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HomeMy WebLinkAboutBLD-23-005760 , P Rier-\'i'l k...i -1.- \,c)\l'A‘„IIN, \0 ) c i 13 _____ ONE & TWO FAMILY ONLY- BUILDING PERMIT Town of Yarmouth Building Department or y 1146 Route 28, South Yarmouth, MA 02664-4492 508-398-2231 ext. 1261 Fax 508-398-0836 j a ;i: :441%'N Massachusetts State Building Code,780 CMR Z., Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: V Lb-a 3-t 60 l Date Applied: R E ' v [—APR .1:3 2023 Building Official(Print Name) Signature Date j SECTION 1:SITE INFORMATION A BUILDING DEPARTM N L°". E N T 1.1 Property Address: — _ t Map1.2 Assessors &Parcel Numbers o/.. G C ECG ,V y4 tv)mcwTh 1.1a 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) 1.5 Building Setbacks(ft) 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 Zone: _ Outside Flood Zone? Check if yeste Municipal 0 On site disposal system 3 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: e� fFe R Coh t~Idvm65 Cq a23 EcKc� Rr) yak ,oU7-I-yA. 47 Name Print City,State,ZIP `� (13 Gdko C1,1 g'-42�1gc3 _Tell'frefa ceGw, L. 0, No.and Street Telephone a' ¢ P Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied ❑ I Repairs(s) ❑ I Alteration(s) Addition 0 Demolition 0 I Accessory Bldg. ❑ I Number of Units 1 Other 0 Specify: Brief Description of Proposed Work2 SECTION 4: ESTIMATED CONSTRUCT N COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.BuiIding $ 110.Gam,GC., 1. Building Permit Fee:S Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee O ❑Total Project Cost(Item 6)x multiplier x 3.Plumbing $ 0 2. Other Fees: S 4.Mechanical (HVAC) $ O List: ue..1 CZ j/O/ 5.Mechanical (Fire �' Suppression) $ Q Total All Fees:$ 6.Total Project Cost: $ /' Check No. Check Amount: Cash Amount: yG,Gu--c.cc) 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) I.(/(,�rn (q�Lacs' P 'f`/\e C.j4 t�� LicenseNumber'1` Name of CSL Holder Expiration Date c—a IM P `� �P f 3 List CSL Type(see below) V No.and Street Type Description (AJ. �RV � Irt f-j Nn„ 6�� © Unrestricted(Buildings up to 35,000 Cu.ft.) City/ n,State,Z_ R Restricted hk2 Family Dwelling M Masonry RC ( Roofing Covering WS Window and Siding :�o$36Q,S110 SF Solid Fuel Burning Appliances Telephone tJJ L Lac i\Mack 1 )l�i6T w,pt 1,to I Insulation Email address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) (.) .ac,t eeRetR3 1,,A3o ace! a� BIC Company Name or HIC Registrant Name HIC Registration Number xpiration Date �qZ c_A1� ST �P1 �-S No.and Street lnl a L�-c�C-2��1 C N aL>Oca;,l N6T W ciRV-zu't \ . .• 0f167. ,dog 360 Su a Email address Ci own, State,LIP 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 No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERIINIIT I,as Owner of the subject property,hereby authorize u,)A L a �� to act on4my behalf, in all matters relative to work authorized by this building permit application. -4444 - Print Owner's Name ectronic Signature) {,,z Date • SECTION 7b: OWNERt 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 Agents Name(Electronic Signature) D oc-� Date NOTES: I. 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(RIC)Program), will not have access to the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the RIC Program can be found at www.mass.sov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) g—(includina g�arabe,finished basement/attics, decks or porch) Gross living area(sq.ft.) Number of fireplaces Habitable room count Number of bathrooms Number of bedrooms Type of heating system Number of half/baths Type of cooling system Number of decks/porches Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-223)1 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 a3 CC, k o k; c1 R.Nee o Work Addi ss Is to be disposed of oat the following location: Xa R H t Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. o4//t Signature of Application Date Permit No. Commonwealth of Massachusetts �$ Division of Occupational Licensure Board of Building Re ulations and Standards Cons ionrS rvisor CS-116646 spires: 12/29/2025 WALACI P MACHADO 193 CAMP STr APT J5 WEST YARMOjTH MA 02673 ,` Commissioner ,dcre '. