BLD-23-001760 UNIT A 07
"'- Office Use Only
(kl. ' 11 OC\ Permit# 9.7
rt"vT^`" c'c_51 Amount 3 5 e_00
Permit expires 180 days from
issue date
L'p-- , 3 --60 ;7I Z
XPRESS SHED PERMIT APPLICAT ON
TOWN OF YARMOUTH
Yarmouth Building Department E I V E D
1 146 Route 28
South Yarmouth, MA 02664 I OCT 03 2022
(508) 398-2231 Ext. 1261
j® ; BUILDING DEPARTMENT
i R U� BY
CONSTRUCTION ADDRESS: )03 ft �j(„w,,r, Ce ti --
OWNER: `W0 C `45l5k.r5 CI rat,, 7-To r 1--I OA GO6-77 C - CY }'-
NAME PRESENT ADDRESS TEL. #
CONTRACTOR: y�r�x, �: h}- `'14 S1slx,rr rcl-�. `1- � '(sM -774 -O —
NAME MAILING ADDRESS TEL.#
,Residential Commercial Est.Cost of Construction$ ritiejr
Home Improvement Contraftor Lic.# 1 4504 Construction Supervisor Lic.# CS -0 75"64 S
Workman's Compensation Insurance: (check one)
I am the homeowner- I am the sole proprietor I have Worker's Compensation Insurance
Insurance Company Name: Worker's Comp. Policy#
CX®) . i U 3 SHED INFORMATION
New f Size L % x W 6 x H —2'S Corner Lot: Yes V No
Per Town of Yarmouth*mint!Br-Law Sec 203.5 Note E:
Side and rear yard.setb(kcks fin-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 lit'eli (12),feet to any
other building on an adjacent parcel. All sheds are required to be located thirty(30) feet from anyfront lot line
Replace existing* V 1 Size I C6 x W x H 6 - ) 0 3 13
*The debris will be disposed of ai: /c(/Mate _ lr e/ SIiNha..
Location of Facility
I declare under penalties of perjurylthat 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.
Applicants Signature: Date: I�/3/RA
Owners Signature(or attachment) /, Date: 10 i3/aa
Approved By: fi �i/ Date: / 2 --
Building Ofle' (or ign EMA DDRESS:
Zoning District:
Historical District: Yes No Flood Plain Zone: Yes No
Water Resolurce 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 LOT # 49 /0
Indicate locaticn of garage or accessory building
Additicns with dashed lines
Sewerage disposal: (cesspool)
Well Leg
t
= 1
I pit 13 ft.
Abutter's
Name Abutter's
Lot# Name
• jt, ),_ Lot#
if this is a REAR YARD
corner lot, If this is a
write in I` 42 -�- comer lot,
name of street.
3ij write in
t name of street.
4 qAt
t .. . 4Z:6
Bono
1 •
: ErDR YARD
?�-u 4i HOUSE SIDE YARD
•
.i i -
•
•
SET EAcu
• loth ft.•
:
4 I'm- nc rmovsl- A
IPoona'
•
Oat...I 2A *' ft. frontage)
s / S u co LA Ks ROAD
---"7 (NAME OF STREET)
, ..
. Supplied by
0104- t 00V ?1,,„ b 14AL
p1.s
• `� . The Commonwealth of Massachusetts
_t —,_ il Department of Industrial Accidents
'�7 _1't 1 Congress Street, Suite 100
: � ,.. Boston, MA 02114-2017
tr ""iiti www.rnass.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): 6e.AYN I r-,CI-c '
l7
Address: 9 it 5)5-)"ers 6(J-t •
City/State/Zip: ilivi,n,,,., eoc+1Oq Oa Os- Phone#: -T?6—0<+c
Are you an employer?Cheek the appropriate box: Type of project(required):
1.0 lam a employer with 1 employees(full and/or part-time).* 7, ❑New construction
2.21am 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.]'
9. ❑Demolition
10 El Building addition
4.❑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.E Plumbing repairs or additions
5.0 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.:
6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.['Other N 0 Ck�
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.
r 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. lithe 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. j
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
�^ -� �2
Signature:
Date: 10�3
Phone#: - `71 r O$4S'
Official use only. Do not write in this area, to be completed by city or town official.
