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BLD-23-001761
C - --eL4L) I6In . Office Use Only OCt Permit# C' -$ )i3i MA ,. _ r Amount 3 5,OD c Permit expires 180 days from issue date EXPRESS SHED PERMIT APPLICATI N TOWN OF YARMOUTH RECEIVED Yarmouth Building Department - 1146 Route 28 OCT 3 ��22 South Yarmouth, MA 02664 (508) 398-2231 Ext. 1261 - - BUILDING DEPARTMENT CONSTRUCTION ADDRESS: Iva SLXnfl 1..G,I4e kOhrif OWNER: t W0 CEM5 11.0 /1tGi5Mr 5 C1rI�,, /-por-V �t 606-77 C - OS54 s NAME. PRESENT ADDRESSL TEL # CONTRACTOR: 6Z.c„r► L=tn,,,h ht- SIS +rr C1•G.)-�r tj_00 f —'77b-0 S' NAME V MAILING ADDRESS TEL.# 4,Residential D Commercial Est.Cost of Construction$ 4r'9Z_' .$,._2 :5 0•CZ)Home Improvement Contractor Lic.# 1"7 4504 Construction Supervisor Lic.# CS -0 7$ 64 S' Workman's Compensation Insurance: (check one) I am the homeowner k I am the sole proprietor I have Worker's Compensation Insurance Insurance Company Name: Worker's Comp.Policy# C SHED INFORMATION '•"--7New,f__ Size L 15 x W b x H .-7'SJ Corner Lot: Yes i No 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 g x W x H 6 ) 0 3 A r. *The debris will be disposed of at _`/C.( DH , �fns 'e,[/ S 1 1 1 u•.. 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: (°/3/i Owners Signature(or attachment) Date: 10/3 Aga Approved By: Date:_ /#"'�"22 Building Official( ig EMAIL ADD 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 3/22 PLOT PLAN FOR LOr # 49 A 7 indicarbe I:catian c# garage or accessary building Additkner with dashed lines Seweragedisposal: (cesspool) EHWell of I --- 1 �3i c tt. a I— — 4 Abutter's Name Abutter's Lot# I Name f/ )` Lot# If this is a REAR YARD corner lot, 4, 42 1t 1" If this is a write in corner lot, name of street. 44— � )�ft•3 f` write in f name of street. 4 "/I b ,c,. 3G}" LAKE 13 ROAD SIDE YARD 35� �� HOtzsE SIDE YARD • • N , : .11 I a s8T BACx • 4 I al- nc+eroaes4 I (lot...! frontage) • / S Uoln tovez RoRD j (NAME OF STREET) —4 / Infarr•mat:1m 01Q� Q1Q\ V I WI b kennc, L Supplied by C&J `� G . 4nSteso r+ p).s The Commonwealth of Massachusetts =::40=1I Department of Industrial Accidents 1 Congress Street, Suite 100 _' _ f` Boston, MA 02114-2017 Nromi• '' www.nzass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information PIease Print Legibly Name (Business/Organization/Individual): r on Address: 9 4 Cifts-< City/State/Zip: ' , } �' 04) 4d67s- Phone #: 6DS-776—0Ss4� 1 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with employees(full and/or part-time).* 7. 7 New construction 2.2fam 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 El 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. Electrical repairs or additions proprietors with no employees. • 12.—Plumbing repairs or additions 5.D I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.I 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other NQWQ (kat) 152,§1(4),and we have no employees. [No workers'comp.insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1Contractors 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. Signature: Date: 10M* Phone#: - �'T - pgtF 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. EIectrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: • 14, 1 ;=11� S�� A v r0 Nip v - � - / vxz Ao s '�° ax I .8-80 -", ovi3e , 14,1, 4 or t3,1-6 m __ ;i z . 3 s s r 'was' kyysLow i ` pii , 4 m• QQ }y ` gay hiTilliiii. . i - 40 sl" 43't . , ,P, 'a -. . pz z `© d� 0mO i - gy p, '` •ik " L�, b.e eI _, ,,„ „ , -,,,, .. ... i„ --(' 'er4 4?" .0 ,eu: ,i3 r -' .A.AP 4,i7> ,4t• ,k\-- , j'y ' 1. k VAS 7.'z — A - \> Pi 2,. 6..3 C ` p '1 ��a Pie 101,\ j, 40,,,, .c, 0 . 