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 201015 02/22/2025 WALACI PEREIRA MACHADO WALACI MACHADO 193 CAMP ST APT J 5 4,04 WEST YARMOUTH,MA 02673 Undersecretary Registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1000 Washington Street -Suite 710 Boston,MA 02118 Not valid without signature Re: 23 Echo Rd Jeniffer Ann Lavash <jeniffer2010@gmail.corn> Wed 10/4/2023 3:20 PM To:Sears,Tim <tsears@yarmouth.ma.us> Attention!: This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete this email. Hi Tim, I will not be using PLJ for anything ever again. The worst experience of my life. So for now, unless or until I find another contractor, I will not be moving forward. Thank you. Jeniffer Ann Lavash On Oct 4, 2023, at 12:30 PM, Sears, Tim <tsears@yarmouth.ma.us> wrote: I am following up with this application, are you planning on going forward with this project? Timothy Sears CBO Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsearsyarmouth.ma.us From: Sears, Tim Sent:Tuesday,June 13, 2023 1:42 PM To: walacimachado@hotmail.corn <walacimachado@hotmail.corn> 23 Echo Rd Sears, Tim <tSea[S@V8rOOVth.[nO.u5> |ue6/l3/2O23 1:42 PM To:wa)acinnachado@hotnnaU.00nn <vva|acinoachodo@hotrnaiiconn> [c]eniffer201O8Dgnnai|.conn `jeniffer2010@gnnai|.conn> I have reviewed the updated information submitted and the proposed deck will require relief from the Zoning Board of Appeals in the form ofa Special Permit and/or aVariance. Regards, Timothy Sears (-BC) Deputy Building Commissioner Town OfYarmouth 508-398-2731 EXt. 1259 rnailto:tSear5Ccby3rnnOuth.rna.us 4/24/23,9:21 AM Mail-Sears,Tim-Outlook 23 Echo Rd Sears, Tim <tsears@yarmouth.ma.us> Mon 4/24/2023 9:17 AM To:walacimachado@hotmail.com <walacimachado@hotmail.com> Walaci, I have reviewed your application and there are some items needed. /1. Health Department sign off(under review) ,/tANater Department sign off 3. Plot plan stamped by Land Surveyor showing setbacks to proposed construction. This house in on a corner lot and may require relief from the Zoning Board of Appeals for the proposed deck. I/2 copies of plans for deck /Specs for LVL beams Please submit these items for review This email is considered a written denial of your permit application per Section 105.3.1 of the Massachusetts State Building Code. Section 105.3.2 states in part that "an application fora permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith" You may appeal this denial to the Building Code Appeals Board in accordance with M.G.L. c. 143 §100, within 45 days of this notice. Timothy Sears CBO Deputy Building Commissioner Town of Yarmouth 508-398-2231 Ext. 1259 mailto:tsearssyarmouth.ma.us https://outlook.office.com/mail/sentitems/id/AAQkADE3MDQ5NWZmLTkOYzItNDIwNi1 iMDQxLWNkMGQyNmE4NzE5NAAQAPJ168URDMFAtOE504C... 1/1 ACORD Client#: DATE TM CERTIFICATE OF LIABILITY INSURANCE 06/06/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT RAPHAEL OLIVEIRA Al A BAIT PHONE (508)771-4600 DISCOVERY INSURANCE AGENCY LLC (A/C,No,EXt): 668 MAIN ST UNIT A EMAIL raphaeldiscoverygmail.com ADDRESS: HYANNIS,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A: Atlantic Casualty Insurance Company INSURER B: PLJ CARPENTRY INC INSURER C: 661 PITCHERS WAY INSURER D:AIM MUTUAL INS CO HYANNIS- 02601 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO TALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRL ADDLI SUBR POLICY EFF POLICY EXP TR TYPE OF INSURANCE NSR WVD POLICY NUMBER (MMIDDIYYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000,00 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES(Ea ocurrence) $ 100,000.00 CLAIMS-MADE I I OCCUR MED EXP(Any one person) $ 5,00000 L261004216-1 8/11/2021 8/11/2022 PERSONALBADYINJORY $ 1,000,00000 GENERAL AGGREGATE $ 1,000,000.00 GENL AGGREGATE (LIM�N IAPPLIES PER PRODUCTS�COMP,OP AUG $ 2,000 000.DO POLICY I 1 M PROJECT I ILOC B I COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accdent) ANY AUTO BODILY NARY(Per person) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per eccmdert) NON-OWNED HIRED AUTOS PROPERTY DAMAGE AUTOS (Per accident) UMBRELLA LfA9 OCCUR EACH OCCURRENCE EXCESS LIED CLAIMS-MADE AGGREGATE GED RETENTIONS D WORKERS COMPENSATION AND EMPLOYERS LIABILITY V/N WC STATUTORY OTH LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEFVMEMBER EXCLUDED? N EE.L.EACH ACCIDENT AWC40070395842022A 6/3/2022 6/3/2023 $ 1,000,000.00 (Mandatory in NH) If yes.describe underE L DISEASE-EA EMPLOYEE $ 1,000,000.00 DESCRIPTION OF OPERATIONS bHcw E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACO RD 101,Additional Remarks Schedule,if mote space Is required) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE IT IS THE CUSTOMER'S RESPONSABILITY TO INFORME ANY CHANGES OR CANCELATIONS. RAPHAEL OLIVEIRA 1 i ©1988-2010 ACORD CORPORATION.All rights reserved. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations • 600 Washington Street Boston,MA 02111 www.mass.govfdia • Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Le ibly Name(Business/Organization/Individual): P L I CARPETRy 1 N C Address: 66 i e I TC H R S 1.0 Ai Ny fl N N o5 A - 02-G o 9 . City/State/Zip:_ Ilya n n i s NA 0160 I Phone#: So g - 360 - S 1 \D Are you an employer?Check the appropriate bow • Type of project(required): • 1.[7] I am a employer with 4. ❑I am a general contractor and I employes(full and/or part-time).* have hired the sub-contractors employees New constriction 2.El I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.: 9. El Building addition required.] 5. [] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work • officers have exercised their 11.❑P1nmbing repairs or additions myself [No workers' comp. right of exemption per MGL 12❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.0 Other employees.[No-workers'----- _ f w N camp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state vyhether 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: £ ISC0J 2y 1NSUeflNCE pGE/VCy LLC Policy#or Self-ins.Lie.#: A w C y 0d 1 C J39 S 8 y 2 D Z Z R Expiration Date: CC:, 1 0 3 / ZO L 3 lob Site Address: 23 E Ck 0 R city/ fate/zip: y )Rt10O TH rill Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 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. Be advised that 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. Si ature: ok, Date: 0 41 j G c.3 Phone#: 5Og36G, �_l—� Q Official use only. Do not write in this area,to be completed by city or town official City or Town: _ _Perauit/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#: PLOT PLAN ` /7 FOR LOT # Indicate location of garage or accessory building Additions with dashed lines Sewerage disposal (cesspool) Well rig 1 I (lot 6 49v' 0 ft. rear) 1 ,buttor's� f&IttCt.4.1k— Abuttor' 'ame lI Name of # Lot # REAARD E this is a t , , If this orner lot, y�' " 1 .... / e•f corner 'rite in name Go - n write i f street. ( .j- name of 34 ,,r qv" $ .. : -t. . : SIDE YARD '.I E YARD : HOUSE : • FT_,, r FT • j .5A 4c): . . ..,. k..\..t SET BAC m : • 43 ft A 1 41 • I f& trr e C fi 6,- e_ (lot......IJ.o. .►.O.Q..ft. frontage) •• / fcMo 200 • / (NAME OF ST EET) > (----)( / Information Supplied by _• . o`: Y/A TOWN OF YARMOUTH 9t4 HEALTH DEPARTMENT . -?,,,c.0 PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant:Building Site Location: 0 3 6 C t�v ro 8 D 1 /.f tc e0 jf jH Proposed Improvement: ( C C 44o V6 W c tV Po (VS/ R E Al 0(/ A )( r S It-n/6 kit'j 4/110 u/C f t E. Mo v c 0. S. F A. (2 j N t,vA 1/ 1'A/5 T 41 11 A/6. A L V L /-16 4 N4 I ,V 5 T if l i ✓t it/ r. t,U/ 5G'i ) C booP- i R6- MD 1/6 u/Ails i9i n111 C20S6T: Applicant: VJ A-2 A C j PC R E r P, X /tI 4 C (-/A ) o Tel. No.: 5Osi 3‘O 5/ l'0 Address: in,3 CA 4 4 P ST AT T S- S' (A/E S l 4/ , Wit, Date Filed: 0"7 V202 "T **If you would like e-mail notification of sign off please provide e-mail address: Owner Name: J. C A/ ( F FC 1 CO.il/ 14/./ q Owner Address: .7 ) C C 0 +". h i /./47 R /1/10 1Ill-I Owner Tel. No.: 6 7 7 k�f.2 40 RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: RECElV ® (1.) Site Plan showing existing buildings, water line location, and septic system location; APR 13 2023 (2.) Floor plan labeling ALL rooms within building (all existing and proposed)— HEALTH DEPT: Note:Floor plans not required for decks, sheds, windows, roofing; f g; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: CL., ___)w DATE: — / c 'dr1 -----. PLEASE NOTE COMMENTS/CONDITIONS: �g.Yq� TOWN OF V RN1OUTl I A WATER DEPARTMENT Q. ` .:'� 99 buck island Road � �vsnacerc 1Vc t Yarmouth,;d1,1 026 7 Tt=h°p oa e x`it1.81 71-7921 • faa, 1,501.1€ 771-799B BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM 44�� BUILDING SITE LOCATION: a EC k p D T g rj PROPOSED WORK: .p cen,0 r—bt.ce04 C _ "C APPLICANT: _ _ „ ► t C' t . Pee i�' _t. ADDRESS: ._- TELPIIONE: O RESIDEN`I'IAL AND/OR COMMERCIAL BUILDING w la.c ,r-,d e h Y' sz 1.1 _ C.Cs r^ Water I)c irtment: Determines Compliance of Water Availability and or existing location Inginecring Department: Determines Compliance for Parkin and Drainage Conservation Commission: Determines Compliance to Wetlands Act: i.e. If lots)border any type of wetlands.streams.ponds,rivers,ocean.bogs,boys.marshland. ETC... 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