am a homeowner and will be hiring contractors to conduct all work on myproperty10 p Building addition I will ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees 1 l.[]Electrical repairs or additions 12.0 Plumbing repairs or additions 5 n 1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet 1 These sub-contractors have employees and have workers'comp.insurance.: 13.0 Roof repairs 6.O we area corporation and its officers have exercised their right of exemption per MGL c 14.El 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. 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Information. insurance Company Name: ice) r"'�(a fl((15}1 I f� Policy 4 or Self-ins.Lic.#: —� ►�/-"l�/y�QS1_ �1/�oa /j ""v t p't rl Expiration Date:_ 8,a0,9 Job Site Address: City/State/Zip: __ Attach a copy of the workers'compensation policy declaration page(showing the policy number and eszpiration 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 r th p , an penalties of perjury that the information provided above is true and correct. Si nature: Date: Phone#: Gffic-al use u"tiy. , o not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2. Building Department 3. Citylfown Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ..4----- ,.• • ' * . , . ,. 2'.2-t..1 -coo7i2' Office '-411'.Consumer Affairs and It ,.Pre,e7,Jez ness-Regulatior ., ) B ol s°t oPna r, z . kmPaslas7at- S.uiettste 502/71016 • Ailh.. Home 'dnprovement al..,z4,..t: tor Registration-. • , Commonwealth of Massachusetts ._ .:-.-.... --2*. _a_ i;:;_ _ .., -sion of Occupational License, , i;, ----=_-_—___ --FilV1= tiara of Swirling RfAylations and Ste-22, ., McGRATH POST & BEAM CO. iii 7----,--L---f-l_fr _-_-. .• -. _ ..i.„a. i t t JAMES McGRATH ,,,., ,-..-..-.,---.-,.....-ia .,.........., ,SFA-C. 3865 ,:y '7''.:': .4'" 5:3016 I t Z, 03/1.4i 259 QUEEN ANNE RD , toi ••----._L_:_T-_,:z Li__________------------- . / AARINICH, MA 02645 Pticigl.t2t : 5,- 2 . ' 40 BREWSTER'','"riA i2":0.q :' 2 :•;:7' :4 it \it S - 1,,, ,,,,,,, - , ''-',*,' .,,' Commissioner &.eQa. . , Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusefts 02118 Home Improvement Contractor Registration Type: Corporation Registration: 132935 MCGRATH POST&BEAM CO. Expiration 10t30/2022 OIBIA PINE HARBOR WOOD PRODUCTS 259 QUEEN ANNE RD HARWCH,MA 02345 Update Address and Return Card. , •;."nlicii of Copmw Mitts 1., Sulkiness Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individust use only TYPE:Corporation before the expiratkwi date. If found return to: Reglattagan URAL/Won Office of Consumer Affairs and Business Regulation 132935 10/30/2022 1000 Washington Street -Suite 710 iveG,FIATH POST&BEAM CO. Boston,MA 02118 D/R/A PINE HARBOR WOOD PRODUCYS JAMES R MCGRATH '2 259 QUEEN ANNE RD ''1,44,-. 1.4 r' .(40'4- HARWICH,MA 02645 .,,..._--- N.IZZIrrrir: signature _ 326 Yarmouth Rd. I Hyannis,MA 02601 1508.771.5007 I Fax 508.771.7070 1 hyannis@pineharbor.com PINE HARBOR 259 Queen Anne Rd. I Harwich,MA 02645 1508.430.2800 I Fax 508.430.1115 I info@pineharbor.com Schedule Date WOOD PRODUCTS 1.800.368.SHED I Customer Service 1.866.SHEDKIT I www.pineharbor.com Estimate old B� �1 1..�t Branch\lvtat-)cThi \ Date_ 1 1 1 1 Invoice# lame - YLr► t \ IL) iC Mai\ ,V. /�l�R> ��"� ,ddress C' � �1 \ ��/^ �� `/l Ph q __S 1 \I A` \ 1 I._ State Y t ` z,o9u QL Pho I `g 1 Vo l @ DESCRIPTION AMOUNT size&Style abw r�� TZ Vrit #_ oundation Special Instructions lour j` WY lours bi, tv►..: 1 r • ,r , 150 Jindows is" a I .► U 60411M113.1111 ding s 414\1 11' NII iikit a ( dik ^ {, rim ,. sot Shingles 11A, _` ;upola&Weathervane R Ither A ia•• �4 Sub Total (j,>:�1, ,' �� 1�L' ap, Tax ,,j, l 1,`'_S ij► 4i417) Installation Delivery TOTAL = Deposit r ;heck Cash Credit Card 1 a a t BALANCE '`t��(� •A: ;ono 10' x 12 ' QUIVETT CAPE „.. 40151 XVIAlni STANDARD BASE PRICE - t 4-igiegii• IS ) ',' • INCLUDES 5 • ONE 3' BEADBOARD DOOR - PRIMED • ONE 24" x 38" VINYL OPENING WINDOW • WHITE CEDAR SHINGLES, PRIMED WOOD CLAPBOARD OR '` ' EVERLAST COMPOSITE CLAPBOARD FRONT • THREE REMAINING WALLS BOARD & BATTEN aroociplek • 3-TAB ASPHALT ROOF SHINGLES • PVC TRIM grogooOk • 4'x 10' STORAGE LOFT .61000,01,00. • 5/8" PREMIUM FLOORING • 10/12 ROOF PITCH $9,175 AS SHOWN WITH OPTIONAL: • 5'DOUBLE BEADBOARD DOOR WITH 4-LITE SASH UPGRADE-PRIMED+$560 • ONE ADDITIONAL 24"x 38"VINYL OPENING WINDOW+$275 • TWO PAIRS OF WOOD BEADBOARD SHUTTERS+$150 • TWO PVC WINDOW BOXES+$150 • PRE-STAINED CEDAR SHINGLE UPGRADE ON GABLE ENDS+$2,120 • ARCHITECTURAL ROOF SHINGLE UPGRADE+$120 ,. ....„."". ...., ,............: ..,..,„„_„,... ......., _...„.„.....,„, ................ „....„„„„„,„„„, ....„.,„. ..,....,.....„ . .....„„..„,.„.„.„„„::„.„.„:„„.„. „.,........„...„,..„,„.....„„„„„ ® .. .... ..... ..„.. PINE HARBOR WOOD PRODUCTS i r l Betta.Buildings by Ns* 010.0*0 *7904111076 toNadowoovi OSPOOMPF 1',24iy S"(nib, r