1 Pn..o '% . . . Y- 71 0 alb a `y„ \b O i, O - :cø-'a Fi .I :° ;S49 *co, I +z ic> v digit \„jOt% 1. 'e � g 9 .I., fK O CO 70 ,. 0 g cn Co --13. 1 ' ‘ ir,0; if> 4. li - 49' ' , 71 > ' 61d6-0_14• • e . crpo -0 PI =C ice— 4• 4 �� 4 4°I t. t a ' 1 QtY p B 2 3P� • iP 144 t 4 \,, k t t t‘ oo�ov 1i '' ' - 4:.*cn 3 ', '- r, ,-, a 't I , se V NOC441 s. / use a�� s\ v' Voit y& P.u C3 g -'," - _ /' .0, a PAO 50-2 I ca rn 1-- _a —I I :-DARMOUTH John J. Mahoney 3831 31-�' Land iw Belonging to • Deed in Book Pogo ._ Land Court Certificate No. in Book Page - In Barnstable Registry of Deeds Swan Lake Shores" @ Yarmouth byNoyes & Bond, Engineers December 1926 Recorded Plan" Date of Plan ._ in Barnstable Registry Deeds, in'planBook 20 No. 15 Filed Plan No. — MORTGAGE INSPECTION PLAN THE MORTGAGE COMPANY . OF THE CAPE & ISLANDS Loan No. 103 Swan Lake Road, West Yarmouth /47 L s-J < Cr N LOT 14 8 Cr • / 38t,_ !a r . e»'E- sra>Py. ev 11"- `� s'4aoD-,Jo.l03 q ow ti, __ -t_ L.OT-1-4:8_A.. • W= x Syv y _ _ L b _ -� �o rn %. F o C _ . C • - 'yi4, <• ,emsN CJ . Opt) si _ * ,SEE:REMARKS June 6,.1985- 3Y Y :�>i JN-44226' - . ss �' ttt s -', Scale-1"-30. �,i; .`x *..),.-Y`' ,,-.� ' x � - I CERTIFY THAT THIS PLAN WAS PREPARED iK-.�,4 xt -. 1.� „. .:.. . r- .f - IN ACCORDANCE WITH THE COMMONWEALTH ii.� r of ° ;" .0, OF MASSACHUSETTS PROCEDURAL AND ' ,* `l : `',:f,ict.. .� •- %, ;--(- v TECHNICAL STANDARDS FOR THE PRACTICE 0. ..2,4 . rt T1} - _ .x.,..fj•::;_fk�„ •! - OF LAND SURVEYING 250 CMR 6.05 AND WITH •+„ 4.�=s + R _ - �_.�. .. - - THE SPECIFICATION SHEET ATTACHED HERETO. s ,, --_ _ rri.,r ilitrM..t 11 _.Fj - gg .'. _ f--. 3 _LN' ��.►�- - - rThilA(NEDNERSBN701,1‘1.:':"-- t.•.'" �G�.-d s ee�� y- :' ' s''• - r,..- •:.YS s•'• +. -7 ry,.. y ,i� , at,."'.+'-e." •_ No.31298 0 Sales Invoice No. 2833 August 22, 2022 6 Rhino Sheds 20 Harding St. Middleboro,MA 02346 (508)488-6612 8 Buyer: Sean Enright 103 Swan Lake Rd. West Yarmouth MA 02673 (508)776-0845 (M) sean@sunfloweroncape.com Description Quantity Ext Price Siding 8 x 6 Economic Storage Vinyl 4'wall height 2 $4,046.00 Shingles Gable Vents(Pair) 2 $0.00 Roof Type High Gambrel Chrome Hardware 2 $0.00 Floor Yes Standard 4'Ramp 2 $0.00 Single Door None Free Delivery and Installation 2 Double Door Gable End 5 Year Warranty 2 Shutters None Subtotal $4,046.00 Surface Turf/Dirt Discount $0.00 Slope No Final Subtotal $4,046.00 Permit No Sales Tax @ 6.25% $252.88 Target Date: Permit $0.00 ........_......_... Customer Notes: On-Site Construction $0.00 Total $4,298.88 Received $200.00 Payment(balance due upon completion)will be made by: Balance Due $4,098.88 CREDIT/DEBIT/CHECK/CASH Rhino Sheds (hereafter referred to as RS),is not responsible for unforeseen ground conditions,such as but not limited to sprinkler systems,septic tanks,electrical wires,stumps,roots,or any other foreign debris that may hamper installation&delivery, including setting anchors or installing posts.Buyer is responsible for informing RS of any underground cables,gas lines,utility hazards,or relevant matters prior to commencement of installation,and agrees to hold RS harmless for any damage done to submerged lines,pipes,cables,or other utility instrumentalities during installation.Additional charges may apply for material,repairs and/or labor.The building is certified for storage only,not for human occupancy. If this unit is not paid in full as agreed,customer grants permission to repossess unit from customer's premises upon which it is placed. This does not relieve customer from liability for the specific performance of the contract however,at seller's option. Customer Signature Date