1
City or Town: I Permit/License#
Issuing Authority (circl one):
1.Board of Health 2.Bi ilding Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Phone#:
Contact Person:
6,4
ice° m I $_ A ° 7 " ts ` ,�� _ \� ' _ _v_<_ 1' t IIVV _- _ I I
a //���[ly- e _ may\ t '
jJ;
0I .4 - ,Sy I ' 0_,y 111 I ' .0. ... A
y
z5= _ i pot + 'II •. - 40, _ ..`
Omm a—i y__ nI IL Off• �� Ilk
v -� `y�/ ���� � ^\> 0ir�
FiS )1" ti „ Pris)s. / ,k, 1,42. -,, 10,0,,,Ittol.A& 4.) A . t
,,,, % 4
+Nr
lii •ii. -/Oir,..* \tr,
mN ` 3 %•s O apP� s
O , tie O�0.0ii,:,),„,<>„ �� ��� \�^ 0
t 40 t_,..4%. t ti.c). \ 41 >1% . 8 ,
a d1t I% '' 12 x / •
§ ,tern 0'4 V'*°+ *Of) ,_ fi k •0 i
a. 1 % yiG0.4
+ g . i .
41 ' s‘E.: 1.2', 2 <9 .* I
00 g,
. 1) .
AG cam`'
CO
W
• 0. 1
ADD {ii f , t
m z (7 V 4,,V G
: ' ;�/
co
m � _ � �
f,
ET
I A1/4 IS 4
'..::' ,,,,, ik ,t t - t NVA
0 CO --4 s, f / - 9> es al
-la' 3'‘`-, ''• / i
iv cp co
'
2,-- z , --, ‘‘ I 1 <2C--: '
J
MO
O f I 4
m - 1 1 - I. ----
-
Lan f Belonging ARMOUTH John J. Mahoney 38311 31-,'
to Deed in Book Page ...
Land Court Certificate No. - in Book - Page...........In Barnstable Registry of Deeds
Recorded Piae'Swan Lake Shores" @ Yarmouth byNoyest: December 1926
Bond, Engineers
Date of Plan —
in Barnstable Registryof Deeds, in'plan Book 29 No, 15 Filed Plan No......»«..»»..«.««.....»»«..._
MORTGAGE INSPECTION PLAN THE MORTGAGE COMPANY . OF •THE CAPE & ISLANDS
Loan No. 103 Swan Lake.Road, West Yarmouth
/417
/ . ‘‘..,. i
in
Ls,J Q
.•• . LOT 14 8 Cr•
T
_= 38,_. • I _i =
9G.
: hiackt).A./03 i d e
- ._ _*t - I j
- .. _ t_ . -L OT-1-4-8=AT.
W=
s . a - x
L .N _J�
•
\� -Ir - - -—_ ('7 d
�= rC
c 3-7- I1
_ � • _ N C-1
. "t rn
_i 47 .c. _
• ell �_ ^' =
*:SEE:REMARKS'.
June-6;_1985- ' • - • }"k1 s: t",>fs
Scale-1"=30.= - '- / ,5 s �y
-` •`'j'(} �}�Y`! �ill..i...Y C'•V 1
•
t• •r• ...4 ., - 1 CERTIFY THAT THIS PLAN WAS PREPARED
_ r. IN ACCORDANCE WITH THE COMMONWEALTH _
)1,1
A�• ; n �x» ;��_ 1��• S; OF MASSACHUSETTS PROCEDURAL AND
r'� =• �,r s?; :;• '� TECHNICAL STANDARDS FOR THE PRACTICE
�'' ��. OF LAND SURVEYING 250 CMR 6.05 AND WITH
i , ' _ - c .ate-; THE SPECIFICATION SHEET ATTACHED HERETO.
- -- :4,!..2f- S •;=_:74----:-;. Eirr
sE sn t , _t r•5 t�I/ '^ 0►1tU- .,. ;:rim`'*4. ("011;
si
-4'4;•y- si yam' : `=r-.,, i % KENNETH 1�
f:• '3 3•1:': .- -
.ir►. .u. .t' ...�c.-j`-s_ _... 3 No.31296 f.0
ry
tiG Y.. 44 W1M.T..xwevyct+•RM r.+Mz:.Pmrs•4.+v.•.Y+ai*-u...,... ,.w. • . • •. •
i
Sales Invoice No. 2833
August 22, 2022
6
RhinoS eds
20 Harding St.
Middleboro,MA 02346
8
(508)488-6612,,
Buyer:
Sean Enright
103 Swan Lake Rd.
West Yarmouth MA 02673
(508)776-0845 ;M)
Description Quantity Ext Price
sea n@sunflowero icape.com
8 x 6 Economic Storage Vinyl 4'wall height 2 $4,046.00
Siding
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 pccupancy.
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